Unsexy Zoe Quinn drollness (prepare the lawyers)
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Ok; so what exactly do you propose we do about depression? Nothing? Even in Japan, where the suicide rate is skyrocketing? It just happens, who cares why, enjoy your suicide?
So the only option, in your mind, is see it as a physical ailment (and treat it with ineffective medications) or do nothing? You completely gloss over therapy, over help provided by friends, family and community?
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When a depressed person says "Nothing I've accomplished is worth anything" or "It's like the sun isn't shining" do we just take that as fact? We don't say "Well, I guess you're right. All that bright light must be coming from something else." Yes, the depressed person feels that the sun is dim and there is no hope, but we don't accept that as fact.
Of course we don't take statements like "It's like the sun isn't shining" as fact. That is what is called a simile. The big clue here is the use of the word "like". It's obvious even to a three year old that this is not meant as a literal statement.
So why should we accept that person's assessment of depression-as-physical-illness as fact? I'm not saying we should just ignore it or belittle it, but we don't have to accept it as unquestionable fact, either.
Some people who suffer from depression suffer from physical pain as a manifestation of their depression. The point that others are trying to make is that there is every possibility that there is a physical cause to depression. Just because we haven't discovered it yet doesn't mean it isn't there. And lack of a test for something doesn't mean it isn't physical either.
How come anti-depressants are no more effective than placebos for most people?
Because the brain is still the most poorly understood organ, and that makes trying to develop drugs that mess with brain chemistry a tricky business. Especially when you throw things like morality and ethics into the mix.
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Of course we don't take statements like "It's like the sun isn't shining" as fact. That is what is called a metaphor. The big clue here is the use of the word "like". It's obvious even to a three year old that this is not meant as a literal statement.
Pedantry alert: it's a simile not a metaphor but the point is otherwise sound.
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Alzheimer's has a physical element. What's the element for depression?
I doubt you'll agree that this "counts", but lack of energy is an obvious one.
It distracts from the things that might help.
Like what?
You completely gloss over therapy, over help provided by friends, family and community?
Do you have any evidence that it's more effective than placebo? Because the common medical wisdom at the moment is that, if/when the correct drug is found for the patient*, the drug is more effective than having friends, family and community.
Your assertion also does not jive with my personal experience of depression at all, since I was severely depressed when at a stage in my life (high school, college) where I lived with family, had far more friends than I do now, and also participated in far more group activities than I do now. But then I was suicidal. Now I am not. How do you account for that?
* The tricky thing here is, while most people do have a drug that works for them, finding it is an extremely involved process of trial and error, with each trial taking several months at the least.
Super trivia quizzz: why is the word "finding" in the previous paragraph (which is surrounded by asterisks) not italicized? Write down your answers on this 8.5x11 piece of paper, roll it in a tube, then cram it in Jeff Atwood's body where the sun don't shine. (Preferable: his aorta. No sunlight there.)
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Answer to your question: there is a * at the start of that paragraph that isn't rendered, which is matched presumably via regex to the end of finding, except because of a tag mismatch, neither tag is rendered but the asterisks are consumed.
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Hurray for Discoregex!
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Pedantry alert: it's a simile not a metaphor but the point is otherwise sound.
Ah, yes. My bad. Apologies. I shall correct it forthwith.
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Ok; so what exactly do you propose we do about depression? Nothing? Even in Japan, where the suicide rate is skyrocketing? It just happens, who cares why, enjoy your suicide?
Sounds like a problem that takes care of itself.
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Pedantry alert: it's a simile not a metaphor but the point is otherwise sound.
Flagged for
buggerybadgery.
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Awesome, thanks, two more flags please, would quite like Knight Pedantic Dickweed of the Most Honourable Order of the Bath.
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Of course we don't take statements like "It's like the sun isn't shining" as fact. That is what is called a simile. The big clue here is the use of the word "like". It's obvious even to a three year old that this is not meant as a literal statement.
It's not a simile, at least not always. Depressed people will actually perceive a cast of darkness and shadow where none exists.
Some people who suffer from depression suffer from physical pain as a manifestation of their depression.
