Posted by dj on July 13, 2000, at 0:53:37
In reply to Re: Stress, Depression role of ADs, posted by SLS on July 12, 2000, at 21:12:00
Scott,
As always your comments are very thoughtful, reasoned, passionate and logical based on the information you've viewed and your interpretation of it.
Though I agree with much of what you've noted, there are some points where I respectfully do not concur with your conclusions, based on what I've read, heard, seen, experienced and my interpretations of those many diverse sources of input over the years.
And like yourself, I could be wrong, and am always open to that possibility. Generally I believe we differ in matters of degree of and impact of influences.
The sources I've cited in my postings here provide a more rounded and even picture than I do and if you haven't already read: "Undoing Depression" (http://www.undoingdepression.com) and/or "Why Zebras Don't Get Ulcers: An Updated Guide to Stress, Stress-Related Diseases, and Coping", I commend them to you, as they are both very scientific and broad ranging in examining and reviewing a variety of theories about the roots of dis-ease and depression from different scientific perspectives and how and where they may come together.
My comments and conclusions from these and other learned, thoughtful and detailed sources barely does them justice, which is why I occasionally post other's commentary, to allow their words to speak to the issues addressed as they intended them to. However I will touch on the assumptions you embraced at the end of your post, elegant and direct as it was and is your style.
> I passionately believe the following statements (not that this means anything), and consider their validity to be self-evident and supported by the proponderance of published and unpublished scientific evidence.
>
>
> 1. Stress can cause depression, although it is obviously not a causative factor in all cases.
>My impression is that it is the primary causative agent, in combination with genetic vunerability and that some are much more vunerable than others. However as Sapolsky carefully accentuates in Zebra: "...one of the critical lessons in behavioural genetics, and one that can't be emphasized enough - genes in this realm are rarely about inevitability, but instead about vunerability. And in the specific context of depression, what this means is that an environmental trigger is needed to turn that vunerability into an overt disease."
In the chapter devoted to the links between stress and depression he does differntiate the different shadings and expressions of depression(s) and that the word likely lumps together a range of dis-eases "that have different underlying biologies". He also notes that once depression has been triggered more than once it develops its own ryhtmnic patterns, seemingly independant of stressors but that severe stress (trauma - be that biological, pscyhological or some combo) seems to be the initial trigger.
> 2. Depression causes stress. Stress can therefore be a manifestation of depression without depression being a manifestation of stress.
>If you check out my Sleep and then Achey-Wakey Fatigue, unless... post above, I quote S. on the stressful nature of depression. However, his and my point is that we both believe stressors to be the initial source of onset of depression.
> 4. Biological and psychological contributions to the evolution of a depressed state are not mutually exclusive. However, either can be sufficient.
>I concur that they are not exclusive of each other. I believe they work in unison. And both can be complimentary sources of stress leading to a depression which may eventually develop its own pattern seemingly independant of stressors, if not dealt with promptly and sufficiently initially.
> 5. Biological depressions usually require biological intervention for rapid resolution. Biological intervention is sometimes necessary for any resolution.
>If you are referring to ADs as biological they are not. They are chemical and pharmaceutical and at best are a pale imitation of biology. They are very clumsy instruments, which is one of my core points, not clean and precise in their impact and effects as the marketers would have the general public believe.
However, ADs can help stabilize one so one can deal with whatever are the intial conscious or unconscious sources of stress, if one so chooses.
> 6. Using the full armamentarium of antidepressant drugs to treat each properly diagnosed case of major unipolar depression, the rate of achieving a robust remission is at least 80%.
>Perhaps, at the early intervention stages. Perhaps not. I have no way to check the statistics but have read enough, from trusted and reliable sources about how the pharmaceutical companies distort statistics and know enough about marketing and public relations to not trust any numbers from those sources, or those funded by them.
I've only scanned "Prozac Backlash" but enough to pick up on some pretty telling and credible critiques which reflect what I've read from other trusted sources, including postings here and my own experiences.
I remain actively skeptical but open...to various possibilities.
Sante!
dj
poster:dj
thread:40133
URL: http://www.dr-bob.org/babble/20000708/msgs/40279.html