I’ve been working in a family practice office the past 2 weeks. It’s truly stunning the amount of people that come in who are on anti-depressants. I was talking about it with a friend and got this response:
Do you ever think that depression is sometimes a sign that we are unhappy with things in our life and instead of changing things to make ourselves happy, we seek pills to cover it up?
So what do you think? I tend to think we are an over-medicated society that looks to pills to solve all our problems (type II diabetes, hypertension, obesity, yada yada). I am in no way saying that anti-depressants aren’t great drugs for people with true major depressive disorders and chemical imbalances (they are awesome and have saved a lot of lives). But do you think that we, as a society are too quick to find fast easy solutions and ignore the root of the problem? Do you think there is anything that can be done about that?
Here’s another thing to ponder along those lines
We had a patient come in who was very obese and complained of back pain. My doc tried to talk to her about her weight as being the cause of the problem. She said “I didn’t come in here to talk about my weight. You need to give me something for this back pain”. It’s interactions like this that cause docs to reach to their prescription pads rather than discuss lifestyle modifications with patients. I think he’s gotten tired of me harping on patients for diet modification/exercise/and smoking cessation. He cautioned me that if we try to talk about lifestyle modification with people on their first visit they are unlikely to come back. It’s been an interesting month, for sure…
Okay and the flip side of that is my girlfriend who is very overweight and kept going to her doctor complaining of heartburn and stomach pain. The doctor kept talking to her about lifestyle changes.
She eventually went to a different doctor who actually did a full workup on her. Three months ago they removed a cancerous tumor on her ovary the size of a softball. Unfortunately stage four.
So you can blame overweight people all you want for their problems but doctors should actually look at the whole patient once in a while. Maybe that back pain is kidney cancer or something serious and is not just a weight related issue.
Reminds me of a good friend. He is overweight, does not exercise much, and has high blood pressure. His doctor put him on blood pressure meds. The blood pressure meds make him depressed, so has been drinking too much because he is depressed. The drinking has made his blood pressure worse. I keep telling him to break the cycle and just EXERCISE to lower his weight, eat better, and the blood pressure will go down. Seems like common sense to me, but not what his doctor suggests…
They should have never let drug companies advertise on TV. Now everyone knows exactly what they need and I bet are pretty demanding when they get to the doc.
I am so sorry for what you are going through. Ovarian cancer is absolutely terrible. And heartburn would be an extremely odd presenting symptom. Thank God she went to a different doc that did a full workup.
I’m not implying that things should not be worked up. The doc I work with is very thorough in always ruling out all serious causes of illnesses. Sadly, >70% of his practice is dealing with illnesses that are preventable with healthy living (like type II diabetes).
Yeah, I agree to some extent. But every once in awhile I think the ads serve a good purpose. You’re going to think I’m joking here when I give this example, but I’m not- I think the Viagra marketing campaign was very successful for a lot of reasons. It 1- Got men to the doctor. A remarkable feat in itself 2- Got plenty of men medical help for serious vascular/endocrine problems 3- Took the stigma out of ED. Sex is important to physical and emotional health and healthy marriages for most people. The drug has really helped a lot of people that wouldn’t have gone to the doc without the extensive marketing
So I’m not anti-drug or anti-drug company. I think medications save a lot of lives/lifestyles… I just don’t think they should be given out as a front line therapy for maladies that can be cured with lifestyle changes.
Funny story though… There was a cialis commercial that didn’t say what the product was for. It showed people fishing (I think). A lot of women were coming in asking for Cialis. When asked why they wanted it, they said they have been having joint pain. They thought it was for arthritis!
I agree with you and last tri and I’m a pharmaceutical rep. I sell insulin, lots of job security with the rising rates of obesity and all the related health problems. Most people want a pill to make things better. I love it when doctors do tell me about the rare patients that change their diet start exercising and no longer have to take any medication.
CLD, I’m sorry to hear about your GF and hope she is doing well.
Unfortunately, I think you are in a position where you see the worst of the worst. You don’t often see the people that changed their lifestyles. How many stories have you heard on ST about people being overweight, deciding to do a triathlon, and totally changing their lives around? How many of these are on some sort of medications? You are probably seeing the people that really don’t want to change and want to pop a pill to fix all of their problems. Also, who goes to see a doctor when they are healthy or believe themselves to be healthy? I’m the atypical guy and I actually go to the doctor when something is wrong.
OK, I have a race in the morning. I’ll write back more tomorrow.
