Depression

flutterflye

coolx wrote: »

Pieta House and the Samaritans deserve alot more support than they recieve. Seriously, these places should be getting grants to cover their expansion into more urban areas and beyond.

Yup, not one doctor or psychiatrist told me about pieta house.
I heard about it from friends.

Dudess

You left out the documented cases of people feeling better when they take anti depressants. That the physical symptoms disappear, the sense of lethargy, hopelessness and despair abate.
Whenever people put forth an argument refuting that (yet not sufficiently backing it up) it just looks like going against the grain for the sake of it. Trying to be a bit of a renegade or something. If you've an axe to grind with a doctor or psychiatrist or drug company or whatever, fine - but no need to deny a very real phenomenon.

Chuck Stone

The chemical imbalance theory is not proven in any way. Zero evidence. Zip. Nada. It is the chemical imbalance theory that AD medication is based on. That's pretty shaky science to say the least.

I'm thinking of starting a thread discussing it out of AH where it will be strictly moderated. I have asked for references from a another source outside boards that pours massive heaps of scorn on psycho-pharmacology in a very calculated and scientific way and have not gotten a response as of yet.

coolx

Dudess wrote: »

but no need to deny a very real phenomenon.

I've never denied it.

Dudess

Fair enough, but explain how anti-depressants work then? And to say the placebo effect is just downplaying how ill people can get with this illness.

stupidusername

flutterflye wrote: »

Yup, not one doctor or psychiatrist told me about pieta house.
I heard about it from friends.

it's never been mentioned to me either. or Aware.

sought help from my doctor in March, got an appointment for April with a psych. they put me on anti depressants, signed me up for talk therapy. i generally go see them every 6 weeks, they'll up my dose, or move me to something new if i want, but when I asked would it be long more till i see someone for therapy my psych didn't even know if I had been put down for it. She checked, and yes I'm still on the waiting list. more than 7 months later. despite having been asked was I suicidal, and answering yes.

coolx

Dudess wrote: »

Fair enough, but explain how anti-depressants work then? And to say the placebo effect is just downplaying how ill people can be.

Maybe for severe cases, yes, medication is required and most practical. As to how these drugs work? I don't know, even the guys at the top of the field don't really know how they work.

From one of the articles I linked:

Daniel Carlat of Tufts University in Boston says: “There is no question that among the medical professions, psychiatry is the most scientifically primitive. We have no more than a rudimentary understanding of the pathophysiology of mental illness and we have resorted to tenuous and ever-shifting theories of how our treatments work.”

tl;dr - we don't know how these drugs really work. They are working to improve this however. These revelations can only help Psychiatry in the long term. Most notably for severely depressed people.

To the poster above - the reason you won't hear Psychiatrists advertising pieta house, is because it's not financially in their interest to do so. Hard to swallow, but this is the main reason.

coolx

stupidusername wrote: »

it's never been mentioned to me either. or Aware.

sought help from my doctor in March, got an appointment for April with a psych. they put me on anti depressants, signed me up for talk therapy. i generally go see them every 6 weeks, they'll up my dose, or move me to something new if i want, but when I asked would it be long more till i see someone for therapy my psych didn't even know if I had been put down for it. She checked, and yes I'm still on the waiting list. more than 7 months later. despite having been asked was I suicidal, and answering yes.

This is a disgrace. Report them.

flutterflye

stupidusername wrote: »

it's never been mentioned to me either. or Aware.

sought help from my doctor in March, got an appointment for April with a psych. they put me on anti depressants, signed me up for talk therapy. i generally go see them every 6 weeks, they'll up my dose, or move me to something new if i want, but when I asked would it be long more till i see someone for therapy my psych didn't even know if I had been put down for it. She checked, and yes I'm still on the waiting list. more than 7 months later. despite having been asked was I suicidal, and answering yes.

I know, sure I was only there with the psychiatrist last week (after waiting ages for this next appointment), I explained about how the previous week I was very, very close to... ye know... and she just sent me on my way, despite me hysterically crying and begging for help.
I was told that I'd be referred to all these different supports, but nope!

Ah, the entire hse needs a total revamp - the are less than useless.

Edited to add: To anyone in need of help - this is just my opinion from my experiences. Do go and seek help, and hopefully you will get it. If not, there are other supports out there, such as pieta house as previously mentioned.

stupidusername

coolx wrote: »

This is a disgrace. Report them.

to who?

stupidusername

stupidusername wrote: »

to who?

The HSE, I would imagine?

stupidusername

Perla Green Barrel wrote: »

The HSE, I would imagine?

but they're working under HSE instruction / procedure / funding. how is reporting them going to do anything?

stupidusername

stupidusername wrote: »

but they're working under HSE instruction / procedure / funding. how is reporting them going to do anything?

