91–100 of 113 posts
96 out of 522 trials identified as low risk of bias (18%)
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I agree with all of this, and I can’t help but ask: when did we start ignoring people’s environment and their circumstances? I have tens of thousands of dollars of student loan debt (my monthly payment is basically a mortgage payment) and I’m not particularly satisfied at work. Is it any wonder I find it impossible to get out of bed? Now, I try to be careful because, sure, perhaps the depression was already there and…
We're not ignoring their environment. But unfortunately, most of the time drugs are quicker and easier for the prescribers, and therefore cheaper and more available for the patient, than extended psychotherapy, etc. If the underlying problem is a psychosocial stressor, the meds won't fix that, though they might help you control the symptoms long enough that they give you the opportunity/resilience to address the stre…
I know the causes of my issues, there are at a minimum mitigations available but I can't BUY them because everything here is a business and competition and someone else took me out of the race by taking lots of money to end my capacity to compete (poor medical intervention) and I was left holding all the additional baggage with no help. I have friends who suffered catastrophes living in countries who don't think social systems are evil, and they had the tools to heal as much as possible and improve their lives and be able to contribute to the whole again. I wasn't afforded that opportunity and it's been a constant downhill slide.
Pardon the tone and it is not directed at you, it just infuriates me that American society ignores such important things and once someone is not able to WIN in the Thunderdome they are cast aside and/or expected to live with little to nothing and even more needs, while it continues focusing on pushing what are in my view largely ineffective, but very profitable "interventions". I find the predilection for painting over damage in this country over restoring/shoring up someone's foundation to be maddening.
I think that the United States is getting better about dealing with mental health, but we still have a long way to go. This is a little soap-boxy and anecdotal, and I apologize if it's inappropriate here. If I hadn't gotten a prescription for Prozac I probably would have killed myself by now. And I definitely would have destroyed my marriage and most of my important friendships. That's not an over-dramatization, it's…
I'd like to expand a bit and reiterate that not everyone who suffers from depression has primary depression with no discernable cause. Most seriously depressed people in my experience have various situational causes (physical health, financial, social etc) and the depression is a side effect of those and not the main issue. Without tackling the root cause, drugs usually just cover, drag out, and add issues, yet the m…
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>If I hadn't gotten a prescription for Prozac I probably would have killed myself by now. The majority of people with depression just get better of their own accord, for no obvious reason. The NNT for most antidepressants is ~7, meaning you need to give them to about seven patients for one patient to see a clinically-significant improvement. The evidence suggests that there's no significant relationship between SSRI…
I agree with all of this, and I can’t help but ask: when did we start ignoring people’s environment and their circumstances? I have tens of thousands of dollars of student loan debt (my monthly payment is basically a mortgage payment) and I’m not particularly satisfied at work. Is it any wonder I find it impossible to get out of bed? Now, I try to be careful because, sure, perhaps the depression was already there and…
b) Saturation marketing of psychiatric medication has caused the general public to grossly over-estimate their efficacy, even in countries where direct-to-consumer marketing is banned.
c) The wholesale price of a generic sertraline pill is about 4¢, so it's cheap enough to dole out like candy.
d) Medicalizing unhappiness is politically convenient.
If you're depressed, you go to your doctor. That's the message you've been told for decades, it's how our society is set up. In another culture, you might speak to your priest or a village elder. It's undoubtedly a net positive that we've got access to some kind of evidence-based psychiatric care, but a lot of the other structures that people used to rely on for psychosocial care have crumbled. We're less likely to know our neighbours. We have fewer close friends. Our employment is more impersonal and precarious. We're less likely to go to church. If we do go to church, it may well be a megachurch with a congregation of hundreds rather than a close-knit community church.
Doling out pills is the absolute cheapest treatment option, even if some proportion of those pills are expensive proprietary drugs. It's orders of magnitude cheaper than psychotherapy and immeasurably cheaper than building a more humane society. Your doctor can't prescribe a good friend, a sympathetic partner or a better job.
