10 ms·

Knowing you "have a problem" doesn't mean you or anyone understands the problem or what to do about it. And even if you know what to do, doesn't mean you can do

by luriel 14y ago

Knowing you "have a problem" doesn't mean you or anyone understands the problem or what to do about it. And even if you know what to do, doesn't mean you can do it either, the psychological, social or just practical barriers can be impossible to climb. Medication has a statistical significant effect, but is often marginal at best, and most of the effect is placebo. And this assumes an accurate diagnosis, and don't count on that, I have had the head of psychiatric care of a major European capital say to me that the science of psychiatric diagnosis is basically worthless, I wouldn't go that far (the split between research and academia and practice is also a huge problem), but is nowhere as simple as some like to make it seem. People and lives are often much more complex than that and much more significant factors. Doctors can also do much more harm than good, locking people up in horribly depressing kafkian institutions because they are suicidal is one of the most insane things I have seen in my life. Imagine what it feels like being locked up against your will, treated almost like an animal, when you have done nothing to harm anyone, and being told it is "for your own good".

huggah 14y ago
True. It took a few years between accepting that I had a problem and finding a solution to it. For many people, it takes a lot longer; some never "solve" their problem at all. But knowing is a necessary first step, and for me, it was the hardest and the one that would have benefited most from posts like this.
- donniezazen 14y ago
  What was your solution, if you don't mind sharing?
  - huggah 14y ago
    My only hesitation about sharing is that I don't want people to extrapolate from what worked for me to expect it to work on themselves. So don't. With that disclaimer, I'll say that I went on several regimens of drugs for a few years. They had serious side effects, didn't work or worked only for a few months. They did keep me afloat long enough to get the rest of my life together. Stephen Ilardi's "The Depression Cure" is 80% insipid self-help; I'm surprised I didn't throw it away in disgust. The remaining 20% (which is mostly the table of contents) had a profoundly positive effect. It did more good than all the drugs I'd taken combined; but I had to take it seriously and have the willpower to make changes. In the end, CBT techniques got me to the point where I instinctively revise my thought patterns. Combined with a lifestyle that includes a lot more exercise, time outside, and physical contact with people I care about, I have been un-medicated for almost three years and haven't had a single major depressive episode.
    - donniezazen 14y ago
      Do you think pushing yourself to do what you think is right is a right course of action or part of solution to your depression?
      - huggah 14y ago
        I don't understand your question. Are you asking whether I think choosing to behave ethically is part of my solution to depression? What do you mean by "do what you think is right"?
jpeg_hero 14y ago
> Medication has a statistical significant effect, but is often marginal at best, and most of the effect is placebo. The point of the author's post is that medication made a huge difference for him Hey's saying: if you have a problem, there might be help for you too. Your comment was just negative side talk.
EricDeb 14y ago
I'm not sure that the abbreviated sentiment that medication has little more effect than a placebo is useful in the realm of mental disorders. Depression/anxiety/ocd are very complex because they deal with the brain/mind, which is poorly understood. To suggest that antidepressants only have a placebo effect despite working in animal models of depression, severe depression, certain depressive subtypes, and less severe conditions in rats and monkeys is not helpful for many sufferers (like the author) who might otherwise benefit.
- ryanmolden 14y ago
  Who cares if something works through the placebo effect, as long as it works. I can't be bothered to look it up at the moment (on my mobile) but I do believe he is correct in that published studies in well regarded medical journals have purported to show just that (effect == placebo), but as I said, from the perspective of the person being treated, does it matter? I agree if it prevents people from seeking help that is bout desirable, but it need not.
  - niels_olson 14y ago
    Yes, actually, it does matter. Side effects of antidepressants include the period of getting just enough energy to kill yourself, and the risk of serotonin syndrome, especially when seeing multiple doctors for multiple issues, who might start SSRIs in near succession. The list goes on for a ways.
    - drumdance 14y ago
      Fine, weigh the risks. But don't dismiss it out of hand. I've used SSRIs off an on for years and can honestly say my life is much, much better for having done so.
    - d0mine 14y ago
      The stronger side-effects the more effective placebos. http://www.youtube.com/watch?v=yfRVCaA5o18 http://www.youtube.com/watch?v=yfRVCaA5o18
  - 14y ago
dkarl 14y ago
