Is there any evidence that you're more likely to have depression if you've had it in the past?

[cinephile]

You know the finding I'm talking about. They say it all the time in newspaper/magazine articles and it's mentioned in some studies: that you're more likely to have another depressive episode (and have it last longer) if you've already had depressive episodes in the past. I think the magic number is three: if you've had at least three depressive episodes before, you're very likely to have another one in the future.

 

This makes intuitive sense, but as we all know, intuitive theories in psychiatry can all go poof when held up to real science. Are there any unbiased studies that have found this theory to be true? Just curious.

[Altostrata]

Prior to antidepressants, that was not held to be true.

 

The frequency of relapse appears to be related to the use of medications. In other words, it's yet another psychiatric tautology: They tracked the frequency of relapse off meds -- without taking into account withdrawal syndrome -- and concluded that depression was chronic rather than episodic.

 

Prior to medication, it was held a person could recover completely from depression, hence the field of psychotherapy, which assumes people can change.

[cinephile]

The frequency of relapse appears to be related to the use of medications. In other words, it's yet another psychiatric tautology: They tracked the frequency of relapse off meds -- without taking into account withdrawal syndrome -- and concluded that depression was chronic rather than episodic.

 

Prior to medication, it was held a person could recover completely from depression, hence the field of psychotherapy, which assumes people can change.

cinephile

Thanks for this theory, Alto! It certainly makes sense in terms of how flawed the relapse/withdrawal studies are and how they mistook withdrawal for relapse.

[Altostrata]

It's not my theory -- Robert Whitaker details this in Anatomy of an Epidemic.

 

My theory is that the statistical incidence of "relapse" in antidepressant research is confounded by misdiagnosed withdrawal syndrome, from which you can recover.

 

Furthermore -- and we all lose sight of this -- depression itself is not a fatal illness; millions of people cope successfully with it without medication. Some people even believe it's part of the human condition. So even if you do have another bout of depression, you can learn how to deal with it.

 

The psychiatric industry has a vested interest in making us terrified that we might become depressed.

[summer]

 

 

Furthermore -- and we all lose sight of this -- depression itself is not a fatal illness; millions of people cope successfully with it without medication. Some people even believe it's part of the human condition. So even if you do have another bout of depression, you can learn how to deal with it.

 

 

 

I agree with this totally... but putting it into practice is quite another thing. I find it nearly impossible to tell the difference between withdrawal and the original symptoms returning. Convincing my family of this is also nearly impossible.

[Rhiannon]

 

 

 

Furthermore -- and we all lose sight of this -- depression itself is not a fatal illness; millions of people cope successfully with it without medication. Some people even believe it's part of the human condition. So even if you do have another bout of depression, you can learn how to deal with it.

 

 

 

I agree with this totally... but putting it into practice is quite another thing. I find it nearly impossible to tell the difference between withdrawal and the original symptoms returning. Convincing my family of this is also nearly impossible.

 

I'm not sure there's a difference.

 

That is: Before the widespread use of antidepressants, the normal course of nonmedicated depression was spontaneous resolution and in the majority of cases no further episodes.

 

So, "the original symptoms returning" is something that it looks like might be kinda CAUSED by the meds. Hard, for me, to distinguish that from "withdrawal", since we don't really know what processes are involved--that is, exactly what the meds do to our brains, exactly what removing the meds from our brains does to our brains, and whether or not these changes are permanent.

 

In other words, pretty much ANY "relapse" is probably attributable in part or whole to the use of the meds in the first place.

 

So...I'm not sure there IS a clear distinction "between withdrawal and the original symptoms returning." It's not just you. It's the whole scenario that happens once AD's are introduced.

 

My own way of dealing with this is, first, a super super slow taper so that hopefully my brain will have lots of time to adjust to the removal of the SSRI and will actually have enough time (hypothetically, knock on wood) to make actual morphologic changes as needed; and second, to realize that in fact I may experience recurrent bouts of depression in the future, given my AD history, and to plan to cope with them without ever taking medication again, using exercise (which beats both drugs and placebos in studies) and light therapy (which I seem to be pretty responsive to). And anything else I can come up with. Maybe grandchild therapy, if I'm lucky.

 

And as far as the title of this thread, ditto Alto as usual: yes there is considerable evidence that people who take antidepressants are likely to have recurrent episodes of depression. However, in the case of unmedicated depression, the majority of people have one episode and get over it and it never happens again. This is well described and documented in Anatomy of an Epidemic by Whitaker. I'm thinking it's probably also in The Emperor's New Drugs by Irving Kirsch, but I haven't read that yet. (I will tho!)

[Altostrata]

If you have other withdrawal symptoms and depression is one of them, I submit depression is probably related to withdrawal rather than return of the original depression.

 

Rhi, you're going to be interested in this blog post by Whitaker: Now Antidepressant-Induced Chronic Depression Has a Name: Tardive Dysphoria , which may be his most important piece since the book. It's gotten a lot of comments on the blog site and on Facebook.

 

I've been involved in e-mail correspondence with Bob Whitaker and Paul Andrews, one of the authors of the papers he's discussing. I'll post highlights in the above topic shortly.

[alexjuice]

My own way of dealing with this is, first, a super super slow taper so that hopefully my brain will have lots of time to adjust to the removal of the SSRI and will actually have enough time (hypothetically, knock on wood) to make actual morphologic changes as needed; and second, to realize that in fact I may experience recurrent bouts of depression in the future, given my AD history, and to plan to cope with them without ever taking medication again, using exercise (which beats both drugs and placebos in studies) and light therapy (which I seem to be pretty responsive to). And anything else I can come up with. Maybe grandchild therapy, if I'm lucky.

 

Agree with those above but would add...

 

I've found supportive, loving human social interaction to be the equal of everything else for my problems. Though depression was/is not my primary concern or the cause for my Drugging...

 

Genuine (unpaid and unsolicited) actions of loyalty, compassion, support, recreation, and affirmation of beliefs, values and worth... these provide a sense of place that can wipe away many of my symptoms. Best with real people sharing real space...

 

Isolation is my enemy. Community my fried.

 

Also like to walk... I tried to 'work out' early in w/d with weights. huge mistake.

 

Alex.i

[Rhiannon]

I've found that being with people who love me and care about me (which means pretty much just my kids, whom I get to see all too rarely) is amazingly, wonderfully healing and therapeutic. I have to agree with that 100%, it's as powerful as anything else or maybe everything else put together.

 

I'm starting to make a few friends but really don't have much of a community. I hope to grow that in my life.