Coming from one of our better commentators on science, medicine, and the like, very optimistic. Been battling my own black dog more effectively in the past three years through medication and therapy. A big jump was taking the Landmark Forum five years ago- when I began to take responsibility for my life. And prayer, too. Lotsa prayer. Can't forget the Big Person's role.
Hopeful news for me and others. At least twice The Worm (as I call it) nearly claimed my life. I credit my survival to the prayers of better Christians than myself, to the loyalty of some truly amazing friends, and to the best wife in the world.
I guess I am puzzled as to why you all think more pharmacological regulation of our inner life is good news.
guess I am puzzled as to why you all think more pharmacological regulation of our inner life is good news.
Because it beats the hell out of wanting to destroy yourself?
Gerard E and Hulk:
Thanks for your testimony. That sort of thing takes a lot of guts.
Art Deco: If you had to live with this thing for one day, you'd understand.
>>I guess I am puzzled as to why you all think more pharmacological regulation of our inner life is good news?
Sorry, I'd posted much more, but it got cut off. I guess that's good. 
Clinical depression isn't just feeling sad and sorry for oneself. It's a debilitating physical illness. Yes, physical, because the brain is part of the body and because it can get screwed up just like any other organ. One can't be talked or encouraged out of clinical depression/anxiety. Might as well try to talk oneself out of the flu or cancer. Self-destruction, ordinarily an unthinkable option, becomes suddenly tempting. I got a valuable insight into Christ's agony in the garden during the time I was laid up in bed with panic/anxiety/depression several years back. I tried to get up and over it, but it was a physical impossibility. It wasn't until I got medical help that I was able to function again, and only then was I able to look rationally at what had caused the attacks to start.
A very good point, Cathy. People need to understand that clinical depression IS NOT A MORAL PROBLEM. The depressive has a chemical war going on in his brain. He cannot simply "snap out of it" or "pull himself together." Trying to solve this problem by will power without medical help makes no more sense than snake handling.Of course he must pray (and ask the prayers of others)--but in this matter, as in all else, prayer is not an excuse for neglecting what you yourself can do.
Great news if true!
Nobody's mentioned Agent Mulder's little experiment with ketamine, though. You know, the episode when he had a hole drilled in his head?
I've always rather suspected that Mulder must have been related to Wolverine, 'cause he surely had mutant powers of healing up after these vicissitudes.
Because it beats the hell out of wanting to destroy yourself?
There is a distinction between wanting to destroy oneself and actually doing it. The questions that arise in this case are two-fold: for one's own interest, to what extent is it proper or prudent to make use of psychotropics rather than strategies to cope with the experience of suffering; and what are the implications for the social life and culture if the default response to this sort of figurative suffering is a trip to the pharmacy. Color me disconcerted by developments such as this.
Art Deco: If you had to live with this thing for one day, you'd understand.
It is a characteristic of pain that the subjective experience we have of it cannot be fully apprehended even by those nearest us. (And I was not aware that my personal history was so widely disseminated).
Clinical depression isn't just feeling sad and sorry for oneself. It's a debilitating physical illness. Yes, physical, because the brain is part of the body and because it can get screwed up just like any other organ.
My understanding of this may be very dated, but as I recall, 'major depression' is not diagnosed through measures of neurochemistry but through a written instrument called a 'Beck Depression Inventory' where you are asked questions about your emotional state (sad, self-pitying, what have you).
One can't be talked or encouraged out of clinical depression/anxiety. Might as well try to talk oneself out of the flu or cancer.
Psychiatrists and the like who traffic in 'cognitive therapy' might wish to take exception to this (and there methods have been deemed in controlled studies to be 'effective' by certain conventional measures).
A very good point, Cathy. People need to understand that clinical depression IS NOT A MORAL PROBLEM. The depressive has a chemical war going on in his brain. He cannot simply "snap out of it" or "pull himself together." Trying to solve this problem by will power without medical help makes no more sense than snake handling.Of course he must pray (and ask the prayers of others)--but in this matter, as in all else, prayer is not an excuse for neglecting what you yourself can do.
In my observation (and my extended family is liberally studded with lunatics and melancholics), people retain qualities of character and personality which are discernable in the matrix of a psychological self which presents them with unusual challenges. They remain moral agents even if they are addled in various ways.
Traders in the cognitive therapeutic program contend that the emotional life is a function of the accumulation of one's cognitions, and these cognitions do include judgments of value (which the therapists adjudge unreasonable).
Psychotropics have been in use only since 1955. Prior to that individuals, families, and communities had other coping strategies (which seldom included handling snakes,
Nobody's mentioned Agent Mulder's little experiment with ketamine, though.
I'm still waiting to hear about the results of Dr House's experiment with ketamine.
Special K: it's not just for breakfast anymore?
My husband went through about 20 medicines before finding some that worked, and he's still not right, just better.
And yes, we pray, too. But he didn't change for the better until he got the right medicine. Can you imagine being completely unable to enjoy life, anything in it? He can take mild pleasure in things now, but it's still a struggle to keep going day by day.
I do wish they'd figure out better ways of diagnosing and figuring out what meds will work - one or two nearly killed.
There is an effort to use EEGs to measure the brain, compare to other readings in the database and what *those* brains responded to - that's pretty helpful, it got my huband one of the medications that works, and our daughter something that's helping her - but very few doctors are doing it. I don't know why.
Forgot about House's ketamine. What was I thinking?!
Relief in two hours? From a shot? I've suffered from depression, off and on, from my teens. No way will it be "gone" in a few hours.
Art Deco, when you get a bad headache, do you take an aspirin? If a diabetic, would you refuse insulin?Just curious.