Knowing the problem is depression and learning to recognize how depression affects me has led to big improvements for me. It doesn't stop me from getting depressed and believing all the same old lies, but when the depression lifts, I get to enjoy not being depressed right away. Before I understood depression, the lies depression taught me tended to stick around. They were part of how I thought even when I wasn't depressed, and I wasted a lot of energy debating them with myself and fretting about problems that were insoluble but weren't really problems. By the time I started feeling hopeful about life again, the next depression was already right around the corner. Now it's much easier to shrug off those false beliefs when the depression lifts and just enjoy being relatively normal for a while. That doesn't mean I won't get depressed again, but depression casts less of a shadow over the non-depressed times of my life. As a really crude analogy, imagine somebody slips a hallucinogen into your drink and you end up having a terrifying conversation with God where he addresses you as Satan, and for weeks afterwards you obsess painfully about whether you're evil or maybe you are actually Satan somehow, living in fear of what will happen next, versus knowingly taking a drug and afterwards saying, "Wow, that was shitty. I thought I was Satan, LOL." In both cases the experience is horrifying and real, but in the first one, the experience continues to be horrifying and real for a long time afterwards. In the second one, only the memory remains real.
- lusr 14y ago
  Absolutely. I haven't seen anybody mention David Burns' book "Feeling Good" but it probably saved my life from a descent into insanity. It's my "bible" now. I knew something was completely and absolutely wrong with my self-destructive thought patterns but didn't understand what until I learned about Cognitive Behavioral Therapy (CBT). A sad observation: everytime I encounter a struggling friend with dysfunctional thought patterns, I work through their thoughts using CBT techniques (without mentioning that's what I'm doing). This almost always results in a calmer friend who starts feeling better about the situation, or at least more confident in their ability to deal with it. I then tell them what I'd done to improve their emotional state and how they can learn to do it for themselves by pointing them to CBT and Burns... and a few months later I find they still suffer from dysfunctional thoughts and haven't bothered following my advice. Funny thing is I was the same; it took a bout of severe depression and reading "Feeling Good" exactly at the time when I could introspect my severely dysfunctional thought patterns for me to accept my situation (having purchased the book a year previously but being dubious about its claims of my "mild" depression at the time). I don't know if this is social conditioning (only "weak" people get depression) or general ignorance of the fact that the mind needs "maintenance work".
lsiebert 14y ago
You want to talk about statistics, but include anecdotal statements from anonymous sources, and end with an appeal to emotion. You want to state that psychiatric medicine is mostly placebo, but don't have any good criticisms to levy against double blind studies of antidepressants with placebos. Given the point of the article was encouraging/helping individuals who have depression to seek medical help, I'm not sure what the purpose of your comments are. It sounds like you had a bad experience with the mental health community. Just like people who have a bad experience with any public service, I feel for you. I might even look at whether there are systemic issues in the provision of the service, in this case mental health. But if your intention is to make people question the efficacy and usefulness of mental health treatment for depressed people, then I feel that you are attacking something that many people have fought hard to get, get attention for and get funded, mental health treatment. Mental health treatment still has a stigma attached to it, that of some inherent deficiency that contributes to mental issues. Adding the unrealistic idea that depressed individuals are going to be locked up and treated like animals isn't helpful in my opinion. I'm not saying that your experience, or the experiences you are familiar with, was/were invalid. However, hundreds of thousands of individuals who find psychological or pharmacological treatment for mental illness of benefit, and many more could benefit but go undiagnosed/untreated.
- Alex3917 14y ago
  "You want to state that psychiatric medicine is mostly placebo, but don't have any good criticisms to levy against double blind studies of antidepressants with placebos." Because maybe he assumes you aren't too stupid to do a simple Google search. Both Emperor's New Drugs and Anatomy of an Epidemic are extraordinarily well written, it's well worth reading both, and there are all sorts of other good books on mental illness as well. This is exactly why HN has become like idiocracy, where anyone who takes the time to become well educated about something before speaking is basically called a faggot for reading books.
  - locopati 14y ago
    I don't understand where your last paragraph of bile is coming from. There's been no name calling here that I can see.
huggah 14y ago
luriel, you added considerably to your post since I first replied, and I feel like it now merits a different response. I agree with almost everything you've said, but feel like your criticism is misdirected and may do more harm than good. Knowing you have a psychological issue is like knowing your application is crashing for some customers. You might have only vague guesses as to what the triggers are, and no understanding of what's actually going on or how to fix it. But now you are in a position to assess the cost and allocate resources to fix the problem. Maybe it will take years of man-hours (in either case) to handle the problem, but now you have a place to start. I don't think Wil was telling people to take medicine; I certainly wasn't. The only thing I'd like to emphasize is that Depression is a problem that can be addressed. Don't ignore it. If you have a problem