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Drugs and Depression

Andreas Lubitz, the co-pilot believed to have deliberately guided Flight 4U9525 into the French Alps killing all 150 people on board was reportedly suffering from depression, and possibly taking anti-depressants to treat his illness.

What hasn’t been mentioned so far is that many anti-depressants disclose in their list of possible side-effects a warning that they may trigger suicidal ideation, suicide or attempted suicide, and in some instances, violent and aggressive behaviour. While clinical studies continue into the association between these drugs and certain behaviours, the evidence is sufficient for drug companies to be compelled to disclose the possibilities to potential users.

There is, justifiably, a concern that depression and those suffering from it will be increasingly stigmatised as a consequence of this tragedy. As the Guardian reports: In a sign of continued nervousness in the light of the tragedy, there were reports on Saturday of pilots offering personal assurances to passengers. One woman tweeted: “Pilot on my @Delta flight announces he and co-pilot are ex-military and ‘we both have wives and kids and are very happy’.”

Apparently being “ex-military”, male, and with a wife and children is some kind of guarantee against depression which will be news to many people given the astronomic rates of post traumatic stress disorder diagnosed in military personnel, to address just one aspect of an idiotic comment that is a small example of the facile discrimination and prejudice anybody with a mental illness can encounter.

Australia has the second highest use of anti-depressant medication in the world after Iceland, from which we can conclude that depression is a common illness in our society and a lot of us are using drug therapy to help us manage it. Death from drug overdose is twice as likely to be caused by drugs prescribed to treat anxiety, insomnia and stress than by illegal substances, a Victorian coroner recently reported.

And it isn’t just drugs prescribed for depression that can cause mental disturbances. I have beside me a box of Metoclopramide, prescribed for nausea caused by other drugs, with a list of potential side-effects as long as my leg, one of which is “mental depression.” There are antibiotics that can cause anxiety. There are anti psychotics that can cause hallucinations. There are sleeping tablets that can cause bizarre sleepwalking behaviours. If anything we need more awareness and education about the possible side effects of prescription drugs, and how those side effects can be safely managed.

It would be the worst possible outcome if the tragedy of Flight 4U9525 was used to stigmatise people with depression not only in the airline industry but in every other occupation. There have already been demands that airlines dismiss pilots with depressive disorders, and while no one wants a pilot in the throes of a seriously depressive episode flying a plane, depression can be managed and people do recover.

As usual there’s been a scramble, instigated by the country’s most reliable drama queen Prime Minister Tony Abbott, to ensure such a tragedy doesn’t occur on an Australian airline. Australia’s national security committee met on Sunday at Abbott’s insistence to discuss preventative measures.

Good luck with that. Absolute safety can never be guaranteed, and flying is still a whole lot safer than driving the Pacific Highway, and a whole, whole, whole lot safer than being a woman in a domestically violent situation in Australia. So far this year, the average is two dead women each week. Still waiting for the Minister for Women to call an emergency Sunday meeting about that.

This article was originally published by Jennifer’s blog No Place For Sheep.

25 comments

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  1. Ro Bailey

    I would be very reassured if a pilot made that comment, I don’t consider it to be a stigma on people who have mental illness.

  2. CMMC

    I think almost every pharmaceutical treatment for depression carries this warning.

    It is the result of ill-informed Born Again types in America who have lobbied endlessly for this.

    They want you to pray your depression away.

  3. Sven

    There is also a justifiable rationale to suggest that tragic, destructive, needless incidents like this will make mental illness *LESS* stigmatised. Physical illness as tangible affliction gains the support and accommodation of friends, family and *employers*. Mental illness, as a less-tangible but often far more destructive disease, remains stigmatised with lack of recognition, support, and in fact large-scale ostracization forcing sufferers underground, particularly in employment, while the psychiatric profession who are charged with assisting the wellness-recovery of sufferers (with some notable exceptions), are culpable in making the problem worse.

    Perhaps this is what Lubitz meant when he said “one day I’m doing to do something that will change the whole system”. Shame on him for destroying the lives of innocent people. But shame on the system as well.

  4. Wally

    Is depression an illness or is it something that happens to all of us at times to varying degrees? Seems to me that an increase in the number of people who suffer from depression goes hand in hand with less parents who believe in smacking their kids. And yes it may only be a coincidence, I could be wrong and I am no expert but it seems to me that as life has become easier (softer) that people get upset at things our ancestors would have considered trivial and we have become less prepared as individuals to deal with harsh events in our lives.

