Anti-depressants

I don’t think everyone fully appreciates what clinical depression is. In England ‘depression’ is a catch all word that describes a broad spectrum of feelings and symptoms. If you are diagnosed as being clinically depressed there are indicated treatments available. I don’t know of a single anti depressant that ‘works’ in less than three months. If you’re on e.g. Prozac for a month and pick up significantly it’s unlikely that the medication is responsible.

Depression is a terrible, debilitating illness which is under diagnosed and under treated. Feeling ‘depressed’ is a lot more common, often transitory, is usually a response to environmental changes, and is commonly inappropriately over treated with medication that is dished out to get the patient out of the consulting room. Every decade seems to produce a ‘smartie’ drug that you just throw at people. Benzodiazepines, then SSRIs – what’s the silly drug on the noughties? Viagra’s a possible candidate, but like the SSRIs and tri/tetracyclics before them, if prescribed appropriately they are highly effective and in some cases, life savers.

Anybody who follows Mick’s advice and finds that it works, wasn’t clinically depressed in the first place.

Cheers

Harry

quote:

I don’t know of a single anti depressant that ‘works’ in less than three months.

Almost all antidepressants can start to work in much less than three months. It depends on many factors including one's metabolism, diet and past experience with antidepressants.

As for Mick's attitude, a terrible irony of depression is that it's so easy to adopt that attitude against yourself, convinced that all you need is "willpower". I have found to my cost how mistaken that idea is.

quote:

Originally posted by Earwicker:
... assuming depression isn't biochemical/genetic in origin (ie endogenous). If it's a genetic trait, the pills will have to work and if they don't, you're f*cked. Simple as that.

Currently, there are known physiological ailments that can reasonably be said to cause depression because the depression they apparently cause subsides when those ailments are adequately treated. Nevertheless, despite all the research that has been done, AFAIK the only objective definition we currently have of depression is that provided by the questionnaires that are used to test for it (*1), since there is no physiological definition of or test for the underlying disease(s). Without that, to label a case of depression as being either reactive or endogenous (in the sense of being overwhelmingly genetic in origin) is science fiction. In my book, "you have endogenous depression" really means "I have failed in my attempt to treat you".

Secondly, assuming that (even if we cannot currently identify them) some cases of depression can reasonably be characterised as being overwhelmingly biochemical/genetic in origin (which I am sure will be the case, eventually) I cannot think of any reason to suppose that antidepressants are the only possible solution. Other approaches, such as exercise, diet and nutritional supplementation, by addressing general health and brain health in particular, more plausibly treat the causes of depression, have fewer if any side effects and sometimes work better, overall - as they are certainly doing in my case.

"Endogenous depression" reminds me of the oft repeated claim that depression is caused by a "chemical imbalance in the brain" and that antidepressants cure it by correcting the imbalance. The impression this gives is of depression having a known cause and of antidepressants being the most direct cure for it. The truth is that antidepressants are a crude (albeit increasingly less crude) and indirect attack on a symptom of depression, but nobody knows why they work. It doesn't help patients when doctors feign omniscience by using terms such as "endogenous depression" and "chemical imbalances in the brain", which they know (or should know) are little more than jargon.

*1 Or, rather, should be used, since some health professionals prefer to interview patients instead, in spite of the research that shows this approach is less reliable.

The term "endogenous depression" is an explanatory fiction, to use the language of the late B. F. Skinner. When faced with a set of dispositions without obvious external antecedents, then the practitioner of this philosophical device creates a verbal label and internalizes the 'cause' within the person where it cannot be verified.

Nick

Kuma

I seriously doubt that anything but harm can be caused to a defence in court based on "I was drunk your Honour". That would be even worse than the good old "it seemed like a good idea at the time" approach...

quote:

That would be even worse than the good old "it seemed like a good idea at the time" approach...

Oh yes. But so many drunken drivers get off from the *murder* charges every year.

quote:

Originally posted by JeremyD:
Currently, there are known physiological ailments that can reasonably be said to cause depression because the depression they apparently cause subsides when those ailments are adequately treated.

Jeremy,

I did the Atkins diet once. A couple of weeks in I got a serious case of depression for about 12 hours. Thank goodness it went away again.

Very strange.

cheers, Martin

Is it time to put on the song 'suicide is painless' yet?

I have two anti-depressants: my son and my daughter.

I take one look at them and cry with joy of life...


Oh and great sex, boxing, good coffee, thai and indian takeaways, a good game of cards...

quote:

Originally posted by kuma:

quote:

That would be even worse than the good old "it seemed like a good idea at the time" approach...

Oh yes. But so many drunken drivers get off from the *murder* charges every year.

I thought there was a "vehicular manslaughter" charge available to police in the US (you are in the US aren't you?). I'm sure, but not certain, that if a homicide was premeditated then being drunk wouldn't constitute a legal defence.

quote:

Originally posted by joe90:
I have two anti-depressants: my son and my daughter.

I take one look at them and cry with joy of life...


Oh and great sex, boxing, good coffee, thai and indian takeaways, a good game of cards...

I don't like kids, I can't box, I don't mind a curry, cards is pain-level and what's sex??

Kuma in the hifi corner (Kate Bush threat):

"I believe that having a bad taste is better than not having any"

That explains your last post on this threat then...