with Depression, do your research; find out what helps, and what doesn't. Stop treating your mental state like it's an immutable part of your environment: change your environment and your behaviors as you discover what you need to be healthier. "Changes to your environment" might include drugs, and even they don't work over the long term, they might temporarily be enough of a lifeline to help you get to a point where you can start hacking at the problem in other ways. Doctors can be helpful guides on this path; sometimes they're not helpful, but in aggregate, I believe they help more than they hurt. Scaring people away from seeing a doctor by telling them that they'll be locked up in a kafkian institution against their will is liable to prevent people from getting help. Of course this has happened, and continues to happen, but it's rare. I think a much more common (and in aggregate, more serious) mode of failure is people's belief that the doctor is in charge of curing them---that the drugs are all it takes---and that they can't or don't need to work on themselves.
SoftwareMaven 14y ago
I can't read the full article (paywalls...grumble...), but this[1] would indicate better-than-placebo performance for those with major depression. Please don't spread unsubstantiated rumors on this topic. As many of us know from personal experience, the results of giving people an excuse to say "that medicine doesn't work anyway" can be devastating. 1. http://psycnet.apa.org/psycinfo/1991-19312-001 http://psycnet.apa.org/psycinfo/1991-19312-001
- philwelch 14y ago
  I've gathered that selective publication of results is the main problem, actually.
  - SoftwareMaven 14y ago
    Indeed[1]. It seems to be endemic of the entire medical field[2][3] and even further removed[4]. Combined with how difficult (if not impossible) it is to reproduce many findings[5], I would call these the most important problems in science today. Science cannot move forward without all of the data (positive and negative) in a reproducible fashion. 1. http://www.ncbi.nlm.nih.gov/pubmed/18199864 http://www.ncbi.nlm.nih.gov/pubmed/18199864 2. http://journals.lww.com/greenjournal/Citation/2003/09000/Evidence_b_i_ased_medicine_selective_reporting.40.aspx http://journals.lww.com/greenjournal/Citation/2003/09000/Evi... 3. http://jama.jamanetwork.com/article.aspx?articleid=198809 http://jama.jamanetwork.com/article.aspx?articleid=198809 4. http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0018362 http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjourna... 5. http://online.wsj.com/article/SB10001424052970203764804577059841672541590.html http://online.wsj.com/article/SB1000142405297020376480457705...
- Alex3917 14y ago
  "Please don't spread unsubstantiated rumors on this topic." You're the one spreading misinformation. How about you actually read some books on the topic before attacking others.
lilsunnybee 14y ago
Yeah this post is really harmful. Antidepressants definitely have significant and varied effects, and those with depression should not be afraid to explore their chemical options, especially if it means lifting out of a life-threatening suicidal phase. Antidepressants affect various neurotransmitters in the brain, either blocking reuptake, or providing artificial analogues, etc. To say they provide mainly a placebo affect is just ludicrous, and suggests a lack of understanding of the science, or any significant practical experience with antidepressants or mental illness. And at least here in the US, there was a little thing that happened in the 60's called deinstitutionalisation (http://en.wikipedia.org/wiki/Deinstitutionalisation http://en.wikipedia.org/wiki/Deinstitutionalisation). No one is locked up against their will for more than 48 - 72 hours at a time, and even then only if they are deemed to pose a significant threat to themselves or others. Not sure what the situation is like in Sweden, but i can't imagine it would be much different. Luriel your personal beliefs are ignorant and harmful. Please stop spreading disinformation that could result it people dying or suffering due to not seeking medical assistance for a medical condition.
- pharrington 14y ago
  Yes, psychoactive chemicals have a very real effect on neurotransmitters; this does not say the physical effect must bear out its stated psychiatric intent. Also while I have no real idea what was going on in the 60s, public mental hospitals in the USA are often terrible to the point of being inhumane. Alot of people I've talked to who've had long and or recurring stays in public institutions compare them, often negatively, to prisons. The private sector is infinitely better in that regard, though. The real issue is just that psychology and psychiatry are both extremely frontier sciences. I agree that encouraging people to avoid them is harmful, but it's not apparent to me that most of what's happening in those fields isn't still largely guesswork. Either way, I'd also like to see the studies Luriel's talking about regarding the efficacy of specific meds.
- dwj 14y ago
  Actually, the evidence does show that many (most?) antidepressants have little effect over and above placebo. Look at the meta-analyses and you'll see that. I'm not sure why it's ludicrous - that's precisely what the science says. Now certainly antidepressants can help many people (my wife for one), but again it is likely to be mostly the placebo effect, which is actually very powerful, especially in depression. For some people a placebo can be the 'kick' they need to get help them get out of their depression. In my wife's case she also used CBT with an excellent therapist, and I think that was likely more useful in the long-term (she is now free of depression).