    Everybody gets depressed so it is not a disease but how we deal with being depressed is what makes some of us bite the bullet and get on with life while others wallow in self pity. It really doesn’t matter how bad things are there is always someone else worse off or doing it harder so there really is no excuse for making your life more miserable when it is quite easy to put one foot in front of the other and move forward.

  5. John

    As someone with a serious mental illness, who takes a lot of meds, that article made my hackles rise. Nothing in particular, but feel a lot of that was, wrong, wrong, wrong…….

  6. Colin

    A whole new thread could be (and perhaps has been) written about the debate over the need for anti depressant and anti psychotic drugs, and the motivations of those who make, supply and prescribe them. It’s not only the side effects of those drugs that we need to be educated about, but the reason for their prescription in the first place. No branch of medicine other than psychiatry permits mind altering drugs to be used to treat a condition that has no objective diagnostic test.

    No, I’m not anti psychiatry, just pro education.

  7. lindsayms

    Australia has the second highest use of anti-depressant medication in the world
    Is that surprising given our current Federal Government?

  8. stephentardrew

    Though medication has side affects and can cause bodily change like weight gain for some sufferers coming off their medication is worse than taking it. I have worked in mental health and the sad thing is that when some sufferers are stabilised with medication they lose the lows while also losing the highs with resultant flat effect and a zombie like demeanor. After a while they throw their medication in the bin only to become depressed, suicidal and on regular occasions attempt to take their lives. It is a complex problem with biochemical implications whether caused by heredity, birth defect, accident or traumatic life experience.

    The anti psychiatry movement has been around for decades however simple appeals to idealised medication free treatment are just that wishful thinking. The question is not knee jerk reaction to excessive use of anti-depressants but what are the actual causes thereof? People who talk about the negatives of medication should sit in a room with a client who is sobbing, having lost all hope, tearing at their hear, and bashing their heads against the wall to understand what real endogenous depression is.

    Too many arm chair psychiatrists as well as the propensity for over medication by some professionals.

    Sometimes it takes a variety of medications before one suitable for the person is found. Some people counter-indicate demonstrating the opposite symptoms hoped for. It is a very complex field demanding a high level of expertise and training. So little is known about brain function that often all that can be done is to experiment with the best alternative and live with the side effects.

    A few weeks in a mental health ward would be a valuable education for most who claim expertise in a field that is complex and highly controversial.

    I have an associate who would be dead today without medication.

    There are degrees of depression however taking medication is a cry for help when often a person does not have the resources to afford professional help.

    There is plenty of on-line material on depression and medication with a broad variety of strategies given so little is known about the complexity of biochemistry.

  9. Matters Not

    stephentardrew wrote:

    medication has side affects

    Yep and it has side effects as well as side affects. As I understand it.

    It is a complex problem with biochemical implications whether caused by heredity, birth defect, accident or traumatic life experience.

    Indeed it is a problem!

    A few weeks in a mental health ward would be a valuable education for most who claim expertise in a field that is complex and highly controversial.

    Agreed! It’s far outside my field of experience or ‘expertise’ but I do worry with the views expressed by some here.

    I ‘believe’ Stephen has much to offer on this very important issue.

    And just for the record, I again stress I only offer a ‘view’. And it’s not based on any physical ‘science’ expertise, just a social science background.

    So perhaps one should discount same?

  10. Annie B

    @ Wally ….

    While I applaud your first paragraph, ( yes, perhaps we have become softer and more spoilt ) – – – I cannot agree with the second paragraph.

    Depression can definitely be a mental illness. …. Clinical depression is diagnosed ( my own daughter has battled it for years ) … as a major depressive illness, and is treated by psychological and medication assistance. …. It does not solve all the problems however….. Help must be sought – somehow – if depression becomes severe ( often noted by family / friends – more than the sufferer themselves ). …. This takes very careful, gentle and understanding intervention … which not everyone is capable of.

    The worst thing one can say to a badly depressed person is ” get up, stop feeling sorry for yourself, it’s all in your mind, move on” ( or words to that effect ) … that only exacerbates the situation. Your 2nd paragraph lists a lot of no-no’s to be said to depressed persons.

