Who Died Today?

[brvheart 1,755]

Can we all finally agree that Speedz needs to prescribe tons of depression medication for nearly every animal he treats?

[vbnautilus 48]

i don't think so. but i'm not really sure. his wikipedia doesnt say anyhting about scientology.

He may have been joking, but was referring to Beck the musician who is a scientologist. Aaron Beck the psychologist is like the grandfather of CBT. His depression measurement scale is still widely used.

[SuitedAces21 2,723]

fuck you mercury. don't joke about depression, shit isnt funny.

[digitalmonkey 929]

I think its hard to talk about cause and effect when it comes to mental events. Thoughts are ultimately electrochemical events. For instance, thinking about really sad things can decrease your serotonin levels... you look at a depressed person's brain and find decreased serotonin... did it cause the depression? Sure, people can vary in their brain chemistry to begin with and that can be a factor, but I think the public idea that depression is the result of a "chemical imbalance" is largely the result of deliberate propaganda by Pharma. The best way to cure depression is by changing your thought process and behavior -- cognitive behavioral therapy. I'm not saying people should never take drugs for depression, or that there are no genetic or uncontrollable biological factors that predispose you, but I think its a mistake to draw the conclusion that because there are neurochemical or neurostructural changes associated with depression that it is caused by something on that level and should be treated on that level.edit: one of my main problems with the disease view is that it tells people that they are "victims" of their depression, which implies that they have no responsibility in making it go away. I think this is a dangerous point of view, especially given that depression is characterized by feelings of loss of control. thinking of yourself as a victim can be part of the problem instead of part of the solution.

I agree with your first three paragraphs, for the most part.Do you consider cancer a disease?

[speedz99 145]

I think its hard to talk about cause and effect when it comes to mental events. Thoughts are ultimately electrochemical events.

I agree with all of this, but I feel like you're dismissing the predisposing biological factors too easily. Sure, one will not become depressed without the predicating sad thoughts, but it's completely unfair to speak about it as if it's always the fault of the depressed person for not just fighting through it. Having a low baseline serotonin level or a drastically reduced level after depressed thoughts compared to the normal person is a medical problem to me. Yeah, some "depression" is just typical sadness over a long period of time that can be treated behaviorally. But some depression is real, based on chemistry beyond the control of the patient, and in these cases medication is important. I know you know this, but I don't understand why you're basically dismissing it.

edit: one of my main problems with the disease view is that it tells people that they are "victims" of their depression, which implies that they have no responsibility in making it go away. I think this is a dangerous point of view, especially given that depression is characterized by feelings of loss of control. thinking of yourself as a victim can be part of the problem instead of part of the solution.

I'm assuming you have some experience with this in your education and professional life, yet you're giving an odd take on it based on my experience. While the above situation is possible, instead most patients are relieved to learn that their depression is based on chemical imbalances, not the fact that they're "broken" spiritually or emotionally or whatever. Any good doctor is prescribing therapy in addition to medication, which should keep your main problem from being a problem for most patients.

Can we all finally agree that Speedz needs to prescribe tons of depression medication for nearly every animal he treats?

We do treat some cats with antidepressants here and there for behavioral issues.

[Dread Aidan 8]

The key to CURING DEPRESSION is to have one or more PETS. It's important to take the necessary precautions that THEY DON'T DIE because that will only EXACERBATE THE PROBLEM. Fish make good pets, but they are difficult TO PET and therefore should more properly be labeled as FOR DECORATIVE PURPOSES ONLY.

[digitalmonkey 929]

I agree with all of this, but I feel like you're dismissing the predisposing biological factors too easily. Sure, one will not become depressed without the predicating sad thoughts, but it's completely unfair to speak about it as if it's always the fault of the depressed person for not just fighting through it. Having a low baseline serotonin level or a drastically reduced level after depressed thoughts compared to the normal person is a medical problem to me. Yeah, some "depression" is just typical sadness over a long period of time that can be treated behaviorally. But some depression is real, based on chemistry beyond the control of the patient, and in these cases medication is important. I know you know this, but I don't understand why you're basically dismissing it. I'm assuming you have some experience with this in your education and professional life, yet you're giving an odd take on it based on my experience. While the above situation is possible, instead most patients are relieved to learn that their depression is based on chemical imbalances, not the fact that they're "broken" spiritually or emotionally or whatever. Any good doctor is prescribing therapy in addition to medication, which should keep your main problem from being a problem for most patients. We do treat some cats with antidepressants here and there for behavioral issues.

