# "Here's what you need to do and here's why you need to do it..."



## MaynardJamesKeenan

Ive been reading everything under the sun lately.  Awaken the Giant Within, The 7 Habits of Highly Effective People, The Richest Man in Babylon etc... Ive even seen a psychologist more than a few times.  What Im missing in my search seems to be a clearly laid out plan for what to do to overcome depression.

Lately ive been keeping track of my daily goals which has helped me accomplish a little more every day but I still feel like there are steps I need to take and right now I dont even see them.

Any books/ideas/resources that sit you down like a 6 year old and tell you step by step what you need to do and why each step is important?  Any help would be appreciated.


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## Into The Light

welcome :wave4:

you may want to check out this link to a depression primer at this thread: Depression Primer: Excellent link about depression - Psychlinks Psychology Self-Help  & Mental Health Forum. it explains things fairly simply and with humor.

my top 5 for beating depression

1. talk therapy (combined with medication depending on how severe your depression is)
2. exercise
3. socializing
4. relaxation/better time management
5. healthy food

reasons why:

1. *cognitive behavioural therapy* (cbt) will teach you to recognize distorted thinking and how to counter it by replacing the unrealistic thinking with realistic thinking. if depression is moderate to severe, medication will be needed or else the cbt just won't work as well. reason: brain needs a little help (all explained in the primer). also may sometimes need medication to help you re-establish healthy sleep at night.
2. *exercise* is really good for you as it releases endorphines and makes you feel good. it also keeps you from thinking and gives your brain a break from all the negativity.
3. *socializing *makes us feel better. we are social animals and need human contact. isolation makes us hyperfocus on ourselves and what we believe are all the things that are wrong with us. 
4. *relaxation* is important to recharge. being depressed is a stressful state and is really draining.
5. *you are what you eat.* your brain needs vitamins and minerals to function well, not sugars. healthy food is better for us and makes us physically feel better and gives us more energy. help your brain rebuild itself using the vitamins and minerals. junk food won't do it much good.

other suggestions: avoid the news (full of doom and gloom), listen to music (but not depressing music, it has to be neutral to upbeat).

let us know if you have any questions


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## Retired

MJK,

Are you seeing a physician along with your psychologist and are you taking any medication to treat your depression and ADD?


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## MaynardJamesKeenan

TSOW said:


> MJK,
> 
> Are you seeing a physician along with your psychologist and are you taking any medication to treat your depression and ADD?



Holy crap.  Its wierd posting in a message board where people help and talk about serious things.  Its very refreshing.

The only two doctors ive talked about my depression with is my psychologist and my general doctor.  My psychologist recomended medication and said talk to my doctor about it.  My doctor prescribed me effexorXR which I took for about a month and dropped.  I dont think I noticed any positive (or negative) effects from it and I still have the idea that I can beat this without medication.  I am taking Adderall for my ADD off and on which seems to be OK.  

Thanks for the link Into The Light


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## Into The Light

a month isn't really that long. you may not have given it enough time. i have also often heard that when people start to do better on medication it's the people around them that notice a difference, but not the depressed person themselves yet.

i do not know how serious your depression is. i know that everything i listed above will work ok for you if your depression is mild. however, starting at moderate depression it would be a good idea to consider medication. without it, all the other steps may not be sufficient and/or more difficult to accomplish.

it may take you a while to understand this but depression is a physical illness. the physical part of your body that is affected happens to be the brain instead of the heart or another organ.

in any case some things for you to ponder over


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## MaynardJamesKeenan

Into The Light said:


> a month isn't really that long. you may not have given it enough time. i have also often heard that when people start to do better on medication it's the people around them that notice a difference, but not the depressed person themselves yet.
> 
> i do not know how serious your depression is. i know that everything i listed above will work ok for you if your depression is mild. however, starting at moderate depression it would be a good idea to consider medication. without it, all the other steps may not be sufficient and/or more difficult to accomplish.
> 
> it may take you a while to understand this but depression is a physical illness. the physical part of your body that is affected happens to be the brain instead of the heart or another organ.
> 
> in any case some things for you to ponder over



A few things...

I think about suicide almost every day (not necessarily doing it but thinking what it would be like).  I have a few big 4 inch by 1 inch burn scars on my shoulder which are self inflicted.  I have lost all contact with friends.  My appetite is horrible.

on the other hand...

My family and co workers dont seem to notice.  Strangers often call me "chirpy".  Sometimes I feel like maybee Im just in a rut.

One of my big things right now is that I think depression is good if that makes any sense at all.  I firmly believe its the body telling you to take a time out and get your things together.  I dont believe its an "illness" per say, more like a symptom, like a fever.  With a fever your body is purposly raising its temperature to kill off invaders.


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## ladylore

Welcome to Psychlinks Maynard. :welcome2:

I agree with ITL with this one in respects to anti-depressents. Depression has been medically proven to be a chemical imbalance (seratonin) in the brain. Anti-depressents are designed to right the levels of seratonin. 

I was on them for a year. It took that long so that my brain could produce enough seratonin by itself. You may want to ask your psychologist about it, especially because of the suicidal thoughts. No one should have to live that way.

One more thing.  It takes about 3 weeks on average to start noticing the effects and to start to feel better, and some more time to recieve therapy while you are on the medication to change thought patterns....

Glad you found us.


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## David Baxter PhD

Also, with Effexor you generally start at a small does, 37.5 mg, and gradually increase that. For depression, an effective dose range for Effexor XR is typically in the 150 - 300 mg range. Chances are, in that first month you hadn't made it to a dose that would be able to provide significant benefits.