Very sorry to hear it. It raises a larger point too that the average time a doc spends with a patient is down to, what, like 5 min now? So, i suppose it’s just easier and more time efficient for a lot of them to just write the prescription.
Jodi - yes, you’re right on. it’s just like anything else, people want to take the easy way out. Popping a pill is much easier than having to deal with the fact that they’re 100lbs overweight. Eating one more donut is easier than doing 1 more hour at the gym (and a lot cheaper). Ask every physician you work with what 2-3 things have changed the course of medicine the most over the last 20 years, and they all will answer the same thing - drugs and insurance. Medicine and technology have changed our world completely, but there are side effects. The “easy way out” mentality grows and grows, and the “it’s all about me” thinking is everywhere.
Another related issue is one of entitlement. Not only is it easier to fix problems (bandage them or mask them with drugs), but it’s their RIGHT to receive the treatment, and for FREE!!! It’s the one thing that has baffled my mind for a few years.
I don’t know if we’re a “medication culture,” but we’re definitely a quick fix culture. It is a pervasive mindset that touches nearly every facet of American life. Whatever it is, we want it faster, easier, cheaper, etc. That includes health. Just look at all the money being made on the ridiculous fitness machines people buy on TV or the quick weight loss pills like Hydroxycut. “You don’t need to go through the hassle of sweating and working hard, you just need our pill, and you’ll look like a model!” I think that’s probably what you see in people coming to the doctor’s office too. “I saw something on TV that might make my life better right this very instant. Give it to me now!”
I see a ton of pt.'s (pre-hospital) who are elderly and on some kind of anti-depressant. Most of the time they have no idea why they are taking it or which of their Dr.'s prescribed it. I have gotten to the point that I can talk to someone and have a pretty good idea inside of a minute what meds they take based on what their primary complaint is, who their Dr. is, and what they look like. It happens with startling accuracy too.
I was on Paxil for a while - I was going through a divorce, feeling very bad, and self-medicating with binge drinking ( as much as my training would allow ), I got to the point of seeking help from an employee assitance therapiist - she recognized I had symptoms of depression, and talked to my MD, they both suggested the Paxil. My question to them both at the time was " terrible things are happening to me, why shouldn’t I feel bad ", they acknowledged it was an excellent point - but my therapist said I should give it a try, because it would help me think through my situation a little more clearly.
And it was true, once the meds kicked in, I was able to put the whole divorce process in perspective and get on with my life. So, it didn’t really cover up my problems, just gave me the break I needed to think things through clearly.
At the same time, I hated the medication, due to significant side effects ( to be blunt, I couldn’t splash ), and the general feeling that although it certainly cut the low points out of my feelings, it kind of took the high points out too. I lasted about 3 months on the stuff before I couldn’t take it. Getting off the medication was very weird - I felt terrible for at least 3 weeks.
So, I was on, and glad I did it, but couldn’t wait to get off.
Now, my ex’s parents are both on Paxil, and have been for years - they are hooked solid, have tried to get off and couldn’t. I firmly belive the only reason they were put on in the first place is that they were bored - retired and nothing to do. In their case, I suspect it is just the new Valium.
My wife went to see her doc about some groin problems. We were hoping for an evaluation that included some stregnth tests, posture analysis, flexibility…maybe a referal to a PT. Nope. Take a warm bath and eat these pills.
I told my friend and he laughed and said, “Yeah. Because thats been her problem all along. She doesn’t eat enough pills.”
To be fair, she did go to a PT and was prescribed deep massage therapy to take care of some sever flexibility problems (that I’ve harped on her about for 6 years now). She has yet to go and its been 4 months!! = (
That’s interesting. One of my major hesitations about the meds is the lack of timeline to get off of them and the withdrawl people go through. They most definitely work (people are sometimes excessively happy…), but I think they are over-prescribed. And the sexual side effects are undisputed. We put a kid on an antidepressant and viagra the other day (he was legitimately very depressed).
Glad you were able to get through your tough spell and then get off the meds. I have found training to be my personal favorite Paxil
That’s funny, because we had the opposite experience in clinic today. We prescribed PT for a woman with Chondromalacia Patella and it took me about 15 minutes to convince her that this was the way to go for her condition. I’m sure she would have gladly taken pills and walked out the door.
Yeah, I just prepared a document on the proper diabetic diet and printed out 15 copies. Left them on the counter… just in case!
I feel that if you get just 1 in 20 people to make a positive change in their lifestyle and get them off medications it’s totally worth it. But I agree with the doc to some extent. I like to mention that diet and exercise can improve (insert disease here), and only push harder when people sound interested.
