depression and drug treatment

[Guest fiznuthian]

well, i've been reading this book called "Depression is a Choice" by A.B. Curtiss.

i'm not finished, but having read through a solid chunk of it i feel that her message

has some merit in some ways, though its obvious the idea that forsaking drugs for some people

could be a very dangerous idea. she's an advocate of cognitive behavioral therapy and feels

CBT should be turned to first before drugs are involved.

 

her argument is that many people who are diagnosed with depression and a few other mental disorders

are often told from the start that they won't be able to win the battle alone, that its not their fault,

and instead suggest drug treatments as the only viable option for treatment. she feels that this occurs far too often

in large part because the pharmaceutical industry has a very large amount of money invested

in the mental health industry. while she doesn't suggest ignoring drug treatments completely, she

feels (in america anyway) that pharmaceutical companies are inadvertently causing over-diagnosing

of mental disorders.

 

she suggests the idea that people sometimes just have chemical imbalances in the brain is really somewhat

of a myth, and the problem lies more in learned behavior than some kind of biology

we're born with. having gone through cognitive behavior therapy with steady success for my

social anxiety disorder and depression, it kind of struck me to look back and think, "wow, i haven't

been depressed in a while". funny though, the idea that a person always has the choice to re-direct their

thinking is really all i've been doing all along through all of it.. making positive behavioral choices rather than continuing to

brick-wall my actions and sit in irrational depressive holes with no escape, is slowly undoing all of the mental damage i had somehow accumulated. the small successes added up and now my thoughts are actually useful and beneficial. and they're not affecting my emotions and the way i behave anymore like they once did.

i have a self-esteem again, just working up my list of small but achievable goals. and now looking back on the past its almost hard to believe

some year ago i was actually contemplating the possibility of suicide. it almost creeps me out thinking about it now, but back then the idea was very real, very scary, and somehow very possible.

 

 

 

in a way i can't help but agree with her, that making the choice to stop undercutting myself entirely is a choice that i can make, and could actually have an affect on the way i feel about other things too. and to stop treating my negative thoughts as if they're all there is to me. i may feel anxious but anxiety is not all that i am. i may feel upset but being sad is not who i am. the idea that the mind ebbs and flows in vibrant color, not black and white. i can't help but think about albert ellis and some of the interviews i watched once.. pretty sure he said something similar.

my neuropsychologist, a very nice lady and very genuine, has had great success treating a variety of mental disorders without drug treatment whatsoever. it's the negative self-talk that hangs people up though, and usually takes time to reverse.. it's hard to get people who have spent 10-20 years shitting on themselves in their inner mind to suddenly say, "hey, i love who i am". but getting them to choose to do things and get out there doing things that benefit them is easier, and has an affect on the way they feel about themselves and their lives.

 

so is giving up drug treatment really a viable option for a majority of people?

are people using their disorders as an excuse? its as if the pharmaceutical companies and psychiatrists

have people so convinced mental illness is a disease that people cling to "i must have depression!"

or "i must have social anxiety disorder!" instead of admitting their weaknesses and choosing to do something about it.

this must especially true for people with social anxiety disorder..

at this point i'm not even sure if its that i have SAD at all (maybe my psychologist would agree).

more than likely i just learned to be socially awkward and being stubborn as i am refused to admit my weakness.

rather than doing something about it i clinged to the idea that i was broken, unfixable, had a disorder,

and needed help..

 

i know quite a few of you have been through some shit, i'd like to hear your experiences.

some of you have probably been worse off than i have, and i don't mean to devalue your experiences in any way

by suggesting your problems aren't real. just trying to explore that maybe there's a different way to view it all.

[lumpenprol]

I've been through it, also was suicidal (and serious about it), made it through with a combo of therapy and meds. Meds are certainly not a cure-all and have nasty side effects (I've never shed the weight I gained on antidepressants), but they certainly disrupted the negative thought patterns that you refer to and helped me to rise above them. At the same time, almost as a side-effect of my therapy I had a real epiphany of sorts that helped me get my life back on track. My depression was due in significant part to the after-effects of a drug overdose, so a lot of my negative thinking centered around the notion that my brain would never function properly again. My epiphany was: "ok, perhaps I'm going to be impaired for a long time, even for life - so the fuck what?" I had put too many expectations on myself, but when I let go of those expectations it helped a lot.

 

tl;dr: many studies have shown the combo of therapy plus meds to be most effective, and I think my experience bears that out. Don't know about CBT in particular...

