Talk:Major depressive disorder

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Major depressive disorder has been listed as one of the good articles under the good article criteria. If you can improve it further, please do so. If it no longer meets these criteria, you can reassess it.
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Depression with catatonic features

How come their is no longer a main article that deals with depression with catatonic features?

Bran scan

In this article (I thought it may be in a similar one, there was a listing of a picture of a brain of a patient with depression (or GAD, etc) and a person without it... Does anyone know where that was?

Minor edit

I just changed the diognostic criteria from "loss of interest or pleasure" to "loss of interest or pleasure in nearly all activities" I know we dont want to just be copying from the dsm but the criteria seemed a bit confusing out of context. "Loss of pleasure" doesnt really make sense in my head but I may just be over tired.

Discussion

I have edited the electroshock section to edit out claims of brain damage. This is not scientifically proven, therefore should not be in an encyclopedia. For direct evidence please check google scholar and search for the American Psyhiatric Association for their research on ECT and brain damage.

"Scientifically proven" is a very slippery concept in psychiatry. A biological cause of depression has yet to be specifically proven but that doesn't stop psychiatrists from assuming that it's the truth. The American Psychiatric Association is not encyclopaedic -- they are extremely biased in favour of the biomedical model of mental illness and tend to disregard the considerable research that flies in the face of it. There is a lot of evidence for long-term memory problems after electroshock. Whether or not this consitutes brain damage is arguable. Francesca Allan of MindFreedomBC 05:50, 5 December 2005 (UTC)[reply]

the Electroconvolsive therapy section isn't NPOV, and not in encyclopedic tone. I also wonder how general some of the comments are (such as that it usually happens 8 AM MTW). I hesitate in mentioning this, as it would be helpful to many people, but it isn't very encyclopedic. Themissinglint 21:06, 5 May 2005 (UTC)[reply]

Unless someone comes up with a good reason not to, I'll be refactoring the "selective noradrenaline reuptake inhibitor" bit. Venlafaxine is a strong inhibitor of serotonin reuptake, and a weak inhibitor of noradrenaline reuptake. Venlafaxine is therefore an SNRI (serotonin-noradrenaline reuptake inhibitor), whereas Reboxetine is a NARI (noradrenaline reuptake inhibitor).

Also, this section makes no mention of Tianeptine and Amineptine. The former is a serotonin reuptake enhancer (SRE), and the latter is a dopamine reuptake inhibitor (DRI) which is schedule II.

Electroconvolsive therapy

I totally agree with the previous comment about Electroconvolsive therapy. This tone is not what you can expect from an encyclopedia. Do you think we should add a NPOV tag? --Cinoche78 17:59, 8 May 2005 (UTC)[reply]

I say we just delete the whole POV part (starting at the second paragraph, as of this writing). It's basically an advertorial and I don't see any information that could be extracted from it by making it NPOV. Lawrence Lavigne 19:48, May 8, 2005 (UTC)

Can we stop the ax-grinding? I'm referring to the appeal to unnamed authority that "A minority of the US psychiatric establishment view ECT as having more benefits than drawbacks." I'd like to actually see the figures which support that statement, especially since I think an actual doctor would not answer that question unless given context about the patient -- ECT has drawbacks, but it produces results in some cases where every other modality has failed. Asking a doctor to judge a treatment like that out of context is like asking them to judge the merits of amputation without telling them the condition of the limb in question. -- Antaeus Feldspar 11:54, 20 May 2005 (UTC)[reply]

Removal of "atropinic shock" and enema stuff

I have removed a lot of rather peculiar material about "atropinic shock" (which has ZERO Google hits, except for this article), and about enemas. -- Karada 22:20, 19 Jun 2005 (UTC)

There are several Medline references to Atropine shock treatment.[1][2][3][4][5] -- ElBenevolente 22:57, 19 Jun 2005 (UTC)

Well, if we are to put it in the article, it should be done with caution, and copious cites, as this does not appear to be a widely-accepted treatment, and all of the cites given above are very old, and do not even give abstracts (the most recent one above is 1964), suggesting it is no longer in use. -- Karada 23:30, 19 Jun 2005 (UTC)

A brief mention of the therapy in the article would probably be sufficient as a former treatment method. ElBenevolente 23:55, 19 Jun 2005 (UTC)

Large turnback

Eh, don't you think that you've removed TOO much? Almost everything I've added, including things I've fixed:

Why tricyclics are still used
Antipsycotics for augmenting antidepressant blood concentrations
Light therapy and exercises
Ugly nameless link to Dr. Ivan's depression Central was fixed by me, but now it's ugly again
Link to Wikibooks - Demystifying Depression removed (this was not added by me)

And more. Don't you think it's a good idea to think before destroying someone's else work?

Yes, thanks to someone from 81.218.179.183 - i don't see any more changes in whole Wikipedia from this one. I think we must revert. What do you think?

Varnav 12:09, 20 Jun 2005 (UTC)

Reverted

Okay, I've reverted back to the edition before mr 81.218.179.183 made a big cleanup without any comments. Now, you complain about that some methods are not actual anymore and article is too large. And, we can not say that ECT is a replacement for atropinic shock method - these are two completely different methods. Insulin shock method is considered old now, but It's still used. So, it's probably a good idea to make a cleanup (not so radical)

Varnav 13:11, 20 Jun 2005 (UTC)

Where is insulin shock still used? Anywhere in North America? Just curious. Francesca Allan of MindFreedomBC 02:51, 29 November 2005 (UTC)[reply]

Wikibook: Demystifying Depression

Some of us have started a wikibook on the subject of depression, based on a two-part series I had written for Kuro5hin. Would you consider adding a link to it?

The book still needs some cleaning up, but it is already quite useful. Moreover, it does cover into detail subjects which most web pages (including this Wikipedia entry) neglect -- the issue of exercise and depression, for example. (Which, by the way, you should probably also address into more detail in this article: too much exercise can worsen a depression!)

