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Thursday, January 16, 2014

What Alternative Medicines (treatments) are there for Depression, Pain or Anxiety?

In a word, none.

What people seem to be looking for when they say, "alternative medicine," are over-the-counter (OTC) products that can be purchased without a doctor's order that may alleviate some symptom or cure a disease. So, "alternative medicines" are unregulated and unsupervised, and they include a very broad variety of pills, oils, tinctures, drinks, foods, and activities that may or may not help you. But what exactly is "alternative medicine?"

 Well, in my opinion, there really is no such thing as alternative medicine. In today's definition, "medicine" is something that really does cure or treat an illness; it either works or it doesn't. So the idea of alternative medicine would mean an alternative to an effective treatment, which would be what - an ineffective treatment? Moreover, there is no governing organization whose role is to appropriately define and decide what, how or when a particular "alternative medicine" should be used. Anyone can make a product and call it alternative medicine, and then make claims about it.

Cartoon by Matthias Giesen

With regards to mental health problems like 
depression and anxiety and medical problems like
pain management, alternative medicines are all just placebos. 

Many people are offended by the thought that "it's all in their head," but it's really not that simple, and it's really not an insult. The placebo effect is a clear reflection of the power of the mind to improve conditions or dysfunctions which arise in the brain, and it is a reflection of the mind-brain-body connection.


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      If you don't know much about the placebo effect and would like to learn more, here are some good books about it. I'm sure you'll find online content, but it definitely will not be as elaborate and specific, or as interesting as these books below:

Complimentary alternative medicine has more to do with marketing than it does with medicine. People who sell non-prescription products with health claims are competing against the medical field. In order to increase their share of the market, they pit themselves against it. For example, they will try to create an "us against them" feeling with consumers by using phrases like "Western medicine" versus "Eastern medicine," or claim that alternative medicine "is natural," implying that it is thus better or safe. The reality is that all chemical treatments are synthesized from nature; some are modified, some are not; but, they either can really treat a symptom or disease or they can't.

Is it really okay for people to be allowed to sell  products as alternative medicines without knowing whether or not they are safe and really work? I don't think so. There continue to be many cases of people who are harmed by alternative medicines because the safety of the product was never determined. The FTC and FDA seem slow to protect consumers. Also, the production of alternative medicines is not well-regulated, so dosages could vary and harmful adulterants may be added. 

In the case of homeopathy, it's just water, 
so there's no risk of harm there, but there's 
definitely no chance of benefit beyond a 
placebo effect either.

There are some over-the-counter medicines that are commonly used for depression, including St. John's Wort and SAM-e. St. John's Wort and SAM-e have been used to treat depression. However, these studies show many of same problems as anti-depressants, such as that they can cause manic episodes, and other problems as well as potentially serious negative interactions with other drugs, and most importantly, they aren't much better than a placebo (sugar pill). As it turns out, anti-depressants do not work better than placebos*** (read The Emperor's New Drugs, Exploding the Antidepressant Myth by Dr. Irving Kirsch). SSRI drugs like Paxil, Prozac, Lexapro, and Zoloft are placebos; they perform better when compared against a sugar pill, but that's not saying much; but when compared to "active-placebos," (something like benedryl) they don't perform better. Interestingly, the more side-effects that an SSRI has, the better people feel it works, which is a clear sign of the placebo effect.

Health stores or health departments in major chains that sell SAM-e, St. John's Wort and other supplements like 5HT are just business owners who are selling products that compete with other medical products. Alternative medicine is a multi-billion dollar a year industry. There probably are vendors who really care about their customers. But I think, and in some cases, I know that the producers of alternative medicine products care only about making money. If they cared about selling cures for illnesses, then they would spend the money to conduct well-designed scientific studies.

Instead, producers and retailers of alternative medicine products often pit their product against FDA approved drugs. I'm by no means a cheerleader for the FDA and I'm definitely a serious critic of pharmaceutical companies, but it even more so for alternative medicines. I see them as taking the easy way out. 

If you are going to claim that your herb or essential oil 
cures depression or anxiety then conduct some valid studies with experimental and control groups and use an active placebo.

Steve Jobs regretted using alternative medicines to treat his pancreatic cancer. There are many cases of people who have suffered from use of alternative medicines. Safety has not been determined - neither the product nor the production process. Regardless of certifications by alternative medicine industry organizations, the level of scrutiny just hasn't been enough.

Another fad in the complimentary alternative medicine industry is vitamins. In the 1980's and early 1990's, Beta Carotene (the pre-cursor to vitamin A) was very popular when anti-oxidants were thought to prevent cancer (hypothesized by nutritionists**). However, after two very large scientific studies in Europe (tens of thousands of individuals participated for many years), the rate of cancer was significantly higher in the group taking beta carotene.
Calcium is another supplement that people are often told to take in large quantities. Only recently it was discovered that calcium supplements can significantly increase the risk of heart attacks in men; apparently the extra calcium damages areas of the heart muscle, and it apparently does not prevent osteoporosis. 

