For an example of how you might look for a connection between 'chemical imbalances' and cognitive states see the article on GABAergic signalling that I linked in this previous post:
http://community.boredofstudies.org/4225903/post-79.html
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The legitimacy of depression as an illness. (4 Viewers)
- Thread starter Hagaren
- Start date
http://community.boredofstudies.org/4225903/post-79.html
Ben Netanyahu
Banned
How about this. How does this fit into NCAP?If we considered it necessary to be moved, it would have been moved.
Do you think all topics about education should be moved to the school folders, and all discussion about drug legalisation to the health subforums?
It's not news.
It's not current affairs.
It's not politics
katie tully
ashleey luvs roosters
Well actually, I guess it is a current affair. I'll find the link, but it was reported last week that an estimated 50% of all Australians suffer from a mental illness.
Cookie182
Individui Superiore
You know that you can't, but such is the nature of much of psychology. How can we test for the productivity of a practicing psychologist? You’re correct, science can not reliably measure these things, and we can only go off the patients and their experiences. It is that old dichotomy of personal belief v science. We only have to flick to the 'Does God Exist' forum to see it in full force. Now, I'm not saying that people who use psychotics never have a more positive experience, of course. But I also think that the problem you raised applies there. Is there a major body of evidence suggesting that behavioural drugs have great long-term success in 'defeating' this 'illness'? If so, then I'm wrong. Otherwise, we do have to at least consider other esoterical alternatives; such is the promotion of the 'self-help' community, faith, etc
IMO I believe many people “think” they are depressed which becomes a self-fulfilling prophecy. I also think it is fair to blame a “cultural” movement, based heavily on egotistical desires etc. People (especially young people) are so plugged into the social matrix- seeking instant gratification at every minute. How many people do you know who live for the nights out, only to get trashed and wake up feeling like shit? Then so forth, the week repeats. Many people think they are “depressed” because their life is not matching up to the ‘wants’ they think they have through social conditioning. What about just being happy in the moment, taking a step back from the minute-to-minute desires? What happened to contentness or at least the gratitude that you were born against the great statistical odds which weighed against this?
Primarily, I think we can blame an identity crisis- and drugs for the long-term can not fix that.
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Kwayera
Passive-aggressive Mod
It's a current issue. I hath spoken.
Ben Netanyahu
Banned
current issues qualify as ncap material?
awesome
ur so much fun as a mod kwayera. so much better than iron eva wos
Kwayera
Passive-aggressive Mod
Major depressive disorder - Wikipedia, the free encyclopedia
Note that there is a large body of evidence for the positive efficacy of various anti-depressant medications, but other than saying that medications work as well as psychotherapy, I can't really affirm the claim that there is a body of evidence that ALL anti-depressant drugs have great long-term success in stabilising a chemical imbalance. Some do, some don't, and it depends largely on the individual.
I don't know many people who have had true clinical depression, but those that have did not have any social "cause" for it, or overlying "feelings of worthlessness", that prompted the condition. Admittedly this is an argument from anecdote, but I believe it's specious reasoning to argue that depression is caused by a cognitive dissonance between expectations and "social conditioning", when there are clear and coherent biological hypotheses for the genesis of the chemical imbalances of the condition.
Major depressive disorder - Wikipedia, the free encyclopedia (Biology)
Kwayera
Passive-aggressive Mod
Intelligent people would assume that current issues = current affairs, yes
Cookie182
Individui Superiore
And then wallah
they feel happier
Edit: Your marketing campaign inevitably reminded me of a GTA 3 ad:
"Try Equinox, by Zaibotzu Pharmaceuticals"
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I wanted to say a few things in response to some topics under discussion in this thread,
On the efficacy of anti-depressants
Focussing on SSRIs, it is reasonable to ask whether SSRIs (like prozac, zoloft, etc) have any real effect on depression. There are some recent metanalyses (that is, studies which compile statistics from multiple reputedly 'good quality' studies) - see here, for example - which question whether SSRIs produce any significant effect beyond that of a placebo. The linked metanalysis produces a typically vague result where there seems to be a positive drug effect but the effect is so small as to cause one to ask whether it is of clinical significance (though they do find a more significant effect size in the severely depressed).
Note, this is only one such study. There are others which disagree. Certainly there exist individual studies (RCTs at that) which demonstrate more significant benefit. Also, there was an interesting article last year in the NEJM which even criticises metanalyses (focussing on depression) and tries to demonstrate how they are affected by publication bias, leading one to wonder whether metanalyses are really the pillar of evidence they are so often claimed to be.
Long story short, this is an area of hot debate. Also note that the above only addresses one class of antidepressants (SSRIs) in the context of one condition (depression). Evidence exists that SSRIs have a positive effect in OCD, generalised anxiety disorder, and bulimia nervosa, for example. Other drug classes like benzodiazepines, tricyclics, amphetamines, and antipsychotics would have to be considered separately.
On the efficacy of anti-depressants
Focussing on SSRIs, it is reasonable to ask whether SSRIs (like prozac, zoloft, etc) have any real effect on depression. There are some recent metanalyses (that is, studies which compile statistics from multiple reputedly 'good quality' studies) - see here, for example - which question whether SSRIs produce any significant effect beyond that of a placebo. The linked metanalysis produces a typically vague result where there seems to be a positive drug effect but the effect is so small as to cause one to ask whether it is of clinical significance (though they do find a more significant effect size in the severely depressed).
