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Columns: Health Yourself

Mood swing

By Victor Katch
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Hooked on pharmaceuticals

Health-Pillhead-9-16Prescription drug use and abuse is a global problem, and the U.S. is the world’s biggest addict!

We are an anxiety-riddled, depressed, and drug-seeking culture. We all just want a little relief from sadness, stress, and sorrow.

The U.S. statistics for prescription drug use are alarming. Almost 60-70 percent of Americans – nearly 3 in 5 adults – take at least one prescription drug. That translates to about 13 prescriptions written per year for every man, woman, and child. Americans use 99 percent of the world’s Hydrocodone (Vicodin), 80 percent of the world’s Oxycodone (Percocet and Oxycontin) and 65 percent of the world’s Hydromorphone (Dilaudid), according to recent statistics.

The most commonly used prescription drugs in the U.S. are mood-altering drugs – opioids and antidepressants.

People use mood-altering  prescription drugs to deal with many different psychological conditions:

  • 6.8 million (3.1 percent of the U.S. population) take prescription drugs to help with generalized anxiety disorder
  • 2.2 million (1.0 percent of the population) take prescription drugs for obsessive-compulsive disorder
  • 6 million (2.7 percent of the population) take prescription drugs for panic disorders
  • 7.7 million (3.5 percent of the population) take prescription drugs for post-traumatic stress disorders
  • 15 million (6.8 percent of the population) take prescription drugs for social anxiety disorders
  • 19 million (8.7 percent of the population) take prescription drugs for specific phobia affects

There are four main classes of mood-altering drugs. Below is a generalized list of drugs that fall into the different drug classes.

Health-Graphic-CLEAN-9-16

Stimulants result in the release of varying amounts of the brain chemical norepinephrine or adrenalin, dopamine, and other brain chemicals.  Stimulants can cause:

  • Dilated (widening) pupils
  • Increased attention
  • Increased reflexes
  • Increased blood pressure and heart rate
  • Increased alertness
  • Decreased need for sleep
  • Decreased appetite

Opioids — natural or synthetic — affect morphine receptors in the brain. Opioids can cause:

  • Constriction (narrowing) of the pupils
  • Constipation
  • Sedation or sleepiness
  • Slowing of the heart rate and breathing rate
  • Dry eyes
  • Dry mouth
  • Decreased blood pressure
  • Pain relief

Sedative hypnotics range from relatively week substances (like alcohol) to very potent ones (like the “date rape” drug Rohypnol). They can be especially dangerous when used in combination with other drugs. These drugs work on receptor systems of the brain to excite and activate the brain, leading to wakefulness and anxiety. Sedative-hypnotic drugs can cause:

  • Relief of anxiety
  • Sleepiness
  • Impaired judgment
  • Bizarre behavior
  • Coma, or even death (at high doses)

Hallucinogens alter perception as part of their central nervous system or brain effects and can cause a low degree of impaired judgment when users become intoxicated. Altered perceptions seem to include many different effects, such as visual distortions, spatial distortions, and loss of time perception.

Drug benefits versus adverse effects

Drug Bottle WarningEvery mood-altering drug associates with certain benefits as well as risks and warnings, i.e., adverse effects, problems, or conditions that are likely to be exacerbated when taking the medicine. Some of these problems are minor, but others can be significant.

For example, Cymbalta (Duloxetine) is a mood-altering prescription drug commonly used to treat depression and anxiety. Doctors also prescribe Cymbalta to help relieve nerve pain (peripheral neuropathy) in people with diabetes or ongoing pain due to arthritis, chronic back pain, or fibromyalgia. This drug can result in the following adverse effects: insomnia, hypersomnia, dizziness, weakness, drowsiness, diarrhea, constipation, nervousness, tension, vomiting, erectile dysfunction, and anorexia.

I am not kidding. And this is not even a complete list of Cymbalta’s side effects.

In fact, additional unwanted adverse effects have been reported, ranging from difficulty swallowing, dark urine, abdominal pain, and hive-like swelling of the face to loss of consciousness, light-colored stools, skin lesions, and vomiting of blood. And those are just a few.

If the adverse effects of Cymbalta weren’t scary enough, the manufacturer also lists other possible side effects. They state on their webpage, “If you notice other effects not listed above, contact your doctor or pharmacist. Many other drugs are known to interact with Duloxetin … this includes many prescription drugs and over-the-counter medicines, vitamins, and herbal products.”

Yikes!

These descriptions are not unique to this drug. Almost every mood-altering prescription drug of significance has similar potential adverse side effects. Of course, most people do not exhibit serious side effects, but many do.

