What's the appropriate use for antidepressants?

[TVAA]

Take a look at this article: Pfizer launches "Zoloft for Everything" ad campaign

Yes, I realize it's a parody, but it's far too close to reality for my comfort. For what should antidepressants be considered the appropriate treatment? "Real" clinical depression? How do we determine if a person's emotions are genuinely the result of a physiological condition?

[John Harrison]

Originally posted by TVAA
How do we determine if a person's emotions are genuinely the result of a physiological condition?

See a psychiatrist?

[december]

Originally posted by TVAA
For what should antidepressants be considered the appropriate treatment? "Real" clinical depression? How do we determine if a person's emotions are genuinely the result of a physiological condition?

Depression isn't always a black-and-white diagnosis. Antidepressants may or may not help. The way to tell is to try them, under the care of a psychiatrist, and see if they help. I would advise that you and your loved ones watch carefully along with the psychiatrist to see whether the antidepressants are helping. Evaluting their impact is often subtle.

[El Zagna]

I take antidepressants for a mild but ongoing depression. I can certainly live my life just fine without them, but there's a lot less joy to it, I'm not as much fun to be around, and I'm less productive. I know I'm not adding much to the debate here other than to give an example of a non-critical use of antidepressants. Is there a threshold of depression that a person has to meet to be a legitimate user of antidepressants?

[Philly Style]

True depression is normally not associated with a particular event. Doctor will prescribe anti-anxiety agents for events like the loss of a spouse (something I don't agree with, myself!).

Depression is a physical illness. Zoloft is not a cure all, and shouldn't be used as such.

[TVAA]

Originally posted by Philly Style
Depression is a physical illness. Zoloft is not a cure all, and shouldn't be used as such.

A physical illness without specific physiological symptoms? When was it actually shown to be physical illness? I'm gonna need some cites here.

[blowero]

It's only a physical illness in the sense that your emotions are tied to physical chemical changes in your brain. But that says nothing. There is no physical test to diagnose a "chemical imbalance" in the brain. It's a chicken and egg problem; when you are depressed, there are changes in your brain chemistry, but a doctor can not tell you which caused the other.

It basically comes down to a judgment call - that's why Zoloft requires a prescription, because you need a doctor to determine if it's the right course of action. Like December said - it's not black & white. And a lot of doctors recommend talk therapy first, and only try medication if that doesn't work.

BTW, a common misconception is that SSRIs like Prozac and Zoloft are "happy pills". They are not. They only make a depressed person feel "normal". From what I understand, if a non-depressed person were to take them, he might feel some annoying side-effects, but would not experience any kind of euphoria.

[John Harrison]

For what should antidepressants be considered the appropriate treatment?

They are also used for ailments not directly related to depression ie: migraines, chronic pain, etc... Do you want to include this in the discussion?

[Broomstick]

Originally posted by Philly Style
True depression is normally not associated with a particular event. Doctor will prescribe anti-anxiety agents for events like the loss of a spouse (something I don't agree with, myself!).

Although I'm not thrilled with the idea of moderating emotions like grief which, although unpleasent, are part of life and must be dealt with, I can see situations where the use of such medications may be justifiable. For instance, if someone loses a spouse but has small children they must take care of then medication may, in some instances, provide needed assistance in keeping them functional enough to continue to be a parent to their children.

I know from experience that sudden death in the family can be paralyzing, or nearly so. When I had to deal with the sudden death of my sister I had the "luxury" of being able to weep and mope and otherwise act out in the care of my husband (who was actually my boyfriend at the time). But if I had had toddlers? Gosh, the thought of having to take care of children AND cope... This isn't an argument to drug people into zombie-hood, just that in some circumstances medications can be tools to enable people to do things that must be done regardless of circumstances.

[MLS]

Broomstick: As mentioned earlier, properly prescribed anti-anxiety and anti-depressants -- and there is a difference -- do not drug people into zombie-hood. In my limited experience, competent doctors don't prescribe these things for immediate tragedies in a person with no prior history of problems, and who is appropriately grief-stricken or sad. It's when the crying becomes continuous and uncontrollable, for example, or when the situation leads to a panic attack (which is much more than just being scared) that meds become a possibility.

Chronic anxiety might be a person who is afraid most of the time even when there's nothing specific to be afraid of. Clinical depression might be when a person is sad most of the time and is unable to be happy or enjoy anything that he would normally enjoy.

[Zoe]

Only a professional can diagnose depression. I highly recommend a specialist (psychiatrist) for treatment. My understanding is that there is movement away from the regular weekly fifty minute-hour sessions to twenty minute sessions perhaps once a month -- with medications. A deeper depression may require more intense attention.

