Anti-depressants "of little use"

[morningpaper]

Anti-depressants 'of little use'

"New generation anti-depressants have little clinical benefit for most patients, research suggests. A University of Hull team concluded the drugs actively help only a small group of the most severely depressed."

I'm not surprised by these findings - I took antidepressants and various other drugs when I had a severe depressive episode over 10 years ago.

I know that people (incl. GPs) want to 'fix' depression but I strongly feel that drugs don't do it. Prozac especially was hailed as the 'wonder drug' at that time but it had no effect whatsoever.

Coming off the drugs was a massive boost to my ego (being dependent on antidepressants etc. I'm sure reminds you that you are 'mad' every morning and evening that you are popping them).

I was 'rescued' by 2 years of psychotherapy. I know it is expensive but when I see friends taking antidepressants I feel really frustrated that they don't spend money on therapy or counselling instead. People think it is 'too expensive' but then they are happy to get signed off work for months. Argh. When I rule the world I will make cheap therapy available to everyone.

Anyway that's my rant of the day

oh, and i had prozac for six months when i was 18/19 and it helped me enormously. but then, i expected it to, and i weaned myself off as soon as i got some semblance of a life on track coz i didnt want to be 'hooked' like my mum.
recently i had cytalopram and... what a waste of time. was a bit of a distraction to feel somewhat like id been caning the E's the previous day for about a week... then just plain dull. no help wahtsoever. made things worse if anything.

I had short term (10 months?) therapy - not counselling and was ok for 3.5 years. Mega stress has brought me here but there is a big leap between the stress in my life and my mental health (i am quite sure that most people planning a wedding and learning to drive and not suicidal haha!) and actually I do find talk about it helps - but my therapy is quite focused and fairly intense.

My therapy is on the NHS btw.

Dorothy Rowe (renowned psychologist, Associate of the Royal College of Psychiatrists and Emeritus Associate of the Royal College) wrote the following in an Openmind article in Jan/Feb 2007 'Farewell to Chemical Imbalance'

3How often have you heard that a chemical imbalance is the cause of depression? A hundred times? If you?re as old as me you?ve heard it a thousand times, and said by psychiatrists in tones of absolute certainty. It?s why the SSRI drugs were made specifically to put serotonin in the brain and thus right the imbalance.

However, without telling the rest of us, psychiatrists have changed their minds. A few weeks ago I was browsing the Royal College of Psychiatrists? website. .... I ... looked at their pamphlet on depression. .... Under the heading, ?Why does it [depression] happen?? is a statement which says that sometimes there?s an obvious reason for becoming depressed and sometimes there isn?t. It?s different for different people. Then there?s a list of the things that can lead you to be depressed. These are: things that happen in our lives; circumstances; physical illness; personality (?This may be because of our genes, because of experiences in our early life, or both.?); alcohol; gender (?Women seem to get depressed more than men do. It may be that men are less likely to admit their feelings and bottle them up, or express them in aggression or through drinking heavily. Women are likely to have the double stress of having to work and look after children.?); and genes (depression can run in families). And that?s it. No chemical imbalance.

There?s never been any evidence for a chemical imbalance in the brain when a person is depressed. That idea was abandoned by scientists thirty years ago. However, a lack of scientific evidence has never stopped some psychiatrists from claiming black was white. It took the Royal College many years to accept that the minor tranquillisers are addictive; that the monoamine oxidise inhibitors are addictive; and, more recently, that the SSRI drugs can provoke suicidal and hostile thoughts. But it does seem, at last, that the Royal College has accepted that depression has far more to do with how we see ourselves and how we deal with our lives than it does with the physical make-up of our bodies.

....Depression cannot be described any longer as a simple disorder of the brain, but rather as a series of behavioural and biological changes that span mind, brain, genes, body ? and indeed affects both psychological and physical health. . .

So everything about us is involved in getting depressed. Not a simple explanation in sight."

Depression is never black and white and it must be very difficult for GPs to assess its severity in a 10 minute consult. I can't know if it was the placebo effect, but prozac certainly worked for me and made it possible for CBT to help me.

