Anti-depressants of little use to all but the most severely depressed

[SpeedRacer 1]

http://news.bbc.co.uk/2/hi/health/7263494.stm

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[Lindsey 0]

I'm not a big fan of antidepressant medications for people who only have mild mood symptoms. BUT, "of little use to all but the most severely depressed" seems a little far-fetched to me. I think of the most severely depressed being people with psychotic depression, who are suicidal, and those who cannot function in society because of their symptoms. I don't know how these researchers define "most severely depressed."

The article speaks to people with mild depression, and their outcomes not being better than placebo. I wonder what they found (or if they even looked at) people with more moderate but chronic or recurrent symptoms. I'd be hard-pressed to believe that these folks don't benefit from antidepressants.

They mention counseling/psychotherapy and there was a suggestion that SSRIs not be used until these other modalities have failed! That's just crap, in my opinion. Not because psychotherapy isn't a good option, but because OPTIONS are good. Being able to CHOOSE psychotherapy or medication or both is a good thing. As we're so involved in discussions about socialized medicine and about Evidence-based medicine, the danger is in lumping all individuals and decisions about their health care into some algorithm that may have shown to be true for a majority of people. What tends to be the best treatment modalities for the majority isn't always true for each person. I might be just a tad sensitive to this, though, as I've been dealing with a government health-care system lately (VA) that won't allow certain treatment options to be used until we've proven that another one...or two....or more have failed. But I guess I'm just kind of ranting now. What was I saying earlier about tangential thinking??? LOL.

linz

--
A conservative is just a liberal who's been mugged. A liberal is just a conservative who's been to jail

[SarahC07 0]

I tend to agree with the article. I've witnessed a couple of people very dear to me struggle with depression and other mental "disorders". Medication did not help them. One person in particular has struggled so long that she's been on and off almost every drug in the market. She claims nothing helps. Her daughter suffers from the same problem but has made incredible progress with an awesome therapist.

If someone's quality of life improves from taking a pill, wether it be a placebo or not, let them take it. And leave 'em alone.

One of my best friends always says: "We're all a little bit crazy. Learn to manage your crazy and then embrace it."

I think it's great advice.

[skiskyrock 0]

I keep seeing this study totally distorted by the media. The point isn't that antidepressants don't work, they do. It is just that the placebo effect for antidepressants is huge. That suggests to me that most people have the internal resources to deal with mild depression, if they are effectively mobilized.

The person who is in one of these studies has probably spoken with a Dr., had someone ask them some baseline questions about how they are feeling, then cared about them enough to give them a sugar pill. They probably walk out of the office with an expectation that things are going to get better.

You could probably get similar or better results with a few sessions of therapy, but who wants to pay for that? Here's a prescription.

For severe depression, the placebo effect is much smaller, and there antidepressants save lives. For mild depression maybe there are better options.

Disclaimer: this is my personal opinion, not that of my employer, who happens to make one of the drugs involved

[riddler 0]

I tend to believe personal experience more than either commercials or studies. I've never taken anti-depressants, but every person I know that has taken SSRIs has felt a significant benefit. Placebo effect or not, feeling better is worth the money.

Of course, we could all just eat better and take care not to pollute our surroundings, get more sleep, avoid alcohol and drugs, and there would probably be a lot less depression in the world. But that sounds like really hard work Easier to take a pill, I guess.

Trapped on the surface of a sphere. XKCD

[NWFlyer 2]

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Of course, we could all just eat better and take care not to pollute our surroundings, get more sleep, avoid alcohol and drugs

For me, I've found that to be the best treatment. If I keep certain things out of my body (most processed food, more specifically refined sugar and simple carbohydrates), drink moderately or not much at all, and exercise regularly, I find that my depression (generally mild-to-moderate) is kept at bay. I've tried antidepressants off and on and never really found any that do much for me. Or, if they do, the effect seems to be short-lived, and I suspect it's that placebo effect - I reach out for help, and the very act of taking action to ask for help also empowers me to take action on the other stuff I know helps me.

But really, it's being able to stay consistent on clean(er) living that keeps my mind healthy. It's when I slip off that path that both my body and mind start to feel unhealthy.

"There is only one basic human right, the right to do as you damn well please. And with it comes the only basic human duty, the duty to take the consequences." -P.J. O'Rourke

[Lindsey 0]

I've tried antidepressants off and on and never really found any that do much for me. Or, if they do, the effect seems to be short-lived, and I suspect it's that placebo effect - I reach out for help, and the very act of taking action to ask for help also empowers me to take action on the other stuff I know helps me.

When I've used antidepressants they've worked very well. Problem is that I just don't like taking them. Have had LOTS more benefit from medicines than from "working through it" somehow. BUT I don't want to be on an antidepressant. Maybe working things out from their core (psychotherapy?) will, in the long run, be a more efficacious option. Who knows? That's why it's great to have options.

linz

--
A conservative is just a liberal who's been mugged. A liberal is just a conservative who's been to jail

[NWFlyer 2]

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That's why it's great to have options.

Yep, and I'd never be one to tell anyone "this is the right option for you." I'm a firm believer that for most people it's probably a combination of a bunch of things that's going to ultimately work... it's having the patience and finding the right providers who are willing to work with you to find the right combination that's the most challenging part.

"There is only one basic human right, the right to do as you damn well please. And with it comes the only basic human duty, the duty to take the consequences." -P.J. O'Rourke

[freefallfreak 0]

Thin Mints works for me...keeps me happy and content.

TripleF

"Upon seeing the shadow of a pigeon, one must resist the urge to look up."

[ryoder 1,590]

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... and exercise regularly...

Bill Maher - "New Rules" - September 28, 2007

http://www.hbo.com/billmaher/new_rules/20070928.html

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In Hillary Clinton's health plan, the words "nutrition" and "exercise" appear once. The word "drugs" 14 times. Just as the pharmaceutical companies want it. You know, their ad weasels love to say, "When diet and exercise fail..." Well, diet and exercise don't fail. A fact brought home last week by a new Duke University study that showed exercise - yes, exercise - is just as effective a cure for depression as Paxil and Zoloft.

So ask your doctor if getting off your ass is right for you!

"There are only three things of value: younger women, faster airplanes, and bigger crocodiles" - Arthur Jones.

[Gene03 0]

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... and exercise regularly...

Bill Maher - "New Rules" - September 28, 2007

http://www.hbo.com/billmaher/new_rules/20070928.html

Quote

In Hillary Clinton's health plan, the words "nutrition" and "exercise" appear once. The word "drugs" 14 times. Just as the pharmaceutical companies want it. You know, their ad weasels love to say, "When diet and exercise fail..." Well, diet and exercise don't fail. A fact brought home last week by a new Duke University study that showed exercise - yes, exercise - is just as effective a cure for depression as Paxil and Zoloft.

So ask your doctor if getting off your ass is right for you!

Nice, I think we have a winner.

“The only fool bigger than the person who knows it all is the person who argues with him.

Stanislaw Jerzy Lec quotes (Polish writer, poet and satirist 1906-1966)