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## lallieth

Hi MJK

Here is a book I highly recommend

Feeling Good: The New Mood Therapy-David D Burns



> Book Description
> 
> The good news is that anxiety, guilt, pessimism, procrastination, low self?esteem, and other "black holes" of depression can be cured without drugs. In Feeling Good, eminent psychiatrist, David D. Burns, M.D., outlines the remarkable, scientifically proven techniques that will immediately lift your spirits and help you develop a positive outlook on life. Now, in this updated edition, Dr. Burns adds an All?New Consumer's Guide To Anti?depressant Drugs as well as a new introduction to help answer your questions about the many options available for treating depression.
> 
> ? Recognise what causes your mood swings
> 
> ? Nip negative feelings in the bud
> 
> ? Deal with guilt
> 
> ? Handle hostility and criticism
> 
> ? Overcome addiction to love and approval
> 
> ? Build self?esteem
> 
> ? Feel good everyday


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## Into The Light

does your therapist know you have suicidal thinking happening? this might be something you could try to open up about.

as for your co-workers not noticing anything - when we suffer from depression for the most part we are able to hide it quite well from people who don't know us that well. you say your family doesn't notice either, that only means you've managed to hide it from them as well. it doesn't mean that you aren't depressed. the suicidal thinking is a symptom, as well as the appetite being bad. the self injury is another problem that people just don't know about. is your therapist aware of the self injury?


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## MaynardJamesKeenan

ladylore said:


> Welcome to Psychlinks Maynard. :welcome2:
> 
> I agree with ITL with this one in respects to anti-depressents. Depression has been medically proven to be a chemical imbalance (seratonin) in the brain. Anti-depressents are designed to right the levels of seratonin.
> 
> I was on them for a year. It took that long so that my brain could produce enough seratonin by itself. You may want to ask your psychologist about it, especially because of the suicidal thoughts. No one should have to live that way.
> 
> One more thing.  It takes about 3 weeks on average to start noticing the effects and to start to feel better, and some more time to recieve therapy while you are on the medication to change thought patterns....
> 
> Glad you found us.



Is it wrong then to think of depression as a symptom instead of an illness though?  Wouldnt evolution have weeded it out by now?  I can't imagine a depressed man having an advantage over others in the compeition of spreading your genes.

I know Im no expert so Im trying to read up/get opinions as much as I can.

David Baxter - I actually probably took EffexorXR for 5 - 6 weeks at a dose of 75mg.  If things get worse I will probably go back on it.

Lallieth - I actually purchased Feeling Good by David Burns about a month ago.  Problem is I bought it with a bunch of other books so its taking me a while to get to.  Ill pick it up when Im done reading The Red Queen.  Its good to know that other people found that book to be useful.

Thanks for the help everyone.


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## lallieth

MaynardJamesKeenan said:


> Is it wrong then to think of depression as a symptom instead of an illness though?  Wouldnt evolution have weeded it out by now?  I can't imagine a depressed man having an advantage over others in the compeition of spreading your genes.
> 
> I know Im no expert so Im trying to read up/get opinions as much as I can.
> 
> David Baxter - I actually probably took EffexorXR for 5 - 6 weeks at a dose of 75mg.  If things get worse I will probably go back on it.
> 
> Lallieth - I actually purchased Feeling Good by David Burns about a month ago.  Problem is I bought it with a bunch of other books so its taking me a while to get to.  Ill pick it up when Im done reading The Red Queen.  Its good to know that other people found that book to be useful.
> 
> Thanks for the help everyone.



MJK

In regards to medication,it takes approx 6-8 weeks for the medication to "kick in" IE-starting to notice mood changes,slowing down of thoughts in the brain etc.Then the medication needs to be taken alot longer than that for stability to be reached.

How will you gauge "when things get worst" before you decide to try the meds again? what will you base that on?


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## Halo

> My family and co workers dont seem to notice. Strangers often call me "chirpy".



I definitely can relate to this as most people that I have contact with wouldn't even know that I suffer from depression nor would they know the extent of it, even my family.  I have had years of hiding it and become very good at wearing a mask for people in my life including my family.  

With that said, this does not mean that I don't suffer from depression and as a result have self-injured and have suicidal thoughts which are a symptom of my depression.  I can definitely portray myself as well put together and "feeling fine" to the rest of the world but what the hardest thing to do is to let down the mask when alone and when I am feeling safe in therapy especially since it is such a habit now to hide my true feelings.

As for Effexor, I was also on it at 75 mg and found that it didn't have much of an effect on my depression or alieving the symptoms at all but I did begin to notice a difference when the dose was increased to 112.5 mg. 

If you are having suicidal thoughts then to me it would be a good indication that medication is needed and I would definitely suggest going back on the Effexor and giving yourself time to get a high enough dose that you will indeed feel the difference.

Take care


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## Retired

> I actually probably took EffexorXR for 5 - 6 weeks at a dose of 75mg. If things get worse I will probably go back on it.



If I understand correctly, your doctor prescribed EFX 75 mg which you took for 5 to 6 weeks and suddenly stopped the medication.

My questions are:

Was the medication stopped on your doctor's advice, and was it replaced with something else?

What was the rationale for stopping the Effexor?

Effexor is not a medication which is taken for an acute situation and then stopped.  This medication is generally prescribed for a prolonged period, years sometimes, because Effexor like SSRI's and other SNRI's re-set the balance of neurotransmitters in the brain thought to be associated with the illness of depression.

It is not taken like an aspirin when you have headache.

Stopping and starting a medication such as Effexor without the guidance of your physician can cause unexpected adverse reactions which can be avoided with correct startup and discontinuation procedures.

Depression is an illness, and your doctor knows the diagnostic criteria to make a firm diagnosis.  As your illness responds to the therapies you and your doctor agree on, your doctor will be able to objectively evaluate your improvement.

You _must_ work with your doctor and therapist as a partner in your health care.


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## MaynardJamesKeenan

My doctor didnt tell me to stop when I feel better.  I stopped taking it because for the entire 5 - 6 weeks I felt it wasnt impacting me at all.  When I stopped taking it I experienced no negative side effects.  If I ever have to go that rout again Ill be more commited.


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## David Baxter PhD

You never made it into the "therapeutic range" during that time, MJK.


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## MaynardJamesKeenan

David Baxter said:


> You never made it into the "therapeutic range" during that time, MJK.



Shouldnt I have felt something though?  My doctor said I should start feeling some effects within 2 - 4 weeks.  I took it consistently for those 5 - 6 weeks so shouldnt I have at least felt some negative side effects or withdrawl?

Also that was the time I really started researching the topic of depression.  While Im no doctor I honestly feel like depression is my body trying to tell me something.  Why take a medication that "covers up" your problem when you can search for the real cause of it?