Here is a link to the book: [6]

Name of Feather 6 July 2005 18:55 (UTC)

Speaking of books, I added John Bentley Mays' memoirs, "In the Jaws of the Black Dogs," to the list near the end of the article. This is a fairly well-known account of life-long depression and I was somewhat surprised that it wasn't listed before. --Todeswalzer 19:22, 14 August 2006 (UTC)[reply]

Just a break-up of the paragraphs

I just broke up the paragraphs in one section because it was becoming a little hard to read...Considering also that depressed people may seek out this article for information on the illness and treatments, I felt also (don't scoff) that, quite frankly, they would find such blocks of text daunting. And considering some of these people may kill themselves if they don't get help - its good to do all that can be done to give them info. Besides, it's just good practice, in today's short-attention-span world!

A Plea: make information more concise but don't cut it

As someone familiar with depression I'd just like to suggest to everyone to try to be generous with the amount of info you provide. Depressed people need all the help they can get - and if they don't get it, they may very well kill themselves. So my suggestion is, think really carefully before limiting the information (read: help) you give them. If it's adding to the clutter, prune the words, not the help.

05:26 14 July 2005 EST

Wikipedia provides a helpful resource

I find that a google search on depression, as well as many of the links at the end of the wikipedia article are pretty crummy, but that's just my opinion.

Personally, I believe that scientific discussion of the possible origins of depression, still a very controversial matter, to be very theraputic. Learning about the disease makes treatment more likely to work. The stigma surrounding depression, as well as the claim that it is a necessary by-product of a thoughtful and creative mind are based in ignorance. These fallacies prevent many from seeking effective treatment.

Online support groups?

Should we be linking to online support groups? If so, should we be linking to one that just reached its first month online? -- Antaeus Feldspar 22:58, 27 July 2005 (UTC)[reply]

According to Wikipedia:External links, there is no reason not to link to online support groups. I took a look at the new site secretworld and found it to be informative, and not too POV. I'd say let it stay. Gbeeker 15:10, 28 July 2005 (UTC)[reply]

Why was the reference to Prozac "poop out" removed?

The knowledgebase of large psychiatric practises indicates that for most chronic ailments, it is necessary to increase the dose of an ssri to maintain effectiveness, or switch to a different medication or a cocktail.

Suprisingly, there is little or no literature on this topic. However, when I thumbed through an evidence based pyschiatric medicine book, this topic is discussed (without any primary reference, of course).

Googling Prozac poop-out retrieves a psychology today article with comments from Donald Klein, an eminent psychopharm guy. Almost half the article is dedicated to Prozac poop-out.

This topic seems a little too important to ignore. Conflict of interest within the funding mechanisms for psychiatric research might be at work here.

This info must be placed in Antidepressants or Prozac, not in this article 81.195.222.220 11:56, 11 August 2005 (UTC)[reply]

Where do these rules come from? People who receive treatment for depression with antidepressants (the most widely used treatment option) should be aware of tachyphylaxis, since there is some likelihood that their doctor isn't. There is also a very strong social stigma attached to having to take more than the normal dose.

Evidence based CBT / IPT

Does this exist?

Very definitely. Check PubMed, Cochrane reviews, or see e.g. [7] --Cedders 12:56, 24 April 2006 (UTC)[reply]

Transwiki from Wikibooks

Depression is used to refer to : (1) A mental state characterized by pessimistic views (2) A despondent inactivity.

The drugs traditionally used in the treatment of depression include: (a) Lithium traditionally used to treat Bipolar Disorder(manic depression) (b) Tricyclic Antidepressants aid the activity of serotonin and noradrenaline (c) SSRI Antidepressants aid the activity of serotonin (d) SNRI Antidepressants aid the activity of serotonin and noradrenaline

Almost all antidepressants are only available with a prescription from a doctor.

Depression is a clinically recognised condition of the brain. Its symptoms may include prolonged depression of mood or feelings of unhappiness, thoughts of suicide or self harm, change in sleeping patterns (increased or decreased sleep), loss of appetite and loss of sex drive as well as feelings of hopelessness, guilt and anxiety. The most common type of depression is called major depression with symptoms including but not exclusive to those listed above. Physiologically, major depression is manifested largely through decreased levels/effectiveness of the brain's neurotransmitters serotonin and noradrenaline. The other most common type of depression is called Bipolar Disorder or Manic Depression. It's symptoms involve mood swings between symptoms similar to Major Depression and/or a state of mania including elation, hyperactivity, anxiety and paranoia.

The causes of depression are not entirely known but the condition may be induced by stress, grief, taking of narcotics or other drugs of abuse or genetic suseptability.

(cur) (last)  02:30, 13 July 2005 24.226.91.89
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"Post-Vacation-Depression

Let's say someone comes back from vacation. Then they want to return to their vacation spot. It gets to the point where it depresses them. It stays that way for longer than usual (let's say about two weeks). Could this be considered clinical depression? Scorpionman 02:14, 20 August 2005 (UTC)[reply]

It could be only if symptoms of clinical depression are present. There are different triggers for certain people. --Dysepsion 02:22, 20 August 2005 (UTC)[reply]

What you propose sounds like an unlikely trigger for clinical depression (as opposed to informal just-feeling-blue "depression") but not at all impossible. Context is highly important; if they come back from vacation to a work situation where they feel trapped, unappreciated and helpless, then yes, it could be the trigger for clinical depression. -- Antaeus Feldspar 21:23, 20 August 2005 (UTC)[reply]

How about "post-holiday depression"? I seem to be suffering from this myself right now. Scorpionman 00:39, 4 January 2006 (UTC)[reply]

Both of the these are references to post-euphoric melancholia, and do not constitute...nor would they be likely to activate...a clinical definable depression. Mjformica 12:25, 4 January 2006 (UTC)[reply]

Why the link...post-euphoric melancholia is a fancy way of saying "the crash after the high". It's self-explanatory. Mjformica 03:13, 17 January 2006 (UTC)[reply]

Depression

Depression can be a life threating illness. It prevades every aspect of an persons life. Things once pleasurable no longer matter. Every day normal events become by rote or simply don't get done. It's costs to family, employers, society cannnot be calculated but must be high. It is one of leading causes of suicide.