Well the fact that someone who not only admitted they were suicidal and made this known to them was left waiting is something that should be addressed.

Lady Chatterton

stupidusername wrote: »

I sought help from my doctor in March, got an appointment for April with a psych. they put me on anti depressants, signed me up for talk therapy. i generally go see them every 6 weeks, they'll up my dose, or move me to something new if i want, but when I asked would it be long more till i see someone for therapy my psych didn't even know if I had been put down for it. She checked, and yes I'm still on the waiting list. more than 7 months later. despite having been asked was I suicidal, and answering yes.

This is so wrong. Those HSE "Mind your Mental Health" adverts on TV really upset me, they encourage people to seek help but in reality the HSE are struggling to provide services on the ground to people who are in desperate need of help. Thankfully, there are lots of GPs who try to meet their patients needs and obviously organisations like Aware and Pieta House offer support and advice too.

Sky King

Ombudsman?

coolx

stupidusername wrote: »

to who?

http://www.ombudsman.gov.ie/en/Publications/InvestigationReports/ComplaintsagainstthePublicHealthService/Name,5029,en.htm

Failing that, maybe try pieta house? I am aware they mainly deal with acutely suicidal people so they may not apply.
You weren't treated too well tbh. You probably won't be able to sue or anything, but that does not mean you were
treated properly by the service. One thing most will agree upon. The HSE is a mess at present.

Seriously, that is beyond a joke stupidusername.

Lady Chatterton

Sky King wrote: »

Ombudsman?

We desperately need a dedicated Health Ombudsman in this country as the HSE is in a state :mad:.

Corkfeen

Perla Green Barrel wrote: »

When things were really bad for me, I asked for time off from my job to try and get my head together. When I asked my manager, they were genuinely surprised that I was going through such a bad time, because when I was in work I was pleasant, polite and professional, when deep down it was eating away at me.

Some are just better at hiding it than others.

In regards to this, I had literally been depressed for 4 or 5 months, it's still sort of ongoing at this point. I told my family at one point and they were literally dumbfounded, didn't have any idea. I was trying to get through every day but kept a similar facade as your own up throughout the day. I still do this to a point but i'm more honest about it at least. It really does show how everyone around us can appear to be perfectly happy but it mightn't be the truth...

WalterMitty

Chuck Stone wrote: »

The chemical imbalance theory is not proven in any way. Zero evidence. Zip. Nada. It is the chemical imbalance theory that AD medication is based on. That's pretty shaky science to say the least.

I'm thinking of starting a thread discussing it out of AH where it will be strictly moderated. I have asked for references from a another source outside boards that pours massive heaps of scorn on psycho-pharmacology in a very calculated and scientific way and have not gotten a response as of yet.

What are you trying to say? That there are no biological/genetic factors in mental illness? That you can think/talk yourway out of any mental distress?

WalterMitty

MrsD007 wrote: »

This is so wrong. Those HSE "Mind your Mental Health" adverts on TV really upset me, they encourage people to seek help but in reality the HSE are struggling to provide services on the ground to people who are in desperate need of help. Thankfully, there are lots of GPs who try to meet their patients needs and obviously organisations like Aware and Pieta House offer support and advice too.

Well Mary Harney's pension doesnt pay itself you know! She needs that 130k a year that could otherwise be used to employ several suicide counsellors.

coolx

WalterMitty wrote: »

What are you trying to say? That there are no biological/genetic factors in mental illness?

To date, we haven't found any reliable genetic factors. The research to date however, proves that that chemical imbalances aren't the cause. This is not my opinion. It is scientific fact that the chemical imbalance theory of Depression is simply false.

The question simply boils down to this simple axiom: Given how little we know about the true causes of severe mental illness, why are we pumping billions into an unproven hypothesis?

We can recognise Depression by symptoms and distress. That is not enough proof to say that we understand the biological basis of Depression. We don't. There are no established biomarkers yet.

Chuck Stone

WalterMitty wrote: »

What are you trying to say? That there are no biological/genetic factors in mental illness?

Nope. I'm saying there is not one scintilla of evidence to support that a chemical imbalance in the brain causes depression.

That you can think/talk yourway out of any mental distress?

I didn't make that claim. I'm not really interested in discussing it here tbh because this is more of a support thread than a debate thread. If I get the references I've requested I'll start a thread elsewhere.

Lady Chatterton

WalterMitty wrote: »

Well Mary Harney's pension doesnt pay itself you know! She needs that 130k a year that could otherwise be used to employ several suicide counsellors.

Mary Harney's pension is the least of the issues. The HSE appointed Professor Drumm as CEO, they gave him a huge salary, bonus and pension, on top of that they paid €3 million to people to advise him in his role as CEO :eek:

In my opinion, anyone who is appointed to the position of CEO should be fully qualified for the role, they shouldn't need €3 million advisers to help them do their job :mad: There is a huge culture of waste within the HSE, that needs to change so that money goes into providing frontline services.

