From: sbharris@ix.netcom.com(Steven B. Harris)
Newsgroups: misc.health.alternative
Subject: Re: Homeopathy is "bullshit" (was: Aspartame (diet drinks) good for 
	you?)
Date: 11 Feb 1999 01:35:43 GMT

In <36c1b28b.5970292@news.mindspring.com> bachcole@mindspring.com
(bachcole) writes:
>
>peter@psyche.demon.co.uk ("Peter H.M. Brooks") wrote:
>
>>Now, depression is an unpleasant illness, quite different from 'being
>>depressed'.
>
>I see, the *ucking MDs now own the word "depression" and "depressed"
>and the rest of us are supposed to kowtow to their definition.  So I
>cannot talk about my experience unless I get an MDs permission slip
>and diagnosis.



   I hate to say it, but I think I'm with Baccole on this.  Pain and
depression are subjective sensations, on which the person suffering is
the authority, not the doc.  If the person tells you something helped
their pain or depression, it's certainly silly to tell them that it
"really" didn't, but they just think it did.

    For certain conditions for which there is no objective test, one
must play by different rules (much as doctors don't want to).  The only
questions which doctors can address in the case of things that work for
pain and depression is not whether or not the treatments "work" in
individual cases.  By definition, anything the patient reports is
working, is working.  There can be no rational argument with this (I
issue a challenge here to those who have another opinion-- but think
carefully before you answer <g>).  The only questions science can
legitimately ask are, how LIKELY, a priori, the treatment is likely to
work on a given patient or patient population.  This is an interesting
question, and one that is more objectively addressed.  You cannot tell
a person who reports that smelling jasmine cured him of his depression.
As a scientist, the best you can do is to report that, based on prior
study (if such exists), his experience is relatively usual or unusual.
You can report the same to someone who asks if buying jasmine (or
whatever) is worth the money.  You can give odds, and let the person
decide how much that money is worth to him or her.  That's it for the
role of science.

                                             Steve Harris, M.D.

From: "Steve Harris" <sbharris@ix.RETICULATEDOBJECTcom.com>
Newsgroups: sci.med
Subject: Re: Definition of "clinical depression"
Date: Fri, 3 May 2002 14:47:06 -0700
Message-ID: <aav0kl$f99$1@slb4.atl.mindspring.net>

James Teo wrote in message <3cd25281.2546101@news.freeserve.net>...
>On Wed, 1 May 2002 17:52:05 -0700, "Steve Harris"
><sbharris@ix.RETICULATEDOBJECTcom.com> wrote:

>>There's nothing even clinically predictive
>>about it. [Has] anybody proven that people who tell you that they're
really
>>depressed and don't feel like living, are any less likely to shoot
>>themselves or need to be hospitalized (or you pick the criterion) than
>>people who meet the formal scoring conditions for DSM but refuse to admit
>>they are depressed?  I don't think so.
>
>Actually yes. DSM-IV depressed people are statistically more likely to
>attempt suicide.

Sure, but that's not what I asked. People who say they're depressed or sad
and don't feel like living are statistically more likely to commit suicide
also, but you don't need a complicated set of criteria to figure it out. The
question is what does DSM-IV add?

Clearly depression for weeks or months is worse than depression for one or
two days. Why did DSM-IV pick 2 weeks?  Long enough for women to get over
PMS, maybe. Who knows?

I am also suspicious over this stuff which attempts to differentiate
depression from "normal grieving reaction".  Clinically they're just the
same! Normal grieving is a polite way of saying you or I would be depressed
too if we had that loss. And we start some kind of stopwatch in which you're
supposed to buck up and get over it. Very Germanic somehow. I can see
Kubler-Ross: You VILL HAFF ZEES STAGES UND you VILL HAFF ZEM IN ORDER UND
you VILL TAKE NO more ZAN PROPER TIME UND you VILL LIKE IT.

Note that most descents into major depressive episodes are kicked off by a
loss, sometimes major, sometimes minor. They start with grief. Then they go
too far. With the rest of us, of course, defining "too far."

SBH


--
I welcome email from any being clever enough to fix my address. It's open
book.  A prize to the first spambot that passes my Turing test.