Doing better with Depression
Posted on 18/12/2009 | 3 Comments
It's hardly a day goes by that we don’t read about depression and its impact on people and the economy and the toll it takes with suicide. We also read about how wonderful treatments are and how it is important to get help as soon as possible. All the above is true and for sure if I, or one of my loved ones, or one of my friends, was depressed I would certainly opt for immediate treatment with an antidepressant medication and an evidence based psychotherapy, delivered by competent health care providers.
But, and this is a big but – the evidence shows that good as our treatments are, they are not as good as they should be. The medications really help a lot but they do not help everyone. The psychotherapies help a lot but they do not help everyone. Combining the treatments helps more people but even this does not help everyone. So what do we need to do?
Well, it's all well and good to make our systems of care more accessible and to train more health care providers to be able to treat depression but wait a minute. Shouldn’t we be spending a whole lot of time and effort on making our treatments better? Shouldn’t we be making sure that when we offer a treatment to someone the chances of it working the first time are as close to 100 percent as we can get? What would you prefer – a one day wait time for a treatment that works 50 percent of the time or a one week wait time for treatment that works 90 percent of the time? And while we are at it – why not a one day wait time for a treatment that works 100 percent of the time.
So we need to invest in treatment research. We can have all the health care providers and all the clinics and all the nice posters on the walls of schools and neat anti-stigma ads on the television and radio and on and on and on – but, if we do not get better at treatment, how much further are we really ahead? Do you know how many high powered (meaning really good scientific studies) have been done in Canada in the last five years on the treatment of some of the most common mental disorders that begin in adolescence. One? Five? Nine? Maybe none? Do you have any idea how much money is being spent on finding out how to better treat young people that have psychosis or depression or obsessive compulsive disorder compared to treatments for other medical illnesses or even compared how much is spent on posters that tell youth about problems? Don’t you think you should have some idea?
We need to invest in a major way in learning better ways to treat mental disorders in this country. We are not doing that in Canada. It is time we started to. Improving access to care is a good idea. Improving access to care that actually works is an even better idea.
-Stan
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This is a great set of comments and rings very true.
I totally agree that scientists (just like everyone else) have their biases and foibles. After all, scientists are human beings too! But science is different than scientists.
The scientific method is the most objective frame that we have by which to evaluate and predict. Science is not about finding truth. It is only about being less wrong most of the time. The scientific method (experimental design and mathematics) gives us the ability to test what we believe. The scientific method is not used to prove something is correct, on the contrary, the scientific method is designed to prove that something is not correct! It is designed to test what is called the “null hypothesis”. It takes ideas that come out of left field (or wherever else they come from) and puts those ideas to an independent test.
t does not drive our beliefs. It does however challenge our beliefs. In that way it is self-correcting. Of course scientific inquiry and understanding lives within a wider social context. That is one of the great features of science.
But gravity is gravity, social context notwithstanding. And thus it is nasty, brutish and long. As Brecht said, (something like this) - the purpose of science is to save us from everlasting error.
By Christina Carew on May 11th
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What people are saying?
Sun said...
People make judgments under depression tend to look at would be very sorry afterwards. In order not to add trouble, may be appropriately slow pace of work and life, add some more love, and family members to enhance communication and emotion, can ease the pressure brought
Comment made on August 05th, 2010
The Ninja said...
I would also suggest that reducing the stigma of depression would go a long way towards ameliorating the current situation. Where I am in Australia, there’s still a lot of the “harden up and shut up” response to depression, although organisations like Beyond Blue and Headspace have helped raise depression’s profile. Most heartening sign of late was the launch of RU OK? Day by the Aussie government (www.ruokday.com.au).
The more people recognise depression as an illness, the more likely it is that medical treatments will one day be up to scratch. Hopefully that day is sometime soon : )
Comment made on August 05th, 2010
Lydia Kolman said...
I totally agree, the biggest help would be research into identifying which drugs will work before treatment starts. The trial and error method is so difficult for the patients and their families. The hope that something will work, the disappointment when it doesn’t and then the weaning off only to try something else is a merry go round of dispair. There is such a lack of hope in depressed people to begin with so each drug failure is reinforcing that hopelessness.
Comment made on August 05th, 2010
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