Right now, on a scale from one to ten.  A five being the emotionaly average person.  Id say Im a hopeful three.  Sometimes I dip to a two or even a one but thats getting rarer and rarer now.  Would you suggest I take a serious look at medicine now?

PS: If you have time, or if anyone has time, please take a look at this Can Anyone Relate? - Psychlinks Psychology Self-Help  & Mental Health Forum I just wanted to see what you thought.  

PPS: Thanks for the help everyone.  Like I said earlier, its awsome running into a message board where people talk about real issues and give a wide range of advice.


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## Halo

> Right now, on a scale from one to ten. A five being the emotionaly average person. Id say Im a hopeful three. Sometimes I dip to a two or even a one but thats getting rarer and rarer now. Would you suggest I take a serious look at medicine now?



My thought would be why settle for a three when if you took medication and talked a little more in therapy that you could be a 6 or a 7.  And also medication will more than likely help so that you don't dip down to a one or two.  Although you say that they are getting rarer, it still happens and no one needs to suffer needlessly if medication will help.  

Also, I believe in another thread you mentioned that you have suicidal thoughts and that is definitely something that medication and therapy can help with.  In my opinion, I would seriously talk to your doctor about medication and getting up to the dose that you will indeed feel the effect.


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## Into The Light

MaynardJamesKeenan said:


> Shouldnt I have felt something though?  My doctor said I should start feeling some effects within 2 - 4 weeks.  I took it consistently for those 5 - 6 weeks so shouldnt I have at least felt some negative side effects or withdrawl?


not necessarily. like i've mentioned before, people around you may notice a change in you before you feel it yourself. 

the other thing is, maybe the dose wasn't high enough. i would recommend that when on a new medication and not feeling any of the anticipated improvement that you go back to your doctor so it can be adjusted. quite often anti-depressants require some fine tuning, as we're all different.



> Also that was the time I really started researching the topic of depression.  While Im no doctor I honestly feel like depression is my body trying to tell me something.  Why take a medication that "covers up" your problem when you can search for the real cause of it?


depression is quite complex and there are many factors. right now all the literature suggests that there are biological as well as situational factors that may lead to depression (not all one or the other). i wish i could remember a link for you to go look at with more info on that. check the depression forum at Depression - Psychlinks Psychology Self-Help  & Mental Health Forum, and i am sure you'll run into a number of articles.

the medication doesn't actually cover up the problem, although i do understand your thinking. the medication allows you to start thinking a bit more clearly and gives you the ability to actually work on your problems. among other things it helps restore your energy levels, which you really do need to be able to handle day to day life plus the things that may have led to your depression.



> Right now, on a scale from one to ten.  A five being the emotionaly average person.  Id say Im a hopeful three.  Sometimes I dip to a two or even a one but thats getting rarer and rarer now.  Would you suggest I take a serious look at medicine now?


we can't really judge it from this distance. you need a professional's opinion. if you are having thoughts of suicide and are injuring yourself, then i would recommend you do consider it and speak to your therapist and your doctor and see what they recommend.



> PS: If you have time, or if anyone has time, please take a look at this Can Anyone Relate? - Psychlinks Psychology Self-Help  & Mental Health Forum I just wanted to see what you thought.


sure thing 



> PPS: Thanks for the help everyone.  Like I said earlier, its awsome running into a message board where people talk about real issues and give a wide range of advice.


glad you've found us. psychlinks is a great place to be, with tons of information and quite a community.


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## Retired

> Why take a medication that "covers up" your problem when you can search for the real cause of it?



Anti depressant medications do not provide symptomatic relief, as you suggest, but rather their action is on the actual brain chemistry that is thought to affect mood.

If you did not sense any change in mood while taking the starting dose of Effexor, then in consultation with your doctor in a follow up visit, your doctor would have likely increased the dose.

Everyone responds differently to medications like these, so time must be invested in modifying the dose and sometimes changing the compound until the right medication and dose is determined for you.

As David says, your brain chemistry was likely not affected as you discontinued the medications.

You need to persist and to maintain a constant communication with your doctor to report your progress, any changes for better or worse so your doctor can make necessary changes.

_That's_ being a partner in your own health care.


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## lallieth

MaynardJamesKeenan said:


> Shouldnt I have felt something though?  My doctor said I should start feeling some effects within 2 - 4 weeks.  I took it consistently for those 5 - 6 weeks so shouldnt I have at least felt some negative side effects or withdrawl?
> 
> Also that was the time I really started researching the topic of depression.  While Im no doctor I honestly feel like depression is my body trying to tell me something.  Why take a medication that "covers up" your problem when you can search for the real cause of it?



Hi MJK

You weren't on a higher enough dosage of the medication for it to work properly,to give you side effects or feel withdrawal.

Generally doctors like to start their patients on a lower dosage of an anti-depressant to see how well it's being tolerated,then bump up the dosage to a therapeutic dosage.It takes at least 6-8 weeks at a therapeutic dose for the medication to start working and for you to notice a difference.

Each medication is different and each dosage is different and must be tailored to suit the patient and their particular situation. 

For example,when I started Celexa I was started at 10 mg,then in a week bumped to 15,then another week 20mg's,and that was enough of a dose for me to be able to deal with my anxiety.But it took at least 8 weeks before I could really note a positive change.

I am not trying to push you into taking medication if you don't want,but what I am trying to point out is that medication can be a very helpful aid in your journey to battle the depression.

Medication does not cover up the problem,in fact it helps to calm you,get your thoughts in order so that you are better able to deal with any underlying problems or issues,causing the depression.You cannot fight the dragon if you don't have the proper weapons.

Trust me I have tried just about everything "on my own" but it was only when I started to take medication,did I realize that taking medication didn't cover up my panic disorder,but augmented my treatment of it.


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## MaynardJamesKeenan

TSOW said:


> Anti depressant medications do not provide symptomatic relief, as you suggest, but rather their action is on the actual brain chemistry that is thought to affect mood.
> 
> _That's_ being a partner in your own health care.



I realize medications action is on actual brain chemistry.  What my question is "Why cant imbalanced brain chemistry be a symptom of something else?"

So the brain isnt pumping out enough seratonin.  Why?  Who says thats the end of the rabbit hole?  

