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The Sound of Ideas

Facing Depression and Finding Treatment

Posted Monday, January 11, 2010

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Depression affects as many as 18 million Americans every year, not to mention their friends and family members. Psychiatric drugs along with psychotherapy can perform minor miracles, but controversial new research suggests for some facing depression, medication may be no more effective than doing nothing. As ideastream - in collaboration with the Plain Dealer - begin a week of comprehensive coverage of depression, we'll spend the hour Monday morning explaining the differences between clinical depression and just "feeling blue," we'll delve into how medication and talk therapies work, and consider other treatment options.

Tags

Health, Facing Depression

Guests

Dr. Keming Gao Assistant Professor of Psychiatry, Case Western Reserve University School of Medicine; Clinical Director of the Mood Disorders Program in the Department of Psychiatry at University Hospitals Case Medical Center
Dr. Toni Johnson Chair, Department of Psychiatry, Metrohealth Systems
Julianne Kurdila, diagnosed with Dysthymia

Additional Information

The Wrong Story About Depression, By Judith Warner, Op-Ed Contributor, The New York Times

Leave a Comment

Please follow our community discussion rules when composing your comments.

Jessica 10:36 PM 1/9/10

I grew up in a family that did not consider depression to be a medical issue, but rather a character defect.  After taking medication, and experiencing a life-saving life of my depression and anxiety, I am so grateful for the professionals that encouraged me to see my symptoms as a medical problem that was no different than having cancer or diabetes.  I wouldn’t ignore either of those diseases or leave them untreated and I can’t ignore my depression by trying to survive without medication.

Thank you for presenting this program.  I look forward to each day’s segment.

David M. Fresco, Ph.D. 3:32 PM 1/10/10

Really glad you are undertaking this topic in the coming week.  Good panelists for this first installment.  Still, your panelists seem weighted more on the pharmacotherapy end of the treatment spectrum.  There’s important psychotherapy work happening in depression too ... here in NE Ohio. 

David M. Fresco, Ph.D.
Associate Professor
Kent State University

Salena Meronk 9:55 AM 1/11/10

Good morning Dan and crew. I suffer from depression and most of my young life my dad would tell me just to snap out of it. I started taking medicine when I was in my 20’s, but all that did was cause massive weight gain ( of which I still can’t lose) and no real change in the lows or the highs. So I took a radical unprecedented approach. I did nothing. In my 30’s (mid) I had gaineds so much weight that I felt even worse than before so I went off the meds and now, when depression hits, I try and take a proactive view. I can feel it coming, I brace myself for it and I know that I will get through it, it lasts mostly days, but sometimes weeks so I know, conciously there is an end to the suffering. Unfortunately, I have been told I am more self aware ( I call it hypochondriac lol) than most so this does work for me. It will NOT work for everyone but I do feel that unfortunately, this is very common ( depression) in most adults. Diet can change your outlook, but I do rely mostly on inner strength.

Jane 10:20 AM 1/11/10

The professional help for depression is so disjointed.....psychiatrist (medication), psychologist (maybe talk therapy), counselor (talk therapy), general doctor(who knows because he/she sure doesn’t know)
The patient has to be the expert because the “experts” don’t talk to each other.  Those of us who are depressed learn from each other...what do you take?....Who do you see for therapy....

Sheryl 10:28 AM 1/11/10

I’ve been dealing with depression/GAD since I was very little. I was never treated for it until after I graduated high school as my family saw it as complete taboo and “just a phase”.
I’m glad that your guest found Paxil to work for her. I was at the opposite end of the spectrum and found it to put me into psychotic rages.
I was on Lexapro during my time at university and found that helped me a lot. I’m currently trying to help myself through a change in diet and taking a vitamin D supplement and right now, it seems to be helping.

Rob Gazy 10:47 AM 1/11/10

My wife has been through the “torture” of every SSRI/SSNI ... psychiatry has become no more than running through all the drugs and hoping for a change in symptoms.  They think everything is brain chemistry...well where is the blood chemistry test?  Can you give me a test that tells me what chemistry in my brain is flawed?  And if depression is now the number one medicine prescribed, why are we all suddenly suffering?  Who is looking into the cause nationwide?  Is it food, water, air, virus?  Or did we suddenly all just “mutate”?

