Posted by SLS on August 21, 2005, at 7:40:29
In reply to Hey folks, it's not just the MEDS, posted by DoYouKnowHim? on August 20, 2005, at 3:28:39
Hi.
I'm sorry that my reaction to your post seemed so harsh. As you can see, it becomes an emotionally charged issue whenever the biology versus psychology of depression becomes a focal point. It is hard to make everyone happy when one attempts to make sweeping generalizations, regardless of how well-intentioned.
It goes without question that your post was well intentioned. As far as projecting the experiences of the self onto others, I am often guilty of the same thing. If I feel that I have found an answer for myself, I almost assume that it will be the answer for others as well. Unfortunately, depression is a single word describing a heterogenous population of suffers, and there is not yet clear specificity at delineating depressive subtypes such that treatments can be determined for each one. Even when two cases of depression look exactly the same, they may respond to surprisingly different treatments.
I like the concept of "depressive pressure". Depressive pressure can be the presence of a chronic psychosocial stress for which psychotherapy and/or environmental change are the best alternatives to reduce. Depressive pressure can take a toll on the brain such that it causes it to malfunction in biologically succeptible individuals. For some people whom respond adequately to antidepressants, future relapses despite continued treatment (known as medication break-through) becomes likely if the depressive pressure created by psychosocial stress remains unmitigated. Psychotherapy here would go a long way to help prevent this from happening, although it is no guarantee. However, the removal of the depressive pressure through psychotherapy is often a well-designed strategy. Unfortunately, the more depressive episodes one experiences, the deeper the biological illness digs into the brain. Subsequent recurrences often occur even in the absence of psychosocial stress. For these people, medical treatment might be both necessary and sufficient.
Another good use of psychotherapy is to clean up the mess left in the wake of an extended depressive episode. Biological depression warps thoughts and feelings. It changes the way people think and behave. It can lead to erroneous perceptions and conclusions about the self and the outside world that psychotherapy can often address.
Another good use of psychotherapy is to help prevent too much of a mess from developing in the first place and allowing the depressed individual to function as well as the biological illness permits. However, when appropriate, it is most helpful that the psychotherapist acknowledge and actually *believe* that the depression is biological. To proceed otherwise can sabotage the efforts of the sufferer to work with the depression as the therapist may convey upon them unreasonable expectations and neglect insights targeted at the reality of the illness. When used properly, psychotherapy can help the sufferer of a biological depression better understand the dynamics of the illness, accept their temporary limitations, reduce anxiety and stress, and prevent suicide.
The sincerity of your concern for the suffering of others and your enthusiasm to share your ideas as to how to reduce it comes through very powerfully in your post. I'm sorry if this has been neglected in the replies you have received.
I wish you continued success following the path of healing you have chosen. It would help a great many people were you to continue to share your experiences in the future. I hope you have not been discouraged from doing so.
Be well.
- Scott
poster:SLS
thread:544171
URL: http://www.dr-bob.org/babble/20050821/msgs/544682.html