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NEWS: Drugs No Better Than Therapy for Treatment of Depression

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posted on Apr, 5 2005 @ 03:03 PM
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A new study in the April issue of the journal General Psychiatry confirms that therapy and cognitive training are as effective as drugs in the treatment of depression. The current trend is medication, but doctors and patient's rights groups worry about the side effects and efficacy of the preferred pharmaceuticals. Anti-depression medications often backfire and actually exacerbate the problem, and in most instances have comparable success rates to placebo (sugar pill). Recent failures on the part of the FDA have cemented the need for careful consideration of these health risks in the minds of many, and this study will hopefully bolster efforts to get people off drugs, and into therapy.
 



www.forbes.com
When provided by experienced psychotherapists, cognitive therapy may be as effective as antidepressant drugs in initial treatment of moderate to severe depression, a new study suggests.

The study, published in the April issue of the journal Archives of General Psychiatry, included 240 people with moderate to severe depression. One group of 60 people received cognitive therapy, another group of 120 received antidepressant medication (usually Paxil), and a third group of 60 received a placebo pill.

According to University of Pennsylvania researchers, patients in the cognitive therapy group attended two 50-minute sessions a week for the first four weeks of the study. They went to one or two sessions a week for the middle eight weeks and to one session a week for the final four weeks of the study.


Please visit the link provided for the complete story.


I'm so glad this study was made public, it's what many in the business of treating depression have been saying for years, based off of their own anecdotal evidence. Most pharmaceuticals are grossly overpriced, questionable in terms of effectiveness and safety, and they must be relied upon as a crutch for the rest of the patient's natural life to be effective. Therapy has none of those limitations, and is by all measures, the more beneficial treatment between the two. Therapy, unlike drugs, is not a permanent fixture, it's not a maintenance issue. You should not have to attend therapy for the rest of your life, which is of course not the case with most pharmaceuticals - they must be taken regularly in order to be effective.

There are certainly cases where drugs are very beneficial. However, they have come to be relied upon more and more, and that is dangerous for the health of our society. Given the side effects of most pharmaceuticals, they should only be relied upon in situations where all other options are exhausted. Unfortunately, instead of being used as a last resort, they are often the primary weapon of choice with today's medical professionals. I'm sure this fact has something to do with lucrative promotional deals and the encouragement of patients whose brains are saturated by colorful advertisements and the fatuous promise of perfect health.

That's not even taking into consideration the damages the manufacturing process causes to surrounding environments. India has experienced somewhat of a fallout from pharmaceutical plants, pollution of rivers and soil, and toxic sludge poisoning wildlife from runoff packed with byproducts. It's a dirty, dangerous business, which explains why international companies locate their factories in regions where there is little focus on human rights and environmental regulation. I hope this study acts as a wake up call to those who rely on synthetic chemicals to correct problems that could be mitigated or solved using good old fashioned conversation with someone who is trained to help. This may herald a sea change in the treatment of depression, one can only hope. Unfortunately I couldn't help but notice that there were 69 instances of this story on Google News, compared to 549 instances of a story relating to the a bad call in a recent game of football.

Related News Links:
www.theworldforum.org
www.slowplay.com
news.xinhuanet.com




posted on Apr, 5 2005 @ 05:34 PM
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[request removed]

www.depressionhurts.com...
Review some treatment options - decent collection, a fair bit of information.

www.npr.org...
Clues to genetic pre-disposition and susceptibility to depression. Some promising new treatments may be just around the corner.

www.clinical-depression.co.uk...
Depression counseling, some techniques.

www.drpodell.org...
Stress management techniques prove quite helpful. I find this works best for me personally. Rather than pay a shrink, or pop a pill, I step back, assess the world, and find I'm still no worse off than 99% of the rest of the folks on the planet. It helps immensely to put things in perspective.

For some people, especially young folks in high school, it seems like life will never change, like things will never get any better. It's that limited world view, a product of little world experience I imagine, that makes the suicide option so appealing. I decided to do this story for ATSNN in light of the recent push to introduce psychological testing in schools, and the over-medication of school children. When the Weisse incident transpired, it set me down this path of learning, and I wanted to share it with everyone in case another disaster can be averted.

The truth is, life is all about ups and downs, there's no way around that - not for anyone. The rich suffer too, we poor buggers of the world all have to remember that to keep things in perspective. Even those who appear to have it all are not free from want, not free from self-loathing, not free from sadness and loss. The universal human condition ties us all together, it drag us down or lift us up. It all comes down to personal perception and strength of will. Of course, information plays a huge role as well, hence, this story.

www.psychiatrictimes.com...
Maternal depression injures children, so to protect them, care for yourself as well. If you are a depressed mother, that transfers down to your child. Just as women who are abused often abuse their children, and children who are abused often beat up and torture their younger siblings, so do mental states 'roll downhill.'

www.mental-health-matters.com...
This site is very pro-medication, which is not good in my opinion. However, they do have a wide range of excellent resources, and diagnostic aids (which may be too liberal IMO) along with contact information and drug information. Take it for what it is.


www.usnews.com...
Over the counter treatment, DHEA, shows some promise. More info above.

www.cnn.com...
Old article on the use of acupuncture and herbal remedies for depression.

alternative-medicine-and-health.com...
This website claims one of the contributors to depression is sleep.
That can't be true, I hibernate all winter and don't get depressed.
I must be pretty zen huh?


www.apa.org...
A good site tailored primarily for women, including some information on genetics, hormones, cognitive styles, and trauma as contributors and possible 'targets' for treatment.

