Split from: Severe Depression

[TobiasTheViking]

people are free to do and say all sorts of things. Everyone else is free to try to convince said person that (s)he is wrong.

 

[Dancing David]

Christ you're f(cking stupid. Try actually reading not just my post but J's last one. He is seeking help and hardly sounds suicidal, and either way I sure as hell am not trying to stop him from seeking help. And how does that make this a "medical problem" anyway? Yknow, the entire point of my post? Nice reading comprehension. How many years did it take you to pass English anyway?

Try untying those knots in your panties and actually attempt to comprehend what I said and what he's said and perhaps the fog in your brain will clear a bit.

I doubt it though. Get family and friends to help, as you are clearly in desperate need of it. Hell maybe you should hit the ER, I think you just popped a major artery in your brain.

Perhaps if you actualy knew some mental health professionals you wouldn't make such sweeping generalizations, the choice to seek medication is a personal one. You CAN REFUSE medication when you are on a psychiatric unit. When people get medicated against thier will it takes a court order or an actual threat to self or others that is clear and present. On a psych floor you are likely to be restrained but not medicated against your will. Unless you deliberately and intentionaly harm someone (excluding and sometimes including psychosis) you will not be medicaly treated but arrested.

Most mental health professionals are not pill pushers, the average time that a person goes untreated is often very long. So perhaps some education would give you a broader perspective, in fact the "we never used to treat this and you shouldn't" is a very prevalent attitude in the US.

There are people who over perscibe and don't do sufficient assesment and diagnosis, including psychiatrists, but if you want to find quick solutions, it is people asking thier GP for help.

In the case of J he said that he has likely had the depression prior to the break up with his girlfriend and that is has lasted a while.

Medication is not helpful to everyone, usualy some life management training, like getting enough sleep and avoiding caffine will benefit many people, CBT will benefit more, and medication is there for those who feel it will benefit them.

Perhaps your extreme attitude is just as harmful as those you say are over treating depression. In my experience of doing intakes and assesments for fiveteen years, most people coming in make the choice as to what they feel will benefit them, a good clinician will discuss the options and leave it to the clients.
I did weekly assesments for ten years and saw over four hundred people there,I did intakes for 3 years and saw 200 and talked to hundreds more on the phone, I did crisis and assesment for two years and did 300 assesments and probably one hundred crisis interventions. The choice is usualy left to the client. Most people will make a choice that they feel will benefit them , even in the ER. Many people just want to talk to someone, and then some will want counseling only , others will only want to see the doctor.

I understand you may doubt the medical model of depression and no, people should not seek medication for short term depressive symptoms, but what would you recomend for someone who is sleeping three hours a night and has suicidal ideation with a plan, even though thier symtoms have lasted less than a week?

 

[Dancing David]

For the record I'd be dead without a "happy pill" my family doesn't quite believe it and hates spending the money on. I can't yet afford to pay for it myself. After living in that hell for so long there is no way I can go back there. I guess though we should not give medication to anyone and let nature take it's proper course...

Did you ever receive vaccinations Bigred? Ever take any medication for anything in your life? You would be dead too maybe... Fun isn't it, but we don't need science in this world, right?

One very serious note, what you typed was beyond stupid. If you don't know something and the matter is this serious keep your asinine opinions to yourself.

Sorry to be a Nosey Norbert but have you tried the pharmaceutical assistance programs, they usualy only cover newer meds. i hated the year and a half I was off my meds.

It is a damn shame that they charge so much for the mood stabalizers.

 

[Mercutio]

We have had some posters here argue very well that depression is not the result of a biochemical imbalance.

Remember, it is not actually the case that it either A) is the result of a biochemical imbalance or B) is not. There is also C) a diagnosis of depression may reflect the influence of any of a number of different underlying physiological conditions.

Even if there is no *one* biochemical imbalance to explain the symptoms of depression (and as one who suffered from extreme hypothyroidism, I assure you there is not *one* physiological syndrome causing these symptoms), that does not mean that one should not seek medical attention for those symptoms. Be aware, because there are several possible causes, there is a possibility of misdiagnosis. This is the case with any medical problem, whether somatic or behavioral. But in my (I am not a physician) opinion, the potential cost of not seeing a doctor is much greater than the potential cost of seing one.

