No Thank you. I think you are such a great asset to this online community.
I just have to say I believe mental illness is so complicated, sociologically, historically personally and otherwise. I don’t think one cure or another is a cure. Because there are too many issues. Although antidepre***** have been a leap forward for many, we all know it’s not the end all. I don’t like someone making lithium jokes. (HAHAHA *knee slapper* Once heard al franken make one) I don’t like people saying that new treatments are all new, because I once read in one my parents textbooks that the Romans physicans sent manic/or depressed patients to baths (that were later found to be high in lithium content.) Glibness we don’t need on the subject of mental illness. It affects many of us (especially and weirdly those who are in mental health families.)

And Kirk, don’t forget there are other reasons for sessions other than the usual psychotherapy crap that are terribly important, like helping patinets overcome stigma that really does exist, help with symptoms when the drugs don’t always kick in etc etc. I hate HMOs thinking they could just prescribe antidepressants and be done with it.

HMO’s that do this for recurrent, moderate, or severe depression fail to provide effective treatment for potentially lethal disease.

This is inexusable.

For depression of more than mild severity – or any recurrent depressions – meds and psychotherapy are the gold standard – the most effective known therapy.

A famous California HMO offers very comfortable outpatient jobs – with caseloads of around 1,000 patients.

How to “manage” their symptoms is up to the doctor, of course.

And after three years, the doctors start to make partner in the famous “non-profit” HMO.

I “managed” by deciding not to do that sort of work.

If my psychiatric colleagues did the same, the HMO’s couldn’t get away with this crap.

When I see cruelty, I’m not quiet.

mui – thanks – and I completely agree with you on both counts. The studies I’m familiar with use psychotherapy with adequate (weekly) frequency, adequate length (60 ish minutes), adequate duration (ongoing in recurrent disease).

And fully trained psychotherapists (not any form of trainee): MD/PhD/MSW level training and completion of training hours.

mui @ 242

kirk murphy @ 221
I agree with all of what you said. But I believe therapy more than the 15 minute once every other month that HMOS were so happy to give unless they thought a patient was suicidal is better. There has to be supervision. Lives are complicated that way. And I think many will not take drugs unless a therapist is on their case.

More from the article: “Karen Hanretty, a spokeswoman for his presidential campaign, said that Mr. Thompson had no authority to decide which clients the firm represented. His work on behalf of Jean-Bertrand Aristide, the deposed Haitian leader — a phone call tMr. Thompson has faced questions about his work for two other Arent Fox clients. He initially denied working on behalf of a family planning group seeking to overturn an abortion counseling ban at federally financed clinics, but billing records showed that he spent nearly 20 hours on the matter. o John Sununu, then the White House Chief of Staff — has also become fodder for his rivals because of human-rights abuses during Mr. Aristide’s presidency.”

http://firstread.msnbc.msn.com…..53228.aspx

-GSD

uhhh…

….GordonM….

Major depression (recurrent) is a disabling biological disorder in which symptoms correlate with disruptions in cerebral function (demonstrable on functional MRI scans).

One in five americans will meet diagnostic criteria for a single episode of major depression in their lifetime. Those who have had three separate and distinct episodes (of two weeks duration or longer- separated by at least six months) of major depression have a near 100% chance of future episodes.

Net US annual productivity loss form depression exceeds that from cardiac disease.

With each episode, the severity and frequency of future episodes increases.

For single episodes of major depression of mild to moderate severity, anti-depressants are as effective as psychotherapy.

Patients with moderate, severe, or recurrent major depression do best with medications and psychotherapy – that combo is the current “gold standard” for treatment of depression and other mood disorders.

[Current studies indicate that the variety of psychotherapy may be irrelevant. Exploratory psychotherapy (which includes what your sensitively describe as “figuring out what the friggin problem is”) is no more or less effective than cognitive-behavioral therapy.]

For patients with recurrent major depression (or single episodes which are “severe” or “severe with psychotic features), psychotherapy alone is ineffective.

For these patients, ideological prescriptions to “figure out what the friggin problem is” sans medication are simply death sentences for some who mistake such afactual assertions for rational bioloogical assessments.

Recent proof of this fact may be disinterred from the increased mortality – that’s dead people, for the ideologues among us – observed with decreased rates of antidepressants in teens.

With decreased antidepressant use, teen suicide rates increased.
Suicide rates decrease with antidepressant treatment.

Of course, for those inured to death by ideology, this is irrelevant.

Oh – and if you think I’m overly harsh:

peer-group rejection of medical care for the medical disease that is depression is the most powerful prediction that a suffering person will not seek (or will reject) effective treatment.

And one of five people you meet will have depression episodes in their lifetimes.

Some will have severe and/or recurrent major depression.

For these people, ill-informed opinions rejecting anti-depressants offer at best a sure route to misery and at worst a lethal prescription.

But hey – that’s what ideologies are all about, right?

Denying the empirical facts that don’t fit with a cherished theory.

Worked well enout in Iraq, right?

GordonM @ 166

Like anti-depressants. Much more, um, cost-effective to just get ‘em stoned rather than figure out what the friggin’ problem is.

THANK YOU. For personal reasons too long and, um, depressing to enumerate, I have a REAL problem with people who glibly dismiss the pharmacology of mental illness.

Oh, and one more senator to watch for tomorrow from the Foreign Affairs committee: David Vitter.

You mean Diaper David Vitter? *s*

Elliott @ 231

the link worked for me, but those were some scary results!!

very scary, innit?

This is flatly untrue. All the repugs waited for this and voted many times.
It’s truly absurd.