So what? The fact that the brain perceives physical pain when it is suffering emotionally is not proof that there's some physical cause for depression. A lot of psychiatric illnesses present with physical sensations and symptoms. They're caused by the brain and CNS.
The point that others are trying to make is that there is every possibility that there is a physical cause to depression. Just because we haven't discovered it yet doesn't mean it isn't there. And lack of a test for something doesn't mean it isn't physical either.
And the point I'm making--and that you're doing your damnedest to ignore--is that "maybe it could be caused by some unknown physical ailment" is not particularly helpful. Especially when "It might be" gets transmogrified into "It absolutely has a physical cause and you are a bastard for even questioning it!"
Meanwhile, I see it as actively harming people to pretend there is a physical cause when none has been named. Might there be one? Sure, but treating it like fact if it hasn't been proven is absurd. Just as absurd as having tens of millions of people on medicines that are no better than placebo.
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But then I was suicidal. Now I am not. How do you account for that?
You found this site and/or otherwise became powered by hatred?
(Just a joke.)
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I doubt you'll agree that this "counts", but lack of energy is an obvious one.
That's a physical manifestation of depression. Where has it been demonstrated that that's what causes depression? (But lack of energy worsens depression, for sure. Which is part of the vicious cycle: depression causes lack of energy which causes more depression..)
Because the common medical wisdom at the moment is that, if/when the correct drug is found for the patient*, the drug is more effective than having friends, family and community.
Horseshit. I don't think you understand psychopharmacology at all. If you look at all the trials (and not just the ones the drug companies publish in glossy brochures) then the difference between placebo and SSRI is non-existent. Just Google "placebo antidepressant" and gaze upon the state-of-the-art medical research.
Your assertion also does not jive with my personal experience of depression at all, since I was severely depressed when at a stage in my life (high school, college) where I lived with family, had far more friends than I do now, and also participated in far more group activities than I do now. But then I was suicidal. Now I am not. How do you account for that?
Just because you had friends and family does not mean they were actively helping your depression. Did they know you were depressed? Anecdotally I've known numerous depressed people I've worked with. At best, treating it as a physical ailment and medicating did nothing. In most cases, it made things worse.
I'll wager I know more about depression than anyone here.
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Appeal to authority fallacy.
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Ok, it seems there's no blood test for depression, but there ARE brain scans.
So, you can clearly look at MRI and tell if person is suffering from depression. It's not just sadness.
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Why do I need to provide evidence? You made the claim that "The vast majority of people with depression have no chemical basis for their depression." with absolutely no support.
I have not made any claims in this thread at all.
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Ok, it seems there's no blood test for depression, but there ARE brain scans.
Which do not work in the vast, vast majority of cases. Honestly, you people are depressing me.
So, you can clearly look at MRI and tell if person is suffering from depression.
No, you cannot. For one, why do you think it's not used as a diagnostic criteria if it was that simple? Goddammit you people are an ignorant bunch of shits.
It's not just sadness.
Yeah, that's exactly what I said, you fucking jackass. Shove your strawman up your ass.
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For one, why do you think it's not used as a diagnostic criteria if it was that simple? Goddammit you people are an ignorant bunch of shits.
Because MRI's are a lot more expensive than the questionnaire, which is just as selective.
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Why do I need to provide evidence? You made the claim that "The vast majority of people with depression have no chemical basis for their depression." with absolutely no support.
I have not made any claims in this thread at all.
Fine, I will rephrase since you are apparently an idiot. "The vast majority of people with depression have no identified chemical basis for their depression".
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And yet the MRI experiment is 93% sensitive and 85% specific. So the "vast majority" of depression patients do have an identified physical problem, under Bayes theorem.
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would quite like Knight Pedantic Dickweed of the Most Honourable Order of the Bath.
So would I, but AFAIK nobody is flagging any of my pedantic dickweedery. I'm tempted to say that makes me depressed, but in the middle of a discussion of serious clinical depression, that bit of humor about trivial situational depression is probably not a good idea.
