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Experimental depression treatment is nearly 80% effective in controlled study

med.stanford.edu

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Re: Experimental depression treatment is nearly 80% effective in controlled study

#261

Post by slfnflctd »

ishche wrote: post #143
gexla wrote: post #82

Earlier quoted context omitted.

Noticed that both you and the OP mentioned drinking. Just the drinking can cause much of this. Drinking screws up your sleep cycle, which can also cause much of this. Drinking sessions are also time consuming, so you have less time for other things you enjoy anyway. Sure, some things you can do while drinking, but those may not be the things you would prefer to be doing while sober.

I was under impression that an alcohol causes a depression.

That's a massive oversimplification which came out of non-scientific 12 step literature and is simply not true in many situations.

I have on many occasions beaten back total anhedonia and a desire to die with a few drinks. It's not an optimal solution obviously, but when your options are limited it is sometimes quite preferable to not drinking.

Re: Experimental depression treatment is nearly 80% effective in controlled study

#262

Post by SketchySeaBeast »

comboy wrote: post #185
pcurve wrote: post #57

“I don’t procrastinate anymore,” he added. “I’m sleeping better. I completely quit alcohol. I’m walking my dog and playing the guitar again, for nothing more than the sheer joy of it.” Most importantly, he said, “I’m remaining positive and being respectful of others. These are big changes in my life.” Serious question: are these typical signs of depression? Now I'm wondering if I have depression.

I think symptoms of depression are reduced to too few dimensions (these being all disorders names coming from a science which cannot reproduce most of its results). Imagine Einstein. He can't figure it out and solve the constant problem. Somethings not right. He's not happy, not sleeping well. He's thinking hard. But then, he takes a pill. Suddenly, no more thinking during bike rides. "I'm just looking around and dop…

Depression and other disorders are primarily described by being disproportionate responses to stimuli. The astronaut isn't clinically anxious being up at 2am before the launch, but if they were because they had to drive to the post office tomorrow that would be. That's not a world solving problem that's keeping them up at night, it's just trying to live. That's the difference.

Re: Experimental depression treatment is nearly 80% effective in controlled study

#263

Post by halfmatthalfcat »

FailMore wrote: post #176

While depression can certainly be caused by chemical imbalance and not because of how your unconscious mind impacts/limits your experience of life, I took the approach that exploring my subconscious through therapy was the way to get out. For me it worked very well and I think the journey is an amazing one to go on. Building from the ground up and understanding all the foundations within. I always wonder about treatm…

I want to echo this. I spent many years in therapy getting to the root of my issues stemming from childhood. It was the most fantastic and arduous experience I’ve ever done.

Therapy helps cultivate self awareness which in turn strengthens inner dialog and allows you to reflect on yourself, almost in third person.

It’s a shame our society stigmatizes therapy to such an extent but it really is a miracle cure for many mental health issues if you put the work in.

Re: Experimental depression treatment is nearly 80% effective in controlled study

#264

Post by errcorrectcode »

For 10 years, I fooled myself into believing I could think my way out of severe depression without medication. It wasn't possible in my case because the physiological and psychological effects were far more extreme than any change of mood or exercise could influence. Then, I took a particular medication and it was like the clouds parted for a couple of years but its effects faded.

I have what could be characterized as treatment-resistant depression. Currently on my 16th antidepressant with a 4th adjunct and they also aren't working.

TMS was suggested but requiring 30 minutes 5 times a week for 6 weeks, followed by 3 more weeks of every other day. This is inconvenient for most people.

Also suggest was ketamine, however it's not widely available here. I'm onto my 4th psychiatrist within a year because of a lack of bedside manner, lack of professionalism, and/or generally lack of a coherent, tailored treatment strategy. I'm finding psychiatrists appear to have worse attitudes and least evidence-based approaches compared to most clinicians. I heard a quote that stuck with me "What's the only medical discipline that treats a body system without examining it?"

Re: Experimental depression treatment is nearly 80% effective in controlled study

#265

Post by naasking »

aabceh wrote: post #244
jjeaff wrote: post #230

Earlier quoted context omitted.

I'm not sure I understand what you are saying. Just that we shouldn't recognize that depression can be a chemical issue because that doesn't help us fix the problem? Are you saying that anti-depressants don't work? So if depression is more about mental models, life choices, and drive and whatever, why do so many people suffer from depression in cycles? There is little change from one day to the next, and yet, many pe…

Anti-depressant alter your brain chemicals almost immediately once you start taking them but the anti-depressant effects usually come a couple of months after. Which suggests there might be more to the issue than just a 'chemical imbalance'.

Altered brain chemistry influences the physical prevalence of the receptors that those chemicals act upon. Those adaptations can take some time.

Re: Experimental depression treatment is nearly 80% effective in controlled study

#266

Post by neuroma »

jjeaff wrote: post #230
neuroma wrote: post #226

Earlier quoted context omitted.

