Dear Dr. Fuller,
“I literally groan every time I see that Depression Hurts commercial. It makes it look like Cymbalta is the answer to whatever ails you, which is I am sure what they want viewers to think.
I rarely refer patients for medication and I work with people fairly long term. In the 35 years I have been doing this work, the vast majority of my patients have improved and become equipped to manage their lives very well. These days I feel quite out of step because I can't promise everything will be better in a few weeks or a few months. I appreciate your work a lot. Thank you.”
Friday, June 08, 2007 7:44:00 AM --- Cheryl Fuller, Ph.D
While I am of the agreement that the least invasive therapeutic approach should be undertaken first, I also seem to acknowledge from your writings and that of the CL PSYCH that your patient populations appear not to be what I consider the worst of the worst.
It also seems obvious to me that I’ve associated and worked with those patients that you have not and who never maintained long-term remission let alone beneficial response from either talk and/or medication therapies etc.
I would just like to make this fact clear to the readership that there is a patient population suffering MDD estimated to number about 4 to 5 million who are not responding to these conventional therapies.
Warmly,
Herb
VNSdepression.com
.
True enough. And some of those treatment resistant patients are likely depressive personalities. The "chemical imbalance" theory of depression is just that, theory, and so far as i am concerned remains theory until there is solid research from sources other than drug-company financed studies provides some conclusive evidence in this chicken and egg problem.
I have a private practice and it is true that patients self-select for me and other therapists not connected with a clinic or a psychiatrist. I am willing to bet though that the results are the same or better with therapy alone as they are with meds alone -- all of the credible research I have read demonstrates that. And therapy does not have terrible side effects.
Dear Dr. Fuller,
While not having any academic or medical credentials and/or licenses to give advice I can share from my 40 some odd years as a depression lay-expert to my spouse that in my opinion your field of practice is more an art than a science and the DSM IV is anything but a pseudo-scientific compilation of symptoms without any valid objective diagnostic means to determine any of those diagnosis and in essence is more theory than anything else.
I would also like to make clear that I endorse education of the patient in collaboration with ones caring, compassionate, knowledgeable and licensed mental health practitioner(s) and that I encourage hope and persistence as well as being a very long time advocate for mental health, wellness and a pro-activist no matter how achieved.
“True enough. And some of those treatment resistant patients are likely depressive personalities.” --- Cheryl Fuller, Ph.D
And so to the converse, that many of these “depressive personalities” unresponsive to years of many therapies exhibit such traits as a result of more serious illnesses such as MDD.
While I cannot speak for others I can speak of my spouse’s case history, one of a happy childhood without any physical or mental abuses or issues with parenting or situational stresses etc. Simply upon awaking one day in her early 20’s, when the world was our oyster, the first symptoms of a depressive illness appeared and the rest is over 4 decades of history of umpteenth therapies, neurologists, psychologists, psychiatrists etc.
Amongst the many hats I’ve worn through the years I have also been that of a trained facilitator for a local chapter of DBSA (Depression Bipolar Support Alliance). Maybe you’ve heard of the organization? Then to, having chaired many of these support groups over the years I’ve listened intently too many of the same similar histories to that of my spouse.
I’ve come to an interesting conclusion; maybe all depression is not due to a “depressive personality” as you may allude but to possible bio-neuro-chemical malfunction in the brain as seems to me based upon my research, knowledge and collaborations of illnesses running in families from generation to generation and especially my empirical data and observations of my spouse’s case history.
I just think that as a clinician one should recognize that in the area of MDD there is no such thing as one size fits all and there is a time and place in the cases of serious MDD patients to realize whether the “depressive personality” or other diagnosis leaves the patient in a life threatening situation which requires other forms of intervention.
I’ll also point out that as in the case of astronomy better equipment has yielded celestial bodies and information that our scientists concluded did not exist previously and similarly as is taking place in the realm of advancing findings of the neuro-science of the brain.
Unlike you I did not have the luxury of placing bets but ha
Woops, sorry about that I didn’t realize there is a limitation on the number of characters to your blog…
Unlike you I did not have the luxury of placing bets but had to make life and death decisions in my spouse’s care. Fortunately, through education and the guidance of some very outstanding medical professionals and researches our odyssey has been one of reasonable good fortune.
My spouse’s mood state as if switching a light switch off and on has gone into a state of control, stabilization and long-term remission of some 7 years with little or no use for psychotropic medications and so too have others experienced similar benefits after their odysseys based upon my collaborations.
Life being that which it is we are also now challenged by another neurological illness to my spouse also lacking diagnostic tools and a means to quantify and qualify an illness. While my spouse has been formally diagnosed with PD (Parkinson Disease) and one of its affects also causing depression I can report there is no adverse change to my spouse’s mood state or her reasonable quality of life.
I do thank you for this opportunity to share with you and your readership my thoughts on the subject of MDD.
Warmly,
Herb
VNSdepression.com
.
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