HSE spent €3m on extra advisers for chief Drumm

Thursday October 07 2010

THREE advisers to former health service boss Brendan Drumm were each paid around €1m by the Health Service Executive (HSE).

The revelation comes as Taoiseach Brian Cowen was yesterday forced to reject opposition claims that the Government was turning a blind eye to waste in spending public money.

Payment records obtained by the Irish Independent reveal huge sums paid to Prof Drumm's advisers, some of whom were earning €1,300-a-day.

Some received massive taxpayer-funded payments despite the fact other people were employed within the HSE to carry out similar functions.

The well-paid advisers included:


Communications consultant Karl Anderson, who earned €996,119 between 2005 and the end of 2009 despite the fact the HSE had fully staffed public relations offices around the country.
Human resources adviser Maura McGrath, who earned €994,334 in the same period even though a human resources boss was appointed internally in 2008.
Management consultant Maureen Lynott, who was paid €1,125,493 between 2005 and the end of last year.

Contracts for Mr Anderson and Ms Lynott, who were handpicked by Prof Drumm for his so-called kitchen cabinet, ran out earlier this month.

New HSE boss Cathal Magee will not be allowed hire his own advisers, such is the furore over the huge fees paid to those appointed to assist his predecessor. The revelations come amid mounting pressure on health chiefs to explain failings after a damning audit report revealed a catalogue of wasteful spending and serious breaches of corporate governance in a HSE-funded training programme.

Front-line

Questions have also been raised about the level of spending on costly external consultants, with opposition TDs claiming the money would be better spent on front-line services. Records seen by the Irish Independent reveal how €76.7m was spent by the HSE on outside consultants between 2005 and the end of last year.

The records also show how HSE bosses have failed to significantly rein in spending on outside advice. Some €15.1m was spent on outside consultants last year, compared to €15.6m in 2008 and €16.7m in 2007.

Many of the companies who benefitted from contracts had close links with the health services. They included Prospectus Consultants, whose managing director Vincent Barton is a former Department of Health official. The firm was paid €1.58m for contracts between 2005 and the end of 2009.

These included advice on adult critical care services, palliative care, obstetrics and gynaecology services, and hospital co-location.

SMG Healthcare Consultancy Ltd, run by another former Drumm adviser, Dr Sean McGuire, was paid €440,864 for primary care and healthcare strategy projects between 2005 and 2008.

Dr Joe Clarke, a GP adviser, was paid €284,915 for consultancy work on family doctor services in 2008 and 2009.

The sums paid included VAT.

Mr Anderson was paid €224,886 last year using the business name Anderson Editorial. At the same time the HSE employed 12 press officers in offices around the country.

Ms Lynott's company, Lynott Management Consultancy, was paid €224,568 in 2009 for advising Prof Drumm.

Ms Lynott is a former chairperson of the National Treatment Purchase Fund.

Both were appointed in 2005 on 60-month contracts, which have just run out.

The contracts required 135 days work per year, with up to 27 additional days if necessary.

Even though Prof Drumm left the HSE in August, their contracts continued to run until last week.

Fees paid for this year have yet to be disclosed, despite requests being lodged with the HSE under freedom of information rules two months ago.

Ms McGrath's company, McGrath Associates, was paid €92,663 last year and €294,785 the year before. Its contract with the HSE ended in February 2009.

It had involved €1,350-a-day, to be paid for three days' work per week for advice on organisational change and strategic human resource management.

"The figures are striking," Fine Gael health spokesman Dr James Reilly said.

"This is clearly further evidence, if it were needed, of the savings that can be made instead of hurting patients on the front line.

"It is only proper that Prof Drumm's successor is not being given the same army of highly-paid advisers."

- Shane Phelan Investigative Correspondent

WalterMitty

coolx wrote: »

To date, we haven't found any reliable genetic factors. The research to date however, proves that that chemical imbalances aren't the cause. This is not my opinion. It is scientific fact that the chemical imbalance theory of Depression is simply false.

The question simply boils down to this simple axiom: Given how little we know about the true causes of severe mental illness, why are we pumping billions into an unproven hypothesis?

We can recognise Depression by symptoms and distress. That is not enough proof to say that we understand the biological basis of Depression. We don't. There are no established biomarkers yet.

You're wrong, up to 50% of major depression is genetic according to twin studies.

You use the term "chemical imbalance" as if it is some scientific term. It is used mostly by anti psychiatry people in my experience. No psychiatrists, neurobiologists,neurologists, neuropsychologists etc would simplistically claim depression is a "chemical imbalance".

