[glok]

But there is a cruel paradox when it comes to mental disorders. While we chase the receding holy grail of future basic science breakthrough, we are shamefully neglecting the needs of patients who are suffering right now. On average, it is probably worse being a patient with severe mental illness in the U.S. now than it was 150 years ago. It is certainly much worse being a patient with severe mental illness in the U.S. as compared with most European countries. Access to community care and decent housing is deteriorating; hundreds of thousands of psychiatric patients are homeless or in prison; there is little system in the mental-health system; and almost all research is strictly biological. Will $650 Million in Genetic Studies Solve the Mystery of Mental Illness?*|*Allen Frances

The links that follow lead to articles that tell a story about treatment for depression. I expect many will find there is too much to read. Even so, I found much that may help those who would seek treatment.

10 Troubling Facts About Antidepressants | Psychology Today
http://www.nytimes.com/2012/04/22/ma...anted=all&_r=0

We possess far fewer devices to look into the unknown cosmos of mood and emotion. We can only mix chemicals and spark electrical circuits and hope, indirectly, to understand the brain’s structure and function through their effects. In time, the insights generated by these new theories of depression will most likely lead to new antidepressants: chemicals that directly initiate nerve growth in the hippocampus or stimulate the subcallosal cingulate. These drugs may make Prozac and Paxil obsolete — but any new treatment will owe a deep intellectual debt to our thinking about serotonin in the brain. Our current antidepressants are thus best conceived not as medical breakthroughs but as technological breakthroughs. They are chemical tools that have allowed us early glimpses into our brains and into the biology of one of the most mysterious diseases known to humans.

The Myth of "Evidence-Based" Treatment of Depression | Psychology Today

So much for “evidence-based” mental health care. This popular myth is resting upon erroneous studies, in which everyone is given the same class of psychiatric medicine, working on the same brain or neurotransmitter circuits. But not everyone needs the same class of psychiatric medicine. Not everyone suffering from depression or anxiety needs the same class of medication. The idea that we have substantial evidence in mental health treatment has to be questioned and for the most part, discarded. We don’t have evidence-based treatment for depression, not yet; we have not yet conducted reasonable, appropriate, sensible research upon which to decide what is effective. Medications need to be prescribed case-specifically, and I would add here, so does the modality of talk-based psychotherapy. So much for “evidence-based” mental health care. This popular myth is resting upon erroneous studies, in which everyone is given the same class of psychiatric medicine, working on the same brain or neurotransmitter circuits. But not everyone needs the same class of psychiatric medicine. Not everyone suffering from depression or anxiety needs the same class of medication. The idea that we have substantial evidence in mental health treatment has to be questioned and for the most part, discarded. We don’t have evidence-based treatment for depression, not yet; we have not yet conducted reasonable, appropriate, sensible research upon which to decide what is effective. Medications need to be prescribed case-specifically, and I would add here, so does the modality of talk-based psychotherapy.

NIMH · Transforming Diagnosis
NIMH · NIMH Research Domain Criteria (RDoC)
Personality, Psychopathology, and the Neurotransmitter Attributes Questionnaire (NAQ) | SAGE Open
Depression Treatment: Psychotherapy, Medication or Both? | Psych Central

For clients who choose to take medications, I think it is imperative they ask those doing the treating if they are familiar with both the NIMH Research Domain Criteria (RDoC) and Questionnaire (NAQ) | SAGE Open. While utilization of these tools may not be utopian, they certainly suggest having greater odds of achieving a better medication experience.

It also seems important to engage in appropriate psychotherapy for your particular presentment.

[Fuzzybear]

[NowhereUSA]

i disagree that it's worse than 150 years ago. they used to lobotomize people (women in particular). as a woman with a mental illness, i appreciate them not cutting out parts of my brain.

i think we're in a transitional period personally. that is, we still have hold overs from old methods while there is an influx of new. as with most things, in the US at least, you have to be your own advocate and it is hardest to do that within the mental health system because you feel so badly as it is and your perceptions can be affected.

thanks for the info though.

[Altered Moment]

The story is very similar to traditional medicine. We have had many long discussions and debates here on these issues.

Traditional medicine (non mental health) has been a process of trial and error throughout its history. Adding one little piece of info to a body of knowledge one puzzle piece at a time. It is absolutely amazing what they know about the circulatory system and the heart now and what they can do. The brain is a much much tougher thing to study. I believe there will be amazing breakthroughs in coming years in mental health. I would agree the current set of meds and treatments is very lacking for many of us. I think it is much much better than it has ever been though.

I have to say I've given up reading about mental illness, treatments, research, etc. What it always comes down to, for me, is: "How are you doing? Which pill do you want?" Any therapist I've ever seen was useless... I used to read articles or books & get excited thinking that perhaps I had finally stumbled onto something that would help. But then, it was just back to the same old stuff.

As long as I don't make trouble for anyone, no one gives a rip about the turmoil that goes on beneath the grimace. I'll survive as long as I have the where-with-all to keep fighting solo, which for now I do. But if at some point I lose that, then it's curtains. From my perspective... it's as simple as that. I do hope others have a better experience. Maybe I'm just having a bad day...

[Altered Moment]

@The Skeezyks -
I recently participated in a debate on facebook about what was known and unknown and meds and all of it. The last post was from a psychiatrist who also suffers from mental illness. He said after it is all said and done the only relevant questions is -

"What works for you?"

[glok]

During my last visit with my psychiatrist at the VA, he was not aware of either the NIMH Research Domain Criteria (RDoC) or the Questionnaire (NAQ). I asked him to read about them before the next session. He did not think it was necessary since I have been taking the same medication for many years. So, I told him I would be asking for a different psychiatrist and left.

The same psychiatrist had previously told me he did not think I needed to be on any medication. Seems he and I are at loggerheads. A change is indicated. I just hope I am assigned one who is not so cock sure of his opinions.