If I hadn't read the silliness you posted in the other thread on this topic, I would probably debate this.
However it's quite obvious there's little point.
Athon
Evolution of Depression
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If I hadn't read the silliness you posted in the other thread on this topic, I would probably debate this.
However it's quite obvious there's little point.
Athon
Chris Haynes
Perfectly Poisonous Person
Melendwyr's credibility is lower than the credibility of...
Lysenko on plant genetics and
Hulda Clark on medicine and
Christine Maggiore on HIV/AIDS and
Tom Cruise on psychiatry!
I'll see if I can track down the research studies. It's been several years since I last studied the topic in depth.
Briefly, though, the most effective strategy in the short term is a combination of CBT and medication. Medication alone works more quickly than CBT (although still on the order of several weeks to months) while CBT has longer-lasting benefits than medication.
Briefly, though, the most effective strategy in the short term is a combination of CBT and medication. Medication alone works more quickly than CBT (although still on the order of several weeks to months) while CBT has longer-lasting benefits than medication.
The Painter
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I believe the science de jour is that it’s a chemical imbalance in the brain. Not enough serotonin. Did everyone forget Darwin? The weak will die off. In society today we coddle the weak. That is an abomination towards nature. Let the weak suffer, and the strong take over. That’s life. Deal with it.
Oooookay. Can anybody see reason to even begin to address the fallacies in this, or shall I just wipe it off my shoe and keep walking?
Why does the topic of depression always attract so many 'experts' who make statements based more on high-school gossip than actual reading?
*sigh*
Athon
Dunno. Why are you here?
a_unique_person
Director of Hatcheries and Conditioning
My own take, it's a degenerate take on the noble "You go on without me" emotion that is necessary at times in a society/group that is often desperately short of resources. The majority live because a few go without.
It will take a while for me to track down the actual research. Until then:
http://www.healthyplace.com/communities/Depression/treatment/therapy/psych_vs_meds.asp
http://www.aafp.org/afp/20060101/83.html
http://www.findarticles.com/p/articles/mi_m3225/is_1999_Feb_15/ai_54113299
I'm sure if you take thirty seconds to perform an appropriate web search, you'd be able to find validation of my claims quite easily. It actually requires a dollop of thought, however, while failing to consider a standard and non-controversial claim until evidence for it is produced is not, so you may not be interested.
http://www.healthyplace.com/communities/Depression/treatment/therapy/psych_vs_meds.asp
http://www.aafp.org/afp/20060101/83.html
http://www.findarticles.com/p/articles/mi_m3225/is_1999_Feb_15/ai_54113299
I'm sure if you take thirty seconds to perform an appropriate web search, you'd be able to find validation of my claims quite easily. It actually requires a dollop of thought, however, while failing to consider a standard and non-controversial claim until evidence for it is produced is not, so you may not be interested.
Lithium is not an antidepressant. MAOI use is now discouraged, due to their dangers, although they're sometimes tried in patients who haven't shown a response to SSRIs or who have a family history of responsiveness to MAOIs.
The short answer, though, is that it doesn't matter. The effect holds true regardless of the drugs used.
(There is an absolutely massive placebo effect with psychiatric medications, particularly with antidepressants, constituting up to 50% or more of the observed improvement. Drugs simply aren't that impressive once the placebo effect is removed.)
Abbyas
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I'm taking a look at your links. And trust me, I'm using a "dollup of thought."
The first one reiterates exactly what you said. Couldn't find what medications they compared it to.
The second again states that the prescription that works best for those with severe or chronic depression is a combination of cognitive therapy and medication.
The third has this to say:
"The authors conclude that cognitive behavioral therapy following successful treatment with antidepressants is effective in preventing relapses in patients with chronic depression."
With this caveat:
"Patients also had to have shown a successful response to a tricyclic antidepressant or a selective serotonin reuptake inhibitor." (MAOIs vs. SSRIs)
I'm not sure where the studies say that cognitive therapy alone works better than prescription drugs alone. The first one does, but I couldn't figure out what they were comparing.
Even if I give that it makes sense that the combination works best, where does it say we're overmedicating? Where does it say that a physiological solution doesn't work?
The first one reiterates exactly what you said. Couldn't find what medications they compared it to.
The second again states that the prescription that works best for those with severe or chronic depression is a combination of cognitive therapy and medication.
The third has this to say:
"The authors conclude that cognitive behavioral therapy following successful treatment with antidepressants is effective in preventing relapses in patients with chronic depression."
With this caveat:
"Patients also had to have shown a successful response to a tricyclic antidepressant or a selective serotonin reuptake inhibitor." (MAOIs vs. SSRIs)
I'm not sure where the studies say that cognitive therapy alone works better than prescription drugs alone. The first one does, but I couldn't figure out what they were comparing.
Even if I give that it makes sense that the combination works best, where does it say we're overmedicating? Where does it say that a physiological solution doesn't work?
Abbyas
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It is used to treat depression:
www.medicinenet.com/lithium/article.htm
Edited to add:
But your 3rd link focused exclusively on MAOIs.
Last edited:
ChristineR
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Concerning the effectiveness of various treatments for depression:
There is no blood test for depression. Depression is quantified by surveying the patient and scoring his answers on a test. The score you get depends on the questions asked and the weight given to each.
