Posted by SLS on June 18, 2010, at 5:20:21
In reply to Re: im also rejecting meds... » SLS, posted by violette on June 18, 2010, at 0:31:48
> "Can one be depressed without having major depressive disorder?"
>
> Well yes, of course,You say "of course", but I think this fact is lost in the conceptualization and treatment of depression. I think too many people are treated biologically whom would be better served with psychotherapy.
> depression is usually viewed in terms of a continuum.
I think this is a useful model.
> So let me ask you a question or two:
>
> Does the lack of just_one_symptom of a DSM diagnosis, which would exclude a patient from the 'MDD' diagnosis on the basis of not meeting the full diagnostic criteria--impact his or her course of treatment or provide any clues as to the causes behind the symptomology? Is it relevant if 5 psychiatrists give 5 different depression-related diagnoses to the same person based upon their interpretations and perceptions (NOS, dysthmia, MDD, etc.)?Those are some great questions. I think the current DSM sucks when it comes to the diagnosis of Axis I disorders. It is primitive and imprecise. In some ways, it is too rigid. In others, it is too brief. If it were to devote as much time to Axis I diagnoses as it does to Axis II diagnoses, perhaps it would be more useful. Biological tests are on the way; some of them to use microarrays to determine gene activity. Until then we must rely on observations that are to a large extent subjective and not amenable to quantification. Sometimes, a diagnosis is not confirmed until someone responds to a particular treatment. It is unfortunate that things should work backwards in this way, but there is a great deal of trial-and-error involved in treatment selection. We know what we know. It is what we don't know that creates frustration and cynicism.
- ScottThe measure of achievement lies not in how high the mountain,
but in how hard the climb.The measure of success lies only in how high one feels he must
climb to get there.
poster:SLS
thread:951378
URL: http://www.dr-bob.org/babble/20100615/msgs/951412.html