Couldnt our body be telling our brain "Hey, our life is really messed up right now.  Brain, can you stop pumping some seratonin so we can get things back on track?"

Humans have evolved for hundreds of thousands of years.  Why on earth would "the depression gene" still be so prevelent today?  Couldnt it be because it helps us instead of hurts us?  Why cover it up with something that we have just tapped into in the past 30 years?

Of course, severe depression should call for medication.  If your that close to the edge any crutch will help.


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## Into The Light

MaynardJamesKeenan said:


> What my question is "Why cant imbalanced brain chemistry be a symptom of something else?"


what would the something else be?



> Humans have evolved for hundreds of thousands of years.  Why on earth would "the depression gene" still be so prevelent today?  Couldnt it be because it helps us instead of hurts us?  Why cover it up with something that we have just tapped into in the past 30 years?


there is a great article somewhere on the forum about that. that shows what the evolutionary advantage would be. i just have no idea where it is. does anyone remember it? something to the effect that it helped you survive - being depressed and withdrawn makes for the rest of the tribe notice you're in need and they take care of you. also, withdrawing keeps you from going out into the dangerous world - thus keeping you safe that way.



> Of course, severe depression should call for medication.  If your that close to the edge any crutch will help.


even moderate depression. because it can turn into severe depression really fast.


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## Into The Light

found the article: Evolutionary Psychology: Depression as a survival tool? - Psychlinks Psychology Self-Help  & Mental Health Forum


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## meagan80

I really enjoyed the "Power of Now".


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## MaynardJamesKeenan

Into The Light said:


> found the article: Evolutionary Psychology: Depression as a survival tool? - Psychlinks Psychology Self-Help  & Mental Health Forum



Great article.  After reading that, doesnt it seem like medication should only be used in a worst case scenerio?  

What is medication for anyway?  Do you honestly believe millions upon millions of Americans are born with a disfuntion in their brain that only medication can fix?

Since the introduction of SSRI's, MAOI's, and Tricyclics do you honestly feel society is "happier"?

I cant reiterate this enough.  I do think antidepressants have a role.  I am NOT one of those people who think theyre for the devil (Tom Cruise).  I just think that in most cases people use them in a crutch which doesnt help in the long run.


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## Halo

MaynardJamesKeenan said:


> Great article.  After reading that, doesnt it seem like medication should only be used in a worst case scenerio?



I don't think that it necessarily has to be a "worst case scenerio" in order to take medication.  I think that it helps many people and in my opinion why wait until someone is at their worst to try medication.



MaynardJamesKeenan said:


> What is medication for anyway?  Do you honestly believe millions upon millions of Americans are born with a disfuntion in their brain that only medication can fix?



Yes I honestly believe that millions upon millions of people have a disfunction in the brain and need medication.  It has been proved time and again that medication plus psychotherapy helps.



MaynardJamesKeenan said:


> Since the introduction of SSRI's, MAOI's, and Tricyclics do you honestly feel society is "happier"?



Maybe happier is not the right word but maybe more aware and accepting.  I do think that society as a whole is beginning to understand that mental illnesses are a real illness that need treatment just like any other illness.



MaynardJamesKeenan said:


> I cant reiterate this enough.  I do think antidepressants have a role.  I am NOT one of those people who think theyre for the devil (Tom Cruise).  I just think that in most cases people use them in a crutch which doesnt help in the long run.



I definitely do not see people using them as a crutch.  Do you think diabetics use insulin as a crutch? Do you think that heart patients use their meds as a crutch?  It is the same thing...an illness that needs medication to help control it.  

Maybe you are not someone who needs medication but please bear in mind that many people take them, including myself and I therefore ask that you please not to put them down or make such general statements such as "people using them as a crutch and don't work".


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## MaynardJamesKeenan

A few things...

- So for hundreds of thousands of years humanity has had a significant percentage of its population suffer from chemical imbalances?  Only just now, we are fixing it with medication?  From the evolutionary perspective that seems ridiculous to say the least.

- Your right.  It has been proved that medication + therapy is very effective.  Have you ever seen the double blind studies where an antidepressant and a sugar pill are the only variables and no therapy is involved?  The results are astounding.  Even the most effective medication has next to no effect on these groups.  What does that tell you?  

- Yes I think America is more aware and accepting but thats not the issue at all.  The issue is emotional levels.  Its a very simple statement, but as a whole, since the introduction of antidepressants, I dont think America has improved at all.  Many would argue its gotten worse.  What does that tell you?

- Yes! Diabetics and heart patients use medication as a crutch.  Look at small segments of the population that live healthy lives.  Look at people who work out their entire lives and eat healthy their entire lives.  This particular population doesnt suffer from the same ailments the rest of America does.  They live longer, fuller lives because they practiced methods that people are suppose to practice.

- Im not trying to put anyone down who takes antidepressants.  If you take them and they work for you thats wonderful.  If I have upset you for some reason you need to look into it further.  Lets say Rush Limbaugh does both of the following...

"All black people are left handed"

"All black people are good athletes"

What draws up more anger/passion/debate?  The second one of course because there is truth to it.


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## Halo

MaynardJamesKeenan said:


> - So for hundreds of thousands of years humanity has had a significant percentage of its population suffer from chemical imbalances?  Only just now, we are fixing it with medication?  From the evolutionary perspective that seems ridiculous to say the least.



Yes now we are fixing it with medication as more research has been done and better and newer medications are working.  Medications have been around for years and this is not something new to the world.



MaynardJamesKeenan said:


> - Yes I think America is more aware and accepting but thats not the issue at all.  The issue is emotional levels.  Its a very simple statement, but as a whole, since the introduction of antidepressants, I dont think America has improved at all.  Many would argue its gotten worse.  What does that tell you?



And what do you base your "assumption" that America has not improved at all?  What you have said here tells me nothing to support your position on medication compared to what research and literature about medication has shown and proven.



MaynardJamesKeenan said:


> - Yes! Diabetics and heart patients use medication as a crutch.  Look at small segments of the population that live healthy lives.  Look at people who work out their entire lives and eat healthy their entire lives.  This particular population doesnt suffer from the same ailments the rest of America does.  They live longer, fuller lives because they practiced methods that people are suppose to practice.



