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.

Birth order makes an enormous difference to one's childhood, for instance.

zippi - in my non-scientific/non-medical opinion - people have widly differing coping abilities, in the same way that people have different responses to pain/fear etc. Maybe these are partly genetic, maybe formed by your parents' attitudes to coping/stress/pain whatever.

Why do people put the emotional aspect before the chemical aspect?

I didnt start to 'feel' (i use that term loosely since i dont think those 'feelings' were me or mine iykwim?) lonely, isolated, cold, unhappy, tearful, pathetic, inadequate etc caused a reaction in my brain that made other things happen. I think it was the 'chemical' alterations in my body and brain that triggered those 'feelings'.

Exactly, VVV!

As my ex-bf once said, 'Counselling did FA for me. But heroin did!'

He'd been trying to self-medicate his mood swings.

Which were the direct result of a severe chemical imbalance.

I think it's a fascinating subject..endless potential for speculation from a medical and non medical poitn of view

Some of the research into depression is really only just beginning to point the way - there's as much still unknown as is known. In the US roughly 50% of those treated for depression (and I'm using the term here in the 'general' depression context - and it's a term that's very loosely applied, there are no tests, only a very broad spectrum of symptoms - rather than to include medical conditions such as schizophrenia, bi-polar etc) do not respond well to drug therapies, and the stats for counselling/psychotherapy are roughly equivalent - works for some and not for others.

There is some research into genetic factors such as the sert gene (which is the one associated with serotonin availability and transmission) which suggests that those with the 'short' version of this gene (which is inherited) MAY HAVE AN INCREASED PRE-DISPOSITION to depressive illness.

There's also some really interesting research into oxytocin (the bonding neuro-transmittor) which is generated and transmitted via human contact (famously during sex!) - high levels of oxytocin lead to increased feelings of well being and contentment.

Personally, whilst I have been diagnosed in the past as suffering from depression and prescribed AD's (which I didn't take), I do believe that there is an increasing tendency to over diagnose, and that the social and cultural factors should not be dismissed.

because reactive depression and clinical depression are 2 different illnesses in my opinion. if you are clincially depressed, it's the chemical imbalance s which cause the feelings, if you are suffering from say, OCD, anxiety, reactive depression PTSD, it's the events and emotions triggered by the events which are the issue.

And let's not forget that clinical depression can often have the effect of the sufferer feeling very little to NO emotion.

In fact, when a person gets suicidal. I mean, REALLY suicidal not just 'cry for help', they often go about it in a fashion that seems very cold and calculating and unemotional.

B/c to them, it's all become quite practical.

oxytocin is also significant in childbirth isn't it and breastfeeding so is this one of the links with pnd

your poor ex bf expat - bipolar is horrible

I nearly didn't go through having kids because I was terrified I had some genetic predisposition and would pass it on (long, long history of mental illness on both sides of the family)

luckily, I seem to have escaped it so far but one of my sisters has already got it quite badly

I have three children, i didn't consider not having them ..feeling quite guilty now!

but I think yours is under control isn't it zippi? I think the type of bipolar (sorry, don't know the correct terminology for the different types) that runs in our family is the one with massive swings that is v hard to control.

Why, zippi?

He did. That was his choice. He knew he had an inherited form of severe bipolar disorder and didn't want to take the risk of passing it on to anyone b/c he felt he wouldn't have wished that on his worst enemy, much less his own kids.

That was his take on it and what worked for him.

Zippi, yes, raised levels of oxytocin are present in (possibly a precursor to) childbirth and mother-baby contact (actually, skin on skin contact seems to raise oxytocin levels generally in the right context - ie absence of any stressors - from what I've read). No idea what the implications are wrt PND.

I found pregnancy and breastfeeding have almost completely eradicated my episodes of depression. Giving up alcohol also made a huge improvement.

I think in lots of ways it feels more controlled if you are permanently depressed..that's why people use alcohol to self medicate i think

I find this discussion interesting.

As I haven't done any study into depression, I don't know very much, but I do have my own experiences to draw on. I have suffered from depression for over half my life and am realising that for me at least, it is always going to "be there", but that I can manage it.

In my case, events can trigger me into a "bout" of depression when my emotions close down and the whole world is grey. I can recognise this in myself whilst or even before it happens now and can make sure I do something about it.

