Depression

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Depression

#1  Postby talkietoaster » Jul 03, 2013 10:14 am

Are anti-depressants a valid way in dealing with depression at all? Do tablets help your overall recovery (if thats possible) is it just a managing medication?

I was wondering for people perspectives because I would think tablets are only there to help manage someones condition while they use the talking therapies to help their recovery like counselling, Cognitive Behavioural therapy etc...
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Re: Depression

#2  Postby Scar » Jul 03, 2013 10:30 am

Tablets are essential during phases when it's really bad. No amount of therapy can help you then.

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Re: Depression

#3  Postby talkietoaster » Jul 03, 2013 10:46 am

Scar wrote:Tablets are essential during phases when it's really bad. No amount of therapy can help you then.

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What does the second line mean?

So tablets are just a form to help manage the mood levels, while therapy should help to stablise the mind in the future, if that is a possibility.
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Re: Depression

#4  Postby Fallible » Jul 03, 2013 11:09 am

talkietoaster wrote:
Scar wrote:Tablets are essential during phases when it's really bad. No amount of therapy can help you then.

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What does the second line mean?


It's the ''sent from my Nexus with Tapatalk" message that some people tag to their posts.

So tablets are just a form to help manage the mood levels, while therapy should help to stablise the mind in the future, if that is a possibility.


I'm a therapist, so here is my take - tablets are for managing a condition, yes, like medication for physical illnesses manage those conditions. Depression can ''go away'' while you are taking tablets, but then it can come and go anyway regardless of whether you are taking medication. For example I took them in about 1997 and have not taken them since, but have only been depressed once since then. Also it depends just how low you are and why you are low. If your depression is situational, tablets can help you through the tough times until life returns to normality, after which you don't need them anymore. Or the causes can be less obvious and not relating to anything specific you're going through, and medication can help you to manage that. Depending on how low my clients are, I might suggest that they try a dual-pronged approach - medication which evens them out, and therefore enables them to be more receptive to therapy. Therapy such as CBT has been shown to be as effective as SSRIs, and of course without the withdrawal symptoms which can be the legacy of some medications.

Edit: and yes, the aim of therapies is to help you to manage life better in the long-term, either by giving you the opportunity to better understand how you tick or to actually re-train your brain to make different connections and perceive things more rationally, which then has a knock-on effect on your mood.
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Re: Depression

#5  Postby talkietoaster » Jul 03, 2013 11:28 am

Fallible wrote:
talkietoaster wrote:
Scar wrote:Tablets are essential during phases when it's really bad. No amount of therapy can help you then.

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What does the second line mean?


It's the ''sent from my Nexus with Tapatalk" message that some people tag to their posts.

So tablets are just a form to help manage the mood levels, while therapy should help to stablise the mind in the future, if that is a possibility.


I'm a therapist, so here is my take - tablets are for managing a condition, yes, like medication for physical illnesses manage those conditions. Depression can ''go away'' while you are taking tablets, but then it can come and go anyway regardless of whether you are taking medication. For example I took them in about 1997 and have not taken them since, but have only been depressed once since then. Also it depends just how low you are and why you are low. If your depression is situational, tablets can help you through the tough times until life returns to normality, after which you don't need them anymore. Or the causes can be less obvious and not relating to anything specific you're going through, and medication can help you to manage that. Depending on how low my clients are, I might suggest that they try a dual-pronged approach - medication which evens them out, and therefore enables them to be more receptive to therapy. Therapy such as CBT has been shown to be as effective as SSRIs, and of course without the withdrawal symptoms which can be the legacy of some medications.

Edit: and yes, the aim of therapies is to help you to manage life better in the long-term, either by giving you the opportunity to better understand how you tick or to actually re-train your brain to make different connections and perceive things more rationally, which then has a knock-on effect on your mood.


Thank for your post Fallible.