Anti-depressants can take six weeks to have an effect. You may need to try two or three different meds to find the right one. The same holds true for shrinks. If you don't feel comfortable with the first one you see after a reasonable time, get a referral to another.

Above all, don't blame yourself in any way for having this illness. It is not a character flaw.

This site may be helpful: http://www.symptoms-of-depression.com/index.php3

I am not a doctor but I a longterm patient.

[doctordoowop]

Anti-depressants treat a lot of things besides depression, like pain(physical)as was said above. Zoloft is FDA approved, & just recently Prozac, for PTSD. Paxil & Zoloft treat panic disorder. Luvox & Prozac for OCD. Older antidepressants (like Elavil) treat adult ADHD. Wellbutrin was found to make smokers lose their habit, so it was put out as Zyban ,at five times the price.

[even sven]

Anti-depressents should be prescribed to those that would be helped by them. Isn't that the point of medicine? If you want to deal with your pain however you want, you are free to do that. But don't deny people the right to choose different ways which may include medication. Not all of us consider medication to be a bad thing. And almost all of us consider medication to be better than uncontrolled drug use, self-injurt and suicide.

I say this as a so-far-unmedicated bipolar. I tried the whole medication thing and came to a bunch of conclusions as to why it wasn't the right thing for me. And I did resent how they pushed it on me (They essentially wouldn't give me any sort of consouling if I didn't take their drugs). But I'd never dream of telling someone not to take medication. Why should I deny them something that can make their life a little bit less hellish than mine?

Mental illness is a tricky thing. How much of it is a "medical problem" and how much is something that is "my fault"? Who knows? I'd personally say neither. I know there is something funny going on with my brain. Normal people don't reach the point where they have to sneak out of class early every day because they can't sit for two hours without crying. But I can't really see it as a medical problem. More like a brain and heart that just arn't quite suited to the world right now. Lots of people don't respect my point of view. And maybe one day I'll come to some big realization and change my mind. But right now I just can't help but think everything is so much more complicated than most people say it is.

Mental illness is very context sensitive. The sorts of disorders that people get vary according to time, place, and social circumstances. In this sense, it's not like cancer or a broken bone or whatever metaphors people use. That doesn't mean they arn't real. It means that they are a pathology that is created both by brain chemistry and by environment. It's all nuanced and complicated. There are no easy answers. But taking pills isn't an "easy way out". at least not for the individual involved.

[phraser]

SSRIs are also used to treat anxiety disorders in companion animals.

[TVAA]

Originally posted by John Harrison
They are also used for ailments not directly related to depression ie: migraines, chronic pain, etc... Do you want to include this in the discussion?

Oh yes.

It's a fascinating question, since it's not understood why they're helpful for such conditions.

There's evidence that suggests that antidepressants have analgesic properties apart from their effects on cognition and emotion. To what degree are these drugs being prescribed because they make people less concerned about their pain and to what degree are they used because they actually reduce pain? When it's considered that attention and concern is a major aspect of pain... well, it becomes complicated very quickly.

[TVAA]

Originally posted by MLS
In my limited experience, competent doctors don't prescribe these things for immediate tragedies in a person with no prior history of problems, and who is appropriately grief-stricken or sad. It's when the crying becomes continuous and uncontrollable, for example, or when the situation leads to a panic attack (which is much more than just being scared) that meds become a possibility.

Problems:

First, we have to note that there are a lot of doctors whose competency is... questionable.

Secondly, antidepressants have been shown to reduce the duration and severity of "normal" grief... and some physicians are in favor of considering bereavement a treatable condition.

Thirdly, who decides what is "appropriate"?

Chronic anxiety might be a person who is afraid most of the time even when there's nothing specific to be afraid of. Clinical depression might be when a person is sad most of the time and is unable to be happy or enjoy anything that he would normally enjoy.

These statements are major oversimplifications... that are precisely what people think of when they hear these diagnostic terms. Which is part of the problem, IMO...

[The Calculus of Logic]

Whats wrong with that? As a species, we humans are finally obtaining self determination. Any attempt to make our existence more fulfilling or less painful is a good thing.

The only problem i would have is the idea that anti-depressants could oneday result in no negative experiences. THe idea of losing a close friend or child and being happy the next day seems a little off putting, but i would still support that over emotional derailment for years on end.

[Melanie]

I don't know if this is the appropriate use, but this is the actual use. To be diagnosed with depression, see 'diagnostic criteria':

http://www.psychologynet.org/major.html

[Guinastasia]

Also, anti-depressants are not Magical Happy Pills. They are an aid-but if you don't include counseling, and other techniques, they aren't going to be much use.

