Emotional problems, such as depression and anxiety, are all too common, affecting over 100 million people worldwide. These problems touch every aspect of our being: mind, body and spirit. They can be debilitating and can wreak havoc on physical health, quality of life, and relationships. Questions about the best way to manage emotional problems have been at the forefront of research for quite a while. One question that my clients ask is if they should try medication or if there is another viable alternative.
A common route for treating emotional problems is through medication. For example, antidepressant are among the most commonly prescribed medication in the world. Reports on the effectiveness of medication such as antidepressants can be confusing and misleading. An article published in Philosophy, Ethics, and Humanities in Medicine (Ioannidis, 2008) stated that a meta-analysis of data submitted to the FDA on the effectiveness of antidepressants found that trial results ignored "negative" drug trial outcomes or distorted the outcomes to appear "positive." Analysis of the drug trials showed that results were positively inflated by 32%, on average. A second meta-analysis of data submitted to the FDA showed the antidepressant-placebo difference was only significant in a minority of severely depressed people (Ioannidis, 2008). In other words, most of the benefits of an antidepressant can be duplicated by the placebo effect in mild to moderate depression. This information was confirmed by the National Institute of Mental Health in 2011.
A common concern of using medication for emotional issues is the possibility of adverse side effects, depending on the drug and dosage. These can include, but are not limited to, insomnia, abnormal heartbeat, weight gain, high blood pressure, blurred vision, fatigue, impotence, loss of sexual desire, dry mouth, and constipation. Not only do these medications come with side effects, patients also run the risk of experiencing withdrawal symptoms when removed from the medication. Withdrawal symptoms can include dizziness, nausea, insomnia, worsening mood, nightmares, muscle weakness, irritability, and headaches.
Many people, who feel that their symptoms are self-manageable or want to avoid the side effects of medication, are choosing alternative methods for dealing with chronic emotional problems. A nationwide survey directed by Harvard scientists found that more and more people are looking for non-conventional treatments for emotional problems such as herbal remedies, nutritional therapy, self-help groups, yoga, massage, vitamin therapy, exercise therapy, and aromatherapy.
Current research supports the effectiveness of some of these alternative means for treating emotional problems. For example, Duke University Medical Center conducted a four month research study with 156 participants who reported symptoms of major depressive disorder. The study compared treatment of depression with aerobic exercise, antidepressant medication (Zoloft), or both. All three groups showed similar, significant improvement in reported symptoms of depression in 4 months, but the exercise only group showed significantly lower rates of relapse than the groups taking medication at the 10 month follow up (Blumenthal, Smith, & Hoffman, 2012).
Other research has supported the findings that 30 - 45 minutes of sustained moderate intensity aerobic exercise three times a week over an extended period of time relieves symptoms of depression as effectively as antidepressants. According to the CDC, moderate intensity aerobic exercise is considered aerobic activity that gets the heartbeat to 50-70% of a person's maximum heart rate. An estimate of a person's maximum age-related heart rate can be obtained by subtracting the person's age from 220.
Although medication can be a necessary life-saver for some, especially those with severe depression symptoms, others are disappointed by the effectiveness of antidepressants or want to try something else. There are other options that can, and should, be considered. In the next post, we'll be exploring a few more of these options.