02 Sep Responding to Your Responses
Last week the Standard-Journal published thoughtful and respectful responses to my last two columns. At first I was a bit self-conscious of the critiques. But since I am a licensed therapist I scheduled some time to talk to myself, and I’m okay now. (Too bad I can’t bill my insurance!)
As these responses were written to appropriately challenge my thoughts in the public forum, I hope it is okay to respond in like manner. I have hoped that my columns would spur public discussion of timely and important matters. Today I hope to further contribute to those conversations.
Regarding Treatment of Depression
Thank you for your observations about the challenges of depression, including the difficulties finding reliable and effective resources to alleviate the “dire feelings of hopelessness and internal strife” which many good people experience. It breaks my heart when I hear of the inept “treatments” we so-called experts sometimes offer. I apologize on behalf of my profession, and hope that I am wise enough not to inadvertently add to the suffering my clients experience.
You describe very accurately the battle taking place within the medical and mental health communities. And yes, many have been “furious” at the suggestion that antidepressants, including SSRI’s (Prozac, Zoloft, Paxil, etc.), are barely more effective than sugar pills.
It turns out that the Food and Drug Administration agrees: the data provided by the pharmaceutical companies confirmed that these antidepressants are about as effective as placeboes.
The FDA gave “big pharma” fifteen years to demonstrate that Prozac and similar medications worked as they claimed, based upon the “chemical-imbalance” theory you articulated so well. From more than seventy qualified studies, the companies were required to present only twelve that demonstrated their effectiveness. The data they presented showed that the average patient on Prozac improved about 28%, while those given placebos improved 24%. Both improved a great deal more than those who received no treatment at all.
So the studies available via the FDA show that antidepressants do work, but that their benefit comes almost entirely from the fact that one is taking something EXPECTED to help one feel better. (Later studies showed that patients receiving Cognitive Behavioral Therapy from qualified professionals showed significantly greater improvement than the other groups, with fewer relapses.)
Even most critics of this research don’t question the findings. But there certainly is a battle about whether the public should be INFORMED regarding the research. Critics insist that since so many individuals believe the medication was responsible for their improvements, we should do nothing to discourage them from continuing to do so. They would not wish to take away the only tools most medical professionals have to help their clients with mood problems—a pen and a prescription pad. And while it may seem cynical, I think the manufacturers have a vested interest in perpetuating the chemical-imbalance theory.
Regarding Increased School Funding
I really cannot disagree with you. Our public school teachers and support staff are often genuine heroes. I have approached a number of my former teachers to thank them for what they gave up for me and for so many others. I want them to be compensated well.
I had only hoped to make these two points in my last column:
1. Increased spending does not lead to obvious improvements in educational outcomes, as illustrated by students in Idaho performing well above its “dead last” status in spending per student while Wyoming spends twice as much and performs much lower in the ACTs.
2. Parental involvement IS a reliable predictor of improved student performance, and the one over which parents have the most control.
But congratulations on the great performance of your children! I am genuinely impressed by their accomplishments. And if you look back at my June 17 column, “The Brainy Bunch”, you’ll read about a family whose children compared very favorable with yours even before finishing adolescence—and all via homeschooling and carefully leveraging resources available to all parents and students.
It might also be worth noting that most of the money beyond Idaho’s current spending goes to administrative and building costs, not to teachers and their classrooms. Even the Madison levy was earmarked for building improvements.
Thanks to you both for your responses, and I hope to continue these and other conversations about how we can improve our lives and the lives of our loved ones here in the Standard-Journal, and on my blog at MichaelWilliamsCounseling.com. Or call me at 360-2365.