I concur. Except for the sad pussy part. I'll accept your word as fact on that matter.

[speedz99 145]

The key to CURING DEPRESSION is to have one or more PETS. It's important to take the necessary precautions that THEY DON'T DIE because that will only EXACERBATE THE PROBLEM. Fish make good pets, but they are difficult TO PET and therefore should more properly be labeled as FOR DECORATIVE PURPOSES ONLY.

I googled this to see if you were quoting someone else. I'm not sure if google was the best route.

I concur. Except for the sad pussy part. I'll accept your word as fact on that matter.

It's not really for sad cats as much as for cats that are acting like jerks for unknown reasons. It's really not very common.

[qyayqi 11]

i had a sad. the doctor said, "get a pet." get a pet, he says. i got a cat. within a week that cat was on antidepressants. goddamn vets hand them out like candy, but my REAL DOCTOR has bought in to cognitive behavioural therapy and i'm stuck with a cat. a cat with a sad.

[Mercury69 3]

He may have been joking, but was referring to Beck the musician who is a scientologist. Aaron Beck the psychologist is like the grandfather of CBT. His depression measurement scale is still widely used.

Yes, I was, but I wasn't sure...Who knows what Beck (the musician) is capable of, now that he hs the support of Scientology?

fuck you mercury. don't joke about depression, shit isnt funny.

But my receptors and synapses are making me laugh at this?!?! I am a ball of confucianism....

[vbnautilus 48]

Do you consider cancer a disease?

I suppose so, yes. Am I walking into some kind of trap by saying that? I haven't thought about that one very much, but it's certainly different from depression.

I agree with all of this, but I feel like you're dismissing the predisposing biological factors too easily. Sure, one will not become depressed without the predicating sad thoughts, but it's completely unfair to speak about it as if it's always the fault of the depressed person for not just fighting through it.

To say that it is the "fault of the depressed person for not just fighting through it" is just putting a negative spin on my position. I am saying that the way out of depression is through changing one's pattern of thought and behavior.

Having a low baseline serotonin level or a drastically reduced level after depressed thoughts compared to the normal person is a medical problem to me.

It just isn't true that depression is caused by such a low level of 5HT that that level constitutes a medical condition on its own. There is variance in the rate of 5HT metabolism throughout the population, and that level can be a factor that affects the probability that your mental state gravitates towards depression. But I think it is almost never "the cause". Ok, sure there are some rare cases where this happens, but the popular view that its usually what is going on I think is just false. For women in the US, lifetime prevalence of depression is 25%. That means one in every four women will experience major depression at some point in their life. Are you telling me that 1 in 4 women have a serotonin system that constitutes a medical condition? I don't think so.

Yeah, some "depression" is just typical sadness over a long period of time that can be treated behaviorally.

No, I am not saying this either. Think of the mind like a dynamical system that is in constant flux. Are you familiar with the concept of an attractor? Its a stable state the system can settle into based on feedback loops that can be difficult to get out of. I think depression is like that. There are habits of thought that form feedback loops and become difficult to dig out of.

But some depression is real, based on chemistry beyond the control of the patient, and in these cases medication is important. I know you know this, but I don't understand why you're basically dismissing it.

It is not any less real due to its psychological nature. I am by no means dismissing it. It's a serious, life-threatening condition. But its one that has largely psychological causes and is best treated psychologically.

I'm assuming you have some experience with this in your education and professional life, yet you're giving an odd take on it based on my experience. While the above situation is possible, instead most patients are relieved to learn that their depression is based on chemical imbalances,

What you're describing is the medical view of depression. Medical science loves the idea that depression is a chemical issue to be treated with drugs. To a doctor, everything is a disease. Many psychiatrists make their living just prescribing these drugs. But psychiatrists typically have very little training in psychology. Of course patients are relieved to hear that. But that doesn't mean its the best thing to tell them for their treatment, or that its correct.

not the fact that they're "broken" spiritually or emotionally or whatever.

No one is saying that.

Any good doctor is prescribing therapy in addition to medication, which should keep your main problem from being a problem for most patients.

I think medication can be useful in many cases to get people out of the hole long enough to do the necessary therapeutic work. Unfortunately this is rarely what happens in psychiatry, although I agree there are some good doctors who make it happen.

[speedz99 145]

I think you strongly implied a lot of things you didn't necessarily mean to imply, at least not consciously. I'd reply to everything, but I'm tired.