[Guest hahathhat]

OP looks incredibly tldr, iz ballin tldr so harddd

 

depression is a natural thing. how are you supposed to feel when your dog/uncle/mum/pop kicks it? you get bummed out for a bit, depending on how close, and the circumstances. is this a "choice" ???

 

it's a problem when the depression is persistent and without real reason (a death, life stress, trauma, whatever).

 

do you have a chemical imbalance, or are you just upset that you have to go to a bullshit job every day, you don't know what you're doing with your life, etc.?

[Guest hahathhat]

My depression was due in significant part to the after-effects of a drug overdose, so a lot of my negative thinking centered around the notion that my brain would never function properly again. My epiphany was: "ok, perhaps I'm going to be impaired for a long time, even for life - so the fuck what?" I had put too many expectations on myself, but when I let go of those expectations it helped a lot.

 

i must admit i am curious.

[lumpenprol]

actually it was a one-two punch - drug overdose and a few years later, the suicide of someone close to me. That's the way life goes...

[kaen]

ive always believed that my depression/borderline was the result of prolonged drug abuse and i still do, but my views on what keeps that going have varied over the years, did i "break" my mind or initiate a permanent change in it, im not sure. i go in and out of varying degrees of just being unable to deal with life, day to day things like getting out of bed, making sure i keep my hygiene in check, remembering appointments and other details, all those things can become mountains to climb for me and then go to functioning sort of normally and when i say sort of, that means being able to do those things and stay up and mobile-ish, interact with people, sometimes venture out on my own. That's pretty much my limit. Anyway i digress, is this something that ive broken inside me for good? i used to think it was - but now im not so sure, i think if i had the right help i could learn better ways to cope, almost like starting again, you learn these basic things growing up but i seem to of been reset and i tell you, its fucking scary. I hope this is the case, because if i am permanently fucked and therapy wont help then bleh, i dont see much future.

 

Ive been on a myriad of drugs to help give me stability and all have failed, some making me worse still. maybe thats just me but drugs have not worked at all.

 

There's also the pitfalls of addiction to contend with, im an addictive person, if its not drugs/alcohol, its food, if not that then spending money i don't have, all these things contribute to the fucked up world i "live" in

[lumpenprol]

kaen, if I can ask, you've had a girlfriend/girlfriends during this time, right? Do you found that has helped at all, or made no difference? For me finally getting to a place where I could date again - or more specifically, fuck again - did me as much good as any medication I was on. The regular, normal erotic release, and person-to-person contact, was very therapeutic...

[logboy]

depression is something I've been aware of - as a condition I fall into when life gets complicated, not a constant state - for 25 years. until ten years ago I didn't approach a doctor about it; whether it's having left it to become part of me or not, but I've found that the bigger issue for me has become any doctor or therapists inability to avoid forgetting aspects that for me gave become fundamental, the inability to avoid a sense people see my visits to a doctor as an

acceptance of any third-party involvement & discussion of opinions / theories is welc

[logboy]

depression is something I've been aware of - as a condition I fall into when life gets complicated, not a constant state - for 25 years. until ten years ago I didn't approach a doctor about it; whether it's having left it to become part of me or not, but I've found that the bigger issue for me has become any doctor or therapists inability to avoid forgetting aspects that for me have become fundamental, the inability to avoid a sense other people see my visits to a doctor as an acceptance of any third-party involvement & discussion of opinions / theories is welcomed or appropriate or inherently constructive. also, even the slightest hint of my health to anyone risks being given far more importance or prejudice than necessary if it then combines with prejudice that's about a picture people have of depression that doesn't acknowledge (and often doesn't intend to) the sheer variety & individuality of symptoms, behaviour, characteristics.

[GORDO]

OP looks incredibly tldr, iz ballin tldr so harddd

 

depression is a natural thing. how are you supposed to feel when your dog/uncle/mum/pop kicks it? you get bummed out for a bit, depending on how close, and the circumstances. is this a "choice" ???

 

 

depression != sadness/feeling bummed out.

 

anyway I do think one can think himself in and out of being drepessed sometimes, but I also think sometimes it goes beyond that and is a serious sickness.

[Guest Gary C]

My reasoning is very similar to kaen's. I believed for a few years that I'd broken myself through drugs/depressive-loops. I wondered whether I could ever function normally, but have come to realise that worrying about that is part of the problem in itself.

I've never subscribed to the idea that drugs could ever help with how I felt. I don't really believe that many psychogical problems really exist. Bi-polar(ism?) just doesn't make any sense to me.

