Depression

Studies of mental functions, behaviors and the nervous system.

Moderators: Calilasseia, ADParker

Re: Depression

#301  Postby DavidMcC » Jul 06, 2014 3:10 pm

nunnington wrote: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.
...

So, what treatments (if any) WERE approved at that time?
:scratch:
May The Voice be with you!
DavidMcC
 
Name: David McCulloch
Posts: 14913
Age: 67
Male

Country: United Kigdom
United Kingdom (uk)
Print view this post

Ads by Google


Re: Depression

#302  Postby orpheus » Jul 06, 2014 3:16 pm

Fallible wrote:
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.


Yes, that was the feeling I had at the beginning of each of my big episodes. I felt as if I were in free fall, and the med put a floor under my feet. I was a hell of a lot lower than was healthy, but at least I could make use of therapy.

Later on, at those moments when I tried to go off or reduce my meds, it was a somewhat different feeling: the floor didn't suddenly vanish; rather it started to slope alarmingly. I think I simply recognized the symptoms and was able to act quickly. In fact, acting quickly is probably much more important than is commonly thought. Depression as a downward spiral is a good metaphor: the longer you wait, the harder it can be to treat.
“A way a lone a last a loved a long the”

—James Joyce
User avatar
orpheus
 
Posts: 7274
Age: 56
Male

Country: New York, USA
United States (us)
Print view this post

Re: Depression

#303  Postby Fallible » Jul 06, 2014 3:25 pm

Orph, did you experience what I've been told is common and contrary to what some might think - if you had any suicidal ideation and if you are comfortable talking about it - that the urge to do it occurs when one has started to pick up again after having begun meds? The thinking is that when you are very depressed you don't have the energy to do anything about it but when you start taking your tablets, for a small window you have both the depression and the energy to carry it out.
She battled through in every kind of tribulation,
She revelled in adventure and imagination.
She never listened to no hater, liar,
Breaking boundaries and chasing fire.
Oh, my my! Oh my, she flies!
User avatar
Fallible
RS Donator
 
Name: Alice Pooper
Posts: 51607
Age: 48
Female

Country: Engerland na na
Canada (ca)
Print view this post

Re: Depression

#304  Postby orpheus » Jul 06, 2014 3:46 pm

Fallible wrote:Orph, did you experience what I've been told is common and contrary to what some might think - if you had any suicidal ideation and if you are comfortable talking about it - that the urge to do it occurs when one has started to pick up again after having begun meds? The thinking is that when you are very depressed you don't have the energy to do anything about it but when you start taking your tablets, for a small window you have both the depression and the energy to carry it out.


I've read that that's often the case, and it makes sense. Similarly (though a bit different), it can be very dangerous to treat someone with bipolar disorder with only antidepressants. The antidepressant must be combined with a mood stabilizer.

In my case the suicidal ideation was never a big feature to begin with. I thought about death a lot, but thoughts of suicide occurred only infrequently. (They were quite disturbing, though.) In any case, I didn't go through the phase you describe – thank goodness. I'm not sure why. Perhaps it was that my energy returned very slowly, not outpacing my mood improving. Perhaps ongoing therapy helped. (actually I'm sure it did.)
“A way a lone a last a loved a long the”

—James Joyce
User avatar
orpheus
 
Posts: 7274
Age: 56
Male

Country: New York, USA
United States (us)
Print view this post

Re: Depression

#305  Postby nunnington » Jul 06, 2014 3:55 pm

DavidMcC wrote:
nunnington wrote: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.
...

So, what treatments (if any) WERE approved at that time?
:scratch:


Their own variety of (non-analytic) psychotherapy.
je suis Marxiste, tendance Groucho.
nunnington
 
Posts: 3980

Print view this post

Re: Depression

#306  Postby DavidMcC » Jul 06, 2014 4:03 pm

nunnington wrote:
DavidMcC wrote:
nunnington wrote: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.
...

So, what treatments (if any) WERE approved at that time?
:scratch:


Their own variety of (non-analytic) psychotherapy.

So it was a kind of postcode lottery, or what?
May The Voice be with you!
DavidMcC
 
Name: David McCulloch
Posts: 14913
Age: 67
Male

Country: United Kigdom
United Kingdom (uk)
Print view this post

Re: Depression

#307  Postby nunnington » Jul 06, 2014 4:08 pm

DavidMcC wrote:
nunnington wrote:
DavidMcC wrote:
nunnington wrote: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.
...

So, what treatments (if any) WERE approved at that time?
:scratch:


Their own variety of (non-analytic) psychotherapy.

So it was a kind of postcode lottery, or what?


You've lost me now. What's it got to do with postcodes?
je suis Marxiste, tendance Groucho.
nunnington
 
Posts: 3980

Print view this post

Ads by Google


Re: Depression

#308  Postby DavidMcC » Jul 06, 2014 4:14 pm

nunnington wrote:
DavidMcC wrote:
nunnington wrote:
DavidMcC wrote:
So, what treatments (if any) WERE approved at that time?
:scratch:


Their own variety of (non-analytic) psychotherapy.

