(Updated Dec. 29)
The idea that patients with depression should eschew antidepressants for other remedies has gained popularity lately, sparking vehement debates in some corners of the web.
Take an interview of Dr. Andrew Weil this week on NPR’s Science Friday. Weil promoted his new book recommending non-prescription remedies, such as exercise and supplements, for people with mild to moderate depression.
Research does suggest that both aerobic exercise and fish oil may ease symptoms of depression. But a number of listeners criticized Weil, who has trademarked himself as “Your Trusted Health Advisor” while also selling his own line of customized vitamins and supplements (just $74.99 for his 30-day “Energy Support” pack).
Weil, I noted, didn’t correctly answer Science Friday host Ira Flatow when asked whether farmed fish (the source of much fish oil) tend to be fed a diet low in omega-3 fatty acids, the component of fish oil thought to combat depression.
Instead, Weil answered an unrelated question, saying that most fish oil is free of contaminants like mercury and PCBs.
(Flatow was right, by the way, according to this National Academy of Sciences article. The authors state that during the last decade, farmed fish were increasingly fed vegetable oils, which cause fish to have lower concentrations of omega-3 fatty acids.)
“Love — not drugs — can save you and your relationship,” wrote marriage and family therapist Deb Schwarz Hirschhorn, adding that “partners can learn how to inject serotonin into each other’s brains with just a well-placed smile and a thoughtful gesture.”
“That’s so much more powerful than drugs, isn’t it?” she asked.
Hirschhorn raised some important points: in some studies, antidepressants have performed no better than placebos; industry-funded research should generally be interpreted with caution; and antidepressants can increase risk of suicide, especially in adolescents.
But she didn’t acknowledge that the increase in risk appears to be small, and that talk therapy can’t effectively replace medication for everyone.
The true picture of both depression and its treatment appears far more complex than that portrayed by Weil or Hirschhorn.
In one health care consumer study, for example, patients tended to report the most benefit from a combination of medication and talk therapy. But other studies found that patients were more likely to get better if they received the type of treatment they asked for, whether or not that included medication.
And in yet another study published this month, depressed patients tended to respond no better to medication or talk therapy than to placebo pills — except African-American men, who responded best to talk therapy.
The bottom line? Watch out for ‘experts’ with straightforward answers about treating depression. No matter where they fall on the spectrum of debate about antidepressants, they’re probably not telling the whole story.
Read more: Buddhist communities in the West have long criticized antidepressants, but that’s changing. Check out this 2009 article by physicians and long-time meditators Roger Walsh, Robin Bitner, Bruce Victor, and Lorena Hillman, published in the quarterly magazine Buddhadharma.