Posted by Ritch on June 19, 2002, at 9:38:49
In reply to more on article... » Ritch, posted by tabitha on June 19, 2002, at 4:55:02
> I agree there's something very "biological" about depression once it takes hold, but I think there could be psychological triggers that start it. I don't know of any therapies that make nearly as much difference as meds though.
> I suspect this author is kind of anti-med, in a Puritan sort of way (we should feel pain because pain builds character). I doubt if he understands what miserable and useless suffering severe depression really is.
> I just appreciated the reminder that NO ONE KNOWS what causes depression, and NO ONE KNOWS why the meds alleviate it. The drugs create a whole host of changes, not all of them positive, and pulling us out of depression is just one of the effects. I don't think doctors appreciate this or fully inform us of what to expect.
I agree that external factors can make a big difference. I got a big promotion at work one time a few years ago just as I was about to sink into my usual summer seasonal depression. It (the promotion) brought me out of the fatigue I was in and I got focused and felt much better. However, it unfortunately only *delayed* the depression for about ten days or so...
I also agree that external stressors can "precipitate" a "cascade" of hormone changes which wind up triggering a major depressive episode. The core of all of this is the individual's "fragility" bio-chemical or emotional. Well.. I think that is where the meds come in. Meds can give people a "thicker skin" than they otherwise wouldn't have. Thicker skins give you more "protection" from stressors that set off the "cascade" of events that could lead to major depression, panic, etc. I suppose ideally, it would be best to target the neuroendocrine "cascading" process instead of inducing a psychological thick-skin state. That way you would "feel" things more fully, but your body wouldn't self-destruct as a response (I am thinking about the CRF antagonists here).
Also, I am really not "anti-therapy" at all. CBT, DBT, etc., also target our "reactive" processes to external stressors at the cognitive level. The problem with therapy is you are highly likely to waste a tremendous amount of money and more importantly, *time*, finding the "right" therapist. Different approaches generally, and different therapist's personalities and skills, particularly, make *getting* good therapy a frustrating crap shoot for many people. The whole process (of obtaining therapy), seems like you might as well be shopping for a new religion, or worse looking for the best fortune-teller in town. So, the "religion" we are being "sold" here apears to be a derivitive of Puritanism, just like you say. :)