Posted by Racer on April 19, 2008, at 11:23:03
In reply to Re: OOOOOOOOOOOOooooooooo, posted by linkadge on April 19, 2008, at 10:30:17
I'm cynical about all of this, but will say this:
Depression is a convenient word to describe a variety of symptom complexes. It's very possible that those studies which have been done to date have included multiple different underlying etiologies. (I won't even point out that they also exclude anyone who has any comorbidities or other confounding conditions.) In my considered opinion, it's also worth considering that depression itself alters psychological functioning, which introduces another variable: how much of the recovery from depression involves being able to replace maladaptive coping mechanisms with more effective, healthier strategies?
What I'm trying to say is that there are so many variables involved in the effectiveness of these medications, it's hard to distinguish just how effective they actually are.
What I've seen over the years, in life, online, wherever, is that some people would very much like to believe that their depression is *solely* biochemical, and that behavioral interventions are entirely unnecessary. It almost seems as though they see as insulting the suggestion than their behavior has any bearing whatsoever on their condition, and they seem unwilling to consider that perhaps addressing some behavioral issues might improve their outcome.
Using a physical example, I have a problem with one hip. My options are more than a little limited -- hip replacement, a surgical procedure to inject medications directly into the joint, medications with lots of side effects which would have a negative impact on my quality of life, etc. The problem is clearly physical, it shows up very clearly on MRI and X-Ray, and it can be addressed chemically or mechanically. And the one thing I have insisted on with each and every one of the doctors I've been referred to is this: I want physical therapy. It can't necessarily fix the underlying problem, but it can sure improve the functioning of the joint.
I believe that the same can be said of psychotherapy for depression. It may not fix any biochemical disturbances, but it certainly can improve functioning -- even in depression which is entirely endogenous. (And I believe in a more holistic view of depression -- that ALL depression stems from some interaction of genetics and environment.)
I'm one who believes that medications are more effective than placebo. In my reading, it looks to me as though there is a pretty robust initial response to placebo -- which is far overshadowed by the more sustained response to medication. That's my reading, my understanding -- and I believe quite strongly that I am more correct than you are. You, of course, believe that your understanding is more correct than mine. I can't see any hope that I can convince you of any strengths to my position, and so I will end here, having had my say.
Good luck in your life, and I wish you well.
poster:Racer
thread:823248
URL: http://www.dr-bob.org/babble/20080412/msgs/824241.html