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Depression lies

wilwheaton.net

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Re: Depression lies

#171

Post by marklabedz »

Buzaga wrote: post #153
chmike wrote: post #95

Earlier quoted context omitted.

I'm afraid the bipolar diagnostic is probably right. I would say the recurrence of the depression is a sign of that. Correlation with season variations is the most common, but not the rule. Medication efficiency and side effect are known to vary individually. In the end, the only thing that matters is that you find a treatment that helps you to feel and live better. I have heard lithium could help smooth the mood cha…

not even psychiatrists know about their diagnosis, since there's no scientific method at all there, just bullet point stories to try to match with the pacient... so I'd suggest not trying to diagnose people over the internet too

Not to mention the politics behind the DSM.

Re: Depression lies

#172

Post by seunosewa »

danielweber wrote: post #116
seunosewa wrote: post #59

Earlier quoted context omitted.

Do that, and also get some drugs.

If someone can take care of their depression without drugs, they should. The same way that if someone can take care of their depression with drugs, they should.

A lot of people think they are taking care of their depression without drugs. But until they try taking drugs, they may not realise how much the depression they think they are taking care of is actually messing up their lives.

Re: Depression lies

#173

Post by cromulent »

jdietrich wrote: post #137

I am rather disappointed by much of the discussion in these comments. The HN community has always taken pride in being careful, analytical and data-led. If someone were to advocate an unproven cancer therapy based on anecdote, they would rightly be harshly criticised. The evidence base for SSRIs is extremely poor. The most favourable metastudies indicate only a very mild benefit, similar to that of many non-drug inte…

So depression is not pathological but the idea of depression is pathological? How meta.

Your comparison with cancer is odious, as you indicate. The idea of depression may be a cause of depression? Check. The idea of cancer might be a cause of cancer? Ridiculous.

The OP may well have helped people with depression (or their friends) recognize or diagnose or de-stigmatize their condition. Your comment? Not so much.

The social stigma of mental illness is real, and castigating people for relating their experiences, and others for applauding and adding to it, for not being strictly evidence based is not nice. Why didn't he perform a double-blind trial on himself, for goodness sake, and hold off on his blog post for a while? Crikey.

Lots of people commit suicide. Why should it matter to them, or their loved ones, if the cause is neurological or psychological? Why does a better life through SSRI's have to be justified to...anyone?

Re: Depression lies

#174

Post by navs »

mnicole wrote: post #122
navs wrote: post #19

Earlier quoted context omitted.

Also consider that many SSRIs actually list suicidal urges as a side effect. In my transition from Celexa to Prozac to Effexor, I've found that transitioning period to be particularly bad. Not to go into too much detail but I've done things of late I never did before and my doctor has said it's likely my change in medication. They say things need to be at their worst before they can get better. That's my mantra.

Effexor literally made me think and act in ways I never had before. There's the disassociative feeling you get from depression, and then there's what Effexor did; effectively making me a ticking time-bomb with an insanely vivid, active (and morbid) imagination. Really dark times, and coincidentally a few months after I'd quit it, Time magazine had a cover article about the rise of [teen] suicides because of it.

Can I ask what you switched to after dropping Effexor? My email is listed in my profile if you wish to answer privately.

Re: Depression lies

#175

Post by chaostheory »

makmanalp wrote: post #157
chaostheory wrote: post #7

I suffer from "mild" anxiety, which has lead to some depression. At times, it's hard to go to venues where there are huge amounts of strangers or even the office at big corporation X (it's not so great whenever you feel like you're choking); but I power through it somehow. I can't get rid of it, but I've found that heavy exercise (ideally both weights and cardio) really helps to mitigate both the depression and anxie…

Hey, sounds like you might have some (maybe mild, I'm not a pro) form of social anxiety. Talk to someone about it, since there are very good programs (e.g. http://www.bostonsocialanxiety.com/ I've seen lauded on reddit) to help you with that. I've seen people with social anxiety completely transformed.

Yeah I have and that was the diagnosis. Thanks for the suggestion though.

Re: Depression lies

#176

Post by lisper »

cromulent wrote: post #173
jdietrich wrote: post #137

I am rather disappointed by much of the discussion in these comments. The HN community has always taken pride in being careful, analytical and data-led. If someone were to advocate an unproven cancer therapy based on anecdote, they would rightly be harshly criticised. The evidence base for SSRIs is extremely poor. The most favourable metastudies indicate only a very mild benefit, similar to that of many non-drug inte…

So depression is not pathological but the idea of depression is pathological? How meta. Your comparison with cancer is odious, as you indicate. The idea of depression may be a cause of depression? Check. The idea of cancer might be a cause of cancer? Ridiculous. The OP may well have helped people with depression (or their friends) recognize or diagnose or de-stigmatize their condition. Your comment? Not so much. The…

> The idea of cancer might be a cause of cancer? Ridiculous.

Not ridiculous at all. There are all kinds of plausible mechanisms for the idea of cancer to cause cancer. Here's just one example off the top of my head: stressing out over the possibility of getting cancer can stimulate the production of excess stomach acid, which can lead to acid reflux, which is known to increase the risk of esophageal cancer.