It suits your employer if you conceptualize your misery as the symptom of a "neurotransmitter deficiency" rather than a symptom of your crappy job. You probably won't be as productive, but at least you won't go on strike or burn down your office. It suits the government equally well if you see misery as a personal rather than societal problem.
Some people are just depressed for no discernible reason. Lots of people are being diagnosed with depression when they're just struggling with a shit set of circumstances that would make anyone miserable. The medical model helps some number of people in both camps. Society needs to do a better job of helping people live healthy and fulfilled lives.
I think that the United States is getting better about dealing with mental health, but we still have a long way to go. This is a little soap-boxy and anecdotal, and I apologize if it's inappropriate here. If I hadn't gotten a prescription for Prozac I probably would have killed myself by now. And I definitely would have destroyed my marriage and most of my important friendships. That's not an over-dramatization, it's…
Also would you say the drug cured you? Are you able to function without taking it now?
Horrible side effects, no tests for diagnosis, no actual cures (have you heard of these drugs actually curing depression? No. Once you get on them you are basically on them for life...)... I think this "Science" of psychiatry has a long ways to go to actually get repeatable, scientifically proven results.
Yes the science has a long way to go, but you're ridiculously generalizing. Some people stay on antidepressants long term, but most don't. Many psychotropics are used only short term. I think your test/cure paradigm is a bit of a "red herring"... maybe it would be nice if it were the case, but symptom (and impact) based diagnosis plus subjective improvement to symptoms, functioning and quality of life still counts to…
Funny enough that all the PR and talk from Pharma companies on these psychiatric drugs is all about treatment, and "living"and "coping"with symptoms... No cures, just selling you pills that don't actually work to cure your problem, just masks the symptoms or distracts you with side effects that are worse than your original issue (like obesity, loss of sexual function, etc...)
>"We excluded quasi-randomised trials and trials that were incomplete or included 20% or more of participants with bipolar disorder, psychotic depression, or treatment-resistant depression." Wikipedia defines treatment resistant depression as "cases of major depressive disorder that do not respond adequately to appropriate courses of at least two antidepressants." Maybe I'm unfamiliar with study methodology, but does…
Earlier quoted context omitted.
>If I hadn't gotten a prescription for Prozac I probably would have killed myself by now. The majority of people with depression just get better of their own accord, for no obvious reason. The NNT for most antidepressants is ~7, meaning you need to give them to about seven patients for one patient to see a clinically-significant improvement. The evidence suggests that there's no significant relationship between SSRI…
This is the main reason I stayed away from medication for 12 years. That is until 3 weeks ago. I decided late 2017, after a major depressive episode, that I needed to get help after 12 years of dealing with this depression. I kept thinking that I had a handle on it, and then it coming back weeks, months or years later. I read The Depression Cure ( https://www.amazon.com/Depression-Cure-6-Step-Program-withou... ) abou…
For me the SSRIs completely wiped out my OCD to the point where I sometimes forget that I have problems with anxiety. Depression is downright benign compared to how bad the situation can get with other psychiatric disorders. Unfortunately the demand for competent medical professionals far outstrips what is available.
I do agree that SSRIs are over-prescribed for minor depression problems, but let's not demonize a whole class of medications which are highly useful for more serious psychiatric issues.
Earlier quoted context omitted.
This is the main reason I stayed away from medication for 12 years. That is until 3 weeks ago. I decided late 2017, after a major depressive episode, that I needed to get help after 12 years of dealing with this depression. I kept thinking that I had a handle on it, and then it coming back weeks, months or years later. I read The Depression Cure ( https://www.amazon.com/Depression-Cure-6-Step-Program-withou... ) abou…
I wish you the best. Definitely don’t be afraid to discuss alternatives with your doctor if you’re not happy with Zoloft...sometimes it takes a few tries before you find whaat works best for you.