Why I Sometimes Feel Betrayed By the Medical Establishment

I am flummoxed by the article I just read in Psychology Today: A Decisive Blow to the Serotonin Hypothesis of Depression by Dr. Christopher Lane, Ph.D. In it, he states that, “the serotonin hypothesis has been challenged repeatedly and found wanting, even as it remains popular and influential.”

I keep going back and forth between Dr. Lane’s article and my writing here. I keep wanting to quote this and that and this other entire paragraph too. If I did, this would get very long. Please read his article before continuing here so I don’t feel the need to copy and paste the whole thing.

To try and sum it up, the article talks about a substantial study that states the link between serotonin levels in the brain and depression are more myth than reality; yet, doctors are prescribing SSRIs based on vague language in advertising about the efficacy of such drugs with little to no proof that treating serotonin levels helps.

Dr. Lane goes on to point out the questions by researchers about whether or not it is ethical to tell patients medicating for serotonin has an effect on their depression while prescribing SSRIs to them when the scientific data is lacking. What are the ramifications?

I can tell you one important ramification. Medical gaslighting. However, I’m not entirely sure where the medical gaslighting begins and ends. I can tell you this article made me seethe with anger.

When I was diagnosed with fibromyalgia, I was told by my doctor that it was believed depression played a role in fibromyalgia pain and that taking medication for the depression would also help with the pain. One problem I tried to point out was that I did not believe myself to be depressed at that time, so why would I want to take an anti-depressant? He insisted I should try it, especially as I was on opioids, and the push away from those types of meds for pain was in full swing. He prescribed me Lyrica.

According to my husband at the time, within hours of taking it, I immediately turned into a different human being. He could not recognize me as me. We immediately went back to the doctor who said that was OK; we just had to find the right drug for me and my chemical makeup. He put me on Cymbalta. Nope. Tried Amitriptyline. Bad idea. I think there was another medication in there somewhere, I can’t remember. My brain was no longer working properly.

He finally settled on Gabapentin a.k.a. Neurontin and told me this has to work, no question. Even though Gabapentin is not labeled as an SSRI like the article is talking about, it does affect serotonin levels in the blood. I hated it. But, because it was well accepted that SSRIs, SNRIs, and/or anticonvulsants help with fibromyalgia and depression, at least according to all of my doctors then which was around 2014 through 2019, I needed to take it. Or, I needed to go back to one of the other meds I had already rejected because they made me feel terrible.

Even though I was protesting against taking any of these meds because of how they made me feel and what my husband was observing in me, I felt I had no choice but to give in to the pressure. Plus, I was being denied the opioids, even though they did help, unless I proved I was trying other forms of pain relief too. So, I took the Gabapentin, along with the opioids. Anyone else see an additional problem there? But, I want to stick to this topic.

Over time with the Gabapentin use, I found my brain fog increasing to the point where I was no longer alive to my family at all. I was missing out on activities; interactions; could not remember entire conversations, events, and movies we attended. I lost the ability to do basic math or find my way around town. I kept blaming it on the Gabapentin. I was continuously told I was wrong. My husband was stuck between being my medical advocate and wanting to believe the doctors that these meds would help me. He was also gaslit and pressured me when he wanted to be a help to me.

Finally, I couldn’t take it anymore. I started lying about how much Gabapentin I was taking. I started halving my doses and flushing what I wasn’t taking. After a couple of months, I halved it again, which is when I told my husband I was weaning myself off. He did not argue. I did this until I was down to almost nothing and then declared I wasn’t taking any more.

I did get some mental improvement over time, a long time. After about three to four years now of not taking any more, I still have some functional issues, especially with basic math.

All that time, I was being told to take a medication that based on this article has a lack of real evidence that it would help. How does that happen?

I am not saying everyone should stop taking meds such as these. I do agree that individuals do have different chemical make-ups that might make these medications quite helpful to another person. I am claiming absolutely no professional knowledge of such meds. I do, however, have personal experience that I was pressured to take these meds when I was saying I didn’t want them while I was in a weakened physical and mental state making it difficult for me to fight for my rights as a patient.

Now, to see an article stating that there is not ample scientific evidence that these meds are even helpful for depression, which my doctor did state I must have because I have fibromyalgia, and I do believe there were times when I was depressed, I am livid that I was pressured to take them at all.

Was my doctor also pressured by the pharmaceutical companies that this medication was the right way to go with patients? Was he also medically gaslit? Or, did he do it solely based on the possibility of making an extra dollar?

This leads me to give this answer to the questions of ethics in telling patients that a medication will help when they don’t actually know: I don’t trust you!

I understand that as a chronically ill patient I am essentially a guinea pig in trying different meds to see what my body may or may not respond to. But, I now see you less as a partner in my overall care. I now see you as a potential villain in my fight for my health and my life when I need you as an ally. I now question every single medication proposed to me.

We need good, honest, caring relationships between doctors, patients, researchers, pharmaceutical companies, and others in the field. Need. When I pop a pill in my mouth and swallow, I am giving you my trust. If you don’t know, say you don’t know. Don’t lie. Don’t betray me. I’ve got enough problems already.