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shugah Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Apr-20-06 10:46 PM
Original message
psych treatment for depression
is there 'talk therapy' for depression anymore, or is it just prescribe a drug treatment?

if there is therapy, what is the methodology? i had some psych courses years ago, but i don't think anyone was paying attention to the real and often debilitating illness of depression. it gets quite a bit of press now, but mostly in the context of the drugs available to treat it.

are the drugs enough?

there was an article recently about a 'depression gene' (http://www.news.com.au/story/print/0,10119,18273308,00.html) but that doesn't answer questions about treatment.

what is the current method of treatment for depression?
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Droopy Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Apr-20-06 10:53 PM
Response to Original message
1. I think it depends on how severe the depression is
If you are bummed because your kid isn't an 'A' student then maybe you need to chat with a therapist.

If you feel like slitting your wrists every morning when you wake up then drug therapy in addition to talk therapy is the way to go.

My psychiatrist recommended talk therapy in addition to drug therapy when he originally prescribed me the meds that I need. But talk therapy alone usually isn't enough when you are dealing with a severe mental illness.
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shugah Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Apr-20-06 11:02 PM
Response to Reply #1
4. do you do talk therapy with your psychiatrist
or a psychologist or other mental health care professional?

i am curious about methodolgy because research (internet and other less convenient methods of research) do not seem to yield any kind of regular treatment method. i know that every inidvidual suffering from a mental illness has unique qualities, but depression is fairly readily diagnosed these days - and it seems that drugs are quickly prescribed, but i can't find much on the therapy methods that can/should accompany the meds.
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Droopy Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Apr-20-06 11:11 PM
Response to Reply #4
6. I have a mental illness other than depression
But depression is a part of my illness. I see a talk therapist sporadically when my schedule permits it. The talk therapist has a Ph.D. in psychology and is someone other than my psychiatrist. I would like for my psychiatrist to be my therapist, but he charges about double what my therapist does for that service.
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shugah Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Apr-20-06 11:34 PM
Response to Reply #6
10. sorry
i did not mean to be nosy - i started this as a general thread about depression and treatment. i have a sincere interest. i have some very close people being treated for depression on varying levels. the only treatment they have in common is drugs. talk therapy seems secondary at best - and one person who asked a therapist about treatment method got a kind of "that's for me to know" response.

so i am wondering about the diagnosis and treatment of depression. it seems like there are plenty of drugs to 'treat' it, but is there a cure?
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AlienGirl Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Apr-20-06 11:26 PM
Response to Reply #4
9. My psychiatrist is my med-dispenser
He has given me referrals for talk therapy, counselors he has worked with before. I haven't ever known a psychiatrist to do talk therapy, actually; in my experience they've always prescribed the druga and referred me to a counselor.

Tucker
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shugah Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Apr-20-06 11:37 PM
Response to Reply #9
11. 'med-dispenser'
that's polite AlienGirl! we call him the 'drug dealer." ;-)
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AlienGirl Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Apr-21-06 12:00 AM
Response to Reply #11
15. Incredibly, his name is Dr. Jones. James Jones. "Jim" to his friends.
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shugah Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Apr-21-06 12:02 AM
Response to Reply #15
17. AAAAAHHHHHH!
;-)
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AlienGirl Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Apr-21-06 12:07 AM
Response to Reply #17
18. Luckily, he's okay with people joking about it
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Vidar Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Apr-20-06 10:54 PM
Response to Original message
2. Look up the counseling model vs the medical model of
Edited on Thu Apr-20-06 10:54 PM by Vidar
psychiatry. Behaviorism, gestalt, & 12 step recovery programs are my favorite methodologies.
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shugah Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Apr-20-06 11:14 PM
Response to Reply #2
7. are they treatment methods for depression tho?
i don't think any of the 3 methods you name are peculiar to treatment of depression?
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bettyellen Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Apr-20-06 11:01 PM
Response to Original message
3. it's more result oriented than it iin woody allen movies. my friend is a
Edited on Thu Apr-20-06 11:05 PM by bettyellen
shrink and there are more goal/ results oriented methods out there these days. planned for a shorter term, often combined with meds.
i forget names, sorry... there's also some wacky (because it involves your eye movements) stuff for trauma where you they help you sort of reprocess the events, and apparently move them to a better part of your brain where you'll deal better with them. she wants to do a seminar on that, she's worked with a lot of survivors over the years. lot of abused women and kids, and a lot of 9/11 survivors. she is a very smart woman, really kickass cool, too. and i've seen her get good results with people, so i can say it's not necesarily a crock.