(There is no evidence that depression constitutes an illness in the medical sense any more than burning your hand on a stove could be called a "disease". Just as a description "injury" would be a little closer... or even something akin to a "fever" in a response to infection ... at least as an analogy.)

Alternative Therapies

I know St. John's Wort as treatment is listed in a lot of magazines and in some studies. Granted it is not an "official treatment" by some opinions, but I think it should be mentioned because things people commonly see on the subject should be addressed here. I think this reasoning should follow for other therapies as well, including older ones that are not used anymore.

Also, when I did a lot of reading into depression I came across an article in a mainstream health or exercise magazine that quotes a study. The study warns that taking St. John's Wort reduces the effectiveness of birth control pills. Perhaps it might be wise for someone to find this reference and mention it? (I'm trying but hoping to have some help). Especially since getting unexpectedly pregnant might not be a positive boon to someone's depression! --Kat 07:58, 24 October 2005 (UTC)[reply]

What reduces the effectiveness of birth control pills? St John's Wort or depression? --bodnotbod 09:49, 24 October 2005 (UTC)[reply]

St.John's Wort. (I re-edited my post for clarity). --Kat 12:17, 17 December 2005 (UTC)[reply]

Definitely not NPOV

This article seems biased against people that aren't depressed. Such sayings as "Normal people can't understand how depression is" seems like a large point of view from one side.--Pichu0102 15:27, 10 November 2005 (UTC)[reply]

Not when its for depressed people.

Since when is a Wikipedia article supposed to be for someone? Isn't a wikipedia article supposed to be an unbiased place of information, not an opinion place?--Pichu0102 05:21, 12 November 2005 (UTC)[reply]

I greatly disagree.

What, so you think a non-diabetic can truly understand what it's like to have diabetes, or someone who's never had cancer can know what it's like to suffer in that way? misanthrope 13:06, 30 December 2005 (UTC)[reply]

STOP THOSE EDITS!

Electroshock has no side effects??? You have GOT to be f'ing kidding me. Francesca Allan of MindFreedomBC 05:03, 15 November 2005 (UTC)[reply]

This is certainly not constructive discussion of article content. Will you please behave? JFW | T@lk 22:38, 15 November 2005 (UTC)[reply]

Jfdwolff: you are so off-putting. I totally sympathize with Francesca. I also don't think her comments were that offensive. Rather, you seem way to uptight about somebody speaking passionately.

I apologize for my earlier tone but your smug statement offended me greatly. Electroshock has devastating side effects (both short and long-term) and your dismissal of this well documented phenomenon is likewise certainly not constructive to a well-balanced article. Francesca Allan of MindFreedomBC 00:37, 16 November 2005 (UTC)[reply]

You must be mistaking me for someone else. I have not edited this article for a while (1 October to be correct). I was simply stating that Wikipedia has civility guidelines, and your use of invective and incredulity does nothing for the article. JFW | T@lk 00:42, 16 November 2005 (UTC)[reply]

I'm sorry I confused you with another editor. Civility is a funny thing. It's okay to write dangerous trash (such as electroshock is harmless) but keep your language ladylike. Very enlightened. Francesca Allan of MindFreedomBC 09:15, 21 November 2005 (UTC)[reply]

So you are still accusing me of writing "dangerous trash", despite my reassurance that I have not edited this article for well over a month? Or do you mean that civility is more important than WP:NPOV? Well, describing other POVs as "dangerous trash" is not conductive to agreeing on article content. JFW | T@lk 00:15, 22 November 2005 (UTC)[reply]

Look, I already apologized in my comment above. And whoever claimed that electroshock is harmless is indeed posting dangerous trash on wikipedia. Just to clarify: I realize that wasn't you. Acknowledging the brutality of electroshock isn't really a POV issue. Electroshock survivors describe being harmed in the short and the long term. Francesca Allan of MindFreedomBC 01:14, 22 November 2005 (UTC)[reply]

ECT has both advocates and opponents. There are many patients who swear by ECT treatment.[8] The most frequently cited side effect is short-term memory loss.--24.55.228.56 04:24, 29 November 2005 (UTC)[reply]

Yes, and a less common (but certainly not uncommon) side effect is permanent memory loss and brain damage. And less common still (but still significant) is death. Some people swear by crack cocaine, too. That's hardly an endorsement. Francesca Allan of MindFreedomBC 04:26, 29 November 2005 (UTC)[reply]

Want to CAUSE depression? Just witness others' being "treated" with shock. About 15 elderly people line up for their treatment, and when they come out they don't recognize anyone, don't remember where they are, why they are there, their room number, anything. I was struck by a speeding truck and suffered a skull fracture and brain damage. When I came around two weeks later I was cheerful too - its just a normal brain reaction to recovering from damage, and what is essentially a "reboot." But the long term results are something else entirely. People need to remember the origins of this "treatment." It was not something arrived at through research, not the result of medical theory - it came about when electricity was new and novel and people invested it with magical powers - there were numerous quack devices sold to produce shocks to "envigorate" you, regrow hair, etc. as if electricity was a vitamin or a miracle cure for everything. THAT is how electroshock therapy came about. 65.35.93.97 (talk · contribs)

Your version of the history is interesting, but please adhere to WP:NPOV when editing articles. JFW | T@lk 00:21, 27 December 2005 (UTC)[reply]

It's more than "interesting," JDW. The four week recovery from closed head injury of electroshock is well-documented. As for the history of electroshock, it was derived from pig slaughterhouse procedure. The sicko that decided it would be good idea to inflict this on mental patients was awarded a Nobel prize. Francesca Allan of MindFreedomBC 18:20, 27 December 2005 (UTC)[reply]

Francesca, we know your opinion. JFW | T@lk 08:12, 28 December 2005 (UTC)[reply]

It's not merely my opinion, JFW. Moniz won the Nobel prize for his work. And the negative effects of electroshock are well-documented but simply ignored. Francesca Allan of MindFreedomBC 15:48, 28 December 2005 (UTC)[reply]

But it's just dramatics. The best medications are derived from poisons. Warfarin is a good example. As for the negative effects: I'm still waiting for your references to serious research confirming your "minor head injury" analogy. JFW | T@lk 18:17, 28 December 2005 (UTC)[reply]

My two cents: Jfdwolff is not constructively contributing to this discussion but rather is passive-aggressively sidetracking discussion. Jfdwolff--you should learn to interact with others in a more conciliatory and constructive fashion, rather than in such impersonal, condescending fashion.