I will be attending a doctors appointment today to see if I can be refered to the counselling / psychological services the NHS gives to people. I have had a hard time for the last 4 years in life (also some past issues), it seems I have been in a permanent state of feeling extremely down, feeling like I have to force myself to work (work helps to distract my mind), I can get extremely sad but I seem to push myself through it (but I do feel happiness with my wife and son, but it seems to revert back to feeling down). I did pay for some counselling privately (did seem to help my mood) but couldn't afforded for a while until fiancial matters got back on track. However, i feel if I can get a free service for a time with some therapy it may help my situation.

It's strange to feel like if I take tablets I have somehow failed. However, after my wife highlighted my mood and then I took it on myself to monitor my mood with a dairy, it seems best I try to get some help. Hopefully I've recognised my problem earlier than others or that my feelings are on the lower end of the scale.

Your post was helpful to put the tablets into perspective.
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Re: Depression

#6  Postby Fallible » Jul 03, 2013 12:02 pm

talkietoaster wrote:

Thank for your post Fallible.

I will be attending a doctors appointment today to see if I can be refered to the counselling / psychological services the NHS gives to people.


Ah, this is probably the kind of service I work for. People are referred to our counselling practice through the NHS. Incidentally my husband has just been through what you are in the process of finding out about. He was quite readily offered therapy as well as medication, and has opted for the belt and braces approach I mentioned above. He is taking a low dose antidepressant (Citalopram) and begins a course of CBT later this month. The waiting list in our area seems to be about 6 weeks, I don't know what your experience will be.

I have had a hard time for the last 4 years in life (also some past issues), it seems I have been in a permanent state of feeling extremely down, feeling like I have to force myself to work (work helps to distract my mind), I can get extremely sad but I seem to push myself through it (but I do feel happiness with my wife and son, but it seems to revert back to feeling down). I did pay for some counselling privately (did seem to help my mood) but couldn't afforded for a while until fiancial matters got back on track. However, i feel if I can get a free service for a time with some therapy it may help my situation.


Definitely. Do you know what you would prefer? The main ones are counselling (Person-Centred) and CBT. Certainly I have seen some people undergo big changes for the better through therapy, but I think it's useful to bear in mind that no one thing works for everybody. One of the main things that you can bring which will enable your recovery will be your willingness to engage, especially with CBT, I doubt this will be a problem for you.

It's strange to feel like if I take tablets I have somehow failed.


Well it's really not all that strange, I often have people tell me when I ask that they aren't taking medication because they want to sort it out by themselves - like they just need to give themselves a kick up the arse and not be so weak. I talk to them about how if they had a physical condition they wouldn't feel weak for taking their medication. If they have an infection they take antibiotics, for example. That seems to make sense to some of them and they reconsider tablets.

However, after my wife highlighted my mood and then I took it on myself to monitor my mood with a dairy, it seems best I try to get some help. Hopefully I've recognised my problem earlier than others or that my feelings are on the lower end of the scale.


This is what makes me think you won't have any problems with motivation in getting better. Although you're low and that affects your motivation, you are already taking it upon yourself to implement things to help you gain a better understanding of your condition and therefore move forward. Good for you, talkie.

Your post was helpful to put the tablets into perspective.
[/quote]

They can definitely be useful and sometimes literally a life-saver. They don't make you leap about with euphoria or change who you are (this is something some of my clients are concerned about). The mainstream ones just level out your mood so you don't experience the crashing lows. Of course there are side-effects. My husband experienced restless legs, short-term increased anxiety (a few days) and an occasional day of feeling tweaked, but these subsided quickly and he is beginning to feel a bit more like himself. Anyway I wish you every success with your progress, and if there's anything I can help with let me know.
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Re: Depression

#7  Postby chairman bill » Jul 03, 2013 12:05 pm

The research (I can dig some out if necessary) suggests that medication is as useful as medication & therapy. I've had both, and the first lot of medication nearly killed me (fucking Prozac). Thereafter I think medication and/or therapy, are just means of keeping a patient going 'til time (hopefully) does the healing.

