7 ms·

reads like a medication pamphlet. therapy is more useful than drugs, even if drugs are needed eventually. but I think this follow the US school of thought, wh

by gcb0 9y ago

reads like a medication pamphlet. therapy is more useful than drugs, even if drugs are needed eventually. but I think this follow the US school of thought, where therapy is just one session required for liability before you're sent to a psych who will prescribe a pill regimen on the very first session. unbelievable.

viach 9y ago
> therapy is more useful than drugs, even if drugs are needed eventually. Is it your opinion based on... ?
- sqldba 9y ago
  Not the OP but Feeling Good states that people responded to CBT as good or better than drugs, though, both at once were more effective again. They could also be thinking of Anatomy of an Epidemic where long term results of people on drugs are worse than those off. Specifically that there's never been such a finding for CBT having a long term negative impact. (Disclaimer: I'm not a medical specialist just a sufferer and reader)
- gcb0 9y ago
  says the whole world. almost every european country requires you to do minimum hours of therapy before and to keep with therapy during the drug usage. to begin with, I could refer you to the study the article is about. it correlates a social setting with high occurrence of depression. then it proceeds to promote the solution with medication. when the obvious solution is changing the social setting! that is the definition of the 80s joke "prozac for bad hair day"
  - vertex-four 9y ago
    Or, in other words, (at least some part of) the medical industry is driven by the neoliberal ideal that it's never anything else that's the problem, only yourself, and you're meant to deal with it with minimal impact on anyone around you? Work must never be an issue, or we might have to treat workers well. Society and societal structures must never be an issue, or we might have to care about each other on a more than skin-deep level and drop this whole "we are all independent beings who are completely unaffected by external factors" madness. At least some part of mental healthcare is essentially a system designed to help people cope with a society which does horrific things to them, and then gaslights them into believing it's their fault for not coping with it.
    - jokoon 9y ago
      > and then gaslights them into believing it's their fault for not coping with it. I don't understand why you say that. Are you saying therapy make people feel guilty of their own self?
      - vertex-four 9y ago
        No, society does that. Our society is, apparently, perfect, and if you have trouble living in it, it's your fault - says society. However, how we often approach mental healthcare - as something individualistic and separate from society - is one of the things that normalises it.
        jokoon 9y ago
        > is one of the things that normalises it. Why ? It depends, coping with the imperfection of society is also something to work on. Accepting its flaws lets you walk around it. Sometimes it's not the individual who is the problem, but it doesn't mean he should not accept how the society is flawed. Mental healthcare and therapy have an individualistic approach because that's what they do, how else? To change society you would need politics, and that's another matter entirely. I often say that mental illness doesn't really exist, because as long as we don't understand the brain there is no "normal" behavior. But as the same time you can't deny that society has its norms.
        vertex-four 9y ago
        > To change society you would need politics, and that's another matter entirely. That's the point - it's not another matter entirely. If society is damaging people's mental health, it's entirely unethical to look the other way and pretend it's each individual's problem. If mental healthcare professionals want to ensure the wellbeing of their patients, they need to be fighting alongside us for widespread societal change, and they need to fight against the myth of poor mental health being an individual anomaly. But getting to that point requires an understanding that mental health isn't individualistic in the first place, which is not what we're told, and it's not what our doctors are taught. What we have right now is, a lot of the time, treating symptoms and providing coping mechanisms instead of treating the causes. Imagine a doctor did that with a broken leg - refused to touch it, but instead provided you painkillers and explained how to plan routes around the city with lots of seats you can sit in when the pain gets too much.
  - icantdrive55 9y ago
    1. In the United States most insurance will pay for a handful of Therapy sessions. 2. I had a breakdown years ago. Looking back it was just a massive Panic Attack. What really surprised me is I woke up the next morning feeling o.k., then out of the blue--life crushing anxiety. Anxiety so bad I just physically shook, and was always in tears. This went on for years. 3. After a week into the anxiety, I saw a Ph.D in psychology. I spent all my savings on these sessions. The result--not a bit of help. Now, they will claim that twice a week for 9 months is "not giving it enough time", but at a $100 a session it was just a waste of money. 4. I was finally referred to a Psychiatrist. He put me on all the antidepressants. None worked. He put me on a long half life benzodiazepine, and with a bottle of wine I was kinda functional. 