[vbnautilus 48]

I think you strongly implied a lot of things you didn't necessarily mean to imply, at least not consciously. I'd reply to everything, but I'm tired.

I think you jumped to some conclusions about what my position was based on what I was arguing against. I was just about to edit to add the following piece: Part of what you seem to be reacting to was what I said about depressed people not being victims. I think I can explain better what I was getting at. Depression is related to the concept of learned helplessnes which actually comes from animal models, so you might be familiar with it. Once the animal learns that it is helpless to avoid what it doesn't like, it behaves helplessly even when its ability to change its situation comes back. Central to the depressive thought process is the feeling of lack of control and helplessness. My point is that part of getting out of depression is learning that you are not helpless and once again feeling in control of your life. This is not about telling people they are broken or that they are stupid because it is all their fault. Rather, its about empowering them to recognize that they have within themselves the capability to change their situation, how they think and feel. Telling them they have something wrong with their brains that they cannot fix but must take drugs to treat does not go in the right direction on this.

[rsmbox 1]

I think you jumped to some conclusions about what my position was based on what I was arguing against. I was just about to edit to add the following piece: Part of what you seem to be reacting to was what I said about depressed people not being victims. I think I can explain better what I was getting at. Depression is related to the concept of learned helplessnes which actually comes from animal models, so you might be familiar with it. Once the animal learns that it is helpless to avoid what it doesn't like, it behaves helplessly even when its ability to change its situation comes back. Central to the depressive thought process is the feeling of lack of control and helplessness. My point is that part of getting out of depression is learning that you are not helpless and once again feeling in control of your life. This is not about telling people they are broken or that they are stupid because it is all their fault. Rather, its about empowering them to recognize that they have within themselves the capability to change their situation, how they think and feel. Telling them they have something wrong with their brains that they cannot fix but must take drugs to treat does not go in the right direction on this.

I'm gonna have to strongly disagree with this. My life is pretty damn awesome for the most part, yet I struggle with depression on a semi-regular basis. I have absolutely no reason to be depressed, and I am fully aware of this, yet without medication, I have times where I absolutely cannot "pull myself out" of my depressive states. It has nothing to do with "learned helplessness," but rather a chemical imbalance that needs to be treated. I'm not saying that every case of depression is similar, and in many cases, yes it is in fact due to a "woe is me" attitude, but it is not wise to lump all depression into one category. Also I pretty much only skimmed most of the other posts so if that has all been said before or I'm taking things out of their original context, then just gop on ignoring me.

[SAM_Hard8 50]

Somebody famous needs to die to get this thread back on track!

[Pot Odds RAC 23]

...I am saying that the way out of depression is through changing one's pattern of thought and behavior....

No.I used to think that people who complained of Migraine Headaches were wimps. I mean, we're talking about a headache here. Take a couple of aspirin, suck it up and get on with it.Then I had my first Migraine. I didn't know that light could make you sick. A Migraine isn't just a really bad headache.Likewise, being clinically depressed isn't just feeling really sad. I also used to think that people who were depressed needed to stop feeling that way. Then I found myself in the pit. That really is the best description I can think of for depression. The Pit. You know you should be able to stop feeling and thinking how you are, you just simply cannot. It is like being in a Pit and knowing you should be able to climb out. But you just cannot. Clinical Depression often isn't even caused by a reaction to specific life events. Clinical Depression is simply not "learned helplessness". It isn't a logical thought process that you're going to think your way out of. It isn't about taking control of your life. I know this, and the depression I've felt has probably only been a 5 out of 10. Having experienced these things has given me an appreciation for other extreme human behavior. Just as you wouldn't tell a schizophrenic to just stop having silly thoughts and breaks with reality, You can't just tell an alcoholic to stop drinking. You can't tell a morbidly obese person to get off their fat ass and get in shape. A migraine is to a headache as schizophrenia is to silly thoughts as depression is to feeling sad.I'm not trying to minimize the sense of individual responsibility. There certainly is a component of taking charge of one's own life, thoughts and actions to each of these. There is just more to "it" than that. It doesn't mean that I don't get frustrated with the failures of an alcoholic or someone who is depressed. Even now, not having a Migraine nor in the Pit of Depression, I feel a certain amount of frustration when people complain of these conditions. I sometimes have to remind myself of what they might be experiencing.

[ajs510 122]

Somebody famous needs to die to get this thread back on track!

Seriously.