Cognitive therapists tend to ask questions about levels of irrational and destructive thoughts. Psychiatrists tend to ask questions about sleep disorders and aches and pains. Talk-therapy psychologists tend to ask questions about attitudes towards life and the future.
The result is that all different kinds of doctors can claim that their treatments are the most effective and that all treatments can be claimed to be equally effective. Really there is no one most effective treatment for depression. Right now the SSRIs are in ascendence because they are cheap, safe, and fast, although not really all that effective.
There is no blood test for depression. Depression is quantified by surveying the patient and scoring his answers on a test. The score you get depends on the questions asked and the weight given to each.
Cognitive therapists tend to ask questions about levels of irrational and destructive thoughts. Psychiatrists tend to ask questions about sleep disorders and aches and pains. Talk-therapy psychologists tend to ask questions about attitudes towards life and the future.
The result is that all different kinds of doctors can claim that their treatments are the most effective and that all treatments can be claimed to be equally effective. Really there is no one most effective treatment for depression. Right now the SSRIs are in ascendence because they are cheap, safe, and fast, although not really all that effective.
ChristineR
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The British Association for Psychopharmacology for one.
And here's a well-known, somewhat controversial, non-technical article which discusses a review of anti-depressants and how the authors interpreted the data to show the drugs weren't astonishingly effective.
http://www.findarticles.com/p/articles/mi_m1175/is_n5_v28/ai_17382257
Googling around I found tons of articles, but not one that really gives the summary I was looking for. But here's one called Clinical trials of antidepressant medications are giving meaningless results which will link you to a whole bunch of articles discussing how the data can be intepreted so that anti-depressants (especially SSRIs) can be considered to be no better than placebo. Most experts think this interpretation is going too far, but no one doubts that drug companies are interpreting the data too positively.
There are two basic problems that I see. One is that the drugs have side effects, so that everyone knows if they are on a drug or a placebo, and this leads to "the amplified placebo effect"--a stronger placebo effect in people who have correctly guessed that they are on the drug. The other is what I mentioned above, that the drug companies are likely to count things like "sleeping more soundly" as an improvement when in fact the depressed person may simply consider it an unimportant side effect.
And here's a well-known, somewhat controversial, non-technical article which discusses a review of anti-depressants and how the authors interpreted the data to show the drugs weren't astonishingly effective.
http://www.findarticles.com/p/articles/mi_m1175/is_n5_v28/ai_17382257
Googling around I found tons of articles, but not one that really gives the summary I was looking for. But here's one called Clinical trials of antidepressant medications are giving meaningless results which will link you to a whole bunch of articles discussing how the data can be intepreted so that anti-depressants (especially SSRIs) can be considered to be no better than placebo. Most experts think this interpretation is going too far, but no one doubts that drug companies are interpreting the data too positively.
There are two basic problems that I see. One is that the drugs have side effects, so that everyone knows if they are on a drug or a placebo, and this leads to "the amplified placebo effect"--a stronger placebo effect in people who have correctly guessed that they are on the drug. The other is what I mentioned above, that the drug companies are likely to count things like "sleeping more soundly" as an improvement when in fact the depressed person may simply consider it an unimportant side effect.
Abbyas
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Okay, looking at your articles, I'm having a hard time coming to the same conclusion.
The first article from the BAP actually says "Antidepressants are effective in the acute treatment of major depression of moderate and greater severity including major depression associated with physical evidence."
That there IS effectiveness.
It does say that "Antidepressants do not appear more effective than placebo in acute milder depression or very mild major depression." Italics mine.
It does not say that they are not effective.
Looking at the second link, the article says the following:
"The reviews (of antidepressant literature) indicate overall that one-third do not improve with antidepressant treatment, one-third improve with placebos, and an additional third show a response to medication they would not have attained with placebos."
Wouldn't this be consistent with what the BAP states? It helps with severe or chronic depression but not acute milder depression or mild depression?
Granted, we have problems in our pharmaceutical situation, but the above articles don't tell me that the stuff doesn't work for those with chronic or severe depression.
The conclusions I see from these articles are this:
Should a doctor give someone meds because they're going through a break up? No. If they continuously can't calm themselves down from a crying jag because they're out of peanut butter? Yes.
The first article from the BAP actually says "Antidepressants are effective in the acute treatment of major depression of moderate and greater severity including major depression associated with physical evidence."
That there IS effectiveness.
It does say that "Antidepressants do not appear more effective than placebo in acute milder depression or very mild major depression." Italics mine.
It does not say that they are not effective.
Looking at the second link, the article says the following:
"The reviews (of antidepressant literature) indicate overall that one-third do not improve with antidepressant treatment, one-third improve with placebos, and an additional third show a response to medication they would not have attained with placebos."
Wouldn't this be consistent with what the BAP states? It helps with severe or chronic depression but not acute milder depression or mild depression?
Granted, we have problems in our pharmaceutical situation, but the above articles don't tell me that the stuff doesn't work for those with chronic or severe depression.
The conclusions I see from these articles are this:
Should a doctor give someone meds because they're going through a break up? No. If they continuously can't calm themselves down from a crying jag because they're out of peanut butter? Yes.