You seriously believe that Diabetics and heart patients are using medication as a crutch?  These people need the medication to survive and live and if they did not have it they would die.  Same can be said for antidepressants.  Many people need them or their depression would become severe enough that they too would lose their life.



MaynardJamesKeenan said:


> - Im not trying to put anyone down who takes antidepressants.  If you take them and they work for you thats wonderful.  If I have upset you for some reason you need to look into it further.  Lets say Rush Limbaugh does both of the following...
> 
> "All black people are left handed"
> 
> "All black people are good athletes"
> 
> What draws up more anger/passion/debate?  The second one of course because there is truth to it.



First of all, you have not upset me and I have nothing to look into about it.  What does upset me though is that you are making very generalized statements about medication which could have an impact on others here on the forum who struggle with whether to take medication for _their_ illness or not. 

Second, you obviously have very strong opinions about medication and that is fine however again I would ask that you not discard medication as useless and a crutch.

Third, if you are looking for a debate about medication and its usefulness then I would suggest that you probably came to the wrong place.


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## David Baxter PhD

MaynardJamesKeenan said:


> So for hundreds of thousands of years humanity has had a significant percentage of its population suffer from chemical imbalances?  Only just now, we are fixing it with medication?  From the evolutionary perspective that seems ridiculous to say the least.



No. There is far more stress and helplessness and hopelessness today than even 20 years ago. And our environment and our neurochemistry interact to produce disorders like depression and anxiety, etc.

Additionally, in the past, before we had psychotrpic medications to treat these illnesses, people were thrown into asylums and chained to their beds 24/7. Would you really like to _return_ to those days?



MaynardJamesKeenan said:


> Your right.  It has been proved that medication + therapy is very effective.  Have you ever seen the double blind studies where an antidepressant and a sugar pill are the only variables and no therapy is involved?  The results are astounding.  Even the most effective medication has next to no effect on these groups.  What does that tell you?



Yes. I've seen them and I've critiqued them. What does it tell me? That bad research, no matter how many newspapers report it, is still bad research.

Pick a study. Any study. And I'll tell you what's wrong with it.



MaynardJamesKeenan said:


> Diabetics and heart patients use medication as a crutch.



Nonsense. They use medications to survive. There's no "crutch" about it.


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## MaynardJamesKeenan

Guys, please bare with me.  I dont know how to divide up quotes like Halo and David Baxter so excuse me if this seems unorganized.

This is in response to Halo...

- The human race has been around for hundreds of thousands of years.  We have been "weeding" out any trait that hurts our reproductive chances, through evolution.  Medication, antidepressants specifically, have been an EXTREMLY recent development.  Thirty years is less than the blink of an eye in the grand scheme of things.  We laugh at what "doctors" did to patients in the mental health field a mere 50 years ago.  I can only imagine what people in the year 2208 are going to think of our practices today.  So to address your first point...No.  Medication for this illness is very new to this world.

- You are also not addressing depression from an evolutionary perspective.  Humans have thrived on this planet in smaller close knit communities with most of our time being spent out doors.  Only in the past 100 years have we shifted to a more isolated and stationary lifestyle.  Most of us are placing stress on ourselves that have never been felt by our ancestors.   

- I just read a study that said 10% of US adults have used an anti depressant sometime in their life.  You dont think thats a little outrageous?  If 1 out of every 10 people naturally had chemical imbalances the human race wouldnt be here as we know it.  If a tribe of 10 people has to care for one "depressed" member that entire tribe is doomed.  Even if that tribe somehow survives that depressed member holds little to no reproductive value to any of its women.  This supports the theory that depression is an aid instead of a disease that only medication can fix.

- As far as America "improving"?  Your right.  I cant prove that.  However, you can't prove the opposite.  All we have is our eyes and brains and it seems to me that we could be doing a lot better than we are.  Heck, TV alone is killing us on so many levels.  Never in the history of humanity have we been drilled with one idea of success than now.  In 2008.

- My diabetes and heart disease comment was only there to prove the point that we can do natural and healthy things to prevent any such disorder.  Like I said earlier, can you imagine a tribe that is constantly outside and eating the freshest food with the same diabetes and heart disease numbers?  Depression is the same way.



This is in response to David Baxter...

- I kind of addressed the "psyche" of America above.  What we differ in is that you basically say we have no choice but to let our environment affect our neurochemistry.  You seem to say "The stress that modern society places on us does cause chemical imbalances in the brain."  I say you are 100% right.  I take it a step further and say we can alter our lifestyle into a healthy one instead of just popping a pill.  Once again in extreme cases medication is absolutly the way to go.  If someone is going to harm themself or others then by all means, give them a crutch.

- I remember getting my EffexorXR the first day and ripping it open to read the ins and outs of it.  The first thing I opened was a large sheet of paper folded like a map with tons of fine print on it.  The info on the fine print ranged from "how to use EffexorXR" to "the negative side effects of EffexorXR".  I clearly remember a write up of a study, in that very pamphlet, that basically said when two groups are given a pill to take.  One being EffexorXR, the other being a sugar pill, without any other therapy, the improvment between the two groups was negligable.  This was not a newspaper trying to get headlines.  This was not a magazine exploiting some study for subscriptions.  This was packaged with EffexorXR in extremely fine print.





Overall I think humanity is terrible at doing, or even knowing, what is good for them.  People dont recognize what truly makes them happy.  I think way too many people say "I am doing everything the surronding culture is telling me to do and Im not happy.  Give me a pill."  The surronding culture doesnt know whats good for anybody.

Doesnt the fact that we get "immune" to certain medication prove that its a crutch?  We are not fixing anything if our body is saying "We have relied on this chemical for too long.  We arent going to produce enough to get the desired result."


