Treating Depression

Lynx_Arc

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Kinda funny that a lot of doctors want to give you pills when a lot of the time it is just faulty thinking that keeps people depressed. I think a lot of depression is because people get stuck thinking inwardly about themselves comparing with what they like or want in others unrealistically instead of being thankful for the things they really do have. I know when I get depressed I remember how truly bad others have it in some places in the world, how bad my mom felt the last part of her life and get somewhat ashamed of the depression that is associated perhaps more with self pity. When I start counting the good things I have instead of the good things I dont or bad things I think I am stuck with I tend to change my attitude.
 

cognitivefun

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a structured approach using cognitive behavioral therapy has been shown to be at least as effective as medication, but more lasting.

In CBT, you learn how your depression is caused by your own confusion, meaning false beliefs. You learn to question those beliefs...in a phrase, not believe your own thoughts.
 

James S

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this is a tired topic around here /ubbthreads/images/graemlins/smile.gif

If you're depressed when your situation is depressing, is that clinical? Taking drugs or talking it out wont change the reality of your life and situation, but you have to be able to do the work to sort through your life which you can't do if you're depressed about it.

The reason that doctors give pills to you on your first visit is simple. Taking pills might not be the best therapy for you, but it will definitely do SOMETHING in the short term. And if that means that you dont try to commit suicide next week before your next visit then they have succeeded. Even if the doc doesn't think necessarily that you will benefit from the drug, he's going to give them anyway so that your family doesn't sue for malpractice after you throw yourself under a train and they wonder why you went to the doc and he didn't do anything.

That, and if you're actually chemically imbalanced the drugs actually help. We've all known people who have been on anti-depressants that they don't need to be. It affects them in strange ways. But I also have the privilege to know someone who is on the drugs who actually needs and benefits wonderfully from them. For her they are a miracle, the difference between handling her own life and being unable to get out of bed and do her job and care for her family. If you're one of those for whom depression is caused by the problem that the drugs specifically address, then only the drugs are going to help you. There is no snapping out of it.

Your doc puts you on drugs regardless because not putting you on them if you need them is much worse than putting you on them when you dont. You can always stop taking them later if they dont work or affect you strangely. You can't start taking them after it's too late.

So lets not be to quick to judge what they do and why. If you have the power to decide for yourself what you should do and you have the power to work through your life and handle your situation and get out of bed with the energy to face the day. Then you're not sick and you can't possible sum up in a post here how to diagnose somebody else. Be thankful that when it's someone in your family that can't face their lives that the doc will put them on something right away! You can talk it out later, but not if they aren't there anymore.
 

cognitivefun

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hey, pills are cool. I'm not against anything. They can help sometimes and they can help someone get into a place where they are more able to handle cognitive therapy.
 

Jefff

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I have to say that there is no better treatmnt than .. pill + therapy combined... I have something called agoraphobia i.e.;agoraphobia is a condition which develops when a person begins to avoid spaces or situations associated with anxiety. Typical "phobic situations" might include driving, shopping, crowded places, traveling, standing in line, being alone, meetings and social gatherings... and with the help of Lexapro and weekly therapy I am begining to overcome this.. just my .02 you can see a more detailed definition here on Agoraphobia
 

greenLED

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I'm afraid American health culture is drug-centered when it comes to treating certain disorders. Patients that are loaded with anti-depressants from day 1 might benefit from a change in life style, and/or psychological therapy. "Get a life!" takes on a new meaning. /ubbthreads/images/graemlins/smile.gif

With that said, each person's pathology/physiology is unique, and some can only survive this by fixing their brain's chemical imbalance with drugs. As Cog- said, then they can benefit from chatting their souls out.
 

Jefff

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the drugs that are out on the market now are so refined that the zombie effects are almost all but gone... I do however agree with the term over perscribed though... and not every pill is right for that person being perscribed.. but you will never know if ya dont try .. EFFEXOR was one that didn;t work for me.. and the side effects were many.. but no one will know until you try it.. doctors are there to try to give a best educated guess at what might work and get close.. and then go from there..

and to reply to the above .. studies show that in behavioral science.. that your brain doesnt kow the difference from a lie and the truth.. your mind does but the brain itself does not.. they put people through one paticular test that comes to mind that proves this .. they were subject to stand in front of a mirror and smile for an hour .. just stand and smile and eventually the sight of your self image of being happy was imprinted onto the sub-concious and infact it did "trick" so to speak there own mind in thinking they were cheerful and happy.. and thus was a sucess in treating depression.. that too was refined over time and now talking about positive and showing the client what and how to overcome the depression greatly has a positive effect on how to deal and cope with depressing things over a continued and prolonged period of time..
 

cy

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Please note in no way am I saying chemical inbalances should not be treated with correct medication.

seems talk treatment has been discount in favor of 100% treatment by drugs. link leads to study proving effectiveness of talk theraphy.

If you ever have a chance read Diagnostic and Statistical Manual of Mental Disorders (DSM IV)
 

bwaites

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The problem with cognitive/talk/counseling is that no one pays for it.

Counselors/Psychiatrists/Psychologists can't make a living if they aren't paid.

Really sick people often can't pay because they are out of work, many people won't pay because they don't feel it helps, others won't pay because, "if the insurance won't pay, why should I?"

The truth is that the best approach is bilateral, medications plus therapy, and it is what I always recommend, but only about 20% of patients actually follow thru with the therapy part.

