psuvm%cjc@psuvax.UUCP (04/22/84)
..................................
A large proportion of people with clinical depression are suffering
from a biochemical abnormality which can be greately improved by
medication with little or no psychotherapy. (This tends to occur more
frequently in in some families, rather like diabetes.) Therefore anyone
experiencing SEVERE depression, especially if there is little external
cause, should see a MEDICAL doctor, not a psychologist who is not trained
in use of medication. Since one characteristic of clinical depression is
" total absence of hope", some friendly person should intervene & take
the patient to a doctor.
C. Clark
cjc@psuvm (bitnet)blenko@rochester.UUCP (Tom Blenko) (04/23/84)
This is an exercise in non-logic, right? A large proportion of people with clinical depression are suffering from a biochemical abnormality which can be greately improved by medication with little or no psychotherapy. (This tends to occur more frequently in in some families, rather like diabetes.) If you have evidence to support this, I'm sure many people in the field would be greatly interested. The people in the field I am acquainted with are NOT aware of it. I think the claim was made that Lithium was an anti-depressant, but then they went back and looked a little more closely at the data...and it turned out that the patient population was 1) unreliable, 2) highly selected -- the test hospital was a regional VA hospital in New England and saw patients on referral and with little monitoring. Therefore anyone experiencing SEVERE depression, especially if there is little external cause, should see a MEDICAL doctor, not a psychologist who is not trained in use of medication. How, exactly, does one determine that the depression is severe, or that there is little external cause? If the medication works (prevents depression), are you treating the cause or the symptoms? If the latter, is that adequate? And who is to decide? Since one characteristic of clinical depression is " total absence of hope", some friendly person should intervene & take the patient to a doctor. Once again, how does the non-psychologist diagnose clinical depression? I don't think you will find the presumptive patient is necessarily willing to take advice from the "friendly" person.
jcz@ncsu.UUCP (John Carl Zeigler) (04/23/84)
It is true that a psychologist is not licensed to prescribe medicine; however, any psychologist worthy of the title can spot patients who may have a need for medical intervention and refer them to a psychiatrist. Most psychologists and psychiatrists avoid using psycho-active drugs because the cure can be worse than the disease. Some forms of mental illness can be traced to dietary deficienties. For instance, my mother suffered mild depression until a doctor (family practice) suggested lithium supplements. --jcz
dyer@wivax.UUCP (Stephen Dyer) (04/24/84)
Sorry, there ain't no such animal as a lithium "dietary supplement." Lithium plays no role in ordinary human ion metabolism, and when administered for the treatment of depression or mania, is acting clearly as an active psychotropic agent. -- /Steve Dyer decvax!bbncca!sdyer sdyer@bbncca
dyer@wivax.UUCP (Stephen Dyer) (04/24/84)
I find this attack against the person who suggested that severely depressed people whose depression is not reactive (i.e. environmentally based) check with a psychiatrist quite peculiar. I don't know what friends you hang out with, and what their specialties are, but it has been pretty clearly shown in the scientific literature that severe depression has a large biochemical component. Drug therapy does not work in all cases, especially if the patients are suffering from a reactive depression brought on by grief, job problems, etc. But, in rebuttal to your glib comment about lithium therapy, drugs CAN be of enormous help. In the treatment of manic-depressive episodes, lithium has an amazingly specific effect, bringing the patient down from his mania without blunting his affect, and decreasing the severity and frequency of depressive episodes. The tricyclic antidepressants are also quite effective in about 60-70% of non-reactive depressions. In fact, electro-shock treatment, which is strictly speaking not a drug but which causes biochemical changes similar to effective drug therapy, can be literally life-saving when no other treatments have proved successful. This last treatment has been a convenient whipping-boy for the ignorant who take their facts from movies like "One Flew Over the Cuckoo's Nest". Naturally, drug therapy may have some side-effects. The key to quality, non- dogmatic therapy is to identify those patients whose illnesses match those which have shown good response to drug therapy, give them the smallest does which works without side-effects, and then work with them within the baunds of traditional psychotherapies, if that is deemed necessary. -- /Steve Dyer decvax!bbncca!sdyer sdyer@bbncca
lee@unmvax.UUCP (04/26/84)
I am a Social Worker and am in charge of a psychiatric out-patient clinic.
I have worked in the psychiatric field for 20 years. In my experience
doctors do customarily use psycho-active drugs in depressions which are
severe or at least moderately severe.
As far as mental illness being related to dietary deficiency, that is possibly
true; the facts aren't in yet but research points to that. However, Lithium
is not really a part of the normal diet. Lithium is a metal used to treat
mostly bipolar disorders (formerly known as manic-depressive disorders)
and is now also being used to treat some other disorders, which I will
not go into here.
Dolores Ward
---------------------------
That was my mom speaking (hi world I am Lee). I'll forward reasonable
responses, etc. to her.
--Lee (Ward)
{ucbvax,gatech,anl-mcs,convex,pur-ee,rice}!unmvax!lee
--
--Lee (Ward)
{ucbvax,convex,gatech,pur-ee}!unmvax!leerwh@aesat.UUCP (Russell Herman) (04/26/84)
Yes, drug therapy unquestionably works SOME OF THE TIME. But there are still
diagnostic-related problems. I've seen a few people labelled "manic-depressive"
and treated with lithium. If it didn't work, they were relabelled "schizo-
phrenic".
--
______ Russ Herman
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