Oh, and BTW, major depression makes a migraine seem like a walk in the park. (It last weeks and months, not days.) Your vaunted pre-1950's "coping strategies" for major depression consisted most notoriously of laudanum addiction, a lifetime in bed, and my personal favorite, suicide.
Yes, Christians unite our sufferings with Christ. We also use the intellect and reason God gives us for temporal cures. Take your pietistic angelism and shove it -- or better yet, spend a few weeks on the schizophrenic ward of the nearest asylum, where you can lecture those poor creatures still uncured by pharmacotherapy all you wish about their moral weakness.
Art Deco, when you get a bad headache, do you take an aspirin? If a diabetic, would you refuse insulin?Just curious.
It is my understanding that there are costs and risks associated with taking insulin injections, so I would strive to avoid it (and if I am not mistaken, most people with adult diabetes get by on a modified diet). I take aspirin on occasion. It is good, however, to school oneself in putting up with certain discomforts. I am unpersuaded that your analogies hold.
Oh, and BTW, major depression makes a migraine seem like a walk in the park. (It last weeks and months, not days.)
Apples and oranges. Again, It is a characteristic of pain that the subjective experience we have of it cannot be fully apprehended even by those nearest us.
Your vaunted pre-1950's "coping strategies" for major depression consisted most notoriously of laudanum addiction, a lifetime in bed, and my personal favorite, suicide.
All things being equal, that would be reflected in comparative prevalence of suicide over time, comparative use of opiates, and comparative rates of labor force participation for men under 55. I would be interested if you could find data indicating there had been a trend toward reduced frequencies of the first two and increased frequencies of the third over the last five decades. (And with two of these three measures, I doubt you can).
Yes, Christians unite our sufferings with Christ. We also use the intellect and reason God gives us for temporal cures. Take your pietistic angelism and shove it
Angelism?
-- or better yet, spend a few weeks on the schizophrenic ward of the nearest asylum,
Again, I was not aware my personal history was so well known by strangers. That having been said, schizophrenics report and present phenomena that may be assessed objectively as well as experienced subjectively (e.g. the presence of voices or conspiracies by co-workers to do them in), and are seldom employable when unmedicated. The analogy is poor.
where you can lecture those poor creatures still uncured by pharmacotherapy all you wish about their moral weakness.
Lectures are not my object.
Schizophrenics used to be suspected of possession; does that mean that we still need to consider them so? Leading psychologists (Bettelheim comes to mind) blamed autism on "refrigerator mothers." I would posit that clinical depression is just starting to be understood from a medical standpoint, and that one day the idea that it is a personal failing will be just as ludicrous.
I believe biographies of Dr. Bettelheim in the last 15 years or so have revealed that his resume was an invention, that the academic degree he received at the Univesity of Vienna was in Art History, and that prior to his emigration in 1939 he was employed as a lumber merchant.
Critics of mid-century psychiatry (e.g. Paul McHugh) have faulted it for taking unproductive theoretical and clinical detours. It would be imprudent to suppose that improved research methods have eliminated this sort of phenomenon, rather than merely rendering it less likely.
I am not an adept of the philosophy of mind (and I would wager most clinicians are not as well), and puzzling this all out is beyond me. Best I can see, you seem to be arguing that one's will and one's capacity for reflection are inconsequential in addressing habits of the mind and habits of the heart. We the meatpuppets. Do you really wanna go there?
No, I do not think we are just "meat puppets." I thought that might be your objection to the idea. We must agree that some people, due to circumstances beyond their control (diseases such as schizophrenia, conditions causing retardation), have limited culpability for their actions, yes? I am only arguing that clinical depression is likely to turn out to be one of these. My husband, who works with researchers on central nervous system diseases, tells me that measurable differences have been found in scans of brains of people with depression versus those without.
I was not aware that Bettelheim's credentials were called into question. While I did not have any respect for his opinions despite his apparent qualifications, I would still not mind seeing sources cited. Even at that, there were still supposedly qualified individuals that bought into his philosophy of autism.
Meat puppets? No. Humans with free will that is sometimes diminished by the still misunderstood illnesses of the brain (an organ like and yet unlike any other)? Yes.
There are two biographies of Bettelheim:
The Creation of Dr. B by Richard Pollack
and
Bettelheim, a Life and a Legacy
by Nina Sutton
The first article on abuses at the Orthogenic School founded by Bettelheim appeared in the October 1990 issue of Commentary. An article in the 27 February 2003 issue of the New York Review of Books reviews a number of memoirs of the Orthogenic School and the two biographies in question.
We must agree that some people, due to circumstances beyond their control (diseases such as schizophrenia, conditions causing retardation), have limited culpability for their actions, yes? I am only arguing that clinical depression is likely to turn out to be one of these.
I will reserve judgment for now. What I have seen of workaday psychiatric practice in action does not persuade me that generic melancholy and 'clinical depression' are distinct phenomena, or that psychiatry has within it the resources to evaluate the reasonableness of a person's view of self or the world around him.
Paul McHugh had an article in First Things a number of years back about how psychiatric diagnoses differ from those of other medical subdisciplines; and also how psychiatry was led astray for four decades by psychoanalyitic theorizing. Suggest we be shy with these fellows.
It is impossible to describe depression to those who have never experienced it.
By Art Deco's reasoning, why can't smokers just quit. Do not put a cigarette in your mouth, seemingly simple, but evidently difficult for those addicted. Same thing for alchohol. Don't drink. Yet many struggle, and for some alchohol is the drug of choice to ease the pain of depression.
Other people's maladies are always easy to fix, just buck up and try harder. While there is no magic pill that makes life's challenges go away, the right medication can help make life worth living, and allow those of us afflicted with depression better able to cope.
That is not my reasoning.
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