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Re: A Theory. - Comments? » Cam W.

Posted by pellmell on September 19, 2001, at 11:45:07

In reply to A Theory. - Comments? » margaret, posted by Cam W. on September 18, 2001, at 21:50:12

> Could something similar be happening in this subgroup of people with depression? Could a "kindling effect" be occuring in this type of depression. I guess, if we assume that this "is" happening, then the treatment would be contiuous maintenance antidepressant therapy (maybe avoiding the SSRIs), with group, interpersonal therapies; as well as other therapy aimed at recognizing the prodromal symptoms of relapse.
>

I think I remember Stephen M. Stahl hypothesizing about this very thing in _Essential Psychopharmacology_. He even went as far as to say that antidepressants might prevent and repair the physical changes to the brain that depression causes, partly by stimulating regrowth of the axons that get pruned during an extended depressive episode.

I think another factor is something that is one of the primary themes of Dr. Peter Kramer's _Listening to Prozac_. On antidepressants many of us feel "better than well," better than we've ever felt, and start to think (probably often rightly) that we've been depressed all our lives. Our self-expectations are changed both qualitatively and quantitatively by these drugs, and life without them (the very same life we lived until we filled our first prescription for Zoloft) just doesn't feel right anymore.

Of course, it seems quite often life doesn't feel right *on* them either...

So, who's next? :)

-pm


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