The heavy cost of happiness

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Food is not the only thing that one can swallow to get fat. In a society reeling from both rampant depression and obesity, the news that the medicines used to treat the former can exacerbate the latter is cruel comedy.

Tucked to the side of the front page on the Mon., Mar. 31 edition of the Calgary Herald was a small headline that read "Depression drugs make patients fat." The article reported that many individuals who take psychiatric medicine to treat depression can experience large weight gains. The Herald article quoted a doctor saying these gains could be anywhere from 10 to 40 pounds--an unseemly amount, for sure. Some months ago, however, while researching for another story, a worker at the Calgary Health Region informed me that the number could be in excess of 70 pounds.

This problem cannot be viewed clearly without realizing that recent studies have found medicinal treatment may only be effective for the severely depressed, a point also made by the Herald. This is a disturbing idea when one considers that medication is currently the standard form of treatment for many types of psychiatric disorders, ranging from severe cases of depression to far less drastic problems. Medication, except in the case of the severely depressed, may be wholly unnecessary and ineffectual.

Another interesting point to consider is that recent research suggests that there are a few, non-medicinal treatment programs that may be as effective as the pill-taking variety--even for the severely depressed. These new treatments include a few different methods of psychotherapy.

If these alternative treatments are able to help individuals suffering from depression without recourse to drug therapy, then they scream to be carefully examined and put into practice if proven successful. Indeed, if they are at least as efficacious as medicine, then they should take over from the happy-pills as the primary method of treatment for all individuals. There is absolutely no reason to put people on meds if they do not need it.

The problem is that these new treatments requires more patient-therapist contact, which is difficult to do in a mental health industry plagued by chronic staffing shortages, as is the case in Alberta. It is simply much easier and less time-consuming to prescribe a pill and some blood tests every once in a while than to engage in regular and potentially-intensive therapy with a patient. There is hope, though. The government recently passed Bill 31 to amend the Mental Health Act and move treatment out into the community. It is purportedly recognized that this bill cannot be implemented without an expansion of services, so this lack of capacity could become less of an issue in the near future. It needs to be addressed, especially if it will help move people into treatment programs without the side-effects.

Certainly there are cases where medication will be a necessary treatment, but the current practice of prescribing pills as the first step to treating depression is likely unnecessary, possibly ineffective and obviously vulnerable to instigating a massive over-medication of society. It can be argued that this is clearly the road our culture has taken, with the explosion of antidepressants and other psychiatric drugs over the last decade or two demonstrating a dubious cultural dependence on little pills.

The ongoing concerns of both depression and obesity are, at least in some ways, related. Society owes itself on two counts to pursue new, non-medicinal psychiatric treatment options.