Joan Di Lillo 10:50 AM 1/11/10

All of theses comments address what works, & big success stories. My sister’s depression cost her her job and her independence.  My sister has been on anti depressants for over 20 yrs, and continues to not have success. She went on to have 7 sessions of ECT and a good semetarian found her sitting in traffic in a catatonic state one night. The man drove her to the emergency room to find limited help for her again. 
Should she continue the ECT or what about the brain implant?  She is presently on 4 drugs including Seraquil, imipramine, lauictal, and pristia.  She is suffering tremendiously and is at a real tipping point.

Tim 10:52 AM 1/11/10

I was diagnosed with depression 10 yrs ago.  Five yrs ago I had a thalamic stroke and six months later developed disabling pain.  After a neuro stimulator implant in my neck ,y depression medicine stopped being effective.  Even now I need to adjust the dosage based on the amount of stimulation I( need to releave pain.  Thoughts?

Laurie 11:00 AM 1/11/10

Hello,
I grew up having a very happy childhood and felt it all change when my parent’s, very surprisingly to myself and my siblings, divorced.  I was about 14 years old, and I wouldn’t say that Depression had set in, but a sadness definately had.
At the age of 19, I began having severe headaches regularly.  Unfortunately, I was at this time a rebellious child/young adult and found that no one believed me.  How can you prove you have a headache?  My headaches becames so severe, that even with medication, I would have a headache 24/7/365.  Again, no one would believe me.  At this point, I would say that depression started to set in.  I soon got married and quickly gave birth to 3 beautiful boys.  My third son, born 13 months after my second, was born shortly before 9/11/01.  Shortly there after, My depression hit hard.  I had three babies in diapers, was afraid of the future for them and just afraid of life in general.  At this point, I was starting to frighten my husband who thought that I might hurt our children. (never crossed my mind, I just didn’t want to BE.) I didn’t want to die, I just didn’t want to feel anymore.  This is when he made a call and got me into theropy and in to see a doctor and put on medication.  For many reasons, I have been through many different doctors, theropists, medications, and degrees of feeling better.  Unfortunately, I have been feeling worse over tha past few years, feeling like a horrible Mother, wife, and have felt unable to work due to my headache and mood swings.  I am still looking for the answer for me, and am still looking for a local theropist. I’m afraid my marriage and family might not survive my ailments if I don’t find the right fix.  Can anyone help me?

Elizabeth 12:11 PM 1/11/10

I am a little disappointed that this episode did not focus more on the evidence against SSRIs for depression. You link to an excellent article above. Here is another one that shows, when looking at both the published AND unpublished clinical evidence of SSRIs, they show little benefit over placebo except for the most depressed patients. These patients respond because they are less likely to respond to placebos, not because the SSRIs worked:

http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.0050045

I also read an article yesterday in the New York Times Magazine about the influence of western notions of mental illness in other parts of the world that reports on evidence that the “illness” or “disease” label for mental illness in the U.S. actually causes people to treat those with mental disorders worse because it runs counter to the conception of self that is pervasive in this country - the “pull yourself up by the bootstraps” type of mentality:

http://www.nytimes.com/2010/01/10/magazine/10psyche-t.html?ref=magazine

Mental health professionals need to be less sure of themselves and should look at all of the evidence - clinical and cultural - that leads them to assign therapies to patients. Remember all the “hysterical” ladies of the 19th century? We now think the doctors back then were misguided. How will these doctors look in a few decades?

Exercise, eating right, getting enough sleep, and working through unhelpful and anxious thought processes will definitely help the depressed patient. Professionals should probably focus their time on helping and guiding patients through these processes. The chemical changes will still take place in the brain without side effects and will last longer.

Dr. Gary F. Joseph 12:36 PM 1/11/10

I enjoyed your Sound of Ideas show this morning.  I did call in but unfortunately you ran out of time before the show ended before I could talk with you.

