Drugs are useless

Study that shows drugs are pretty much useless.

http://www.plosmedicine.org/article/inf ... ed.0050045

Conclusions

Drug–placebo differences in antidepressant efficacy increase as a function of baseline severity, but are relatively small even for severely depressed patients. The relationship between initial severity and antidepressant efficacy is attributable to decreased responsiveness to placebo among very severely depressed patients, rather than to increased responsiveness to medication.

I guess you lot need to sort yourselves out.

These findings suggest that, compared with placebo, the new-generation antidepressants do not produce clinically significant improvements in depression in patients who initially have moderate or even very severe depression, but show significant effects only in the most severely depressed patients.

On the contrary, they have uses. Depression can stem from other disorders such as OCD or malnutrition related to eating disorders, which new generation antidepressants are also used to treat.

What I'm reading in this article is that talk therapy or lifestyle changes would be the most beneficial treatment to people with less severe depression.

justonemoreperson wrote:I guess you lot need to sort yourselves out.

Um, no. Trying to sort oneself out without help often leads to prolonged suffering. We have a responsibility to make the effort but it doesn't have to be done alone.

Try to keep it supportive, JOMP.

ladyswan wrote: lifestyle changes would be the most beneficial treatment

If the drugs are proving to treat other disorders then that's a separate issue. I agree that lifestyle changes are the best option. For those who are currently relying on drugs that, in themselves, do little good then they are focusing in the wrong areas.

If the drugs appear to be helping shows that the person is able to make those changes themselves, as the changes are largely subconscious.

Try to keep it supportive, JOMP.

Helping people face reality is supportive. These people hear sunshine, lollipops and rainbows all the time and it seems to make bugger all difference.

I saw that article in a separate website and thought it was interesting. If people choose to ignore it and carry on buying magic beans then that's their choice, but it might be useful to some.

Nice signature.

justonemoreperson wrote:Helping people face reality is supportive. These people hear sunshine, lollipops and rainbows all the time and it seems to make bugger all difference.

LOL! Never had a doctor or therapist tell me stuff like that. They downplayed side effects and risks, but never promised me it would be a magic bullet solution. The good ones were honest and made it quite clear that thought patterns, diet changes, and physical activity were the best solutions. The bad ones hated questions or ignored concerns.

It's been my experience that depression doesn't respond well to facing reality, because doing that is part of what caused it in the first place. A helping hand or someone to listen had a better effect on mood. I'm sure there are some people who would get out of depression faster if someone helped them see things for what they are, though.

I believe research has shown that a combination of medication and psychotherapy is the most effective treatment for severe depression.

Something to keep in mind is that there is severe depression and severe depression, meaning different subcategories which might need a different treatment regime than regular, but severe, unipolar depression. It would make sense that antidepressants alone would not be sufficient to treat the condition, if they are appropriate in the first place. For example many people with bipolar depression do not respond well to antidepressants and how easy is it to misdiagnose ? Or how people with psychotic symptoms, were they included in these studies?

I just don't think it's that easy as recommending a lifestyle change. Just think about it, when they say severe they mean debilitated, unable to take care of oneself, depressive stupor. There is no lifestyle to change when someone's unresponsive to any attempts to communicate.

That's true, Akama. I cannot take antidepressants because they aggravate my bipolar symptoms.

For the sake of this discussion, I was talking about people without severe depression. The link JOMP shared states that the medications aren't better than a placebo unless the depression is severe. It would be rather silly to tell someone who can't take care of the basic necessities that they need to get up and exercise, or go outside and interact with others.

Depression is more prevalent in stable countries. Countries that undergo hardship, wars, starvation etc. have less cases of depression than most "western" cultures. Now, I appreciate that it's probably also to do with priorities of their medical systems, but the epidemic of depression is a first-world, last-three-decades problem.

It seems to me that it's similar to the rise of asthma in children - living in a clean environment forces the child's immune system to go overboard looking for something to fight, so kids end up with things like asthma. Roll the kid around in sh1t for the first few years of their life and they'll be fine.

Depression is much the same (for the sake of the chest-beaters, let's assume that severe cases can be genuine and that I'm just talking about the rest). We have nothing to worry about in western society; anyone on this forum is unlikely to starve to death, their children are probably not going to die of cholera, your house will probably not get bombed and unless your children go to a school in North America they have a fighting chance of reaching adulthood without being shot.

And yet, depression exists more in these places than elsewhere. Why? Because we have nothing to worry about and so our brain goes into overdrive looking for sh1t to stress on and suddenly things that are irrelevant become way out of proportion and we end up in a melancholy, which we're allowed to do because we all have a welfare system that can support it.

Take a person with "social phobia" who can't leave the house, starve them for a few days and stick a bag of food in the street and watch the bugger run out to get it. It's all about priorities.

I guarantee that at least 30-40% of people on this forum with depression could do something about it themselves is they weren't so f*cking useless. It's the 21st Century version of the "bad back" - it cannot be medically proven and its socially unacceptable to criticise anyone who says they have it.
To say that people won't naturally milk that for all they can get is naive and unrealistic.

Depends if the depression is primarily due to a biochemical imbalance in the brain or external factors.

mood stabilizers are effective in bipolar depression for example.

but drugs may not be useful, other than as a placebo, if the depression is caused by external factors.

justonemoreperson wrote:I guarantee that at least 30-40% of people on this forum with depression could do something about it themselves is they weren't so f*cking useless.

Jomp, I've noticed that you have a preoccupation with the 'usefulness' of people. do you feel useless deep down because your mother gave you up for adoption at birth, and your valuation of others solely in terms of their 'usefulness' maybe partly stems from this abandonment wound?

I can sort of relate in how I value people due to similar experiences, but do you think it's related to that for you?

JOMP, if you want to debate the existence of depression, head over to the anti-psych forum. People with diagnosed depression or depressive symptoms come here for support. Whether or not you feel this is a legitimate psychiatric disorder is not the point.

Keep it supportive.