Posted by SLS on September 10, 2009, at 6:19:22
In reply to 'treatment resistant depression', posted by rickjen on September 10, 2009, at 3:21:30
> What does this mean? I never thought antidepressants were supposed to take away ALL of your depression symptoms. OR ARE THEY???? Any input would be appreciated. Thank you.
"Depression" is one word that, unfortunately, has many meanings. Depression can be the result of internal psychological conflicts that result from a lack of nurturing early in life or from trauma. It can be the result of bereavement and grief. It can be a reaction to many different kinds of loss. However. depression can also have biological underpinnings, even if the original psychosocial stress was external or internal.
Called "major depressive disorder" (MDD), it represents a specific clinical diagnosis that is made according to a medical guideline. When the diagnosis is made accurately, which is difficult because doctors are evaluating a subjective experience, it seems that there are strong biological components. PET and MRI scans have detected differences in the shape and function of the brains of people with MDD. Genes have been identified that are associated with MDD, although there are more than just one. In short, MDD is very often a biological condition triggered by psychosocial stresses. However, once triggered, biological therapies might be necessary to treat it. There is also a depressive counterpart to bipolar disorder. This usually needs a biological therapy to treat, and is often resistant to treatment.
In addition to drug therapy, psychotherapy is often recommended to deal with the origninal triggering issues, or those that have developed as a direct result the biological depression.
Just as there are microbial infections that are resistant to treatment with antibiotics, there are MDD depressions that are resistant to the first series of antidepressants tried. There are several different definitions of how many failed drug trials qualify someone as being treatment resistant. For the most part, it is an arbitrary number. I think that it is unusual to find people who are completely refractory to all available treatments. Often combinations of drugs from different classes are necessary to bring about an improvement.
Psycho-Babble is a community that seems to be comprised of a high percentage of treatment-resistant people or people with troubling side effects. It is important to take this into consideration if one is attempting to formulate an idea of how the average person with MDD responds to treatment.
- Scott
poster:SLS
thread:916286
URL: http://www.dr-bob.org/babble/20090902/msgs/916297.html