5. My point is try Psychology/Psychiatry. Remember it's more of an art, than a science. I didn't realize this when I was in my twenties. Over the years, I have seem the spark dwindle from my Psychiatrist's eyes. I think if he had a do over, he would have picked a different speciality. 6. If I had a do over, I would have skipped it all. I did eventually stop drinking, but for years it was the only drug that worked, besides having to beg for low doses of benzodiazepines. I'm now trying to get off benzos, but figure why, at this point in my life. It's still a bitch getting any controlled drug from most doctors. 7. I can say this. So many of you will just get better with Time, but it might take awhile. (The "Professionals" conviently leave this out. There are some studies praising time verse therapy/drugs, but they are buried, and were small studies. I my case, it felt like I wounded my brain that night of the huge anxiety attack, and it would take years to heal. The experts told me most people do get better in a few weeks. I didn't. The depression arose because my life went from great to just lucky to get to sleep. Exercise did help eventually. At first, it didn't at all. I needed alcohol. I didn't want to blow out my liver in my twenties, so I only drank when I absolutely needed it. Don't overload that liver. 8. I once had a talk to a resident Psychiatrist. At first, he was a a cheerleader for his decision to specialize in psychiatry. After some debate, and honest reflection, he admitted to me all the modalities/drugs work a tiny bit in some patients, and the profession has a way to go. 9. I do know this, patients whom have been on a drug for a period of a few years shouldn't have to go into those prearranged sessions, just to refill a script. If the drug does not require blood monitoring, the patient should get refills. I know so many people who self medicated with alcohol, because our American system of treating mental illness sucks. 10. Time. I know, who has time. I need to function tomorrow. You have my heart.
  - Noos 9y ago
    But you can have the best social setting, and mental illness will still happen and still affect you dealing with things. Depression makes it just as hard to get out of bed on nice days as foul ones.
    - peteretep 9y ago
      Quite. Sadness, apathy and anxiety are all symptoms of mental illness. But they're symptoms of all sorts of things too -- including social setting etc, and so people tend to conflate the two.
    - gcb0 9y ago
      yes, but thats off topic to the article, which focus on a very specific region/profession/time.
  - peteretep 9y ago
    You are confusing therapy being the front-line treatment with it being the most useful treatment.
- privateprofile 9y ago
  There is a growing body of research [1] that questions the usefulness of drugs for mental health. I personally know a case at a local hospital (in Europe) where a switch off meds and into therapy brought serious improvements in elderly patients. [1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2582668/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2582668/ , https://blogs.scientificamerican.com/cross-check/are-antidepressants-just-placebos-with-side-effects/ https://blogs.scientificamerican.com/cross-check/are-antidep... , https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4592645/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4592645/
peteretep 9y ago
> reads like a medication pamphlet I did both. The therapy was of limited use. The pills were like a light switch that have simply turned off my mental illness with almost no side-effects.
- ThrowawayP 9y ago
  > The pills were like a light switch that have simply turned off my mental illness with almost no side-effects. That means that you're in the not particularly large fraction of people that the pills work well for. Good for you. For the rest of us, well, the pills can be a hell of side-effects, tolerance, and rebound ... and that's if they have any primary positive effect at all.
  - peteretep 9y ago
    > not particularly large fraction Citation?
    - DanBC 9y ago
      Draft NICE guidance on depression probably has lots of information. https://www.nice.org.uk/guidance/GID-CGWAVE0725/documents/draft-guideline https://www.nice.org.uk/guidance/GID-CGWAVE0725/documents/dr... Pages 38 to 45 probably most useful, especially pages 40 onwards. (Personally, I think meds are useful, and I think good quality talking therapies are useful, and I think people should have access to both, and access to a range of psycho-social interventions.)
  - gcb0 9y ago
    the pills does have lots of side effects. if they work on one aspect, they do work on others, because there is not a single pill on the market that can target one receptor only. absolutely no reseach, not even the ones very favourable to the drugs, show zero side effects. none. zero. targeting a single receptor with full confidence is the holy grail of big pharma. what happens with your case, is that you do not care about side effects. or even welcome them. just like most depressed people in bad marriages welcome the lower sex drive, or stressed people at work welcome the drone like sleepless life. And you will not even know you are living like that until you go to a good therapist, which seem to be very rare in the US. all that said, I sincerely whish you get well and eventually go without the meds. And I am happy you did seek out help. That's the rigth spirit. Just do not shrug off therapy. Do take the time to work with a few different ones during a year, even if you honestly believe the meds cured you 100%

by gcb0 9y ago

viach 9y ago

> therapy is more useful than drugs, even if drugs are needed eventually. Is it your opinion based on... ?