    ….. it IS in the mind, and has a lot to do with natural chemicals that are, or are not, working properly in the brain …. ( but that’s another subject ).

    I think stephen t … would most likley agree with me on that.

    Sadness, loss, grief, and stress, can exacerbate a former prediliction to the condition – or it can cause an onset of real ( or serious ) depression. However, on a level playing field ( for want of a better description ) those four states of mind can be ‘ lived through ‘ … can be dealt with in time. REAL depression however, needs assistance – quickly.
    ………….

    As an added bit of information :::: …. there is a ( potentially very serious ) form of depression after the birth of a baby for a woman. … Post natal ( post partum ) depression. …. It is caused partly by a huge shift in hormonal structure … and can be quite dangerous. …. It is also caused by biological ( hormones as mentioned ) , psychological, social and environmental factors. …. …. this is not something to be swept under the carpet. … It is a genuine condition and needs attending to. …. I know what I am talking about – been there, done that – but only after the birth of the first of my 3 children.

  11. Kerri

    “Australia has the second highest use of anti-depressant medication in the world after Iceland.”
    I am on two anti depressants!
    Neither are for depression but both are for muscle relaxation to deal with Fibromyalgia.
    The stats are misleading as anti-depressant drugs are often used for complaints other than depression.
    I often wonder if I would be depressed if it weren’t for the anti-depressants?

  12. Annie B

    @ Jennifer Wilson.

    A great article and an excellent approach to it. …. Thank you.

    One thing however :::

    ” What hasn’t been mentioned so far is that many anti-depressants
    disclose in their list of possible side-effects a warning that they may trigger
    suicidal ideation, suicide or attempted suicide, and in some instances, violent
    and aggressive behaviour. While clinical studies continue into the association
    between these drugs and certain behaviours, the evidence is sufficient for drug
    companies to be compelled to disclose the possibilities to potential users.”

    Thing is, most ( but not all ) … drug prescriptions, are SUPPOSED to disclose on a pamphlet inside EVERY box containing a medication – whatever it might be – ALL of the detail relative to that drug – including all side effects, and possible ( even remote ) side effects.

    Unfortunately, many people open a box of medication, trusting their doctors ( and they should – to a large degree ) … and simply throw out the pamphlet without reading any of it. … Many people don’t even consider asking a chemist ( who is far better versed in the interactions, side effects, and contra-indications of medications, than most doctors ) … about the drug they are about to take.

    …………….

    Case in point : …. and absolutely true in every detail.

    I am epileptic. …. 95% under good control. ….. by the use of a maintenance drug, which is not specifically an anti-epileptic drug ( like Dilantin et al ).

    A doctor I attended 2 years back ( but never again ) … had some ‘thing’ against the maintenance drug I had been on for 18 years, because if ‘can be very addictive ‘ ( yes, I know that ) and decided that I should have another drug altogether … ” which will do everything for you and more, than the drug you are on” ?? hmmmmm. …[ I had been having some small episodes ( absolutely nothing major – mainly nightmares and some flash-backs ) … which began to occur after my mothers’ death – and made the mistake of mentioning it to the doctor concerned ]

    So – I go on this new drug ( Cymbalta ) … and within a month I have two major ( Grand Mal – now called tonic-clonic ) seizures, plus a great many temporal lobe seizures. After being fit free for 2 years …. So I go back to the pack to re-read the pamphlet.

    Ye Gods …. it can cause seizures ( in persons who are not even epileptic ) …. ??

    I go to my chemist who advises that I should stop taking the medication immediately and re-see the doctor. I had asked the chemist if this drug was ‘ suitable as ” a maintenance drug for epilepsy “. …. I wish I had taken a photo of the look on his face. “ABSOLUTELY NOT ” …. ( It was also not advisable for a blood condition I have. ??? )

    So there ya go. …. I only pass on this information, to show that we have to be very very careful in what we take, and to promote the habit of asking a chemist about any prescribed drugs’ properties and side effects, especially if the drug company hasn’t bothered to add a descriptive pamphlet to the product.

    Trust this has helped somewhat.

  13. Annie B

    @ Kerri …

    . ” I often wonder if I would be depressed if it weren’t for the anti-depressants?”.

    Don’t go there Kerri.

    You have been given anti-depressants ( which ARE used for many situations other than depression ) …. for a particular ( and often very painful ) condition.