[TVAA]

If depression is a physical, biochemical disorder, then why do those criteria state that it's not major depression if it's due to a physical illness?

Antidepressants are often given prophylactically to patients recovering from surgery, "in case they become depressed".

And the criteria for depression are routinely ignored, because insurance companies won't pay for any type of treatment if people don't fit within the DSM standards, or the practitioner feels the person would benefit from treatment... or because the criteria are intentionally so broad that no one actually takes them seriously.

[jsgoddess]

The appropriate use of anti-depressants is the same as for any drug. When the drug's good effects outweigh the side-effects (and the cost), then they are appropriate.

ADs don't make everything rosy. They just enable some people to get out of bed in the morning. That tends to be a Good Thing.

Julie

[TVAA]

Originally posted by jsgoddess
The appropriate use of anti-depressants is the same as for any drug. When the drug's good effects outweigh the side-effects (and the cost), then they are appropriate.

Incorrect. Proper medical treatment should be used only when it's medically necessary, which is not merely when treatment might be beneficial.

The standards for intervention are quite stringent. The fact that they're ignored is irrelevant.

[MLS]

TVAA, you are absolutely right that what I wrote was a great oversimplification; I was just trying to give a couple of examples.
Indeed, as Guinastasia said, they are not "happy pills," and would not take away all negative feelings, as Calculus fears. They might help you to deal better with the negative feelings, though. In the tragedies mentioned, they might help a person to grieve and be sad without, say, becoming suicidal. Again, just an example. I also agree that one must be careful, since indeed there are some doctors that are too willing to just give a pill because it's perceived to be easier than counseling and other remedies. After all, it is well known that 50% of all doctors graduated in the bottom half of their class. To put it another way: What do you call someone who graduates last out of med school? "Doctor."

[Papermache Prince]

Originally posted by TVAA . . .And the criteria for depression are routinely ignored, because insurance companies won't pay for any type of treatment if people don't fit within the DSM standards, or the practitioner feels the person would benefit from treatment... or because the criteria are intentionally so broad that no one actually takes them seriously.

I'm going to need some cites here.

[TVAA]

I'll see if I can find some... my discussions with psychiatrists and years of research into applied psychology don't really qualify, after all.

You might be able to find references yourself... the tendency of practitioners in the field to sidestep the DSM has been a major in-house problem for years.

[lander2k2]

I'd like to throw in some questions:

When mind-altering drugs—be they be the illicit variety or the prescription variety—weren’t available, how do we suppose that those folk got by? Did they crumble into perpetual anxiety attacks and depressive states or did they simply deal with it and get on with life?

If anti-depressants cure physiological ailments why do people seem to become dependant and not get cured so that they can cease medication? With penicillin, you take it for a couple of weeks and the ailment is cured and you cease treatment. With Prozac and such, often people become addicted and can’t stop without serious side effects. Is this really medicine? Or is it simply legal drug dealing?

What is the difference between taking Prozac or Zoloft and smoking pot or snorting cocaine (other than the laws of the land)?

[TVAA]

People can't become addicted or dependent on antidepressants, lander2k2. They are habit-forming (and tend to lose effectiveness with time) despite constant claims to the contrary by corporate interests.

There's also little basis to the claim that antidepressants have no effect in "normal" individuals. Without pronounced negative affect, though, their effects aren't so obvious.

[even sven]

Originally posted by lander2k2
When mind-altering drugs—be they be the illicit variety or the prescription variety—weren’t available, how do we suppose that those folk got by? Did they crumble into perpetual anxiety attacks and depressive states or did they simply deal with it and get on with life?

Why do you think that society's taboos on suicide are so strong? Throughout history, people have been killing themselves, going into hermithood, becoming alcoholic or just plain going crazy. If you read older books, you'll see that a lot of characters have the same sorts of mental issues that people deal with today. They didn't deal with it much better than we do. Depression and anxiety disorders have been around for a long long time, and so have the many ways people deal with it.

If anti-depressants cure physiological ailments why do people seem to become dependant and not get cured so that they can cease medication? With penicillin, you take it for a couple of weeks and the ailment is cured and you cease treatment.

Major depression is a chronic disease. It may never go away. Anti-depressents are treatments, not cures. Are diabetics "addicted" to insulen? No. They have a chronic disease that can be helped by certain chemicals.

[even sven]

Originally posted by TVAA
Incorrect. Proper medical treatment should be used only when it's medically necessary, which is not merely when treatment might be beneficial.

