Thursday, August 18, 2011

The Case For and Against Antidepressants



There is polemic going on in the magazines about the use of antidepressant medication. It seems like the case against them is gaining ground. The Week magazine (July 29/11) seems to feel that they are useless. Worse, no one knows how they work or where in the brain. And in some studies they are about equal to placebos.

It all gets confusing, more so when there is no real understanding about what depression is. So allow me to enter the fray. Depression is repression elevated to great heights due to the onslaught of very early trauma and is a counterpart repression. The deeper the depression the more likely it emanates from our life before birth at even at birth. It is, in effect, massive global repression. And what happens is that catastrophic imprinted pain has to be repressed continuously; and in the service of repression there is an exhaustion of serotonin (and other inhibitors) supplies. Thus, it may be possible during life in the womb that our set-points for serotonin are very low and remain so throughout our lives. Naturally, then we grow up needing outside help to boost our supplies of key inhibitory medication. We may take any one of the SSRI’s to enhance serotonin. Those repressors lighten the burden of a system overloaded with pain. They help ease the load and lend a shoulder to the gating system. So do they do any good? Of course, if we are simply helping normalize supplies; all of these key mental medications do is mimic what the brain normally does all of the time. But when the system is overloaded the brain cannot function normally. Then we need outside help.

So how is it that placebos do almost as good as SSRIs? Because thru suggestion we produce the very same painkilling chemicals that we do with real medication. That is why it is so easy to sell hope. The dispensers of booga booga nearly always get rich because their ideas, now inculcated into us, cause the dispensation of pain- killing chemicals. And we think that the phony product really works. It isn’t the product it is the vendor. It isn’t that phony and neutral medications work as well as real ones; it is that the suggestion or implication that accompanies giving the placebo works in the brain to manufacture neuroinhibitors which enhance gating. So it is hope again, sold in the form of implication, “This ought to do the job.” That is why cults and religion works so well; that dispense hope; the dispenser is the cult and the leader. He actually controls the pain of the worshiper. He tells us he is making a better world for us but meanwhile we are obliged to make a better world for him (and it is most often males) by giving him our money and possessions.

So now there is the assumption that we are dealing with a chemical imbalance; and if we are satisfied to deal with only surface appearances then it is true. There is an imbalance which is only part of the story. What causes it is what is not obvious and what is not seen or even imagined. If a theory doesn’t allow for deeper events then it will never be seen. And here again we have cognitive therapy dealing only with what is current and obvious, but not really true.

Without a proper theory and a bit of science, to boot, one can give into the notion that these drugs do help only slightly. If we don’t know how deep the pain lies, and if we don’t know that ideas produce painkillers, and if we don’t know that ideas that contain hope work the same way in the brain as true medications, then we will never understand how to deal with depression. Too often we just address each new medication de novo, as something new and unrelated and we do not place it into a gestalt context (meaning an overview). There are those who swear that anti-depressive medication has helped them. And it does by normalizing the balance that the system should do on its own. Overload of pain prevents it. Helping the system produce enough to make us feel better is all it is about.

14 comments:

  1. Dr. Janov,

    I understand that SSRI’s are a crutch, but most of the depressed see it as the only and the ultimate solution.

    Nearly all of the depressed have no understanding how the medication works and psychiatrists are not willing to provide information. In the end the trauma is not solved with antidepressants and the side effects, weight gain just to mention one, can worsen depression.

    Another reason is the missing true empathy for the patient. An appointment with a psychiatrist can be max. 10 minutes. In many reported cases they have no interest in hearing about the patient history.

    Psychiatrists are not willing to explain what will be happen if the patient would like to stop the medication. This is the moment they would have to admit that depression will likely return, simply because the source of depression is not solved.

    Exactly here begins the REAL problem: psychiatrists do not believe that there is a solution beyond antidepressants and the patient believes, - I must take the pills for life.

    This is how long co-dependencies are forged between psychiatrists and patients.