by luriel 14y ago

huggah 14y ago

True. It took a few years between accepting that I had a problem and finding a solution to it. For many people, it takes a lot longer; some never "solve" their problem at all. But knowing is a necessary first step, and for me, it was the hardest and the one that would have benefited most from posts like this.

donniezazen 14y ago
What was your solution, if you don't mind sharing?
- huggah 14y ago
  My only hesitation about sharing is that I don't want people to extrapolate from what worked for me to expect it to work on themselves. So don't. With that disclaimer, I'll say that I went on several regimens of drugs for a few years. They had serious side effects, didn't work or worked only for a few months. They did keep me afloat long enough to get the rest of my life together. Stephen Ilardi's "The Depression Cure" is 80% insipid self-help; I'm surprised I didn't throw it away in disgust. The remaining 20% (which is mostly the table of contents) had a profoundly positive effect. It did more good than all the drugs I'd taken combined; but I had to take it seriously and have the willpower to make changes. In the end, CBT techniques got me to the point where I instinctively revise my thought patterns. Combined with a lifestyle that includes a lot more exercise, time outside, and physical contact with people I care about, I have been un-medicated for almost three years and haven't had a single major depressive episode.
  - donniezazen 14y ago
    Do you think pushing yourself to do what you think is right is a right course of action or part of solution to your depression?
    - huggah 14y ago
      I don't understand your question. Are you asking whether I think choosing to behave ethically is part of my solution to depression? What do you mean by "do what you think is right"?

jpeg_hero 14y ago

> Medication has a statistical significant effect, but is often marginal at best, and most of the effect is placebo. The point of the author's post is that medication made a huge difference for him Hey's saying: if you have a problem, there might be help for you too. Your comment was just negative side talk.

EricDeb 14y ago

I'm not sure that the abbreviated sentiment that medication has little more effect than a placebo is useful in the realm of mental disorders. Depression/anxiety/ocd are very complex because they deal with the brain/mind, which is poorly understood. To suggest that antidepressants only have a placebo effect despite working in animal models of depression, severe depression, certain depressive subtypes, and less severe conditions in rats and monkeys is not helpful for many sufferers (like the author) who might otherwise benefit.

ryanmolden 14y ago
Who cares if something works through the placebo effect, as long as it works. I can't be bothered to look it up at the moment (on my mobile) but I do believe he is correct in that published studies in well regarded medical journals have purported to show just that (effect == placebo), but as I said, from the perspective of the person being treated, does it matter? I agree if it prevents people from seeking help that is bout desirable, but it need not.
- niels_olson 14y ago
  Yes, actually, it does matter. Side effects of antidepressants include the period of getting just enough energy to kill yourself, and the risk of serotonin syndrome, especially when seeing multiple doctors for multiple issues, who might start SSRIs in near succession. The list goes on for a ways.
  - drumdance 14y ago
    Fine, weigh the risks. But don't dismiss it out of hand. I've used SSRIs off an on for years and can honestly say my life is much, much better for having done so.
  - d0mine 14y ago
    The stronger side-effects the more effective placebos. http://www.youtube.com/watch?v=yfRVCaA5o18 http://www.youtube.com/watch?v=yfRVCaA5o18
- 14y ago

dkarl 14y ago

Knowing the problem is depression and learning to recognize how depression affects me has led to big improvements for me. It doesn't stop me from getting depressed and believing all the same old lies, but when the depression lifts, I get to enjoy not being depressed right away. Before I understood depression, the lies depression taught me tended to stick around. They were part of how I thought even when I wasn't depressed, and I wasted a lot of energy debating them with myself and fretting about problems that were insoluble but weren't really problems. By the time I started feeling hopeful about life again, the next depression was already right around the corner. Now it's much easier to shrug off those false beliefs when the depression lifts and just enjoy being relatively normal for a while. That doesn't mean I won't get depressed again, but depression casts less of a shadow over the non-depressed times of my life. As a really crude analogy, imagine somebody slips a hallucinogen into your drink and you end up having a terrifying conversation with God where he addresses you as Satan, and for weeks afterwards you obsess painfully about whether you're evil or maybe you are actually Satan somehow, living in fear of what will happen next, versus knowingly taking a drug and afterwards saying, "Wow, that was shitty. I thought I was Satan, LOL." In both cases the experience is horrifying and real, but in the first one, the experience continues to be horrifying and real for a long time afterwards. In the second one, only the memory remains real.

