Meds vs. Meditation for Depression

Iwill never forget the moment a couple of years ago when my bupropion kicked in. I was sitting on the sun porch of an Airbnb on a family vacation. I had started taking the antidepressant about six weeks prior, but had not noticed much difference in terms of my anxiety and depression. But that morning on the sun porch, shortly after taking my daily dose, I distinctly felt a flicker of well-being. Then it flickered out. Then the next day it flickered on again. Over the coming weeks, that sense of well-being grew from brief flickers to my predominant experience over the course of the day. Then again, my mindfulness practice has also grown into something that profoundly shapes my experience of each day. Which “med” deserves the most credit? Medication, or meditation? For many of us affected by depression, modern antidepressants have been literally life-saving. The first antidepressant medications to be approved in the US were monoamine oxidase inhibitors, or “MAOIs” (such as isocarboxazid), and tricyclic antidepressants, or “TCAs” (such as nortriptyline), as well as lithium. MAOIs and TCAs remain in use as second-line therapies, but they have more significant side effects than the more recently developed medications including selective serotonin reuptake inhibitors, or “SSRIs” (such as fluoxetine). Other newer classes of antidepressants including serotonin and norepinephrine reuptake inhibitors, or “SNRIs”, and norepinephrine and dopamine reuptake inhibitors, or “NDRIs” — of which the bupropion I have been taking is the only example approved for the treatment of depression in the US. Many medical conditions improve as a result of the “placebo effect” — the combination of the psychological effects of thinking you are being treated for your condition plus the fact that many diseases (like the flu, or a sprained ankle) get better on their own over time. Extensive investigation over many years has demonstrated that the placebo response rate of depression is right…

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