Posted by SLS on January 7, 2010, at 13:24:46
In reply to Re: Antidepressants only for severely depressed--, posted by inanimate peanut on January 7, 2010, at 11:31:14
> So what does that mean if you have severe depression but a med works partially and so your depression is not so severe anymore? Would these drugs not work for the now not-so-severe depression?
That's a good question.
I don't think it is a matter of how severe the depression is so much as it is whether or not you are treating the right condition with the chosen remedy.
I think a higher percentage of people describing mild depression are experiencing psychogenic rather than biogenic depression when compared to the percentage of those describing more severe depressions. If drugs are of little value when there is no biological anomaly, then it would appear that a smaller percentage of mild depressives will respond to a drug in a clinical trial. The rate of response would be little better than that of placebo. If, instead, you allow only those with severe depression to enter a trial, the drug will separate itself from placebo more robustly simply because the chosen subjects will be more likely to have the illness being investigated.
I know that things are not so black and white. However, I think the trend is for more severe depressions to have a greater biological component to them, and that they are more likely to respond to biological interventions than are psychogenic depressions. If, then, someone with a biological depression were to respond only partially to a given treatment regime, they might yet respond more robustly when the treatment is refined. It is possible, of course, that there also be psychological issues to be addressed. Any depression resulting from the persistence of such issues might appear as being residual to the biological disorder, and thus be wrongly assumed to be the result of an incomplete biological response. Psychotherapy might then be indicated.
Too many words, I know. The bottom line is that you do not have to settle for a partial response..
- Scott
poster:SLS
thread:932723
URL: http://www.dr-bob.org/babble/20100103/msgs/932829.html