All of this trumpeting of one weak study might stop the placebo-effect from helping other people. Placebos are actually amazingly powerful & it is a real pity they can't be perscribed!

As others have said, talking therapies can't usually do much for people who are severely depressedl. I do think they have a huge role to play in preventing it from happening again though.

smurfgirl- i can relate to your experience of depression.its so true that some people will be deeply affected by things that wont bother others in the slightest.i am reading a good book at the moment called 'the highly sensitive person' by elaine aron,which has a good theory explaining why that might be.

countingthegrey-excellent post

there is a huge difference between the older psycho-analytical therapies and person-centerd councelling,and the newer CBT.i never found sitting and going over and over past events to be very helpful.a short course of councelling was useful for me just after i'd come out of an abusive relationship,just to get things out of my system,but there was no way it was going to fix the underlying issues with my self-esteem that caused me to get involved with a man like that in the first place.

OK, someone answer me this: how do 'genes' cause depression then, if not by creating a biochemical imbalance in the brain???

Genes are just the codes that enable our cells to symthesise peptides and proteins that have a specific function in our bodies, be they enzymes that catalyse biochemical reactions, or receptors for neurotransmitters, etc. Hence, I would have thought that some forms of depression ARE a chemical imbalance in the brain caused by genetics. I'd be interested to know how else 'genetics' could manifest itself in depression?

Women suffer clinical depression more than men because pregnancy, child birth and breastfeeding affect the hormonal balance of the body.

The chemical affects of child birth on mood are well known. For example the three day blues after childbirth or Perpetual Psychosis.

What is not understood is the structure of the brain. Everyone's brain is very individual. It is hard to tell from a scan whether someone is depressed.

www.nytimes.com/2005/10/18/health/psychology/18imag.html

But then again its impossible to predict the affects of cerabral palsy from a brain scan. No one would suggest that severe CP can be cured by CBT. Powerful drugs which aren't fully understood are used to prevent people with CP having fits.

It would be interesting to know if the mental health of adopted children is affected by the mental health of their adoptive parents. I am sure that the quality of parenting that children recieve affects their adult mental health.

Emitrius associate of the Royal College or not this "SSRI drugs were made specifically to put serotonin in the brain and thus right the imbalance." is incorrect. SSRI's dont "put" anything into the brain.

RT, CBT has good short term results and so it good for targets (as are SSRI's) but most need to go back for more.

I wish people would stop trying to take sides, this is the medicla profession trying to help people with depression within a tight budget. It's imperfect but we are all a damn sight luckier than pervious generations who had to live with depression and the devestating repercussions it has or get stuck in an asylum.

well said,monkeytrousers

mental health will never be black and white,and all that has happened really is its come to light that ssri's arent a magic cure(which most people knew anyway!),but anything that helps has to be a good thing,and reasearch is ongoing,new drugs are being produced all the time,new therapies are being looked into,and as you say,thank god we have come a long way since the days a severly depressed person would have been thrown in the nut house to rot

I think that the brain is complex. This is part of the problem, that different medications have different affects on people.

I am glad that I am better and leading normal healthy life. Frankly I don't care if it was the placebo affect that made me better.

Beginning to wonder whether ANY of my contributions to this thread will get acknowledged!! It's like taking to a brick wall with you lot!

petlamb-i will come clean and admit to ignoring your earlier post to me as i have no idea what/who the FDA are/is

i thought edam addressed the rest of your points though?posters only tend to address each other personally on here when a fight is brewing

hence why got back on the fence as i'm too scared to fight with monkeytrousers.

PetLamb,
I think that genes can cause a chemical imbalance. However our parents also affect out personality in the way they bring us up.

Genes also affect IQ, hieght, weight, intelligence and general physical health. These factors can impact on our mental welbeing and maybe indirectly affect our brain chemistry.

Genatic influence can only account for around 50% - I think anyway, I was at a seminar a few weeks ago and it was said to be around this numberm - obhvioulsy, it's a bit more complicatedc though I'm not the person to be able to explain it.