What is "medically necessary"? I don't really need to take birth control pills. I don't need laser eye surgery. Heck, I don't need to see any better than well enought not to accidently step in front of a truck. Maybe I can start a thread about how contact lenses are overprescibed. A suicidal person doesn't need treatment, they can just be tied down. A person with gangrene doesn't need for their arm to be saved. Amputation is good enough. You got a headache? Well you don't really need that tylenol. Heck, people don't need anathstic during surgery. Need I go on?

Look, I'm no drug pusher. In fact, I have a lot of issues with the way that anti-depressents are currently prescibed. I don't like seeing them used as a replacment for therapy. I don't like seeing them pushed on people with the only goal being to get them happy enough that they can go to work every day. I don't like how side-effects, physical dependence and the eventual loss of effectivness are glossed over. I don't like how instead of looking at the problems in our society, we demand that everyone's head lines up lock step. But I really don't see what is wrong with people who are hurt taking steps to make it better. Anti-depressents have helped a lot of people. Who the heck are you to tell them that their condition doesn't merit treatment?

What exactly is your agenda anyway? What is your experience with phsychiatry, and what is your experience with depression? What are you trying to prove?

[occ]

Originally posted by TVAA
[b]
Antidepressants are often given prophylactically to patients recovering from surgery, "in case they become depressed".
B]

Got a cite for that? Considering that the SSRIs are generally given a couple weeks before their effectiveness is verified, it seems unlikely that they would be given for surgical recovery, unless a specific problem with depression is noted. Hell, painkillers would be much more effective for, you know, the physical pain that often accompanies recovery.

[jsgoddess]

Originally posted by TVAA
Incorrect. Proper medical treatment should be used only when it's medically necessary, which is not merely when treatment might be beneficial.

If the AD is beneficial, it should be used. My getting out of bed in the morning isn't "medically necessary."

Julie

[lander2k2]

Originally posted by TVAA
People can't become addicted or dependent on antidepressants, lander2k2. They are habit-forming (and tend to lose effectiveness with time) despite constant claims to the contrary by corporate interests.

What is “habit-forming” if not a euphemism for addictive? Yes, anti-depressants lose effectiveness over time. People build up tolerance. A hard-core drunk can down enough whiskey to knock out a rhino and a heroine junkie can shoot up enough junk to kill three non-users. Doctors up the prescription, other drug users just drink/smoke/inject/snort/inhale/swallow more. What’s the difference?

There's also little basis to the claim that antidepressants have no effect in "normal" individuals. Without pronounced negative affect, though, their effects aren't so obvious.

I’m beginning to think that you were being sarcastic with your post and that you actually agree with me. Now I feel a little silly.

[occ]

Originally posted by lander2k2
I'd like to throw in some questions:

When mind-altering drugs—be they be the illicit variety or the prescription variety—weren’t available, how do we suppose that those folk got by? Did they crumble into perpetual anxiety attacks and depressive states or did they simply deal with it and get on with life?

No, those unable to cope committed suicide. More functional people were able to get by, but lived extremely difficult lives.

What is the difference between taking Prozac or Zoloft and smoking pot or snorting cocaine (other than the laws of the land)?

Pot and cocaine produce highs. SSRIs do not; they address specific symptoms of depression. Pot and cocaine tend to impair one's functioning, whereas SSRIs tend to be activating. (Well, cocaine improves functioning in the short term, but is unsustainable and thus not useful as an antidepressant).

There's no conspiracy here; these drugs can and do help many.

[Qadgop the Mercotan]

Originally posted by occ
Got a cite for that? Considering that the SSRIs are generally given a couple weeks before their effectiveness is verified, it seems unlikely that they would be given for surgical recovery, unless a specific problem with depression is noted. Hell, painkillers would be much more effective for, you know, the physical pain that often accompanies recovery.

I suspect the poster is referring to post-surgical depression, a very real and difficult to treat phenomenon which often occurs a few weeks after major surgery or illness. SSRI's can be quite helpful here, as in post-partum depression.

QtM, MD

[lander2k2]

Originally posted by even sven
Why do you think that society's taboos on suicide are so strong?

Because things like suicide, like drug use, are a general barometer for the depravity of a culture.

Throughout history, people have been killing themselves, going into hermithood, becoming alcoholic or just plain going crazy. If you read older books, you'll see that a lot of characters have the same sorts of mental issues that people deal with today. They didn't deal with it much better than we do. Depression and anxiety disorders have been around for a long long time, and so have the many ways people deal with it.

I agree completely. People with problems have always either sunk into some dependence of some sort or they have confronted life’s slaps in the face and moved on.

