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Dr. Larry Larsen
October 9, 2011
I am responding to your recent column because of increasing evidence that the high incidence of depression is, at least in part, iatrogenic. In light of that research, prescribing antidepressants is not to “err on the side of caution,” especially with the young. The warnings of practitioners and researchers like Giovanni Fava that, “Use of antidepressant drugs may propel the illness to a more malignant and treatment unresponsive course” cannot go unheeded with a business-as-usual approach by the clinician if the patients’ interests are uppermost.
While I am sure that you care deeply for your patients, your column continues what is now the Obama party line that everything is OK. Well, there’s trouble in River City and ignoring the problem with these drugs will help no one but the pharmaceutical industry and they, if I may say so, don’t need your help.
Forgive me for thinking like a psychologist, but I am wondering why you are so passionate.
On the other hand you do raise some valid points. First, let’s be certain the word “iatrogenic” means the same to both of us. Generally, a disease is iatrogenic if caused by the treatment itself. If that is what you mean, it is not frequently true, at least not in my experience. If you mean the disorder of depression is a result of life experiences, then I agree. Brains do not live in jars. Just as other organs of the body react to circumstances, so does the brain.
In some instances the medications do exacerbate depression and hypomania. However, I cannot throw the baby out with the bath. Medications often do help. As you pointed out in the remainder of your email, edited for space, other methods such as cognitive treatment, exercise, and the like are very helpful in treatment. Reaching for the pill first is usually not the best course.
All that being said, this is a newspaper column. I would not presume to diagnose and treat someone from email correspondence. That goes for books and articles which espouse a one way approach to almost everything.
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Dr. Larry Larsen is an Andover psychologist. If you would like to ask a question, or respond to one, you can e-mail Dr. Larry Larsen at lrryllrsn@CS.com.