So it was a kind of postcode lottery, or what?


You've lost me now. What's it got to do with postcodes?

Have you not heard of the phrase, "postcode lottery"? In case you haven't, it means that the treatment you get depends on where you live or (more preciesly), who you go to for treatment.
May The Voice be with you!
DavidMcC
 
Name: David McCulloch
Posts: 14913
Age: 67
Male

Country: United Kigdom
United Kingdom (uk)
Print view this post

Re: Depression

#309  Postby Fallible » Jul 06, 2014 5:15 pm

orpheus wrote:
Fallible wrote:Orph, did you experience what I've been told is common and contrary to what some might think - if you had any suicidal ideation and if you are comfortable talking about it - that the urge to do it occurs when one has started to pick up again after having begun meds? The thinking is that when you are very depressed you don't have the energy to do anything about it but when you start taking your tablets, for a small window you have both the depression and the energy to carry it out.


I've read that that's often the case, and it makes sense. Similarly (though a bit different), it can be very dangerous to treat someone with bipolar disorder with only antidepressants. The antidepressant must be combined with a mood stabilizer.

In my case the suicidal ideation was never a big feature to begin with. I thought about death a lot, but thoughts of suicide occurred only infrequently. (They were quite disturbing, though.) In any case, I didn't go through the phase you describe – thank goodness. I'm not sure why. Perhaps it was that my energy returned very slowly, not outpacing my mood improving. Perhaps ongoing therapy helped. (actually I'm sure it did.)


Thanks, Orph. My knowledge of medication is far less than it is of therapy. Glad to hear you didn't suffer from much suicidal ideation to speak of.
She battled through in every kind of tribulation,
She revelled in adventure and imagination.
She never listened to no hater, liar,
Breaking boundaries and chasing fire.
Oh, my my! Oh my, she flies!
User avatar
Fallible
RS Donator
 
Name: Alice Pooper
Posts: 51607
Age: 48
Female

Country: Engerland na na
Canada (ca)
Print view this post

Re: Depression

#310  Postby Beatsong » Jul 06, 2014 7:06 pm

DavidMcC wrote:
nunnington wrote:
DavidMcC wrote:
nunnington wrote: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.
...

So, what treatments (if any) WERE approved at that time?
:scratch:


Their own variety of (non-analytic) psychotherapy.

So it was a kind of postcode lottery, or what?


I don't think that's what was meant. Only that the psychotherapy that was favoured was of the non-freudian variety. Eg cognitive-behavioural, gestalt, etc.
NEVER WRONG. ESPECIALLY WHEN I AM.
User avatar
Beatsong
 
Posts: 7027

United Kingdom (uk)
Print view this post

Re: Depression

#311  Postby Beatsong » Jul 06, 2014 7:15 pm

DavidMcC wrote:
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.


I'm not sure it's possible to know that you're treating "the cause" when we so often don't know what the cause is.

When a treatment works we might determine the cause from that. Eg if talking about your childhood for long enough makes you less depressed, we might say the depression was due to childhood trauma; if taking anti-depressants makes you less depressed, we might say the depression was due to some chemical situation that the anti-depressants addressed. But as has been explained at length already, that doesn't really follow. The fact that a particular intervention has a positive effect doesn't prove that the malady was initially caused by the lack of that intervention. And it's kind of circular: we need to know the cause to assign the treatment, but we only define the cause retrospectively by reference to which treatment worked.

Really I think it's just a question of knowing what works, and the limitations on how well and how often it works. We know antidepressants "work" in some limited ways in terms of lifting mood. We also know that they're not a cure-all, that their effect can get weaker over time, and that they can have certain side effects that are worth avoiding if there are better along term alternatives.
NEVER WRONG. ESPECIALLY WHEN I AM.
User avatar
Beatsong
 
Posts: 7027

United Kingdom (uk)
Print view this post

Re: Depression

#312  Postby DavidMcC » Jul 06, 2014 7:30 pm

Beatsong wrote:
DavidMcC wrote:
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.


I'm not sure it's possible to know that you're treating "the cause" when we so often don't know what the cause is.

...

I didn't say it was, but the fact remains that what works will likely depend on that unknown cause.
May The Voice be with you!
DavidMcC
 
Name: David McCulloch
Posts: 14913
Age: 67
Male

Country: United Kigdom
United Kingdom (uk)
Print view this post

Re: Depression

#313  Postby Ironclad » Jul 07, 2014 12:25 pm


!
GENERAL MODNOTE
How about if everyone gets to the topic and stays there? These back and forth accusations of who is or isn't trolling is at best off-topic and at worst, inflammatory.

Disagree as you will, address the posts.

For Van Youngman - see you amongst the stardust, old buddy

"If there was no such thing as science, you'd be right " - Sean Lock

"God ....an inventive destroyer" - Broks
User avatar
Ironclad
RS Donator
 
Name: Nudge-Nudge
Posts: 23920
Age: 52
Male

Country: Wink-Wink
Indonesia (id)
Print view this post

Previous

Return to Psychology & Neuroscience

Who is online

Users viewing this topic: No registered users and 1 guest