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Calling for a new approach to depression

theguardian.com

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Re: Calling for a new approach to depression

#131

Post by nasredin »

flowless wrote: post #109
thaw9876 wrote: post #38

> We need to feel we belong. We need to feel valued. We need to feel we’re good at something. We need to feel we have a secure future. And there is growing evidence that our culture isn’t meeting those psychological needs for many – perhaps most... This (emphasized) is what I think is causing my increasing anxiety and depression. I look around at people, talking loudly, showing off, taking selfies, buying expensive c…

Same here. One of the most disturbing scenes I'm witnessing like every night is couple of homeless people sleeping in front of the church while each morning there are these noble ignorants walking around them who even call them selves Christians.. Anxiety is just another term for caring too much in some cases (This was mentioned here on HN last time I was reading similar discussion).

Disagree.

I think you are descibing empathy and selfishness, not anxiety.

Anxiety and empathy are probably somehow connected, but they are different things.

Re: Calling for a new approach to depression

#132

Post by paines »

milankragujevic wrote: post #87

I am disenhearted by the apparent pseudo-scientific thinking in the comments on this article, and how it'll "be better if you just go workout and eat better", which might work for some people, but not for everyone. If there was a scientific study about changing life habits to stop depression, I'd bet that it would have the same amount of effectiveness or even less than SSRIs. I myself have been "miraculously" cured f…

Bice bice jarane!

Thanks for writing this!

Re: Calling for a new approach to depression

#133

Post by musha68k »

milankragujevic wrote: post #87

I am disenhearted by the apparent pseudo-scientific thinking in the comments on this article, and how it'll "be better if you just go workout and eat better", which might work for some people, but not for everyone. If there was a scientific study about changing life habits to stop depression, I'd bet that it would have the same amount of effectiveness or even less than SSRIs. I myself have been "miraculously" cured f…

A good friend killed himself after his doctors put him on meds. We will never know what really happened but it turns out that lots of psychiatric medications first become "effective" in the "drive" department rather than lighten depression syndromes. Not a good dynamic at all when you are already in a suicidal state.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2824975/

Not saying these meds don't work, they actually might work "too well" in some ways and that surveillance of and constant checking-in with patients is very important especially at the beginning and during periods after stopping treatment.

Re: Calling for a new approach to depression

#134

Post by matt4077 »

nasredin wrote: post #126
erkose wrote: post #69

Earlier quoted context omitted.

I'd like to see some controlled studies with marijuana.

Not gonna happen. Cannabis is on Schedule 1. Which, IIRC means zero beneficial medical use (think heroin, cocaine). See the recent article with pictures of the "marijuana" that the government gives to researchers. And with Sessions as the AG, I don't think the situation is changing soon.

"Medical Marijuana" should be a known term for someone who has heard of Jeff Sessions, considering most of the legalisation debate was initially focussed on such uses. https://en.wikipedia.org/wiki/Medical_cannabis lists some uses and existing research.

Depression is probably a bad fit for Cannabis. Within the space of drugs that are used recreationally, Ketamine is (was?) the big hope.

Re: Calling for a new approach to depression

#135

Post by matt4077 »

aaavl2821 wrote: post #68

One of the biggest reasons that antidepressant meds are the go-to treatment for depression in the US is reimbursement. This reason is a cause of another important problem with mental healthcare in the US: shortage of mental health providers Reimbursement for psychotherapy has been getting squeezed in the last several years. Reimbursement for psychotherapy is generally based on time: i.e. $x for a 30 minute session, $…

You make a completely benign mechanism sound like a vast conspiracy...

The simple fact, which you already mentioned, is that psychotherapy takes dozens of sessions with an expert to be effective. Cost of treatment is in the four digits, easily, while medication costs less than $10/week since most SSRIs are no longer protected by patents.

Psychotherapy and medication have almost identical effectiveness, making the latter the preferable first-line option in almost all cases.

Re: Calling for a new approach to depression

#136

Post by Ntrails »

nasredin wrote: post #120
zbobet2012 wrote: post #106

Earlier quoted context omitted.

There are many, many studies on changing life habits (working out) as a methodology to treat depression. It is actually _as effctive_ as SSRI's, and MORE effective for a longterm treatment for depression.* However, _not all treatments work for everyone_. Certain SSRI's work for some and not others. This also holds for exercise. [1] https://www.ncbi.nlm.nih.gov/pubmed/26978184 [2] https://www.ncbi.nlm.nih.gov/pmc/arti…

Not an expert. Low energy often comes with depression. So it's not easy as telling a depressed person to "do more exercises". Depression is "invisible". I like to think that being depressed is like having a broken leg. You can't just get better by yourself, you need proper medical treatment.

