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samboct -> RE: Generic Antidepressants (11/16/2010 11:42:47 AM)
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Lady C
I'm sorry- I must disagree with this statement: "Sam. a chemical imbalance can't be treated with talk therapy"
I know that there are a lot of people that think this way. Drug companies are getting richer with this idea and there are a lot of physicians and other scientists who would agree with you. So did the docs who treated my friend (who died some years back.) Nevertheless, based on newer research with fMRI mentioned earlier in this thread- it's an inaccurate statement.
One way to think about the brain is that its a computer that uses both chemical signals and electrical signals to function. Thus- it's really pretty different from the silicon based machines we're using to communicate. The theory espoused above- that certain types of brain maladies can be altered without changing the chemistry, i.e. by changing the electrical pathways only, is probably wrong. Too much of the brains interconnects are based on chemical signals- thus any change in brain function is going to result in altered chemistry. Also note that the brain's ability to perceive the environment and adapt to it, or maladapt is unique amongst our organs. No other organ, solely on the basis of perceived external stimuli, can react so strongly. You can look at a fire and think its hot long before your skin's temperature rises and begins to sweat. Enough external stimuli can damage the brain. One way to look at talk therapy is that if harmful external stimuli exists, then healing external stimuli must also exist. No other organ responds this way. Doubt this theory? Look at infants that have been raised by loving parents, and infants that have been dumped in orphanages.
Your post makes a reference to two types of depression. Let's call them situational and organic for lack of a better term. Situational depression is caused by circumstances that most people would find intolerable- such as being in a concentration camp, failed career, exiled, etc. While many people would become clinically depressed under these circumstances, not everyone would, but clearly, it's possible to cause a depression in many people- a depression that will potentially last the rest of their lives. Depression lasts a long time- if you're mourning the death of a loved one, you may be feeling down, but its not a depression in the clinical sense unless it lasts for years.
The second type of depression- organic depression, is a brain that refuses to be content although based on its situation- it should be. This is the type of depression that is most widely recognized in creative people such as musicians or actors that take their own lives. (I'm using suicide as a proxy for a strong depression.) We look at people such as Kurt Cobain or Marilyn Monroe who have had extraordinarily successful careers, people that love them, and good friends- yet are terminally unhappy. Clearly, these people are not situationally depressed- most of us envy their success. Yet clearly there is depression here. One viewpoint is that no matter what success these people had- they would still be depressed. But people who suffer from situational depression from being in a concentration camp aren't going to be depressed if they would have had a career, 2.2 kids in the 'burbs and a split level ranch in NJ instead.
So clearly- there are at least two disparate illnesses here that present in a similar fashion. Again, from my perspective, there are eery echoes of the findings in cancer- where we're up to over 60 different types of breast cancer. In terms of depression, it might be nice if we had better identification of the underlying cause of the illness, but if the treatment modalities remain so limited, it may not matter much.
The straightforward theory on depression would suggest that a situational depression will respond to talk therapy, and an organic depression will respond to medication. Unfortunately, I don't think it's that simple-individual human chemistry plays a role here as well. Again, based on fMRI studies, it looks like both drug and talk therapy treatment can alter brain chemistry. Thus it boils down to the problem that you don't know which type of treatment is going to work best for a particular individual or type of depression- and hence my original comment that talk therapy may be worthy of consideration.
Cheers,
Sam
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