I've already provided links elsewhere to Breggin's research. As it disagrees with your POV, you won't deem it "serious." That's not how research is judged. My point was not dramatics. Electroshock wasn't "derived" but merely transferred from the slaughterhouse to the lunatic asylum. Francesca Allan of MindFreedomBC 15:14, 30 December 2005 (UTC)[reply]

Francesca, I'm sorry but I'm must correct you on the historical aspect of ECT. ECT isn't the toy of some cowboys experimenting with the all-new electricity magic. It came from the clinical observation (late XIX, early XXth century) that people experiencing epileptical seizures we're somehow shielded from psychosis (hallucination, delusion and the like). So those clinicians started to experiment on ways to cause seizures in patients suffering from severe schizophrenia, using for many years chemicals like camphor since they felt it was easier to administrate in a controlled way. Psychosis was somehow lessened, but it is the depressive symptoms who where the most affected by this. This is how it came to be used for depression. In time, electricity (first AC and bilateral, now DC and usually unilateral) came to replace drugs since it is generally safer. It is still widely in use for severe, medically refractory depression, or severe depression with psychotic symptoms. Don't get me wrong, it is not used frequently for the average, my-mother-in-law-has-it type of clinical depression. It is used mainly on those who are very severely incapacitated by their depression, who do not respond to treatment, either pharmaceutical or psychotherapeutical, or who exhibit psychotic symptoms. It is not used in first line, but it produces results, and its side effect are way less severe than 50 years ago, and way under the effects of being severely depressed and psychotic. As such, it's place is discussed in every medical cursus, along psychopharmacology and psychotherapy. Duf_Sherby 15:57, 3 may 2006 (EAT)

Internal contradiction

These two apparently contradictory sentences appear nearly next to each other (in the section "Signs and symptoms", in the paragraph beginning "Because of this profound..."):

Because of this profound and often overwhelmingly negative outlook, the depressed individual is unlikely to recover on their own without some sort of treatment.

If left untreated [depression] will generally resolve within six months to two years although occasionally depression becomes chronic and lasts for many years or indefinitely.

Neither of these statements is sourced. I think this whole paragraph should be removed and replaced with a sourced figure (or range of figures) estimating the likelihood that untreated depression will resolve itself. --Delirium 00:52, 16 November 2005 (UTC)[reply]

The "six months to two years" bit was discussed at Talk:Clinical_depression/archive 2#Will really untreated clinical depression resolve from 6 to 24 months?. When I was first told this, I was told that there were studies that show that to be true - but I don't have information on the pages. Ideally we need those references. I think the first bit ("unlikely to recover") may be referring to the risk of suicide or those people with long-term or recurring depression. But I'm not sure, and it's not what I understood to be the usual course of the illness. -- sannse (talk) 21:17, 28 December 2005 (UTC)[reply]

recent change by dr. raymond lam

The word electroshock is not only used by detractors. It is also used by people who are neither for nor against the procedure but who simply support the honest use of language. As for there being no neurobiological proof of brain damage from electroshock, it's always amusing to compare the differing standards that psychiatry employs. There is no neurobiological proof of mental illness but that doesn't stop psychiatrists from incarcerating, force drugging and electroshocking anyone deemed mentally ill. Why do you (and the majority of medical doctors) disregard anecdotal evidence? I have been harmed by electroshock and so have thousands of others. Your arrogance is simply breathtaking. Francesca Allan of MindFreedomBC 04:40, 30 November 2005 (UTC)[reply]

Francesca, please remain civil, assume good faith and make no personal attacks. You are not being fair to an editor who has just made his first edit to Wikipedia and is simply working his POV into the article according to his understanding. There are less abrasive ways of enlightening Dr Lam.

As for the neurobiology: this is actually a fairly academic thing. About 65% of all medical treatments that are used have no identifiable evidence base. But ECT does work, at least according to those studies that the psychiatric community relies on. And results count, in the long run. JFW | T@lk 13:19, 30 November 2005 (UTC)[reply]

Sure, JDW. electroshock "works." So does being smacked in the head with a log! The psychiatric community is notorious for disregarding anything that runs counter to their paradigm. Why aren't patients listened to? I am almost 2 years post-electroshock and I *still* have not recovered. It's hard to stay civil when somebody assures me that I wasn't harmed when it's quite clear that I was. Each electroshock treatment lasts for about 4 weeks, the same amount of time it takes to recover from a mild head injury. What about the neurobiological proof issue? Why do I have to prove neurobiologically that my brain was damaged? Why isn't psychiatry held to the same standard, i.e. provide proof that mental illness is a neurobiological disorder? Francesca Allan of MindFreedomBC 15:24, 30 November 2005 (UTC)[reply]

I can't seem to make it clear here that the distinction between psychiatry and the rest of medicine is that psychiatrists are legally allowed to incarcerate, force drug and electroshock unwilling patients. Francesca Allan of MindFreedomBC 15:33, 30 November 2005 (UTC)[reply]

You are fully entitled to your POV and sympathise with your distress, but perhaps you shouldn't have projected it on unsuspecting Dr Lam.

