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- Chris OConnor
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Anti-depressants - ever taken them?You can take this poll completely anonymously. Just don't do a follow-up post and we won't know who posted what. But if you're feeling like sharing share.ChrisResults (total votes = 23):Yes, and I am currently taking them 8 / 34.8%  Yes, in the past 5 / 21.7%  No, never taken them 8 / 34.8%  No, but I feel I might take them someday 2 / 8.7%
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The silence is deafening in this thread. I have found personal stories helpful in my life, so I will share a bit. Feel free to ask questions if you want, I don't mind.I have tried anti-depressants and do not take them now. I was at a point where I was extremely frustrated with my inability to get things done, which for me can easily fuel a depressive episode. I tried some anti-depressants that are approved for ADD (since I have both and I find that they fuel each other, so 2 birds with one stone approach seemed best). I didn't notice any improvements with the first one and it made me sick to my stomach. The second one prevented orgasms so I quit taking it as soon as I figured that out. The third one didn't really do anything either besides make me queasy again, so I quit with the drugs and concentrated on other ways of coping.There are several things that I found to be more effective for me than anti-depressants. The most important think is keeping the running commentary in my head positive. The times that I have struggled the most with depression were times when I allowed myself to wallow in self-pity and thoughts of how hopelessly futile everything is. Allowing myself to believe that "it's hopeless" and "everything always goes wrong for me" have never gotten me anywhere. I've always known how to argue with those thoughts, but I have found a type of psychology that structuralized a method of doing it and uses it as a therapy method. That would be Rational Emotive Behavior Therapy (that was developed in 1955 by Albert Ellis, as every single site I have ever seen about it is sure to mention).Another very important factor to my not having a major depressive episode for quite awhile is that I cut way back on my alcohol consumption. Alcohol makes the body think that there is enough happy juice floating around in the brain causing the brain to quit producing it. I haven't been really depressed since before I cut back to drinking once or twice every other month.Something that I know affects my moods but I do not work on enough is what foods and chemicals I put in my body. When I eat fresh vegetables and other good food instead of processed crap I always feel better mentally and physically. Too much sugar, caffeine, and nicotine has the opposite effect. Most importantly I have a loving husband who is willing to make fun of me till I snap out of it. Nothing can take the place of a good support system.I am glad that I can function without taking medications. I personally don't trust them and think much more research is needed before I would feel comfortable adjusting my brain chemistry by that method again. At the same time I do not think people should refuse to take them because of the misguided notion that popping pills is a cop out or that only "natural ways" should be used. That's total BS. I know what it's like to not be able to convince myself to get out of bed. Going to the gym would not have gotten me out of bed at that point in my life. I only have 'mild' depression...I am not about to insist that everyone should cope in the same way I have. That would be ignorant of me. All the positive thinking in the world cannot change the way some brains function. It's even possible that being on happy pills for the short time I was readjusted the chemistry in my head enough for my body to naturally maintain it from that point.
I take an antidepressent, Zoloft (sertraline HCL), but not for depression. I was diagnosed with "impulse control disorder" which interstingly enough did not go away when the pundits of DSM-IV decided it's not a condition anymore. Basically what it does for me is give me a second or two leeway to allow my conscious mind to overcome a reflexive impulse. I would estimate, for example, that my road rage is about 2% of where it was prior to treatment. Not that I dont' feel the feeling; but before I'd find my foot slammed down on the accelerator, whereas now I find myself THINKING about slamming my foot down on the accelerator, and almost always think better of it. If you make yourself really small, you can externalize virtually everything. Daniel Dennett, 1984
Nice post, Scrumfish. I've read a lot about REBT. Did you work with a therapist in learning the techniques or was it a do-it-yourself effort?I am interested in the idea, which you find in later REBT literature (e.g. Walen, Dryden and DiGiuseppe - A Practioner' Guide...) that most of the distortions go away if you become throroughly convinced of two principles:1. Unconditional Self Acceptance (USA)2. High Frustration Tolerance (HFT)Have you tried anything along these lines?
For a while, it was thought that there might be a connection between Impulse Control Disorder and Tourette syndrom. I haven't read anything lately on this.Many people find St. Johns' Wort very effect for all kinds of symtoms, from depression, to lack of energy, to impulse control. Because the United States medical industry insists on viewing St. John's Wort as an herb, and not a drug, there have not been too many decent studies on it, and therefore you have to fool around with doseage on your own.Not nearly enough work has been done regarding the chemical/electical functionings of the brain, and my personal opinion is that ALL....yes, ALL, mental disorders and mental conditions are a hardware problem. We don't try to fix a faulty car engine by sitting down with it to talk about it's mother, we add fluids, adjust cables, etc. , and that's exactly what we should be doing with mental disorders...checking the hardware itself. It is only recently that the role of hormones is beginning to be understood.Marti in Mexico
marti: We don't try to fix a faulty car engine by sitting down with it to talk about it's motherNo, but we might check the programming of its fuel injection computer.No doubt you are right, Marti, that everything is hardware if you are willing to treat all memories and beliefs as manifestations of hardware state (which of course they are) - but there are ways of changing beliefs which don't involve pharmacological intervention.
I was on them for a few years. I found, that if you are a minor, getting on them is the easy part. No doctor wants to take you off of them because they don't want to get sued by parents if you relapse. So I had to spend years of my life after I was better convincing Doctors it was ok to take me off the stuff.What intrigued me about the experience was that I started a young age and continued to take them for years. When I stopped taking them I found out that I was still emotionally numbed for several years (apparently not unheard of). Of course I happen to be of the first generation of people they tried medicating at such a young age, so there are no studies on what to expect in the long run.I was lucky in that I knew someone who had been through a similar treatment (similar diagnosis, number of years, type of, and age range on medication) who was several years older. When I got to certain points of change from the medication gradually leaving my system (it's been over 5 years and I'm not sure it is all gone) my friend had been through them. I found this helpful because I began to notice changes at roughly the 2 year point. Though at about the four year point, the advice offered continued to be similar to my circumstances, our cases divirged rapidly from that point. In the last year, I have found our similarities have shrunk in number. Doug Larson: "The cat could very well be man's best friend but would never stoop to admitting it."