edit to add: for depression, i have seen prozac and wellbutrin work well (and quickly) for many people.
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BikeWriter Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Apr-20-06 11:09 PM
Response to Original message
5. The V.A. seems to think highly of group therapy...
I go once a week.
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shugah Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Apr-20-06 11:48 PM
Response to Reply #5
14. does it help?
do you also have 'scrips?
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BikeWriter Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Apr-21-06 12:20 AM
Response to Reply #14
20. They've tried various drugs on me. I'm still...
a pain in the ass and they seem to make me tenser. I don't know if the therapy helps, but I am still breathing. :shrug:
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AlienGirl Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Apr-20-06 11:24 PM
Response to Original message
8. Cognitive-behavioral therapy is pretty cool
Basically, it teaches the user how to identify and interrupt destructive thought-patterns. It's often used along with drug therapy: the medicine helps deal with the "low mood for no good reason" parts, and the therapy helps deal with things like catastrophizing and stuff like that.

Tucker
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shugah Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Apr-20-06 11:44 PM
Response to Reply #8
12. that sounds constructive
what is the method? many depressed people can already identify the destructive thoughts. does this method offer an alternative thought process?
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AlienGirl Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Apr-21-06 12:01 AM
Response to Reply #12
16. Yes, it does
I shouldn't go into details about the methods, for fear of running afoul of the rules concerning medical advice, but there is a lot of information available about it online.

Tucker
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Wapsie B Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Apr-21-06 12:21 AM
Response to Reply #12
21. Learned Optimism is one of many books that goes into this method
of changing one's perception of the world by changing their thoughts.

http://www.amazon.com/gp/product/0671019112/103-4599072-9385417?v=glance&n=283155


Viktor E. Frankl has authored a number of books on this subject as well.

http://www.amazon.com/gp/product/0738203548/ref=pd_bxgy_text_b/103-4599072-9385417?%5Fencoding=UTF8
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AlienGirl Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Apr-21-06 12:34 AM
Response to Reply #21
26. I didn't like Learned Optimism: too many sad stories about doggies
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Wapsie B Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Apr-21-06 12:58 AM
Response to Reply #26
30. Yeah and he took 3/4 of the book on fluff
and not really get to the "how to's" until the back chapters.
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blitzen Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Apr-20-06 11:46 PM
Response to Original message
13. Freud, father of the "talking cure," is no longer taught in Psychology
Edited on Thu Apr-20-06 11:47 PM by blitzen
departments in the US. American psychology/psychiatry is almost totally ignorant concerning psychoanalysis
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realisticphish Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Apr-21-06 12:25 AM
Response to Reply #13
22. yes, thank god
since Freud's theories were essentially pure, uncut bullshit
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blitzen Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Apr-21-06 12:26 AM
Response to Reply #22
23. i pretty much expected at least one reply like that
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realisticphish Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Apr-21-06 12:29 AM
Response to Reply #23
24. well
you should. Considering it's all arbitrary nonsense, with essentially zero research behind it.
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blitzen Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Apr-21-06 12:40 AM
Response to Reply #24
27. i have no desire to start a flame war...but tell me one book you've read
by Freud and then tell me what objections you have to it....


if you haven't read any, then try "Psychopathology of Everyday Life." I'd bet that you would enjoy it--it's a fun read.


I don't mean to insist that Freud and psychoanalysis is a cure or the best cure for depression...But the original poster had asked about "talking"--and psychoanalysis is in part bassed on the notion that neurosis is not neurological but rather a matter of language--hence, the "talking cure."
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realisticphish Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Apr-21-06 12:47 AM
Response to Reply #27
28. i don't wish
to start a flame war either, but what does reading books by freud have to do with it?