I find it both interesting and tragic that we in the medical field still subscribe to the notion that we should push a pill for big pharma, rather than correct the problem.  I also find it interesting that there isn’t more question about the adds like the recent one about adding Abilify to a patients medication regimen because 2/3 of those persons treated with antidepressants still have symptoms.  Why isn’t it implied that one of the reasons the treatment isn’t effective is because the patient is MISDIAGNOSED. To iterate this point, I will refer to 3 cursory references.

a.  We can do neurotransmitter testing to get us closer to the answer of the problem, yet patients are rarely offered this as an option. As physicians, we would NOT treat Diabetes without checking blood sugar, we would not treat Hypertension without checking Blood Pressure, nor would we treat thyroid dysfunction without checking Thyroid function.  Yet we treat supposed neurotransmitter abnormalities with clinical impression and trial and error at the expense of a lot of patient distress AND OF COURSE THE COST OF THE DRUGS THAT BENEFIT THE PHARMACEUTICAL COMPANIES. I am not suggesting that there is not such a thing as depression from neurotransmitter abnormalities AND I do believe that some patients are appropriately treated with SSRIs. I do have a concern for the overuse of the diagnosis, the overuse and inappropriate use of antidepressants and anti-anxiety medications.  It is appalling that we as physicians push a label and pill on patients rather than treat the accurate cause.

b.  There is a study out of Ann Arbor, Michigan conducted by Pamela Smith, M.D. where a group of previously diagnosed “clinically depressed patients” who were on antidepressants were tested for hormone (endocrine) abnormalities (estrogen, testosterone, progesterone, pregnanelone, cortisol) and once these abnormalities were corrected, AN AMAZING 92% of these patients were able to discontinue their antidepressants because their symptoms resolved.

c.  As a physician trained in the treatment of hormone dysfunction, I have seen the depression, anxiety, mood swings, loss of joy, sleep dysfunction, loss of libido, weight gain, loss of confidence, fogginess of thought, etc all get corrected back to normal once the hormones and/or neurotransmitters were tested and corrected by replacing the patents own natures hormones, getting people to sleep so they can heal adrenal stress, and increasing their exercise and changing a few things in their diet.

Thank you for your time and the show.  I would be happy to discuss further and give monthly free seminars to the public.

Dr. Gary F. Joseph
330 819 7419

BodyLogicMD of Cleveland
4700 Rockside Rd
Suite 535
Independence, OH 44131
(866)972-5265
gjosephdo@bodylogicmd.com

Marlene Beggs 9:34 PM 1/11/10

As I was listening to the program Mon. morning, the role of exercise was only mentioned twice and briefly.  I am just finish listening to the book on CD and reading SPARK The Revolutionary New Science of Exercise and the Brain by John J. Ratey, MD, a prof. of psychiatry at Harvard Univ. as well as having a private practice in MA.
He explains the new research showing that exercise is the best defense against everything from mood disorders to ADHD to addiction to Menopause to Alzheimer’s.  His web site is www.johnratey.com.
Also helpful in learning about the brain is the following site:
http://ngm.nationalgeographic.com/2007/11/memory/
brain-interactive.

The case studies and research given in Ratey’s book are explained in lay language.

Mike 4:10 AM 7/16/10

The professional help for depression is so disjointed.....psychiatrist (medication), psychologist (maybe talk therapy), counselor (talk therapy), general doctor(who knows because he/she sure doesn’t know)
The patient has to be the expert because the “experts” don’t talk to each other.  Those of us who are depressed learn from each other...what do you take?....Who do you see for therapy.... thyroid symptoms

Ulf 7:11 AM 9/3/10

I’ve been dealing with depression/GAD since I was very little. I was never treated for it until after I graduated high school as my family saw it as complete taboo and “just a phase”. 

alistortelini 8:39 AM 10/8/10

Throughout the course of our lives, we all experience episodes of stress, unhappiness, sadness, or grief. Often, when a loved one dies or we suffer a personal tragedy or difficulty such as divorce, loss of a job, or death of a loved one, we may feel depressed (some people call this “the blues"). Most of us are able to cope with these and other types of stressful events.

Over a period of days or weeks, the majority of us are able to return to our normal activities. But when these feelings of sadness and other symptoms make it hard for us to get through the day, and when the symptoms last for more than a couple of weeks in a row, we may have what is called “clinical depression.” The term clinical depression is usually used to distinguish the illness of depression from less difficult feelings of sadness or the blues.

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Every weekday at 9:00 AM (EST), The Sound of Ideas reports the news, explains the news, and sometimes makes news. The Cleveland Press Club awarded it “Best Radio Show” in Ohio and thousands daily find it to be an indispensable source of information about what’s most important to Northeast Ohioans.

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