Again, in the large studies patients are definitely being listened to. Otherwise there could never have been a comparison with the control group as to cognitive side-effects etc. But let's not try to rehash the discussion; if you can provide adequate resources (e.g. Breggin's work or major websites), there is reason why the negative patients' view should not be included in the article. JFW | T@lk 16:27, 30 November 2005 (UTC)[reply]

Well, Dr. Lam shouldn't write such statements if he doesn't want to be slammed for them. And, no, JDW, patients are NOT being listened to. If they were, we would have a vast range of voluntary, humane and effective options for the mentally ill. Wendy Funk, electroshock survivor, permanently lost her entire pre-shock memory. In the process, when she pointed this out to her doctor, his response was "What difference does it make?" and that's the title of her magnificent book. Francesca Allan of MindFreedomBC 01:06, 1 December 2005 (UTC)[reply]

So why would it not be possible to say: Mental health professionals say... etc. However, some previous recipients of ECT counter that many patients do indeed suffer severe after-effects, including [...]. Source: Breggin/Funk etc. This is the way NPOV works. Rather that trying to make one view look like the total and absolute truth, simply repeating what each side says makes a page truly neutral. Everyone always debates the facts; Wikipedia is not an arbiter to say who's correct and who's incorrect. JFW | T@lk 01:30, 1 December 2005 (UTC)[reply]

Because Breggin IS a mental health professional and he is not alone in his concerns. Your wording above, despite your obvious good intentions, will give the impression that professionals think electroshock is safe and effective while lunatic scientologists believe otherwise. Francesca Allan of MindFreedomBC 01:43, 1 December 2005 (UTC)[reply]

Paraphrasing somewhat, of course. :) Francesca Allan of MindFreedomBC 01:45, 1 December 2005 (UTC)[reply]

Okay, but Breggin is a vocal but not numerical minority. So the text should be: "Most psychiatrists [...] some say [...]". NPOV is full of weasel terms, whatever the critics may think. JFW | T@lk 02:01, 1 December 2005 (UTC)[reply]

How about "other psychiatrists ..." or "a minority of psychiatrists ..." or "however, some psychiatrists ..."? By the way, JDW, have you read Breggin's article? Francesca Allan of MindFreedomBC 03:51, 1 December 2005 (UTC)[reply]

Can't say that I have. JFW | T@lk 09:04, 1 December 2005 (UTC)[reply]

Well, I hope you consider reading it at some point because he makes a great case for the abolition of electroshock. Francesca Allan of MindFreedomBC 15:11, 1 December 2005 (UTC)[reply]

Francesca you should edit the borderline personality page.

Commercial Violation

References to the website fishoilblog.com keep cropping up in this article as a reference. It is a commerical website designed to get readers to subscribe to a newsletter where fish oil is sold. This is clearly a violation of Wikipedia standards for neutral references. No doubt the owner has used this ploy to improve his search engine postion by getting links from Wikipedia.

You are correct. If it is your assessment that these are commercial links they may freely be removed. There is lots of spam on Wikipedia. I remove it on sight, although the discussions can be tedious. JFW | T@lk 11:18, 11 December 2005 (UTC)[reply]

Use of unproven statements

While there are probably more present in this article, given the nature, I am at the moment only taking issue with this particular statement (given that it's the only one I've spotted as of yet):

"People that accept satisfactory outcomes in lieu of "the best" outcome tend to lead happier lives." (under Causes for depression)

While such a statement makes sense, it is at present only justifiable in that it appeals to common sense. However, this statement cannot be proven, and because it cannot be proven, it has not been proven, and because it hasn't been proven, it has no place in this article (see Wikipedia's page on verifiability, although whoever penned the above statement shouldn't in reality need to read that, given that the verifiability page should be familiar to any editor). Given the nature of this article, I think it's in need of a re-evaluation of its conforming to standards... 72.140.7.191 02:30, 16 December 2005 (UTC)[reply]

Accuracy in reporting and bifurcation

"Clinical Depression" and diagnoses falling on the Depression spectrum are not the same thing. As this section has exceeded the recommended limit for content, may I suggest separating the two topic areas? Mjformica 13:15, 31 December 2005 (UTC)[reply]

Enemas???

I've removed this whole subsection to talk, as, without supporting cites, I find it highly dubious.

Enemas and colon hydrotherapy

Severe clinical depression is often accompanied by constipation. Tricyclic antidepressants themselves also tend to produce constipation as a side effect. ^{[citation needed]} Laxatives reduce the absorption of an antidepressant in the small intestine, thereby reducing its bioavailability and clinical efficacy. ^{[citation needed]} Warm water enemas, on the other hand, do not interfere with antidepressant absorption, and may have a slight antidepressive effect by increasing serotonin production in thick bowel wall and temporarily raising serotonin level in the bloodstream. ^{[citation needed]}

-- Karada 01:03, 2 January 2006 (UTC)[reply]

Request for Comment: User Conduct

Mcman Legal threats, hostile revisions, failure to collaborate, gaming the system (WP:POINT), assuming bad faith(WP:AGF), uncivil behavior (WP:CIVIL), harassment (WP:STALK), ignores consensus (WP:CON), and engages in personal attacks (WP:NPA). --Mjformica 16:38, 6 January 2006 (UTC)[reply]

I would respectfully request that other users and contributors disregard this formal RFC, as I believe that Mcman and I have come to a point of resolve without the need for outside intervention. If you care to comment here, I, personally, would consider it an academic exercise that may bear on the community at large, but would not bear on the resolution to which I feel my Wiki-colleague and I have come. --Mjformica 13:19, 7 January 2006 (UTC)[reply]

Apology to contributors

Before mjformica posted the above, I had asked an independent mediator to step in to resolve issues between myself and mjformica.

For the record, mjformica deleted my contributions with public comments that included "palpibaly incorrect" and "wrong again." Then he posted me a piece of hate mail saying I "am not a clinican" and to cease writing for Wikopedia.

For the record, I have bipolar disorder and depression is a constant in my life. I have been awarded a major award by the Connecticut Psychiatric Association for my writing on depression and bipolar disorder and Harper Collins will be publishing my book in November. I have 25 years of editorial/journalism/publishing experience. I have a reputation for writing on complex matierial in a very clear manner. I have written full-time on mood disorders for nearly seven years. I am very respectful of clinicians and researchers and they have been very gracious to me. My minor contributions on Wikipedia are based on interviews with the leading experts, as well as their writing.