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## Mari

H! MJK I think it is good that your are thinking about these things but you need to do a lot more reading and studying regarding some of your arguements. I do not have any specific books to recommend but I would suggest some books on evolution, anthropology, history of humankind, cultural deveopement, medicine through the ages, native culture. Dr. Baxter seems straightforward and knowledgable so you might want to be a bit more trusting of that. You seem to refer to a crutch as necessarily a bad thing. I just noticed that my son's crutches from when he had a broken ankle are still lying on his cupboard floor. I wonder if he was supposed to return them? He had no trouble accepting crutches when he needed them to help him walk but when he needed 'crutches' to help him through his depression he refused. Why? I have to go now but I think that question has already been well answered by many people on this forum. :heart: Mari


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## David Baxter PhD

MaynardJamesKeenan said:


> The human race has been around for hundreds of thousands of years.  We have been "weeding" out any trait that hurts our reproductive chances, through evolution.  Medication, antidepressants specifically, have been an EXTREMLY recent development.  Thirty years is less than the blink of an eye in the grand scheme of things.  We laugh at what "doctors" did to patients in the mental health field a mere 50 years ago.  I can only imagine what people in the year 2208 are going to think of our practices today.  So to address your first point...No.  Medication for this illness is very new to this world.



We already laugh at medical and "psychiatric" practices that existed prior to the development of medications. But what has that to do with the efficacy of the medications we have now? They work and for many/most p[eople they work quite well. The thrust of current phranaceutical research is to make them work better by refining the mode and targets of action. 



MaynardJamesKeenan said:


> You are also not addressing depression from an evolutionary perspective.  Humans have thrived on this planet in smaller close knit communities with most of our time being spent out doors.  Only in the past 100 years have we shifted to a more isolated and stationary lifestyle.  Most of us are placing stress on ourselves that have never been felt by our ancestors.



As I said above.



MaynardJamesKeenan said:


> I just read a study that said 10% of US adults have used an anti depressant sometime in their life.  You dont think thats a little outrageous?  If 1 out of every 10 people naturally had chemical imbalances the human race wouldnt be here as we know it.  If a tribe of 10 people has to care for one "depressed" member that entire tribe is doomed.  Even if that tribe somehow survives that depressed member holds little to no reproductive value to any of its women.  This supports the theory that depression is an aid instead of a disease that only medication can fix.



Nonsense. So 10% have used an antidepressant. I would bet that well over 90% have used an antibiotic or a painkiller of one sort or another. What does that prove? It's a meaningless statistic. And no, I don't think there's anything outrageous about it.



MaynardJamesKeenan said:


> My diabetes and heart disease comment was only there to prove the point that we can do natural and healthy things to prevent any such disorder.  Like I said earlier, can you imagine a tribe that is constantly outside and eating the freshest food with the same diabetes and heart disease numbers?  Depression is the same way.



Again, what has any of this to do with the efficacy and utility of antidepressants? Who do you see saying that depression is best treated by medication alone? There's no question that the treatment of depression is most effective, both in terms of relieving symptoms and in preventing further recurrences, by a combination of medication, psychotherapy, and life-style changes. You're arguing against a straw man, a viewpoint no one is espousing. And, to be blunt, I find such debates tiresome.



MaynardJamesKeenan said:


> I kind of addressed the "psyche" of America above.  What we differ in is that you basically say we have no choice but to let our environment affect our neurochemistry.  You seem to say "The stress that modern society places on us does cause chemical imbalances in the brain."  I say you are 100% right.  I take it a step further and say we can alter our lifestyle into a healthy one instead of just popping a pill.  Once again in extreme cases medication is absolutly the way to go.  If someone is going to harm themself or others then by all means, give them a crutch.



1. Please read the Forum Rules - carefully.

2. The lifestyle points you make I have no issue with. However, you are simply wrong about medications for those who suffer from depression, anxiety disorders, etc. First, medication does not need to be and should not be restricted to "extreme cases". Second, medication is NOT a "crutch".



MaynardJamesKeenan said:


> I remember getting my EffexorXR the first day and ripping it open to read the ins and outs of it.  The first thing I opened was a large sheet of paper folded like a map with tons of fine print on it.  The info on the fine print ranged from "how to use EffexorXR" to "the negative side effects of EffexorXR".



So? These are a list of *possible* side-effects, not probable. Millions of people have taken the medication with no side-effects at all. Have you ever looked at the warnings for aspirin? or cold tablets? 



MaynardJamesKeenan said:


> I clearly remember a write up of a study, in that very pamphlet, that basically said when two groups are given a pill to take.  One being EffexorXR, the other being a sugar pill, without any other therapy, the improvment between the two groups was negligable.  This was not a newspaper trying to get headlines.  This was not a magazine exploiting some study for subscriptions.  This was packaged with EffexorXR in extremely fine print.



Uh-huh. Show me the study and I'll tell you what's wrong with it. A little information can be a dangerous thing, especially if not viewed with a critical eye.



MaynardJamesKeenan said:


> I think way too many people say "I am doing everything the surronding culture is telling me to do and Im not happy.  Give me a pill."  The surronding culture doesnt know whats good for anybody.



That doesn't mean that physicians are handing out that "pill" indiscriminately. Or that physicians don't know what works and what doesn't.



MaynardJamesKeenan said:


> Doesnt the fact that we get "immune" to certain medication prove that its a crutch?  We are not fixing anything if our body is saying "We have relied on this chemical for too long.  We arent going to produce enough to get the desired result."



No.


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## lallieth

Hi MJK

Here is the bottom line.If you do not want to use a medication to help you in fighting depression,that's fine,that is your choice.I do agree that we need to take care of ourselves better,as far as our physical health and that being physically healthy can help our mental health.

However,please do not sit in judgement of those that take medications as an aid to battle their mental illness.It is a very personal choice and when you make statements such as medication being a "crutch" you are insulting another's person right to choose what is best for them.

Many of us have struggled with the decision to take medication,and after doing much  soul searching,we have come to the conclusion that medication is the best way to go..for us.

You have not had enough experience in taking medication to make an informed decision as to how well it works for other's

Reading studies and doing research is all well and good,but in the final analysis,those of us that have been on meds for a long period of time,know first hand how it can help,we don't need a study to tell us that we have been given our lives back.

Do not judge until you have walked a mile in my moccasins


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## MaynardJamesKeenan

First of all, I want to clear this up.  In high school all my friends called me the devlis advocate because I would debate anything that could be debated regardless of how I felt about the subject.  If Im sounding insensitive I dont mean to be.  I think I just naturally form arguments that get people riled up.  I like hearing the other side of the story so "attacking" others, even if its not sincere, seems to bring it about most often.  Long story short.  Im not nearly as anti antidepressant as it seems.

