Posted by Racer on March 3, 2006, at 13:25:28
In reply to Antidepressants don't work except for when they do, posted by SLS on March 3, 2006, at 7:32:07
Sorry -- can't resist...
Yes, what you've said is completely true. I agree entirely. But I'm gonna add my thoughts on why...
Seems to me that psychiatry is different from other areas of medicine because it's much more subjective. Just like you questioning your response to -- was it mifepristone? -- after seeing the reduction in your HAM-D scores? There are no blood tests that can be done to diagnose bipolar or depression, it's all based on a clinical picture, and there's a lot of wiggle room within that. (Like the doctors now saying that there is no such thing as co-morbid depression and anxiety, those two symptoms together are ALWAYS bipolar.)
I think we'll someday find out that depression, for example, is a cluster of probably unrelated conditions with a similar set of symptoms. And that that's why some people respond to Drug A, and others don't.
Also, as you say, psychosocial factors play a large role, as well. If we all had a great social support network around us, supporting and encouraging us, I'd bet we'd mostly respond a whole lot more quickly than if we had to struggle along, and try to pay all our bills on inadequate resources due to the economic effects of our depression/bipolar/etc. This is certainly one area where you can't separate nature and nurture.
OK. Done now. You can now return to your regularly scheduled programming...