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Really? That's not what any of the doctors I've or people I've dealt with have said or act like. Even my psychologist (who can't rx) was fairly insistent that w

Really? That's not what any of the doctors I've or people I've dealt with have said or act like. Even my psychologist (who can't rx) was fairly insistent that without medication there was only so far she could go and refusal to take it was a problem. Then there's the fact that a lot of people end up on anti-depressants and feel much better and are happy with the result.) (Though I agree that mental meds are fairly shitty overall. Particularly anti-depressants and anti-psychotics. And they're really heavy treatments with potentially horrible side effects, so a talking therapy makes sense as it won't, for instance, cause your skin to die and fall off unlike some meds. Docs seem sorta-OK prescribing amphetamines in combination, but vastly more hesitant to even consider opiate treatment for depression.)

bcarlyle 11y ago
Clinical psychologist here. The doctors I work with prescribe cognitive behavioral therapy as the first hand treatment for depression and antidepressant when therapy is ineffective (which isn't all that common). One of the reasons that antidepressant are so widespread is that doctors are usually in charge of treatment and seldom perform therapy but are very used to prescribing medication. Also the fact that millions of people are depressed makes it hard to give everyone access to therapy. In my opinion it is much harder to treat a patient on antidepressant since they respond worse to treatment then a depressed patient who is not on medication. Depression is a devastating disease but it is astounding how effective therapy can be for a lot of patients. I regularly meet patients who are very depressed when we first meet who manage to overcome their depression in a couple of weeks. Physical activity is also very good at treating depression. http://www.tandfonline.com/doi/abs/10.1080/17437199.2015.1022901 http://www.tandfonline.com/doi/abs/10.1080/17437199.2015.102... If everyone would exercise the demand for therapists would be much lower. One mistake that many depressed patients make is holding a strong view that they are a person who suffers from depression. This keeps the patient from realising that depression is a condition caused by their interaction with the environment and that it isn't personal. I think one problem with the article is that it seems that the person still views herself in this way instead of fully realising whatever it is that is needed for keeping him/her from becoming depressed again.
klibertp 11y ago
> Docs seem sorta-OK prescribing amphetamines in combination, but vastly more hesitant to even consider opiate treatment for depression. I wonder, do opiates have any positive effect on depression? Short- or long-term? What about physical dependency? What about psychological addiction?
DanBC 11y ago
There's a difference between saying "medication works" and saying "medication works by correcting a chemical imbalance". > Docs seem sorta-OK prescribing amphetamines in combination, but vastly more hesitant to even consider opiate treatment for depression.) Ketamine is currently experimental for major depression and anhedonia. Opiates are currently the med most used in death by suicide in the UK, (#1 opiates, #4 opiate and paracetamol combination) so it seems reasonable to be cautious about prescribing opiates to a group at increased risk of suicide.

bcarlyle 11y ago

Clinical psychologist here. The doctors I work with prescribe cognitive behavioral therapy as the first hand treatment for depression and antidepressant when therapy is ineffective (which isn't all that common). One of the reasons that antidepressant are so widespread is that doctors are usually in charge of treatment and seldom perform therapy but are very used to prescribing medication. Also the fact that millions of people are depressed makes it hard to give everyone access to therapy. In my opinion it is much harder to treat a patient on antidepressant since they respond worse to treatment then a depressed patient who is not on medication. Depression is a devastating disease but it is astounding how effective therapy can be for a lot of patients. I regularly meet patients who are very depressed when we first meet who manage to overcome their depression in a couple of weeks. Physical activity is also very good at treating depression. http://www.tandfonline.com/doi/abs/10.1080/17437199.2015.1022901 http://www.tandfonline.com/doi/abs/10.1080/17437199.2015.102... If everyone would exercise the demand for therapists would be much lower. One mistake that many depressed patients make is holding a strong view that they are a person who suffers from depression. This keeps the patient from realising that depression is a condition caused by their interaction with the environment and that it isn't personal. I think one problem with the article is that it seems that the person still views herself in this way instead of fully realising whatever it is that is needed for keeping him/her from becoming depressed again.

klibertp 11y ago

> Docs seem sorta-OK prescribing amphetamines in combination, but vastly more hesitant to even consider opiate treatment for depression. I wonder, do opiates have any positive effect on depression? Short- or long-term? What about physical dependency? What about psychological addiction?

DanBC 11y ago

There's a difference between saying "medication works" and saying "medication works by correcting a chemical imbalance". > Docs seem sorta-OK prescribing amphetamines in combination, but vastly more hesitant to even consider opiate treatment for depression.) Ketamine is currently experimental for major depression and anhedonia. Opiates are currently the med most used in death by suicide in the UK, (#1 opiates, #4 opiate and paracetamol combination) so it seems reasonable to be cautious about prescribing opiates to a group at increased risk of suicide.