Why The Science Behind Anti-Depressants May Be Completely 'Backwards'

Anti-depressants are the most commonly-prescribed medication in the U.S., with one in 10 Americans currently taking pills like Zoloft and Lexapro to treat depression. But these pharmaceuticals are only fully effective roughly 30 percent of the time, and often come with troublesome side effects.
In a controversial new paper published in the journal Neuroscience & Biobehavioral Reviews, psychologist Paul Andrews of McMaster University in Ontario argues that this failure of medication may be based in a misunderstanding of the underlying chemistry related to depression.
Andrews surveyed 50 years' worth of research supporting the serotonin theory of depression, which suggests that the disease is caused by low levels of the "happiness" neurotransmitter, serotonin.
But Andrews argues that depression may actually be caused by elevated levels of serotonin. And this fundamental misunderstanding may be responsible for inappropriate treatment: The most common form of antidepressants are selective serotonin re-uptake inhibitors (SSRIs), which operate by targeting serotonin receptors in the brain in an effort to amplify serotonin production.
Currently, scientists are unable to measure precisely how the brain releases and uses serotonin, because it can't be safely observed in a human brain. But Andrews points to research on animals which suggests that serotonin might work just the opposite from what we've assumed.
In this scenario, elevated serotonin levels that are released and used by the brain during depressive episodes trigger processes that promote rumination -- the obsessive negative thinking that is the hallmark of depression. Then, because they facilitate the production of serotonin, SSRI treatments exacerbate rumination and actually worsen symptoms of depression, especially at first, Andrews explained. Over time, in some cases, the SSRIs can reverse ruminative processes and reduce symptoms -- but this is in spite of the medication, not because of it.
Of course, anti-depressants do help many people who are struggling with depression. However, the research points to the need for a greater understanding of the many factors that may contribute to the development of this common mental health disorder.


http://www.huffingtonpost.com/2015/02/28/how-anti-depressants-work_n_6707272.html?utm_hp_ref=science

the BEST cure for depression is to find out whats depressing you ....and either figuratively or literally if possible, kick the shit out of it .....

darknessss wrote:the BEST cure for depression is to find out whats depressing you ....and either figuratively or literally if possible, kick the shit out of it .....

100% agree Victor. As I have said before people need to find the root cause of the problem, being able to recognise what the problem is, so you can then be able to help resolve and fix trhis problem and move forward. I also think many become dependent on these drugs, which really only help block out the problems for a limited time. Support is also very key in helping people.

Brasidas wrote:

darknessss wrote:the BEST cure for depression is to find out whats depressing you ....and either figuratively or literally if possible, kick the shit out of it .....

100% agree Victor. As I have said before people need to find the root cause of the problem, being able to recognise what the problem is, so you can then be able to help resolve and fix trhis problem and move forward. I also think many become dependent on these drugs, which really only help block out the problems for a limited time. Support is also very key in helping people.

and therein lies one of the biggest problems, simply because you end up with 2 problems to deal with then

As you say support and councelling are the biggest help, the trouble is its considered too expensive....and its not as easy/profitable a handing out a bottle of pills...

the support is just not there, at least not in sufficient amount

darknessss wrote:

Brasidas wrote:

100% agree Victor. As I have said before people need to find the root cause of the problem, being able to recognise what the problem is, so you can then be able to help resolve and fix trhis problem and move forward. I also think many become dependent on these drugs, which really only help block out the problems for a limited time. Support is also very key in helping people.

and therein lies one of the biggest problems, simply because you end up with 2 problems to deal with then

As you say support and councelling are the biggest help, the trouble is its considered too expensive....and its not as easy/profitable a handing out a bottle of pills...

the support is just not there, at  least not in sufficient amount

Have to agree 100% as support and councelling are the key and why in this area we should provide more people. The drugs do not work effectivelly and again are only a means of suppressing the problems, tot he point those in need of this are not solving the issue's that face them. In a way I believe this method is really letting down people and can and does make these people feel even more worthless. Why not use the money used to purchse these drugs in the NHS to provide more people helping give support. I understand some will need some drugs to help at first in some cases, but the amount that become addicted top them shows how dangerous this approach is.

different things work for different people.

depression can be caused by an actual lack or or imbalance in the human brain of certain chemicals and that is why antidepressants are the correct help in certain instances.

not disagreeing with that cass but for far too many, throwing a box of pills at them doesnt work and is in fact counterproductive.....

darknessss wrote:not disagreeing with that cass but for far too many, throwing a box of pills at them doesnt work and is in fact counterproductive.....

oh I agree Hon. same scenario sometimes as someone demanding pills from their doctor for a cold. as antibiotics don't cure viruses. But I know a few times in my adult life a short course of ADs helped get me back on track and lots of others too. Sometimes though Doctors (and others in general) still don't underdstand or believe in depression and that is just as bad.

check out this brilliant video that did the rounds - I really like how it describes it

https://www.youtube.com/watch?v=2VRRx7Mtep8

https://www.youtube.com/watch?v=XiCrniLQGYc

Cass wrote:different things work for different people.

depression can be caused by an actual lack or or imbalance in the human brain of certain chemicals and that is why antidepressants are the correct help in certain instances.

