We are a commune of inquiring, skeptical, politically centrist, capitalist, anglophile, traditionalist New England Yankee humans, humanoids, and animals with many interests beyond and above politics. Each of us has had a high-school education (or GED), but all had ADD so didn't pay attention very well, especially the dogs. Each one of us does "try my best to be just like I am," and none of us enjoys working for others, including for Maggie, from whom we receive neither a nickel nor a dime. Freedom from nags, cranks, government, do-gooders, control-freaks and idiots is all that we ask for.
Antidepressants fail to help around 70% of depressed patients on the first try.
Antidepressants are now the treatment of choice for anyone with acute or chronic symptoms of "major depression," ie anxiety, disturbed sleep, hopelessness and helplessness, self-hatred, appetite loss, irrational guilty feelings, loss of sex drive, inability to concentrate, sometimes suicidal feelings, and inability to find pleasure or interest in things. In my experience, the vast majority of patients with a fair number of those symptoms feel better with antidepressants, but, in my view, medicine should never be given without psychotherapy of some sort.
Where it gets complicated is that 1. there are many kinds of depression besides major depression; 2., the personality type, and personal strengths and weaknesses can effect the way depression occurs, and whether it occurs at all, and, 3. life circumstances have a real impact on the ability to improve depression with medicine (if your business is going bust, or your child dying with cancer, no antidepressant will make you merry).
I'll try to keep it brief. The generic term "depression" runs the gamut from the heavily-inherited form that occurs in Bipolar Disorder (which is probably a brain-wiring abnormality), to the grief-like depressive reactions to life-events, especially loss, which occur in vulnerable people. In between are sad-sack people with chronic mildy depressed mood, and many people with chronic mood problems due to personality disordersor neurotic problems. My point is that there is not one "depression". The word refers to a group of symptoms, not a diagnosis.
Because depression is not a unitary phenomenon, different forms require different treatment approaches, whether psychotherapeutic or chemical, but the research says preferably both for severe depression.
It is not widely understood that the new SSRI antidepressants are not "mood elevators." They have no effect whatsoever on people without depression, which is why they are never abused.
I will have to follow-up with a Part 2 later, because this is getting too long, according to our blog rules. "Short and sweet." But some subjects are complex and nuanced, as our esteemed French Senator likes to say.
Speaking as a patient, I must say that the ssris have saved my life (after a lifetime of chronic depression and suicidal eoisodes. But while they give life, they also diminish it. No more transports of sexual desire and satisfaction (which used to brighten even my blackest despairs unmedicated). Life without love or good sex really sucks. If I wasn't the sole breadwinner for 5 people I would rather risk another depression if I could feel affectionate and
Swamped by a depressing family situation. Sexually abused by my maternal grandfather,neglected by a frequently manic mother,whipped with a belt by my father,constant crises of my bipolar brother and sister. I always felt fortunate that I was "only"depressed as my relatives' violent manias, complicated by drugs and alcohol, were so much more disrptive.
I asked for ssri's only in desperation as I became unable to sleep,eat,work and obsessed with ways of killing myself. Took them for the sake of my 3 kids.
One of them autistic, another suicidal and refusing to work, only one an achiever as I was with "only" sad moods. My husband chronically unemployed. A miserable,conflict torn 18 year marriage.
. If we weren't all so talented, I'd have said that judicious birth control might have been better.
I am grateful to my persistent MD for keeping me alive to meet my responsibilities. But my life is not worth living,despite his help and my struggles.
Right now am struggling w one parent dying 3000 miles away in agony while my sister filches his pain meds. That is depressing as there is noone else who can care for them. The other parent paralyzed and bipolar and developing dementia. Depressing. Living paycheck to paycheck,car payments and 12000 in credit card debt I am at least consoled that millions of my fellow Americans are in the same boat.
Church and faith have sustained me with more hope than any medicine. And I do love my kids and do everything for their sake. I would be long dead if I didn,t believe that they need me. Enough. I wish there was a drug that could delude me that life was good. Ssris take away much pain but they also make it impossible to feel pleasure. A blunting of feeling.Like a condom--necessary but yukky and reduces sensation. Really enough from me now.
And to add insult to injury, a prescription is now a public lifetime Scarlet M, a means to deny any and every persion their God-given Rights. Shared widely across all levels of government, and publicly disclosed at any time for political purposes.
Better to just make the best of the time you have been given, than submit to the stomping boot.