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Because MRI's are a lot more expensive than the questionnaire, which is just as selective.
Wow, you really don't know what the fuck you're talking about, do you? Yeah, MRIs are expensive. So are most psychiatric medications, not to mention the medication maintenance appointments. Believe me, if MRIs were a successful diagnostic criteria, people would be demanding them before shelling out tens of thousands of bucks on meds and doctors.
What's more, if MRIs are used to diagnose depression, then a lot of people who are currently diagnosed as depressed are going to lose that diagnosis. That doesn't sound helpful.
Finally, the fact that there are observable differences on MRI for some depressed people DOES NOT mean there is a physical cause of depression. It just means that MRIs can detect differences in mood--WHICH IS NOT NEWS. We can observe orgasm on MRI, does that mean orgasm must be a physical disease, too? Or does it merely mean that, since our brains are electrochemical, our thoughts and feelings actually can be observed electrochemically?
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And yet the MRI experiment is 93% sensitive and 85% specific. So the "vast majority" of depression patients do have an identified physical problem, under Bayes theorem.
No, they don't. That's not proof of a physical fucking problem, you illiterate piece of shit. That's proof that we can detect certain differences of mood with MRI.
Jesus, how can you people fail basic logic so fully? I don't understand it.
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I'm right!!!!
<snip>
Look at the picture. Those neurons are firing weaker than they should. That makes your brain slow. You have no energy. Everything is a chore. It makes sense the fainter brain is depressed. The point is, this is a physical thing that is actually, measurably happening. You can clearly see it using this machine. Why would a chemical test convince you when a picture wouldn't? What's so special about chemicals?
Now can you think this away? Perhaps. Your thoughts are some kind of physical or chemical reactions in your brain. Theoretically, you might influence a brain to change a thing here or there. In practice, it seems this sort of thing rarely works and meds are more effective for most people.
Am I ignorant? Of course. And so are you. We are like two managers discussing TDD and dependency injection based on the things they overheard or skimmed over during lunch break. If in doubt, leave it to the professionals. And in this case, they happen to disagree with you.
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I poked a friend with my finger. She was depressed.
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I poked a friend with my finger. She was depressed.
That's because you ruptured her. Try patching her and then pumping her back up. Also, it's not with finger you should be poking.
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Whoosh? Or a stretch?
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That's a asterisk inside a SUP tag. The EXACT SAME CONSTRUCT is used about two paragraphs up, and it renders fine there. How fucking broken can a single website be.
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Where has it been demonstrated that that's what causes depression?
Like 10 posts ago, I specifically said we (as a society) do not know what causes depression. So if you're trying to cast me as a hypocrite or whatever, I'm not even sure what you're trying to do here.
Horseshit. I don't think you understand psychopharmacology at all. If you look at all the trials (and not just the ones the drug companies publish in glossy brochures) then the difference between placebo and SSRI is non-existent. Just Google "placebo antidepressant" and gaze upon the state-of-the-art medical research.
I think you should go give your Scientology buddy Tom Cruise a big ol' smack on the lips because you're obviously at least a fucking OT-3 by this point.
Just because you had friends and family does not mean they were actively helping your depression. Did they know you were depressed?
Of course not. That's the fucking point.
I'll wager I know more about depression than anyone here.
I'll wager you think you do.
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This is the experiment to find out.
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We are like two managers discussing TDD and dependency injection based on the things they overheard or skimmed over during lunch break.
No, I actually have a substantial amount of experience with this.
If in doubt, leave it to the professionals. And in this case, they happen to disagree with you.
No, they don't. Please try to follow because you seem quite slow. In one study, they were able to kind of predict who was depressed--out of the people who participated in the study--based on MRIs. That does not prove that depression is based on a physical source. That's not even what they claim. What's more, they don't claim that this is at all an appropriate method for diagnosing depression. I don't know of any mental health professional who would suggest you can diagnose depression from an MRI.
Yes, there are differences that can be observed between most people who have been diagnosed as depressed and those who have not based on MRI. I don't understand how you can misread that to imply that MRI would be a successful diagnostic tool (it would exclude a lot of people who are definitely depressed), or that it proves depression is physical in origin.