One thing I will admit is that Im not addressing how effective current medication can be.  If it works for a large percentage of the population then God bless it.

I think a few things just worry me concerning the topic.

1) From my point of view, our current society seems to want the "quick fix" more than anything.  I wonder how many people taking anti depressants say "Im not happy.  I tried to fix it.  Give me a pill."? 

2) Lets say your 30 years old and are depressed.  You turn to antidepressants to "fix" your depression.  Do you rely on pills for the next 60 years of your life?  I just dont see an exit strategy that I like.

3) It seems like for every "illness" there is a healthy way to deal with it.  Dont want to be obese?  Eat right and excersize.  Dont want Alzheimers?  Work your brain out.  Dont want lung caner?  Stay away from cigarette smoke.  Of course in a perfect world obesity, alzheimers, and lung cancer would still exist, albeit in smaller numbers.  Some people are just genetically predisposed to certain illnesses.  For these people surgery and medication would still be needed.  Why do we treat depression any differently?


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## braveheart

My experience is that anti-depressants don't fix depression, but they help make my life a little more bearable as I face myself and overcome the demons of my past through therapy. 

I am 38 years old, and have been depressed and anxious since I was very young. The reason? Abuse, bullying and emotional neglect. 
Before therapy and medication I was a wreck, basically. Now I am starting to form a sense of self. 

If you look a bit deeper into the lives of all the people prescribed anti-depressants in the world, you would probably find that there's more to this depression thing than meets your eye at first scientific look. We are human beings who are hurt. Why leave us screaming when there is something that can bring relief? 

In times past I would have been locked up forever, like my father threatened to do to me when I was upset when I was young. But no, I have a job, and I am working intensely in therapy to gain some sense of self. The self that was shattered over and over again when I was growing up. Living in the world is painful for me, and medication seems to help make it feel a little bit safer for me as I work my way through what I need to work through in therapy.


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## lallieth

HI MJK

I don't think that there should be a debate as to why people choose to use medications.Personal decisions are not open for debate,that is why they are called "personal decisions"

If one were to debate the good and bad and the ugly of medications for mental illness,it would never be resolved because there are no grey areas,only black and white..you are either in the "for" camp or the "against" camp.

While I respect someone's opinion's about medication,unless they have personal experience with it,I have to assume their arguments against meds, are taken from various studies and from the experience of someone else.

Mental illness cannot be boxed up with illness,such as obesity or lung cancer.These are physical ailment's caused by external factors only,whereas mental illness is caused by physical and emotional internal AND external factors and simply cannot be wished away,or "cured" by eating better or getting enough exercise.

If I had a choice to watch my mother take an anti-depressant every day for the rest of her life,to give her back her quality of life,versus sitting in a state of severe depression day in and day out,then of course I would advise her to take the medication.

For some it literally does mean the choice between life and death,and how can that be debated successfully?


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## ladylore

I agree Braveheart and Lallieth. Medication helps balance out the brain chemistry so that people can do the work and given a fighting chance. This simply to me is about saving peoples lives and give people back a quality of life they deserve and want for themselves. There is no need to suffer when something can be done about it.


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## MaynardJamesKeenan

lallieth said:


> If I had a choice to watch my mother take an anti-depressant every day for the rest of her life,to give her back her quality of life,versus sitting in a state of severe depression day in and day out,then of course I would advise her to take the medication.



Who put it in your head that there are only two options?


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## Halo

lallieth said:


> Mental illness cannot be boxed up with illness,such as obesity or lung cancer.These are physical ailment's caused by external factors only,whereas mental illness is caused by physical and emotional internal AND external factors and simply cannot be wished away,or "cured" by eating better or getting enough exercise.



While I agree with most of your post above, I do not agree with the above statement in which you say that obesity and lung cancer are caused by external factors only. These illnesses can be caused by internal factors including genetics or an eating disorder which can cause obesity and lung cancer from someone who has never smoked.  I think that any illness can have external factors to it but some time there is a predisposition to a particular illness or genetics can play a part.  I say this because because a friend of mine died at the age of 17 with lung cancer having never smoked nor was around second hand smoke in her life.  I therefore don't think that the illnesses that are talked about can be purely external factors.



MaynardJamesKeenan said:


> Who put it in your head that there are only two options?



I know that your question was not directed at me but I feel compelled to answer.  

If someone is severely depressed what other options are there besides medication to help them get well?  Please do not say "get out and get fresh air", eat healthy or exercise.  While all those are good things to try and do, if a person is severely depressed just getting out of bed in the morning can be a challenge let alone trying to do anything else.

What other options were you thinking if it is not medication?


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## Into The Light

MaynardJamesKeenan said:


> 1) From my point of view, our current society seems to want the "quick fix" more than anything.  I wonder how many people taking anti depressants say "Im not happy.  I tried to fix it.  Give me a pill."?


you are making huge assumptions here. this is a very general and broad statement, and i also think it is a very popular misconception. first, from what we know, it seems only about 30% of people suffering from depression actually get treatment for it. mostly because either they don't know they're ill, or won't admit to being ill (can't get treatment for something if you refuse to acknowledge the problem).

second, it seems to me that most people resist medication. many people come here saying they don't want the meds and want a different way of managing and recovering from their condition. (i was one of them.)

third, anti-depressants aren't happy pills. a non-depressed person would not feel any elevation in mood if they took them.

anti-depressants reduce emotional pain and help restore energy levels. depressed people struggle with even the smallest of tasks that don't take any effort on a healthy person's part. that boost is very much needed.



> 2) Lets say your 30 years old and are depressed.  You turn to antidepressants to "fix" your depression.  Do you rely on pills for the next 60 years of your life?  I just dont see an exit strategy that I like.


again, you are making way too many assumptions here.

1. anti-depressants alone will NOT fix your depression. they take the edge off. without therapy, you're not going to improve beyond that.

2. who says you'll need them for the next 60 years? some people may, and others may not. it's highly dependent on the person (their body chemistry, their history of depression, situational factors contributing to the depression). i've been on them for a year and a half, and to be safe will probably continue for at least another 6 months as recommended. but by then i don't see any reason why i can't taper off and stop them.



