Depressed About Results? Science May Explain It

[scotty]

http://online.wsj.com/article/SB1201...googlenews_wsj

Depressed About Results? Science May Explain It

January 26, 2008; Page A9

Word comes that unpublished studies of antidepressants show the drugs are overrated ("Antidepressants Under Scrutiny Over Efficacy," Personal Journal, Jan. 17). This isn't a surprise to many of us who have prescribed them. Sadly, the $21 billion antidepressant industry is built more on marketing hype than medical science.

The medicalization of depression dates to a "chemical imbalance" theory of the late 1950s, when some patients taking the anti-hypertensive drug reserpine got depressed. Reserpine was known to partially deplete catecholamines, a kind of neurotransmitter in the brain, of which serotonin is one example. This led to the theory that depression was caused by low catecholamine levels. Drugs have been successfully marketed as antidepressants by showing that they enhance catecholamine activity.

While this looks like a neuroscience success story, the truth is that no case of depression has ever been shown to be caused by low catecholamine levels. If you find this hard to swallow, ask your physician what your serotonin level is and how it compares to a group of depressed, suicidal patients. The honest answer is that they are the same.

Psychiatrists can promulgate chemical imbalance theories and sleep well at night because they are devout biochemical determinists, for whom every thought or feeling is caused by chemical reactions in the brain. To the true believer, good feelings come from good chemistry, bad feelings from bad chemistry. If the science hasn't been worked out yet, it is only a matter of time. What is important is that depressed people keep those catecholamines "balanced." Whether bad theories arise from bad chemistry has not, to this point, generated much interest.

To be sure, antidepressants can be helpful. The sedating ones, for instance, often benefit depressed people who can't sleep. But the real harm of these drugs is the theoretical baggage that comes with them. The more a patient believes that pills are the cure for depression, the less likely he is to think seriously about the meaning of his life.

Michael J. Reznicek, M.D.
Psychiatrist
Spokane, Wash.

[safarigal]

Originally Posted by scotty

http://online.wsj.com/article/SB1201...googlenews_wsj

The more a patient believes that pills are the cure for depression, the less likely he is to think seriously about the meaning of his life.[/b]

Michael J. Reznicek, M.D.
Psychiatrist
Spokane, Wash.

How true...we've all experienced this while being on anti-depressants. I never gave a thought to the meaning of my life while on SSRIs.

Therapy is the cure, if you can get it, afford it and find a great therapist.

[scotty]

What I found especially poignant is that it's written by a psychiatrist.

[zappelina]

Originally Posted by safarigal

Therapy is the cure, if you can get it, afford it and find a great therapist.

I don´t fully agree with this. The cure is changing the situation that causes the depression if and when in can be done which isn´t always the case. If it can´t be done, no therapy in the world will cure the depression. A good therapist may be able to see things from a different angle than you can do yourself and thereby provide some valuable insights and support but it is not really a cure. Perhaps it´s time to realise and accept that there´s a time for joy and a time for sorrow, a time for activity and initiative and a time for passive contemplation. This is normal and natural. We should perhaps believe in and rely more on ourselves, our instincts, intuition and feelings than on authorities, be they doctors, scientists or various therapists.

[Songbird]

good feelings come from good chemistry, bad feelings from bad chemistry. If the science hasn't been worked out yet, it is only a matter of time.

Actually I do believe this, and the reverse of it too. But I believe the full science has not been worked out yet and with these drugs they are tinkering with things they don't fully understand, and without any understanding of the real cause, i.e. if there is an imbalance of something, where is it, and what actually caused the imbalance in the first place, these drugs do not address the underlying causes. I believe the chemistry concept is right in principle, but the rest of it is half-baked.

In any case, the drugs do not really address the imbalance, SSRIs do not increase serotonin, only reuse more of what is already there. If we really all had serotonin deficiency, tryptophan would be the more obvious treatment.