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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

#51

Post by dsego »

justasitsounds wrote: post #35

There seems to be an increasing number of non-academic articles, essays and books that are expressing the idea that the Serotonin hypothesis of depression is flawed. It seems like the drug industry just picked up this idea in the 70s and has been running with it (to the bank) ever since Anecdotally, I have come to believe that SSRIs have a temporary mood-altering effect, possibly combined with a placebo effect that w…

Almost all antidepressants list the increase of suicide risk as a side effect, which is frightening.

Zoloft for example [1]:

> An increased risk of suicidal thinking and behavior in children, adolescents, and young adults (aged 18 to 24 years) with major depressive disorder (MDD) and other psychiatric disorders has been reported with short-term use of antidepressant drugs.

[1]https://www.drugs.com/sfx/zoloft-side-effects.html

On a personal note, I am very sorry for your loss.

Re: Calling for a new approach to depression

#52

Post by cpncrunch »

blhack wrote: post #24

There are two things that both get called "depression". Like so many other confusing things, this all is the result of fuzzy language. There is depression: the feeling of being sad. This can be triggered by all sorts of environmental factors, and is ultimately a psychological disorder that can be solved by changing environment variables. There is also depression: the neurochemcial/neurophysiological disorder that has…

IMO it seems more likely that there is one "thing" called depression, that it is caused by a number of factors such as stress, emotional upset and illness, and that the chemical imbalance is the brain's way of generating feelings of depression.

Re: Calling for a new approach to depression

#53

Post by jdietrich »

aalleavitch wrote: post #40
drumhead wrote: post #21

I'd like to think that medical professionals and academics in the mental health field have probably been thorough enough in their research to have looked at these finding over the years. I somehow doubt a person whose graduated in Social and Political Science and has no medical or scientific background might actually know what they're talking about in relation to this. Interesting thing about the author. He was a ris…

I feel like the more I learn about psychiatry, the less faith I have in psychiatrists. It is astounding what we don't know, and how wrong we've been in the past. (B.S. in Biology and Psychology, studied neuroscience in school)

There's a bit of a paradox at play.

We know that placebo effect is incredibly important in the treatment of depression and other psychiatric disorders. We know that there are still huge areas of uncertainty and ignorance and that our best treatments just aren't very effective. If we publicly admitted those facts, then our already not-very-effective treatments would get less effective, because the placebo effect would diminish.

If we admit that psychiatry still has lots of glaring deficiencies, then a lot of people will end up getting sicker. If we don't admit it, then we might not invest enough in fixing those deficiencies. Nobody has a clear answer to this quandry.

Is it worth sacrificing some patients now for the benefit of patients in the future? Would admitting the deficiencies in psychiatry dissuade people from seeking treatments that are actually effective? Is it possible to maintain a public facade of effectiveness, while privately accepting that we don't know what the hell we're doing? Would that be ethical? Does the risk of believing your own bullshit outweigh the benefits to patients of getting a good placebo?

Re: Calling for a new approach to depression

#54

Post by rootw0rm »

TheSpiceIsLife wrote: post #27
nixpulvis wrote: post #17

I've been depressed, and I'll tell you this straight up. If a doctor gave me a cow instead of the pills, I would have been way better off... ignoring all the actual problems the cow solved for the rice farmer in the article, just the honesty of the doctors recognizing the real issue in the right spirit would have made me laugh, and prolly "cure" me, at least for a little while.

Getting two (sibling, Border Collie x Foxhound) puppies, and taking a boatload of magnesium and Vitamin D, a fair bit of rock climbing, skiing, jogging, and weight training, seems to have alleviated me of all my anxiety and depression. I obtained a prescription for an SSRI from a doctor, sat in the car outside the pharmacy for an hour staring at the prescription, then drove home. No way, fuck that those drugs. I've a…

I can tell you from experience that you made the best decision of your life right there. I started down that road as an impressionable teenager, and it took me a decade to regain control over my life.

Re: Calling for a new approach to depression

#55

Post by pmoriarty »

"And that’s when, after two more years studying civil servants, he discovered the biggest factor. It turns out if you have no control over your work, you are far more likely to become stressed – and, crucially, depressed."

I wonder how this research squares up with the so-called Executive Monkey experiment, which found that it was actually the monkey with more control that had more stress.[1]

[1] - https://en.wikipedia.org/wiki/Ulcers_in_Executive_Monkeys

Re: Calling for a new approach to depression

#56

Post by nixpulvis »

com2kid wrote: post #44
nixpulvis wrote: post #22

Earlier quoted context omitted.