There are plenty of mental health professionals who dispute the biological hypothesis of depression. I can't believe this is news to any of you. What's more is this is a field that, biologically speaking, is really in its infancy. Fifty years ago they were lobotomizing depressives or giving them high doses of haloperidol. (They also did shock therapy which, oddly enough, does seem to have some positive effects at times.)
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I think you should go give your Scientology buddy Tom Cruise a big ol' smack on the lips because you're obviously at least a fucking OT-3 by this point.
I guess you didn't bother doing the search I told you to. This isn't some disputable opinion--anti-depressants only work for a very small percentage of people. Likely those who have some kind of actual organic brain problem rather than the vast majority of depressed people.
Of course not. That's the fucking point.
Huh? How is that the fucking point? If nobody knew you were depressed, then I don't see how you are dismissing therapy, friends, family and community support.
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Likely those who have some kind of actual organic brain problem
So then you're admitting that real depression is actually a physiological problem? Looks like blakeyrat wins. I am ashamed.
[quote=Kirsch (the main doctor at fault for all your antidepressants are no better than placebos links)] Placebos are great for treating a number of disorders: irritable bowel syndrome, repetitive strain injuries, ulcers, Parkinson's disease.[/quote]
Guess that means ulcers aren't really a disease, people should just think them away.Google stress causes ulcers, because just like your FUD google for antidepressants vs placebo, it will turn up just as much controversy and determination that stress causes ulcers
BTW, searching google for something is always going to yield a ton of results regardless of whether it is "right".
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oh right, zoe quinn.. never heard of her, and I'm thinking it is probably for the best.
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Actually, the story was--sort of--more interesting in a "can't avert your eyes from teh trainwreck" than what this thread got derailed--see what I did there?--into.
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You don't know what you're talking about and you've just made it obvious to everybody who passed Statistics 100. Good work.
sACC volume reduction was noted in 66 of the 71 patients receiving treatment of MDD, with sensitivity of 93%, specificity of 85%, and accuracy of 90%.
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So then you're admitting that real depression is actually a physiological problem?
What? No. I never disputed that some people might have some physical problem that results in depression. I'm disputing that depression, in general, and in the vast majority of cases, is proven to have a physical cause. It has not been.
Guess that means ulcers aren't really a disease, people should just think them away.
How the fuck did you get to that conclusion?
Google stress causes ulcers, because just like your FUD google for antidepressants vs placebo, it will turn up just as much controversy and determination that stress causes ulcers
No. There is no medical evidence at all that stress causes ulcers. You're spewing absolute bullshit. Ulcers are caused by h. pylori. Jesus fucking wept.
BTW, searching google for something is always going to yield a ton of results regardless of whether it is "right".
There are dozens of studies on the placebo vs. antidepressant topic. For the vast majority of people, placebos are as effective as antidepressants. This has been known for over a decade now. The question is no longer "Do antidepressants work better than placebos for most depressed people?" (and it hasn't been for some time) it's "Why do some people still see better results from antidepressants?"
By the way, the field has been moving away from antidepressants and to antipsychotics for awhile now. That's a whole 'nother can of worms.
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You don't know what you're talking about and you've just made it obvious to everybody who passed Statistics 100. Good work.
sACC volume reduction was noted in 66 of the 71 patients receiving treatment of MDD, with sensitivity of 93%, specificity of 85%, and accuracy of 90%.
Did you even read that? I can't fathom how you can be so stupid. As I've said now, what, a dozen times, that does not establish any physical cause for depression, nor does it establish that MRI will work as a diagnostic tool. I'm not saying that one day they won't be able to fairly accurately diagnose depression, but they cannot now.
That was a test of 88 people over the age of 54 who had already been diagnosed as depressive. First off, 88 people over the age of 54 is not nearly large enough or diverse enough to study depression effectively. Second, they're being diagnosed via MRI. There was already another mechanism that was used to diagnose them as depressed.
Honestly, I don't know how it's possible for you to not understand this.
