A river of lost souls runs through western Colorado
washingtonpost.com
washingtonpost.com
Dang.
If it's true as claimed that medications only help half the time, this seems like a strong encouragement to try things like exercise, yoga, and lifestyle changes before going the medication route.
Unless you're so depressed you honestly can't make those changes... as commenters have mentioned, sometimes medications are absolutely helpful, needed, and life-saving. I've heard of cases where being on a medication just for a short time helped people break out of a rut.
If you're getting a prescription, it seems worthwhile to ask docs for options that are less problematic to get off of.
You're looking at exercise, social activity, and other lifestyle changes as a means of combating depressive symptoms. That's absolutely true, and there's a wealth of peer-reviewed evidence to support that. Almost anyone with a depressive disorder would benefit. For that matter, almost anyone would benefit. And the social aspect, with friends and family pushing and supporting you as you set out on those efforts, can absolutely play a profound role in mitigating those symptoms (assuming those around you notice; it's quite common for people even with severe depressive disorders to be able to mask their feelings from even those closest to them). But for the worst cases, and even many that aren't as severe, those first steps are the difficult on a level that those who don't suffer from depression can't really conceptualize.
Imagine a mental pain so severe that it cuts through to your very soul; an existential despair so pervasive that simply envisioning a life without it is nearly impossible. I remember a professor of mine discussing a former patient of his: the patient described her depression as an overwhelming hopelessness so great that even suicide was too much of an effort despite wanting to do just that. Obviously, she managed to get help at some point but I remember feeling goosebumps along my spine as those words were repeated to us. It was a chilling description of an inner hell that nobody realized this woman was living in.
At some point in their lives, almost every single human being will feel a sense of hopelessness, despair, sadness, etc. Even the shitty emotions are part of the human condition. It's when they start to interfere with your ability to function in everyday life, and/or they persist for a longer period of time, that you start to look at a problem beyond the norm. Depression isn't about simply hitting rock bottom; it's more about not being able to see anything but. But even that's a bit of a generalization.
It'd be easier to take the advice if it was pushed as "it helps some people a lot. It might help you, if only a bit".
That said, I still absolutely agree with you. Lifestyle changes can have a profound impact on depression, and perhaps more importantly, can help support other behavioral changes long-term. They might not make the problems go away, but they'll absolutely help people get through the worst aspects, even if other treatments (medication, therapy, CBT, etc.) are needed alongside them.
Of course, the public doesn't necessarily see things that way. There's a common belief that the right medication will 'cure' the problem for you or, barring that, make it go away. After all, that's how other medications work! Blood pressure problems? Take a pill. Bacterial infection? Antibiotics, and poof, it's gone! That's a huge problem for psychiatry, and it's one that's probably not going to go away anytime soon. Your GP might be willing to prescribe an antidepressant, an ethical psychiatrist is almost always going to be the better choice precisely because treatment isn't about just receiving a script and heading to the pharmacy.
Of course, I've also heard psychiatrists call me irresponsible for going off medication that was actively holding me back from the energy and motivation I need to work well (and feel good about my life).
There is certainly a diversity of opinion amongst practicing psychiatrists even what the role of the medication is.
The SSRI detox is no joke, but it was a relief compared to sleeping much more than necessary.
Medications help pharmaceutical companies make money all the time.
There is a huge incentive for this path and it's hard to come-by adequate science, since a large percentage of funding for long-term and expensive studies comes from the very same pharmaceutical companies.
I am posting this here in hopes of making it available to people reading comments here who wish they had alternatives to medication, but just do not know how to make that work. It isn't guaranteed to work, but it's a place to start getting more informed.
Yes, a tired meme, but what is asserted without evidence can be dismissed without evidence...and at a rung above no evidence, can be eviscerated with a link from a first pass at a google search.
[0] http://www.mayoclinic.org/diseases-conditions/depression/exp...
Sure, you don't feel it so strongly while you're high. That's one of the nicer things about that particular drug, paranoia aside. But that only works while you're high, subject to the same habituation process as anything else - and it's not the same as actually doing something to help yourself.
