dealing w/ depression

[Gaendaal]

[Agreed. I got a little worked up in the earlier post, but I agree that antidepressants are often overprescribed to people who don't need them

Medication, as a whole, is over-prescribed to people who don't need it. The whole issue with antibiotics becoming less effective is due to them being given to people who don't need them, just for the sake of giving them something.

There's various reasons for this, some more nefarious than others.

[quinn]

If all of life is meant to be to improve on one's self, then all of life should be spent doing something...even the act of sleeping, as far as my comprehension goes, is doing something. There will always be some sort of movement, per say, if I'm doing anything right in "life". And it's when I take myself this seriously, that makes everything funny.

[Adrian]

this is very big subject and has become even bigger the longer this thread has been active.
I few thoughts I have:
depression and related afflictions such as bi-polar are hereditary to an extent - if it 'runs in the family' you have a higher risk of getting it, but that only makes you more inclined to get it, it's not a guarantee that you will... other factors such as upbringing, social environment and basically what happens to you in your life also come into it.
Therapy and medication will help, but getting the right diagnosis is tricky (I've found that no two specialists agree on a diagnosis for the same patient), and then getting the right medications will be tricky again. Added to this of course the pharmaceutical industry which often does not have patients's best interests at heart doesn't help either. And this will get worse with DSM-V on the way...
Relapse into depression is very common; even more common than cancer I believe. In fact, I wish to call depression (the serious version of it at least) soul-cancer, because that is what it is, as it is quite often life wrecking and in some cases lethal.
One in 4 people will at least once in their lives develop a mental disorder. That means we all have to deal with it sooner or later, either because we ourselves get afflicted, or directly know someone that is/was/has been.
Let's keep talking about it - even if we can't offer direct help, we can at least let people know that we are willing to listen.

I hope michael is ok.

[schiksalgemeinschaft]

the thing is that people going through normal phases in life (e.g. mourning) are being diagnosed with depression nowadays, prescribed expensive medication, etc.

so my question is: where do these figures (1 in 4 develop a mental disorder) come from, and what does "mental disorder" mean? Being upset for a couple of months because you lost your job? Does that count?

[bryan]

Schik, the over-prescription of drugs is not unique to just this area of medicine. Why not discuss painkillers, cholesterol reducing meds, etc... ? There are plenty other potential soapboxes to step up on, knowhatimean? I take it you specifically have a problem with the idea of depression. OK, then.. what would you propose?

[schiksalgemeinschaft]

Schik, the over-prescription of drugs is not unique to just this area of medicine. Why not discuss painkillers, cholesterol reducing meds, etc... ? There are plenty other potential soapboxes to step up on, knowhatimean?

sure, there are soapboxes everywhere, lots of drugs is over-prescribed, etc. Why not discuss all that? Well, I thought this thread was about depression, not about cholesterol or other health issues?

I take it you specifically have a problem with the idea of depression. OK, then.. what would you propose?

I guess your take is wrong. I'm not saying depression doesn't exist, nor that it can't be a serious thing, nor that medication can't work, I'm only saying that:

a) some* people/doctors/etc draw the depression card too quickly & easily, since it has become a pretty meaningless signifier, nobody seems to know what is meant by the word (as some posts in this thread hint at, and as the broadening of the definitions/criteria in DSM-V signals as well).

b) there are lots of problems with anti-depressants itself: how can we be certain that the placebo effect doesn't play a big role? Since nobody has a clear idea about what depression is, it simply isn't possible to set up falsifiable experiments. As Dehue wrote in her book, not a single anti-depressant has been proven to work in independent, double-blind studies.


What do I propose? More ethics (enforced by state control) in the pharmaceutical industry, and less market-driven healthcare in general.

*edit

[mudd]

i don't think depression is medically ambiguous.

m

[jkudler]

i assume he meant that its diagnosis depends on subjective judgment of a constellation of self-reported symptoms. while it might not be ambiguous at all to the sufferer (which should be what matters), the question is what role medicine should play. that doesn't mean that depression isn't *real,* but it can't be chemically tested the way eg a virus or cancer can be. not to mention that the DSM changes regularly (narcissistic personality disorder no longer exists, if i understand correctly). the placebo effect is very real, but that can be a good thing (eg http://www.nytimes.com/2010/12/28/healt ... tions.html). and i've seen numerous big studies finding little non-placebo value from prescription anti-depressants. of course, some individuals still find them immensely helpful. for my money, while people should certainly seek help for mental health issues, there's just tons of evidence showing things like exercise (especially), eating right, getting sleep, and having a decent social network are highly effective treatments for depression and anxiety.

-j.

[schiksalgemeinschaft]

thank you for phrasing eloquently what I meant.

