Reducing the Brain, Ignoring the Soul - page 3

by finness

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Reducing the Brain, Ignoring the Soul Grace E. Jackson, MD December 5, 2002 There are at least five problems with the chemical imbalance model of mental disease: 1) the model ignores the reality that there has never... Read More


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    StuPer - it is rather convenient, isn't it, that certain schools of counselling/therapy consider themselves too mysterious and unquantifiable to be researched adequately? Which allows them to get away with the self-proclaimed tales of their efficacy - a bit like religion, really: "we can't prove it one way or the other, you just have to believe". I imagine Rogerian counselling could lend itself to - at the very least - a qualitative review. And given that Dissociative Identity Disorder and False Memory Syndrome are both creatures of the consulting room, artefacts of the therapist/client relationship, then I would say that certain forms of therapy are actually more damaging than anti-deps.

    In contrast to some of my earlier statements on this forum, I have become more and more convinced of biological theories of depression, which is why I believe (and research tends to back me up) that neurotransmitter modification and the kind of neuromodulation which effective therapies like CBT provide are the only truly proven effective measures.
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    There's a BIG contradiction here Clive!! If you choose to believe the "chemical imbalance" cause of depression you must look at the success parameters. They too are based on someone elses determination of success, just like therapy. There is no measurement of neurotransmitters that is available. No "serotonin level" to be drawn. Just subjective or objective result reporting. Calling it a chemical imbalance removes the stigma attached to depression, but doesn't make it absolute. Now add in to the mix what are the other ramifications of altering neurotransmitters. The human body is one big feedback system. If you change the serotonin level believing that that is the cause of depression you have to realize that that will effect how the adrenal glands work, the pituitary gland, production of liver enzymes,thyroid function etc...... It's not as simple as it is made out to be. Now add in the placebo effect of a "miracle" drug group that have been marketed for everything from depression to shyness. That's a powerful stimuli !
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    I would also add that there is a chicken and egg issue, if the 'chemical imbalance' was precipitated by a non-pharmaceutical change (reactive to social situation etc), why is the only proven restoration by giving the brain an alien drug. The fact that imbalance is caused without chemical addition definately lends weight to the idea it can be restored without drugs, don't you think?
    The use of antidepressants maybe easier, and more convenient, but I cannot recall a patient who recovereed from a clinical depression by pills alone.. not one. They have their place but are certainly not the answer, and as I said their efficacy is far (according to company stats) from glorious. The point Isyorke makes is also extremely important, not even the most ambitious neurologist, psychiatrist, etc would claim to have a complete understanding of the way the brain works, or what impact medications have on the individual, hence all the side-effects discovered after the approval of a drug. Lastly is'nt that use of antidepressants and other psychotropic medications a 'leap of faith', we may know some direct benefits, but not the multivarious other possible implications, Clozapine being a case in point.
    As I said counselling maybe a mixed bag, and thats why when recommending couonselling to a patient I ensure they are aware of the pit-falls and the need to find someone who they relate to and how there maybe a need to swap counsellors a few times to meet their needs..... just like trying to find an antidepressant that works for an individual client.
    regards StuPer
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    "As I said counselling maybe a mixed bag, and thats why when recommending couonselling to a patient I ensure they are aware of the pit-falls and the need to find someone who they relate to and how there maybe a need to swap counsellors a few times to meet their needs..... just like trying to find an antidepressant that works for an individual client"

    Well put Stuper!! There are good counselors/therapists/psychologists and there are bad. I was lucky to find one for my son who has been wonderful. Recognizing the paxil withdrawal and at the same time working on what caused the paxil to be prescribed for in the first place. My son is in a MUCH better place now because of this mans interventions. I can't say the same about my son's experience with paxil.
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    StuPer - I've never advocated for meds alone as a treatment for depression. My feelings are that the chemical imbalances which are a feature of depression may - when the depression is still "mild to moderate" - be amenable to change through effective therapy (i.e CBT) that encourages learning (and thus neuromodulation) and without the need for medication.

    However, there comes a point when the depression is so severe that no amount of talking to the person will do anything. What you need to do then is tweak the serotonin and then, once the person's brain is actually functioning again, attempt therapy. However, I tend to think that normal human interactions - passing the time of day, talking about ordinary things, showing concern and kindness - are as effective or even more effective than formal therapy.

    lsyorke - as you know, I've read and been very moved by the struggles and hardships your son and you have been through. Yes, there are serious problems with the way drugs are marketed, with the behaviour of pharmaceutical companies and with the prescribing practices of some doctors. However, none of that detracts fromthe fact that millions of people (including my partner) owe their current well-being and perhaps even their lives to anti-depressant medication.
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    I feel that treating a person with depression with medication helps to allow that person to be receptive to counseling. As a person who has suffered pretty severe depression in the past, I can tell you that no amount of talk would help at that time. The medication after weeks allowed me to get my butt outta the house for a therapy session. I know this very simplified but true in my case.
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    Quote from laughingfairy
    I believe that antidepressents are too quickly perscribed with out the counseling and othe coping mechanisms taught.
    Amen.
    and that goes for all phsycho medicine. We need the best of both worlds.
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    CliveUK,
    I completely agree with your comments, and the need for antidepressants in severe depression, in fact I have participated in numerous ECT sessions for clients who were so sererely depressed they would'nt respond to anti-depressants either.
    regards StuPer
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    Me too StuPer. ECT is a controversial treatment, but in terms of side-effects, it's probably safer than some anti-depressants.
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    sorry, too sleepy


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