Vitamin D is the most recent popular craze. With not much conclusive scientific evidence, people are being told to ingest super huge quantities of vitamin D. For example, in a review of studies about vitamin D, it did reduce mortality for 1 person out of 150 who took it regularly for four years; however, too many people dropped out of the studies to draw a conclusion that it will reduce mortality for most people. Another review of studies showed that there is not enough evidence to claim that vitamin D can treat chronic pain or for treating multiple sclerosis. Another recent study claims to have closed the case on the idea that Westerners need vitamins; they're probably right.

Some doctors make claims that mega-doses of certain vitamins will cure mental health problems. I had one client who was being prescribed mega doses of B vitamins for years. It didn't seem to help one bit, but the client and her parent continued to believe in it. That's another problem with taking any pill for a mental health problem, it's very difficult to measure whether or not it really works. To start with, most doctors who prescribe pills don't regularly measure specific symptoms, and clients almost never think to keep track of any specific symptom on a regular basis. The fact is that most people who take pills of any type continue to feel about the same over time, with some ups and downs that they attribute to increasing their dose or changing their pill. There are financial benefits for doctors who maintain large caseloads and this may encourage them to continue prescribing pills that aren't working, or prevent them from directly asking the patient to specifically and regularly track their progress.

The rate of disability due to mental illness in America
is at an all time high in spite of the fact that pharmaceutical 
companies and psychiatrists are alleging that they have 
all of these wonder drugs for treatment.

Here's a table borrowed from this website detailing the more dangerous alternative medicines:

** Nutritionists lack credibility when it comes to making claims that are scientifically sound since they are not practitioners of modern scientific methods. If you want a practitioner who is trained in valid dietary science, then see a Registered or Licensed Dietitian. I know a guy who was able to get his pet cat certified as a nutritionist over the internet!

*** Anti-depressants work better if they have more side effects. As side effects decrease, patients report less success. This is seen with different types of placebos, too. However, anti-depressants do seem to dull the emotions of people, and this effect seems to get worse over time for many patients and may reflect a type of drug-related neurological damage.

Acupuncture is also a placebo, but a very powerful one. This seems to difficult to believe for people who are unfamiliar with the power of placebos, but it's actually quite typical. The fact is that the more invasive the procedure, the greater the placebo effect. In world war two, a field medic named Henry Beecher ran out of morphine; so, he told the wounded soldiers he was giving them IV morphine which was really just a saline solution, and it worked; he was able to conduct what would normally be excruciating procedures. What has been discovered about placebos is that everything from the color of the pill, the size of the pill, and the amount of the pill make a difference; it's even cultural, for example, in Italy, a blue pill works better for increasing energy level, where in America, a red pill works better for that. Also, shots work better than pills, IV's better than shots, and surgeries better than those. A recent placebo is to cut open someone's knee or ankle and wash it with platelets. It's a placebo, but it can dramatically reduce or cure chronic ankle pain.

To sum things up, here's what you need to know about alternative medicine for mental health:

1. All alternative medicine treatments for mental health are placebos.

2. The placebo effect is a very real and potentially powerful self-healing process based on beliefs and expectations of the patient and "healer."

3. People who produce and sell alternative medicine products are often trying to make money and really aren't interested in your well-being - not much different than any other corporation whose only legal or ethical responsibility is to their shareholder.

4. Alternative medicines can be harmful or even fatal since they are rarely tested for safety, and the production process may not be regulated or supervised, allowing for harmful adulterants.

5. Vitamins are not needed for nearly all westerners. Vitamin fads are even popular in medical clinics as well as alternative medicine clinics, but these fads have been shown to be useless in nearly every case (e.g., vitamin B*) and potentially seriously harmful or fatal in others (beta carotene, Germanium, and calcium). Vitamin D is currently all the rage, but not much is known about it's good or bad health effects for most medical issues.

6. Don't rely one bit on news or media reports about alternative medicines or vitamins. News reporters (CNN, FOX, etc..) are not scientists and often hire consultants who are biased one way or another. Reliable information can be found at the source, such as the FDA, NIH, American Academy of Science, National Academy of Science, and the Cochrane Collaboration.

*Thiamine is an effective treatment for memory loss related to alcoholism.

Mental Health Advice Disclaimer: The information included in this post and blog are for educational purposes only. It is not intended nor implied to be a substitute for professional mental health treatment or medical advice. The reader should always consult his or her mental health provider to determine the appropriateness of the information for their own situation or if they have any questions regarding a mental health or medical condition or treatment plan. Reading the information on this website does not create a therapist-patient relationship.

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