Show me empirical research done on the efficacy of Freud's concepts, and I'll think about it.
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blitzen Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Apr-21-06 12:49 AM
Response to Reply #28
29. i like your fish
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liberaltrucker Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Apr-21-06 12:16 AM
Response to Original message
19. Drugs are the preferred treatment these days
I've been taking Effexor XR for 4 years.
Symptoms(sp)...gone.

I went through tricyclics(Sinequan) and group
therapy in the 70's.....was total bullshit,
at least for me.

Modern drugs, in my(layperson's) opinion, are
the way to go.
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BlueIris Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Apr-21-06 12:31 AM
Response to Original message
25. All I can post is: depression sufferers, get help now.
Few things are worse than suffering with this illness. With the right provider(s) and treatments strategies for you, it can be a very treatable condition. If you think you may have it, seek help ASAP.
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havocmom Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Apr-21-06 01:05 AM
Response to Original message
31. I got both. The pills, once we got the right ones for me, helped
but the cognitive therapy really showed me how to change my thinking and then my life. Without getting the chemicals working in my brain again, that probably wouldn't have happened. So, look for a good dose of both if you need meds - the talking is what you learn from and learning is a big plus! It puts you in charge of handling the depression instead of being a victim all the time.

Understanding one's thinking processes better so one can make choices about how to respond to life's challenges is really good. Pills can help restore the ability to see beyond the very dark place some of us get stuck in, but cognitive work gives one some real power and restores free will.

And understanding how nutrition affects depression is also VERY good. The food we eat/supplements we take have a bearing on how our brains function. Many people with depression are helped greatly with adjustments in diet/supplements. Helps a lot of us cope and not swing too far off when stressed. I, like many people with depression, need lots of B's & folic acid. Foods that are rich in those are good for my body/mind. Helps me get sleep and deal with daily stresses better.

Depression is not just solved by a pill. It has many facets and if people really want to get better, all facets addressed in time is very liberating. Relying just on pills to feel better is just another prison.

Each of us is a whole person. It is wise to be treated as such. People with depression are not just walking chemical imbalances. People deserve to feel whole. It takes work, courage, knowledge and understanding. The right doctor can be a great partner in the process.

I was blessed.
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MsKandice01 Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Apr-21-06 01:09 AM
Response to Original message
32. I have Dysthymia
Which is characterized as a constant, mild, long-term depression. There are no distinct highs and lows, it's just always there. I've had it for what I estimate to be at least 13 years or so (and I'm only 30). My doctor has prescribed Celexa but I have yet to take it.
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Jazz2006 Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Apr-21-06 02:08 AM
Response to Original message
33. My two cents worth....
Edited on Fri Apr-21-06 02:17 AM by Jazz2006
Clinical depression is a very real and physical medical problem (i.e. a chemical imbalance in the brain) and is, in that sense, no different than any other real and physical medical problem for which various medications prove useful. Taking medication for clinical depression is no different than taking aspirin or tylenol or ibuprofen for headaches, taking allergy medications for allergies, taking antibiotics for infections, etc.

Unfortunately, there has long been a stigma attached to clinical depression because it has long been erroneously viewed as a "mental disorder" or a "psychological problem" instead of the actual physical and medical problem that it is.

The word "depression" has ambiguous meanings so for a long time, many people did not (and many people still do not) realize that clinical depression is not simply "feeling down" or "having the blues" so they equate "depression" with simply needing a good talking to while they ignore that actual depression (i.e. clinical depression) has a physical genesis.

My best friend since age 12 - one of the most intelligent, most grounded, most astonishly incredible people I've ever known - suffers from clinical depression, which she was afflicted with about 9 years ago. But when it happened to her, she was so utterly baffled and so utterly entrenched in the myths that have been propogated for so long, that she almost killed herself instead of seeking treatment.

I won't go into great detail here and now about how she later described it to me, going from one day feeling perfectly fine and the next day feeling like she was on the brink of a huge, black, gaping abyss and being utterly unable to find the will to get out of bed, - this from a no-nonsense, hard charging, bright, amazing, articulate, successful, outgoing and energetic woman with a vast network of friends, colleagues, and family - but it was so horrific that it still hurts me when I think about what she went through.

