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Re: OOOOOOOOOOOOooooooooo

Posted by linkadge on April 19, 2008, at 13:02:49

In reply to Re: OOOOOOOOOOOOooooooooo » linkadge, posted by Racer on April 19, 2008, at 11:23:03


>What I've seen over the years, in life, online, >wherever, is that some people would very much >like to believe that their depression is >*solely* biochemical, and that behavioral >interventions are entirely unnecessary. It >almost seems as though they see as insulting the >suggestion than their behavior has any bearing >whatsoever on their condition, and they seem >unwilling to consider that perhaps addressing >some behavioral issues might improve their >outcome.

Thats why I think stepping back from boards like this can be a good thing. Although I have no studies to support the assertion, I would tend to think that people who consider medications just one tool in the box can probably go a lot further in recovery.

>I want physical therapy. It can't necessarily >fix the underlying problem, but it can sure >improve the functioning of the joint.

Yes. People use the analogy that depression is like diabeties, (ie you wouldn't tell a diabetic not to take insulin). This is true, but even my diabetic roomate (with an insulin pump) tells me that his effort improve his situation with dietary interventions and exercise has dramatically altered the way his body needs/utlizes insulin.

>I believe that the same can be said of >psychotherapy for depression. It may not fix any >biochemical disturbances, but it certainly can >improve functioning -- even in depression which >is entirely endogenous.

Absolutely. Its just like mice with Huntingons (an absolutely 100 percent genetically inherited disease attributed to a single faulty gene) can dramatically increase life expectancy and disease progression with simple things like exericse. There you have it, proof that environemntal manipulations can alter the way that genetic abnormalities express themselves.


>That's my reading, my understanding -- and I >believe quite strongly that I am more correct >than you are.

You're entitled to your opinions.

>You, of course, believe that your understanding >is more correct than mine.

I personally wish that the case for antidepressants was stronger.

>I can't see any hope that I can convince you of >any strengths to my position, and so I will end >here, having had my say.

In science opinions are of limited usefullness. Other meta analysis before this have reached similar conclusions: that antidepressants are only very marginally more effective than placebo, and that this insignificant margin decreases even further when active placebos are used. I wish it weren't true. Please show me a meta analysis involving more clinical trials in which antidepressants overall fair better against placebo.

Publication bias in these sorts of things is strong too. This study is one of the first that attempts to reduce the effects of publication bias. In analysis of clincial trials of modern AD's it has been found that the single greatest predictive factor for the outcome is the identity of the funding body (i.e. if Lilly sponsors the study, Prozac comes out ahead). That says to me two things: that a) the data is flawed and that b) even in its flawed stated it still can barely proove its case!

Linkadge


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poster:linkadge thread:823248
URL: http://www.dr-bob.org/babble/20080412/msgs/824252.html