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I think that redirecting R&D money will bring us to the goal much faster.
I am not sure "for profit" is where we should be expecting major advancement. Possibly, but I personally dont think so. With profit as the incentive progress can be hamstrung because of the risk/reward paradigm and the sheer cost of undergoing R&D. Recoloring and repackaging lipstick so its patent-able and slightly different when putting lipstick on a pig is much cheaper. We see it in the numbers I posted a few posts back regarding the amount of medications released versus novel medications release in the article I quoted.
Perhaps more federal dollars could be given to the cause so that non profits, schools, universities and such can tackle the issues we as humanity face today (depression and mental illness being a few of them) with greater speed, risk taking and urgency.
I agree with you 100%. We need a lot of options and although it may burn some people's britches to acknowledge it--sometimes, for some people, medications ARE the answer. I know the OP didn't want people's personal stories, but before I get called out for talking out my a**, an antidepressant WAS the answer for me. And I certainly can't be the only one out there (I think one other person on this forum said the same thing worked for them, but of that I can't be a hundred percent sure of that b/c of my faulty memory).
I get the negativity toward antidepressants. It may appear something doctors like to use because it seems like a quick fix; and in many cases that may be what is going on. But let's not throw the baby out with the bathwater. Antidepressants can be useful for a lot of people. What needs to be worked on is using them for the right situation, not just throwing them out there for everyone and expecting it to work.
Sorry this is long, but its not really that 'simple'. The mental health system is dealing with something very complex, and with equally complex patients. Drugs can be tested and their 'normal' results be described. But each patient is a whole new situation, with their own special body chemistery. What works wonders on you may be disastor to your friend. Society has recognized that there is a problem, but the one solution, works for everyone isn't it. We pass out drugs without proper evaluation without working WITH a medical doctor. Having to involve a group muddies up the water. And as 'standards' are established, they leave behind a lot of people. Those left behind are lucky if someone will treat them as an individual. Often this is your regular medical doctor. Mine was perfectly fine for me using other than over strong pills, and not the only patient who had chosen to do as I did.
That was the short, read the long if you wish. But the mental health system is broken and needs to pay actual attention to individuals rather than 'general standards' and letting pills make all the bad go away.
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Meds are not a general subject, but an entirely individual case. But all the 'standards' are a broad sweep.
Patients get chided for being responsible somehow for them not helping when maybe physically they never have a chance. But like with me, there wasn't 'time' to explain that drugs act quick or not at all with my situation. And the average for an appointment was fifteen minutes, about the time it takes to get out the pad and do a few official things. But not do real care. And they need to ask if the patient has problems what they are. But not in fifteen minutes. I made them late explaining my medical history, ten years of illness and now three surgeries, and cross your fingers with pills. They ignored me.
So, what isn't working in this 'system'? What's missing beyond real service, as the above isn't.
We need more options for treatment too. Meds need to be, by defination, a bridge to less or none. If you still need them you get them, but many quit them to get rid of the side effects, or maybe they've found a drugless way. And before taking out the perscription pad, the doctor assures that the patient has had a medical evaluation, anything effecting the drugs working identified, and it known that the drug will not cause physical harm due to health. Health in general is far too often not considered. You 'get used to it. Not.
The mental health establishment is fixated on a 'standard' human being, but they don't exist. Norms are general. Someone needs to define when normal becomes wrong. When does 'energetic' become 'manic'? and quiet and thoughtful become 'withdrawn'? Before we had an official science, unless one was doing actual harm to themself or others, they were 'different', but now as we can 'fix' them pills its somehow 'wrong'.
No, a blanket refusal of meds is not a good idea. But so is a blanket use of them. We need to stress learning how to identify and face triggers. Maybe a drug will help for a time, but goal is making peace with it and moving on. And only the person effected can find this place. Finding it within yourself to defuse that trigger is effective and better than pills.
Nor are meds made to fix it forever. They are to manage the situation and the patient to find other ways within a peaceful space. But dose them where they do less than magically make it all go away. And some of us see that already, but often get disregarded. But I think a lot of people with real concerns, like I had, get that ignored as its not the 'norm'. At the time I first saw a doctor, meds were okay since I needed the background noise to quiet. But even then, I had *problems* with them and reactions which I knew were not good. I've long had to be very careful with medications since my surgery, years before. I don't absorb food and meds in any reliable way. Pdocs just said take more. I felt utterly zonked out, and didn't like it and took away the pills, very slowly and carefully.
I remember the doctor saying I seemed better. I said I was. But I was still phasing out the pills and would continue to, whatever was said. I'd tried explaining how pills don't work on me. They ignored that. I had tried to discuss how 'internally' I don't absorb medications reliably or right. He disregarded that. I was just plain sick and tired of it sounding like it was all my doing, especially since I was feeling better since I'd been backing away. Maybe we need to restructure how we look at treatment, expecting the patient to work on small tasks and learn to control a little at a time. And at the same time, educating DOCTORS that while the magic pill is easy, its not really 'fixing' anything. Some need meds, but not forever. Some do. But dosage and details must be reevalued frequently so its the least workable. But the pills need to be at the right dose, not enough that the patient doesn't bother them anymore.