    Three entities are involved in this unethical game. The pharmaceutical companies, the psychiatrist (unwilling to look beyond its UNI-knowledge) and the client.
    The first two benefit financially, the third …?
    Sieglinde

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  2. What about the suggestion that SSRI antidepressants as well as other sorts of psychiatric medication actually produce adverse effects to a number of patients, worsening their depression and causing suicidal ideation?
    http://www.youtube.com/watch?v=URP6m0RaQzE This video is only one of many filmed on this subject, featuring only few among many witnesses of such cases. In Sweden where I live now, it was found that among the 1129 people who committed suicide in 2007, more than 700 were on psychiatric medication. The stories about certain psychiatric medication driving to suicide even "healthy" (not depressed) persons who were paid to try them for side effects seems to beat the assumption that it is merely depression itself that drives these people to suicide.
    I do not mean to say that I actually believe that normal people can be driven to suicide simply because of a drug's side effects. I have been on antipsychotic medication for my bipolar disorder and I did have painful and unbearable side effects, namely akathesia and the worst mixed episodes in my life. For the first time in my life I felt very easily irritated and wanted to shout at people or even hurt others, and I felt that if I didn't move all the time I was going to die. This feeling of restlessness and the need to move was familiar to me already, although it was always felt much milder, and it had been a major motivation behind my training as a dancer -and usually training relieved me from this feeling. While on medication the feeling was very strong and unbearable and I had no way to deal with it other than running all the time. I would go out and run every day until I was utterly exhausted, otherwise I felt I was going to die or harm someone. I'm not as naive as to assume that the medication caused these feelings to begin with. I am aware of the fact that these were first-line rooted feelings of my own. I do believe however that my medication (risperidone) played a major role in them surfacing so fiercely, even though it was strange because otherwise many of my feelings were actually repressed by the drug, causing me to sleep very heavily but also to focus better and be more productive, at least when not on a mixed episode or experiencing akathesia. The drug was a bit like a burglar breaking into a house and causing a mess: Yes the socks may be mine but I would have never put them inside the oven and turn it on, meaning that it may have been my own feelings but my brain and my body had learned to deal with them and somehow keep them under control until the medicine came and messed everything up. This is how I experienced it. And I do fear that had I not been so well aware of my condition and had I not found running as an outlet, I would have definitely been a threat to myself and/or others, because of this drug. I never experienced these tormenting episodes again after quiting the pills.
    (to be continued)

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  3. (comment continued from above)
    My girlfriend suffers from chronic major depression [and yes, one cannot find a more typical demonstrator of first-line trauma than her, having severe panic attacks, colitis and strong abdominal pains that have troubled doctors for years (they have been unable to trace the pain's cause), etc etc, and she was a premature baby that spent about a month in an incubator] and for all I know after she started taking SSRI drugs several years ago she has been more self-destructive (she's a cutter) and suicidal than she was before. Now, after 4 years of being on these meds, her behavior and mood has stabilized, but during the first couple of years it was frightening, I think it was a miracle that we didn't lose her!

    So I have been wanting to ask you about your opinion on this matter, on such undesirable effects by psychiatric drugs, and was even considering messaging you in private actually through facebook, before you had even posted this article. I have done a lot of personal research on this subject in Sweden and I have documents to share as well should you be interested, because I really need to understand. Many people in my life, both family and friends, spent or are spending their whole lives on psychiatric medication, in some cases I think that these drugs in fact killed them (I know you would say that their pain killed them, and you would probably be right, but I will use the burglar paradigm again here), I have been prescribed such drugs myself (apart from risperidone I was also prescribed citalopram and lithium but never agreed to take them fearing their known side effects) and I'm struggling to understand their mechanism of action. It is particularly frustrating that the experts themselves do not seem to know it! So I would truly appreciate your insights on this matter, regarding the adverse effects of psychiatric medication "causing" or worsening the very symptoms they are supposed to alleviate.

    Thank you for reading this long comment.

    Stella

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  4. We "know" too much… and above all… about wrong things to feel about live... thoughts against emotional leakage. This means that knowledge in itself is a barrier ... barrier to knowing what caused us to know in order not to feel. We learn to listen to emotional leakage in primal therapy.

    Frank

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  5. Do you have any idea how neurosis varies across different societies and cultures?

    A Rejec.