Depression Talk is cheap Apr 14th 2005 From The Economist print editionAnd surprisingly effective FOR almost a century after Sigmund Freud pioneered psychoanalysis, "talk therapy" was the treatment of choice for many mental illnesses. Artists and writers lined up to lie down and be analysed, and the ideas of Freud, Jung, and other influential psychiatrists permeated the intellectual world. They also seeped into the popular consciousness, and still pop up today whenever someone talks of a subconscious desire, a Freudian slip, a death wish, or an Oedipal complex. But advances in neurology, and especially in pharmacology, have called such therapy into question. When psychological and emotional disturbances can be traced to faulty brain chemistry and corrected with a pill, the idea that sitting and talking can treat a problem such as clinical depression might seem outdated. Robert DeRubeis of the University of Pennsylvania and his colleagues beg to differ, however. They have conducted the largest clinical trial ever designed to compare talk therapy with chemical antidepressants. The result, just published in Archives of General Psychiatry, is that talking works as well as pills do. Indeed, it works better, if you take into account the lower relapse rate. The study looked at a relatively modern type of talk therapy, known as cognitive therapy, which tries to teach people how to change harmful thoughts and beliefs. Patients learn to recognise unrealistically negative thoughts when they occur, and are told how to replace them with more positive ones. It may sound too simplistic to work, but other studies have shown it can be used to treat anxiety, obsessive-compulsive disorder and eating disorders. Dr DeRubeis wondered just how effective it really was for depression.In the study, 240 patients with moderate to severe depression were divided into three groups. One group was treated with cognitive therapy, a second with Paxil, an antidepressant drug, and members of the third group were given placebo pills. (Those in the second and third groups did not know whether their pills were placebos or not.) After 16 weeks of treatment, the results for those on cognitive therapy and drugs were identical. Some 58% had shown perceptible improvement. By contrast, only 25% of those on the placebo improved. That was encouraging. But the really surprising advantage of cognitive therapy is that it seems to keep working even after the therapy sessions are over. A year after treatments ended, only 31% of those who had received it had relapsed into their former state, while 76% of those who had been given antidepressants, and then been taken off them, had done so. Even patients who stayed on antidepressants for the intervening year did not do any better than those who had taken cognitive therapy and then quit.If Dr DeRubeis's study can be replicated (an important "if" in a soft-edged discipline such as psychotherapy), it has implications for the way clinical depression should be approached in the future. One consideration, at least in America, where the study was done, is that many medical-insurance companies that are willing to pay for antidepressant drugs nevertheless refuse to pay for psychotherapy. A successful replication of the DeRubeis study ought to change that
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Ken, I did work with a therapist that used REBT. We didn't talk about USA, but there was lots of discussion of frustration tolerance. An important part of the therapy was filling out ABC worksheets, the ABC standing for Activating event, irrational Belief, and Consequences. The worksheet was similar to this three minute exercise. The more I wrote out and thought about this process the better I got at it and the more automatic it became. I still use it and it's definitely still helpful.Marti, many members of my family prefer taking herbs to taking prescribed drugs. St. John's Wort is one bottle one could find in the cabinets of my family. Another one is Sam-e, or S-Adenosyl methionine. This site has links to some books about SAM-e and this one has a bit of info on it. (DO NOT take SAM-e if you have manic-depression). It would definitely be good to have complete studies done of the herbs that are recommended for various ailments. I would not be surprised if some of them worked better than developed medication, but I suspect that some of them have a placebo effect. Here is an article on how effective placebos are (until you tell them it's a placebo). I completely agree with you about the need for more research on the chemical and electrical functions of the brain. I also agree that problems in mental processes are a result of problems in the physical processes of the brain. Hopefully someday they will be able to scan the brains of everyone seeking psychiatric treatment. However, I do not think that medication is the only way to fix the hardware for everyone (not that you were suggesting that, Marti). Here's an article about the effectiveness of a pacemaker-like device connected to the brain with promising results for people with depression that didn't respond to medication and perhaps Obsessive Compulsive Disorder. I have had meditation recommended by several mental health professionals. There is very interesting work being done with biofeedback for mental health problems, often in conjuction with REBT and CBT. It is clearly possible to change the chemical and electronic patterns of the brain without taking medication. Brain scans from before and after various treatments clearly show these changes. With the awful side effects that I have experienced with medication, I much prefer other methods of dealing with depression and ADD.Our brain processes are affected by everything we put into our and do with our body. Hormones, exercise, sugar, and so many other things each have a part. Even our own thoughts have an effect. It is possible to create new neural pathways in the brains, and consciously making oneself think positive thoughts has an effect. Here is information about comparing brain scans of CBT patients to anti-depression patients. CBT is similar if not the same as REBT, though I'm sure I've pissed someone off with that statement. Once again I would like to stress that prescribed medication is sometimes the best option a person has to lead a fulfilling life, or even to just be able to function. The individual and his doctor or therapist can make the best decision on that.
I would say that for a patient with real problems, therapy is better than drugs, but both is probably best.Medicine designed to adjust brain chemistry are in essence treating the manifestation of the problem, not its roots. Getting at the roots is what a good therapist is for. That would explain a higher relapse rate for those not in therapy. Doug Larson: "The cat could very well be man's best friend but would never stoop to admitting it."