I've been a part of a few groups, and this negativity is not so unusual at all. In group we could talk about it. Real medical concerns are common, as is pdocs who don't listen. Patients quietly doing an adjustment of dosage is also common, mostly because doctor won't listen. Or the effects are oblidertating all their joys. Several people had medical concerns and had cut back their meds, others didn't like the effects, that 'freeze up' of emotion and feeling and were going to 'adjust' their meds if the doctor kept ignoring them. Everyone felt as if their own concerns and perception of what was a problem was being ignored and told it wasn't important. A few had found docs who would and would work with them but most wouldn't give more than their fifteen minutes. If anyone wonders why those with 'conditions' don't cooperate, they should do some research.
But to the poster above, no I'm not for throwing out the baby with the bathwater. But it IS for asking how the patient FEELS with the meds, and if its just dulled nothing. One woman who came to group had cut back the pills and was learning to live with some cycling over feeling like the walking dead. Her doctor had no suggestions other than take the pills. She was backing them out and called it a victory.
"Normal normal' people have moods too, and nobody rushes up with a bottle of AD's for them.
What we need is MORE doctors educated in all the options, not just their favorite one, input by patients, and more options presented, and the reality that some of us just may always react with more signels than others. Maybe you need some meds, but just the bare amount to keep you from crashing. Maybe you have sadness and regrets and happy times and so on with that, but that is LIFE. If a mild pill helps them surf through it better, fine. But only enough they can keep surfing. Nobody can tell when your AD is too high but you. Nobody can tell when your being 'quiet' is your in deep thought and when your just down but you. Meds should be the very least that work. It can be found by experimenting, cutting pills slowly until there are less, or none. But it would be better if the pills were designed to be taken in smaller doses, so one could easily find the very least they needed. I did this with the worse offender by using a pill cutter, but it would have been better if it was not needed to chop them up. When I took none, I still had some in the bottle. I used knowing the internal clues instead. But this takes time and patience. For the patient it means there is no real instant fixit. For the doctor it is a loss of control of the patients obedience. The one I had said he hoped it worked but he just could NOT work with me. I said that was fine.
I wrote up a paper on how someone with my sort of problem, absorbtion wise, doesn't get the same out of pills and how to get around it. I stressed that before telling someone how necessary it was to take their meds, you should find out if the person taking them reacts *normally* to pills. Their specualty is mental health, but a regular doctor would listen if you said that doesn't work for me, and he/she needs to as well.
I've tried a few meds for low grade generalized anxiety and depression. Nothing has really done much. Fine. One data point.
But still, when I see that one commercial, at least daily, with the depressed people with the smiley faced paddles - saying my anti depressant isn't helping me.......and the commercial responds - so here take this ADDITIONAL drug to make it work better
I mean come on. In any other world that would scream SCAM.
You are assuming that was my assumption. Your assumption is incorrect.
My view is that while there are some trying for novel treatments, more needs to be done regarding coming up with novel options and that the typical SOP of a good portion of the field of just rehashing old med/formulation for profit, while beneficial to the shareholder and to the company, is not generally not beneficial to society.
The common strategy of rehashing SSRIs with usually relatively minor formulation changes, often for patent and profit purposes, even in the face that they are not significantly more effective placebo, in the long run, is not helping or going to help the vast majority of those suffering from depression.
The reality is that while they might not be perfect, they do provide some relief for many people. No one is trying to say that they are the answer. I have a family member that is a seventysomething mental health professional. She says that most younger people going into the field have no idea how bad mental illness can be because they don’t come into contact with truly mentally ill people because most people get at least SOME relief with medications. When she went into the field back in the ‘70s, that was not the case. There were few options and most had pretty extreme side effects and/or didn’t work for a lot of people.
For example, I tried amitriptyline for my migraines and the side effects were not acceptable for me. I had horrible night sweats, some weight gain, and also had awful leg cramps and neck pain in the night. It was supposed to make me sleepier and get a more restful night’s sleep, but it did not. When I decided to go of it, it was also absolutely miserable.
If the placebo effect were enough to help me with my bipolar, than the multivitamins I was/am taking would be the end of it. Right?
I've tried to do this without meds, and I don't care if anyone doesn't get it or thinks I am weak. I need my meds as part of my overall treatment plan. I wish I didn't. Meds, journaling, therapy, support groups, music, exercise, meditation, you name it, I do it or have at least tried it. This is so awful I would do just about anything to not feel this way. I try talking about it to people with the hopes of showing them that bipolar isn't just something that happens on some TV show. I am so tired of people that criticize me for taking meds and say that they are a "cop out". Live my life for a week and see if I am the type of person that is prone to "cop out". I work my behind off at work and am trying some side things to make more money. I am doing phenomenally well at my job right now, and, honestly, I don't know how I am doing it because even with my treatment plan I feel like I am on the verge of just losing it. I've told people that I shouldn't drink because I very well may have a problem with alcohol, and what do they do? Invite me to the bar or bring beer to my house so they can drink it. I am just furious right now. These are supposed "social drinkers" that can't or won't just have a coffee or a ginger ale with me? People might get sick of me talking about it, but the lack of support is just awful.