Why is it that people buy all this medical disorder crap when it is just plain drug use like it always was? Pharmaceutical corporation = supplier. Doctor/psychiatrist = dealer. Medicated patient = user/junkie.

Seems like we’re adopting euphemisms so that money can be made by the manufacturers of these drugs.

I don’t especially have a problem with the stuff that people take. The thing is that they could brew in their basement or grow in their back yard stuff that is just as effective as the junk you get in a pharmacy—the behavioral medications that is.

Major depression is a chronic disease. It may never go away.

Because the drug companies and their doctors tell you so?

Anti-depressents are treatments, not cures.

Then any drug from smack to peyote is a treatment. Agreed?

Are diabetics "addicted" to insulen? No. They have a chronic disease that can be helped by certain chemicals.

I love it when diabetes is brought up. Do you all read the same script or what? Insulin is not mind altering. Are you addicted to oxygen? Do you have a chronic disease that is alleviated by the intake of oxygen?

Diabetes is a specific physiological condition. From what I understand it is spawned by diets full of processed junk food, but that is another issue. These “chemical imbalances” in the brain seem to be just manifestations, not causes of the conditions that are diagnosed. Take a so-called mentally healthy individual and monitor his/her brain chemistry during a major emotional upset like a death in the family. You think any change in brain chemistry caused their grief?

[lander2k2]

Originally posted by occ
No, those unable to cope committed suicide. More functional people were able to get by, but lived extremely difficult lives.

Or they used alcohol or opium or whatever. Lots of people are still committing suicide. Lots of them had been on anti-depressants as well. Some of them are even going nuts with guns while on this mood altering medication. And I’ve personally known people on these psychotropic drugs that still led extremely difficult lives despite their medication. They were merry right after taking a pill but when that wears off, the difficult life is still there.

Those unable to cope committed suicide? Don’t psychiatrists have the highest incidence of suicide? Why aren’t they coping? They have access to the drugs.

Pot and cocaine produce highs. SSRIs do not; they address specific symptoms of depression. Pot and cocaine tend to impair one's functioning, whereas SSRIs tend to be activating. (Well, cocaine improves functioning in the short term, but is unsustainable and thus not useful as an antidepressant).

I'll contest the "high" claim based on personal experience. I've seen changes in mood in people taking the stuff. Is it because we're dealing with "prescription" doses and that the high is more subtle that it is different to cocaine?

I’ve seen pot and cocaine address specific symptoms of depression, right along with alcohol and magic mushrooms. You seem to have conceded that cocaine effects the serotonin in the brain in a similar way to Prozac etc. So why is it that Prozac is legal and cocaine isn’t?

There's no conspiracy here; these drugs can and do help many.

Ask a junkie. The drugs help him. Ask his dealer. They help him too.

I never said there was a conspiracy. Making and selling Prozac is no more a conspiracy than making and selling cocaine. Is that next in the list of empty remarks behind diabetes as a counter to the notion that anti-depressant are just more drugs. You guys do have a script don’t you.

[MLS]

So many things wrong, lander. Many people with diabetes have nothing wrong with their diet at all. It's a chemical imbalance, a malfunctioning organ, in this case the pancreas.

You are confusing temporary sadness and grief with chronic depression. Believe me, people don't get into clinical depression because they wanted to. Do you think we choose to feel that way?

A drug addict becomes addicted when he starts taking heroin or whatever. His initial aim is to become high -- an abnormal state. A clinically depressed person is in an abnormal state to begin with. He takes the anti-depressant in order to feel normal. In some cases it's necessary to at least start with some medicine in order for the person to be accessible to therapy.

For some of us, without the balancing agent, we are anxious, afraid, and/or continuously sad FOR NO REASON.

Without the balancing agent, a clinically depressed person can go outside on a beautiful spring day, having not a single ache or pain, hear birds singing and feel the gentle breeze and have no joy at all. Hearing children laughing deepens the depression as one realizes that this is all beautiful, and others are happy, and you cannot be. Do you have any concept of what it would be like to go through life like that? Every single day? Having nothing to look forward to? Not wanting to sleep because you knew you would wake up to yet another day of mental horror?

A suicidal person is not depraved. He or she is attempting to escape from unendurable pain.

Chronic depression and anxiety sometimes is a chronic condition that will never go away by itself. This is known first hand by many of us for years and years before any doctor ever said any such thing.

"Any drug from smack to peyote" is not a treatment. Many such things will make you sicker or dead. Throughout history, though, in the absence of knowledge we have now, many people have tried these and other chemicals such as alcohol in a futile effort to get rid of the symptoms.