I don't doubt there are people with depression for whom marijuana has been a substantial help. That's great! I'm glad for them, and that legalization is making it easier for people whom marijuana helps to maintain access to it. I also think it's reasonable to approach marijuana with the same caution as any other potentially beneficial drug. Arguing that, because there's no uncontested evidence that marijuana causes depression, there's no harm it can possibly do a person with depression - does not seem all that cautious to me.
This is the saddest thing. My wife remarked that there was a weird sense of expectancy that if you were a white female of middle age you were expected by your peers to be taking anti-depressants.
Coincidently, my mother has three sisters, and all of them are in this age range. Two are on antidepressants. Two of them drink a bottle or two of wine a day. There is some overlap there.
Mother's little helper...
Durango's water supply is the Animas, which is downriver from Silverton, and many old, abandoned mines and basically SuperFund sites (even though there's pressure to not call them that - or get that Federal $$$ to fix the problem, for fear of tourist dollars leaving). Are there known correlations between the types of acidic chemicals and heavy metals found in this type of polluted water and mental health?
I ask because Durango is a beautiful, sunny place. It's hard not to be there in the summertime and not feel wonderful. Yes, in the winter, it's a little more clausterphobic, and you ARE in the middle of nowhere, but it doesn't have the depressive anxiety feeling of a place like Leadville used to have, when their main Moly mine closed down.
http://www.cnn.com/2015/08/12/opinions/pagel-animas-river-po...
I wish they'd released this.
EDIT: I just emailed the article author asking if they'd release the data in a Github repo [1]. Default to action.
There is a maxim worth adopting.
- http://www.cdc.gov/nchs/data/hestat/suicide/rates_1999_2014....
If they (WaPo) had included CDC instead of the "Federal Health", it might have been easier for you to find?
If you are generally interested in the topic, there are many other "factoids" and scattered data sets. Here are a couple:
- https://www.statista.com/topics/791/suicide/
- https://ourworldindata.org/suicide/"Although more men than women take their own lives, the rate of suicide has nearly doubled among middle-aged white women since 1999..."
And the whole article is about women who take suicide. The writer is a woman but this is typical for big publishers like Washington Press. They very seldom write about mens problems and challenges.
Newspapers often report the fact that rates of death by suicide are rising. (It's a bit more complicated than how they report it - there was a decline in rates for many years). Most of the rise is in women. In the UK rates of death for men have dropped a bit, but rates for women have risen a bit, causing the overall number to rise.
Washington Post has written before about the disproportionate number of male deaths by suicide, so they're not ignoring it.
A couple of examples:
https://www.washingtonpost.com/national/health-science/the-h...
https://www.washingtonpost.com/news/inspired-life/wp/2016/08...
If you want an anti-feminist article that mentions in passing male suicide: https://www.washingtonpost.com/posteverything/wp/2016/06/30/...
High altitutes can increase suicide and depression in certain people. While in others, they get a sense of feeling "at home".
https://mic.com/articles/104096/there-s-a-suicide-epidemic-i...
One group at increased risk of death by suicide are LGBT people (at all ages). Religious groups tend to do badly by these people, and anecdotally there's a few news article about deaths by suicide of LGBT teens who were part of LDS church.
http://www.deseretnews.com/article/865646414/LDS-Church-lead...
I hope you don't mind if I add, to to try to somewhat dissuade others' anger: Some people respond harshly when one who is not atheist simply says what one knows personally from experience. It's usually good to hear a variety of viewpoints. I just know what I see, etc and how it all relates. So I just try to keep going forward with purpose and direction, because I know where it leads, and the things I can't control will be OK eventually.
But women attempt suicide more often than men. And women have started using more lethal means than they used to. And the combination - more suicide attempts, more lethal methods, is worrying.
But my compassion is gone after the election.
If women switch to more lethal methods - which is what this article says is happening - they'll soon overtake men in numbers of deaths, especially in this age group.
The burden of proof is with you, not with savanaly.
If there is such a medication, it should be trivial for savanaly to point it out.
SSRIs only /treat/ (not cure) a deficiency of serotonin, which for some people is all they need. I think some people have a strong genetic predisposition to depression, however that doesn't mean "therefore medication."