    For instance, Valium is prescibed – [ though it can be addictive ] …. not only to relax a person who needs a relaxant, but also to ‘unwind’ jammed up or seriously spasmed muscles.

    Have a talk to your chemist about it …. if you are in any doubt whatsoever.

    Otherwise, if they work – and are not giving you any physical, emotional or mental grief …. don’t worry – – – but still ask a Chemist – just for your own peace of mind..

  14. Jexpat

    Generally, it’s wise to wait for the results of investigations to come in before assigning blame and running off on tangents.

  15. Frank Delta

    just flushed down the toilet self esteem of many depressed men, will now be stigma & shame to say Im depressed and maybe take medication, how many guys lives are ruined by women abusing them ??

  16. Annie B

    @ Frank Delta ….

    Your comments are sad to read.

    There is NO stigma attached to having depression. …. Or should I say there never should be.

    There’s no doubt that depression can be caused or be exacerbated by abuse – by a woman to a man, and by a man to a woman…… Part of the cruel side of the world we live in. … That doesn’t excuse any of it though.

    If you are depressed, or feeling varying senses of depression, you should seek help from a doctor that you trust. Do it sooner than later please. … It is a mind/body situation, not just ‘something in the head’. … it is also to do with chemical imbalances in the brain, which can be very adequately dealt with by professionals.

    More women than men seem to be able to speak out about these matters. …. Perhaps because men think they have to be ‘strong’ in the face of dreadful sorrow and self esteem issues – and therefore do not seek the help they need.

    It is not right to deprive oneself of assistance. If a person tears a hamstring, where do they go – to a doctor ? – yes. Depression is as much a recognised and treatable condition, as a torn hamstring is ( not being facetious there ).

    We are people, first and foremost – not just genders. …. and all people with a tendency to depressive disorders, or with outright depression, deserve and should seek, treatment.

  17. gangey1959

    @Annie B. I have a wonderful Neurologist who is helping me through a comparable situation.
    I do Job Club with a guy out in Lilydale. He too is Ex-Military. Wife. Kids. Desperate to work. Really great guy. Except that he’s completely screwed up by what he did when he WAS military. Now in that respect he’s a basket case. I think he could still fly a plane though.
    Maybe our PM could give him a job.

  18. Mary Walters

    Depression is a really dangerous illness and it must be cured WITHOUT DRUGS!
    I was in this situation. I had been on anti-depressents for over a year without any change, in fact, things were getting worse. I had been suffering because of depression and anxiety for a long time after divorce and one day I realized how close to suicide I was…
    But then I reversed my behaviour with an anti-depression system (I wrote my full story on my site – click on my name to read it, hope this help), and now I am a happy woman always in a good mood. So there ARE systems, that work without drugs.

  19. stephentardrew

    gangey:

    I worked with vets for years dealing with homelessness, PTSD, family breakdown, domestic violence, self-harming, interpersonal violence, self-hate and a range of psychiatric and personality disorders due to military experience. No matter what you do its difficult to assuage pain and guilt simply because it takes a huge amount of effort and application to deprogram the autonomic nervous system and neutralise subconscious fears.

    We still hide behind nationalism and patriotism avoiding the fact that war is a vile and destructive pursuit hypocritically handed over to our immature youth to do the fighting while reprogramming the body and mind to ignore and suppress the natural drive of fight and flight. It is no wonder military personnel who have seen action are so traumatised.

    The public and politicians who cry out for war should be he ones to go to war.

    It’s so easy to be an armchair soldier.

    My heart goes out to those traumatised by war in response to the demands of the corptocracy, protection of resource by the political elite and those who seem to get a kick out of others fighting wars..

    There is a distinct difference between peace keeping and war and sadly enough the standard for assistance for peace keepers, for example Totally and Permanently Incapacitated, is much higher than that for regular soldiers. Yet to my mind it is far more important to help keep the peace than to start wars.

    A quick review of Chomsky on war will demonstrate how many actions the US and its allies, including Australia, have been illegal and straight out immoral since the second World War.

    Sadly it is our soldiers who suffer when the true facts come to light.

    Imagine what it is like to realise you have been maiming civilians, women and children in an unjust war.

  20. stephentardrew

    Let Mr Darwin speak or himself.

