Mr.Samsa wrote:I notice that you seem to have messed up your quote tags there, David. Or did you?

Yes, I did, and I wouldn't be the first, nor the last, no doubt.

EDIT: More off-topic banter from Mr.S.

Fallible wrote:David's just claimed elsewhere that someone removed the offending words from a post he reported since he reported it, even though a few seconds' perusal of said post will find the words still very much in evidence. Is it actually worth taking anything he says seriously at this stage? Can't we just shrug our shoulders and walk away now?

Yes please.

DavidMcC wrote:

Mr.Samsa wrote:I notice that you seem to have messed up your quote tags there, David. Or did you?

Yes, I did, and I wouldn't be the first, nor the last, no doubt.

EDIT: More off-topic banter from Mr.S.

Yep I am afraid.

I would like to add a postscript to Fallible, who seems to think that I was accusing every poster on this site of being "irrational". I want to assure her that I make no such accusations. My beef was and is with some of the mods, who played ball with Cdesign... when he demanded that my thread about a weird group called Icarus Interstellar (who got a little funding from JPL to investigate FTL "warp drives") be moved from where I put it (Pseudoscience) to Physics.

I couldn't care less about your inane ramblings, leave me out if it. Stick to the topic or GTFO.

Fallible wrote:I couldn't care less about your inane ramblings, leave me out if it. Stick to the topic or GTFO.

It was sticking to the topic before you derailed it with misunderstandings that seemed to provoke you in the first place.

You're trolling again. It's already been explained to you at length how your accusation of me derailing it is a simple matter of you having "misunderstood" what the topic of the thread is, jut like you "misunderstood" who had said what when you accused people of altering posts and just like you "misunderstood" when you claimed that the phrase "thick skull" had been removed from a post when it's still there to this day. Stop trolling, stop lying and stop prodding me to respond to your blatant provocation.

Fallible wrote:You're trolling again. It's already been explained to you at length how your accusation of me derailing it is a simple matter of you having "misunderstood" what the topic of the thread is, jut like you "misunderstood" who had said what when you accused people of altering posts and just like you "misunderstood" when you claimed that the phrase "thick skull" had been removed from a post when it's still there to this day. Stop trolling, stop lying and stop prodding me to respond to your blatant provocation.

So you don't have anything more to say that is on topic. Your denunciatiion of my "ramblings" is nothing but a cover for your perverse view that my posts about whether depression is a syndrome or a well defined condition are somehow "off topic". In reality, they were an on-topic response to Mr.Samsa's first post in ths thread. One that, for no known reason, angered you, and still does, it seems.
I am not trolling. If anyone is, you are.

This thread is kind of promising. Ten years ago, the standard "medical model" dogma was that medication was absolutely the only thing for depression and that everything else is useless. Even during the lifetime of this forum, I've seen threads where the majority consensus, vehemently argued with dissenters called "irresponsible," was that no non-drug therapy for depression was valid. Since then, I think there's been a lot of evidence that various therapies, such as the cognitive/rational/emotional/behavioral alphabet soup, can be rather effective.

The view I've held for a quarter of a century now is that medication for "mood" disorders is like the starter motor of the car. It's handy to start it when it's stopped, but by all means, give it some gas and let it go and disengage the starter at some point. Don't run the car on the starter motor (like David Copperfield does with his motorcycle onstage) and expect it to run forever that way. It's just going to stop working and drain the battery.

Other disorders, such as thought disorders, are different. There's a lot of evidence that some medication just works, though it takes a lot of trial and error to find a medication that works.

Yes, I found Prozac very useful when I was in the throes of sincere suicide ideation. I stopped taking it after 3 months and followed the behavior I was taught to deal with my mood, so much so that when I sunk into thinking about suicide and withdrawal from my life in 2012, I was able to come out of it with chemicals. Again, last year, when I started hiding in my bed again, when the doc prescribed drugs, I took my "blue pill" only when I had to deal with a specific stressor. I still haven't used the sleeping pills he prescribed.

epepke wrote:

This thread is kind of promising. Ten years ago, the standard "medical model" dogma was that medication was absolutely the only thing for depression and that everything else is useless. Even during the lifetime of this forum, I've seen threads where the majority consensus, vehemently argued with dissenters called "irresponsible," was that no non-drug therapy for depression was valid. Since then, I think there's been a lot of evidence that various therapies, such as the cognitive/rational/emotional/behavioral alphabet soup, can be rather effective.

Is your background medical? I ask, because I had the reverse experience. I trained as a psychotherapist 35 years ago, and there was suspicion of the medical model in some branches of therapy, possibly partly a hangover from the anti-psychiatry movement (Laing and so on). This has faded, so that most schools, as far as I'm aware, now accept the use of medication, but I think quite a lot still argue that talk therapy is essential for many people. It's not either/or, of course.

Yes, that's my experience from the last decade. Tutors big up talking therapy as most effective (their own model, of course ) - IIRC the most which can be said is that it's as effective depending on the model and delivery type. From my limited experience, Person Centred tutors are the biggest culprits, with the CBT tutors of my acquaintance being more accepting of the role of medication in the treatment of mental illness. I don't know anything about tutors from many other models though.

