Cure Depression Without Medication. My Thoughts (about the treatment of depression) (LONG) ?
Q.You bring up a lot of issues that are definitely...shall I say, controversial. For me, talk therapy has been a key treatment to my recovery and I was lucky enough to find a good therapist who charged on a sliding scale. At present, I take a low dose AD pm to help with my migraines and dysthymic serotonin levels. I think that getting proper sleep has allowed me to assimilate info learned in therapy.
A.The drug companies realize that to make such a claim, they would have to be able to first define the disorder exactly and completely enough to allow researchers to be able to say with reasonable certainty that a given drug at a given dosage did in fact eradicate every last trace of the disorder's biological substrate. But depression is a very complex biopsychosocial disease entity, one that changes it shape from patient to patient and sometimes within the same patient over time. Since mapping out the precise nature of depression in objective, verifiable terms is something that continues to elude science, it is hard to state the conditions under which a definitive cure could be demonstrated. This is one of the things that makes psychiatric research so frustrating and so challenging. This is an interesting thesis, but again, unless the disease can be defined empirically in a manner that permits experimental manipulation, it is not possible to state for certainty just what antidepressants do or don't do to the symptom complex we call depression (and the state of outcome research is such that this sort of study won't be conducted for sometime to come). Early in my training, I was quite skeptical of the benefits of drug treatment for depression, thinking that the drugs merely ameliorated symptoms but did nothing about the underlying disorder. But after seeing many patients successfully recover and regain normal lives after being treated with antidepressants, I had to temper my disbelief and acknowledge the possibility that, in at least some cases, antidepressants did in fact seem to actually arrest the disease process. This was especially the case in patients who continued to improve even after drug treatment was discontinued. Although I became convinced of the utility of drug treatment as something more than a palliative intervention, there were some things that continued to fuel my skepticism, things like the fact that *some* cases of major depression remit spontaneously, without any form of treatment at all, or the fact that some patients I knew were absolutely convinced that their therapist had cured them (of course spontaneous remission could well have occurred during therapy, but there was no way to test this in these particular cases). After years of helping people confront this wretched disorder, I gradually began to view depression as essentially a molecular neurochemical phenomenon that could a) respond or not respond to various forms and combinations of medication; b) respond or not respond to the passage of time; and c) could respond or not respond to various forms and combinations of psychotherapy, with or without medication. The only constant factor was the disorder's variable forms of presentation and the need to attack it using every weapon in the clinician's therapeutic armamentarium, with different configurations of treatment being appropriate for different individuals at different times and under different circumstances. The clinician's most crucial and most difficult task, then, was to determine just what sort of depression he or she was dealing with. The answer to that question provided the answer to the question of how to proceed therapeutically. I, too, believe depression is curable. Sometimes the cure is medication, sometimes it is therapy, sometimes it is both, and sometimes it is neither. It always seemed to me that in the U.S. the quick, fast relief was sought in the treatment of patients, using meds a lot of the time. Medication is used as well over here, but in the cases where it is needed only (in the opinion of the treating doctor/ therapist/ psychologist). I think people just aren´t as willing to treat patients with medication as they are in the U.S. . Also, getting a certain drug to be approved for use is much more difficult over here, I think, than over there. As far as therapy is concerned, it doesn´t have the kind of status over here that it does over there. If I told someone I´ve known for some time I´m doing therapy because I have a depression, they might think I´m in the looney bin, or just plain crazy, or have to put on a straight jacket before I go to sleep. In the U.S. ,even big old Arnold Schwarzenegger can say on a talk show (jokingly) that it would take 5 hrs of "shrink work" - as he put it - to get them well again if they see him with masks on in certain films he´s done. So it is socially more acceptable , and therefore the need for therapists is also greater.
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