Posted by SLS on October 4, 2005, at 9:45:44
In reply to Re: Professor at Med School Says Wean off All Meds, posted by linkadge on October 3, 2005, at 22:32:10
> I know this is a med board, but I think this guy is on the right track.
>
> LinkadgeHmm.
If you don't need drugs, don't take them. That's a pretty simple principle to understand and follow.
Psychotherapy is sometimes all that is needed if the depression is not biologically driven. That's another pretty simple idea to work with.
How do you know when someone needs medication?
Never?
It is a tough decision to make. There are so many variables. That's why psychiatrists get paid the big bucks. That's why the competent ones are actually worth it.
The longer one goes without successfully treating major depressive disorder (MDD), the worse the depression gets and the more resistant to medical treatment it becomes. This is particularly true for people whom develop depression early in life.
Linkadge, it might be difficult to parse out exactly why your depression has become more severe and resistant to drug treatment. However, it does follow a pattern that has been observed and noted by psychiatry.
It does seem that people who have been exposed to a particular drug become more resistant to it over time if it is repeatedly stopped and restarted. If one is to discontinue medication, the more gradually the drugs are tapered, the lower the risk of relapse. Taper periods can be weeks to months long. During a slow taper, if a relapse occurs, you can quickly raise the dosage of the medication and recapture the antidepressant response. For those people who need long-term or indefinite treatment, the longer the time spent between an abrupt discontinuation and eventual relapse, the less likely they are to respond adequately to the same drug. This is probably less of a problem for people whose depressive episodes are separated by years than for someone who has demonstrated a higher rate of recurrence.
Linkadge, it is entirely possible that you suffer an Axis I and Axis II disorder comorbidly. The Axis II personality disorder might produce enough psychosocial stress to drive the Axis I mood disorder. The Axis I mood disorder might make it much harder to do the psychological work necessary to process psychotherapy. It might be an ideal multimodal treatment strategy to pursue both treatments concurrently.
- Scott
poster:SLS
thread:562069
URL: http://www.dr-bob.org/babble/20051003/msgs/562678.html