Bill
 

nikon

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James S.....Well said /ubbthreads/images/graemlins/thumbsup.gif


cy....."link leads to study proving effectiveness of talk theraphy"........Just to keep our terminology correct, nothing is ever proven by a study. Evidence is gathered. If other studies replicate these findings, they can add to the body of evidence. But they might still be wrong.
 

UncleFester

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James said this is a tired topic. It HAS been discussed here before. One or two other times I've posted this link to a site about depression. There's some truth there. Please take the time to look at it.
 

cobb

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I had a brief problem once with depression. As a guy, I immdiately could not see the benefits of talking about it, man that seemed silly and fairly unmanly. Drugs were used and they had a delay in their workings and some side effects.

What changed me was sylvia browne. I was watching her on the montel williams show and got some of her books. She more or less said we are given problems to over come and wrapping your lips around the end of a gun wont do it. If you kill yourself god will make you repeat your life and problem til you over come it. That changed me, I sure dont want to go through this again.
 

sunspot

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Thanks for this thread. I had not seen a previous one.
Thanks to you, James S. I had been on "Yak" theraphy for years, with no improvment. After trial and error with AD's, Lexapro did the trick. Turns out I'm one of the chemical imbalance folks. I'm doing just fine, now.
 

cognitivefun

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Cognitive behavioral therapy isn't yak therapy. I believe in whatever works for you. But don't discount CBT.

I feel that depression is a result of believing our own false thoughts. CBT helps free us from the power of those thoughts. We may still have the thoughts (for awhile) but we don't believe them anymore.

There are a number of versions, but they all work the same way. This stuff has clinical research backing it up. It works.

See http://psycharts.com/Cognitive_Theory.htm

This isn't yakking. Here is some clinical studies from the above page. The bottom line is that CBT is more effective than medication. Medication can be used with CBT. And CBT is short term, it isn't years of therapy. There is a structured approach that requires 2 - 4 months.

1. Evans, M. D., Hollon, S. D., DeRubeis, R. J., Piasecki, J. M., Grove,W. M., Garvey, M. J., & Tuason, V. B. Differential relapse following cognitive therapy and pharmacotherapy for depression. Archives of General Psychiatry, 1992, 49, 802–808

2. Fava, G., Grandi, S., Zielezny, M., Rafanelli, C., & Canestrari, R.Four-year outcome for cognitive behavioral treatment of residual symptomsin major depression. American Journal of Psychiatry, 1996. 153, 945–947

3. Paykel, E. S., Scott, J., Teasdale, J. D., Johnson, A. L., Garland, A., Moore,R., et al. (). Prevention of relapse in residual depression by cognitive therapy: A controlled trial. Archives of General Psychiatry, 1999, 56 ,829–835.

4. Beck, A. T., Epstein, N., & Harrison, R. Cognitions, attitudes and personality dimensions in depression. British Journal of Cognitive Psychotherapy, 1983, 1, 1–16.

5. J. D. Teasdale, R. G. Moore and H. Hayhurst, M. Pope. S, & Williams, Z. Segal. Metacognitive Awareness and Prevention of Relapse in Depression: Empirical Evidence. Journal of Consulting and Clinical Psychology. 2002, . 70, 2, 275–287

6.John D. Teasdale Zindel V. Segal J. Mark G. Williams Valerie A. Ridgeway Judith M. Soulsby Mark A. Lau. Prevention of Relapse/Recurrence in Major Depression by Mindfulness-Based Cognitive Therapy - - Journal of Consulting and Clinical Psychology 2000 68, 615-623
 

Jefff

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[ QUOTE ]
Lexapro did the trick. Turns out I'm one of the chemical imbalance folks. I'm doing just fine, now

[/ QUOTE ]

that is awesome .. this is what I am on now and seems to be helping me out a great deal along with CBT.. I am also being let out of my own prison *so to speak* too... THANK GOD!!!!! I have been living with Agoraphobia for over 5 years now.. and trapped in my home.. and had almost lost all hope..
 

sunspot

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Jefff. I had mild Agoraphobia (crowds) and panic attacks on Interstate highways. 99% gone. It is like being out of prison.
I think I will look into CBT.
 

Jefff

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I was pretty much trapped in my house for the past 2 years.. by saying that I mean litteraly.. I would try to get out and go to the park but I had like only a mile radious that I was able to ride with my wife and would have an attack .. and I thought they were heartattacks at first .. but then the fear of having to go to the doctor would also trigger it .. it was a constant hell and I am so glad that I finally was forced to get a doctor's help I had tried to self medicate with over the counter stuff for vertigo and dizziness pills and lost hope that anything would ever help me . I can not believe that one lil pill has that much power to let me get back out into the real world and let me have my life back .. but that alone would not have helped me .. the comfort of my therapist reasurring me that I would not die and that i am fixable helped a great deal and prayer.. I hope you or anyone out there having to live with this or any type of depression gets the help they so desperatly need and deserve..

I would say so far the lexapro has got me at least 70% back to normal but that is a long way from 5 or 10% that I have been .. but I am only a few weeks into the therapy and pills but yet just tonight I was able to take my wife out to dinner and actually enjoy most of it but there was still that wonder if it gonna happen thought in the back of my head.. but not so overwhealming that it kept me from doing what I had set out ..
 
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