But depression comes in a lot more forms than just a simple serotonin deficiency, it's also thought that dopamine and norepinephrine play important roles. Personally, antidepressants never helped me, though a combination of physical exercise (https://en.wikipedia.org/wiki/Neurobiological_effects_of_phy... - seriously read that, I used to think exercise was just about living longer and being "healthy" in some abstract sense, which were the opposite of what I wanted at the time) and meditation has helped. It hasn't made me happier but I think it's effectively treated my depression.
When someone doesn't have the ability to "lift" themselves out of their depression, there isn't suddenly a binary "either they need an SSRI/SNRI or RIP tough luck". Some people have hypothyroidism (this was my case) and no amount of psychoactive drugs is going to help with that because the neurotransmitters aren't even being manufactured in the first place and even if they were you'd barely have the energy to utilize them. Other people just don't respond to SSRIs but would still respond to the massive boost of not just serotonin but dopamine and norepinephrine caused by daily (especially aerobic or HIIT) exercise (it also rewires the reward centers and dozens of other things, read that article). Some people might have bottled up emotions or physical influences increasing their cortisol - high cortisol can make you feel depressed too. Meditating lowers that and brings out your emotions so you can cry if needed (which FURTHER decreases cortisol). That was kind of the last component for me.
Some depressed people need someone to not just give up after trying an SSRI but actively get them doing the lifestyle changes, whether that's self-applied in CBT as in Feeling Good, exercise, meditation, getting out more, whatever. Like they seriously need to be guided to do it in real time, they can't just be expected to even remember to do it. Also blood work and hormone tests are simple to do - it might just be a lack of micronutrients or hyper/hypothyroidism (especially in this age group of middle aged women. personally I'm 20f)
I didn't say medications doesn't help some people. I didn't say medications don't help ever.
I did say that medications can't cure depression.
It's kind of like rebooting a computer, it does not always work and sometimes it makes things worse. But, comparing the cost vs benefit it's generally worth trying.
Doctors don't have a cure for depression at the moment, it's true. They also don't have cures for HIV/AIDS, or diabetes, or asthma, or lots of other chronic medical conditions (see https://www.cms.gov/Research-Statistics-Data-and-Systems/Sta... for a list of the most common ones).
But they do have medications that can make it possible for people with those conditions to lead long, productive, more or less normal lives. Are you suggesting the people with these conditions should be turning those medications down? That they should refuse any treatment short of 100% removal of the underlying condition, even if by doing so they reduce the length and quality of their own life?
Why, exactly? Why on earth make the perfect the enemy of the good like that?
I did not suggest that people should turn down medication, or refuse treatment.
I didn't say anything other than that medication doesn't cure depression - which I stand behind.
Let me turn the tables on your indignance for a moment - why don't you care about the causes of depression? If the incidence is on the rise, the causes must be getting stronger. How can you condone simply restoring people to productivity with drugs when there is an increasingly serious problem harming them in the first place?
Further, it's not clear that the actual incidence is on the rise or if this is reversion to the mean etc. We have shifted what people call Depression and how willing people are to seek treatment. The age adjusted suicide rate was actually higher from 1950 - 1980 than it is today.
In 1950 the rates of suicide for 75–84 years old people was 31.1 in 2010 it was 15.7. If you look at the actual rate by age it's all over the map. http://www.infoplease.com/ipa/A0779940.html
It sounds like for some reason you are now just trying to say that depression isn't really on the increase in certain places.
Why would you say that?
Depression is closer to a symptom than an illness.
How would you suggest I go about curing my hope problem? I have too much of it. It's a double-edged sword in that it keeps me down, but it is also the only thing that stops me from 'pulling the trigger'.
Like many other things too much depression for too long becomes clinical depression. Then it is no longer serving its proper function and becomes a pathology. People with clinical depression can't "hope" their way out of it anymore than someone with eczema or cancer can "wish" those conditions away.
Imagine we used the term "stomach bug" for both food poisoning and stomach cancer. Now imagine you have stomach cancer and everyone keeps telling you to drink plenty of fluids, rest, and it will go away. That's basically what your post is saying.