 

Slow introduction to social-situations (I worked at a bar) and healthy routine (now I'm at a 9to5) are the only cure. It helped me to empathise that everybody feels unworthy and that with regular distraction you naturally turn into what you consider to be a normal person.

 

That still sounds really depressed, lol. I probably am though, I'm quite a negative person.

[Blir]

Christ, everyone on WATMM's miserable!

 

When going through adolescence I thought I was depressed, like all teens really. I wasn't though, just a bit morbid.

 

Pretty moody at times though!

[lumpenprol]

lol, goes well with your avatar.

 

Watmm has had quite a few "depression/medication" threads over the years, I remember them containing some interesting stories and good advice.

[kaen]

kaen, if I can ask, you've had a girlfriend/girlfriends during this time, right? Do you found that has helped at all, or made no difference? For me finally getting to a place where I could date again - or more specifically, fuck again - did me as much good as any medication I was on. The regular, normal erotic release, and person-to-person contact, was very therapeutic...

 

Being attached to someone has its pros and cons in this regard, of course when you are in a stable relationship, are getting your dick wet regularly and having good times then of course you are going to feel able to cope better, its almost as if you feed off of the other persons normality and routine. BUT it can also make you lazy and complacent, because you are happy you try less to keep yourself healthy, because you have someone (generally) who doesnt care what you look like and they are happy with how you are.

 

There also the fact that these relationships can and most likely do end, and when your talking about someone as affected as a manic depressive/borderline whatev mentalcase, it will pretty much put you back to -100 on the scale of BEING ALRIGHT.

 

meh, fucking double edge sword and all that

[Blir]

My ex was manic depressive, she was really bad actually. Started when she begun to have panic attacks around 15/16 years of age, she was really happy before that but it proper fucked up her life to not be able to do anything social without having a panic attack and feeling like her heart was exploding.

 

She wasn't really the same after that (we got together while she was in her depressive phase) but I loved her anyway. Drugs didn't help her one bit, actually in one case one of her medications had the side effect of making her suicidal, which was pretty upsetting. After that she stopped taking medication and started to improve a lot. She eventually had an operation that cut a nerve or something, which helped the panic attacks a great deal.

After years of being so fucked up it took her a while to get back to reality as such, CBT helped her a great deal, pretty much the only thing that did. She said I was the main reason things got better, according to her mother I was the reason she didn't kill herself.

 

It's a shame things fell apart, I still really love her.

[Guest fox]

many studies have shown the combo of therapy plus meds to be most effective Don't know about CBT in particular...

 

this is very, very true. in fact many therapists who do CBT or any of the variations on it will also point you in the direction of meds. with meds the key is to give them a chance to work (six to eight weeks minimum) and to have realistic expectations (it's not like taking a tylenol and feeling better 30 min later, usually other people can tell they're working for you before you do etc) and also to work with your doc to find the med that works for you.

[Guest naos]

My reasoning is very similar to kaen's. I believed for a few years that I'd broken myself through drugs/depressive-loops. I wondered whether I could ever function normally, but have come to realise that worrying about that is part of the problem in itself.

 

I've read a lot about the ways in which mind deals with emotional attachments,and I learned that there really is no easy way out. It's like battle for St. Petersburg. Usually my mind can't notice small improvements I make in changing my habits/behaviour because their effect is acumulative.

so, it's natural for me to go through usual emotional loops before the change actually takes place.

It takes a lot of patience and self-remembering, and those "aha"-moments to regain control over mind, I guess.

I had and still have problems with emotional attachments to persons/situations because they corode my self-esteem and ability to think clearly, so I'm trying to fight it by dissolving my mental habits and by being as descriptive and objective as I can when dealing with present situations.

 

I used to think this "emotional angle" of viewing things/people gave me a feeling of self-importance and individuallity, but it actually just made me weaker in many ways and more egoistic.

[Guest Coalbucket PI]

I was prescribed antidepressants once but I decided not to take them, but just talking to the doctor a bit made all the difference, and made me feel like I was taking control of the situation, which was enough to start pulling me out of it. I don't think those pills would have done me any good and I think for relatively minor depression or social anxiety like I had it is a bit worrying how quickly they resort to medication, especially since you have to take them for at least 6 months

[chassis]

Ordered one of these for a relative recently.

http://www.mindfulnesstapes.com/

 

Even being a big scientific skeptical bastard, I still believe cognitive therapy works. Drugs aint always the answer.

