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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

#91

Post by hndamien »

colordrops wrote: post #78
dsego wrote: post #66

Earlier quoted context omitted.

I am also very disillusioned with the psychiatric profession. The way they prescribe drugs seems no better than guesswork. Two years ago my dad having what I recognized as parkisonisms and akathisia but the psychiatrist said it wasn't possible because they had stopped giving him haldol. But then when she saw him, she said why we didn't come sooner (it's always the patient's fault) and quickly prescribed akineton. Thi…

Making money for big pharma, unfortunately. It's really ugly out there.

The was a guy named Loren Mosher who was the head of the National Institute of Medical Health (NIMH) who vehemently spoke out against the use of neuroleptics. He was removed from his position despite there being numerous studies (including one done by the World Health Organisation (WHO)) indicating that the use of these/ access to drugs were correlative to rates of chronic conditions. He also ran the Soteria project that had moderate replicable success without drugs by having patients live together in certain controlled conditions.

Re: Calling for a new approach to depression

#92

Post by hndamien »

dsego wrote: post #72
seibelj wrote: post #36

Years of strict exercise, diet, meditation, breathing techniques, various forms of therapy, and numerous self-help books did not cure my anxiety and depression. 2 weeks after starting a low-dose (10mg / day) of Lexapro made me feel better than I had in 10 years. Don't be afraid of medication if other techniques fail. My life was ostensibly fine, with a good job, friends, and family. I had a chemical issue, which is s…

Glad it works for you. I took a small does for one week. First two days was great, everything had an aura about it. Also, I felt very warm all the time. After 3-4 days I lost erections and then just threw them into the trash bin. Didn't want to risk it. I have a family member who needs viagra because antidepressants messed up his nerves. Psyhcs will tell you it's temporary, well, not always, but they won't admit it.

While I am fairly vehemently against them and pro LSD as an option, I tried a short course of Lexapro and it was mildly helpful for about 3 months. A decade later I had the audacity to try again under different circumstances. Day 3 I had the worst and only panic attack of my life and decided to call it a day and use mindfulness techniques to deal.

Re: Calling for a new approach to depression

#93

Post by gcb0 »

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, $…

thank you for finally making clear the evil incentives behind US psychiatrist being less than drug peddlers.

always wondered how the drug industry managed to coerce a whole professional group into being so malignous to society.

Re: Calling for a new approach to depression

#94

Post by eigenschwarz »

seibelj wrote: post #36

Years of strict exercise, diet, meditation, breathing techniques, various forms of therapy, and numerous self-help books did not cure my anxiety and depression. 2 weeks after starting a low-dose (10mg / day) of Lexapro made me feel better than I had in 10 years. Don't be afraid of medication if other techniques fail. My life was ostensibly fine, with a good job, friends, and family. I had a chemical issue, which is s…

If you don't mind sharing, I am curious about some of the dietary interventions you tried.

Re: Calling for a new approach to depression

#95

Post by refurb »

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, $…

Doctors don't make any money from writing a script (beyond the payment for the consultation). In fact, the would make more money if they used counseling rather an a drug.

Re: Calling for a new approach to depression

#96

Post by mmirate »

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…

> So, I guess that makes me complicit in all this too.

No, that makes the salespeople, and your bosses at that communications company, complicit. We're just as neutral and tool-like as the computers we program.

Re: Calling for a new approach to depression

#97

Post by ianai »

justasitsounds wrote: post #70
dsego wrote: post #51

Earlier quoted context omitted.

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-ef…

Like all side-effect warnings I'm pretty sure the warnings about increased suicide risk are only added after the drugs have been on the market for a while (and having accumulated a few lawsuits). As with the generic 'this product may contain nuts' warnings on food these smack of post-hoc ass-covering to me. While my scepticism of 'alternative' medicine, magical thinking and general woo-woo is as strong as ever, my ex…

I think those side effects are boilerplate across all drugs of the same action/class. Support for this is in the allergic reaction language. This is from someone who recently went through many Rxs in search of something that would work. (The ultimate lesson I learned was to seek professionals that specialize in whatever the chronic illness may be.)

Maybe science and medicine have much yet to learn or are being led astray by current theories.

I am sorry for your loss. My own mother has a severe hack and cough from a life of smoking. I know I’ll miss her deeply when she leaves me someday. I can’t fathom how painful that must be.

Re: Calling for a new approach to depression

#98

Post by jdietrich »

ekwelio399 wrote: post #77
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…

Tenured professor of psychiatry here. I'll give you the summary of research on depression: 1. Emotional state is like blood pressure. It's a continuously varying thing. There is no discrete depressive disease state, just an extreme end of a continuum. 2. Just like blood pressure, though, very high blood pressure (or low) represents an illness state, a potentially very serious one. The etiology is a different matter.…

> Different psychotherapies do not differ in efficacy on average. The superiority of cognitive-behavioral therapy, etc. is a myth.

Slight nitpick: CBT has a much larger and more reliable body of evidence than most other therapies. It's probably no more effective than other therapies, but it is very cost-effective, mainly because of the short duration of treatment. There is some evidence to suggest that self-guided or internet-delivered CBT may be as effective as traditional CBT delivered by a trained clinical psychologist, which would be a huge win in terms of cost and availability.

On a personal level, I'd recommend trying a wide range of psychotherapies if you can afford it. On a societal level, I endorse mass adoption of CBT. It's not necessarily the best therapy, but it's the easiest to deliver at scale. Access to treatment is the issue right now, especially in lower-income countries.

Re: Calling for a new approach to depression

#99

Post by JDiculous »

> 13% of people say they are “engaged” in their work – they find it meaningful and look forward to it. Some 63% say they are “not engaged”, which is defined as “sleepwalking through their workday”. And 24% are “actively disengaged”: they hate it.

In my opinion this should be a national emergency on par with something like the opioid crisis (a symptom of this). We're a nation of depressed, drugged up zombies sleepwalking to our unfulfilling office jobs everyday to pay off our student loan / mortgage debt (yes I know not everyone is in that situation, but even if only 10% are that's 30 million people).

Re: Calling for a new approach to depression

#100

Post by tasty_freeze »

wu-ikkyu wrote: post #7
com2kid wrote: post #5

This explanation does not work for all types of depression. There are people who have wonderful lives, fulfilling jobs, happy families, who are still depressed. We need to be more careful in our language, the word depression has become overused, much like the drugs used to treat it.

>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 is an artificial event that never really happened, your emotional state and your physical state don't care what your intellectual understanding is.

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