Anti Depressants lower suicide risk

"....A third of people suffering serious depression recover with the first antidepressant they try, and well-educated white women are most likely to benefit, according to initial results of an eagerly awaited study on the controversial drugs.

"One key finding: Patients whose depression symptoms disappeared took higher than typical drug doses, and received close monitoring and frequent dose adjustments in the first three months a level of care that few U.S. patients today receive...."

LINK 2:

"....The Food and Drug Administration warning two years ago seemed like a cruel irony: Antidepressants might make certain patients suicidal, the last thing anyone would expect from drugs so widely accepted as an antidote to the misery of depression.

But now, a large-scale, federally funded study suggests that the suicide fears may be largely unfounded. The study of 65,000 adults, adolescents, and children being treated for depression found that suicides were extremely rare and the number of serious attempts immediately dropped by more than 50 percent compared with the month before patients began taking antidepressants.

The bigger worry, said the authors of the suicide study published in today's American Journal of Psychiatry, is that antidepressants don't significantly help most people who have chronic depression. A separate major report in today's issue of the journal found that antidepressants brought complete relief to about 30 percent of patients who have recurrent bouts of depression -- and half saw no improvement at all...."

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My comment:
One of the problems is that modern HMO's require you to be "efficient"...

And ironically, seeing a person and talking to them for an hour or even a half hour is not paid very much...and if your HMO expects you to see thirty people in an 8 hour shift, who has time to listen and counsel people?

(I love taking off warts: I get a good payment from the insurance company for a few minutes work...talking to depressed people takes time, takes an emtional toll on the doctor, and unless you "document" everything, which we don't do for privacy reasons, you don't get paid much).

Anti depressants help the mood...but often there are underlying problems.

You get a woman in menopause. She is depressed. You use and anti depressant, and voila, the moodswings and tiredness and black moods improve. But she is still depressed...why? Because she grew up with an alcoholic father, her teenagers are on drugs, she never worked out her anger of her divorce, she is stuck in a lousy job, etc. etc....and these things you cannot easily change, even in a 30 minute counselling session...

So we "bandaid" people, and often I tell them to go to church for the social suport network and to talk to God about these things (and sometimes tell them to try a different church)...and often I see the teenager etc...causing the problem. I also encourage them to go to aerobics, yoga class, back to college etc.

And, of course, I check for coexisting medical problems anemia and hypothyroidism or occult cancer......

Luckily, life cures most depressions....

But there are people in severe depression that nothing helps...and those like Tom Cruise who scoff at depression have never seen or met a truly depressed person....

I often think of Hopkin's poems describe depression best...

"No worst, there is none. Pitched past pitch of grief,
More pangs will, schooled at forepangs, wilder wring.
Comforter, where, where is your comforting?
Mary, mother of us, where is your relief?
My cries heave, herds-long; huddle in a main, a chief
Woe, world-sorrow; on an age-old anvil wince and sing -
Then lull, then leave off. Fury had shrieked 'No ling-
-ering! Let me be fell: force I must be brief'.

O the mind, mind has mountains; cliffs of fall
Frightful, sheer, no-man-fathomed. Hold them cheap
May who ne'er hung there. Nor does long our small
Durance deal with that steep or deep. Here! creep,
Wretch, under a comfort serves in a whirlwind: all
Life death does end and each day dies with sleep."

-- Gerard Manley Hopkins.