Now I notice that mjformica has accused me of "legal threats, hostile revisions," etc. All this is wholly untrue. I did tell him he had no right question my credentials or delete my contributions or make the public comments he made. Nevertheless, he continued to delete my contributions.

Then I requested independent mediation.

I am hoping independent mediation will work. Until the matter is settled by a mediator, however, I trust that mjformica respects my writing and does not once again delete my contributions.

Once again, I am sorry for putting all of you through this.

Unfortunately, I do not believe that the request for independent mediation follows the protocols for RFC, as noted in the Wikipedia policies and procedures, whereas the above post does. Conflicting editors are first to request contributor arbitration from members on the section talk page, then, if that conflict cannot be resolved in that forum with the participation of at least 2 other contributors, a request for formal arbitration via the Admins may be requested, although it may not be accepted.

In addition, I did not delete Mcman's posts, but edited, revised and expanded them. I thought that was the idea. You will note that all of the information contained in his writing is contained within my revision, along with requests for specific citations as requested by one of the Wiki-Admins. Therefore, I would argue that it is he, not I, whom is guilty of wholesale deletion. Mcman is also of the opinion that my language is too dense for Wikipedia. If someone would comment on this, it would be appreciated.

Finally, I would quote Mcman here...

Now I notice that mjformica has accused me of "legal threats, hostile revisions," etc. All this is wholly untrue. I did tell him he had no right question my credentials or delete my contributions or make the public comments he made. Nevertheless, he continued to delete my contributions.

I did not question McMan's credentials, as an expert patient. He has no credentials as a clinician, and I made a statement -- albeit somewhat forcefully -- to that effect, in light of what I perceived to be some of his gaming and POV -- my opinion. Although his standing within the patient, and possible within portions of the professional, community may be substantial, and he is, and I quote myself, "...doing good work as a patient advocate and educator...", he is still not a clinician.

I will grant there has been hostility and rancor in some of my editorial tags. I publicly apologize for that.

Secondly, if (quoting McMan's private posts to me) "...wholly libelous...", and "...serious consequences..." do not constitute legal threats and menacing, then I don't know what would.

And lastly, in the interest of putting this whole thing to rest, anything Mcman writes from this point forward is fine with me. Good, bad, or indifferent, I won't touch it without asking, and I would ask the same of him. To that end, McMan, would you kindly review and revise -- then send along, should you be obliged -- the copy that you deleted which included your work and mine...for which I believe you thanked me, initially.

I sense at this moment Mcman believes he has proved his point, and won the day. Regrettably, power goes to the one who yields...Sun Tsu. --Mjformica 12:58, 7 January 2006 (UTC)[reply]

I note your comments

Thankyou, Mjformica. I accept your good faith. I trust that the same consideration you extend to me you will extend to all the other contributors. McMan

This is not a courtesy, it is a compromise, and one I am pleased that you are willing to accept. It applies specifically to our relationship. To the best of my knowledge, no one else has a problem with me...quite the contrary.

That said, would you kindly review the section that I posted to you privately containing your initial work, my expansions, and my edits for readable at your suggestion, then comment. Thank you. --Mjformica 13:43, 8 January 2006 (UTC)[reply]

Causes of Depression - Heredity

"The tendency to develop depression may be inherited; there is some evidence that this disorder may run in families."

This is very vague. Can we get this expanded on? Or at the very minium, a resource link??--Jaysscholar 16:47, 24 January 2006 (UTC)[reply]

Kendler et al 2006 Am J Psych 163(1):109-14 found heritability estimates of 42% in women and 29% in men, but there's plenty of literature on this topic.--Coroebus 13:50, 17 February 2006 (UTC)[reply]

HYPOMANIA :The definition I found almost elswhere is totally diferent than the one on this article,in fact as the names suggests is a form of mania: " The clinical features of mania reflect a marked elevation of mood, characterized by euphoria, overactivity and disinhibition mania ",far from the state of depression and anxiety,and panick attacks definition on this site. Any clues?

You are correct. The individual who initially contributed this section was operating from a POV that focused on the anxiety-depression connection, and overlooked the inclusion of a clear definition. No harm, no foul. Check the re-write. Mjformica 12:17, 29 January 2006 (UTC)[reply]

It is easy to see the depression in heridity. So the society/state will not see any resposibility for their mistakes. To see their mistakes mean to make a social programm, what they don`t want. --Fackel 00:05, 1 June 2006 (UTC)[reply]

Broken Link

Under External Links, I deleted the MADRs test because the link is broken. 14:27, 25 February 2006 Spikedupback529

Link readded with new source.

Monkeyman^(talk) 19:45, 25 February 2006 (UTC)[reply]

External links cleanup

The external links section looks to have a lot of 'dubious quality' links, and far too many links in general. I'm going to do some trimming. Barrylb 20:35, 28 February 2006 (UTC)[reply]

I've replaced the myriad of links with a single link to a directory (dmoz). Barrylb 13:30, 1 March 2006 (UTC)[reply]

I've asked User:Lex Mons to desist from adding a recent set of external links because they are not of high enough value to include:

http://www.depression.com - a pharma company site
http://www.psycom.net/depression.central.html - an arbitrary, poor-quality-looking site run by an individual
http://www.philosophicalsociety.com/Archives/Philosophy%20And%20Depression - a broken link and a site that has been linkspammed to several articles by 68.104.183.247 who has also made edits to the external links in this article
http://www.medicinenet.com/depression/article.htm - some arbitrary site about depression
http://www.ndmda.org/ - redirects to http://www.dbsalliance.org/ - some arbitrary support site

-- Barrylb 15:09, 4 March 2006 (UTC)[reply]

magnesium

I am moving the magnesium entry here because this site[9] says that magnesium glutamate and magnesium aspartate can worsen depression, and one manufacturer adds glutamate.

Magnesium has gathered some attention [10][11].

What should we do? Should we write it as,

Magnesium has gathered some attention [12][13], although there is an anecdotal report that magnesium glutamate and magnesium aspartate can worsen depression [14].

? --Mihai cartoaje 22:28, 28 February 2006 (UTC)[reply]

POV Identifier...

