Okay, this is pointless. I don't think I'm going to post on this thread any longer.
Your description of how the diagnosis of depression is made is blatantly incorrect.
I said absolutely nothing about the diagnosis of depression. I mentioned the quantified scaling of depression for the purpose of evaluating treament.
The answers on a survey in no way substitute for the experience and training of a professional.
Answers on a survey are what is used to quantify improvement. What has that got to do with the need for experience and training?
It may not be practical to do brain biopsies to diagnose serotonin deficiencies, but that doesn't mean there haven't been actual measures of serotonin which correlate with other diagnostic criteria for depression.
As I recall, I was the one who first mentioned this. In any case, there is not a 100% correlation between depression and serotonin levels, so even if we had that test it would not be used to evaluate treatment.
To you and to the others posting in this thread that believe depression is subjective, there are no physical measures, and so on,
I didn't say that.
I ask what research have you read on
neurotransmitters?
The belief everything has to be diagnosed with a laboratory test indicates naivety about how a health care practitioner actually makes a diagnosis.
I didn't say that.
The fact you think a diagnosis which can be measured in blood levels is superior to that of a good diagnostician's observations reveals your lack of knowledge about just what is involved.
Of course it's superior if you are trying to quantitatively compare different treatments. I said nothing about diagnosis.
I don't know what your reasons were for making such a claim
I don't what your reasons are for making the claims you're making.
but people without a medical provider education often look at diagnostic guidelines or criteria for a diagnosis and draw the incorrect conclusion that interpreting the criteria is a simple matter. In reality, it just isn't that easy.
I never said anything of the kind.
Take something as simple as pain. If pain is listed as a feature of appendicitis can you then just go out and tell when someone with pain might have appendicitis? Even if you know to look for lower right quadrant abdominal rebound pain you still could not
distinguish potential appendicitis with any degree of accuracy without additional training and experience.
I don't see any relevance to the issue at hand.
The diagnostic criteria for depression are assessed generally by an extensive interview and other observations one makes when seeing a patient. You are looking for any number of things which are not merely on a "list". You would have seen other patients who had similar symptoms that you can compare their degree of depression with the symptoms your current patient has. You would have had experience with patients who were suicidal as well as patients who were grieving and not necessarily pathologically depressed. You would be looking at body language, drug and alcohol use, family dynamics, stress, and so on that contributed to the patient's current condition.
None of which is useful in comparing treatment efficacies unless you quantify it.
As to the different slant different specialties focus on, while I totally disagree with your examples,
What examples?
there is some truth to the statement, but in no way is it to the degree you claim. Nor is psychiatry that unscientific such as to make every treatment as meaningless as the next. A surgeon may very well think a surgical intervention is the first choice while a medical provider might prefer to try drugs first. One psychiatrist may prefer to try counseling first, while another has found drug treatments much more successful.
I'm really not sure what you're getting at. This seems fairly obvious.
One cannot conclude that because multiple treatments are equally effective those treatments are merely placebos.
Since I never said any such thing, I'm running out of ways to answer you.
And because different providers prefer different options does not mean any provider is wrong. There are many times you do have more than one choice of treatment. They may work equally well. In such a case either the provider or the patient might prefer one treatment over another or might respond to one treatment and not the other. Counseling may be effective with some patients but it is not superior to medications for depression. Some patients do respond to different drugs making any study which only looks at SSRIs incomplete.
More common sense without any real relevance.
But I see no research which indicates one can talk a person out of depression who has a true neurotransmitter deficiency any more than you can talk a person out of Parkinson's symptoms caused by dopamine deficiency.
At last, a claim I could comment on. But unfortunately, I'm tired of googling up studies for you.
At the same time, the science of mental illness lags behind the science of other illnesses. But it isn't so far behind as to be unscientific or nothing more than placebos and guesswork. What is lagging are treatments which are as effective as needed to restore all mentally ill persons to normal levels. We can help some people function better, but that person may not reach a level where they are no longer noticeably mentally ill. OTOH, a diabetic may look OK with treatment, but we haven't reached the best outcome for them either. The diabetic still has severe damage accumulating and will often have many medical problems despite the best treatment.
All fairly straightforward and obvious, so I really don't see why you're bothering repeating it.
The "therapists" you listed are not all "doctors". They range from counselors with a little training to medical doctors.
I could have missed some, but I made an effort to only quote competent and respected doctors, either MDs or Psychologists.
In the field of psychology there are plenty of unlicensed providers and sham treatments available.
This is not true, at least not in the U.S. Psychologists are licensed. Unlicensed providers exist of course, but they cannot call themselves Psychologist.
It's my understanding French psychiatrists may still use techniques developed by Freud. Those providers, treatments and theories are not what modern evidence based psychiatry is all about and should not be confused with true psychiatry.
This may be true, but I don't see how it relates to any of this.
As to effectiveness of SSRIs, just how many
outcome studies have you read in order to draw that conclusion?
SSRIs are moderately effective. I never said they weren't.
Well, I count roughly ten incidences of you accusing me of saying things I never said, and five comments that are broadly true, but have no relevance to anything I said. There is obviously no point in my saying anything to you. Good luck on whatever it you are trying to do.