[speedz99 145]

I'm not saying that every case of depression is similar, and in many cases, yes it is in fact due to a "woe is me" attitude, but it is not wise to lump all depression into one category.

This is all I'm saying. VB, you're still spending pretty much all your time arguing one point, which while true for some people, is not nearly always the case. And even within your point, that people should be encouraged to pull themselves out of depression through the power of poitive thinking instead of being saddled by the anchor that is antidepressant medication, there's some unfortunate assumpetions made there. Sure, some people can become dependant on those drugs and assume that there's nothing they can and/or should be doing on their own to get well. But that's not at all the typical case. There are many good psychiatrists/psychologists out there that merely supplement behavioral therapy with medication, they don't just say, "Well, your only chance is to change your brain through drugs." I know you already said that, but I think you're underestimating how many good ones are out there. Maybe we're not disagreeing too much on the basics, just on how far the scale tips in either direction. I did like how you transitioned from calling it serotonin to 5HT though. Oh, and, real quick, the 1 in 4 women thing isn't the type of depression I'm talking about. I'm talking about people who have lifetime struggles with depression.

[vbnautilus 48]

I'm gonna have to strongly disagree with this. My life is pretty damn awesome for the most part, yet I struggle with depression on a semi-regular basis. I have absolutely no reason to be depressed, and I am fully aware of this, yet without medication, I have times where I absolutely cannot "pull myself out" of my depressive states. It has nothing to do with "learned helplessness," but rather a chemical imbalance that needs to be treated. I'm not saying that every case of depression is similar, and in many cases, yes it is in fact due to a "woe is me" attitude, but it is not wise to lump all depression into one category. Also I pretty much only skimmed most of the other posts so if that has all been said before or I'm taking things out of their original context, then just gop on ignoring me.

Have you tried cognitive behavioral therapy? I am not saying that one should just "will themselves" out of the situation. It takes very specific practices. I don't think someone can do it on their own if they don't know how.

Likewise, being clinically depressed isn't just feeling really sad.

Nobody said that it was. It is interesting that my view of depression as psychological is being taken as minimizing. The condition would not be any more serious if it were better explained at a neurochemical level than a psychological level.

Having experienced these things has given me an appreciation for other extreme human behavior. Just as you wouldn't tell a schizophrenic to just stop having silly thoughts and breaks with reality, You can't just tell an alcoholic to stop drinking. You can't tell a morbidly obese person to get off their fat ass and get in shape.

Schizophrenia is not treatable with cognitive behavioral therapy. Depression is. I'm not making this up. It's not my opinion. We're talking about empirical research. Success rate of CBT for depression is around 75%. That is better than antidepressants which have a success rate of 30-50% on their own. You've really made my point for me by bringing up schizophrenia. It is a great contrast. There is very little you can do to alleviate schizophrenia without drugs. It really does appear to be an organic brain disease with a very large genetic component and structural changes to the brain that are visible to the naked eye. This is simply not true of depression. It's an entirely different beast.

A migraine is to a headache as schizophrenia is to silly thoughts as depression is to feeling sad.

This has nothing to do with the cause or solution to these conditions. Because schizophrenia is caused by improper development of the brain does not mean that depression is.

This is all I'm saying. VB, you're still spending pretty much all your time arguing one point, which while true for some people, is not nearly always the case.

I think it's generally the case. The thing you are describing is the exception to the rule, and strangely, as demonstrated in this thread, it is the view that has been sold to the public as the typical scenario.

And even within your point, that people should be encouraged to pull themselves out of depression through the power of poitive thinking instead of being saddled by the anchor that is antidepressant medication, there's some unfortunate assumpetions made there. Sure, some people can become dependant on those drugs and assume that there's nothing they can and/or should be doing on their own to get well. But that's not at all the typical case. There are many good psychiatrists/psychologists out there that merely supplement behavioral therapy with medication, they don't just say, "Well, your only chance is to change your brain through drugs." I know you already said that, but I think you're underestimating how many good ones are out there. Maybe we're not disagreeing too much on the basics, just on how far the scale tips in either direction. I did like how you transitioned from calling it serotonin to 5HT though.

5HT was fewer letters. In my experience most people don't even know the difference between a psychiatrist and a psychologist. Do you know many psychiatrists? They are walking prescription pads.

Oh, and, real quick, the 1 in 4 women thing isn't the type of depression I'm talking about. I'm talking about people who have lifetime struggles with depression.

Those 1 in 4 are women who meet the diagnostic criteria for Major Depressive Disorder.