[jkudler]

aw, thanks. re-reading this thread, i realized other people made similar, very good points, esp. billy. another thing i wanted to add is that in my (fairly limited) experience with therapy, it's good to trust your instincts and be kinda ruthless with ditching someone you don't like in favor of someone you do. there's about a billion schools of therapy out there, and while studies show that just going to *someone* helps and that even talking to semi-educated friends is good, i think it's important to find someone you can be simpatico with and respect.

-jesse

[Jesse]

while people should certainly seek help for mental health issues, there's just tons of evidence showing things like exercise (especially), eating right, getting sleep, and having a decent social network are highly effective treatments for depression and anxiety.

-j.

While I sort of understand the impulse to exchange anecdotal and opinion-based stuff about mental health diagnoses, I will say this: I retired from 26 years of being a mental health clinician in 2008. I saw hundreds of clients, in settings from forensic ICU, to community-based clinics, to in-home therapy. My clients suffered from diagnosed mood disorders, brain disorders and [many] from existential/spiritual and, importantly, economic/class conditions that ameliorated their somatic issues.
That's just a bona fide I offer to say this- these boards are ok for swapping ideas and feelings about a lot of things, but anyone suffering from depression should seek assistance with diagnosis and treatment regimens anywhere but these boards. It's that consequential. Anyone posting their perspective on mental illness need have a care about their audience-when you're in a box of unrelieved pain for long enough, you'll take guidance from anything that floats, frequently to our own peril.
That's my ethical hit, not dismissing someone might post something actually helpful to the sufferer.
To the Kud's point in that quote above, cf. my friend Dr Henry Emmon's work, published as The Chemistry of Joy and The Chemistry of Calm. His fundamental old-wine-in-new-skins presentation of combining diet/exercise/meditation with, at times, medications and talk therapy, was very useful to me in helping the clients I served. We need more integrated humans, so integrative medicine makes sense.

[Wombatz]

. . . having a decent social network [is a] highly effective treatment for depression and anxiety.

-j.

I'm sure the irony is unintentional, but it's deep.

[jkudler]

what, because depression makes people withdraw? sure, but a lot of people can also make an effort to call a friend or family member, or to talk about things they might otherwise feel stigmatized about.

[Adrian]

yes - the stigma needs to go. Please let's talk about it - it's important!

[Moon]

I've had typical depression since I was about 18-19, strange versions of it before that since probably two-three years old, but that might just be stress from domestic violence. I've also had quite bad anxiety for the same amount of time, but have worked hard on getting rid of it, partly successfully. I can now think about doing a job interview without starting to shake and throw up, haha.
Four or so months ago I decided to give my most serious try to get rid of depression, as that little voice of logic that keeps you a little bit above bottom had gotten a lot quieter. After quitting nicotine, exercising more, keeping myself busy with all kinds of projects, trying to be the best boyfriend, I ended up with the worst period so far, which happily enough lasted long enough for something horrible to happen at the same time, amplifying everything into this strange and terrifying, hazy week.

I'm not saying that being social, work satisfaction, exercise etc. don't work, cause it definitely distracts you at least, endorphins and whatnot, but I think I'm going to try to go the doctor way for once, as I didn't really try it seriously last time. Too scared to show up for the therapy, hah. I don't really care if drugs are placebo, I'd use astrology or eat a horse-only diet if it'd help. I'll let you know how it works, I'll probably treat it as some sort of experiment.

Meanwhile, do you think it would be negative for me to assume that the problem might be a 'faulty brain' and not one of those things you can 'think' yourself out of? Last thing I want is to limit myself.

Quick digression: Does anyone else with depression here get a problems with their stomach? I throw up very easily when I'm in bad cycles and get a lot of pains and weird nervous feelings. I remember someone saying to me once that turmoil in the brain sits in the stomach, but can't remember if it was science/psychology or some kind of buddhism thing. Children that are depressed get stomach problems, this is a fact I think. And I'm quite childish

[jkudler]

no, there's lots of science linking the stomach to emotions and such. my doctor friend or someone said there's theories that there's some kind of "second brain" in the gut. it's highly, highly linked to mental states.

-jesse

[faster]

my doctor friend or someone said there's theories that there's some kind of "second brain" in the gut.

http://online.wsj.com/article/SB1000142 ... lenews_wsj

[jkudler]

i man, i read about that last week.

here's some articles on the underlying concept:
http://www.scientificamerican.com/artic ... cond-brain
http://www.nytimes.com/2005/08/24/healt ... .html?_r=1

[faster]

i man, i read about that last week.

I and I would have been surprised if you hadn't.

[jkudler]

http://www.youtube.com/watch?v=PVOME9EkJ_M