No wonder so many people are single. A few years ago, I spoke to a group of high-schoolers about the Jewish idea of love.
Placebos can cause terrible side effects. Aside from the sort of side effects that you expect with any drug, there are three side effects of SSRIs that I consider especially worrisome and worthy of further discussion.
These are weight gain, sexual side effects, and emotional blunting. Weight gain is often listed as one of the most common and debilitating effects of SSRIs.
But amusingly, when a placebo-controlled double-blinded study was finally run, SSRIs produced less weight gain than placebo. After a year of pill-taking, people on Prozac had gained 3. There is now some talk of SSRIs as a weak but statistically significant agent for weight loss.
One symptom of depression is not eating. Then they get better, either because the drugs worked, because of placebo, or just out of regression to the mean. When you go from not eating to eating, you gain weight. Sexual side effects are a less sanguine story.
Here the direction was opposite: Numbers I have heard for the percent of people on SSRIs with sexual side effects include 14, 24, 37, 58, 59, and 70 several of those come from here.
Researchers investigating the topic suggest people worried about sexual side effects should switch to alternative sexual-side-effect-free antidepressant Serzone. You may remember that as the antidepressant that worked worst in the efficacy studies and brought the efficacy of all the other ones down with it.
Also, it causes liver damage. In my opinion, a better choice would be bupropion, another antidepressant which has been found many times not to cause sexual side effects and which may even improve your sex life. Bupropion causes insomnia, decreased appetite, and in certain rare cases of populations at risk, seizures.
It is generally a good choice for people who are worried about SSRI side effects and would prefer a totally different set of side effects. So after you recover, you can wait the appropriate amount of time, come off the drugs or switch to a different drug or dose for maintenance and no harm done.
The situation no longer seems so innocuous. Despite a lack of systematic investigation, there are multiple reports from researchers and clinicians — not to mention random people on the Internet — of permanent SSRI-induced sexual dysfunction that does not remit once the drug is stopped.
This is definitely not the norm and as far as we know it is so rare as to be unstudyable beyond the occasional case report. On the other hand, I have this. But I am very suspicious. I feel like this provides moderate anthropic evidence that it is not as rare as everyone thinks.
The last side effect worth looking at is emotional blunting. A lot of people say they have trouble feeling intense emotions sometimes: Sansone and Sansone report: As for prevalence rates, according to a study by Bolling and Kohlenberg, approximately 20 percent of patients who were prescribed an SSRI reported apathy and In a study by Fava et al, which consisted of participants in both the United States and Italy, nearly one-third on any antidepressant reported apathy, with 7.
A practicing clinician working off observation finds about the same numbers: Rather, they find that—in contrast to their periods of severe depression—they are able to enjoy life again, with all its joys and sorrows. There is a subgroup of depressed patients whose depression takes the form of not being able to feel anything at all, and I worry this effect would exacerbate their problem, but I have never heard this from anyone and SSRIs do not seem less effective in that subgroup, so these might be two different things that only sound alike.
A couple of people discussing this issue have talked about how decreased emotions help them navigate interpersonal relationships that otherwise might involve angry fights or horrible loss — which sounds plausible but also really sad.
I have not been able to find any case studies or testimonials by people who say this effect has been permanent. My own experience was that I did notice this even before I knew it was an official side effect that it did go away after a while when I stopped the medications, and that since my period of antidepressant use corresponded with an important period of childhood socialization I ended out completely unprepared for having normal emotions and having to do a delicate social balancing act while I figured out how to cope with them.
Your results may vary. The conventional wisdom in psychiatry is that antidepressants and psychotherapy are about equally effective.
Depressed people are not generally known for their boundless enthusiasm for performing difficult tasks consistently.
Also, Prozac costs like 50 cents a pill. Contrary to popular wisdom, it is almost never the doctor pushing pills on a patient who would prefer therapy. Although there are differences between the role of placebo in psychotherapy and pharmacotherapy research, psychotherapy has an effect size that is comparable to that of antidepressant medications.
Whether these effects should be deemed clinically relevant remains open to debate. Another study by the same team finds psychotherapy has an effect size of 0.Mar 03, · Note: Amy Krouse Rosenthal died on March 13, , 10 days after this essay was published.
You can read her obituary here. In June, , her husband published this response. I . Thank you for this well written essay. For years I struggled with the adult relationship with my mom, analyzing why I would make her mad, short, abrasive. I love you more than you say you love me times a million more, and just so you know I love you MORE square root that by infinity.
I love you more than an angel loves the heavens. I love you more than all the rain drops that fall in a summer thunder storm. Related Book Ebook Pdf I Love You More Than You Know Essays: The Collaborative Habit Life Lessons For Working Together - Does This Clutter Make My Butt Look Fat An Easy Plan For Losing Weight And Living More.
I just want you to know that I love you too much. You are the most beautiful person in my life. The fun and joyful times that we shared, never fails to bring a smile to my face. Hope you are doing good.
Stay in touch. We shared some good times together. Read More. Words 5 Pages. My Life as a Soundtrack Essay My Love Letter to You. Mar 24, · A RELATIVELY new field, called interpersonal neurobiology, draws its vigor from one of the great discoveries of our era: that the brain is constantly rewiring itself based on daily life.