 

[Dancing David]

News to me. But women don't either?

SSRIs should only be used to treat depression as a result of chemical imbalance. Otherwise the reasoning and consequences are no different than alcoholism or overuse of narcotics. The high requirement of artificial stability wanes, while a physical tolerance develops. What doesn't change is the reason for the substance abuse, which is constantly covered up through chemical self-harm. Any doctor who uses his authority and qualifications to prescribe someone SSRIs because of a situation, not a disabling chemical imbalance, commits a far larger crime than any street drug dealer.

What evidence do you have that psychotropics other than anxiolytics are addictive? A person should not be perscribed an AD unless they are depressed, but they are no more addictive than insulin is to a diabetic.

Now a depressed person should learn healthy skills just as a diabetic should control their diet.

But ADs are not addictive. You have stated it before, that they are addictive, now back your assertion with evidence.

Where is your data and research? Demonstrate that ADs are addictive and that they meet the criteria as set forth in the DSMIV-R for substance dependance, show me all relevant studies and data. The mere assertion that diabetes requires higher doses of insulin does not constitute addiction.

Do you know the difference between exogenous and endogenous depression? If it is depression it doesn't matter. If there is the prescription of any AD or psychotropic medication there should be weekly monitoring of symtoms and side effects (until they adjust), patients should be informed of the side effects and warned to call thier doctor if they occur.

edited to remove extraneous sarcasm and pomposity.

 

[athon]

We have had some posters here argue very well that depression is not the result of a biochemical imbalance.

Remember, it is not actually the case that it either A) is the result of a biochemical imbalance or B) is not. There is also C) a diagnosis of depression may reflect the influence of any of a number of different underlying physiological conditions.

Even if there is no *one* biochemical imbalance to explain the symptoms of depression (and as one who suffered from extreme hypothyroidism, I assure you there is not *one* physiological syndrome causing these symptoms), that does not mean that one should not seek medical attention for those symptoms. Be aware, because there are several possible causes, there is a possibility of misdiagnosis. This is the case with any medical problem, whether somatic or behavioral. But in my (I am not a physician) opinion, the potential cost of not seeing a doctor is much greater than the potential cost of seing one.

This was actually my argument for deciding to try more behavioural changes to address the problem rather than chemical. I don't doubt that it's a biochemical skew that creates depression, although the underlying impediments and influences might not be so clear cut. In addition, biochemistry is a complicated field, and the blunt tools of pharmaceutical treatments aren't always the most efficient at tuning our biochemistry.

That said, sometimes even a blunt tool can slam the system back into being somewhat more useful. Knowing when and how is something that is open to questioning, of course.

Athon

 

[SirPhilip]

Only speaking from experience but, there tends to be a machismo element with men.

Tends?

 

[SirPhilip]

I don't believe anybody has the right to stop others from committing suicide. Right to live is also Right to die. It's a free country!

The problem is, you can affect somebody's mood to the point they will want to die. Emotions are the catalyst of thoughts. If you are anhedonic/dysthymic all your thoughts will be constrained into cascades of miserable associations or flat judgements.

 

[SirPhilip]

We have had some posters here argue very well that depression is not the result of a biochemical imbalance. Remember, it is not actually the case that it either A) is the result of a biochemical imbalance or B) is not. There is also C) a diagnosis of depression may reflect the influence of any of a number of different underlying physiological conditions.

It's either psychological (e.g "My girlfriend left", "I lost my job..", "I saw my dad having sex with Margaret Thatcher when I was a kid.."), psycho-physiological ("..when I'm on the highway I think a roadside bomb is going to go off and I freak out, I also am very depressed and angry for no apparent reason.") or chemical ("I'm usually a very upbeat person, in fact I won the lottery yesterday, and for some inexplicable reason, Natalie Portman is all over me, but suddenly everything seems meaningless, pointless, hopeless and futile..").

Even if there is no *one* biochemical imbalance to explain the symptoms of depression (and as one who suffered from extreme hypothyroidism, I assure you there is not *one* physiological syndrome causing these symptoms), that does not mean that one should not seek medical attention for those symptoms.

