This post links to three articles, two on depression and one on research. The depression articles convey information inconsistent with much that the public is currently being told. The research article is another condemning the machinations of researchers.

Dr. Jonathan Rottenberg is the author of the depression articles. I think he is more honest about treating depression than many, even though I think he overstates the case for remission. The first article entitled, Improvement in Depression: Now or Never, is subtitled: How depression treatment is like roulette. http://www.psychologytoday.com/blog/...n-now-or-never

Rottenberg confirms much of what I long ago suspected in these paragraphs:

Our knowledge of how and why people pull out of depression is primitive. But primitive as it is, we can build on two big facts. Fact One: We know from epidemological research that for most who suffer, depression will improve slowly, with gains uneven, halting, and fragile. And ultimately, about two-thirds of those who partially recover will fall back into an episode of depression. Thus, a key research question is why is improvement so slow for most, with gains often reversing.

Fact Two is in many ways more curious and interesting. In study after study, it's those who improve early --often about 1/3 of those studied-- who retain and often expand upon their gains. For example, Szegedi and colleagues reported in 2009 an analysis of over six thousand patients who had been enrolled in drug trials: improving early --in the first two weeks-- was an extremely strong predictor of ever improving. This apparently robust finding runs against the longstanding idea in pharmacology that antidepressants take many weeks before their clinical action in the brain can manifest itself. But perhaps what is most curious of all is that it does not appear to matter what kind of therapy it is -- the importance of early improvement has been shown for cognitve therapy, drug therapy, and even for placebo pills. If you get better early, you have a good chance to get well. The finding has also been extended to severely depressed inpatients in a hospital. Those who do best in the first two weeks do best in the long run.

The flip side, the implication, is scary: It suggests that improvement in depression is often now or never. We must build upon our knowledge of what is special about those who respond now to shrink the pool of nevers, the propoprtion of those who will have to suffer for a very long time before even partial relief arrives. If we could predict who would respond to what beforehand - and assign accordingly, we would be well on the road to containing depression. As it stands, starting a treatment for depression is like spinning the roulette wheel -- some will win for sure; but more will need to try their luck again.

The second Rottenberg article is entitled, Back from the Black: Why Do Early Improvers Improve? Rottenberg gives his readers four and a half hunches about why roughly 1/3 of those in a depressive episode show rather substantial and early improvement in their depression. The hunches are based on the primitive knowledge Rottenberg referred to earlier. http://www.psychologytoday.com/blog/...rovers-improve

While interesting reading, reliance on even the primitive knowledge is suspect based on the third article, entitled, Psychology rife with inaccurate research findings. It seems fabricating data is not an unusual phenomenon in the mental health arena. http://www.psychologytoday.com/blog/...earch-findings

The article concludes:

Critics say the widespread problems in the field argue strongly for mandatory reforms, including the establishment of policies requiring that researchers archive their data to make it available for inspection and analysis by others. This reform is important for the credibility of psychology in general, but absolutely essential in forensic psychology.

Reforms would seem to be a good idea? Duh! Unfortunately, we may learn even the limited research used by Rottenberg may be tainted.