Medication and Depression

[lsbskins1]

In the "Meaning of Life" thread, we ended up in this discussion. I think it is worthy of it's own topic.

Is using an antidepressant medication simply a crutch that helps the patient avoid the underlying problem or is it a positive aid to recovery?

Let me state that I have been diagnosed with Major Depressive Disorder and am currently taking Cymbalta. I feel it has helped me. I take it in conjunction with sessions of Cognitive Behavior Therapy. I have had problems in the past with depression, but had an extended period where I was neither on medication nor in any type of therapy. If I had to make a choice between the two, I would say that I am helped more by the therapy, but...and this is a very big but...I never, ever benefited from therapy without first beginning on medication. The depression was too dark and too deep.

My thoughts are: Used responsibly and in the right mixture of time and place, both are essential to those who are clinically depressed. There are obviously no absolutes in this world and an insignificant statistical minority can and may recover using only medication or only talk therapy, but for the larger majority, both are good and helpful tools.

Thoughts? Disagreements?

[Jack]

This is one of those issues that can only be addressed on a personal basis. I don't think medication is for everyone, nor does the same medication have the same effect on everyone. And some people prefer to self-medicate. You have to experiment to find what works best for you. It might convince you that chemicals aren't for you. Whatever it takes or doesn't take to get you through the day.

[no1ninja]

Since you ask for comments,


Western Cultures seems to have higher amounts of depression and suicide than third world countries.


Major Depression Facts | Clinical-Depression.co.uk



This suggests to me that the problem is not chemistry.



Kids for instance do not want to commit suicide. Teens on the other hand do. What is the difference between these groups? Teens suddenly attribute a higher value of their self worth based on appearance, sexuality and relations.

The way advertising works is by telling you that you lack something and that in order to be "cool" or "complete" you need to have it. Most forms of advertising for cosmetics and fashion attack the individuals sense of identity.


Perhaps the people that are depressed have a higher emotional attachment to their individual identity.

[no1ninja]

.

It may, however, be remarked that suicide is much more common amongst Protestant than amongst Roman Catholic communities, while Jews have a smaller suicide-rate than Roman Catholics . A point of considerable interest is the increase of suicide in relation to the advance of elementary education . Ogle states that suicide is more common among the educated than the illiterate classes . It is also more prevalent in urban than in rural districts . A curious feature in large towns is the sudden outbreak of self-destruction which sometimes occurs, and which has led to its being described as epidemic . In such cases force of example and imitation undoubtedly play a considerable part, as it is well recognized that both these forces exert an influence not only in causing suicide, but also in suggesting the method, time and place for the act Age above five years is exempted from furnishing its quota of suicidal deaths, although self-destruction between five and ten years is very rare .

Here is another source, not the best one, but it brings some points to the debate: SUICIDE (from Lat. sui... - Online Information article about SUICIDE (from Lat. sui...



EDIT: A lot of these points seem to suggest that it is the system of beliefs and the information that you allow in to your head that causes the vast majority of suicides. I don't think this is the sole reason, but a contributing factor has to be the tools an individual has developed in assessing their own self worth.


EDIT2: here is another intersting study

http://archive.lib.msu.edu/DMC/Afric...z002002009.pdf




Supposedly these number distributions are fairly common amongst most societies as to the most dangerous time for an individual to commit suicide. Older people rarely commit suicide, they have learned to cope with their realities. Men in their mid thirties have a high rate of suicide, maybe because their expectations of life does not mesh with their current predicament. These are just my opinions.

[Jack]

Teens suddenly attribute a higher value of their self worth based on appearance, sexuality and relations.

I credit that to self-awareness. It seems that the early teens is the time when many of us become self-aware for the first time in any meaningful way. We have finally lived enough years to begin to build a self-image. We start to think things like, "I'm just like my old man when I..." We aren't yet old enough to hear our parents words coming out of our mouths, that's later. The more heightened awareness we have of ourselves, the more we see others as, well, other. Not us. We are vulnerable to thoughts of being absolutely alone, absolutely meaningless, absolutely without hope; we know that acknowledging those conditions too often can lead to insanity in some people. Suicide is an essentially insane act. No one of a sound mind commits suicide. Something somewhere has gone terribly wrong. The will to survive is our most basic instinct. Everything we do, at every moment, relates to our will to survive. It takes a massive mental effort to over-ride that core imperative and welcome your own death. For some, self-awareness destroys the will to live. Other options range from denial to coping.