Question on protocol. Can just anyone, including an anonymous user, just float in and drop a POV or NPOV tag on an article. And, if so, once done, who has the right/authority to remove said without it being considered vandalism. I'm not certain this one was justified. --Sadhaka 19:17, 7 March 2006 (UTC) ^{Talk to me}[reply]

The Psychonutritional Treatment of Clinical Depression

I'm a little skeptical of this section. I think it's OK to mention well-established (or research-backed) "alternative" treatments, but they should be clearly labeled as such. Stephen Barrett's Quackwatch has this to say about it (emphasis mine):

Today's "fad" diagnoses used to explain various common symptoms are chronic fatigue syndrome, hypoglycemia, food allergies, parasites, "environmental illness," "candidiasis hypersensitivity," "Wilson's Syndrome," "leaky gut syndrome," and "mercury amalgam toxicity." The first four on this list are legitimate conditions that unscientific practitioners overdiagnose. OhNoitsJamie^Talk 05:24, 9 March 2006 (UTC)[reply]

I've moved it here for a rewrite. -- Barrylb 05:46, 9 March 2006 (UTC)[reply]

I have re-written the artilce and placed on the main page Jurplesman 02:04, 11 March 2006 (UTC)[reply]

With the second advert tag I have now removed the article altogether and I do not intend to contribute to Wikipedia anymore. Jurplesman 05:12, 11 March 2006 (UTC)[reply]

Why has this been removed???

It is rather ironic that you should mention Dr Stephen Barrett, the great self-appointed defender of organized medicine in America. I hope this is not going to be a sign of your personal bias against alternative medicine. More than half of medical consumers are consulting alternative medical practitioners See: Alternative medicine. Plus Bensousan.

Thus a lot of readers will be interested in an alternative approach to the treatment of depression.

My approach stems from my experiences as a Probation and Parole officer, having worked over 30 year in the field of psychotherapy and Clinical Nutrition. I use a combination of Clinical Nutrition and psychotherapy as explained in my book Getting off the Hook.

Although Clinical nutrition is often classed as Alternative Medicine it is an evidence based medical science, supported by numerous studies. See: Research Evidence for Hypoglycemia.

Can somebody explain to me why this article has been removed from the main article?? Jurplesman 03:39, 10 March 2006 (UTC)[reply]

The editor who moved your content here said, "moving to talk - needs rewrite" in the Edit summary field. It could also be because of this WP:NOR.

Monkeyman^(talk) 03:47, 10 March 2006 (UTC)[reply]

I have rewritten the article and placed on the main page. Jurplesman 02:05, 11 March 2006 (UTC)[reply]

I've added an 'advert' tag against your contribution because your writing style sounds like an advertisement and still needs work. -- Barrylb 02:46, 11 March 2006 (UTC)[reply]

I have removed the article altogether and I do not intend to contribute to Wikipedia anymore.Jurplesman 05:10, 11 March 2006 (UTC)[reply]

Useful Link

We have just added article and video content created by key opinion leader Physicians as well as government health organizations and would like to be considered as a useful resource for this page. We are hosting an online symposium on mental health and spirituality and think this would also be a valuable contribution to the community.

Thank you,

Ryan depressiontreatment com Depression Treatment —This unsigned comment was added by Ryanandrew (talk • contribs) .

You've already been blocked once for commercial link spamming. What makes you think this is different? OhNoitsJamie^Talk 00:30, 22 March 2006 (UTC)[reply]

Recent links

Someone recently added these links. They seem like good sites but is this leading to our links section getting too big? Do these sites deserve special mention? -- Barrylb 05:35, 29 March 2006 (UTC)[reply]

http://www.cci.health.wa.gov.au/resources/consumers.cfm (Excellent self help resource for the treatment of mood disorders including depression, low self-esteem and social anxiety)

http://moodgym.anu.edu.au (Interactive Free online program offred by reputable Australian university for the treatment of depression)

http://bluepages.anu.edu.au

Depression is not a state of sadness

Sadness is an emotion. Depression is blockage of emotion! Here's one take... Sadness vs Depression

Expression of emotion vs Repression of emotion

Cure vs Illness (Solution) vs (Problem)

Loss of love vs Lack of love

Feel alive vs Feel dead

Healthy vs Sick

Passes with time vs Persists with time (self-alleviating) vs (self-perpetuating)

Cause-effect close and known vs Cause-effect distant and often unknown (e.g. death in family) vs (e.g. hereditary)

Attracts sympathy vs Attracts scorn

Selfless vs Selfish

Draws others closer vs Distances others

Widely understood vs Widely misunderstood

What on earth is this??? Dcteas17 01:24, 7 April 2006 (UTC)[reply]

It's an unsigned comment presumably meant to help editors distinguish features of two meanings of 'depression' for contributing to the respective articles. This distinction is made fairly clear (despite the potential for overlap) in depression (mood), certainly as regards adaptive/maladaptive distinction and presence of known cause. (Perceived) 'selfishness' or need and availability for social support is possibly a tricky point that should be covered in one or both articles if the contributor writes again; I have some articles on the subject too but they might apply to both subjects. --Cedders 13:36, 24 April 2006 (UTC)[reply]

Adding to the biological/physiological causes of depression

I don't know if this is too theoretical to post, but as a grad student interested in the biology of depression, I am frequently surprised as to how little the new biological basis of depression is being discussed.

I spent about 6 months with an antidepressant lab, and there are 3 new theories for the biological causes that are not discussed here:

1. HPA axis and depression 2. Neurotrophin theory of depression 3. Depression and neurogenesis

1. Briefly, stress causes an increase in the hpa axis: CRF -> ACTH --> cortisol. This was found to occur in patients with depression (Nemeroff) High levels of cortisol are associated with, among other problems, a decrease in the volume of the hippocampus, and damage to the cells in the hippocampus (Sapolsky and McEwen). This finding is still contravercial though, it has been replicated by some, but not other scientists. Excess levels of cortisol have been repeatedly shown to decrease brain derived neurotrophic factor (BDNF) in the hippocampus.

