Posted by jane d on September 7, 2002, at 21:15:38
In reply to Re: 'Poop out' » johnj, posted by dr dave on September 4, 2002, at 13:41:42
> I haven't really found that people on SSRIs are more likely to relapse than people on other antidepressants. I do find that people can feel better on an antidepressant for a while and then relapse - which doesn't necessarily mean the drug has stopped working.
>
> Antidepressants can successfully elevate an individuals mood, but it can be the case that the factors that have led to that depressive state in the first place can continue and overwhelm what effect the drug has had. I don't think people's mood state can be permanently elevated by a drug such that other influences cannot have an effect. If someone's life is chronically difficult, be that because of external problems or because of unhelpful ways of thinking or reacting to circumstances, this can lead to depression. Antidepressants can alter the balance of positive and negative influences on that persons mood, but if the difficulties continue they can reverse that shift. If your life has felt devoid of pleasure for six months, that exerts a certain downward pressure on your mood. If your life has felt devoid of pleasure for six years, that is going to depress your mood more strongly. In this situation the pressures that are chronically exerting a negative influence on your mood need to be identified and sorted out, as any medication may be fighting an unwinnable battle.
> I haven't really found that people on SSRIs are more likely to relapse than people on other antidepressants. I do find that people can feel better on an antidepressant for a while and then relapse - which doesn't necessarily mean the drug has stopped working.
>
> Antidepressants can successfully elevate an individuals mood, but it can be the case that the factors that have led to that depressive state in the first place can continue and overwhelm what effect the drug has had. I don't think people's mood state can be permanently elevated by a drug such that other influences cannot have an effect. If someone's life is chronically difficult, be that because of external problems or because of unhelpful ways of thinking or reacting to circumstances, this can lead to depression. Antidepressants can alter the balance of positive and negative influences on that persons mood, but if the difficulties continue they can reverse that shift. If your life has felt devoid of pleasure for six months, that exerts a certain downward pressure on your mood. If your life has felt devoid of pleasure for six years, that is going to depress your mood more strongly. In this situation the pressures that are chronically exerting a negative influence on your mood need to be identified and sorted out, as any medication may be fighting an unwinnable battle.
>Dave (and anyone else out there),
For some reason this description resonated with me in a way that other descriptions of non physical factors in depression haven't. I'm not sure why. I'm definately a fan of medication but I've not been able to recapture that first feeling of really being "ok" that I experienced the first time.
Among other things, I've been wondering how this view fits with the seeming success of maintenance medication. Does maintenance medication only work to prevent a long lasting relapse in people exposed to periodic short term stresses? Or does it give some small level of protection against chronic stresses - enough for mild ongoing problems. Or could it be not the medication itself, but just change - any change - in your brains neurochemistry that gives you a window in which habits of thought and feeling are no longer so firmly embedded?
A muddled Jane staring out from behind the "medication camp" lines.
poster:jane d
thread:109458
URL: http://www.dr-bob.org/babble/20020906/msgs/119243.html