There are, generally three: Dopamine, Serotonin, Opioid. A negative imbalance of any can easily produce disabling anhedonia/dysthymia or suicidal thoughts. Anyone who is having intrusive, suicidal thoughts without any justification should get evaluated, as what they are suffering from is most likely chemical depression. Someone who just came back from Iraq after a two year tour, is a different story.

 

[SirPhilip]

We meet again dancer. This time though, you have a small part of the brain to hop around if bullets strike near your feet, so keep them on solid ground I ask..

What evidence do you have that psychotropics other than anxiolytics are addictive? A person should not be perscribed an AD unless they are depressed, but they are no more addictive than insulin is to a diabetic.

Wikipedia is your friend. I'm not. What evidence do you have that SSRIs would not, if used beyond recommended dosages or even at recommended dosages, have significant rebound? There is plenty of controversy surrounding that, completely legitimate.

Now a depressed person should learn healthy skills just as a diabetic should control their diet.

Unless they are depressed due to an imbalance; in which case they have no control over their mood, and their thought and judgement are distorted as a result.

But ADs are not addictive. You have stated it before, that they are addictive, now back your assertion with evidence.

I reffered to psychological dependency obviously, with a physical rebound (withdrawal period). Although flatly saying "AD's are not addictive" is making me depressed about what to expect below.

Where is your data and research? Demonstrate that ADs are addictive and that they meet the criteria as set forth in the DSMIV-R for substance dependance, show me all relevant studies and data. The mere assertion that diabetes requires higher doses of insulin does not constitute addiction.

Still sore from the bruises suffered during your evasions in that other thread, aren't you. I concede, no really, SSRIs couldn't possibly be addictive...

Do you know the difference between exogenous and endogenous depression?

No actually I don't. Cool words though, enlighten me. You failed to do any of that in the other thread.

If it is depression it doesn't matter. If there is the prescription of any AD or psychotropic medication there should be weekly monitoring of symtoms and side effects (until they adjust), patients should be informed of the side effects and warned to call thier doctor if they occur.

Like any drug that influences or directly regulates mood, SSRIs must have a degree of physical rebound if stopped. If the person is chemically depressed, withdrawal is simply delt with in a controlled way, similar to patients taking opioid drugs. If a person is 'suicidally depressed' due to an event, not because they have a physical imbalance and taking them at much higher dosages and if they stop and a rebound occurs, they will likely go through severe withdrawal and associate this with the situation.

..edited to remove extraneous sarcasm and pomposity.

Ah, "extraneous". What's this definition.

"..introduced or coming from without; not belonging or proper to a thing; external; foreign: extraneous substances in our water."

Like extraneous volumes of text? The duller your points become, remember, the sharper the barbs around my statements tighten..

 

[Dancing David]

We meet again dancer. This time though, you have a small part of the brain to hop around if bullets strike near your feet, so keep them on solid ground I ask..

Still no substance, only the pithy retort.

You haven't answered the questions in the other thread.

Care to have a public dispute about sleep, moderated by any number of psychologists on this board? Still think you can slep while you are awake?

Wikipedia is your friend. I'm not. What evidence do you have that SSRIs would not, if used beyond recommended dosages or even at recommended dosages, have significant rebound? There is plenty of controversy surrounding that, completely legitimate.

Rebound is not the definition of addiction.

Unless they are depressed due to an imbalance; in which case they have no control over their mood, and their thought and judgement are distorted as a result.

Ah yet the benefits of life style changes are still thier although potentialy less effective.

I reffered to psychological dependency obviously, with a physical rebound (withdrawal period). Although flatly saying "AD's are not addictive" is making me depressed about what to expect below.

Care to point to any recent use in research of the the phrase 'psychologicaly dependant', that is not a criteria of addiction.

Still sore from the bruises suffered during your evasions in that other thread, aren't you. I concede, no really, SSRIs couldn't possibly be addictive...

Care to take it up in a new thread? Then your claims won't be hidden in the R&P forums, would you like to do it in this forum?

Still want to say that you understand the clinical use of the term sleep?

No actually I don't. Cool words though, enlighten me. You failed to do any of that in the other thread.

It has to do with the possible causes of depression, some people are vulnerable to depression from outside stressors others are vulnerable to depressions when they are not under stress, if someone feels that thier functioning is impacted due to depression it doesn't matter if they have 'situationaly' or not.

