Law & Order SVU: Antidepressants

In an episode of Law & Order: Special Victims Unit, a man placed on antidepressant medication kills in a fit of "manic" behavior. Yet mainstream tv sends mixed messages.

I started channel surfing last night and ended up watching most of an episode of Law & Order: Special Victims Unit. As part of the secondary plot of the episode "Uncle", an elderly man - the uncle of one of the show's recurring characters - is put on antidepressant drugs to help him fight debilitating depression. Uncle Andrew perks up and becomes involved with his life again. Perhaps a little too much so. When an accidental run-in with a rapist the police are having trouble convicting brings him into the episode's primary plot, he goes into a manic rage, "takes matters into his own hands," and kills the criminal himself.

I was shocked - not by the degree of violence (which anyone exposed to the media has come to expect from television) but by what I consider a distressingly accurate portrayal of the dangerous effects of antidepressant drugs.

Anyone who has been watching the news knows that the past decade's widespread recognition of depression as an illness has led to greater acceptance of the disease, as well as an increase in the perscription and use of antidepressant drugs.

Now that it's considered a physical as well as psychological ailment, more people than ever are willing to admit to being depressed. They are also seeking treatment - treatment that doctors are eager to provide.

Depression, anxiety, stress, moodiness, hormonal imbalance, weight gain, weight loss, eating disorders, postpartum depression - any of these or a long list of other symptoms are cause enough for many doctors to perscribe antidepressant drugs... whether or not they are truly needed.

I don't doubt that, properly used and administered, antidepressants help some people. The trouble is that no one is really sure when. And using these drugs as a cure-all without enough knowledge of their risks may have some pretty scary side effects and implications.

Increasingly, these drugs are being given to children and infants to treat attention deficit disorder (ADD) and attention deficit hyperactivity disorder (ADHD), despite the fact that most antidepressant drugs have not been tested for safety in children.

What's more, the news is revealing a disturbing trend of outbreaks of violence and killing sprees whose perpetrators had been on antidepressants meds or who had just changed their dosage or perscription of the drugs. (My first response when I heard about the Virginia Tech masacre was, "I wonder what kind of antidepressant he was on?")

In the Law & Order: SVU episode "Uncle", a police psychologist diagnoses Uncle Andrew's behavior on the drugs as "manic" - a reaction that some people, he says, will have when taking antidepressants (implied is that it only occurs when they take the "wrong" antidepressants; moments later he's trying to convince Uncle Andrew to try a different drug). Andrew could be acquitted on an insanity defense, he says, because his behavior when he killed under the effect of mood-altering drugs was not sane and was not his own.

Those who have come off antidepressants often report feeling this same gulf between their behavior and feelings while on the drugs and their behavior while they are "themselves." The drugs put a wall between them and the world.

Many report feeling angry, unable to express themselves, or increasingly desperate to do violence to themselves or other people while taking the drugs. Those who do, whether by attempting to kill themselves or to harm their family, friends, or other people, unanimously report a huge weight of grief and disbelief in the wake of their actions - actions they can't imagine themselves taking without he bizarre unreality the drugs provide.

In the final scene of the episode, when Andrew is pressured to try another antidepressant med for his mood disorder, he forcefully turns it down. Even knowing that without treatment he will return to an unresponsive, nearly catatonic state, he refuses medication - his remorse over the murder he has committed under the manic fog of the drugs is so intense.

I am both pleased and challenged to relate to this tv episode. On the one hand, I'm glad that a popular primetime show has tackled the issue of antidepressant drugs and dealt with it in a way that I found fair and realistic.

But I am also disappointed by the character of the police psychologist who, even after the murder that a man has committed while "manic" on antidepressant drugs, tries to offer him another brand. Just like real doctors, he still has a lot to learn.

Read more: The Dangers of Antidepressant Drugs