I take anti-depressants. Maybe there is some placebo effect, but even if there is then I feel that it is worth it. Without the anti-depressants I find that I start to spiral down into a grey person, who does not enjoy life.

I have tried various forms of counselling. I am very good at opening up at first and getting everything off my chest but then feel there is little else to be done or said. There is no specific trauma that has happened to me and I think it is more a case of how I deal with things.

I haven't tried CBT, which I think could possibly help me, but I have a book on it which I will get round to reading one of these days .

I am pretty sure that my mum suffers from depression, although it is not something we have ever discussed. I don't think she is being treated for it, although again I may be wrong. I also believe that her father had it as well.

So although I can see that there may be no proof that there is a genetic link, I think that I possibly am pre-disposed towards some amount of depression.

I control it, rather than it controlling me. To me that makes the difference.

I think that not all mental health problems that leave you feeling down etc are depression and thats the difference for me.

I had ALL the symtoms of a mental health 'disease' - suicidal, self harming, down, lonely, paranoid, constant crying etc but a psychiatrist and a mental health nurse BOTH diagnosed as not having an illness, clearly I had problems but there was not chemicals causing it. Does that make sense? And it was hard for me, because nobody believed that i did not need tablets to make me better. I had intensive therapy for 18 months and I did get better because it changed the way I felt about myself and things.

And I had a wonderful happy childhood - but my perception of things was off which contributed to my issues. Its not necessarily about big things happening, its about how you react and perecieve the small stuff.

After DS was born, I felt very down, although I don't think it was PND per se, more my own body's way of reacting to things. Similarly with the depression I had during my pregnancy with DD - I don't think that was AND either.

I like Churchill's description of his depression as his balck dog.

There's also an attitudinal issue which is that if you are feeling 'down' it's somehow a problem. Feeling 'down' is sometimes a perfectly reasonable response to either events in the environment, or to some biological event that results in less than optimal health.

The media feed us lots of expectations about 'happiness' as some sort of norm or entitlement or permanent state, and there are many people who chase the high of happiness thinking there's something 'wrong' or they have a 'problem' if they're not happy.

Lots of confusion around 'mood' and 'depression'.

Gosh - poor zippi, you did get a roasting for what looked like a fairly innocent comment.

My whole family seems cursed by anxiety and depression of varying degrees. If there is no genetic predisposition, then it speaks volumes about the childhoods we all must have had.

But I disagree, I think that the dysfunction is genetic in origin. It is strongest in people who are most closely connected, and seems to be diluted the further you get from the root. I can see the difference in temperament between my two wonderful dds. I suspect I know already which one of them is going to have a tough time in life, because of a negative outlook (which I relentless try to shift to positive), and which one will bounce through life like Tigger. I will let you know in 20 years time if I am right!

It always puzzles me why it is so controversial to link personality traits to genetics, when it is so obvious that physical attributes are inherited.

There was a professor who wrote an article in one of the sundays about 6 months ago that was v interesting,esp as my mother has suffered with depression all her life and has made our lives hell at times because of it. He was investigating other ways in which serotonin could be raised apart from the tablets.There are things in everyday life like walking by the sea playing with your kids etc that all cause a small rise in serotonin but nothing significant compared to pills However when he set up controls to test his theories he found that the patients who didn't take pills but did all the walking exercise etc all reported improvements which far exceeded the doctors possibility (the serotonin could not have raised significantly in teh time).He believed that it was their attitude and their willingness to try this alternative which had affected them.My mum is someone who has the attitude that just taking pills is enough and changing her lifestyle and attitude has nothing to do with it.

I think more and more research is being directed into genetics because it helps explain why poeple can react so differently to things but the danger would be in trying to explain everything at the genetic level. Most scientists today accept that research from one level (eg genetic) can help inform our understanding of another level (eg psychological) and vice versa. To try and explain anything about the human condition from just one level is a pointless exercise.

Well, IME over the past 20+ years I have found pills an absolute life-saver. For now, no pills and just talking, which seems to stave off the worst of it, although I feel like a raging loon sometimes. Depression IS a very physical thing and it can be so destructive. I can't think of anything useful about it apart from it hasn't killed me (yet!). It is self-limiting and most people get better for at least some of the time.I do think that some people are more susceptable (sp) than others in the same way that PTSD affects some people and not others.

this is interesting on depression gene and pre disposition with a trigger and a lcak of relationship to serotonin

here