After a recent golf outing, my friends and I discussed the medications each of us were taking, including mood-altering drugs. I was shocked! Of the 2o or so people, about 17 were taking at least one prescription drug. Eight were taking mood-altering drugs and had experienced side effects serious enough for them to stop taking the drug.

I don’t know about you, but I don’t want to take any prescription drug unless absolutely necessary. If possible, I want to treat any medical condition, particularly mood-related disorders, with interventions with no known adverse side effects.

Are there mood-altering medicines that have no serious, adverse side effects we can use with confidence about their documented benefits?

Yes! Physical activity is medicine and it comes with no side effects. Well, it does have some side effects. But they tend to be positive ones.

Documented benefits of physical activity as medicine

Here’s what you can expect after you start a physical activity program:

  • You’ll sleep better
  • You’ll feel better
  • You may be able to stop taking some prescription meds
  • You’ll burn more calories so you can eat more
  • You’ll digest food more quickly and efficiently
  • You’ll increase blood flow to the brain; focus will improve
  • Your sex drive will change (for the better)
  • You’ll get an energy boost
  • You’ll improve balance and coordination
  • You’ll get immediate stress relief
  • You won’t get fatigued as easily
  • You’ll increase self-confidence
  • You’ll offset cognitive decline
  • You’ll alleviate anxiety
  • You’ll sharpen your memory
  • You’ll help control addictive behaviors
  • You’ll increase relaxation
  • You’ll be more productive
  • You’ll become an inspiration to family and friends
  • You’ll get to enjoy the great outdoors
  • You’ll recover faster from illness
  • You’ll strengthen bones and prevent osteoporosis
  • You’ll reduce your risk of Type 2 diabetes and metabolic syndrome
  • You’ll reduce your risk of some cancers
  • You’ll be able to prevent falls
  • You’ll increase your chances of living longer
  • You’ll improve your ability to manage pain
  • You’ll recover faster from surgery
  • You’ll improve your posture
  • You’ll lower your blood pressure
  • You’ll increase brain cells
  • You’ll counteract the effects of pollution more easily
  • You’ll help prevent or delay many diseases and disabilities
  • You’ll protect yourself against colds, flu, and some infections
  • You’ll go to sleep earlier

And on and on. There’s not enough room to list everything that can be improved by just a little, regular physical activity.

Physical activity: This “drug” works!

Since at least the 1960s, exercise scientists have studied the effects of physical activity on almost every body system. The collective evidence overwhelmingly shows that increased activity has direct and positive effects on:

  • Muscles
  • Lungs
  • Diaphragm
  • Heart and cardiovascular system
  • Stomach and intestines
  • Joints
  • Brain
  • Kidneys
  • Adrenal gland
  • Skin
  • Face

The free medicine to feeling better

Physical activity costs nothing, and it feels really good. So, I want to challenge you to join me. Let’s go for a walk together – nothing outrageous, just a 30-minute walk every day. You should do this just to begin to feel better, or because it’s a beautiful day, or because you want to experience fresh air, or simply because it’s just nice to be alive – for one more day. Just go outside and walk, nothing else – and all the other stuff I list will take care of itself.

Of course, you can do more if you want!

Feel free to tweet me @whatakatch and let’s see how long it takes us to walk 1,000 miles collectively. I will update the cumulative mileage and report the results in my next column.

References

  • de Souza Moura, A.M., et al. 2015. “Effects of aerobic exercise on anxiety disorders: A systematic review.” CNS Neurological Disorders Drug Targets; 14(9):1184.
  • Edwards, M.K., et al. 2016. “Effects of a sedentary behavior-inducing randomized controlled intervention on depression and mood profile in active young adults.” Mayo Clinic Proceedings; 91(8):984.
  • Gerber, M., et al. 2016. “Exercise is medicine for patients with major depressive disorders — but only if the ‘pill’ is taken!” Journal of Neuropsychiatric Disease and Treatment; 12:1977.
  • Guszkowska, M., et al. 2004. “Effects of exercise on anxiety, depression, and mood.” Psychiatria Polska; 38(4):611.
  • http://www.cdc.gov/nchs/data/hus/hus15.pdf#079
  • Jayakody, K., et al. 2014. “Exercise for anxiety disorders: Systematic review.” British Journal of Sports Medicine; 48(3):187.
  • Jiang, D., et al. 2016. “The role of Tai Chi in mental health management — Lessons learned from clinical trials.” Reviews on Recent Clinical Trials; Jul 29. [Epub ahead of print].
  • Kantor, E.D., et al. 2015. “Trends in prescription drug use among adults in the United States from 1999-2012.” Journal of the American Medical Assn.; 314(17);1818.
  • Kim, T.K., et al. 2016. “Chronic stress and moderate physical exercise prompt widespread common activation and limited differential activation in specific brain regions.” Neurochemistry International; S0197-0186(16)30091-2.
  • Lindheimer, J.B., et al. 2016. “The effect of light-intensity cycling on mood and working memory in response to a randomized, placebo-controlled design.” Psychosomatic Medicine; Aug. 20. [Epub ahead of print].
  • Mothes, H., et al. 2016. “Expectations affect psychological and neurophysiological benefits even after a single bout of exercise.” Journal of Behavioral Medicine; Aug. 9. [Epub ahead of print].

