Warning: This post is definitely snarky, and also I lost my "serious" tone at one point and went way back deep into sarcasm because, well, just cuz. BACK TO POST This just in! Add more medicine to your medicine and we can help you fix anything! P.S. More breaking news - your mind is connected to your body! Some scientists say they even interrelate! ________________________ We don't know shit about what causes depression. We don't know if it's serotonin imbalance for instance, we just do know for sure that if we give you SSRIs, you'll feel better. And, well, serotonin being the feel-good-happy chemical that it is, it shouldn't be a shock that throwing more at a person will make them feel better. I would like to point out that good diet, exercise, and maybe some meditation apparently all help lower/manage inflammation as well...but they're barely mentioned in this article. Funny story - exercise really helps with depression, too. I'm not a doctor, but I think I read somewhere that meditation can be really good for, like, your brain. Those little white fibers in it or something. And vegetables?!?! I think the correct term for those is "superfoods" these days, right? Oh, wait - you're right. Organic superfoods. They have to come from plastic bags so you know they're clean and also where they're from. Without a label how would I know you got the right kind of Morningstar broccoli? Farms, CSAs, gardens, and anything with dirt on it - that "food" is for squares. And hippies. Wait - uh - are you telling me - are you telling me that if I get outside, and move around a little more, and maybe don't kill your body with sitting - warning, shit health posts galore ahead, I'll just - uh - feel better? That's crazy. That's impossible. That sounds cheap, and it sounds like work. Don't you know paying for a rainbow of magic pills to fix all your symptoms is better? It's efficient. It's really like magic. One pill, and my headache's gone. Another pill, and I'm wide awake. Too awake? Here's a pill that'll make you sleep. Here's a pill to lift your mood. Here's a pill to cut your anxiety. Here's a diet pill. It's like liquid exercise, except in capsules! And literally, no sweat! _________________ Look, guys. Science is great, medicine is great. They've found that eating habits may be influenced by gut bacteria, which is fascinating. Maybe anorexics and bulimics have substantially different gut flora. There's this crazy idea we can fix them by making them eat poop pills or giving them fecal transplants or whatever, so that healthy, well-adjusted, non-societally-damaged gut bacteria can move on in to these sick bodies like neighborhoods and fix 'em up. Change the brain by changing stuff in your gut. Maybe we really can fix people's brains by giving them medicine that sticks into the right part of the body and changes the chemistry that eventually ties back to the brain and gets it all back into whack. But I really don't think we should do away with talk therapy, and I'm not a fan of popping pills to fix imbalances that can be easily managed with healthy lifestyle decisions. (I'm talking more inflammation here than depression - although exercise can absolutely help depression, I'm not deluded enough to think it's always a viable option or successful, especially with extreme cases.)
We definitely shouldn't take away talk therapy. Depression might end up being almost totally physical in nature, but just living with it changes a person, even after they have 'beaten' it. The biggest thing that I've learned from medical anthropology is that proper healing, real, effective medicine and medical professionals, treat both body and mind. Each affects the other, and to say otherwise is unscientific. I'm for holistic medicine personally. Holistic meaning all-encompassing. Hard data, and empathy combined.
Hell of a lot more than we used to. Are you not much of a fan of insulin shots, then? Your post fits into my point. We've got to stop thinking of these things as mental 'imbalances'. There's no such thing. It's all physical, and there isn't a reason in the world why we can't design drugs that can help treat depression. Talking to people is great ... if they're sad. It'll help. But talking won't cure an actual physical disease, which is what "depression" is (there are better names for the phenomenon that have been come up with in the last ~10 years but offhand I can't think of them). I am as worried about the trend of over-dosing (especially children) as anyone, but that's a skepticism I selectively apply when it fits the facts. The facts appear to be that "depression" is a physical disease with physical symptoms that can be alleviated. The brain is an organ, as mysterious as its inner workings may yet be.We don't know shit about what causes depression.
But I really don't think we should do away with talk therapy, and I'm not a fan of popping pills to fix imbalances that can be easily managed with healthy lifestyle decisions.
I think you're both right, in that each other's approach is not looking at the full picture. Depression is a physical disease; it requires physical treatment (medication, diet, and exercise: choose 3). But it is a physical disease that is deeply challenging psychologically, and unhealthy coping mechanisms can cause lasting damage. It would be irresponsible to offer only physical treatment without at least assessing whether the patient needs help dealing with and repairing the psychological effects. And what do you know, integrate the two extreme points of view and we've arrived at basically what doctors are doing now. Maybe the medical profession aren't all idiots after all.
I do think you can say that about any disease, not just those in the nebulous psychosomatic category. All major disease cause lifestyle disruption and can certainly require talk therapy after/during (although I firmly believe love, attention and care from family or friends is much better).