No, I'm not addicted to my anti-depressant. But I'd rather take a little pill every day than to go through life in fear and gloom. I don't feel "hyped" or "zombie-like." I feel normal. I can go to work and love my family and enjoy the world's beauty. I can feel angry at injustice and sad about tragedy. I just don't have to cry for hours on end for no reason.

[jsgoddess]

Originally posted by lander2k2
Take a so-called mentally healthy individual and monitor his/her brain chemistry during a major emotional upset like a death in the family. You think any change in brain chemistry caused their grief?

And if you have someone who didn't just suffer "a major emotional upset" but whose behavior is indistinguishable from someone who did, what then?

Julie

[FranticMad]

Originally posted by lander2k2
Pharmaceutical corporation = supplier. Doctor/psychiatrist = dealer. Medicated patient = user/junkie.

Yes, let's take the "War on Drugs" into the psychiatrist's offices, shall we? Let's toss those pathetic patients out of the doctor's offices and onto the street where they can buy their drugs from non-corporate entrepreneurs. And no more junk food either. No smoking. No red meat. No sugar.

Sigh. So many things wrong with your posts, as MLS pointed out. It's late or I would proceed to dismember your point of view into tiny pieces, backing each of my disputation with citations from several sources more reputable than your assertion "personal experience".

Moan. Another anti-corporate ranter who knows nothing about biology or psychology but thinks he has the answers for the world.

[spectrum]

There is a stigma, a hateful, destructive stigma, in our society, that objectifies and punishes those with mental illnesses. Calls us weak, pathetic, blames us for our condition. Then when some of us get the help we need, people like Lander slime their way in and compare us to junkies and drug abusers, simply because we're trying to live normal -- not high, not special, normal -- lives. It is one of the more evil components of our society, one of the last acceptable prejudices. It's okay to hate the mentally ill, the depressed, the suicidal, because obviously, we deserve it. It's our fault. People like Lander help perpetuate and spread this myth.

Lander, I hope all your children suffer from crippling manic depression.

[even sven]

Heck, maybe I am depraved, drug addicted, and weak.

I don't care. I don't want to die.

And if one day it comes to drugs to keep me from suicide (which I suspect will one day be the case) then I'm gonna take the drugs. And it doesn't matter one whit whether you "believe" in depression or not.

[OliverH]

Originally posted by lander2k2


Because the drug companies and their doctors tell you so?

Um, lander, ever heard of molecular biology?

Then any drug from smack to peyote is a treatment. Agreed?

No, since they don't have specific effects.

I love it when diabetes is brought up. Do you all read the same script or what? Insulin is not mind altering. Are you addicted to oxygen? Do you have a chronic disease that is alleviated by the intake of oxygen?

Diabetes is a specific physiological condition. From what I understand it is spawned by diets full of processed junk food, but that is another issue. These “chemical imbalances” in the brain seem to be just manifestations, not causes of the conditions that are diagnosed. Take a so-called mentally healthy individual and monitor his/her brain chemistry during a major emotional upset like a death in the family. You think any change in brain chemistry caused their grief?

What seems to be the case to you is entirely irrelevant. As long as you don't even know what a hormone is, don't know what diabetes is, and don't know what antidepressants do, all you are doing is ranting about issues you have no idea about.

There is several types of diabetes, and they are caused by a multitude of factors. Insulin is used because insulin is precisely the problem in diabetic people. For the same reason, antidepressants are used, because they address precisely the problem with neurotransmitters depressed people have.
(cf. eg. Life Sci 2003 May 23;73(1):1-17 'G protein signaling and the molecular basis of antidepressant action.' by Donati RJ, Rasenick MM.) Do you even know how antidepressants work? Do you know what serotonin is? (Cf. also Tafet GE, Toister-Achituv M, Shinitzky M. 'Enhancement of serotonin uptake by cortisol: a possible link between stress and depression.' in
Cogn Affect Behav Neurosci. 2001 Mar;1(1):96-104. Sulser F. 'The role of CREB and other transcription factors in the pharmacotherapy and etiology of depression.' Ann Med. 2002;34(5):348-56, McLeod TM, Lopez-Figueroa AL, Lopez-Figueroa MO. 'Nitric oxide, stress, and depression.' Psychopharmacol Bull. 2001 Winter;35(1):24-41. or Muller M, Holsboer F, Keck ME. 'Genetic modification of corticosteroid receptor signalling: novel insights into pathophysiology and treatment strategies of human affective disorders.' Neuropeptides. 2002 Apr-Jun;36(2-3):117-31. and many, many others)

And yes, that major change in brain chemistry CAUSED their grief. Because it is that change in brain chemistry that evokes emotions. What is at issue is what caused that change in brain chemistry. In one case, it is a temporary experience that can be dealt with. In the other case, it is an underlying change in the neurological makeup of the brain.