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  6. Stella, you might read my book on Depression called The Janov Solution, and also there is a lot that I explain in the book coming out Life Before Birth. As you know I cannot comment on a case I know nothing about. It would be pure charlantism. I think you should go back to some of my blogs which might help you understand more. art janov

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  7. Sieglinde: Very well said, thanks. art

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  8. Anonymous: No that is the work for sociologists and anthropologists. art

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  9. Dr. Janov,

    you are welcome.
    I’m aware of these facts since 2000.

    Sieglinde

    Frank:

    You say: “We learn to listen to emotional leakage in primal therapy.”

    I ask: what about people with emotional leakage and can’t afford to come to the primal center or live in other countries?

    There is nothing out there besides CT and antidepressants.

    Sieglinde


    Stella:

    “So I would truly appreciate your insights on this matter, regarding the adverse effects of psychiatric medication "causing" or worsening the very symptoms they are supposed to alleviate.”

    I support your concern.
    Being on Welbutrin from 1993 – 96 and Effexor from 1997 - 99 I failed my Exam in Psychology.
    With leaking gates wide open, I was a walking emotional wreck with no connection to the left brain. Feeling constantly near death (first line) without being able to go there by myself, I became suicidal. What saved me was - I stopped Effexor abruptly and I went on an 8 week roller coaster ride with withdrawal symptoms.
    Only then did my two side brain function come back. What I discovered was, the years on Effexor were worse than the original depression. Besides 70 pounds weight gain, in 2001 all I studied for two years, was gone, vanished.
    In retrospect I can say, it felt like I didn’t have a short term memory while on Effexor. Today I know for sure, antidepressants can interrupt the right – left brain connection.

    Sieglinde

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  10. Sieglinde,

    As you may know…I am one of those advocating a lawsuit against the now established practice in the psychological and psychiatric field... a legal process that aims to spread the primal therapy in a revolutionary spirit.

    I know many including myself who need help from the center. I work with myself and I know how the process is progressing and what needs in order to "dare" recognize what the symptomatic reactions really is about.

    I advocate an internet ... process with Janov as an escort but I also understand his difficulty when he do not know how participants would react… and if something goes wrong... Art would be located too far away.
    I am still a supporter of that the center could help many as they formerly been at the center but is not in a position to move on.

    As I said, I am an advocate of a legal process ... a process that I see would be difficult to lose if it is worked through in order to be what it is really is about… and what the public can pick up in order to arouse the question of primal therapys eligibility.

    Frank

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  11. Art and Sieglinde, thank you both.
    Art, thank you for your suggestions, I will do further reading.
    Sieglinde, thank you for sharing your own experience. Even though I was on antipsychotic and not antidepressant medication (I was also on benzodiazepines -Xanax- for my anxiety and panic attacks for a few months) I can identify 100% with your experiences. Short term memory was also seriously impaired in my case -I remember shopping at a flea market with my girlfriend, and three minutes after having bought some lettuce and while still holding the bag with the lettuce I asked her "so, are we going to buy some lettuce?". I was like that all the time back then and I could not tell if it was my condition or the drug that did it, because people would tell me "it's your depression that's getting worse, it's affecting your memory". But a couple of months after I quited the drugs these symptoms went away.

    Thanks again
    Stella

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  12. Frank,

    I did not knew that you are in a legal process for PT.

    You say: “I know many including myself who need help from the center.”
    Let me be the other one who needs to go to LA. Too many childhood and birth imprints.

    The one who knows what works is never satisfied with substitutes. The same counts for defending what we know.

    Yes, we need PT centers worldwide.
    I also do my best to introduce PT, but some brick walls are very high.

    Sieglinde

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  13. A facebook comment:
    "Depression = Repression. Simple. When we repress emotions all 'energy' is expelled to keep the pain unconscious thus there is not much serotonin left.. When I used to explain this to a one lady she got very very Angry towards me :) she likes her drugs though. It makes her life more at 'ease' that is. Of course."

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  14. I just heard something very interesting on Radio 4 this morning. It seems that like the conceptive Pill having effects on fish etc making them turn more female so to are the SSRI antidepressants having effects. It seems that the Morcombe Bay fishery is being effected by this (potted brown shrimps on toast are fantastic!). Peroxatene is leaching into the environment and causing shrimps to take risks. Rather than hiding in amongst the kelp and other shelter the shrimps effected by Peroxatene are starting to head into open water where they get eaten!!!!

