first time poster! anyway, you should know an alcoholic beverage is a depressant, therefore a poor choice for depressed people.
LINK TO COLUMN: Do antidepressants only work because of the placebo effect? - The Straight Dope
I believe that is equivocating two different uses of the word “depressant”.
That is not speaking about psychological state, but rather an emotional state. Alcohol in fact makes some people cheery. It takes away filters and self-control. It also affects memory. And most people report a pleasant buzz.
That’s not to say that alcohol is the best treatment for clinical depression, but it isn’t going to trigger a slightly sad person to jump out a window. It might, though, remove the person’s inhibition that is keeping them from killing themselves. If they can muster the effort.
Which is why there is a link between suicide and antidepressants - severely depressed people often simply don’t have the energy or focus for suicide. Then they start on antidepressants, get a little better, and can carry out the deed.
Depression really, really sucks.
Welcome to the Straight Dope Message Boards, Paul A, we’re glad you found us. For future ref, it’s helpful to other readers if you provide a link to the column in question in the opening post of a new thread. Saves search time and keeps us on the same page. Yes, I know, it’s the column of the week this week, but in a few days it will disappear into the vast Archives. So I’ve added the link for you. No biggie, you’ll know for next time, and, as I say, welcome!
Cecil,
I’ve been in treatment for PTSD for several years. The diagnosis has been a godsend, as the lifelong symptoms I’ve always had are now making sense. Working through the trauma has activated a lot of sh$t, requiring meds. I told a psychiatrist that I sometimes use a British OTC homeopathic product for anxiety called “Rescue Remedy,” that it works for my mild anxiety, and if this is a placebo effect I am experiencing, I don’t give a damn, relief is relief, so three cheers for the placebo-affect. Further, I can assure you that diazepam (Valium ®) works; it hits like a ton of bricks and in properly modertated doses, releaves anxiety without causing the sombulence. Regarding the over-prescription of anti-dpressants, it is a problem, but also keep in mind that anti-pressants are ALSO prescribed and clincially effective for; a) menstral symptoms, b) neuralogical pain, incuding nerve damage in oncology and AIDS patients, c) smoking cessation, d) Alchohol withdrawal, e) as well as being used for those pesky psychiatric disorders that western culture proliferates.
LINK TO COLUMN: http://www.straightdope.com/columns/...placebo-effect
First of all, all I wanted to do was enter a comment. Talk about jumping through hoops: no simple comment area, but I have to register for a forum I’ll probably never visit again. Plus I need to add a link to the article. Phew!
Well, with that all out of the way, I wanted to point to the one tiny point in your blog post where you mention that the only people antidepressants were helping were…people who are really depressed. That point seems to get lost among the jibberjabber about the millions of people whose GPs are writing scrips for Prozac and Wellbutrin due to work overload or whatever. The fact is, despite the rash of recent–and misleading–“studies” showing that AD’s don’t work any better than a sugar cube, for the chronically, seriously depressed, these drugs are a literal lifesaver. I would surely be dead by now if I had not been put on Prozac in 1994. It completely changed my life. I quit binge drinking, I stopped being depressed, my wife decided to not leave me…and now I have two kids in college and live a happy, normal life.
Antidepressants do relieve the symptoms of depression. They correct the brain chemistry imbalances which cause endogenous depression. You need to keep taking it in order for it to keep working. ADs are not addictive, nor are they a scam, if you are suffering from depression.
On the other hand, probably the vast majority of scrips are written for people who aren’t depressed, and surveying this group of people is useless, misleading, and harmful. In my opinion, GPs have no business prescribing psychotropic drugs. Keeps Big Pharma happy, though. 
[quote=“Irishman, post:2, topic:645186”]
I believe that is equivocating two different uses of the word “depressant”.
That is not speaking about psychological state, but rather an emotional state.
(edited out some stuff)
An interesting distinction you are trying to make, but no, referring to alcohol as a depressant is referencing its physiological effect. Read your own wiki cite for more. The reason “Alcohol in fact makes some people cheery” is related to which functions of the brain are depressed first, therefore “It takes away filters and self-control.”
http://www.straightdope.com/columns/...placebo-effect
In the article Cecil notes that antidepressant prescriptions have increased by 400% but he doubts life has become 400% more depressing. I don’t know whether those prescriptions are justified or not but the problem with depression is not external events but the depressed person’s reaction to them. Depression can be triggered by something trivial or nothing at all.
Bob N, thanks for the contribution. On the chance that you do come back here, you might like to know that the bit about adding a link to the column you’re commenting on only applies when you’re starting a new thread, not when you’re adding to an existing one. But it was nice of you to do it, anyway.
You are correct, it is a physiological effect. My point is that when a person is “depressed”, that means something different than when a person takes a “depressant”.
Yes. How many depressed patients have used OTC ethanol therapy, and have then heard a psychologist or shrink say something like “Why do you use alcohol when you feel depressed? It’s a depressant, and will only make you more depressed?” WTF? Because it makes one feel a little better, ferchrissakes! Doctors who say that to their patients only demonstrate that they are blowing shit (what else?) out their ass, as opposed to making any attempt to be, you know, actually helpful.
I once encountered one of the managers from my workplace, in a lounge with his secretary, both of them partaking of, uh, alcohol therapy. He said it served as an “anesthetic”.
I’m a bit confused by the subject, and even those familiar with the field seem to come to different conclusions. I read an opinion piece which is critical of some of the studies cited in the response, but I’m not sure what weight to attach to it. It’s called In Defense of Antidepressants and was published in the New York Times in 2011.
The points made about a lack of wash out period in some of the meta-analyses and the efficacy of antidepressants in stroke patients and animal models were interesting to me.