Re: Depression lies

#177

Post by SeanDav »

jdietrich wrote: post #137

I am rather disappointed by much of the discussion in these comments. The HN community has always taken pride in being careful, analytical and data-led. If someone were to advocate an unproven cancer therapy based on anecdote, they would rightly be harshly criticised. The evidence base for SSRIs is extremely poor. The most favourable metastudies indicate only a very mild benefit, similar to that of many non-drug inte…

Before I actually experienced depression first hand I might have made a comment pretty similar to yours.

Before you actually experience the sapping, frightening, frustrating, even debilitating condition that is depression, it is easy to stand on the sidelines and make all kinds of logical arguments and find bits and pieces of research supposedly supporting any particular viewpoint, for or against.

I would even have been quite judgemental about the character of people claiming they had depression. After all it just in the mind isn't it? Pull yourself together, get some exercise, eat a healthy diet, would have been my advice. I would also have been missing the point completely. Those are of course all good things to do and will help with depression. The point, is that depression makes you almost incapable of doing these things. Until you experience, either in your own self of through someone very close to you, the full manifestation of depression, you just actually don't have a clue.

You are a virgin trying to talk about sex. You may think you know the theory, you may be very widely read, but you are still a virgin.

Depression is a highly complicated and very subjective condition that cannot easily be diagnosed. It is far from scientifically understood. No one knows exactly why certain drugs work or don't work. This just makes it harder for the sufferers, who often have to undergo all sorts of different drugs/treatments to find one that works for them, that is if they are lucky enough to actually find a treatment that works.

I personally was lucky to find a treatment that worked. It was a combination of CBT and drugs. You can call it placebo effect, you can call it anything you want but for me it works.

I personally know 4 other people who suffer or suffered from depression. 2 of them recovered without drugs after many months, 1 without any treatment and 1 with the "wrong" treatment, i.e. tranquillisers. The third person, like me responded to CBT and drugs, albeit different drugs. The 4th person is not fully cured and suffers bouts. Any amount of different drugs and treatments have not completely controlled the condition.

I am not even sure why I am posting this, other than to try raise awareness that Depression is not simple, it can happen to anyone and often happens to highly intelligent, motivated people as well as your average Joe.

Re: Depression lies

#178

Post by jdietrich »

jdietrich wrote: post #137

I am rather disappointed by much of the discussion in these comments. The HN community has always taken pride in being careful, analytical and data-led. If someone were to advocate an unproven cancer therapy based on anecdote, they would rightly be harshly criticised. The evidence base for SSRIs is extremely poor. The most favourable metastudies indicate only a very mild benefit, similar to that of many non-drug inte…

A commenter asked for citations, so here are the most important:

Meta-analysese of the efficacy of SSRIs: http://www.plosmedicine.org/article/info:doi/10.1371/journal... http://jama.jamanetwork.com/article.aspx?articleid=185157

Evidence of the non-publication of antidepressant trials: http://www.nejm.org/doi/full/10.1056/NEJMsa065779

A good summary of the evidence against neurochemical hypotheses is Eero Castren's "Is mood chemistry?" (Nature Reviews Neuroscience 6, 241-246 (March 2005)), but even the most cursory search on pubmed paints a very clear picture.

Re: Depression lies

#179

Post by im3w1l »

readymade wrote: post #155
jdietrich wrote: post #137

I am rather disappointed by much of the discussion in these comments. The HN community has always taken pride in being careful, analytical and data-led. If someone were to advocate an unproven cancer therapy based on anecdote, they would rightly be harshly criticised. The evidence base for SSRIs is extremely poor. The most favourable metastudies indicate only a very mild benefit, similar to that of many non-drug inte…

The politics of antidepressant medication is a political minefield, all the more dangerous because it seems everyone has to have a strong opinion, regardless of a professional or personal experience. While it's true that the efficacy of SSRIs is not an open and shut case, skepticism such as yours is not exactly the medical consensus either. Some of those meta studies with unfavorable results don't make much of an att…

The first two paragraphs were good.

Re: Depression lies

#180

Post by jdietrich »

SeanDav wrote: post #177
jdietrich wrote: post #137

I am rather disappointed by much of the discussion in these comments. The HN community has always taken pride in being careful, analytical and data-led. If someone were to advocate an unproven cancer therapy based on anecdote, they would rightly be harshly criticised. The evidence base for SSRIs is extremely poor. The most favourable metastudies indicate only a very mild benefit, similar to that of many non-drug inte…

Before I actually experienced depression first hand I might have made a comment pretty similar to yours. Before you actually experience the sapping, frightening, frustrating, even debilitating condition that is depression, it is easy to stand on the sidelines and make all kinds of logical arguments and find bits and pieces of research supposedly supporting any particular viewpoint, for or against. I would even have b…

You seem to be refuting an argument that I haven't made.

Firstly, how very presumptuous of you to assume that I haven't suffered from depression.

Anecdote is not the singular of data. Whether I have or have not suffered from depression has no bearing whatsoever on my ability to analyse the available data. Having had cancer gives you no insight whatsoever into the biology of cell division.

Depression is known to spontaneously resolve in the vast majority of cases without any treatment, which creates a wholly misleading picture of the efficacy of treatments for depression amongst patients. Our most effective treatments for depression only shorten the duration of depressive episodes by a few weeks and reduce the likelihood of relapse by a few percent.

I am not arguing that depression is a simple phenomenon, but rather that it is a complex psychosocial problem for which our best treatments are utterly marginal, and that the clinical model may be a fundamentally inappropriate approach.

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