[blowero]

Originally posted by lander2k2
I'd like to throw in some questions:
When mind-altering drugs—be they be the illicit variety or the prescription variety—weren’t available, how do we suppose that those folk got by? Did they crumble into perpetual anxiety attacks and depressive states or did they simply deal with it and get on with life?

They either "dealt with it", or ended up in a mental institution, I imagine. Either way, their quality of life was diminished. I'm not sure what your point is, though. If I couldn't walk, I would get around in a wheelchair, because that would be my only option. But I certainly wouldn't choose to.

If anti-depressants cure physiological ailments why do people seem to become dependant and not get cured so that they can cease medication?

They don't cure. The effects of antidepressants only last as long as the person is taking the drug.

With penicillin, you take it for a couple of weeks and the ailment is cured and you cease treatment. With Prozac and such, often people become addicted and can’t stop without serious side effects. Is this really medicine? Or is it simply legal drug dealing?

SSRIs like Prozac do not make you "high". If it allows a person who would otherwise have a debilitating condition to function, what's wrong with that?

What is the difference between taking Prozac or Zoloft and smoking pot or snorting cocaine (other than the laws of the land)?

I don't think you really understand what major depression is and how serious it can be.

[blowero]

Originally posted by TVAA
People can't become addicted or dependent on antidepressants, lander2k2. They are habit-forming (and tend to lose effectiveness with time) despite constant claims to the contrary by corporate interests.

There's also little basis to the claim that antidepressants have no effect in "normal" individuals. Without pronounced negative affect, though, their effects aren't so obvious.

What effect do they have on "normal" people?

[Broomstick]

Originally posted by lander2k2
Why is it that people buy all this medical disorder crap when it is just plain drug use like it always was? Pharmaceutical corporation = supplier. Doctor/psychiatrist = dealer. Medicated patient = user/junkie.

You clearly do not understand the distinctions between the categories listed above. But I'm not sure you're willing to listen to anything but your own ramblings.

I don’t especially have a problem with the stuff that people take. The thing is that they could brew in their basement or grow in their back yard stuff that is just as effective as the junk you get in a pharmacy—the behavioral medications that is.

No, it's not. Herbal medicine - which is what you're talking about, essentially - is notoriously inconsistent and the quality varies all over the place. That's one reason for the rise of the pharmaceutical manufacturer - quality control and consistency, so that if you take something you know you're taking a reaonably pure substance of a known quantity.

And you are correct that some people self-medicate... but the long term side effects can be very unpleasent.

Then any drug from smack to peyote is a treatment. Agreed?

Not exactly.

First of all, there is a distinction between "smack", a street available, heavily "cut" - with God knows what - product of highly variable quality and purity and a drug like morphine or heroin. Morphine is administered for acute physical pain, such as arising from surgery or traumatic injury in a controlled setting where (ideally) the minimum amount required for the job at hand is used. "Smack" is typically self-administered for mental pain in an uncontrolled setting, using the maximum amount short of killing the person (if that can even be determined, given the uneven quality). Perhaps there is no difference to you - there is to a lot of the rest of us.

I love it when diabetes is brought up. Do you all read the same script or what? Insulin is not mind altering.

As a matter of fact, it can be when administered in sufficient doses.

Are you addicted to oxygen?

Absolutely - I'll die without it.

Diabetes is a specific physiological condition. From what I understand it is spawned by diets full of processed junk food, but that is another issue.

You do not understand.

Diabetes is several "physiological conditions". It is NOT "spawned" by diets full of "processed junk food". Diabetes was first described and named in ancient Greece, thousands of years ago, long before junk food was invented. In those days it was invariably fatal. If there weren't a lot of diabetics around until the 20th Century it's because they all died in a fairly short time after diagnosis. Or, if they had adult-onset they went blind or had their limbs rot off or their kidneys fail and never knew why.

To answer an earlier question - in the old days, folks who couldn't find a way to cope with their mental illness either wound up dead, in jail, or in a madhouse. A substantial number were not able to "deal with it" and yes, some did "crumble into perpetual anxiety attacks and depressive states"

[Broomstick]

Originally posted by Papermache Prince

I'm going to need some cites here.