 

Victor Katch

Victor Katch

VICTOR KATCH has been active in the exercise, nutrition, and weight control arena for more than 40 years at the University of Michigan. He earned his undergraduate degrees in international relations (political science) and physical education (kinesiology) from California State University at Northridge. He also did undergraduate work in international relations at the prestigious University of Uppsala in Sweden. Katch's graduate degrees are from the University of California, Berkeley. He is a professor in movement science in the School of Kinesiology. He has three children and five grandchildren, and is an avid exerciser who enjoys year-round walking and jogging with his wife, Heather, and playing golf whenever possible, weather permitting.

COMMENTS

  • Karen Markey

    A super-duper article I’m sending to sedentary friends to help convince them to get out there and get moving!

    Reply

  • Chris Arbor - 2016

    Helpful article. I’m just confused on how this math works out: ”Almost 60-70 percent of Americans – nearly 3 in 5 adults – take at least one prescription drug. That’s about 13 prescriptions for every man, woman, and child.” It seems to suggest that the average number of prescriptions for people who take at least one prescription is on the order of 15 prescriptions at any given time. I find that hard to believe. I would assume that most people taking more than 10 prescriptions are in hospital.

    Reply

  • Andy Idema - 1996

    Super-duper indeed. Informative.

    Reply

  • Russell Lyons

    Chris Arbor: The figure “13 prescriptions for every man, woman, and child” is unrelated to “Almost 60-70 percent of Americans – nearly 3 in 5 adults – take at least one prescription drug.” Instead, it comes from the total number of prescriptions written by doctors in a given year divided by the US population. I found that out by simply Googling the phrase “13 prescriptions for every man, woman, and child”. In particular, that phrase should have been written something like “13 prescriptions written per year for every man, woman, and child”.

    Reply

  • Russell Lyons

    Wow: in the time I used to write my comment to respond to Chris’s question, the confusing sentence disappeared from the article without mention.

    Reply

    • Deborah Holdship

      Thanks for clarifying, Russell. I was in the process of doing the same thing and took down that sentence in the interim. Appreciate your help! (Ed.)

      Reply

  • Muffy MacKenzie - 85

    Challenge on! Putting my shoes on for a walk right now!

    Reply

  • Susan Truckly - 1985

    I am disappointed that your article did not contain any reference to the appropriate and effective use of mood stabilizing and antidepressant drugs for people with clinical depression or/and bipolar disorders.

    Reply

    • Bonnie Stinson - 1981

      Susan, you are absolutely correct. The medications that are available today are lifesaving, not only in terms of suicide, but in terms of allowing those with a mental illness to have a full life. Clearly, those who believe that a walk outside will cure schizophrenia, bipolar illness, major anxiety disorders, etc. do not understand the true nature of a mental illness. Furthermore, the article’s attitude is insulting to those who work to help those with a mental illness as well as to those who are living with these issues.

      Reply

    • Rachel Kaminskiy - 2013

      I agree and thank you (Susan) for your comment. While exercise can help with the symptoms of mental health conditions it may not be effective enough to allow someone to function. Just as there are people who have high blood pressure or cholesterol even if they eat well and exercise, someone may require the use of medication to lesson the symptoms of their mental health condition.
      Folks who suffer from addiction are more likely to have a co-morbid diagnosis of a mental health condition (likely was present prior to the start of substance use). The brain of a person fresh into sobriety may benefit from these types of medications as it will likely be deficient in the ability to re-absorb serotonin for many months into sobriety.
      …I’ve gone on for long enough!

      Reply

    • Caroline Smith - 1957

      Susan Truckly, I agree with you. I know that exercise is a natural “upper”, but exercise alone cannot be expected to treat those persons diagnosed with clinical depression or bipolar disorders.

      Reply

    • Victor Katch

      Of course you are correct, mood stabilizing drugs can be effective and appropriate for many people, where other “natural” remedies simply do not work. Thank you for bringing this important point to the attention of the readers; I should have included this in my article.

      Reply

  • Annie Wallace - 1969

    I about a Fitbit 3 years ago and just received my Great Wall of China award. I have walked 5,500 miles..and I will be 70 in a few weeks. I LOVE all the benefits and especially being outside enjoying what the world has to offer each day.

    Reply

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