Like any drug that influences or directly regulates mood, SSRIs must have a degree of physical rebound if stopped.

that is not a criteria solely for dependance.

If the person is chemically depressed, withdrawal is simply delt with in a controlled way, similar to patients taking opioid drugs. If a person is 'suicidally depressed' due to an event, not because they have a physical imbalance and taking them at much higher dosages and if they stop and a rebound occurs, they will likely go through severe withdrawal and associate this with the situation.

If they aren't depressed then they are likely to become agitated and anxious, although many people are subject to that anyhow, it is a complication of treatement with the SSRIs and the ones that are like Cymbalta as well.

That does not mean they are addictive.

Ah, "extraneous". What's this definition.

"..introduced or coming from without; not belonging or proper to a thing; external; foreign: extraneous substances in our water."

Like extraneous volumes of text? The duller your points become, remember, the sharper the barbs around my statements tighten..

And would you care to bring that discussion to this forum?

The more extreme your rhetoric the less substance you have. Care to discuss your usgae of the word sleep in the Science forum?

 

[Dancing David]

There are, generally three: Dopamine, Serotonin, Opioid. A negative imbalance of any can easily produce disabling anhedonia/dysthymia or suicidal thoughts. Anyone who is having intrusive, suicidal thoughts without any justification should get evaluated, as what they are suffering from is most likely chemical depression. Someone who just came back from Iraq after a two year tour, is a different story.

Oh great now you are posting dangerous twaddle, I hope you avoid the crisis intervention field. Your mindless crap in the R&P Forum is less harmfull but this is dangerous. I don't think you have posted your credentials as a crisis intervention counselor have you?

Are you really saying that a person who has "intrusive suicidal thoughts" with "justification" should not seek evaluation?

Are you sure that is what you are saying?

That is really dangerous, are really sure that is what you mean to say?

 

[SirPhilip]

Oh great now you are posting dangerous twaddle, I hope you avoid the crisis intervention field. Your mindless crap in the R&P Forum is less harmfull but this is dangerous. I don't think you have posted your credentials as a crisis intervention counselor have you?

Argument from authority, this soon? You decided to smack heads with me once again, and this isn't ambiguous, so counterpoints shouldn't be something I have to beg for if I'm off on something, now should it..

Are you really saying that a person who has "intrusive suicidal thoughts" with "justification" should not seek evaluation?

Suicidal thoughts can arise due to a fixed, low-set mood as a result of dysthymia/anhedonia, or situations. I assume you know what this is like, otherwise there is no point in a decent exchange with you, as you can't relate, and further will make another mess for me to clean up trying to invalidate valid things I explain in a lovingly verbally abusive way.

Are you sure that is what you are saying?

I'm saying that common situational depression ("Nothing is going the way it should.."), not to be confused with psycho-physiological depression, such as PTSD, requires therapy, not drug dependency, unless diagnosed with chemical depression.

That is really dangerous, are really sure that is what you mean to say?

It is dangerous to encourage anyone who is not suffering from chemical depression, especially if you are in a position of authority, into a dependency on prescription drugs - not therapy or a combination of the two with a primary emphasis on therapy. You could argue this is standard procedure, but I see too many people on anti-depressants for the wrong reasons; what really bothers me isn't what they are prescribed, but someone made them think something was to be gained, rather than a price to pay by shoving things under the rug. These same people eventually discover another class of natural anti-depressants that inspired Huxley's Brave New World: the opioid kingdom, then discover the law of diminishing returns the hard way, and become heroes or statistics.

 

[William Rea]

Tends?

Yes, tends.

I can point you towards sources that will confirm that men are less likely to seek treatment for depression if you wish?

 

[William Rea]

It is dangerous to encourage anyone who is not suffering from chemical depression, especially if you are in a position of authority, into a dependency on prescription drugs - not therapy or a combination of the two with a primary emphasis on therapy. You could argue this is standard procedure, but I see too many people on anti-depressants for the wrong reasons; what really bothers me isn't what they are prescribed, but someone made them think something was to be gained, rather than a price to pay by shoving things under the rug. These same people eventually discover another class of natural anti-depressants that inspired Huxley's Brave New World: the opioid kingdom, then discover the law of diminishing returns the hard way, and become heroes or statistics.