sqldba 9y ago
Not the OP but Feeling Good states that people responded to CBT as good or better than drugs, though, both at once were more effective again. They could also be thinking of Anatomy of an Epidemic where long term results of people on drugs are worse than those off. Specifically that there's never been such a finding for CBT having a long term negative impact. (Disclaimer: I'm not a medical specialist just a sufferer and reader)
gcb0 9y ago
says the whole world. almost every european country requires you to do minimum hours of therapy before and to keep with therapy during the drug usage. to begin with, I could refer you to the study the article is about. it correlates a social setting with high occurrence of depression. then it proceeds to promote the solution with medication. when the obvious solution is changing the social setting! that is the definition of the 80s joke "prozac for bad hair day"
- vertex-four 9y ago
  Or, in other words, (at least some part of) the medical industry is driven by the neoliberal ideal that it's never anything else that's the problem, only yourself, and you're meant to deal with it with minimal impact on anyone around you? Work must never be an issue, or we might have to treat workers well. Society and societal structures must never be an issue, or we might have to care about each other on a more than skin-deep level and drop this whole "we are all independent beings who are completely unaffected by external factors" madness. At least some part of mental healthcare is essentially a system designed to help people cope with a society which does horrific things to them, and then gaslights them into believing it's their fault for not coping with it.
  - jokoon 9y ago
    > and then gaslights them into believing it's their fault for not coping with it. I don't understand why you say that. Are you saying therapy make people feel guilty of their own self?
    - vertex-four 9y ago
      No, society does that. Our society is, apparently, perfect, and if you have trouble living in it, it's your fault - says society. However, how we often approach mental healthcare - as something individualistic and separate from society - is one of the things that normalises it.
      - jokoon 9y ago
        > is one of the things that normalises it. Why ? It depends, coping with the imperfection of society is also something to work on. Accepting its flaws lets you walk around it. Sometimes it's not the individual who is the problem, but it doesn't mean he should not accept how the society is flawed. Mental healthcare and therapy have an individualistic approach because that's what they do, how else? To change society you would need politics, and that's another matter entirely. I often say that mental illness doesn't really exist, because as long as we don't understand the brain there is no "normal" behavior. But as the same time you can't deny that society has its norms.
        vertex-four 9y ago
        > To change society you would need politics, and that's another matter entirely. That's the point - it's not another matter entirely. If society is damaging people's mental health, it's entirely unethical to look the other way and pretend it's each individual's problem. If mental healthcare professionals want to ensure the wellbeing of their patients, they need to be fighting alongside us for widespread societal change, and they need to fight against the myth of poor mental health being an individual anomaly. But getting to that point requires an understanding that mental health isn't individualistic in the first place, which is not what we're told, and it's not what our doctors are taught. What we have right now is, a lot of the time, treating symptoms and providing coping mechanisms instead of treating the causes. Imagine a doctor did that with a broken leg - refused to touch it, but instead provided you painkillers and explained how to plan routes around the city with lots of seats you can sit in when the pain gets too much.
- icantdrive55 9y ago
  1. In the United States most insurance will pay for a handful of Therapy sessions. 2. I had a breakdown years ago. Looking back it was just a massive Panic Attack. What really surprised me is I woke up the next morning feeling o.k., then out of the blue--life crushing anxiety. Anxiety so bad I just physically shook, and was always in tears. This went on for years. 3. After a week into the anxiety, I saw a Ph.D in psychology. I spent all my savings on these sessions. The result--not a bit of help. Now, they will claim that twice a week for 9 months is "not giving it enough time", but at a $100 a session it was just a waste of money. 4. I was finally referred to a Psychiatrist. He put me on all the antidepressants. None worked. He put me on a long half life benzodiazepine, and with a bottle of wine I was kinda functional. 5. My point is try Psychology/Psychiatry. Remember it's more of an art, than a science. I didn't realize this when I was in my twenties. Over the years, I have seem the spark dwindle from my Psychiatrist's eyes. I think if he had a do over, he would have picked a different speciality. 6. If I had a do over, I would have skipped it all. I did eventually stop drinking, but for years it was the only drug that worked, besides having to beg for low doses of benzodiazepines. I'm now trying to get off benzos, but figure why, at this point in my life. It's still a bitch getting any controlled drug from most doctors. 7. I can say this. So many of you will just get better with Time, but it might take awhile. (The "Professionals" conviently leave this out. There are some studies praising time verse therapy/drugs, but they are buried, and were small studies. I my case, it felt like I wounded my brain that night of the huge anxiety attack, and it would take years to heal. The experts told me most people do get better in a few weeks. I didn't. The depression arose because my life went from great to just lucky to get to sleep. Exercise did help eventually. At first, it didn't at all. I needed alcohol. I didn't want to blow out my liver in my twenties, so I only drank when I absolutely needed it. Don't overload that liver. 8. I once had a talk to a resident Psychiatrist. At first, he was a a cheerleader for his decision to specialize in psychiatry. After some debate, and honest reflection, he admitted to me all the modalities/drugs work a tiny bit in some patients, and the profession has a way to go. 9. I do know this, patients whom have been on a drug for a period of a few years shouldn't have to go into those prearranged sessions, just to refill a script. If the drug does not require blood monitoring, the patient should get refills. I know so many people who self medicated with alcohol, because our American system of treating mental illness sucks. 10. Time. I know, who has time. I need to function tomorrow. You have my heart.
- Noos 9y ago
  But you can have the best social setting, and mental illness will still happen and still affect you dealing with things. Depression makes it just as hard to get out of bed on nice days as foul ones.
  - peteretep 9y ago
    Quite. Sadness, apathy and anxiety are all symptoms of mental illness. But they're symptoms of all sorts of things too -- including social setting etc, and so people tend to conflate the two.
  - gcb0 9y ago
    yes, but thats off topic to the article, which focus on a very specific region/profession/time.
- peteretep 9y ago
  You are confusing therapy being the front-line treatment with it being the most useful treatment.
privateprofile 9y ago
There is a growing body of research [1] that questions the usefulness of drugs for mental health. I personally know a case at a local hospital (in Europe) where a switch off meds and into therapy brought serious improvements in elderly patients. [1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2582668/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2582668/ , https://blogs.scientificamerican.com/cross-check/are-antidepressants-just-placebos-with-side-effects/ https://blogs.scientificamerican.com/cross-check/are-antidep... , https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4592645/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4592645/