Note, this is only one such study. There are others which disagree. Certainly there exist individual studies (RCTs at that) which demonstrate more significant benefit. Also, there was an interesting article last year in the NEJM which even criticises metanalyses (focussing on depression) and tries to demonstrate how they are affected by publication bias, leading one to wonder whether metanalyses are really the pillar of evidence they are so often claimed to be.
Long story short, this is an area of hot debate. Also note that the above only addresses one class of antidepressants (SSRIs) in the context of one condition (depression). Evidence exists that SSRIs have a positive effect in OCD, generalised anxiety disorder, and bulimia nervosa, for example. Other drug classes like benzodiazepines, tricyclics, amphetamines, and antipsychotics would have to be considered separately.
I find a major problem with this site, and threads like this, is you tend to get so fired up about people being idiots, that you feel like you have to spend time and effort proving and explaining yourself... when really it's just a waste of time =(
It's a vicious cycle.
It's a vicious cycle.
Kwayera
Passive-aggressive Mod
KFunk - I was led to believe that SSRIs are falling out of favour, at least in places like the US/UK, for the treatment of depression. Is this true, and as a result of that metanalysis?
Physical happenings and mental activity
Firstly, a lot of the confusion surrounding what to make of the term 'chemical imbalance' lies at the philosophical level. As Mr. Netanyahu so eloquently expressed, how on earth can we reduce the human mind to mere chemistry? The fact that peoples' folk psychologies often make use of concepts like free will, spirits and body-independent rational faculties can make it hard to reconcile our picture of the human mind with the chemical picture painted by science. The waters get muddied quickly.
Nonetheless, strong evidence exists linking mental processes to the anatomy and electrochemistry of the brain. For example, neuroscience has mapped several cognitive functions on the brain such that for a given function (for example, visual recognition of faces) (1) there is an area of the brain which is metabolically active on brain scans when the function is performed, (2) the function is either impaired or eliminated when this same region of the brain is damaged (e.g through stroke) and (3) the function can be modulated through administration of drugs which afect chemistry in that region or when electrical/magnetic stimuli are applied to that region. Alcohol, caffeine and recreational drugs (see hallucinatory neurophysics) provide further beautiful examples of the chemical constitution of experience.
Kwayera
Passive-aggressive Mod
The placebo effect is fascinating. You should read Bad Science by Ben Goldacre - it's a great (and scary) book regarding CAM and the misrepesentation of science, and it devotes a whole chapter to the placebo effect.
Cookie182
Individui Superiore
I think its good when you can come into a thread, obviously with preconceptions, and leave having extended your learning. Kudos, patricularly to Kfunk.
Also, thank you Kwayera for a small debate- I certainly broadened my mind slightly on the issue, although I do still leave thinking that in possibly a majority of depression cases, chemistry is not the only explanatory variable.
Good night and self bless
Also, thank you Kwayera for a small debate- I certainly broadened my mind slightly on the issue, although I do still leave thinking that in possibly a majority of depression cases, chemistry is not the only explanatory variable.
Good night and self bless
On chemicals and causation
An important point that seems to be missed here is that 'chemical imbalances' and 'negative self-thought' may either be intimately related, or may be one in the same thing.
If we accept the neurochemical basis of the human mind then doesn't it seem reasonable that chemical imbalances could alter one's temperament, thought processes, mood, and so forth, and similarly that one's experiences and thought processes may alter brain chemistry and structure. Evidence exists for both. We know that drugs (read: chemicals) can alter cognition, experience and behavior. For a current hot example of the link between genes, chemicals and behavior see the role of Monoamine Oxidase in Aggression. Furthermore, we know that experiences can alter brain structure and cognition - for example see studies on hippocampal volume in taxi drivers and one of many thousands of studies linking early childhood relationships with later emotional functioning.
It may well be, and indeed seems likely, that both nature (life experiences, exposure to chemicals and disease) and nurture (genes, inherent brain chemistry) cause depression. It may well be that one is born with a predisposition on account of the genes that control brain chemistry, determining things like temperament (upbeat? anxious? risk-taking?) and propensity towards certain thought patterns, and that such tendencies interact with experience to determine whether one becomes depressed. Things are complicated when we realise that environmental influences (even in the womb!) - social, chemical, infectious etc - can alter gene expression in cells.
tl;dr -->
Essentially the picture is complicated. Brain chemistry alters cognition/behavior and hence experience. Experience alters brain chemistry. In many cases chemical and mental changes are one in the same thing, though I expect it is more likely that they simply overlap in a lot of cases (given that specific neurotransmitters and chemical processes each seem to subserve multiple mental functions).
My opinion is that, considered broadly, you cannot, and should not, try to fully separate the chemical and the mental/social/whatever. There may, of course, well be instances of depression which are primarily chemical (e.g. where ultimately a gene is at fault) or primarily reactive (e.g. depression triggered by loss). Regardless, we need to appreciate the complex interelationships that exist.
I'm not sure about prescribing trends tbh, though I'm sure there are studies or media releases out there addressing the issue.
Certainly I can affirm that SSRIs are a matter of debate at the moment. This is partly as a result of metanalyses, as you have noted. Also, in the context of children and adolescents there is the data which suggests that SSRIs, perhaps with the exception of prozac (fluoxetine), initially increase suicide risk, i.e. during the peroid when activity levels are increased but before mood effects kick in. This result is controversial, however, and for many good reasons. There are still many strong advocates of SSRIs and they remain part of the standard treatment for many.
It will be interesting to see what trends emerge in the near future. More interesting will be the new designer drugs which come out of the pharmaceutical industry - I <3 rational drug design.