[SuitedAces21 2,723]

this may be a little off-topic, but fuck it:vb what are your thoughts on alcoholism? i would assume you view it similarly to depression. it's always bothered me when people called alcoholism a disease and asked for sympathy because they cannot control it. i'd love to hear your thoughts.

[vbnautilus 48]

this may be a little off-topic, but fuck it:vb what are your thoughts on alcoholism? i would assume you view it similarly to depression. it's always bothered me when people called alcoholism a disease and asked for sympathy because they cannot control it. i'd love to hear your thoughts.

I agree its surely not a "disease". But I don't agree that people don't deserve sympathy because they can't control it. Alcohol and other drugs act directly on the brain systems that control wanting, and that makes it very difficult situation to get out of. What's interesting in light of this discussion is that even people that do consider alcoholism a disease seem to be ok with the solution to it being behavioral (e.g. 12-step programs).

[speedz99 145]

Those 1 in 4 are women who meet the diagnostic criteria for Major Depressive Disorder.

I realize that, but again, that doesn't mean they're all women who have lifetime struggles with depression. There are certainly many people who meet those diagnostic criteria at some point in their lives and should be treated behaviorally. That's not the kind of clinical depression I've been referring to...I suppose it's my fault for thinking we were talking about severe, crippling, long-term depression, as opposed to "my life isn't going how I wanted it to go and now my sadness is spiralling down" depression.

In my experience most people don't even know the difference between a psychiatrist and a psychologist. Do you know many psychiatrists? They are walking prescription pads.

Yeah, and surgeons tell their patients that they need surgery. Not because they're all just jerks who want to cut people up (although some are), but because most of them truly believe surgery is the best option. And they make sure to prescribe physical therapy because they know that cutting alone won't be a definitive long term cure.

vb what are your thoughts on alcoholism? i would assume you view it similarly to depression. it's always bothered me when people called alcoholism a disease and asked for sympathy because they cannot control it. i'd love to hear your thoughts.

Just like there are depressed people and "depressed" people, there are alcoholics and "alcoholics". I think that for some people, maybe not many, but some, it really is a disease. I honestly believe that their brains react differently to alcohol and the subsequent cravings, and I consider an abnormal, harmful reaction to be a disease process.

What's interesting in light of this discussion is that even people that do consider alcoholism a disease seem to be ok with the solution to it being behavioral (e.g. 12-step programs).

That's probably because there's no long-term "make me stop craving alcohol" medication out there.

[SuitedAces21 2,723]

I agree its surely not a "disease". But I don't agree that people don't deserve sympathy because they can't control it. Alcohol and other drugs act directly on the brain systems that control wanting, and that makes it very difficult situation to get out of.

i'm generally less sympathetic than the average person. but the only alcoholics i've ever seen are friends father's who have everything going for them - family, job, money, whatever -- and they throw it away for booze and then beg for forgiveness becuase they cant control it. i find it pathetic. it just generally bothers me when people compare things that they can control to actual disease. alcoholism is nothing like schizophrenia.

[speedz99 145]

it just generally bothers me when people compare things that they can control to actual disease. alcoholism is nothing like schizophrenia.

I feel more sympathetic towards someone with a brain tumor than towards a lifetime smoker with lung cancer, but that doesn't mean they aren't both diseases.

[vbnautilus 48]

Yeah, and surgeons tell their patients that they need surgery. Not because they're all just jerks who want to cut people up (although some are), but because most of them truly believe surgery is the best option.

This is why you don't go to a surgeon when you have a problem that can be addressed by changing your diet. Let's take gastric bypass surgery as an example. Maybe in extreme cases of obesity this is a good idea (I'm not convinced that it is, but I don't know enough about this to take a firm stance). Imagine if because this works to treat obesity --and it does work, but only temporarily-- that it was concluded that the cause of obesity is a stomach that is too large. The condition of obesity was then described to the public, who happily agree with the medical professionals that obesity is essentially a "gastrointestinal imbalance". Even if there are some people who are obese due to genetic factors or medical conditions they cannot control, for whom this surgery is the only option, this message is totally inaccurate and counterproductive. That is what I am saying about the "chemical imbalance" view of depression.I say, obesity is not a problem with the stomach, and everyone gets upset and insists "no, I'm talking about really, really, morbidly obese people". Fine, the fact that you can treat these people with gastric bypass or that its the right thing to do does not change the underlying issue of obesity.