Anecdotally, if nothing else, I believe that relying upon alcohol if you are a depressed person leads to a bad outcome in the long term (it may make you feel ‘better’ in the short term). Over-reliance on any ‘anesthetic’ tends to be a poor life-management strategy.
LIke most who wish to profess and behave in a professorial manner, Cecil shared many statistics on the effectiveness/ineffectiveness of antidepressants, however failed to state the verifiability and merit of his data.
Mr. Adams is not free from the peer review process. Until he presents the sources for his research and statistics, his commentary on the matter remains only that: a commentary.
Please present your sources, Mr. Adams. Opining serves no one.
Antidepressants continue to be a major cause of contention. The statistics are problematic for lots of different reasons.
Firstly, a lot of people who report depressive symptoms aren’t actually depressed; they are responding the way anyone would in difficult circumstances. If your marriage breaks up, or you lose your job, or someone close to you dies, then its entirely normal to be depressed even for months, but most people will move on by themselves. But, those people still get given antidepressants, and count as a success (either for a placebo or an antidepressant) when they get over whatever was the proximate cause for them being depressed.
Next, depression is seldom something that is constant and can certainly be effected by things that happen to you. Getting a new doctor or a different drug can make people feel more positive about their outlook even before they take any pills (like “Yes! I’m finally getting the right treatment!”). In those kind of cases, its extremely hard to tell if its a placebo effect or the drug working as intended or what. But again, the patients report improvement even though its because of nothing related to the pills.
Another thing to take into account is what people you are accepting into your study. Only accepting severely depressed people who have suffered for years then it will be hard to show success. You might see improvement, but not actual success in making them feel not depressed. Particularly if they are depressed enough that years of counselling and drugs haven’t significantly helped them, a new drug likely won’t do that. If you accept people who have been diagnosed recently, then its hard to say if they are genuinely depressed or not (see the first paragraph).
Finally, depression is tricky when it comes to measuring improvement, and thats because the only way to find out is to ask people if they feel better or not. There just isn’t an objective scale of how depressed someone is. If you’re having a good day (or not), then you say you feel better (or not), because thats how you feel at the time. But that doesn’t mean anything about the drugs. Some people respond well to having doctors fuss around them, others just want to be left alone and say whatever they think will get them out the door fastest. There’s as many reasons for people to say they feel better or not as there are patients and few of them are connected to the medications.
So the results of any study are a complete crap shoot, based on the kind of people you get in your trial and how you structure it. I can’t say anything does or doesn’t work, just that its extremely hard to get good data and whichever side you come down on there are studies that will back the view up.
Now… In terms of antidepressants being linked to suicides I don’t think there is a strong link. Again, its hard to say for sure, but it strikes me that its a case of post hoc ergo proptor hoc. People who kill themselves are almost certainly extremely depressed. Extremely depressed people are also likely to be receiving treatment for that. That doesn’t mean that treatment for depression makes you likely to kill yourself; being extremely depressed makes you likely to kill yourself. As a parallel; almost all people who die of cancer are receiving chemotherapy, does that mean that chemotherapy is causing their deaths?
As for alcohol (or anything else) as being good or bad for depression, the fact remains that many people self-medicate with all manner of things. Alcohol probably isn’t a great idea in principal but it doesn’t mean it can’t help. Most people, even depressives, find a few drinks in good company makes them feel better, although my money is on being around friends and having fun rather than drinking that is helping. Alcohol remains the go-to for huge numbers of people; when most people think of having fun they think of their drinking establishment of choice, or beers on their buddies sofa. Is it better than pozac ? Maybe. If cutting loose every now and again makes the world seem a much happier place then who I am to say you’re wrong.
Ironically, yes; at least for some (but your point is well taken).
Your long, excellent post is full of good things. But as to the first sentence of the excerpt here, it was addressed upthread as a function of deepest depression (lack of will and drive)–>antidepressant–>a slight improvement of deep depression (just enough to take suicidal action).
As Andrew Solomon put it in his The Noonday Demon, [paraphrasing] when you can’t even get out of bed to put your socks on, committing suicide is sadly beyond your ability.
Psychs have to watch early recovery like a hawk.
To follow on from that, suicidal ideation can also be measured (though again, usually through self-report). It’d be possible to conduct a double blind study with an antidepressant condition and a placebo condition on severely depressed people to account for the difference due to the antidepressant alone, but doing so would be fraught with ethical issues. Bridge et al. did it for paediatric major depressive disorder OCD, other anxiety disorders and found no significant increase (doi:10.1001/jama.297.15.1683.). Jick et al. also found no significant increase of suicide risk in the general population (doi:10.1001/jama.292.3.338.).
I don’t believe Cecil ever claimed to be a part of the medical literature. I don’t think he’s striving for anything more than a commentary. Opining does serve someone. It serves The Daily Reader in giving them content to publish, it serves Cecil in keeping him fed, and it serves the readers in giving them an attempt at a thoughtful review of the current thought on the topic.
I should point out that many people self-medicating depression with alcohol are not doing it in the company of friends, but rather indulging alone, often at home. It’s the “sit around with a bottle until it’s finished” or “have a drink or two until I feel better” kind of drinking, which is often a tell-tale for alcoholism. If their alcohol indulgence was taking place in the company of friends, then it wouldn’t be much different than anyone else hanging out with friends and getting a buzz.
I have been clinically depressed for most of my 50 years and I can tell you that if alcoholic tendencies are not present, a bit of ‘anesthesia’ (alone or in company) can be a wonderful thing. Without it, I would never have the opportunity to escape from my ‘head’ – which is absolutely necessary for my well-being.
“Beer is proof that God loves us, and wants us to be happy” - Benjamin Franklin