Just to be clear, as I have seen some posts about it, the study in the original post of this thread is referring to traditional antidepressants alone, not to anti-psychotics, anti-seizure, mood stabilizers, any other type of medication or the pharmaceutical industry as a whole.
This study is NOT showing that mental illness, (regardless of what it is) is not real. Nor did the article say that those with mental illness can just think it off or deal with their illness homeopathic. None of this stuff was mentioned in the study nor in the original post.
Again, the study in the original post was specifically about antidepressants, nothing else and that antidepressants are shown to not be significantly more effective then placebo.
Hopefully, better technologies come into play for the afflicted and in the meantime, that those who suffer from mental illness can find relief in a method, regardless of the studied effectiveness of a particular method.
For the millions that are "treatment resistant" to antidepressants and highly discouraged because of it thinking you are too broke to fix, hopefully, this study will give you some light and show you, "its not you".
Well, I know they work for me because I have gone off my antidepressants and went straight back into major depression. It works. I am not giving them up.
Some excerpts from the article (parenthesis and bolded parts by me - stuff I really liked)
The major scientific discoveries reported last week by the Psychiatric Genomics Consortium in Nature Genetics are a hard-won breakthrough in our understanding of this very common and potentially disabling disorder.
The background risk of depression in the general population is about one in four (of all humans)– each of us has a 25% chance of becoming depressed at some point in our lives.
For the first time, scientists around the world....have been able to combine DNA data on a large enough sample to pinpoint which locations on the genome are associated with an increased risk of depression. So we now know, with a high degree of confidence, something important about depression that we didn’t know this time last year. We know that there are at least 44 genes, out of the 20,000 genes comprising the human genome, which contribute to the transmission of risk for depression from one generation to the next.
More realistically, all of us (humans) will have inherited some of the genes for depression and our chances of becoming depressed will depend in part on how many and their cumulative impact
This is telling us that we shouldn’t be thinking about a black-and-white distinction between us and them, between depressed patients and healthy people: it is much more likely that our complex genetic inheritance puts all of us (humans) on a continuous spectrum of risk.
More surprisingly, many of the risk genes for depression also play a part in the workings of the immune system.
There is growing evidence that inflammation, the defensive response of the immune system to threats such as infection, can cause depression.
We are also becoming more aware that social stress can cause increased inflammation of the body. For decades we’ve known that social stress is a major risk factor for depression.
Now it seems that inflammation could be one of the missing links: stress provokes an inflammatory response by the body, which causes changes in how the brain works, which in turn cause the mental symptoms of depression.
There have been no major advances in treatment for depression since about 1990, despite it being the major single cause of medical disability in the world.
There is so MUCH WE can do for ourselves vs feeding the drug industry and their drugs. I've been that route before I learned from years of reading, talking to others, getting thyroid supported and finding meditation....
I read an interesting article on some of the research that is going on in regards to depression, bipolar disorder and other mental health illnesses. This stuff is the forefront of current medical research (as of Sep 2017).
This article is from the "US National Library of Medicine National Institutes of Health.gov:
1. Inflammation in the brain in regards to mental illness
2. Mylin sheaths (nerve coverings) in regards to Bi Polar disorder
3. Gut microbiome (gut bacteria) link to mental health
4. Brain imaging to find structural differences in the brain in mental health patients - also functional differences
5. The role of dopamine in regards to eating disorders
Some possible treatments discussed:
1. Transcranial magnetic stimulation (TMS)
2. Ketamine (sub anesthetic levels)
3. Deep brain stimulation
4. Probiotic regime/treatment to treat Major Depressive Disorder
The linked article is a fairly long read and very technical but it might provide some areas of research and hope for those interested.
While this is not mentioned in the article, interestingly, nothing is being described/pursued with SSRI's. Perhaps SSRI's is a dead end and, while they help some with a true Serotonin deficiency, there is a reason why SSRI's are not more effective then active placebo and a great many (millions of) people are not helped with traditional SSRI's.
Mental health may not generate as much media buzz and funding as other areas of medicine (such as cancer etc.) but there is a major unmet clinical need for major advancement to end suffering, disability and violence (against oneself or another) and ultimately death (in some cases) due to mental health.
It is a shame that mental health is a leading cause of disability (and possibly violence) in the US, yet the funding it gets it less then that of cancer and some other diseases. That is why it is encouraging to read the advancements and areas of study in treating mental health. More study, funding, research and advancement is needed to effectively treat mental illness and the suffering it causes both to the millions afflicted and for those around them.
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