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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by Phillipa on August 24, 2012, at 15:50:42
Since I think alot and ponder a lot was thinking since maois discovered by accident with TB patients feeling good. What happened to people with depression before then. There could not have been drug resistance as no drugs. So what happened did people get spontaneously well, die or what? Phillipa
Posted by jono_in_adelaide on August 24, 2012, at 20:06:02
In reply to Before Maois Was there any Tx for Depression?, posted by Phillipa on August 24, 2012, at 15:50:42
ECT
Amphetamines
Opium
Time
Posted by johnLA on August 24, 2012, at 20:22:14
In reply to Before Maois Was there any Tx for Depression?, posted by Phillipa on August 24, 2012, at 15:50:42
great question phillipa-
as a former history teacher i am interested in what responses you will get.
my random thoughts after 'studying' depression for over 2 years now...
i think ect pre-dates antidepressants? lobotomies too. also some type of insulin shock/coma procedure i think i have read.
cold shower/water therapy i have read about too.
you also had plain old psychotherapy/analysis (freud/jung) for decades before ad's.
'bibliotherapy' (reading books) was often prescribed for 'shell-shocked' ww1 veterans. (what we would call post traumatic stress disorder/depression today.)
you had asylums for the poor and 'nicer' places for the rich. do a google on jfk's sister (forgot her name). she had a lobotomy and spent the rest of her life in a institution. though she had her own home on the grounds and private nurses. she lived a long life there. sad her story is.
last year i read 'lincoln's melancholy' which was all about his bouts with suicidal depression. good food, exercise (hunting, riding a horse or chopping wood) and being out in nature was recommended to him. i mentioned this in another thread; look at a $5 bill. lincoln is only about 51. he looks beat. his depressions started from a early age after several losses. he was on 'suicide watch' a few times as a young man. he was well loved by his community and many reached-out to help him. also, being married to mary todd was no picnic. she ended-up in an asylum herself until she died. i think historians claim she was severely bipolar.
also, look-up the story of mary ellen copeland? i think was her name. she was put in an institution in the 30's and kind of started a cbt type of program on her own in there. today it's known as 'w.r.a.p.' i believe.
as a greek-american! ;) i am curious what hippocrates would have recommended. i'm sure he would apply his famous 'first do no harm' to even his depressed patients. depression is described and i believe named for the first time in ancient greece (melancholia) over 2500 years ago. there is even some ancient greek art work showing depressed persons. (by the way psyche mean 'soul/spirit' in greek.)
morphine of course was used as well as other drugs like cocaine, caffeine (snorted), and i'm sure others to lift one's 'spirits.'
no joke; you ever watch the fim 'the exorcist?' the priest in in was a greek orthodox priest...i have had my parish priest come twice to my home to do a 'blessing' (really a exorcism by traditional terminology). incense burning, centuries old byzantine chanting, the whole deal as i knelt before him. scary, huh? i have four byzantine icons in my room right now. and this personal irony; the patron saint from the island in greece i come from is the patron saint also of the mentally ill for orthodox christians! on his feast day sick people/pilgrims come from all over greece to have his remains/icon pass over their bodies in hopes of being healed.
i'll stop there. i have more...the 'teacher' in me is coming-out. sorry! i was always good at realizing when to stop a lecture. ;)
one final thought though. and, i don't want to come across as anti-med because then the threads turn hostile sometimes. it's hard for us with depression to really know what's best. psychiatry itself is at war with itself in many ways right now. big pharma suppressing studies about antidepressants efficacy/etc. just the explosion of the amount of pills that people are on in the last 25 years is mind-boggling. (and, not just for depression.) we, the usa, are one of the very few countries to advertise medications on tv. sometimes i feel 'played' by the whole biz of psychiatry. today i went to my pdoc and he really wants me to start viibryd. i couldn't help, but see all the sample/starter packets he had in his office. easily the most of any other drug he had samples of. hmmm?
curious as to what others will come-up with. i miss teaching. not because of what i know, but from what i would learn from a classroom of 40 12th graders. especially when one of them would ask such an interesting question as you have...
Posted by johnLA on August 24, 2012, at 20:42:40
In reply to Re: Before Maois Was there any Tx for Depression?, posted by jono_in_adelaide on August 24, 2012, at 20:06:02
what's the difference between an aussie and a greek?
a greek takes about an hour to say what an aussie can in a minute!
nice post jono.
john
Posted by Phillipa on August 24, 2012, at 21:38:50
In reply to Re: Before Maois Was there any Tx for Depression?, posted by johnLA on August 24, 2012, at 20:22:14
Hi missed you. You are right as was also reading some google searches. I do remember also reading that Freud himself used cocaine. Was In Van Goth that cut off his ear? I think many committed suicide also.
Oh the drug companies are scaring many people with their TV ads.As if a male would you take viagra and maybe be blind, deaf, or dead all for sex.