I don't think anyone has implied that unecessary prescriptions are a good thing? Where are you arguing from on this?

In many cases even chemically imbalanced depressives have learned coping strategies that are unhealthy. It would require medication to even get them in a position to unlearn those strategies and adopt more constructive patterns of behaviour.

Medication without therapy simply is not acceptable in any scenario.

 

[SirPhilip]

I don't think anyone has implied that unecessary prescriptions are a good thing?

Dancing David will, watch.

Where are you arguing from on this?

The obvious, I know - it's probably going to be reiterated over-and-over again soon, too.

Medication without therapy simply is not acceptable in any scenario.

Completely agree. Although people often sort themselves out. I mostly blame pharmaceutical companies' marketing.

 

[skeptifem]

Its so weird. Having an imbalance of chemicals in the brain can cause all sorts of behaviors that people consider legit (insomnia, for instance) but depression is somehow different when its caused by imbalance of chemicals?

 

[athon]

Its so weird. Having an imbalance of chemicals in the brain can cause all sorts of behaviors that people consider legit (insomnia, for instance) but depression is somehow different when its caused by imbalance of chemicals?

Because everybody feels down from time to time, so it's difficult for many to see how clinical depression is different. It's easy to imagine insomnia, easy to imagine hearing voices where you shouldn't...but depression, that's just the blues, right?

As it has been said, pharmaceutical treatments without behavioural changes are never a good idea, for a number of reasons. But sometimes the brain can benefit from a bit of a kick, in order to make the behavioural changes possible. Deciding when and what to prescribe is difficult and obviously is open to debate.

I'd be shocked and dismayed if anybody suggested that unnecessary medication should be prescibed, but I seriously doubt anybody would argue that, by nature of the word 'unnecessary'. Of course, deciding what is necessary and not depends on the situation.

This field is always a touchy one with people, with emotions running high on both sides. Still, we can endeavour to keep a rational and evidence-based mind about it, surely.

Athon

 

[Solus]

Because everybody feels down from time to time, so it's difficult for many to see how clinical depression is different. It's easy to imagine insomnia, easy to imagine hearing voices where you shouldn't...but depression, that's just the blues, right?

As it has been said, pharmaceutical treatments without behavioural changes are never a good idea, for a number of reasons. But sometimes the brain can benefit from a bit of a kick, in order to make the behavioural changes possible. Deciding when and what to prescribe is difficult and obviously is open to debate.

I'd be shocked and dismayed if anybody suggested that unnecessary medication should be prescibed, but I seriously doubt anybody would argue that, by nature of the word 'unnecessary'. Of course, deciding what is necessary and not depends on the situation.

This field is always a touchy one with people, with emotions running high on both sides. Still, we can endeavour to keep a rational and evidence-based mind about it, surely.

Athon

It's hard for me to a rational debate because the issue is too personal too me. certain attitudes here remind of me a very ignorant person in my life who I used to call "dad".

I feel I know so much more about this then most except psychological doctors and other suffers. To dismiss my word makes my blood boil. Those who have no knowledge about a such a serious topic should not discuss it. I at least would expect some respect but instead I get called an idiot.

The thing is people can hide behind a computer screen and act like compete
bastards. To my own face I would not get those kind responses.

This my new response to any ignorant person who wants to discuss mental illness based off material he watched on television. I think it will serve me better.

 

[Solus]

unnecessary[/u] medication should be prescibed, but I seriously doubt anybody would argue that, by nature of the word 'unnecessary'. Of course, deciding what is necessary and not depends on the situation.Athon

I won't link to that forum here but you should see the medication section. half the posts are about how xanax and other addictive drugs are a wonderful cure for the problem. That doesn't bother though because it's like talking to a wall, they are already doomed. Medication is a last resort to the problem.

The best post ever was on in that section was on using opium to deal with anxiety issues... I did report that one and it was removed. That medication section really needs to be moderated properly or just closed because it gives tons of bad advice.

I hate having to take medication but I deal with it. In my case it's a serve issue though. By no means is the answer to every problem medication. Nothing is wrong with therapy though provided the therapist is researched and properly qualified.