Fallible wrote:Yes, that's my experience from the last decade. Tutors big up talking therapy as most effective (their own model, of course ) - IIRC the most which can be said is that it's as effective depending on the model and delivery type. From my limited experience, Person Centred tutors are the biggest culprits, with the CBT tutors of my acquaintance being more accepting of the role of medication in the treatment of mental illness. I don't know anything about tutors from many other models though.

Yes, there is a lot of turf warfare in therapy - I am talking about the UK there. In the last few years, there has been a lot of bitterness, during the attempt to found a single accrediting body. One problem was that one government agency seemed to be introducing medical terminology into the whole business, and many British therapists just said, whoah, no thanks. And then the idea of the single body has been abandoned (I think). Herding cats, I suppose.

But I think different people need different kinds of therapy, so it's a bit odd to say 'mine is superior'. I don't think there is a one-size-fits-all.

No, exactly. One of the reasons that there are so many models is because no one model works for all.

I don't know if they've abandoned the one single body idea. I do know that the BACP has started making us all jump through extra hoops in order to keep the privilege of parting with £17 a month. So they're abolishing the membership level I'm at and I've got to do more fucking assignments to just stay a member of the organisation.

Fallible wrote:No, exactly. One of the reasons that there are so many models is because no one model works for all.

I don't know if they've abandoned the one single body idea. I do know that the BACP has started making us all jump through extra hoops in order to keep the privilege of parting with £17 a month. So they're abolishing the membership level I'm at and I've got to do more fucking assignments to just stay a member of the organisation.

I had a supervisor who was a very cold man, and I thought to myself (being very green), how can such a cold man work as a therapist, which he did? It was later, when I'd had some of the rough edges knocked off me, that I realized that some people can only tolerate somebody distant and cold, to work with. Horses for courses.

It was the UKCP which ran into trouble over national regulation, but then it was all abandoned as the Tories came in, and said basically, fuck off. Which was a great relief.

FWIW, my experience was this:

1st major depressive episode: needed both meds (Paxil) and talk therapy (combination of cognitive behavioral and interpersonal). After a few years I stopped the med; continued the therapy. I was fine for a few more years – until suddenly I wasn't. 2nd episode hit very quickly, was worse than the 1st - and harder to treat. Went back on the Paxil - and found it did nothing. The search was on for something that would work and that I could tolerate. Miserable time: several doctors, many meds and combinations of meds, dosage adjustments, etc. I felt (I think this is Andrew Solomon's line) like a science project with no due date. Somewhere in there my diagnosis was changed from depression to bipolar spectrum disorder. The meds based on this helped more, but it still took a long time to get the combination and dosages right. Therapy continued during all this. For a little under a decade I've been pretty stable with these meds and therapy. Every few years I would try to stop the meds (always w/doc's guidance), and each time my mood spiraled out of control. So for the foreseeable future I'm going to continue with both therapy and meds.

Edit: I should add that the talk therapy has been and continues to be essential too. It has given me immensely helpful tools without which I would have been lost. But it seems neither meds nor therapy alone are enough for me. The combination is key.

Fallible wrote:No, exactly. One of the reasons that there are so many models is because no one model works for all.

...

That was a point I was making before the thread went crazy. It probably means that depression is "only" a symptom, with various possible causes, that ultimately have to be treated according to the nature of the cause, even if some "cure-all" can help initially.

One of the strange things that I remember 30-40 years ago in the British therapy world, was that there was a disapproval of both medication and psychoanalytic approaches in some branches. However, these disapprovals have faded considerably; nearly all schools of therapy accept the need for medication for some people, and many schools have incorporated some kinds of psychoanaytic ideas, especially the 'integrative' schools. It would be an interesting book to trace these developments, and their roots in socio-political developments; well, someone else can do that, if they haven't already. I suppose it was partly a late 60s and early 70s movement, coupled with anti-psychiatry, so a kind of rebellion, but all rebellions fade in the end.

orpheus wrote:FWIW, my experience was this:

1st major depressive episode: needed both meds (Paxil) and talk therapy (combination of cognitive behavioral and interpersonal). After a few years I stopped the med; continued the therapy. I was fine for a few more years – until suddenly I wasn't. 2nd episode hit very quickly, was worse than the 1st - and harder to treat. Went back on the Paxil - and found it did nothing. The search was on for something that would work and that I could tolerate. Miserable time: several doctors, many meds and combinations of meds, dosage adjustments, etc. I felt (I think this is Andrew Solomon's line) like a science project with no due date. Somewhere in there my diagnosis was changed from depression to bipolar spectrum disorder. The meds based on this helped more, but it still took a long time to get the combination and dosages right. Therapy continued during all this. For a little under a decade I've been pretty stable with these meds and therapy. Every few years I would try to stop the meds (always w/doc's guidance), and each time my mood spiraled out of control. So for the foreseeable future I'm going to continue with both therapy and meds.

Edit: I should add that the talk therapy has been and continues to be essential too. It has given me immensely helpful tools without which I would have been lost. But it seems neither meds nor therapy alone are enough for me. The combination is key.

I've been taught that medication renders one more able to engage in and benefit from the talking therapy. When you're depressed you're often beyond being able to give a fuck about therapy or to take much of it in.