Also Not An Expert.

Replace the broken leg with a generic bad back (non surgical) and it's not a bad equivalence.

Medical advice in many cases is to do things which hurt (exercise, stretching, lose weight) otherwise the back won't get better, but doing nothing will almost certainly lead to stagnation or a worsening of the condition. You can take pills which may reduce the pain, but those are not really a long term solution on their own.

I don't wish to diminish how hard it is (in either case, intentionally causing yourself discomfort is utterly exhausting in every way). It often is both possible and beneficial so be wary of writing off a school of thought entirely.

Re: Calling for a new approach to depression

#137

Post by zafka »

matt4077 wrote: post #134
nasredin wrote: post #126

Earlier quoted context omitted.

Not gonna happen. Cannabis is on Schedule 1. Which, IIRC means zero beneficial medical use (think heroin, cocaine). See the recent article with pictures of the "marijuana" that the government gives to researchers. And with Sessions as the AG, I don't think the situation is changing soon.

"Medical Marijuana" should be a known term for someone who has heard of Jeff Sessions, considering most of the legalisation debate was initially focussed on such uses. https://en.wikipedia.org/wiki/Medical_cannabis lists some uses and existing research. Depression is probably a bad fit for Cannabis. Within the space of drugs that are used recreationally, Ketamine is (was?) the big hope.

Ketamine is being used by quite a few doctors to treat depression. There are actual "Ketamine clinics" that specialize in it. The big guys are catching on to the fact that is works, and are devising analogues: http://adisinsight.springer.com/drugs/800037644

Re: Calling for a new approach to depression

#138

Post by Sean1708 »

marian_ge wrote: post #47

Dismissing the scientific trials as flawed by cherry picking and then choosing an anecdotal cow to make a point seems ironic to me. The only thing I can get from this is that we may not have the whole picture regarding depression and focusing only on medication is the wrong thing. But as far as I know from people battling with this is that even in my country the doctors strongly recommend lifestyle changes and hours…

Yeah the author said something along the lines of

> beyond only the packs of pills we have been offered as often the sole item on the menu for the depressed and anxious

several times in that article, and it just doesn't ring true for me. Maybe the author is specifically talking about American psychiatry or maybe the people I know were just lucky, but all the people I know that have been to their GP about depression or anxiety (granted not a huge sample size) were offered CBT first and foremost and only one of them was prescribed medication at all in the end.

Re: Calling for a new approach to depression

#139

Post by [deleted] »

tasty_freeze wrote: post #100
wu-ikkyu wrote: post #7

Earlier quoted context omitted.

>There are people who have wonderful lives, fulfilling jobs, happy families, who are still depressed. If someone truly feels and believes they have a "wonderful" life, it would seem they are not suffering from crippling depression. Though what I think you're trying to say is there are people who are depressed even though they seem to have all of their basic human needs being met.

You must not know anyone well who has depression then. A person can intellectually see that their life is not so bad ... but their emotional and corresponding physical state are an entirely different matter. An analogy I make sometimes is this. Have you ever been scared while watching a scary movie, or laughed at a comedy or teared up at a fictional drama? Even though your intellect knows the thing you are watching i…

[deleted]

Re: Calling for a new approach to depression

#140

Post by wu-ikkyu »

tasty_freeze wrote: post #100
wu-ikkyu wrote: post #7

Earlier quoted context omitted.

>There are people who have wonderful lives, fulfilling jobs, happy families, who are still depressed. If someone truly feels and believes they have a "wonderful" life, it would seem they are not suffering from crippling depression. Though what I think you're trying to say is there are people who are depressed even though they seem to have all of their basic human needs being met.

You must not know anyone well who has depression then. A person can intellectually see that their life is not so bad ... but their emotional and corresponding physical state are an entirely different matter. An analogy I make sometimes is this. Have you ever been scared while watching a scary movie, or laughed at a comedy or teared up at a fictional drama? Even though your intellect knows the thing you are watching i…

You're assuming our intellectual assessment of our lives is always right and without bias. Just because we don't recognize something as being "real" doesn't mean it can't have real effects on your mental wellbeing.
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