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Huh? How is that the fucking point? If nobody knew you were depressed, then I don't see how you are dismissing therapy, friends, family and community support.
Maybe nobody knew I was depressed because I didn't tell them I was depressed because that's a part of depression.
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For the vast majority of people, placebos are as effective as antidepressants. This has been known for over a decade now. The question is no longer "Do antidepressants work better than placebos for most depressed people?" (and it hasn't been for some time) it's "Why do some people still see better results from antidepressants?"
Then I don't even what you're arguing. It is clear that plenty of people are given pills for depression (and in this day and age, plenty of other psychological disorders) when they should not have been diagnosed as such, just because it's easier.There is no medical evidence at all that stress causes ulcers.
I didn't say there was. I was pointing out that googling a phrase and getting results that agree with you doesn't make it real.
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Oh, she was the girl who did that shitty hackjob of jamming an rfid chip into her hand because that's totally how augmentation works guys?
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Yup, but that's a minor detail in this story of stupidity.
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>implanted a chip in the back of her hand that can be programmed to perform various functions. Her first use of the chip was to load it with a download code for the game Deus Ex. Quinn also has a magnetic implant in her left ring finger.
jamming an rfid chip into her hand
These two statements do not seem to be equivalent.
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https://health.columbia.edu/system/files/content/healthpdfs/CPS/depression_medication.pdf
Morbs. Stop.
You aren't a doctor. You have no place advising people about what is and isn't a medical condition. Let the people with medical degrees (i.e. doctors) do that.
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depressives are desperate to see their condition as a physical illness
Not really, no. A lot of them hate themselves exactly because they can't just snap out of it, and they feel they should be able to if they tried.
"You don't know what depression is like" is irritating. I'm sure most people don't know what it's like
But that's kind of the point - people mistake depression for sadness, and try to cheer you up. It works just as well as in the comic - it's not "I'm REALLY SICK, don't you understand?", it's "I'm not fucking sad, and what you do doesn't help".
Of course it's going to construct cartoonish views of "happiness" and "wellness", simply to make them seem all the more unattainable so that you will give up trying. It causes you to misconstrue happiness and wellness as destinations--elite vacation spots where you will never be welcome--because that obscures the truth that happiness and wellness are processes--long, tiresome, and with constant failures.
But "happiness" is not objective anyway. And what happens in depression is that you can't delude yourself that "well, I have a nice wife, a good job, lots of friends - therefore I'm happy, because that's the definition, right?". And yet, you don't feel happy.
Is it wrong? Perhaps, but convincing oneself of that is just as fruitless as convincing someone to weep at Moulin Rouge.
As to whether it's "physical" or not - well shit, everything in our brain is. A right treatment could probably wipe out exactly that memory of when you were 16, got drunk and screwed a whale on the beach - the only problem is, we're kinda too stupid to do that yet.
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Meanwhile, I see it as actively harming people to pretend there is a physical cause when none has been named. Might there be one? Sure, but treating it like fact if it hasn't been proven is absurd. Just as absurd as having tens of millions of people on medicines that are no better than placebo.
As I mentioned in my earlier post, drugs are a crap shoot because:
the brain is still the most poorly understood organ, and that makes trying to develop drugs that mess with brain chemistry a tricky business. Especially when you throw things like morality and ethics into the mix.
Also in that same vein:
This is also one of the treatment approaches for chronic migraine (which, BTW, has a perceivable physical aspect if you are using an fMRI). When I started suffering from chronic migraine 20 years ago, they first started trying different interrupt medications - at the time there were no approved prophylactics for migraine - to halt the progress of an existing attack. I'd try each for a few months and then move on. After I ran out of interrupt meds to try, they started running me through other medications that had off-label uses as migraine prophylactics. At best, a medication would actually work for 6 months, and then it would suddenly just stop working. I'm actually at that point with my current medication, and I'm hoping it breaks the record.
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they're being diagnosed via MRI. There was already another mechanism that was used to diagnose them as depressed.
No shit, Sherlock. How do you think a new diagnostic tool is tested? By comparing it to an already used and accepted diagnostic tool.