[no1ninja]

Here are some Canadian statistics:

Key Suicide Statistics

Suicide rates in Canada have been rising sharply for nearly five decades. Suicide deaths in Canada numbered 3764 in 2003 (BC Partners for Mental Health and Addictions [BCPMHA]: [COLOR=#0000ff]www.heretohelp.bc.ca/sites/default/files/images/17_suicide.pdf[/COLOR]) In the past three decades, more than 100,000 Canadians died by suicide. These deaths include people from all socioeconomic, age, gender, culture and ethnic groups. (The CASP Blueprint for a Canadian National Suicide Prevention Strategy, October, 2004) [CASP 2004]. Of the 82 countries reporting suicide statistics to the WHO, Canada ranks 26th putting it in the top third. [CASP 2004] BC's suicide rates have remained fairly stable, roughly 500 per year [BCPMHA] Of all age groups in Canada, men over the age of 85 have the highest rate of completed suicide rates. [BCPMHA] Suicide is the leading cause of death for men aged 25 to 29 and 40 to 44 (1999). [CASP 2004] The rate of completed suicides is three to four times as high for males, while females are more likely to attempt suicide than are males [CASP 2004] Suicide is the second leading cause of death for youth aged 15 to 19 in BC, Canada, and worldwide. The Canadian suicide rate for this age group increased five-fold between 1952 and 2002. [BCPMHA] In a survey of 15,000 grade 7 to 12 students in BC, 34% knew of someone who had attempted or died by suicide; 16% had seriously considered suicide; 14% had made a suicide plan; 7% had made an attempt and 2% had required medical attention due to an attempt.(Canadian Mental Health Association: [COLOR=#0000ff]www.cmha.ca/bins/content_page.asp?cid=3-101-104[/COLOR]). [CMHA] In 2003, 4% of male and 10% of female high school students in BC reported making a suicide attempt (McCreary Adolescent Health Survey 2003). [McCreary]. The suicide rate for First Nations people in BC is almost three times higher than for the total Canadian population (1997). The suicide rate in Inuit communities ranges from two to six times higher than the national average. [CASP 2004] In 1999, suicide was the leading cause of death for First Nations youth between 10 and 19 years. [CASP 2004] A 2003 survey of BC youth reports that in the previous 12 months, attempted suicide rates for bisexual males were four times higher, and for gay males three times higher than for heterosexual males. Attempted suicide rates for lesbians were five times higher, and for bisexual females four times higher than for heterosexual females. (McCreary 2003).

It is interesting that bi/gay males have higher suicide rate. I think we can all understand that, again this does not point to chemistry but identity.

Notice that aborignal kids also have a high rate of suicide, we now know that these communities suffer some of the highest rates of sexual abuse.

[lsbskins1]

It may simply be a chicken/egg question but depression DOES correlate with neurotransmitters. Does the "thinking" cause the brain to lose transmitters or does the loss of transmitters cause the depression. This question has not been answered, but that a depressed person's brain chemistry is different is pretty well established. See here: Depression

I did find the original link from no1ninja very interesting. The Human Givens Theory is very intriguing. It is facenating to consider that it may answer, or begin to answer, the chicken/egg aspect of the question. If social pressures are shown to be a leading causal factor in depression, then it would be that the "negative thinking patterns" or "misuse of tools" lead to the messed up brain chemistry. But, that does not mean that anti-depressant medications are unnecessary.

[no1ninja]

Quote by: lsbskins1 It may simply be a chicken/egg question but depression DOES correlate with neurotransmitters. Does the "thinking" cause the brain to lose transmitters or does the loss of transmitters cause the depression. This question has not been answered, but that a depressed person's brain chemistry is different is pretty well established. See here: Depression I did find the original link from no1ninja very interesting. The Human Givens Theory is very intriguing. It is facenating to consider that it may answer, or begin to answer, the chicken/egg aspect of the question. If social pressures are shown to be a leading causal factor in depression, then it would be that the "negative thinking patterns" or "misuse of tools" lead to the messed up brain chemistry. But, that does not mean that anti-depressant medications are unnecessary.

I don't think they are un-necessary, I would just only use them as short term crutch, not a way of life.

Just like sometimes the best thing to do is to just get drunk with your friends to forget about a relationship.... if you start doing it every day you become a lush.


For myself, I found that exercise was a very good and reliable way to change my mood. Also organizing and cleaning was helpful as it allowed me to symbolically attach what I was doing externally with bringing order to my internal environment. Than just looking at how much I accomplished gave me a huge sense of satisfaction.

The other aspect that I enjoy is taking courses. I am 36 and I still take university and college courses, they help me improve my knowledge, meet people and gives me a focus/direction when my life lacks it.

[lsbskins1]

Quote by: no1ninja I don't think they are un-necessary, I would just only use them as short term crutch, not a way of life. Just like sometimes the best thing to do is to just get drunk with your friends to forget about a relationship.... if you start doing it every day you become a lush. For myself, I found that exercise was a very good an reliable way to change my mood. Also organizing and cleaning was helpful as it allowed me to symbolically attach what I was doing externally with bringing order to my internal environment. Than just looking at how much I accomplished gave me a huge sense of satisfaction. The other aspect that I enjoy is taking courses. I am 36 and I still take university and college course, they help me improve my knowledge, meet people and give a focus/direction when my life lacks it.

I would not disagree with any of the above statements. As a matter of fact, that is what CBT is really all about. See, sometimes, you just need to flesh out the positions to find that you really aren't all that far apart in your thinking. The only thing I would add is that some people do need long term medication because when they stop the drugs, for whatever reason, the brain chemistry reverts. But, that is what science is all about. Figuring out why that happens.

[Atmospheric]

Perhaps the people that are depressed have a higher emotional attachment to their individual identity.

