Anti-depressants doing more harm than good, killing the elderly

[Dancing David]

In this case, saying "partial" and "full-blown" is both misleading and unscientific. (not terms used anywhere on the wiki pages on this, for example) Also the analogy to depression is improper, there is no parallel in genetics or heritability, this is a condition ubiquitous to age and race. Finally, it's not "full trait", it's developing the disease. We can tell the trait works for a purpose and the disease is an occasional unwanted result. Obviously, many more people have the protective trait than develop the disease. So the fact that this mutation sometimes leads to disease is just a cost that is outweighed by the benefit. When there is no more malaria, the disease starts to disappear, it's a complete picture.

So, depression evolved as a function, and can become disordered for a multitude of reasons, but like sickle-cell, there is nothing "partial" or "not directly selected for" about it.

Yo are correct I did not parse exact language and my usage is confusing:
http://en.wikipedia.org/wiki/Heterozygote_advantage

in the case of sickle cell disease the benefit comes more from the presentation of the individual who are carriers of the single gene set (heterozygous) as opposed to those who have the complimentary gene (homozygous)

So again in this case of sickle cell those who have the (in my faulty language) partial trait (heterozygous) are likely have a benefit in reproduction due to the the protective effects vs. the detriment, but those who have the (in my faulty language) full trait (homozygous) are likely to have a detriment in reproduction due to increased mortality.

So in depression if we have an even more complex set of genetic factors (which is likely given the multiple pathways currently suggested) then for an individual who has a very high chance of endogenous major depression they are (in my thought) more likely to have a greater preponderance of the expression of those genetic factors. Now it is very likely to be a large number of genetic sites, a mix of homozygous and heterozygous and then inter uterine and post birth developmental factors as well.

So what may be beneficial to an individual in reproductive success as a heterozygous genes in levels of arousal may lead to panic attacks and obsession in those with homozygous genes. But given that there are multiple expressions of depression and currently a growing number of indicated neurotransmitters and biological pathways: this statement is a gross over simplification.

And that is not even considering the developmental aspects differences in enzyme gradients that guide neural development of structure of the brain systems and there influence on later potential for dysfunction.

 

[Dancing David]

You need to look at what they are saying are the homeostatic properties of depression are, not dismiss that aspect of the theory by saying that contentment is homeostatic, if that's your contention.I understand what the words mean individually but have no idea why you think it's a rebuttal.

You're saying that they do not compare treatment with SSRIs with no treatment at all? And that no studies are referenced in this regard?

"In this period of low motivation, energy is saved and new goals can be found."
"In addition, “psychomotory changes,” such as solitariness, decreased appetite, and insomnia also reduce distractions."

You know dude, I swear you have not even looked into this at all. If you had, you'd be offering rebuttals to those common positions, not asking questions.

Myself I wish I had time to look into it more.

I could keep going but yeah, it's late.

Cheers

"In this period of low motivation, energy is saved and new goals can be found."
seems to be asserting the conclusion, I may have missed it but was this more than speculative. was there evidence of this? Is it in the original paper?


I am talking about how these traits such as psychomotor retardation are not beneficial to the individual, so just asserting that the could be (as the article seems to do) would not exactly be what I call not addressing a common position. Now people with extreme psychomotor retardation and other vegetative symptoms are not as common as people might think, yet it is not an advantage for those who have it.

Feeling like you don't have energy and it is an extreme effort to engage in the activities of daily living is not usually viewed by that individual as a great thing.

So the statement that this somehow can reduce distraction seems little odd to me.

 

[Dancing David]

You're saying that they do not compare treatment with SSRIs with no treatment at all? And that no studies are referenced in this regard?

Not really although I have to parse the meta-analysis in the last one:

An alternate view is that current diagnostic criteria do not accurately distinguish between true instances of disorder and normal, evolved emotional responses to stressors (Wakefield, 1992, 1999; Watson and Andrews, 2002; Hagen, 2003; Horwitz and Wakefield, 2007; Andrews and Thomson Jr., 2009; Andrews et al., 2011).

These are the articles except for the Hagen 2003


http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermToSearch=1562108

http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermToSearch=10466261

http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermToSearch=12204312

http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermToSearch=21672593

http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermToSearch=19618990

http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermToSearch=21779273

 

[Pup]

"In this period of low motivation, energy is saved and new goals can be found."
seems to be asserting the conclusion, I may have missed it but was this more than speculative. was there evidence of this? Is it in the original paper?


I am talking about how these traits such as psychomotor retardation are not beneficial to the individual, so just asserting that the could be (as the article seems to do) would not exactly be what I call not addressing a common position. Now people with extreme psychomotor retardation and other vegetative symptoms are not as common as people might think, yet it is not an advantage for those who have it.

Having a mechanism for psychomotor retardation certainly seems beneficial, otherwise we'd be wasting energy constantly. It seems especially advantageous if it kicks in when the organism is engaging in an activity that isn't providing sufficient benefit, such as working toward a hopelessly unattainable goal.

Like other disorders that need "cured," it's only a problem when the mechanism is kicking in for no reason or, unfortunately, is kicking in for the right reason but the reason can't be fixed.

The argument that some people suffer disadvantageously from depression, so depression isn't advantageous for everyone, sounds like saying that some people suffer from cancer, so cell division isn't advantageous for everyone. Well no, of course not, but having a mechanism for cell division is advantageous, but the unfortunate side effect is that it sometimes gets out of control.

Research may or may not bear that out, but the advantage of a mechanism for depression doesn't seem counter-intuitive to me, or something that I'd immediately be skeptical of.