The brain is massively complex, and with all complex systems things can go wrong , too much or little of neurotransmitters/hormones, neuronal damage or atrophy,receptor sensitivities, neural connections etc. Thats just the hardware of the brain and of course there is then psychologcal and environmental factors.
Neurotransmitters are involved in mood just not in way the old "chemical imbalance" marketing story led the public and even doctors in past to beleive. Targeting these neurotransmitters and their receptors indirectly causes changes in the wider functioning of the brain leading to relief of symptoms.

Chuck Stone

You post is full of contradiction.

WalterMitty wrote: »

You use the term "chemical imbalance" as if it is some scientific term. It is used mostly by anti psychiatry people in my experience.

Why prescribe AD's which are thought to work on the chemicals in the brain then? Is that scientific or is it faith healing?

No psychiatrists, neurobiologists,neurologists, neuropsychologists etc would simplistically claim depression is a "chemical imbalance".

Yet psychiatrists and GP's routinely, I'm led to believe, prescribe psychoactive compounds? Why would they do this if they had no faith in the chemical imbalance theory?

Neurotransmitters are involved in mood just not in way the old "chemical imbalance" marketing story led the public and even doctors in past to beleive

So there is new research that has refuted or improved upon the chemical imbalance theory?
Source please.

Targeting these neurotransmitters and their receptors indirectly causes changes in the wider functioning of the brain leading to relief of symptoms.

Targeting them with what?

Warper

Amazing the amount of people that are unaware of depression and its effects? Talking to a good few people at work today and Gary Speed came up. Everyone was like, why did he do it, there must have something going on, how did he hide it if he was depressed. They thought he must have been in financial difficulty or something like that, no one even mentioned depression. They couldnt get their head around it?

philstar

fryup wrote: »

personally speaking...do i think gary speed suffered from depression....no

there's no way he could have played top flight football for the best part of 20 yrs if he did, there's no way he would have taken up an international high profile manager job if he did

look at his relaxed/happy demeanour on football focus just hours before he died

i honestly think there's more to this than depression..something or someone pushed him over the edge

i agree, we all know how draining both physically & mentally depression is...i find it hard believe a high energy pro-footballer like Gary Speed suffered from the illness..there most be more to this

K-9

coolx wrote: »

Here is the NEJM meta analysis I was referring to: http://www.nejm.org/doi/full/10.1056/NEJMsa065779

Compared to the placebo group for each study, the results are pretty grim.

"Among 74 FDA-registered studies, 31%, accounting for 3449 study participants, were not published. Whether and how the studies were published were associated with the study outcome. A total of 37 studies viewed by the FDA as having positive results were published; 1 study viewed as positive was not published. Studies viewed by the FDA as having negative or questionable results were, with 3 exceptions, either not published (22 studies) or published in a way that, in our opinion, conveyed a positive outcome (11 studies). According to the published literature, it appeared that 94% of the trials conducted were positive. By contrast, the FDA analysis showed that 51% were positive. Separate meta-analyses of the FDA and journal data sets showed that the increase in effect size ranged from 11 to 69% for individual drugs and was 32% overall."

Interesting. I'll have a good read of that later.

Dudess wrote: »

My friend was diagnosed with depression/anxiety in August. He had no motivation to do anything, even wash a cup - and he's a neat freak. He wasn't taking care of his personal hygiene. He was awake all night and lying in bed all day - he's usually out like a light, sleeps like a log and gets up at a normal hour. He quit his job of six years - just walked out, despite how hard it is to get a job at the moment.
He was put on anti-depressants and Xanax. He felt worse initially. And then very slightly improved, but still felt sh1t for ages. The meds took two and a half months to kick in fully, but they did - and he is now back to his old self and thankfully got a job.

That is NOT the placebo effect - ffs! :mad::rolleyes:

Indeed. Many don't read the leaflets, you can feel worse initially.

WalterMitty

Chuck Stone wrote: »

You post is full of contradiction.



Why prescribe AD's which are thought to work on the chemicals in the brain then? Is that scientific or is it faith healing?



Yet psychiatrists and GP's routinely, I'm led to believe, prescribe psychoactive compounds? Why would they do this if they had no faith in the chemical imbalance theory?



So there is new research that has refuted or improved upon the chemical imbalance theory?
Source please.



Targeting them with what?

Doctors prescribe medications that target monamine systems as targeting these has shown to indirectly releive depression.
They target them with medications. An ssri increases serotonin in synapses but that alone doesnt releive depression quickly.
I dont know what you mean by "chemical imbalance " anyway . Everything in the brain is electrical and chemical.

Lady Chatterton

philstar wrote: »

i agree, we all know how draining both physically & mentally depression is...i find it hard believe a high energy pro-footballer like Gary Speed suffered from the illness..there most be more to this

You could argue that because of this that he may have had the strength to fight or conceal the condition for a prolonged period of time. Obviously, we are only speculating here.