Most doctors, even those working with mental health, don't believe the chemical imbalance stuff. That's why recommended first line treatment for mild to moderate depression is a talking therapy.

Really? That's not what any of the doctors I've or people I've dealt with have said or act like. Even my psychologist (who can't rx) was fairly insistent that without medication there was only so far she could go and refusal to take it was a problem. Then there's the fact that a lot of people end up on anti-depressants and feel much better and are happy with the result.)

(Though I agree that mental meds are fairly shitty overall. Particularly anti-depressants and anti-psychotics. And they're really heavy treatments with potentially horrible side effects, so a talking therapy makes sense as it won't, for instance, cause your skin to die and fall off unlike some meds. Docs seem sorta-OK prescribing amphetamines in combination, but vastly more hesitant to even consider opiate treatment for depression.)

Clinical psychologist here.

The doctors I work with prescribe cognitive behavioral therapy as the first hand treatment for depression and antidepressant when therapy is ineffective (which isn't all that common).

One of the reasons that antidepressant are so widespread is that doctors are usually in charge of treatment and seldom perform therapy but are very used to prescribing medication.

Also the fact that millions of people are depressed makes it hard to give everyone access to therapy.

In my opinion it is much harder to treat a patient on antidepressant since they respond worse to treatment then a depressed patient who is not on medication.

Depression is a devastating disease but it is astounding how effective therapy can be for a lot of patients.

I regularly meet patients who are very depressed when we first meet who manage to overcome their depression in a couple of weeks.

Physical activity is also very good at treating depression.

http://www.tandfonline.com/doi/abs/10.1080/17437199.2015.102...

If everyone would exercise the demand for therapists would be much lower.

One mistake that many depressed patients make is holding a strong view that they are a person who suffers from depression.

This keeps the patient from realising that depression is a condition caused by their interaction with the environment and that it isn't personal.

I think one problem with the article is that it seems that the person still views herself in this way instead of fully realising whatever it is that is needed for keeping him/her from becoming depressed again.

There's a difference between saying "medication works" and saying "medication works by correcting a chemical imbalance".

> Docs seem sorta-OK prescribing amphetamines in combination, but vastly more hesitant to even consider opiate treatment for depression.)

Ketamine is currently experimental for major depression and anhedonia.

Opiates are currently the med most used in death by suicide in the UK, (#1 opiates, #4 opiate and paracetamol combination) so it seems reasonable to be cautious about prescribing opiates to a group at increased risk of suicide.

> Docs seem sorta-OK prescribing amphetamines in combination, but vastly more hesitant to even consider opiate treatment for depression.

I wonder, do opiates have any positive effect on depression? Short- or long-term? What about physical dependency? What about psychological addiction?

Extraordinary claims generally require excellent citations.

A component of the solution might be to take appropriate medication. I tried getting over the shit stew with drugs and no intentional internal change, first with prescribed drugs, then with, uh, other sources. It's so easy to believe that it's completely beyond your control, that it's a neurochemical problem that you cannot solve until the state of the system changes.

Meditate on this one for a bit: youtube.com/watch?v=lGwKXzH6tZY

I wonder if there's a chance that your personal illness isn't generally applicable to everyone's?

peteretep, of course it isn't generally applicable to everyone's. It is an illustrative point: you have a lot more control over your head than you'd like to admit.