I wonder if the problem is two different uses of "depression," so some are using it as only referring to what we'd call clinical depression, while others like me are using it in its literal meaning, to refer to any depression of psychomotor function, however slight? In other words, I'd be talking about normal cell division and cancer as variations of the same thing and saying it's generally beneficial, while others would consider cell division normal and cancer a separate disease and be skeptical of any hypothesis that cancer is beneficial.

 

[Professor Yaffle]

Lewis Wolpert on his book Malignant Sadness:

The main title, Malignant Sadness, is meant to emphasise the very serious nature of a depressive illness and also to reflect my conviction that normal sadness is to depression what normal growth is to cancer.

http://www.nytimes.com/books/first/w/wolpert-sadness.html

 

[Dancing David]

I wonder if the problem is two different uses of "depression," so some are using it as only referring to what we'd call clinical depression, while others like me are using it in its literal meaning, to refer to any depression of psychomotor function, however slight? In other words, I'd be talking about normal cell division and cancer as variations of the same thing and saying it's generally beneficial, while others would consider cell division normal and cancer a separate disease and be skeptical of any hypothesis that cancer is beneficial.

I agree, I have stated I am using the term as in major depressive disorder and I believe that they do reference that term in the article as well. And that seems to be the focus of teh article as well since they focus on the medical treatement of depression.

But any anxiety is not an anxiety disorder, being a little sad or worn out is not major depressive disorder, etc...

I am trying to say that traits associated with 'depression' such as hightened arousal and anxiety may be beneficial, full blown anxiety is not.

Just so, having circadian rythyms is useful, insomnia and delayed sleep phase is not.

 

[Dancing David]

Lewis Wolpert on his book Malignant Sadness:



http://www.nytimes.com/books/first/w/wolpert-sadness.html

I think one of my supervisors said that the difference between sadness and a depressed mood disorcer is like the difference between weather and climate.

 

[mijopaalmc]

I am looking into the hypothesis that the monoamine homeostasis is at the root of depression, now it will be involved in the neurobiology for sure but the papers assertion that it is the root of depression may be harder to establish.

It is my understanding that the biogenic monamine hypothesis for psychiatric disorder is extremely problematic. This is not to say that biogenic monamines play no role in the neurochemical etiology of psychiatric disorders. However, the relationship between biogenic monamines is necessarily as straight-forward as it is often portrayed. For instance, tianeptine (Stablon, Coaxil, Tatinol), a selective serotonin reuptake enhancer, also functions as an anti-depressant, so looking at the absolute level of serotonin in isolation may not be the best measure of mood disturbance.

 

[Joey McGee]

"In this period of low motivation, energy is saved and new goals can be found."
seems to be asserting the conclusion, I may have missed it but was this more than speculative. was there evidence of this? Is it in the original paper?

It's from an article in the Economist (I'd already linked to) describing the conclusions of Nesse et al., describes a number of studies. The point is that these are the common threads of understanding in the field based on the complete picture of studies done.

I am talking about how these traits such as psychomotor retardation are not beneficial to the individual, so just asserting that the could be (as the article seems to do) would not exactly be what I call not addressing a common position. Now people with extreme psychomotor retardation and other vegetative symptoms are not as common as people might think, yet it is not an advantage for those who have it.

Of course it's not, but a slightly depressed state can be and they have shown that over and over. Severe depression isn't being called an adaption here, it can be termed something like a dysregulation of an adaption. The vegetative state is at the extreme end.

Sickle-cell disease isn't of benefit to anyone either, but no one is saying that sickle-cell trait is not an adaption. It really is not a good analogy though.

Feeling like you don't have energy and it is an extreme effort to engage in the activities of daily living is not usually viewed by that individual as a great thing.

So the statement that this somehow can reduce distraction seems little odd to me.

Right, that's a cost, the benefit is having the time and space to analyse one thing at a time in great detail and make new decisions about life. The key is that if you just end up doing nothing and nothing inspires you, nothing comes along in your life (perhaps the shut down evolved to be reversed by certain triggers, for example social attention or new actors in life), and you're basically just a sick mess, then the adaption has failed, it is not working, and intervention of some kind is warranted.

Pain is not viewed as a great thing either, until people learn what those who do not have the ability to feel pain have to deal with (oops I bit off my tongue, not the hamburger...)

 

[Zeuzzz]

It seems to me that there's a trade-off between quality of life and length of life. Personally I think we too often choose the latter.

This makes it sound like it's either one or the other. It's not.

Many drugs not only improve peoples quality of life but their length of life.

 

[Zeuzzz]

I think one of my supervisors said that the difference between sadness and a depressed mood disorcer is like the difference between weather and climate.

Brilliant analogy.

 

[Dancing David]

It's from an article in the Economist (I'd already linked to) describing the conclusions of Nesse et al., describes a number of studies. The point is that these are the common threads of understanding in the field based on the complete picture of studies done.

I am not sure that an article like that is exactly what I would call a research paper.

And so not really what I would cite here, yes it presents an idea, but hardly shows it in a controlled situation.

If you wish to cite the papers be Neese and Wrosch that would make more sense. This article cites only research by Wrosh, and is unclear if it talks about one or two papers.

Again we come down to the same issue again, in the original article (OP) they refer to clinical depression, but there seems to a variety of uses of a term that is both clinical and common.

It looks like this is the Wrosch paper

http://crdh.concordia.ca/Wrosch_lab/Publications/pdfs/JPSP_2009.pdf

I think you will find that the results are carefully stated but I am surprised by the low effect values and correlates, so I would say suggestive but not definitive.

So any sweeping statements made by others should contain words like 'possible suggests', not phrases like 'demonstrates'

 

[dropzone]

Jesus, Joey, first I shouldn't be in AA and now I shouldn't take my antidepressants? Am I doing ANYTHING right?