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Re: assumptions elizabeth

Posted by Dr. Bob on January 30, 2002, at 18:59:24

In reply to assumptions about talk therapy and meds sid, posted by Elizabeth on January 30, 2002, at 8:19:11

[Posted by Elizabeth on January 30, 2002, at 8:19:11

In reply to http://www.dr-bob.org/babble/20020124/msgs/91533.html]

> [Dr. Bob: This post concerns both medications and talk therapies and doesn't necessarily belong in one forum or the other. I prefer to post here in part simply because I don't generally read PSB. I'm not willing to say that one board is better than the other, but the attitudes expressed on PSB seem to me to be more intuitive or emotional than those here, so I feel more comfortable here on PB. I hope you'll respect this. TIA.]

Well, let me try something new: part I'm leaving here (reposted below) and part I'm moving over. You don't need to read all of PSB, you know, you can just read these particular threads. :-)

http://www.dr-bob.org/babble/social/20020125/msgs/17202.html
http://www.dr-bob.org/babble/social/20020125/msgs/17445.html

Bob

> It is possible for people who are in talk therapy to recognize why it may not be working for them (often, as has been mentioned, because they're just too depressed) and decide to pursue other forms of talk therapy (e.g., psychodynamic psychotherapy instead of CBT) or that talk therapy in general isn't likely to help them (or that they need to wait until they're less depressed, for example). In contrast, we can't see what's going on in our brains at the molecular level, so we don't have a way of evaluating what medication is most likely to yield success, or whether medication is likely to help at all. I hope this illustrates why people feel justified in making a decision to pursue psychotherapy or not but can't be certain that medications will or will not work for them without trying them (it's a mixed blessing that there are so many of them to try these days). I also think there are things that we don't understand about how talk therapy works (although in this regard CBT is probably the most simplistic type of talk therapy), so it's not necessarily a good idea to rule it out altogether.

> > So I decided to try meds for the residual depression. As it turns out, it seems I have an anxiety disorder, and my doc is not convinced that I still have depression.
>
> What sort of residual symptoms do you have? Residual depression is by its nature hard to treat, since it's the part of the disorder that doesn't improve with the treatment being utilized. I think that it often requires some creativity to treat residual symptoms.
>
> > I did a test the other day and ranked very very low for depression and high for anxiety.
>
> Which test was it? IME, the results of self-report rating scale tests can be misleading. Self-report is important, but it's only one tool in making a diagnosis. Sometimes people's answers on these tests can be misleading. For example, I've noticed that some people with dysthymia seem to exaggerate the severity of their depression. (This is understandable, since dysthymia is chronic.) A problem I sometimes have in trying to answer questions on diagnostic questionnaires is that I tend to take the questions on these tests more literally than they probably were intended to be taken.

> -elizabeth


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poster:Dr. Bob thread:75408
URL: http://www.dr-bob.org/babble/20020124/msgs/92253.html