lusr 14y ago
Absolutely. I haven't seen anybody mention David Burns' book "Feeling Good" but it probably saved my life from a descent into insanity. It's my "bible" now. I knew something was completely and absolutely wrong with my self-destructive thought patterns but didn't understand what until I learned about Cognitive Behavioral Therapy (CBT). A sad observation: everytime I encounter a struggling friend with dysfunctional thought patterns, I work through their thoughts using CBT techniques (without mentioning that's what I'm doing). This almost always results in a calmer friend who starts feeling better about the situation, or at least more confident in their ability to deal with it. I then tell them what I'd done to improve their emotional state and how they can learn to do it for themselves by pointing them to CBT and Burns... and a few months later I find they still suffer from dysfunctional thoughts and haven't bothered following my advice. Funny thing is I was the same; it took a bout of severe depression and reading "Feeling Good" exactly at the time when I could introspect my severely dysfunctional thought patterns for me to accept my situation (having purchased the book a year previously but being dubious about its claims of my "mild" depression at the time). I don't know if this is social conditioning (only "weak" people get depression) or general ignorance of the fact that the mind needs "maintenance work".

lsiebert 14y ago

You want to talk about statistics, but include anecdotal statements from anonymous sources, and end with an appeal to emotion. You want to state that psychiatric medicine is mostly placebo, but don't have any good criticisms to levy against double blind studies of antidepressants with placebos. Given the point of the article was encouraging/helping individuals who have depression to seek medical help, I'm not sure what the purpose of your comments are. It sounds like you had a bad experience with the mental health community. Just like people who have a bad experience with any public service, I feel for you. I might even look at whether there are systemic issues in the provision of the service, in this case mental health. But if your intention is to make people question the efficacy and usefulness of mental health treatment for depressed people, then I feel that you are attacking something that many people have fought hard to get, get attention for and get funded, mental health treatment. Mental health treatment still has a stigma attached to it, that of some inherent deficiency that contributes to mental issues. Adding the unrealistic idea that depressed individuals are going to be locked up and treated like animals isn't helpful in my opinion. I'm not saying that your experience, or the experiences you are familiar with, was/were invalid. However, hundreds of thousands of individuals who find psychological or pharmacological treatment for mental illness of benefit, and many more could benefit but go undiagnosed/untreated.

Alex3917 14y ago
"You want to state that psychiatric medicine is mostly placebo, but don't have any good criticisms to levy against double blind studies of antidepressants with placebos." Because maybe he assumes you aren't too stupid to do a simple Google search. Both Emperor's New Drugs and Anatomy of an Epidemic are extraordinarily well written, it's well worth reading both, and there are all sorts of other good books on mental illness as well. This is exactly why HN has become like idiocracy, where anyone who takes the time to become well educated about something before speaking is basically called a faggot for reading books.
- locopati 14y ago
  I don't understand where your last paragraph of bile is coming from. There's been no name calling here that I can see.

huggah 14y ago

luriel, you added considerably to your post since I first replied, and I feel like it now merits a different response. I agree with almost everything you've said, but feel like your criticism is misdirected and may do more harm than good. Knowing you have a psychological issue is like knowing your application is crashing for some customers. You might have only vague guesses as to what the triggers are, and no understanding of what's actually going on or how to fix it. But now you are in a position to assess the cost and allocate resources to fix the problem. Maybe it will take years of man-hours (in either case) to handle the problem, but now you have a place to start. I don't think Wil was telling people to take medicine; I certainly wasn't. The only thing I'd like to emphasize is that Depression is a problem that can be addressed. Don't ignore it. If you have a problem with Depression, do your research; find out what helps, and what doesn't. Stop treating your mental state like it's an immutable part of your environment: change your environment and your behaviors as you discover what you need to be healthier. "Changes to your environment" might include drugs, and even they don't work over the long term, they might temporarily be enough of a lifeline to help you get to a point where you can start hacking at the problem in other ways. Doctors can be helpful guides on this path; sometimes they're not helpful, but in aggregate, I believe they help more than they hurt. Scaring people away from seeing a doctor by telling them that they'll be locked up in a kafkian institution against their will is liable to prevent people from getting help. Of course this has happened, and continues to happen, but it's rare. I think a much more common (and in aggregate, more serious) mode of failure is people's belief that the doctor is in charge of curing them---that the drugs are all it takes---and that they can't or don't need to work on themselves.