Yes but it's not just that people are just attached to their identity. They are completely consumed by it. Depressed or not, I think we all experience it to some extent.

Lots of the time we do not live in the present moment. We live in the delusion of our past and future. We become so wrapped up in it, we can actually become the delusion. In other words, we become delusional.

Focusing on a task brings us back to the present moment.

I think the depressed would benefit more from a wise spiritual leader guiding them out of the delusion than a doctor treating their symptoms with prescription drugs.

[Cruella]

Wise spiritual leader? Oh, for goodness sake.

[GeminiBrian]

Quote by: Atmospheric I think the depressed would benefit more from a wise spiritual leader guiding them out of the delusion than a doctor treating their symptoms with prescription drugs.

Whilst I am sympathetic to your Zen-like philosophy, Atmospheric, I have to ask you whether you have any personal experience of being in the grip of major depression episode?

Unless you have, you may not realise that you can easily lose, amongst other important things that give value to your life, the ability to make sense of what people are saying to you, which is terrifying.

The wall around you may not let anything in, not even wise spiritual guidance, since people's speech, however well-intended, has no power to dispel the internal agony, or even to have any meaning at all.

At such times, taking medication, or more precisely, being compelled to take medication, is the only answer. Your brain chemistry is so disorientated by malfunctioning serotonin and dopamine neural pathways that you are quite literally unable to process information properly.

As lsbskins correctly points out, it is irrelevant which order either social pressure or chemical imbalance first came into play - addressing the former on its own (without drugs) is pointless after the process has become self-destructive in its intensity.

Even trained psychiatrists often fail to empathise with this predicament unless they themselves have been through something similar - as Dr Louis Walpert testified most eloquently in the book he wrote after he had been suddenly struck down with severe clinical depression. (A Malign Sadness).

He had not realised up to that point how misguided and inadequate much of the treatment he was used to giving his depressed patients had really been, despite his highly-qualified expertise in the subject.

[Deadeye]

I suffer from chronic, constant, loud/squealing tinnitus. If you can imagine someone blowing one of those tin whistles constantly in your ears you can picture what I experience constantly.

The only time I have relief is when I'm sleeping or in a shower, where the sound of the water masks the noise, which is really a squeal or whistling. It's rather like the 12 o'clock whistle....or possibly a screaming tea pot.

I've had it since I was injured in the infantry...working around tanks, and artillery, grenades, machine gun fire, etc.. War is loud.

When it got extremely loud I considered suicide. It's not the tinnitus (ringing), but the anxiety that it engenders. I got hearing aids, which help. I also take a light "happy" pill. It helps me to sleep and eases some of the anxiety.

Tinnitus is one of the most common reasons for suicide. Try it for a while. Just put a fire under a filled tea pot and set within a few feet of it and try to read the paper. Try to hold a conversation. Death begins to look pretty good.

[Atmospheric]

I think the depressed would benefit more from a wise spiritual leader guiding them out of the delusion than a doctor treating their symptoms with prescription drugs.

You may not realise that you can easily lose, amongst other important things that give value to your life, the ability to make sense of what people are saying to you, which is terrifying. The wall around you may not let anything in, not even wise spiritual guidance, since people's speech, however well-intended, has no power to dispel the internal agony, or even to have any meaning at all. At such times, taking medication, or more precisely, being compelled to take medication, is the only answer. Your brain chemistry is so disorientated by malfunctioning serotonin and dopamine neural pathways that you are quite literally unable to process information properly.

Whilst I clearly see your point GeminiBrian, the discussion evolved to the macroscopic perspective of the prevalence of depression in our society. In a macroscopic analysis, we are forced to make generalizations and they, by their nature, cannot stand up to the individual cases on the extremes of the bell curve.

Humbly, I suggest that a spiritual belief in some thing grander than the individual's identity would be the most effective method for preventing and lifting our society out of depression.

In the severe cases, we would need to resort to drugs. That is not to say they are a cure by any means.

There are only a few forces in the mind powerful enough to drive a person to commit suicide. They are severe depression, insanity and misguided spiritual beliefs. I raise this notion to demonstrate the power of spiritual beliefs on the human mind. This force can be inverted and used for good.

Please note that I do not advocate for organized religion in its current obsolescent state.

[Disinformant]

Most pharmaceutical drugs only attempt to do safely what cannabis does naturally. When the doctor checks to see if you've been drinking enough water and the content of your diet, he should also ask, "hey before coming here did you try and smoke weed? that usually works"

[Cruella]

Sources, please.

[Disinformant]

New antidepressant drug increases 'brain's own cannabis'
Anandamide - Wikipedia, the free encyclopedia

[Cruella]

That's a single drug. Where are the sources for your assertation that "most pharmaceutical drugs" work that way, please?

[Disinformant]

hmmm? i think you misunderstood something

[GeminiBrian]

Quote by: Atmospheric Please note that I do not advocate for organized religion in its current obsolescent state.

I suggest that before we proceed any further it would help if you defined exactly which system of belief it is you advocate - at the moment, you keep us guessing.