 

But Ive no real insight to depression, ive never been depressed. Anytime I feel bad, its usually because of lack of exercise.

[logboy]

Ordered one of these for a relative recently.

http://www.mindfulnesstapes.com/

 

Even being a big scientific skeptical bastard, I still believe cognitive therapy works. Drugs aint always the answer.

 

But Ive no real insight to depression, ive never been depressed. Anytime I feel bad, its usually because of lack of exercise.

 

mindfulness is, for me, an attempt by therapists to give even less away about how the mind works. it's essentially a faith-based breathing technique to recenter your focus. slightly like hypnosis. when I asked a psychotherapist to explain it to me, he refused, essentially, and tge book I read felt inredibly wishy washy.

[Guest fiznuthian]

i think it's interesting that a lot of you feel therapy and drugs in combination can be more effective. i do agree, in that i think noone should ever rely on drugs alone to bring them back. personally i feel it's dangerous, and part of why i avoided psychiatry like the plague. i'm pretty sure my psychologist would agree, and she's well versed in biological systems as well as clinical neuropsychology and cognitive neuropsychology. she tells me that although she has a personal beef with a lot of psychiatrists and how they approach treatments with drugs and giving people no direction to go with them, drugs in some cases are useful because they provide a platform for people to work with. it's the severe cases where people learn that they have no escape, have no choices to make, and end up stuck in a loop of damaging behavioral choices that won't let any cognition free. they will never choose to behave in a way that doesn't parallel with how they feel, and because they choose behavior that confirms the fear holds them back, they feel ever more trapped and with no say in the matter. in those cases it's nice that a person can take a drug and just feel okay, or feeling well enough to make the choice to change their behavior, and then subsequently the self-talk and emotional side of things falls in line over time.

 

it's the idea that a person may not be able to change how they feel, but they can choose to act any way they wish because the pre-frontal cortex can claim neural territory.. in particular it can keep the hypothalamus busy when otherwise left on their own accord the hypothalamus, amygdala, etc overtake and irrational fears continue to taint how a person perceives the world around them.

it's like a muscle, being able to say to yourself, "i am feeling very sad right now, but i am going to make the choice to find people to spend time with". it's not always easy, but a person always has that choice. complete the task and it gives a small but important feeling of success.

i think a lot of what neuropsychology is all about, atleast when dealing with therapy (or really, cognitive behavioral therapy) is that its impossible to feel two different ways at once or think about two different things at once. behavior can override the way a person feels and limit cognitive resources that would otherwise be invested in fears.

 

in my case its knocking two birds out with one stone. i've regaining my ability to choose my own behavior, and realizing that making beneficial behavioral choices has a tremendous impact on how i feel about myself. its allowing myself to recognize and become aware of my fears and not ignore them, then choose to behave in ways that contradict and restrict them.

 

i'll be the first one to admit that those fears really can and have added up fucking quick. that emotional loop of "have i broken myself for good?" that you guys keep mentioning is ridiculously scary, and i'm sorry you've had to go through it. glad to hear most of you are doing better these days though. hopefully someday we'll all feel alright again.

[jhonny]

Ordered one of these for a relative recently.

http://www.mindfulnesstapes.com/

 

Even being a big scientific skeptical bastard, I still believe cognitive therapy works. Drugs aint always the answer.

 

But Ive no real insight to depression, ive never been depressed. Anytime I feel bad, its usually because of lack of exercise.

You don't need to be a skeptic to recognise the evidence for the effectiveness of CBT and other pychological therapies (PTs). Sometimes it's easier to say "well that makes sense" about something pretty sensible like CBT, rather than some unique inhibitor properties of some slightly different molecule.

 

I'm a health economist doing a major piece of research looking at the delivery and system of care for patients with long term depression. In the UK there has been a steady growth in PTs, and it's much easier for patients to move from a loop of "GP -> Meds -> GP -> Meds" and now patients can get directly referred by GPs to CBT delivered as the IAPT system. I think in the UK, compared to the US, there isn't so much pressure from pharma on professionals to use meds, and the evidence base for tailored and combination therapies using meds + CBT or gCBT or IPT or counselling is expanding. This is still massively difficult to implement, and its something I've been looking into using simulation modelling techniques to determine how limited resources could be best used.