    So PT is needed to save the food chain too!

    ReplyDelete

Review of "Beyond Belief"

This thought-provoking and important book shows how people are drawn toward dangerous beliefs.
“Belief can manifest itself in world-changing ways—and did, in some of history’s ugliest moments, from the rise of Adolf Hitler to the Jonestown mass suicide in 1979. Arthur Janov, a renowned psychologist who penned The Primal Scream, fearlessly tackles the subject of why and how strong believers willingly embrace even the most deranged leaders.
Beyond Belief begins with a lucid explanation of belief systems that, writes Janov, “are maps, something to help us navigate through life more effectively.” While belief systems are not presented as inherently bad, the author concentrates not just on why people adopt belief systems, but why “alienated individuals” in particular seek out “belief systems on the fringes.” The result is a book that is both illuminating and sobering. It explores, for example, how a strongly-held belief can lead radical Islamist jihadists to murder others in suicide acts. Janov writes, “I believe if people had more love in this life, they would not be so anxious to end it in favor of some imaginary existence.”
One of the most compelling aspects of Beyond Belief is the author’s liberal use of case studies, most of which are related in the first person by individuals whose lives were dramatically affected by their involvement in cults. These stories offer an exceptional perspective on the manner in which belief systems can take hold and shape one’s experiences. Joan’s tale, for instance, both engaging and disturbing, describes what it was like to join the Hare Krishnas. Even though she left the sect, observing that participants “are stunted in spiritual awareness,” Joan considers returning someday because “there’s a certain protection there.”
Janov’s great insight into cultish leaders is particularly interesting; he believes such people have had childhoods in which they were “rejected and unloved,” because “only unloved people want to become the wise man or woman (although it is usually male) imparting words of wisdom to others.” This is just one reason why Beyond Belief is such a thought-provoking, important book.”
Barry Silverstein, Freelance Writer

Quotes for "Life Before Birth"

“Life Before Birth is a thrilling journey of discovery, a real joy to read. Janov writes like no one else on the human mind—engaging, brilliant, passionate, and honest.
He is the best writer today on what makes us human—he shows us how the mind works, how it goes wrong, and how to put it right . . . He presents a brand-new approach to dealing with depression, emotional pain, anxiety, and addiction.”
Paul Thompson, PhD, Professor of Neurology, UCLA School of Medicine

Art Janov, one of the pioneers of fetal and early infant experiences and future mental health issues, offers a robust vision of how the earliest traumas of life can percolate through the brains, minds and lives of individuals. He focuses on both the shifting tides of brain emotional systems and the life-long consequences that can result, as well as the novel interventions, and clinical understanding, that need to be implemented in order to bring about the brain-mind changes that can restore affective equanimity. The transitions from feelings of persistent affective turmoil to psychological wholeness, requires both an understanding of the brain changes and a therapist that can work with the affective mind at primary-process levels. Life Before Birth, is a manifesto that provides a robust argument for increasing attention to the neuro-mental lives of fetuses and infants, and the widespread ramifications on mental health if we do not. Without an accurate developmental history of troubled minds, coordinated with a recognition of the primal emotional powers of the lowest ancestral regions of the human brain, therapists will be lost in their attempt to restore psychological balance.
Jaak Panksepp, Ph.D.
Bailey Endowed Chair of Animal Well Being Science
Washington State University

Dr. Janov’s essential insight—that our earliest experiences strongly influence later well being—is no longer in doubt. Thanks to advances in neuroscience, immunology, and epigenetics, we can now see some of the mechanisms of action at the heart of these developmental processes. His long-held belief that the brain, human development, and psychological well being need to studied in the context of evolution—from the brainstem up—now lies at the heart of the integration of neuroscience and psychotherapy.
Grounded in these two principles, Dr. Janov continues to explore the lifelong impact of prenatal, birth, and early experiences on our brains and minds. Simultaneously “old school” and revolutionary, he synthesizes traditional psychodynamic theories with cutting-edge science while consistently highlighting the limitations of a strict, “top-down” talking cure. Whether or not you agree with his philosophical assumptions, therapeutic practices, or theoretical conclusions, I promise you an interesting and thought-provoking journey.
Lou Cozolino, PsyD, Professor of Psychology, Pepperdine University