Great Post, thank you for sharing. I do take issue with the commonly parroted claim that depression can be a chemical imbalance. It's a notion arising from pharma marketing psyops, and is largely without utility. It even risks being an antipattern. The few pros include separating responsibility and thus alleviating some guilt, which often coexists with depression, and annoying spiritualists. Tell me if I missed any.…

I'm not sure I understand what you are saying. Just that we shouldn't recognize that depression can be a chemical issue because that doesn't help us fix the problem? Are you saying that anti-depressants don't work? So if depression is more about mental models, life choices, and drive and whatever, why do so many people suffer from depression in cycles? There is little change from one day to the next, and yet, many pe…

Okay how about a new analogy:

Your web app malfunctions, and a diagnostic sweep suggests the code is compromised. It's cloud hosted and open source. You're part of a team and see various recent revisions that could have exposed the app to malicious use. Furthermore your cloud provider is upgrading their hardware. Your app has to come offline whilst it's patched. Its a critical service for some clients who are hounding you.

You ask for help from a professional to get things back and working.

They say, "It is due to an electrical imbalance in the computers."

In psychiatry people are analogously doing just that.

We know sure that neurotransmitters have a role in mental health, in the same way as engine oil has a role in a car. Right amount in right place is necessary, but not sufficient, for good operating. If I brough you my faulty car and you jept harking on about engine oil, I'd be miffed.

Incidentally I'm a staunch monoist materialist and believe brain states and mind are facets of the same phenomena. My gripe is with pharma marketing penetrating our collective psychology. Equating depression to monoamine derangement was a very attractive notion for all but in 30 years remains unproven, and not very helpful in guiding treatment.

Re: Experimental depression treatment is nearly 80% effective in controlled study

#267

Post by Ovah »

Fun fact: the number needed to treat (NNT) for SSRI, the first line medication for depression, is a whopping 11! The NNT tells us the number of people we need to give a drug to in order for just one person to receive a benefit. I.e. if 11 people with depression are prescribed SSRI, only 1 of 11 will benefit from it. At least that's what I was taught in med school. Psychiatry has in the past decades been a game changer for schizophrenia, bipolar etc. But I feel like there room for so much more to be done for people with 'mild' anxiety and or depression.

Re: Experimental depression treatment is nearly 80% effective in controlled study

#268

Post by matbatt38 »

andai wrote: post #111
ajaxexact wrote: post #79

Earlier quoted context omitted.

If you feel persistently low, tired, unhappy, or unable to do things then it's a real possibility. The PHQ-9 is a pretty standard depression screening questionnaire that you can complete in a minute or two. https://www.mdcalc.com/phq-9-patient-health-questionnaire-9

This doesn't control for the fact that the world sucks now, does it? I read a few months ago that ~25% of young adults had thoughts of suicide in the past year, so I think it's safe to say that the causes are more external than internal at this point.

> This doesn't control for the fact that the world sucks now, does it? I read a few months ago that ~25% of young adults had thoughts of suicide in the past year, so I think it's safe to say that the causes are more external than internal at this point.

How did you come to think depressions' cause must be internal ?

Re: Experimental depression treatment is nearly 80% effective in controlled study

#269

Post by comboy »

SketchySeaBeast wrote: post #262
comboy wrote: post #185

Earlier quoted context omitted.

I think symptoms of depression are reduced to too few dimensions (these being all disorders names coming from a science which cannot reproduce most of its results). Imagine Einstein. He can't figure it out and solve the constant problem. Somethings not right. He's not happy, not sleeping well. He's thinking hard. But then, he takes a pill. Suddenly, no more thinking during bike rides. "I'm just looking around and dop…

Depression and other disorders are primarily described by being disproportionate responses to stimuli. The astronaut isn't clinically anxious being up at 2am before the launch, but if they were because they had to drive to the post office tomorrow that would be. That's not a world solving problem that's keeping them up at night, it's just trying to live. That's the difference.

Unless there would be something big at the office. Or they hated they job. Or they get burned out because it offers them no life-work balance and space for other activities and relationships outside of it.

In all cases above it's not the brain chemistry that you probably want to fix. But you probably can do just that..

Re: Experimental depression treatment is nearly 80% effective in controlled study

#270

Post by naasking »

comboy wrote: post #214
leafmeal wrote: post #211

Earlier quoted context omitted.

Anti-depressants aren't like a "happy pill". It's not like soma from a Brave New World.

OK, in too much simplified version: you not being content with the state of things may not necessarily be your fault - it may be the things fault. Of course you can change yourself, all problems are within you, they are created by your optimization function. Apocalypse is not a problem unless you don't want it to happen. Without people who don't make themself content with the state of things right now it's not a nice…

I don't think it's ever the thing's fault. If you're actually depressed about not solving a really challenging problem, this results from a process that works differently in people who aren't susceptible to depression. For instance, maybe you get depressed because you thought you could solve it much more quickly, and you're realizing your self-assessment is entirely wrong, and this starts negative thought spirals that maybe your abilities to do anything are over inflated, and that you'll just experience frustration and negative emotions in tackling anything, and this sucks the drive and enjoyment you used to experience from any of your hobbies.

If you weren't susceptible to depression these spirals wouldn't take hold, you might just say, "huh, now that I've learned more, I realize this is a harder problem than I first thought" and you just carry on.

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