Clearly I guess you did not read the article I guess, hence:

As people and physicians become more aware that antidepressants only work for a limited period of time, and are less safe than they have been supposed, the use of antidepressant medications will decline and the use of psychotherapies will increase.
I would suggest that the attempt to pharmacologically reduce depressive symptoms is not likely to produce lasting effects. You can get these temporary effects, but they're not likely to be lasting effects, and they can cause a whole lot of problems.
Psychotherapy is more likely to produce lasting effects, and can help people cope with the things that actually triggered their depressive episodes, and that's why these therapies are more productive in the long run.

Brasidas wrote:

Cass wrote:different things work for different people.

depression can be caused by an actual lack or or imbalance in the human brain of certain chemicals and that is why antidepressants are the correct help in certain instances.

Clearly I guess you did not read the article I guess, hence:

As people and physicians become more aware that antidepressants only work for a limited period of time, and are less safe than they have been supposed, the use of antidepressant medications will decline and the use of psychotherapies will increase.
I would suggest that the attempt to pharmacologically reduce depressive symptoms is not likely to produce lasting effects. You can get these temporary effects, but they're not likely to be lasting effects, and they can cause a whole lot of problems.
Psychotherapy is more likely to produce lasting effects, and can help people cope with the things that actually triggered their depressive episodes, and that's why these therapies are more productive in the long run.

that is one viewpoint. thanks.

Cass wrote:

Brasidas wrote:

Clearly I guess you did not read the article I guess, hence:

As people and physicians become more aware that antidepressants only work for a limited period of time, and are less safe than they have been supposed, the use of antidepressant medications will decline and the use of psychotherapies will increase.
I would suggest that the attempt to pharmacologically reduce depressive symptoms is not likely to produce lasting effects. You can get these temporary effects, but they're not likely to be lasting effects, and they can cause a whole lot of problems.
Psychotherapy is more likely to produce lasting effects, and can help people cope with the things that actually triggered their depressive episodes, and that's why these therapies are more productive in the long run.

that is one viewpoint. thanks.

One that has lots of evidence to back it up.
Again like I said earlier in some cases and only in short or limited courses are viable. So many have become dependable to many of these medications, which again only surpress feelings for a limited time bringing countless side affects. The best way is to coach, help and support people, with providing and trying many psychotherapies, The methoodology to maintain people on such medication is self defating in itsefl, as the way forward is to help them cope and mange with their problems, that they can surpress these problems without any medication.
Depression is horrible for many people and why to me you have to help them and support them..


Here you can read this for yourself Cass, as to me this is such an important issue where we can help those who need it most:

Treating depression with drugs

It's possible that, like millions of others, you may be taking drugs (antidepressants) of some kind to treat depression. Antidepressants are often the first treatment option prescribed by health professionals.
By understanding that antidepressants actually treat what is a common symptom of depression, rather then the condition itself, we can begin to understand some key facts about antidepressants, namely:

• Why antidepressants are only effective in around one third of cases, and partially effective in another third. The other third of cases get no benefit at all.
  
• Why the rate of relapse is so high when depression is treated with antidepressants alone?
  
• For many people, the side effects are more unpleasant than the depression itself, so they discontinue treatment.
  

We'll also consider why, if these drugs are as good at beating depression as we are told, is depression on the increase, and sufferers treated solely with antidepressants have an 80% chance of having a second episode of major depression?
If depression is making you feel really bad, the relief that antidepressants can sometimes bring can be very welcome. However, if you want to have the best chance of avoiding a relapse further down the line, it is essential you get the right kind of therapy, or skills training. We'll look at this later in the Depression Learning Path.
 

The cart before the horse

One of the main reasons given for depression being described as an illness (and therefore to be treated with drugs) seems, at the least paradoxical, if not misleading.
It is reasoned by some that the high rate of relapse after drug treatment indicates that depression should be treated as a chronic disease, i.e. treatment by long term, high dosage medication.
This is the explanation used, rather than the fact that drugs do not treat depression, merely the symptoms.
Yet, if we consider:

• The average length of depression, if left untreated is 8 months.
  
• Depression medication, typically, has to be taken for 6 weeks before it is known if it is effective or not, and then continued for 6 months.
  
• Citing relapse as a reason, some treatments recommend a "3 phase approach' which can last well over 2 years.
  