SoftwareMaven 14y ago

I can't read the full article (paywalls...grumble...), but this[1] would indicate better-than-placebo performance for those with major depression. Please don't spread unsubstantiated rumors on this topic. As many of us know from personal experience, the results of giving people an excuse to say "that medicine doesn't work anyway" can be devastating. 1. http://psycnet.apa.org/psycinfo/1991-19312-001 http://psycnet.apa.org/psycinfo/1991-19312-001

philwelch 14y ago
I've gathered that selective publication of results is the main problem, actually.
- SoftwareMaven 14y ago
  Indeed[1]. It seems to be endemic of the entire medical field[2][3] and even further removed[4]. Combined with how difficult (if not impossible) it is to reproduce many findings[5], I would call these the most important problems in science today. Science cannot move forward without all of the data (positive and negative) in a reproducible fashion. 1. http://www.ncbi.nlm.nih.gov/pubmed/18199864 http://www.ncbi.nlm.nih.gov/pubmed/18199864 2. http://journals.lww.com/greenjournal/Citation/2003/09000/Evidence_b_i_ased_medicine_selective_reporting.40.aspx http://journals.lww.com/greenjournal/Citation/2003/09000/Evi... 3. http://jama.jamanetwork.com/article.aspx?articleid=198809 http://jama.jamanetwork.com/article.aspx?articleid=198809 4. http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0018362 http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjourna... 5. http://online.wsj.com/article/SB10001424052970203764804577059841672541590.html http://online.wsj.com/article/SB1000142405297020376480457705...
Alex3917 14y ago
"Please don't spread unsubstantiated rumors on this topic." You're the one spreading misinformation. How about you actually read some books on the topic before attacking others.

lilsunnybee 14y ago

Yeah this post is really harmful. Antidepressants definitely have significant and varied effects, and those with depression should not be afraid to explore their chemical options, especially if it means lifting out of a life-threatening suicidal phase. Antidepressants affect various neurotransmitters in the brain, either blocking reuptake, or providing artificial analogues, etc. To say they provide mainly a placebo affect is just ludicrous, and suggests a lack of understanding of the science, or any significant practical experience with antidepressants or mental illness. And at least here in the US, there was a little thing that happened in the 60's called deinstitutionalisation (http://en.wikipedia.org/wiki/Deinstitutionalisation http://en.wikipedia.org/wiki/Deinstitutionalisation). No one is locked up against their will for more than 48 - 72 hours at a time, and even then only if they are deemed to pose a significant threat to themselves or others. Not sure what the situation is like in Sweden, but i can't imagine it would be much different. Luriel your personal beliefs are ignorant and harmful. Please stop spreading disinformation that could result it people dying or suffering due to not seeking medical assistance for a medical condition.

pharrington 14y ago
Yes, psychoactive chemicals have a very real effect on neurotransmitters; this does not say the physical effect must bear out its stated psychiatric intent. Also while I have no real idea what was going on in the 60s, public mental hospitals in the USA are often terrible to the point of being inhumane. Alot of people I've talked to who've had long and or recurring stays in public institutions compare them, often negatively, to prisons. The private sector is infinitely better in that regard, though. The real issue is just that psychology and psychiatry are both extremely frontier sciences. I agree that encouraging people to avoid them is harmful, but it's not apparent to me that most of what's happening in those fields isn't still largely guesswork. Either way, I'd also like to see the studies Luriel's talking about regarding the efficacy of specific meds.
dwj 14y ago
Actually, the evidence does show that many (most?) antidepressants have little effect over and above placebo. Look at the meta-analyses and you'll see that. I'm not sure why it's ludicrous - that's precisely what the science says. Now certainly antidepressants can help many people (my wife for one), but again it is likely to be mostly the placebo effect, which is actually very powerful, especially in depression. For some people a placebo can be the 'kick' they need to get help them get out of their depression. In my wife's case she also used CBT with an excellent therapist, and I think that was likely more useful in the long-term (she is now free of depression).