 

Really interest thread guys,

[Guest fiznuthian]

I was prescribed antidepressants once but I decided not to take them, but just talking to the doctor a bit made all the difference, and made me feel like I was taking control of the situation, which was enough to start pulling me out of it. I don't think those pills would have done me any good and I think for relatively minor depression or social anxiety like I had it is a bit worrying how quickly they resort to medication, especially since you have to take them for at least 6 months

 

so true.

but i'd like to point out that the "they" that turn to drug treatment so quickly are psychiatrists.

i visited three psychiatrists seeking help, and all three of them wanted to put me on drugs.

the first suggested i go get a prescription for benzodiazepines that day, even calling my family doctor to let him know i was coming,

then scheduled an appoint for a couple weeks later to come in and talk to him for a half hour.

the second did the same.

the third finally recommended SSRIs as they were shown effecting against depression as well as social anxiety. thankfully at this point i told her that i was not willing to try drugs first, and after persisting she finally just wrote me a number to a pscyhologist who used to do work for their psychological center. come to find out, the lady she sent me to had issues with the way that place treated people and quit the job because of it to start her own practice doing cognitive behavioral therapy.

 

what's strange to me is that psychiatrists often tell people they're going through "therapy" when what they really mean i just talking it over, or giving a person a place to vent their issues while taking drugs daily. i think this is very dishonest, as most of them are not trained in existing therapies backed by clinical research end up going about it with no real direction or plan.

my first day with my psychologist and i knew something was different. she was constantly asking questions, digging deeper, while writing EVERYTHING down in a notebook. shortly after she administered a large questionnaire to investigate ADHD qualities. then we sat down and made a list of things my fears held me back from doing, ranked the anxiety i experience doing them on a subjective scale 1-100, and then developed a heirarchy and plan of action. she constantly asked me to throw out subjective rating scale numbers and took notes of my progress to evaluate.

she spent a lot of my time seeing her after sorting through my life history, not rambling on about the fears or my problems.. we would bring it up, keep them in mind, and then she would help me choose to go activities that contradicted how my mind felt. i was given mental exercises that keep my mind busy enough to not feel overwhelmed. she constantly provided techniques that were effective in giving me control of situations.

we don't spend much time talking over my problems, and instead remain aware of how i feel while in pursuit of other feelings. turns out she was right and its not possible to feel two ways at once, and the environment i place myself in has a tremendous impact on the feelings that take over.

 

from what i've seen, her application of therapy is cold and calculated, totally unlike anything that was offered to me by psychiatrists. she's a scientist first and foremost, and attempts at all cost to stick to methods proven to actually work. her wall of literature is ridiculous to look at, and not a single self-help book to be found..

it makes me wonder how i would have faired on SSRIs or benzos talking over my issues every week. would i still be sinking into the depressive doom-states i became so comfortable with even now?

[Guest hahathhat]

Therapists are people too. Some are brill, others are total crap. If you're going for therapy, find one you like, who has similar views. It's important to note that a therapist has a certain view of reality, and part of their job is to bring you into alignment with that view of reality! So make sure it's a reality you like/accept.

 

What did she think about your mushroom obsession, Fiznuthian? Seems like the sort of thing about which a doctor would say, "It's all nonsense!" and not let you get a word in edgewise... I _hate_ that about doctors/professors/etc.!

[Guest fiznuthian]

Therapists are people too. Some are brill, others are total crap. If you're going for therapy, find one you like, who has similar views. It's important to note that a therapist has a certain view of reality, and their job is to bring you into alignment with that view of reality! So make sure it's a reality you like/accept.

 

What did she think about your mushroom obsession, Fiznuthian? Seems like the sort of thing about which a doctor would say, "It's all nonsense!" and not let you get a word in edgewise... i _hate_ that about doctors/professors/etc. :)

 

yes, that is true.. i guess my post came across rather hateful towards psychiatry. i just don't trust that they're utilizing what's known to be scientifically accurate and useful. once again this is probably more to do with the pharmaceutical industry, it's not at all uncommon for drug studies to be funded by, well, big pharma itself. i'll admit, i'm sure most of them are very genuine and concerned for their patients. seeing people so broken every day would kind of do that to ya, i'd hope. either that or desensitize them.

 

heh, she thinks my mushroom obsession is interesting. i'm able to cite many studies from peer-reviewed journals so for her as a scientist she understands where i get my views on how mushrooms can affect health. at least until evidence adds up confirming otherwise. the rest, well, its not a bad thing that i think fungi are cool and useful.

she thinks its a good thing that i invest my time in mycology in general, but its rare for her to ask questions about my interests and things i do in my leisure time.. she devotes her time to what prevents me from living the life i desire in my mind most of which has nothing to do with fungi. of course, thats what i pay her for!