You are correct that there is a physical basis for many disorders that are labeled as solely cognitive issues, however, there is some middle ground here. You shouldn't downplay the effect cognition can directly have on the overall health of an individual. The tie between placebos and their effect on our immune system is not something you should ignore. Placebos are a hell of a thing, and double blind studies are really difficult to accomplish, for this reason. Their is some underlying physical link between the two, somewhere, absolutely, and the faster we find a direct link, the better, but what if, for instance, the effects of a medical treatment for depression involving inflammation pathways can be counteracted by a lack of therapeutic assistance to help cope with the cognitive effects of depression? We don't know a lot more things than we thought we didn't know, especially since this whole gut bacteria thing started rearing it's head, but we sure do know what can help, for certain cases. Overhauling our definitions of delineating what is "physical" and what is "mental" is a very current issue, however, the line may be blurring more than it is shifting, and many professionals are looking more and more away from just simply "here is mechanism, here is treatment." Also, psychotherapy has proven to be, by far (for now), the most effective treatment for PTSD. Setting fire to the DSM won't change that fact. From here (in 2008, granted):The largest number of studies on psychotherapy for PTSD
indicates that cognitive-behavioral treatments, as well as Eye
Movement Desensitization and Reprocessing (EMDR), are the
most effective types.
Hey, flag, come on. You can talk all you want and it won't impact diabetes. But it's undeniable that talk therapy can help people suffering from a variety of mental issues. I'm not saying everyone, but I'm also saying it's a lot more effective than attempting to talk someone out of a sugar coma would be. You can't medicine someone off of a ledge if they are already there. If you can manage your potential health problems without paying into Big Pharma, I say, do it. I also say, don't buy into a hot drug the pharmaceutical companies are pushing because it's a money maker - aka, just be skeptical. Anti-inflammatories are probably nowhere near the Cadillac or even the Mustang of drugs for drug developers. However, with the prevalence of depression in our current population, if you started pushing them as an add-on treatment non-discriminately you could probably build a large market rather quickly. If you can't, or if you can't reasonably, then use what you have available to you. I don't take aspirin often, but sometimes I have an awful headache and nothing else has helped. If you're obese and you haven't had success losing weight through traditional methods I'm not going to sit at the table and judge you if you go for lap band surgery. Frankly, not really my business or place to judge. I think we over-prescribe and I think we prescribe instead of treating problems via methods that promote, in general, healthy lifestyles. It is however foolish to say that, for instance, exercise will cure suicidal depression. In fact it's not foolish it's downright dangerous. Talk therapy works well for a lot of people suffering from a vast variety of disorders. Sometimes it's vital that patients also take medication, like a lot of BDP sufferers for instance. Therapy can help patients who aren't prone to staying on medicine once they feel "better" stick to it - people suffering from bipolar disorder for instance, who often go off their meds after a period of initial success. If we have to choose between medication that helps the symptoms of depression and no medication at all of course I choose the former, because any help is better than none. But I'm also extremely skeptical of the fact that we can fix people with ingrained mental issues only using medicine. You can make a poop pill to cure an anorexic but until the anorexic does a lot of work fixing what's in his or her own head, they will refuse that cure. I have seen people with mental issues or disorders who find that disorder comforting, who believe it is justified, and that living another way or trying to fix their issues would be failure. We have to talk to those people. We have to change their minds as well as their chemistry.
I see what you mean. But I think a lot of people get sadness -- let's call it small-d depression -- mixed up with Depression. I think it's very possible that talking helps sad people. I do not think that talking can help someone with a physical problem in their brain, or in their immune system. "Healthy lifestyles," to me, means getting rid of the disorder, not trying and potentially succeeding to get rid of the disorder using holistic methods because we're angry at Big Pharma. In a nutshell, this is where we disagree. I think unhappiness and negativity and that sort of thing ought to be fixed with talk therapy, to avoid needless dosages and chemical interference. But let's leave actual diseases to the doctors. Discriminating between the two is very difficult, right now, but the point of this article is that it won't always have to be.But I'm also extremely skeptical of the fact that we can fix people with ingrained mental issues only using medicine.
Here's a problem though. As it currently stands in the west, we isolate illness/disease/suffering from a person. In doing so, we isolate the person from most of their other normal social connections. In his book Stranger in the Village of the Sick, Paul Stoller details a fundamental difference between the Biomedical approach to healing that his oncologist/oncology team takes back in the States, and the approach of his sorcery master in Niger. I'll attempt to illustrate below. Someone gets a positive cancer diagnosis, and then suddenly their life changes drastically. They spend hours and hours sitting, sometimes alone, waiting for test results, or hooked up to various therapy devices. They are lied to about the discomfort of procedures (Common practice, becoming less common now. Honest docs get higher patient satisfaction ratings than ones who lie about pain/discomfort levels), and are often left without anyone to explain to them the 'why?' of it all. While a person with cancer may be receiving appropriate biochemical care for their illness, mentally/emotionally/spiritually they are left out in the cold. This void can be filled by religion for some folks, family/friends for others, but the biggest aid seems to come from doctors who are genuinely interested in their patients understanding of their illness, and who make the effort to not only look at the chart and biological data, but the person. Call it the placebo effect, call it the blessing of Aesculapius, all I know is that it makes people get better, and it usually makes them get better faster. A talented physician reduces suffering in whatever manner they can. If that includes allowing a patient a chance to say a quick prayer with the physician to whatever deity/spirit/ancestor they believe guards them, I say it is a goodness, and I would love to hear the counterarguments. Edited for clarity. It's late and I should stop posting like this.But let's leave actual diseases to the doctors.