I often wonder if medicine can really combat depression caused by environmental factors such as loss of job, loss of a loved one, etc.? I mean, we know it cannot change such environmental factors…so, can it still help? Just curious! - Jinx
IANAP, but I don’t think the drugs are all that effective even in the best of conditions. There are some studies that show that placebos are as effective as pharmacological treatments for depression, and daily exercise is likely to be equally effective in cases. So during periods of exceptional duress the patient would probably find temporary relief from anti-anxiety products like benzodiazepines (xanx), and have hit or miss success with an anti-depressant.
I apologize in advance if this mildly informed WAG turns out to be total bollocks.
In common speech these days, we say that anyone who is sad or unhappy is “depressed.” Clinical depression, as a doctor would define it, is more specific. A person who is unhappy because of a tragedy such as the recent death of a close friend, is not clinically depressed.
No doctor would ever prescribe a treatment that involved just drugs as such an approach is generally not thought to work.
IIRC (it happens!):
Drugs do not affect “cause”, they simply counter-balance the effect.
A fine point, but a point - it doesn’t matter how you came to be depressed (again, this is a medical definition of “depression”, not the common one), the drugs simply counter-act the result of the depression.
Psychotherapy (at least, cognitive-behavioral therapy) appears to be as effective as medication for depression. For situational depression such as you describe, I would strongly suggest counseling and interpersonal support as a first intervention, if only because medication is a more intrusive intervention. In general, I would suggest that medication for depression always be used in conjunction with counseling and behavioral interventions–from the perspective of clinical anecdote, this is more effective both at the time of the distress and for training the person to recognize and respond to future distress.
this and the previous post covers a lot of effective ground
the sufferer must come to terms with their non wellness
and focus on cause… by talking or reading into the subject…and immediately effect and the most proficient way which suits them to alleviate symptoms. its not giving in to drugs, it is intelligent use of resources… as the condition improves so does the sufferers appraisal of where they should be applying effective measures
you cant exercise well if you are frightenened of going outside and likewise when released from the downgrading effects of being a prisoner in your home you relate more to the environment conducial to activity…and so polarise attitude away from the drug treatment…which should not be ceased too quickly as it gives security of mind.
a positive action done each day and recognised as being positive to the sufferer and others is of great encougagement. however small.
its a two way street.
Jinx,
I’m not a doctor and don’t play one and I’m not going to “recommend” anything to you :). I’ll just try to answer your question of fact.
Three points:
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Some medicines do actually directly combat the “causes” of illness. The best example of this is antibiotics. They work by directly killing the bacteria or fungus or protozoan which is causing the illness.
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More often, a medicine works by altering something in the body’s physiology which does not directly work on the “cause” but rather on the cause’s physiological effects in the body. There are a whole bunch of examples – one good one is antihistmines. They don’t affect the cause – which is typically some allergen which causes a histamine reaction – but they do work on the histamine cycle in the body and short-circuit it, prevent further effects. Typically there is some good science in these cases which helps us understand why the medicines work.
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In many cases, a medicine is used solely becuase it works, even though we don’t know why. Lots of pyschiatric medicines fall in this category. For example, SSRI’s (selective serotonin reuptake inhibitors) like Prozac can combat depression. We know that they have an effect on the brain via some effect on neurotransmitters. What we don’t know is why inhibiting serotonin reuptake combats depression. We’re not even sure which neurotransmitters, or even if neurotransmitters, are the cause of the problem or if it is something else entirely. All we know is that SSRI’s do a particular thing to the brain, and that people who take SSRI’s often have their depression alleviated. So this last case we are not combating the cause at all, we are just discovering something that works.
So can medication combat “environmentally caused” depression. The factual answer is, sometimes yes. SHOULD medication be used to combat “environmentally caused” depression? That is a question of ethics, not of fact.
I’ll also just point out that not all depressions are environmentally caused – some are physiologically caused, and in the most severe cases medication does work quite well.