Speaking as someone who works in the Evil Insurance Empire: What will and will not be treated varies from one insurance plan to another, at least here in the US. Some will only treat on strict, DSM diagnosis. Others allow more leniency. A clear case of "your mileage may vary"

[Guinastasia]

Originally posted by spectrum
There is a stigma, a hateful, destructive stigma, in our society, that objectifies and punishes those with mental illnesses. Calls us weak, pathetic, blames us for our condition. Then when some of us get the help we need, people like Lander slime their way in and compare us to junkies and drug abusers, simply because we're trying to live normal -- not high, not special, normal -- lives. It is one of the more evil components of our society, one of the last acceptable prejudices. It's okay to hate the mentally ill, the depressed, the suicidal, because obviously, we deserve it. It's our fault.

Yes Yes YES!!!
I can't tell you how many people have told me that my ailments would go away if I'd just "grin and bear it," or "chin up!". Or if I just accept JAYSUZ!!! into my heart.

Or they tell me that medication is just a crutch. Yes, it is. So fucking WHAT? I wonder if they go up to the man with one leg and yank his crutch away and scream, "Walk on your own!"

[AHunter3]

blowero:

t's only a physical illness in the sense that your emotions are tied to physical chemical changes in your brain. But that says nothing. There is no physical test to diagnose a "chemical imbalance" in the brain. It's a chicken and egg problem; when you are depressed, there are changes in your brain chemistry, but a doctor can not tell you which caused the other.

Very well put.

[John Harrison]

Hey, lander2k2, since this thread is similar to this previous thread, do you think that you could give us some type of cite for a statement that you made?

Drugs cover up yet, in the long run, exacerbate mental problems.

Normally I wouldn't do this, but your arguments in this thread are essentially the same, and I was curious about your answer.

If anti-depressants cure physiological ailments why do people seem to become dependant and not get cured so that they can cease medication? With penicillin, you take it for a couple of weeks and the ailment is cured and you cease treatment. With Prozac and such, often people become addicted and can’t stop without serious side effects. Is this really medicine? Or is it simply legal drug dealing?

Do you know the difference between addiction and physical dependence? I ask because you seem to be using them the same way in this statement.

[AHunter3]

spectrum

There is a stigma, a hateful, destructive stigma, in our society, that objectifies and punishes those with mental illnesses. Calls us weak, pathetic, blames us for our condition. Then when some of us get the help we need, people like Lander slime their way in and compare us to junkies and drug abusers, simply because we're trying to live normal -- not high, not special, normal -- lives. It is one of the more evil components of our society, one of the last acceptable prejudices. It's okay to hate the mentally ill, the depressed, the suicidal, because obviously, we deserve it. It's our fault. People like Lander help perpetuate and spread this myth.

There is also a social myth, a hateful, destructive social myth in our society, that venerates and praises the wonders of the pharmaceutical industry and the efficacy of the psychiatric profession. Says mental illness is a biological condition of the brain, a physiological brain malfunction, and that the pills the pharmaceutical companies manufacture and the psychiatrists prescribe are magic bullets that go right in there and fix the nasty old chemical imbalances and make everything right as rain. And when some of us find these little mind modifiers to be not to our liking, we are said to lack insight into our condition, for which reason we should be stripped of our right to make our own treatment decisions. And when people like Lander point out that arguments supporting psychiatric drugging here in this thread could be applied in support of (recreational) drug pushers and junkies and their relationship with each other, people get offended.

Hey, if medication helps you face the day, more power to you.

But it is true that the arsenal of psychiatric medicines is composed mainly of clumsy systemic neurological impediments -- broadly effective chemicals that mess around with synapsing either by directly impacting neurotransmitters or indirectly by impacting uptake mechanisms that would otherwise soak up certain naturally occurring neurotransmitters or neurotransmitter catalysts.

The ones that have been around long enough to have been studied tend to show signs of being dangerous. Every decade brings its new shiny "atypicals" or "new generation" antipsychotics and antidepressants which don't have such side effects, and then time goes on and it turns out they do, too.

And it remains as true as ever that depression, like all the other psychiatric diagnoses, consists of its symptoms. There is no underlying physiological condition that has ever been substituted in the definition such that if you have the symptoms but don't have the physiological condition you don't have the mental illness. Furthermore, the symptoms which constitute the disease are spelled out in such a way that there are no formal explicit criteria which must be met before the diagnoses can be confirmed, nor any which, if present, rules it out, so its existence in any given case remains a matter of opinion.

Kindly keep in mind that while the psychiatric profession and its pills may have saved your life, many others have not experienced them so benignly, and we are tired of hearing their positions reflected in the general social opinion as if they were neither dangerous nor controversial.