peteretep 9y ago

> reads like a medication pamphlet I did both. The therapy was of limited use. The pills were like a light switch that have simply turned off my mental illness with almost no side-effects.

ThrowawayP 9y ago
> The pills were like a light switch that have simply turned off my mental illness with almost no side-effects. That means that you're in the not particularly large fraction of people that the pills work well for. Good for you. For the rest of us, well, the pills can be a hell of side-effects, tolerance, and rebound ... and that's if they have any primary positive effect at all.
- peteretep 9y ago
  > not particularly large fraction Citation?
  - DanBC 9y ago
    Draft NICE guidance on depression probably has lots of information. https://www.nice.org.uk/guidance/GID-CGWAVE0725/documents/draft-guideline https://www.nice.org.uk/guidance/GID-CGWAVE0725/documents/dr... Pages 38 to 45 probably most useful, especially pages 40 onwards. (Personally, I think meds are useful, and I think good quality talking therapies are useful, and I think people should have access to both, and access to a range of psycho-social interventions.)
- gcb0 9y ago
  the pills does have lots of side effects. if they work on one aspect, they do work on others, because there is not a single pill on the market that can target one receptor only. absolutely no reseach, not even the ones very favourable to the drugs, show zero side effects. none. zero. targeting a single receptor with full confidence is the holy grail of big pharma. what happens with your case, is that you do not care about side effects. or even welcome them. just like most depressed people in bad marriages welcome the lower sex drive, or stressed people at work welcome the drone like sleepless life. And you will not even know you are living like that until you go to a good therapist, which seem to be very rare in the US. all that said, I sincerely whish you get well and eventually go without the meds. And I am happy you did seek out help. That's the rigth spirit. Just do not shrug off therapy. Do take the time to work with a few different ones during a year, even if you honestly believe the meds cured you 100%