The Center for Mind-Body Medicine

Happy Valentine's Day

Valentine’s Day often offered choices and called up anxiety as well as affection. Was it presumptuous – or misleading- to send a card to x? Would y feel hurt if I neglected her? What kind of card could best, most honestly and lovingly convey feelings that were sometimes complex or even mixed. It was always easiest with little children I loved. I smiled and printed carefully and drew hearts, feeling happily like a child myself.

Today I find I’m doing something different. I begin the morning with thoughts of the children I love, my own and others’. I look at the photos I carry with me, see, in my mind’s eye each one playing, silently thank God or Nature or more often both, for their existence. And then as my day unfolds, on the way to the train back to Washington, their mothers come to my mind, and their fathers too, and I respond with unwritten valentines of gratitude. “Thank you for your children whom I love.” And my heart keeps opening, on the phone to friends and colleagues, on the screen of emails. “Happy Valentine’s Day,” I write to people I don’t know that well but like; “send your children Valentines. “ I find love coloring my glances at the train’s conductors with the day’s red roses pinned to their lapels. I sense sweetness in the suited men and women on their way to meetings.

The anxiety of choice or appropriateness evaporates. You are all my valentines.

Dr. James S. Gordon, a psychiatrist, is the author of Unstuck: Your Guide to the Seven Stage Journey Out of Depression and the Founder and Director of the Center for Mind-Body Medicine in Washington, DC. He is also Dean of the College of Mind-Body Medicine with Saybrook University.

Good News, Bad News, Better News

This week’s Journal of the American Medical Association reports on the successful use of Viagra by women whose sexual desire and orgasmic capacity have been diminished by the antidepressant drugs they’ve been taking. The data on the benefits of Viagra (which does not ordinarily enhance desire or improve sexual function in women), when compared to an inert placebo pill, are statistically significant. The article is hopeful. Relief is at hand.

That’s the apparent good news. But so far as I’m concerned, it’s overwhelmed by two large, unanswered bad news issues. Viagra may be significantly better than placebo at dealing with the symptoms of sexual dysfunction, but it’s not at all clear that the antidepressant drugs, whose side effects they’re addressing, are better than placebo for improving the symptoms of depression. Two recent reviews of the literature, including one in the prestigious New England Journal of Medicine, show that when all the studies – the negative ones the drug companies file away, as well as the positive ones they rush to publish – are put together, the drugs are far less useful than physicians and the public have long been led to believe.

A reasonable person has to ask, why then are women (and men) in such large numbers (more than 200 million US prescriptions in 2007) taking drugs to improve their mood which appear not to work very well, and so often (in up to 70% of cases) have negative sexual side effects? And ask as well, why researchers are reporting so cheerfully about the use of Viagra, a drug with its own side effects, to counteract the side effects of antidepressant drugs that may only be marginally helpful?

It’s time to step back from this cycle of promiscuous prescription and unpleasant side effects, to look for better news in an approach that is likely improve mood and perhaps even enhance sexual functioning without the negative consequences – and the expense –the drugs bring. This approach which I describe in my new book, Unstuck: Your Guide to the Seven Stage Journey Out of Depression, details a variety of therapeutic techniques including exercise, meditation, nutrition, and psychotherapy. Each is as likely to improve mood as antidepressants. Used together they may also have positive sexual and emotional “side benefits” – improved energy, greater calm, enhanced body image, self-esteem and self-control, and maybe even more interest in and compassion and love for one’s partner.

Coming up soon: More Responses to A Readers’ Question about Depression and Posttraumatic Stress

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