For some, only medication will work, and again, for some, it becomes a life-long requirement.
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Re: Depression

#8  Postby Fallible » Jul 03, 2013 12:11 pm

I was given Seroxat which it was later found sometimes casued increased suicidal ideation. I think it was linked to some cases of family wipe-outs also. This was about 16 years ago now though.
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Re: Depression

#9  Postby chairman bill » Jul 03, 2013 12:13 pm

If I remember correctly, it wasn't an increase in suicidal ideation, but an enhanced tendency towards impulsiveness, such that suicidal ideation was more likely to be acted upon. That's certainly how Proxac impacted on me. Terrifying stuff, as if constant thoughts of suicide weren't bad enough.
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Re: Depression

#10  Postby Fallible » Jul 03, 2013 12:16 pm

Ah, thanks bill. Yeah, must have been a nightmare. Again you might know more, but I think men tend to act more impulsively anyway on their suicidal thoughts whereas women tend to contemplate it and discuss it more..?
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Re: Depression

#11  Postby talkietoaster » Jul 03, 2013 1:13 pm

Fallible wrote:

Ah, this is probably the kind of service I work for. People are referred to our counselling practice through the NHS. Incidentally my husband has just been through what you are in the process of finding out about. He was quite readily offered therapy as well as medication, and has opted for the belt and braces approach I mentioned above. He is taking a low dose antidepressant (Citalopram) and begins a course of CBT later this month. The waiting list in our area seems to be about 6 weeks, I don't know what your experience will be.


I think it just depends on the demand sometimes, I could possible take that long for me. In the meantime I am moving housing so that should keep me busy somewhat.

I work in the NHS as well (hospital, 2nd job), I figured depending on the doctor I get he should offer both types. Probably a low dose because when I compare how I act to those that have high doses, I feel I am lower on the scale. I can still get out of bed, to my job, do things at home like playing with my son and spending time with my wife. So I try to think of it as a positive that I haven't let those slip, where my wife told me when she was depressed due to her history would sleep 20 hour days. So I feel I am more informed then most so I am keep a better handle of it.

Fallible wrote:
Definitely. Do you know what you would prefer? The main ones are counselling (Person-Centred) and CBT. Certainly I have seen some people undergo big changes for the better through therapy, but I think it's useful to bear in mind that no one thing works for everybody. One of the main things that you can bring which will enable your recovery will be your willingness to engage, especially with CBT, I doubt this will be a problem for you.


I think I would prefer Counselling of a Psychotherapist (i am more open to take a low dose of Anti-D, if they helps me in my daily life), due to the fact my father never gave me support in dealing with my mums death at 10 years old. I have alot of baggage, you know how it goes it have this chain reaction through the family. Especially my father was born in 1938, so for him to get counselling is a complete no no, stiff upper lip and get on.

I was asking about Anti-D's because I used to go to the gym, I lost lots of weighted but I think just recently in the last 3-4 months my mind have got to the point on only surviving. Wake up, breakfast, job etc... if you know what I mean. I make sure I can complete the basics of life, being de-motivated for something I love like the gym, swimming has hurt.

I am aware that one things doesn't work for all, but knowing I was responsive to counselling that would be logical to follow with CBT.

Fallible wrote:
Well it's really not all that strange, I often have people tell me when I ask that they aren't taking medication because they want to sort it out by themselves - like they just need to give themselves a kick up the arse and not be so weak. I talk to them about how if they had a physical condition they wouldn't feel weak for taking their medication. If they have an infection they take antibiotics, for example. That seems to make sense to some of them and they reconsider tablets.


Thats why I like your post because it made me, see it that way and has made me more comfortable with the idea. But I'll see how the doctor will advise me.

Fallible wrote:
This is what makes me think you won't have any problems with motivation in getting better. Although you're low and that affects your motivation, you are already taking it upon yourself to implement things to help you gain a better understanding of your condition and therefore move forward. Good for you, talkie.