• Other treatments, such as a combination of cognitive, behavioural and interpersonal therapy, have a much lower rate of relapse. (We recommend that relaxation techniques are also used, to calm the emotions and allow a faster, more effective participation in therapy. It is also essential that the patient's lifestyle is checked to ensure that their basic emotional needs are being met.)
  
• Also, we should take into account the side effects of drug treatments, which we will come to soon.
  

Then it is clear that:
The ever-growing use of antidepressants as the primary weapon against depression, is highly questionable, particularly as a long-term solution.
The 'chemical imbalance' treated by antidepressants is almost always a result of depression, not a cause.
Antidepressant medication can be useful for some people in lifting severe depression symptoms quickly, but should not be the sole treatment for depression.
Without appropriate skills training, therapy, or whatever you want to call it, there is no reason why the depression shouldn't come back when a similar life situation arises again.
 
 

Treating depression with psychotherapy or counseling

All psychotherapies are not the same, and some can worsen depression, rather than improve it.
When discussing using the treatment of depression with psychotherapy, it is important to make some distinction in the types of treatment. While some have been shown to have high success rates, others are shown to be less effective than actually leaving the depression untreated.
 

How does therapy actually work?

Therapy for depression works in many ways - emotional support, problem solving, examining and changing thinking styles, checking basic needs are met, looking at behavior, teaching social and other skills and so on...
However, a good way to think about it is to look at the Cycle of Depression. Good therapy or counseling will break the cycle as quickly as possible, in as many places as possible and give you skills to ensure it stays that way.
In fact, the quickest way to lift depression is to cut down the amount of negative rumination, or introspection the depressed person is doing.

http://www.clinical-depression.co.uk/dlp/treating-depression/treating-depression-what-treatment-actually-works/


Psychotherapy is effective and here’s why
October 2011, Vol 42, No. 9
Print version: page 14
Psychotherapy works, and the science and research are there to back it up, said Bruce E. Wampold, PhD, at the APA 2011 Annual Convention symposium, "Psychotherapy Effectiveness: What Makes it Work?"
Answering just what makes it work is complex, said Wampold, a professor of counseling psychology at the University of Wisconsin–Madison, but relationships and customized treatments play key roles.
So what makes a good therapist? According to research presented by Wampold, a good therapist:

• Has a sophisticated set of interpersonal skills.
  
• Builds trust, understanding and belief from the client.
  
• Has an alliance with client.
  
• Has an acceptable and adaptive explanation of the client's condition.
  
• Has a treatment plan and allows it to be flexible.
  
• Is influential, persuasive and convincing.
  
• Monitors patient progress.
  
• Offers hope and optimism (realistic optimism, not Pollyanna-ish).
  
• Is aware of a client's characteristics in context.
  
• Is reflective.
  
• Relies on best research evidence.
  
• Continually improves through professional development.
  

With an effective therapist, science shows that psychotherapy even works better in the long-term and is more enduring than medication. In fact, not only is it more cost-effective, but psychotherapy leads to fewer relapses of anxiety and mild to moderate depression than medication use alone—so much so that Norwegian Health Authorities have issued new guidelines concerning treatment of mild to moderate depression and anxiety, stating that psychological interventions, not medications, should be applied first.
So what's stopping psychotherapy for being the go-to treatment for nonpsychotic conditions? For one thing, major pharmaceutical companies heavily market their medications directly to the public and health professionals, said speaker Steven Hollon, PhD. While therapy is getting sharper, more effective, and more enduring, it is continuing to lose market share to medication.
But it doesn't have to be this way, said APA officials. There is an increased effort by psychologists and APA to change attitudes and make psychotherapy a first-line treatment. With evidence-based treatment guidelines under development, and the move for an official statement by APA on psychotherapy's effectiveness, one day medication may lose its market share to psychotherapy.

thanks to research there are a variety of ways to treat depression - including combinations of different therapies. people need to work with their medical Providers to find what is the most effective treatment. what works for some may not work for others.

psychotherapy is yet another tool in the box to use if appropriate for the individual concerned.

Cass wrote:thanks to research there are a variety of ways to treat depression - including combinations of different therapies. people need to work with their medical Providers to find what is the most effective treatment. what works for some may not work for others.

psychotherapy is yet another tool in the box to use if appropriate for the individual concerned.

Again the medication can only treat the symptoms not the depression itself, hence why medication is only effective in 30% and dopes not help them long term Cass. We need to move away from drugs to treat depression as it is conter productive in many cases and costly, where better support and therapy is provided through psychotherapy is esential. Hence why more and more people with depression today are rightly opting for psychotherapy, as it has helps many in the long term, where as medication does not..

You seem convinced on a belief to the effectiveness of the drugs Cass, so I doubt we are never going to agree on this.
 
All the best and goodnight

I always thought AD's were a tool to use alongside therapy.
In other words, they are the pathway to make you feel on an even keel in order to get you to the therapists office?
Or am I missing the point here?