Sure they have a good life when they try to enumerate the qualities of a good life, what they forget is that some "needs" may be unknown to them, though if they listen the needs aren't usually very quite.

Or they have bi-polar disorder and are on a downswing. That alone will do it. Some forms of depression are medical, people need to be aware of this. Thinking that everyone can be cured by running off and finding one's true self is incredibly dangerous. For some people, that is the solution, but for others, running away from their support network is the exact wrong thing to do. All that said, soul crushing jobs are so…

I think a very large percent of people would be happy with your old time antidote, but it's more an issue of security in realizing that. I would personally change your word meaningful, to my word, sustainable.

P.S. Who said anything about running away from support networks? Listening to your needs I suspect might look like asking someone for help, or something along those lines. But that's just it, everyone's needs aren't the same.

Re: Calling for a new approach to depression

#57

Post by nixpulvis »

wu-ikkyu wrote: post #39
mabbo wrote: post #37

Earlier quoted context omitted.

That's how I've often described it before. Feeling like shit when your life is terrible is normal. Feeling like shit when your life is awesome is not. The problem is that the pill often works regardless of why you feel like shit.

>Feeling like shit when your life is terrible is normal. Feeling like shit when your life is awesome is not. Could it possibly be that our idea of an "awesome life" is mistaken?

BOOM, exactly.

Re: Calling for a new approach to depression

#58

Post by jdietrich »

wu-ikkyu wrote: post #31
drumhead wrote: post #21

I'd like to think that medical professionals and academics in the mental health field have probably been thorough enough in their research to have looked at these finding over the years. I somehow doubt a person whose graduated in Social and Political Science and has no medical or scientific background might actually know what they're talking about in relation to this. Interesting thing about the author. He was a ris…

>I'd like to think that medical professionals and academics in the mental health field have probably been thorough enough in their research to have looked at these finding over the years. You might like to read up on the short history of modern psychiatry. You'll find a great deal of mistakes, pseudoscience, and human rights atrocities.

The same could be said of all of medicine, albeit over a longer timespan. Semmelweis was vilified for suggesting that doctors should wash their hands. Chemie Grünenthal covered up the devastating effects of thalidomide. American manufacturers spent much of the 1980s selling HIV-contaminated blood products to the rest of the world. Less than 20 years ago, rofecoxib (Vioxx) killed about 100,000 people. A lot of surgeries that are routinely performed today are completely unsupported by clinical evidence.

It's largely a good thing that recent history looks hopelessly primitive and barbaric to us, because it means that we're making progress. Psychiatry still has a long way to come, but we need to be careful to not throw the baby out with the bathwater. Access to psychiatric care has a hugely positive impact on the overall disease burden; mediocre treatment is better than no treatment at all.

http://www.thelancet.com/journals/lancet/article/PIIS0140-67...

Re: Calling for a new approach to depression

#59

Post by anigbrowl »

jamesrom wrote: post #25
foobarbecue wrote: post #6

Why did my comment get flagged? I assume this was a mistake, so reposting: tl;dr: Many people diagnosed with depression are actually just sad because modern society is kinda lame. (The article argues this point cogently, and I agree with it.) [I slightly edited this because I think people thought I was saying that I think all depressed people are faking or something]

I think "modern society" is a scapegoat here. You aren't yearning for a more antique society. You are romanticising the past. The part you are looking for is being connected to a community, and there's many more ways to do that today than ever before.

Um, no. You can critique the present as being flawed in some manner without necessarily wishing to go backwards. Your argument seems to rest on the notion that we are at some sort of optimum and any changes to society will inevitably make things worse. You overlook, for example, the possibility that the GP is able to imagine superior future(s) the most probable one and is expressing disappointment at our failure to pursue them.

Re: Calling for a new approach to depression

#60

Post by nixpulvis »

mabbo wrote: post #46
nixpulvis wrote: post #11

Earlier quoted context omitted.

Seems to me this person has a secret issue you're not aware of then...

You're missing the point, I think. What they are saying is that some depression is just purely a disease and not caused by events in life, or not caused by any psychological problem. If you disagree, that's fine, but it sounds to me like you're simply dismissing that idea. Consider it like this: most qualities in humans fall into some sort of normal distribution. Some 1% of the population are the 1% with the least na…

I don't think I'm missing the point. And I'm not saying people aren't effected by chemical levels and biological systems I don't fully understand... what I am saying is, anyone who tells you they have a wonderful life and then tells you they are depressed is leaving out something important.

Now for the critique, the OP didn't really make it clear who's idea of a wonderful life it is. I also use the word secrect as a way to throw some shade, because the word secret implies the owners knowledge of the secret, which is not alway the case here, I should have just said "... has a secret."

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