Thank you for the vote of confidence. I do want to get back to doing things I loved to do because I am always been a person that believes I can accomplish anything if I put my mind to it. So I know I need to do this, to accomplish my goal to get back on track with my personal life. I feel I have been lucky I haven't neglected my son or wife regardless how I feel, where I know some people can get very withdrawn.

Fallible wrote:
They can definitely be useful and sometimes literally a life-saver. They don't make you leap about with euphoria or change who you are (this is something some of my clients are concerned about). The mainstream ones just level out your mood so you don't experience the crashing lows. Of course there are side-effects. My husband experienced restless legs, short-term increased anxiety (a few days) and an occasional day of feeling tweaked, but these subsided quickly and he is beginning to feel a bit more like himself. Anyway I wish you every success with your progress, and if there's anything I can help with let me know.


Thanks for highlighting the effects, this should help me make a good decision if I the anti-depressants or not. I have found that I have never reacted to any medication, so my body seems to be pretty good at assimluating tablets. So I won't have a worry to take them I think, I will just make sure I'll keep an eye on my mood as I know it can take a few weeks for the anti-depressants to take effect.

Thanks for your input Fallible, completely invaluable. I hope you husband progress's well. :cheers:
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Re: Depression

#12  Postby Fallible » Jul 03, 2013 1:20 pm

Thanks. You too, talkie. This is all just my take, I'm not a medical professional. Hopefully you have a good GP who you can thoroughly discuss things with before deciding what to do. Would be interested to know how it goes. :cheers:
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Re: Depression

#13  Postby talkietoaster » Jul 03, 2013 1:21 pm

chairman bill wrote:The research (I can dig some out if necessary) suggests that medication is as useful as medication & therapy. I've had both, and the first lot of medication nearly killed me (fucking Prozac). Thereafter I think medication and/or therapy, are just means of keeping a patient going 'til time (hopefully) does the healing.

For some, only medication will work, and again, for some, it becomes a life-long requirement.


I'll love to read up on the research if you can get it. Everytime I don't understand something I always read up on it, I hate being ignorant to the reality of something I have no clue about.
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Re: Depression

#14  Postby Ironclad » Jul 03, 2013 2:10 pm

talkietoaster wrote:Are anti-depressants a valid way in dealing with depression at all? Do tablets help your overall recovery (if thats possible) is it just a managing medication?

I was wondering for people perspectives because I would think tablets are only there to help manage someones condition while they use the talking therapies to help their recovery like counselling, Cognitive Behavioural therapy etc...


For me they were a valid recovery aid but they were essential for me as councelling therapy was to be a long time coming.
I switched to SNRIs after a couple of years, I'd heard these new breed of pills were a little like MDMA, but just like prozac they were side effect evil for me. Though l do gather these are 'better' for many.
CBT just didn't cut it for me, l had better joy with psychotherapy & SSRIs. Oh, for me about five years on pills was enough. The therapy was the real key to escape my depression but the drugs were the life saver.

Four years (ish) on, no pills or relapsing. I demanded to the doctor that I was to take a reducing scheme, despite him insisting that it's fine to take the for life, and here we are. So yes, the therapies all work. So use them if you need them. :)
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Re: Depression

#15  Postby chairman bill » Jul 03, 2013 2:30 pm

talkietoaster wrote:
chairman bill wrote:The research (I can dig some out if necessary) suggests that medication is as useful as medication & therapy. I've had both, and the first lot of medication nearly killed me (fucking Prozac). Thereafter I think medication and/or therapy, are just means of keeping a patient going 'til time (hopefully) does the healing.

For some, only medication will work, and again, for some, it becomes a life-long requirement.


I'll love to read up on the research if you can get it. Everytime I don't understand something I always read up on it, I hate being ignorant to the reality of something I have no clue about.