Fortunately, this story has a happy ending.

Instead of leaping into the abyss, she sought medical attention after several days of being completely unable to get out of bed, go to work, answer the telephone, interact with her family, carry on a conversation, etc. Dragging herself to her doctor's office was a monumental accomplishment in the circumstances and it took pretty much every ounce of self-preservation instinct that she had left in her - where she found out that she was not crazy, she was not psychotic, she was not unusual, and she had no reason to feel the shame that generations before her had foisted upon those who suffer from clinical depression.

Where she learned that depression is not "feeling the blues", that depression is not "feeling down", that depression is not "having a bad day", that depression is not "hysteria" and that depression is not "mental illness".

She was prescribed medication, the name of which escapes me now, and told that it would take some time to really take effect. After a few days, she started to feel human again. After a few weeks, she was almost her old self.

She was advised that she would probably have to continue on the medication for at least a year, that she might have to continue on it for many years, but that in no event should she just stop the medication because an abrupt discontinuance could be harmful.

Like so many people, though, she discontinued the medication abruptly after a year, never went to the doctor, never sought any further input. Who can blame anyone for that? Most of us probably don't like to take medication when we think there's no reason for it, and in her view, everything was fine and dandy again and there was no reason to keep taking the medication.

And, she was indeed fine.

For a long time.

But then depression reared its ugly head again a few years later, and she very nearly killed herself.

Like I said, this has a happy ending, though. She didn't succeed in killing herself and she has been taking Celexa for the past few years. She knows now not to stop unilaterally, and she knows that it may take several years before she can go off of her medication in such an uncontrolled fashion.

She has a terrific family, a whole lot of friends, is hugely successful in her rather high profile career, and she has made a point of telling the truth about her clinical depression diagnosis even when everyone around her was offering to "cover" for her.

She said, "No, I'm not going to lie to anyone about this. The truth is much more important and it deserves to be spread. Depression is not a frivolous and manufactured little "poor little woman" mental disease. It's real, it's medical, and if it can happen to me, it can happen to anyone."

- I'm sorry for the length of this post, but the topic hit a nerve. Every day, I am grateful that people like my friend stand up and try to educate others to say, "No, no, no, no, no ~ this isn't a "girl thing", it doesn't mean I'm crazy, and it is not something to be ashamed of."


(edit to remove the square brackets that apparently cause words to not show up in a post :) ~ ~ learn something new every day here!)

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shugah Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Apr-21-06 07:26 AM
Response to Reply #33
36. absolutely
depression is different than feeling down. i am glad that it is recognised and treated in this day and age. drugs seem to be a a very effective treatment in many cases.

i'm glad your friend found the help she needs. i also think it's inteersting that she has to defend depression as not 'being a girl thing.' most of the people i know that are being treated for depression are male.

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Jazz2006 Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Apr-21-06 02:35 AM
Response to Original message
34. And, for the record,
Just in case it's misconstrued, all of that (my prior post) is not to suggest for a second that there are not other types of useful therapy that may be beneficial to those suffering from depression in conjunction with other illnesses or even those suffering from depression without any other illnesses. My real point was that clinical depression is not and should not be viewed solely as a "mental problem" and should not be associated with the negative connotations that the term suggests.

Cheers, Jazz.

P.S. I am quite sure that I am not articulating any of this nearly as well as I wanted to.

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HEyHEY Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Apr-21-06 03:01 AM
Response to Original message
35. Ask Tom Cruise, he'll know
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xchrom Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Apr-21-06 07:44 AM
Response to Original message
37. i've suffered from clinical depression for many, many years.
and at different times have used drug as well as therapists -- always in combination.

the thing is that the longer your depression goes on -- the more difficult it is to treat.

it may also be of some help to see if there are any possible genetic links -- today i manage my depression -- and i no longer look for a cessation. and i'm not the only one -- the longer it goes the less likely you are to be rid of it completely.

and contrary to one above poster -- psychoanalysis{freud based treatments} is still alive and well -- though it's very expensive and requires years of treatment. usually multiple times a week.

i would love, love to do it.
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