In Life Before Birth Dr. Arthur Janov illuminates the sources of much that happens during life after birth. Lucidly, the pioneer of primal therapy provides the scientific rationale for treatments that take us through our original, non-verbal memories—to essential depths of experience that the superficial cognitive-behavioral modalities currently in fashion cannot possibly touch, let alone transform.
Gabor Maté MD, author of In The Realm of Hungry Ghosts: Close Encounters With Addiction

An expansive analysis! This book attempts to explain the impact of critical developmental windows in the past, implores us to improve the lives of pregnant women in the present, and has implications for understanding our children, ourselves, and our collective future. I’m not sure whether primal therapy works or not, but it certainly deserves systematic testing in well-designed, assessor-blinded, randomized controlled clinical trials.
K.J.S. Anand, MBBS, D. Phil, FAACP, FCCM, FRCPCH, Professor of Pediatrics, Anesthesiology, Anatomy & Neurobiology, Senior Scholar, Center for Excellence in Faith and Health, Methodist Le Bonheur Healthcare System


A baby's brain grows more while in the womb than at any time in a child's life. Life Before Birth: The Hidden Script That Rules Our Lives is a valuable guide to creating healthier babies and offers insight into healing our early primal wounds. Dr. Janov integrates the most recent scientific research about prenatal development with the psychobiological reality that these early experiences do cast a long shadow over our entire lifespan. With a wealth of experience and a history of successful psychotherapeutic treatment, Dr. Janov is well positioned to speak with clarity and precision on a topic that remains critically important.
Paula Thomson, PsyD, Associate Professor, California State University, Northridge & Professor Emeritus, York University

"I am enthralled.
Dr. Janov has crafted a compelling and prophetic opus that could rightly dictate
PhD thesis topics for decades to come. Devoid of any "New Age" pseudoscience,
this work never strays from scientific orthodoxy and yet is perfectly accessible and
downright fascinating to any lay person interested in the mysteries of the human psyche."
Dr. Bernard Park, MD, MPH

His new book “Life Before Birth: The Hidden Script that Rules Our Lives” shows that primal therapy, the lower-brain therapeutic method popularized in the 1970’s international bestseller “Primal Scream” and his early work with John Lennon, may help alleviate depression and anxiety disorders, normalize blood pressure and serotonin levels, and improve the functioning of the immune system.
One of the book’s most intriguing theories is that fetal imprinting, an evolutionary strategy to prepare children to cope with life, establishes a permanent set-point in a child's physiology. Baby's born to mothers highly anxious during pregnancy, whether from war, natural disasters, failed marriages, or other stressful life conditions, may thus be prone to mental illness and brain dysfunction later in life. Early traumatic events such as low oxygen at birth, painkillers and antidepressants administered to the mother during pregnancy, poor maternal nutrition, and a lack of parental affection in the first years of life may compound the effect.
In making the case for a brand-new, unified field theory of psychotherapy, Dr. Janov weaves together the evolutionary theories of Jean Baptiste Larmarck, the fetal development studies of Vivette Glover and K.J.S. Anand, and fascinating new research by the psychiatrist Elissa Epel suggesting that telomeres—a region of repetitive DNA critical in predicting life expectancy—may be significantly altered during pregnancy.
After explaining how hormonal and neurologic processes in the womb provide a blueprint for later mental illness and disease, Dr. Janov charts a revolutionary new course for psychotherapy. He provides a sharp critique of cognitive behavioral therapy, psychoanalysis, and other popular “talk therapy” models for treating addiction and mental illness, which he argues do not reach the limbic system and brainstem, where the effects of early trauma are registered in the nervous system.
“Life Before Birth: The Hidden Script that Rules Our Lives” is scheduled to be published by NTI Upstream in October 2011, and has tremendous implications for the future of modern psychology, pediatrics, pregnancy, and women’s health.
Editor