> 3) It seems like for every "illness" there is a healthy way to deal with it.  Dont want to be obese?  Eat right and excersize.  Dont want Alzheimers?  Work your brain out.  Dont want lung caner?  Stay away from cigarette smoke.  Of course in a perfect world obesity, alzheimers, and lung cancer would still exist, albeit in smaller numbers.  Some people are just genetically predisposed to certain illnesses.  For these people surgery and medication would still be needed.  Why do we treat depression any differently?



we don't. we treat depression exactly the same way. prevention: exercise, socialize, take time for yourself, eat well. but too many people don't do this. and too many people unfortunately are in situations where they can't prevent depression (i am thinking abuse victims here). in the cases that people do end up with depression, if it is more than mild depression, medication is important. but again, medication alone only takes off the edge. it doesn't cure the depression. that requires therapy and hard work along with the medication.


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## David Baxter PhD

MaynardJamesKeenan said:


> First of all, I want to clear this up.  In high school all my friends called me the devlis advocate because I would debate anything that could be debated regardless of how I felt about the subject.  If Im sounding insensitive I dont mean to be.  I think I just naturally form arguments that get people riled up.  I like hearing the other side of the story so "attacking" others, even if its not sincere, seems to bring it about most often.  Long story short.  Im not nearly as anti antidepressant as it seems.



You may be in the wrong place, then. This is a "Psychology Self-Help and Mental Health" forum primarily intended to be an information and support venue for people struggling with mental health issues. A bit of debate now and then isn't necessarily a terrible thing but when it amounts to implying that other members are wrong for following the advice of their physicians and therapists, it steps over the line of the forum guidelines. There are other forums on the net that encourage this sort of debate. Psychlinks just isn't one of them.



MaynardJamesKeenan said:


> 1) From my point of view, our current society seems to want the "quick fix" more than anything.  I wonder how many people taking anti depressants say "Im not happy.  I tried to fix it.  Give me a pill."?



I would say close to zero. In my experience, which is now over 30 years as a practising psychologist, the problem is usually trying to encourage people who could benefit from medication to give it a try. I don't know anyone who is taking medication just for the hell of it. People so inclined are far more likely to turn to alcohol or street drugs.



MaynardJamesKeenan said:


> 2) Lets say your 30 years old and are depressed.  You turn to antidepressants to "fix" your depression.  Do you rely on pills for the next 60 years of your life?  I just dont see an exit strategy that I like.



For the vast majority of people, that isn't necessary. Many are able to discontinue the medication after 1-3 years, with perhaps a booster period if there is a recurrence of depression. Some people do need to remain on the medication for longer - but only those that NEED to be on it longer. I take medication for hypertension - that's going to be for the rest of my life as far as I know. That's fine with me. If it enhances and improves the quality of my life and prevents more serious consequences, why on earth would i want to ever stop taking it?



MaynardJamesKeenan said:


> 3) It seems like for every "illness" there is a healthy way to deal with it.  Dont want to be obese?  Eat right and excersize.  Dont want Alzheimers?  Work your brain out.  Dont want lung caner?  Stay away from cigarette smoke.  Of course in a perfect world obesity, alzheimers, and lung cancer would still exist, albeit in smaller numbers.  Some people are just genetically predisposed to certain illnesses.  For these people surgery and medication would still be needed.  Why do we treat depression any differently?



As I said above, this is a straw man argument. The situation you describe doesn't exist, except in your imagination. Therefore, any further response to your scenario is totally pointless.

And, intentional or otherwise, your comments in this thread are insensitive to other members and hurtful and offensive to other members. This is a breach of our forum rules and guidelines and will not be tolerated. 

As lawyers like to say, govern yourself accordingly.


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## MaynardJamesKeenan

This is going to be a dumb question because peoples pride will be attached to their answer but Ill ask it anyway.

How many people, who are on anti depressants, are happy?   

As Ive looked through this entire message board the past few days Ive noticed alot of peoples "My Moods" have been negative.  I noticed this even before this debate started.  Now I havent been here long at all so my "sample" is very narrow but its interesting non the less.


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## Halo

MaynardJamesKeenan said:


> How many people, who are on anti depressants, are happy?



Again, antidepressants don't make a person instantly happy...working on themselves in therapy by dealing with their issues and becoming a healthier person will make someone happy.  Pills don't do the work...people do.



MaynardJamesKeenan said:


> As Ive looked through this entire message board the past few days Ive noticed alot of peoples "My Moods" have been negative.  I noticed this even before this debate started.  Now I havent been here long at all so my "sample" is very narrow but its interesting non the less.



Although people's moods may be described as negative, people who are taking medication as well as some who are not are all dealing with issues in their life many in therapy and when you do that it brings up a variety of emotions, negative and otherwise. This is a self-help forum after all and people are encouraged to be honest with how they are feeling and to obtain support from other members.  They are not expecting you to be taking a poll of their moods to try and prove your point about medication and its usefulness.


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## Into The Light

depressed or not depressed, people still have problems, mjk. maybe you are thinking that not being depressed equals being happy. that's not quite how it works. people can have problems and not be depressed. 

problems affect our mood. say you don't get a promotion at work but you worked hard and feel you deserved it. that can make you feel upset and unhappy. that'll last for a few days or whatever and then you bounce back. 

i agree with everything halo said.


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## braveheart

A pill can't take away the sadness and grief of having lived through a traumatic or difficult past. And nor should it.


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## Misha

Ok I may be totally wrong here but I was always under the impression that anti-depressants were just what their name says.... they work against depression.  That doesn't mean they're going to swing you to the other side of the spectrum.  What they do is relieve the biological reasons for depression and give you the stability you need to change things in your life and learn positive coping strategies.  That's where you start looking for happiness, or at least contentment.  I have never taken anti-depressants with the expectation they make me happy.  I take them to keep me alive and out of hospital.  They give me a chance to make myself happy.


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## MaynardJamesKeenan

Misha said:


> I take them to keep me alive and out of hospital.  They give me a chance to make myself happy.



I think that cleared it up for me.  If they allow you to work on yourself then Im all for them.  Thanks Misha.


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