Have you ever been prescribed a medication for the side effects of another medication you are already taking? This all-too-common problem is leading to a more insidious problem that I identified in last week’s blog as an epidemic of iatrogenesis: When the treatment is a cause of disease.
In the last blog, we looked at this term in connection with a NY Times article written by Amy Silverstein a heart transplant patient, who had contracted terminal lung-cancer directly (according to her own doctors) as the result of taking a “toxic mix of immunosuppressant drugs her entire life.” She died in between writing that blog and this one. Here’s a link to her obituary. It doesn’t mention a word about iatrogenesis.
Silverstein’s situation is for obvious reasons, not something the average person can relate to. And I don’t know anyone who is familiar with the word iatrogenic. But iatrogenesis is all too common, and from my perspective, oftentimes related to the treatment of health problems caused by stress.
Whether it’s migraine headaches, back pain, depression, anxiety, insomnia or gastrointestinal problems, these issues (which are sometimes caused by stress) are usually treated with drugs. And as we know all too well, most pharmaceutical treatments come with side effects and those side effects are sometimes serious enough to require another prescription to treat a problem caused by the treatment!
Take insomnia for example: In roughly 50% of cases, insomnia is caused by stress. If your choice of action is to take an insomnia medication, chances are you’re going to experience side effects. According to the Cleveland Clinic website: “Approximately eight out of 10 people experience a hangover effect the day after taking sleep medicine. They feel drowsy, have muddled thinking and experience dizziness or balance problems. These daytime effects can negatively impact your ability to drive, work, go to school and complete daily tasks.”
“Additional side effects include:
Constipation or diarrhea
Digestive problems, including gas, heartburn and nausea.”
Now if you are tempted to take medications for any of the above side-effects this would be an all-too-common example of iatrogenesis.
The subtle irony here is, if your insomnia is caused by stress, your prescription is NOT ADDRESSING THE ROOT CAUSE OF THE PROBLEM, it is simply masking your symptom of stress which is sleeplessness. So, if your stress doesn’t go away, your stress-related insomnia isn’t likely to go away either, and if you keep taking your insomnia medications, (not only will you become dependent on them) you may be tempted to take other medications for the iatrogenic conditions caused by the side effects.
Can you see what a vicious cycle this is? Now, another choice of treatment for insomnia is cognitive behavioral therapy (CBT) which has NO SIDE EFFECTS. CBT is going to help you address the root of the problem, which may be a better way to deal with the stress you are experiencing during the day (and don’t forget the secondary stress you feel as the result of lying in bed awake, unable to go to sleep).
CBT, like other complimentary treatments for stress related problems, like meditation, yoga and certain mindfulness practices DO address the root of the problem and don’t put you into this iatrogenic spiral, where you're not only taking medication to hide your main symptoms you're taking medications to treat the side effects!