  21. eli nes

    Sadly the wallys are all too prevalent.
    For those who know people suffering depression There is certainty that there is no ‘varying degrees’! It is terrifying and unable to be understood by we, who feel depressed now and then.
    The word itself has become the problem and it is now in danger of being a lifelong stigma for its sufferers.
    Unless the 20% of politicians diagnosed with depression and taking proscribed antidepressant medication assume the leadship of the debate then any professional, with responsibility for passengers, will no longer be free to seek help for the disease and that is very scary.
    ‘perspective
    Another woman murdered by her partner making it an average of two a week double last years average.
    A ‘Germanwing’ by the end of the year???

  22. Wally

    @eli nes I have a sister in-law who suffers with Schizophrenia and a friends partner is a manic depressant (bi polar). Both of these are mental disorders that are well documented debilitating conditions that adversely affect peoples lives. The most difficult thing is to get sufferers to accept the illness and stay on their medication, when they go off the medication they go off the rails and can be a danger to themselves. My sister in-law often refuses to have her medication until the Police round her up and take her to Dax House. There are many underlying issues that contribute to her illness but unfortunately they cannot be overcome and even if they could she will never be 100%.

    We went through a stage where every problem child was diagnosed to have ADHD and the same is happening with depression, anybody who has something tragic happen in their life is diagnosed to be depressed. Not a manic depressant just depressed and they are depressed BUT why are they not being diagnosed as manic depressants? People who are depressed need help from trained professionals but in the main they just need help to get on with life and to put what is depressing them into perspective. And from my earlier post it is a loss of perspective that has turned a natural mood that we all suffer at times into being a mental disorder or a sickness.

    The press do little to help often they confuse Schizophrenia and Bi polar then they should be reporting manic depression so when they say depressed what does it really mean?

  23. townsvilleblog

    No more stigma please, we’ve had enough. I have chronic major depression with associated anxiety disorder, I can no longer work, but would not think of doing what this pilot did if I lived 100 lifetimes. This is a one off, this particular bloke hid his illness from the public so well because he was determined to do what he did. He must have been at rock bottom, and like Australia there was nowhere that he could go to find treatment. Mental illness is real, its as real as Climate Change though there are some that don’t recognize either. A very tragic freak accident, my heartfelt solidarity goes out to all families concerned.

  24. Annie B

    @ Mary Walters …

    Interesting reading your blog.

    There are many excellent sites available to anyone wishing to research Cognitive Behavioural Therapy ( CBT ) …. and it is a great form of therapy – if a person has the desire, the energy and the determination to do it.

    The Catch 22 there is – – often seriously depressed persons do not have those 3 personal drives at the time when most needed. …… Desire, energy, determination. But we can hope – and as you have said, it has done you the world of good.

    I don’t know if you paid for a course or not – that is not my business to know either, so I am not asking.

    However, I did find – for anyone interested … an excellent site which costs nothing ( so far have found no indication of any fees payable, except a small advert. for self help books available at Amazon ).

    Because I am a bit of a treacle beak, I downloaded the 1st .pdf of 60+ pages, to have a look at. ….. It is first and foremost – appealing. It explains much about the next 6 stages – which get to the various symptoms and problems … It also advises to not download the lot at once, but complete the 1st stage first, and go back to the site and then on to 2, 3 etc. in stages. It is aided by images – ( fun for the most part ) … and the wording is simple and straight forward. …. The way it is set out, in boxes of text, small diagrams etc. – also appeals to the mind to be uplifted just by reading it. ( then I had a squiz at no. 5 !! )

    From the looks of it all, it is excellent. Very much worth a look at. ….. and I think would take a fair amount of continued work throughout the day – as set out. ….. Example : in analysing a situation that causes e.g. a bad or depressive thought. ” Define the worry ” …. can I do anything about it ? ( Yes ) ( No ) … if yes, define a plan, if no – let it go and change focus of attention. etc. etc.

    http://www.get.gg/cbtstep1.htm ….. it is a UK site – I have bookmarked it.

  25. Bruce

    Everyone should note the pilot was working against medical advice (allegedly). The large number of depressed and anxiety disorders in society that DO NOT CAUSE HARM TO OTHERS is being overlooked by this tragic example, the statistics show we are still safe. I accept this is meaningless to the victims and their families.
    Both psychiatric and psychological help is well developed and improving, medical help may not always fit at first but it is out there.

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