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Prozac 'no better than placebo' for treating children with depression, experts

(www.theguardian.com)
206 points pseudolus | 2 comments | 21 Nov 25 00:02 UTC | HN request time: 0.526s | source
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Razengan ◴[21 Nov 25 20:49 UTC] No.46008818[source]▶
> treating depression

Most of the "treatment" is apparently just telling people to stop feeling sad [0], or giving them drugs

[0] https://old.reddit.com/r/thanksimcured

but no one bothers to take the time out to sit down and figure out WHY they feel sad and FIX THAT FOR THEM. That takes too much work.

Sometimes depression is this vague feeling that this world is just wrong. That Damocles' sword of mortality. The nagging sense of ultimate pointlessness. You can't really "fix" that. But having stuff to ignore it helps, like video games :')

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jdietrich ◴[21 Nov 25 22:43 UTC] No.46009923[source]▶
If someone is sad for a specific, identifiable and tractable reason, then they are experiencing a categorically different phenomenon to someone who just feels sad all of the time regardless of their life circumstances.

One of the key diagnostic criteria for melancholic depression - what we might lazily and inaccurately call biological or "real" depression - is mood unreactivity. Someone with severe melancholic depression could win the lottery one week, lose all of their family in a plane crash the next, and feel literally nothing about either event.

Some people with atypical depression (or normal sadness that has been mis-diagnosed as depression) can respond rapidly and dramatically to a change in their circumstances. For many others with depression, there is no external why - something has gone fundamentally wrong in the functioning of their brain. Trying to help those people with talk therapy or exercise or companionship would be as futile as using those things to treat hepatitis or gangrene.

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1. Razengan ◴[21 Nov 25 22:56 UTC] No.46010045[source]▶
> Trying to help those people with talk therapy or exercise or companionship would be as futile as using those things to treat hepatitis or gangrene.

I get what you want to say, but to nitpick the analogy: If the "treatment" for gangrene is amputation, then that's not really "fixing" anything. That's just the scorched earth strategy of destroying the afflicted along with the affliction. Like lobotomies. What do people think of them now?

> Someone with severe melancholic depression could win the lottery one week, lose all of their family in a plane crash the next, and feel literally nothing about either event.

Why SHOULD someone feel a specific feeling about any event? If you're subconsciously aware of the ultimate pointlessness of any event, if you're aware that feelings won't change what happened, you won't. You'd move on and handle the new reality in the means available to you.

I'm not saying that medicine should never be used and there's never a "chemical" cause to sadness (or any "wrong" feeling), just that it may be used too often as a lazy escape for the "helpers".

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2. jdietrich ◴[21 Nov 25 23:12 UTC] No.46010187[source]▶
>Like lobotomies. What do people think of them now?

Lobotomy was in fact an effective treatment (albeit with extremely severe side-effects), but we now have much better and safer treatments available. The abandonment of lobotomy was fundamentally driven by the invention of effective antidepressants, antipsychotics and mood stabilisers. Neurosurgery is still offered to an extremely small proportion of patients suffering from very severe and treatment-resistant depression and OCD.

https://www.cambridge.org/core/journals/bjpsych-advances/art...