I'll see what I can dig out. In the meantime, if you've any academic articles on the subject that you want, let me know & I'll see if I can get hold of the relevant pdf
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Re: Depression

#16  Postby Asta666 » Jul 03, 2013 3:56 pm

talkietoaster wrote:Are anti-depressants a valid way in dealing with depression at all? Do tablets help your overall recovery (if thats possible) is it just a managing medication?

I was wondering for people perspectives because I would think tablets are only there to help manage someones condition while they use the talking therapies to help their recovery like counselling, Cognitive Behavioural therapy etc...

They seem to be pretty effective, although maybe not because of the proposed biochemical mechanisms of action in milder cases.
Here you can read for free an interesting meta-analysis from last year comparing the effectiveness of treatment methods for depression, which IMO utilized robust selection criteria: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3408478/
:thumbup:
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Re: Depression

#17  Postby Scot Dutchy » Jul 03, 2013 4:27 pm

I was very depressed when my girlfriend died in 2002 and suffered from severe panick attacks.

I was given medication and saw a psychotherapist. The medication just kept me stable and stopped the panick attacks taking control of me.

I saw the psychotherapist for 7 months and also ended up in a self help group which did a lot of good.

Now I have cronic tinnitus. There is nothing physically that can be done. I have seen a psychologist and she recommended me to a psychotherapist who specialises in tinnitus treatment. The only thing it will be October before she can treat me. Apparently she is the only one in the Netherlands with this specialism.

The tinnitus has one very bad side effect. I get tinnitus attacks during which I lose complete control and can do anything (very scary). I am taking daily Oxzepam which stops the attacks occuring and keeps me quiet.
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Re: Depression

#18  Postby talkietoaster » Jul 03, 2013 6:42 pm

Asta666 wrote:
talkietoaster wrote:Are anti-depressants a valid way in dealing with depression at all? Do tablets help your overall recovery (if thats possible) is it just a managing medication?

I was wondering for people perspectives because I would think tablets are only there to help manage someones condition while they use the talking therapies to help their recovery like counselling, Cognitive Behavioural therapy etc...

They seem to be pretty effective, although maybe not because of the proposed biochemical mechanisms of action in milder cases.
Here you can read for free an interesting meta-analysis from last year comparing the effectiveness of treatment methods for depression, which IMO utilized robust selection criteria: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3408478/
:thumbup:


Thanks for that, will be reading up shortly. :thumbup:
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Re: Depression

#19  Postby talkietoaster » Jul 03, 2013 6:43 pm

Scot Dutchy wrote:I was very depressed when my girlfriend died in 2002 and suffered from severe panick attacks.

I was given medication and saw a psychotherapist. The medication just kept me stable and stopped the panick attacks taking control of me.

I saw the psychotherapist for 7 months and also ended up in a self help group which did a lot of good.

Now I have cronic tinnitus. There is nothing physically that can be done. I have seen a psychologist and she recommended me to a psychotherapist who specialises in tinnitus treatment. The only thing it will be October before she can treat me. Apparently she is the only one in the Netherlands with this specialism.

The tinnitus has one very bad side effect. I get tinnitus attacks during which I lose complete control and can do anything (very scary). I am taking daily Oxzepam which stops the attacks occuring and keeps me quiet.


I hope October comes round quicker for you. I have a colleague at work I just met today that has Tinnitus, horrible stuff. Thanks for your input its useful getting a consensus. :cheers:
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Re: Depression

#20  Postby talkietoaster » Jul 03, 2013 6:47 pm

Quick Update -

I have been to the Doctor and when he asked me to talk through I am feel and what is going on in my life. He pretty much said there is no wonder you are feeling how you are. What I will do is refer you to, to our in house counsellor at the Surgery so you can be seen straight away in a week and I will give you a low dose of anti depressants.

So I feel pretty good I made that first step and the doctor said he was confident in how I have approached this that I should be alright. However, if there is any change make sure I see him straight away. He is a good doctor, he helped me before with a whiplash injury.

Either way I am on the first steps to get this sorted, just taken my 1st dose now. I feel good at the moment, feels like a burden has been lifted off me.
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