I didn't know that about jfk's sister. What a tragic family. Hope others do jump in as I wonder what the properties were that caused the maois to be given to those with TB? Phillipa
Posted by linkadge on August 25, 2012, at 9:06:09
In reply to Before Maois Was there any Tx for Depression?, posted by Phillipa on August 24, 2012, at 15:50:42
I don't know the full answer but...
In the early 1900's, garden variety depression and anxiety were probably commonly treated with the so called 'tonics' like 'Vin Mariana' etc. These were beverages containing a variety of ingredients like alcohol, opium, cocaine, caffeine etc. I don't know if they all required a prescription per se. but many were likely available at pharmacies.
In the 50's stimulants were probably most used for certain depression, although I think that ECT use was the treatment of choice for 'real' depression.
In the late 50's you started to see MAOI's and imipramine both about the same time. Although, it probably took time for people to really see the clinical difference (if there is any) between stimulants and antidepressants. After all, stimulants worked immediately, antidepressants didn't and had all sorts of nasty side effects.
Here is an advertisements for the use of ritalin to treat depression. Although the ad is in 1969, there seems to be some realization that they were effective and better tolerated by some patients.
http://amphetamines.com/methylphenidate/getthingsmoving.html
Linkadge
Posted by Bob on August 25, 2012, at 17:04:39
In reply to Re: Before Maois Was there any Tx for Depression?, posted by linkadge on August 25, 2012, at 9:06:09
> I don't know the full answer but...
>
> In the early 1900's, garden variety depression and anxiety were probably commonly treated with the so called 'tonics' like 'Vin Mariana' etc. These were beverages containing a variety of ingredients like alcohol, opium, cocaine, caffeine etc. I don't know if they all required a prescription per se. but many were likely available at pharmacies.
>
> In the 50's stimulants were probably most used for certain depression, although I think that ECT use was the treatment of choice for 'real' depression.
>
> In the late 50's you started to see MAOI's and imipramine both about the same time. Although, it probably took time for people to really see the clinical difference (if there is any) between stimulants and antidepressants. After all, stimulants worked immediately, antidepressants didn't and had all sorts of nasty side effects.
>
> Here is an advertisements for the use of ritalin to treat depression. Although the ad is in 1969, there seems to be some realization that they were effective and better tolerated by some patients.
>
> http://amphetamines.com/methylphenidate/getthingsmoving.html
>
> Linkadge
>
>Just as a follow-up... one of the episodes in Mad Men on AMC this past season showed a secondary character suffering from depression and receiving ECT treatments. I think they over did it a little though as she had at most a handful of treatments (or maybe even just one) and then she no longer recognized acquaintances. I guess it could happen after one or two treatments but it doesn't seem likely to me.
Bob
Posted by Phillipa on August 25, 2012, at 21:44:18
In reply to Re: Before Maois Was there any Tx for Depression? » linkadge, posted by Bob on August 25, 2012, at 17:04:39
I wanted to lose some weight although I'd lost weight during the pregnancy of my Son. So the ob-gyn gave me a diet pill said one month only. Took l pill every other day. And the windows on the outside of home got washed daily what would this have been? At the end of the pills was starting to have trouble falling asleep. I didn't have any mental issues when took it at age 22. Phillipa
Posted by papillon2 on August 26, 2012, at 0:48:55
In reply to Re: Before Maois Was there any Tx for Depression?, posted by jono_in_adelaide on August 24, 2012, at 20:06:02
There's always been some form of psychotherapy. One of the earliest forms was psychogogy: http://www.psychiatrictimes.com/blog/eghigian/content/article/10168/2096101
Posted by bleauberry on August 26, 2012, at 5:47:42
In reply to Before Maois Was there any Tx for Depression?, posted by Phillipa on August 24, 2012, at 15:50:42
Before meds, plant medicines were mainstream medicine. Not much profit there though. When drugs were invented, the profits pushed plant medicines into the background. Not that they were more or less effective than meds, just that there wasn't as much profit in them. There are some common ones most people have heard about, for depression. There are many uncommon ones too. Some plant medicines for psychiatric symptoms have track records going back 2000 years and literally hundreds of scientific studies on them.
Posted by linkadge on August 26, 2012, at 15:48:51
In reply to Re: Before Maois Was there any Tx for Depression? » linkadge, posted by Bob on August 25, 2012, at 17:04:39
Although I don't recommend the use of ECT even nowadays, there have probably been some improvements in the way it is administered since then.
I don't doubt that ECT has been used as a form of behavioral control. ECT can certainly cause cognitive impairment, and there is human evidence that this impairment increases with the number of treatments.
I personally think that pharmacological treatment of depression has become progressively less effective over time. I.e. stimulants > MAOI > TCA > SSRI.
Linkadge
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