Peter

A solution is a long walk and fresh air. Works for me every time.

Jono

"I don't like kids, I can't box, I don't mind a curry, cards is pain-level and what's sex??...quote Earwicker.

Earwicker,

I suggest you side step depression, shoot yourself and end it all right now.

If nothing else you have cheered me up.

Regards

Mick

quote:

Originally posted by Mick Parry:
"I don't like kids, I can't box, I don't mind a curry, cards is pain-level and what's sex??...quote Earwicker.

Earwicker,

I suggest you side step depression, shoot yourself and end it all right now.

If nothing else you have cheered me up.

Regards

Mick

I've cheered you up?? Ah well, I shall die happy!

EW

Observing this from a short distance, I am not really sure it is a joking matter!

EW, just give Mick the pleasure of the thought for a few seconds, but leave it at that. I have no advice on how to deal with it, but having seen it close to in my childhood home (look at my earlier posts here) and I am sure it must be very bad sometimes.

Fredrik

Perhaps it would be interesting to ponder exactly what a mental illness really is? Mr Parry seems to think that a failure to function is just a matter of choice and that people who fail to do so cannot be considered ill with depression (or whatever is causing them a problem) but a merely useless. I would encourage him to look at what has changed in the DSM (The Diagnostic and Statistical Manual of Mental Disorders) over each version.

In a different milieu being arrogant, smug, overly self assured and impolite might be considered a mental illness? Perhaps trying too hard to be ironic might someday be a pathology as well?

Hmm....kids, boxing and sex...I can hear a lot of myself in what you've shared, Earwicker

I was pretty depressed when I was younger, never clinically diagnosed as such or anything like that, but extremely unhappy.



Then one day, I discovered Kate Bush, and the rest is history

Deane

I am sorry but you are speaking to the unconverted.

If I feel fed up, I go for a walk, ride the motorbike, go to the club, take the wife out for a meal, kick the dog and do a 1001 things that cheer me up.

Listening to music is a good stress reliever and believe me my job is 100% stress but I learn to live with it.

If I can do it, so can anyone else.

Regards

Mick

Depression is not feeling "fed up" Mick.

Depression happens every day. It wakes you up at night for a few minutes and disturbs your deep sleep patterns. It makes it more than just difficult to contemplate rising from bed in the morning. Depression steals your enjoyment of things that formerly interested you and affects you appetite. Depression lowers your libido. Depression is NOT stress and it cannot be relieved by a short period of enjoyment of something.

quote:

Originally posted by Mick Parry:
Deane

I am sorry but you are speaking to the unconverted.

If I feel fed up, I go for a walk, ride the motorbike, go to the club, take the wife out for a meal, kick the dog and do a 1001 things that cheer me up.

Listening to music is a good stress reliever and believe me my job is 100% stress but I learn to live with it.

If I can do it, so can anyone else.

Regards

Mick

A bit of stress and major depression are VERY different things. Anyway, I thought you'd long since retired?

Major depression is an utterly debilitating, hellish illness that's hard to cure/remedy and is fatal in 15 % of cases. Stress is... well, just stress, curable, as you say, by a nice walk, a few beers and some decent music.

Unfortunately, suicide is the only 100 % reliable cure for major depression.

EW

Earwicker

I retired last year but am back working again, sometimes as a consultant and sometimes on PAYE.

I am working because I have just bought a house in Spain and I want to clear it off without denting my savings.

Working for this has given me another goal and that becomes fulfulling. I do not have the time to be depressed.

I am still convinced all this is down to an attitude of mind.

Regards

Mick

quote:

Originally posted by Mick Parry:
I am still convinced all this is down to an attitude of mind.

Mick

What works for you doesn't necessarily work for everyone else. Surely you must've learnt that over your successful career?

Jay

Mick

I'm happy for you. Really. Not to have the slightest understanding of the type of suffering that depressive illness brings to life is to be envied. Perhaps you're just lucky. I rather doubt that you have all that much control over your attitude however - but then I'm an arrogant bastard so perhaps not surprising that I think that about you.

Deane

Dear Mick,

Are you a Medical Doctor? The reason I ask, is that it would bolster the crdibility of your assertions vz-a-viz depression, which I assume we can term a form of mental illness.

Illness, or disease, is not voluntary. The cures for the many forms of disease, are miriad, and indeed many are not understood, even if they work. I see no reason to suppose that depression is not like many diseases, a phenomenon that strikes in varying degrees of intensity, and as such it is quite unreasonable to assume that someone seriously depressed is funking out, and just need to buck their ideas up. It is not possible to reasonable hold that view, without a gross over-simplification. If you wonder about the (your quote) alleged lack of mental illness during the Wars, I wonder what you think Shell-shock was?

Anyway, unless you really are an expert in the field, I think you may well be treading on very thin ice asserting what you have, variously, above.

I offer this thought only as one who really would not venture opinions on any number of subjects, where my knowledge of, or qulaification within, the area are non-existent. I am inclined to observe that your understanding of and qualification in medical science (and the mental health speciality) are, at best, minimal, amd quite possibly non-existent. I would be glad enough for you to confirm that I am wrong, possibly with the details that allow to expound with authority on this issue, so that I may be convinced of my wrongness.

Fredrik