2. Antidepressants as well as exercise have been shown to increase the levels of BDNF in the hippocampus (Duman). To paraphrase one article "BDNF does to the brain what sunlight and water do for plants"; i.e. it is essential for normal growht and functioning.

3. More recently, it has been shown that cortisol decreases the number of formation of neural stem cells that normally actively divide in the hippocampus, as well as the number of new neurons that they produce (Duman). Antidepressants and exercise can counteract this loss (Duman).

Scientists are still debating how significant these biological factors are to the actual feeling of depression itself (Duman, Sapolsky).

I might write this up more formally later (with references) on when I have more time. But briefly this comes from the work of Ron Duman at Yale, Robert Sapolsky and Bruice McEwen at Stanford and Rockefeller, and Charles Nemeroff at Emory. Of those four people, I have personally met two, and exchanged e-mails with the other two. —The preceding unsigned comment was added by 71.134.206.170 (talk • contribs) . 15 April

Sounds good, particularly Sapolsky as source; there's as much evidence for involvement of HPA axis and other neuroendocrine systems as there is for monamines. --Cedders 13:23, 24 April 2006 (UTC)[reply]

Editing down?

I'm seeing the warning that the article is getting a little long, just as I'm adding a little more to it. Even if there weren't the concerns of the person making the pleas above, there is no reason to cut stuff, but it could be moved to create a betetr article. Firstly, I'd suggest that the section on antidepressants could be merged with the introduction of the article with the same name, since at the moment that article is a bit technical and could do with a clearer historical introduction; and the text included here is mostly to do with differing modes of action and side-effects which are common to treating other conditions and not solely relevant to this article. There's also no obvious link to the 'other' overview article on antidepressants.

Secondly the two sections on anxiety and hypomania seem to be a bit out of place and unclear, so could perhaps be made into a separate article. While it's an interesting thesis and some mention must be made of comorbidity between anxiety and depression, the linking of hypomania with depression will be very confusing for some readers. ICD-10 defines hypomania as 'persistent mild elevation of mood, increased energy and activity, and usually marked feelings of well-being and both physical and mental efficiency' which is clearly the opposite of clinical depression. I'm not sure what is meant by 'Another important point is that hypomania is a diagnostic category that includes both anxiety and depression' - superficially this is false, so I wonder how much of the text to preserve. I think it would suffice to say that positive and negative affect are sometimes considered orthogonal (or the same in better English), or a state of agitation and 'upset' has some of the features of a wider definition of hypomania, i.e. sympathetic arousal. --Cedders 13:23, 24 April 2006 (UTC)[reply]

possible copyvio

http://www.depression-tips.com/

The types of depression section appears to be a cut and paste of this site. —The preceding unsigned comment was added by 210.15.254.45 (talk • contribs) .

Looking back in the history of the article all the way back as far as 2003, that section has grown organically over a period of time. Since the web site in question is claiming copyright from 2005, I would suggest that the site's content is possibly a copyright violation of this article, rather than the other way around. --GraemeL ^(talk) 00:36, 16 May 2006 (UTC)[reply]

The section in question was created with this edit and evolved from there. --GraemeL ^(talk) 00:45, 16 May 2006 (UTC)[reply]

..and it looks like credit has since been added at the bottom of that page as coming from this article; whether that appeases copyright violation rules I don't know, too lazy to read into it, but there you go. 66.94.9.51 05:54, 23 May 2006 (UTC)[reply]

Deleted edit - biological/psychological

I removed the following text, added in a recent edit by User:66.81.158.60.

In 2006 , Aiven Andrians , an independent researcher (not a proffesional psychologyst)in the field of psychology classified depression in two distnict catagories of :

1- Biologycal Depression caused by biologycal factors in the brain and / or the body. Usualy treated with medication by a trained Psychiatrist .

Common prescribed medications are : prozac , Paxil , Zoloft ,

Also treated with St. Johns Wort in the case of minor depression in the Europe .

2- Psychologycal Depression caused by negative chilhood events and / or current negative life events . Usually treated by a trained Psychologist.

Obviously it would need some copyediting no matter what, but it struck me as suspicious on three counts (to my knowledge anyway, please correct me if I am wrong):

I believe the biological/psychological distinction is far older than 2006 and has been discussed by psychologists and other researchers at length.
I believe that the distinction between biological and psychological origins of depression is largely deprecated these days, on the basis that it is not easy to determine, is not an either/or dichotomy, and is not as helpful for treatment plans as the included text would suggest.
A Google search for Aiven Andrians didn't provide any relevant hints, casting doubt on the accuracy.

If I'm wrong on any or all of the above three counts, then please feel free to revert (or better still, reinsert an edited version) of the text. Paddles ^T_C 09:53, 11 August 2006 (UTC)[reply]

treating depression

any word on which country is the best at treating depression

Intro wording

"clinical depression is a clinical diagnosis and may be different from the everyday meaning of "being depressed". Many people identify this feeling as "being blue", "feeling sad for no reason", or "having no motivation to do anything"."

I think this is rather confusing: what does "this" refer to, clinical depression or the everyday meaning? I was bold and changed it to:

"clinical depression is a clinical diagnosis and may be different from the everyday meaning of "being depressed". Many people identify the feeling of being depressed as "being blue", "feeling sad for no reason", or "having no motivation to do anything". Clinical depression is generally acknowledged to be more serious than normal depressed feelings."

I'm sure it could be worded better, but I think this clears it up a little, at least. If you can word it better please do :-) — E ditor at Large ^(speak) 19:13, 25 November 2006 (UTC)[reply]

monty don?

Why is there a link to the Monty Don page on the external references section?-Mysticfeline

History = Horrible

"The Ebers papyrus (ca 1550 BC) contains a short description of clinical depression. Though full of incantations and foul applications meant to turn away disease-causing demons and other superstition, it also evinces a long tradition of empirical practice and observation."

Okay, first of all, that papyrus didn't contain a description of "clinical depression" it contained a description of something much different which you're interpreting as similar to clinical depression. The second sentence is so bad, I can't even make sense out of it. Actually I'm going to cut this.