If depression really is just a chemical imbalance, why does counselling work as well as anti-d's in some cases?

[Enid]

I can never understand that one.

Because you can change the chemical balance in your brain by changing your behaviour.

well the way I understand it is that if you have a lot of shit you find hard to deal with (for whatever reason), you wear down your reserves of serotonin and run the risk of being depressed.

In some cases, raising the level of serotonin (through ADs alone) means you are able to deal with your shit better and get on with life. In other cases, you need counselling to deal with the shit and can do natural things to increase your level of happy chemicals (like exercise, doing things that make you happy) and can possibly get away without needing that extra chemical boost.

I think in most cases, it is recognised that a combination of the two has the best outcome (for long term success).

I guess it must be down to the individual situation each time.

it isn't just a chemical imbalance.

environment is what creates the chemical changes.

this can be extreme: if a baby is seriously neglected, then certain synaptic links in the brain don't actually develop, leading to serious psychological problems in adulthood.

the lack of support some women face having had a baby, the ambivalence they feel towards the baby and their hatred of themselves for that, all the stuff brought up about their own relationships with their early caregivers can contribute to post-natal depression.

I think that medication without some form of talking therapy is a travesty in most cases (unless the cause of the depression is a very specific circumstance is not a lasting factor.

Its because there is an interaction between the neurochemicals in your brain and the environment. By the environment that means your experiences etc as well as what is going on around you. Just like the neurochemistry of your brain can effect how you feel about things in your life - your life can effect the balance of chemicals in your brain.

can you?

really?

The root cause of depression is often something from the past, which is the stuff that counselling can help with, but it's the chemical imbalance that means some people become depressed while others with similar backgrounds don't.

Maybe.

Also there are different types of depression. Clinical depression is a chemical imbalance in the brain that needs treating with medication sometimes forever whereas other depression is caused by something such as grief and this is more successfully treated with counselling, CBT etc to get to the root of the problem.

not all depression is a chemical imbalance, reactive depression for example is caused by, a trauma or stress which snowballs. Counselling can be particularly effective for that.

you have to remember that anti-depressants are much cheaper (in the short NOT long term) then counselling.

good counselling readily available to all would however save the NHS millions.

because...the chemical imbalance is "cuased" be something in the first place...your brain reacts to it's 'environment' by producing more or less of chemicals. It's not just a one way reaction.
For example:
Feeling happy produces endorphines which make you feel happy
eating chocolate also stimulates endorphines which makes you feel happy

so changing the chemical can cause the reaction but so can changing the reason the chemical is there...
Not explaining this very well, sorry...

because there are different types of depression. in some cases its a chemical imbalance, sometimes you are depressed because something very bad is going on in your life. so while counselling wont help with a physical health problem, it could help with depression that is caused by emotional problems.

and in the time its taken me to type this, i bet 20 people with quicker fingers have got in front of me saying the exact same thing!!

what prompted your thoughts on this Enid?

but so many people say to people who may be depressed 'its a physical thing, like the flu, it is a chemical imbalance, pills will help'

you can't 'counsel' your way out of the flu

Oh look In the time it took me to type my pathetic attempt to explain, several othe rpeople came along and did it much more coherently!

but you need to have a good councellor for it to work.
I had a shit one. I'd rather have the ADs.

Think also about things which make you happy..or sad, you can to an extent control or intervene in your own mental state can't you?

Laughter is medicine for example..this can be measured scinetifically.

anti-depressants are best used for severe cases of persistent depression to enable the person to be able to engage with the counselling process.

but you can build up immunity to viruses if you improve your mental health

personally, I don't think depression is ever 'just' a chemical inbalance - something has got you there in the first place

I think people say that to make other people feel better - also, in many cases, by the time you have admitted you have depression, you are in a place where only medication can help you because you are so so low

I don't think counselling is always beneficial or relevant, because not all depression has a cause that is identifiable as something needing remediation. But if you mean empowering someone to take control of their own lives then that is different

prompted by another poster

an exhausted, stressed mum with a five month old baby

If her gp gives her anti-d's I think that is f*cking shocking. What is wrong with us that we are not allowed to feel exhausted and tired? If we have to hide it with pills we will never properly rest and things will never get better.

it is NOT like a bodily illness.

people cling the diagnosis of clinical depression because there is a stigma attached to mental illness and because it feels safer to be able to say: look i've got an illness, i'm curing it with pills.

the fact is that depression is extremely serious but it isn't an illness. it is a mental state that at it's most extreme can lead someone to be entirely unable to function in their lives, or even to kill themselves.

it is a sad indictment of our society that when someone is depressed they often get a response of 'pull yourself together' and are only taken seriously if they are able to get a psychiatric diagnosis.

yes Enid, you're right. And counselling will not work for everyone. And it would be very irresponsible if GPs referred evryone for counselling just because they were on anti-ds. Similarly, not everyone who goes for counselling is depressed.

x posts with opposite views

some peoples brains just lend themselves to mental illness

but enid, yes if you have flu the body will raise your temperature to reduce efficiency of virus reproduction etc, but I'd love to see stats on what having emotional support + physical care as opposed to physical care alone during the illness does to recovery figures (quite possibly it makes them worse, actually!) also paracetamol etc have a physical effect but a large chunk of that is placebo. not a simple physical/mental split, it's all interlinked.

I saw that enid - she is clearly exhausted poor woman, a lot on her plate - I also hope her GP only sends her away with a prescription for lots and lots of bed rest to get her strength back.