Reply to Large study shows SSRIs work for only 15% of patients, huge placebo effect

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[quote=Anonymous][quote=Anonymous]Great. So depression isn't a chemical imbalance and SSRIs don't work. Just buck up! Pull yourself up by your bootstraps!

Research is good. I'm not faulting those who author the studies, but the repercussions of this are concerning to me. It's been a long hard road to convince people that depression isn't just a personal weakness.  Now we're back to saying maybe it is?[/quote]

OP here and I don’t see it like that at all.

The thing I’ve struggled with is that the “chemical imbalance” theory makes people think that if you just take a drug to fix the imbalance, then presto chango, no more depression. When that didn’t work for me, I had people in my life who absolutely then concluded “oh then this is just your fault.” So then I was dealing with three things at once: my depression, the side effects from drugs that did not fix my depression, and a sense of defeat at not having solved my depression easily through drugs like all the ads convince people is possible.

I agree with the PPs that sometimes SSRIs are useful for kick starting a process that can be next to impossible without some kind of ignition. I am definitely not saying drugs don’t have a place— they absolutely do. But it’s problematic that most people view SSRIs as the first line of defense against depression when they work for such a small percent of people. When I’ve struggled with the medication in the past, I’ve been told that I’m part of a small subset of people with depression who don’t respond well to drugs. But it turns out that’s probably not the case. Factoring placebo effect and the fact that the drugs often don’t work well long term, I’m probably in good company and instead we should view those whose depression responds well to medication as a lucky minority. But we need more solutions for the other 85% of people. Drugs, sure, but also a real acknowledgment that long term relief probably lies elsewhere. We have to figure out how to get people access to alternative therapies, and how to pay for it.

Another note: one thing I often think as someone who responds well to CBT/DBT is that part of the solution lies in educating EVERYONE in better thought patterns, even people who aren’t depressed. It should be part of standard education, like sex Ed. Because one thing I’ve realized is that part if the problem is about relationships and communication. We need a common vocabulary for talking about emotions, especially negative and scary emotions. Teaching depressed people this vocabulary gets us halfway there. But if everyone knew it, I think a lot of these issues would be easier to bear.[/quote]

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