--- In [email protected], "shanti2218411" <[EMAIL PROTECTED]> wrote: > --I have provided psychotherapy to hundreds of people with a dx of > some type of depression( there are multiple types of depression eg > Major Depressive Disorder,Dysthymia, etc).There are numerous possible > causes for depression eg developmental,biological,enviormental.The > state of the art re understanding the basis and/or treatment of > depression is still pretty basic and will probably remain so for the > forseeable future.One of the most powerful elements of any effective > treatment whether psychiatric or medical is HOPE.The instillation of > hope will frequently evoke the placebo response.The latter is a real > psycho-physiological phenomenon(a good non-technical book on the > subject is "Remembered Wellness" by Herbet Benson).There is no doubt > that much of the reason why medications work(as well as psychotherapy) > is due to the placebo effect.So it is likely that both scientology, > which frankly is in many respects a form of psychotherapy,and > medication help a significant # of people because it gives them hope > which then leads to changes in behavior and mood.These changes might > also result in changes in brain chemistry. The placebo effect has been > shown repeatedly to potentially exert profound effects on > physiology.As to whether there is any therapeutic (vs placebo)effect > for medications my clinical expereince is that there is for a subset > of depressed patients especially individuals who have major depressive > disorder.Kevin
Thanks for your input Kevin. Though the placebo effect may potentially exert profound effects on physiology, it doesn't mean it always does. Hard to believe that all SSRI users, many who modulate usage to find appropriate dose, and or try various variants, cannot pick up direct physiological effects from the drug itself as dosage and type changes. Or are you you suggesting SSRI's don't have a direct physiologic effect? Or that they do, but it is generally not relevant to depression type symptoms? Hard to beleive either with 100's of studies countering both points. I am sure the placebo effect is pronounced for some. Particularly a Hawthorne type related effectt where patients respond to attention and caring -- from or implied from the therapy. I would think that talk therapy would have a far more powerful placebo / Hawthorne effect than pills. How much hope is really instilled in knowing there is a 50/50 chance you may be taking a pill that is a sugar pill? Vs. a 100% situation of regular conselling with a caring professional. Yet the summaries I have seen, and at least a handful of people I have talked to who have had both (antecdotal, and not conclusive, I admit) indicate strongly that SSRIs are far more effective than talk therapy alone. If its all hope inducing placebo effects, the effects should be similar across all therapies. Or even higher for talk therapy since it is 100% and has the human touch / caring factor. But this is not the case. So, again, it doesn't make much sense to me that most SSRI effects are placebo. Third, many report physiologic side effects of SSRIs, particularly sexual. Often, those these can be mitigated with dosage and type. Clearly subjects are not going to experience a placebo effect for a generally negative side effect. Thus the sexual side effects indicate a direct physiologic response in the body from the drug. It seems strange, given this direct response, that then the beneficial responses can be attributed to palcebo effects. Doesn't make sense to me. Does it to you? Since you are not a prescibing physician or psychiatrist, do you see the direct before and after responses, and real time responses to changes in dosage and type of medication? Do prescibing doctors share with you the full medical work up of the patient so that you are aware of all the responses to the medication? It would seem that a prescribing physician would have a better view and ability to discern placebo and direct effects. If hope and palcebo effects are the major impact of your work, how do you view your profession, your contribution? It would seem that any caring figure would be as effective as your psychotherapy if its mostly placebo / hope effects. If that is how you really feel, why not hand your patient load over to a caring grandmother and reduce rates by 90%? (I am not suggesting you do that, because I dont believe the placebo effect is as prevalent as you appear to believe. But if you really do believe it is widely prevalent, why are you still practicing? You are a person of integrity, per your past posts, so i can't believe that you feel your contribution is minimal. If it is not, there must be more than the placebo effect to your work, and presumably SSRIs. To subscribe, send a message to: [EMAIL PROTECTED] Or go to: http://groups.yahoo.com/group/FairfieldLife/ and click 'Join This Group!' Yahoo! Groups Links <*> To visit your group on the web, go to: http://groups.yahoo.com/group/FairfieldLife/ <*> To unsubscribe from this group, send an email to: [EMAIL PROTECTED] <*> Your use of Yahoo! Groups is subject to: http://docs.yahoo.com/info/terms/
