Is that so?

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.

I am going to say it.

It comes to a willpower and individual strenght. Or at least to self-preservation. How we manage the bad times. If you give in and let your entire life collapse, it is hard to rebuild back. When one tries to hold together or preserve at least the most crucial aspect the recovery is easier. Going totally crazy is easy (read Coelho or Susanna Kaysen... they been there, done that)... but it is hard to recover from. It is hard to re-learn how to live.

Yeah, support system is important in the bad phase. Sometimes one has to reach out and ask others to help them get through it... but they cannot walk through the fire for you. You have to do it, still. And the "support system" can be counterproductive if they enable you in the bad ways, in not-living. It "no, you really can't, can't you see how broken you are?".

Taking break from life is easy and tempting... but often there is price to pay.

Dagnabbit! My first DAY on Prozac, I took 10 mg, then an hour or so later I took another 10 mg, then again - for a total of 30 mg - and I SWEAR the racing thoughts stopped. But 5 T's and/or pdocs since have told me that was IMPOSSIBLE because of the RESEARCH! LIAR LIAR PANTS ON FIRE! I am ALWAYS right. But I agree with Venus - changing how you live, getting out of depression, even on meds, is like removing a suit of armor, one piece at a time, over years.

Hanskter, could be the placebo effect.

(I remember once I bought this "sleepy tea". Was expensive. Made a cup and explained my roomie what it is. Slept so well that night, first time in a long period... when I woke up I realized I did not touch my tea. I gave my mom some and she had the same experience:P Minds work in strangest ways....).

WOW, what an interesting read~! my personal experience tells me that the information here is very representative of many people's experience. i know that if someone had told me that my recovery would take 20 yrs, i might not have held on, and kept trying. so information can be a two-edged sword. it is no surprise, however, that mental health "research" is seriously flawed, in method and manner. the truth is buried by the giant Pharmacy companies, i think. and the American Medical Association is hand-in-hand with them, clinging to the medical model against all other options.

i hope you do some research into the Rehabilitation Model of recovery some time, Elan~~ thanks for this. best wishes, Gus

Could be placebo effect, except that I didn't even realize something was "wrong" - that these thoughts weren't normal, that they were bothering me, that they were intrusive - until they STOPPED. What was happening that day was, I had been given the prescription earlier in the week but didn't want to start the meds on a workday. That Saturday I kept running into my long-time crush (at that point I was ONLY 10 years into it!) in the freakin elevator with his horrid (did I spell that right?!) girlfriend every time I left my apartment, and kept getting more and more "depressed" - I didn't really have a name for my feelings. (This WAS the previous century, ya know! REALLY dark ages!) Anyway, all of a sudden - it's QUIET in my head! I'm like, WTH? I didn't know it could be like that, CALM. I know I "get" it from my mother, because one time I was sitting with her, and I could just SENSE that that was going on in HER head, because it was starting to overflow out of her mouth. A very weird negative adrenalin. Not anxious, because we would NEVER admit fear or weakness; not out of control, because we can do ANYTHING, and yet...? I think Type A personalities are usually more successful, so it's not that either? I don't know. I need to read these articles!