I know this is a bit long, but I think there's a wealth of good information out there, and if more people had access to it, I believe more people would get the treatment they need before something terrible happens.

I also have a couple of bits of advice from my personal experience that may be of use. Excercise is very helpful for treating depression, especially Tai-Chi and various martial arts.

Some dishes that may aid in the fight against depression: Wolfberry and jujube soup. Frog rice. Snow Pear porridge. Black Bean and Catfish soup. I hear Chrysanthemum tea can also prove beneficial, and is useful if you are overheated or are sensitive to caffeine - Honeysuckle tea works similarly. I would include recipes for these dishes, but this article is long enough already, I can do so if prompted, or you can search online.


Things to remember:
1. Depression is highly treatable, don't lose hope.
2. Depression is very common, you're not alone.
3. Depression is less a disease than a state of mind, and your mind is your own.
4. There are more support groups and web rings than one can shake a stick at - close to a million web pages just on alternative treatments, nevermind traditional and philosophical.
Use them if you need them, that's what they are there for.

I wish you all the best of health, mental and otherwise.

Edited to remove request for clarification that was misconstrued as an insult. The offer still stands - I'm very open to criticism, please don't hesitate to offer advice regarding anything from grammar to spelling to factual accuracy - I give you my word I won't bite your head off.

[edit on 5-4-2005 by WyrdeOne]

[edit on 5-4-2005 by WyrdeOne]



posted on Apr, 5 2005 @ 05:41 PM
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I for one think you do excellent work WyrdeOne...nevermind a few typos or grammatical errors, you make your points quite well.

I don't like that anonymous u2u thing...if you've got something to say, say it...that's what I think anyway.

Keep it up!



posted on Apr, 5 2005 @ 05:47 PM
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Thanks for the vote of confidence.
My spelling is so-so, my grammar is off and on atrocious, but my syntax and vocab make up for it, mostly. :shrug: What can ya' do right? I really was honest about taking suggestions, I take criticism at face value, and if I think it will help, I'll use whatever suggestions people want to throw my way. I'm not one of those snippy writers who get their fur all up at the mention of a spelling error.

I agree about the anonymous comments, but I can also understand why people would be afraid to let their identities be known, especially when commenting on a moderators story or what not. They might be afraid it wll come back and bite them in the bum. I definitely like the new system of voting better than the old one though.
for SO and anyone else involved with the coding. It's been working seamlessly, for me at least.



posted on Apr, 5 2005 @ 06:07 PM
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nice info wyrd. there have been several threads of late that end up saying that thes meds may be bad. now you find a recent artical good on ya!

as for the voteing thing from what i have seen people seem to vote not on actual content but based on if they agree with it or not.
if they don't seem to like what it says they vote down if they agree with it they vote up. there are some on the otherhand that actualy follow the suplied reasonings. they could be more helpfull if a space was given to point out what spacificaly is wrong.



posted on Apr, 5 2005 @ 07:45 PM
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I actually voted yes on your story. I don't know if you did a "fix" before I read it or not. But do you really think it's appropriate to act the way you acted when some one has exercised their legitimate right to give CONSTRUCTIVE criticism?

I will continue to vote for the story alone and ignore the childishness...but my thoughts are that maybe not everyone will if they find a response such as the first in this one.



posted on Apr, 5 2005 @ 08:00 PM
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WyrdeOne

you need to chill a bit.

People are free to vote as they see fit and you are not helping your hand by calling them out on it.

Having said that I liked the article, but disagree with the findings. I have lived with a Bi-Polar woman (aren't they all) for over 25 years and lithium has made a total change in her that 15 years of therapy didn't dent. I agree that a lot of people are medicated that dont need it but there are some who couldnt benifit any other way

[edit on 5-4-2005 by Amuk]



posted on Apr, 5 2005 @ 08:07 PM
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valhall
How do you think I'm acting childish? I GENUINELY want to know what's wrong with the story so I can fix it to everybody's liking. That's not childish as I see it - that's what I have to do every time I deal with an editor, I'm quite used to it and have no fear of it. People are obviously free to vote however they please, I'm not looking to change that, or in any way influence the process - what was it that I said that gave people that impression?

I want to know what can be done to improve the quality of this story. I wanted the person who voted against it for that reason to give me some advice. If it was something along the lines of "the syntax of the first paragraph was unwieldy.", or "There's two mispelled words and a couple of sentence construction errors, here and here." Great, I'll make the adjustments and heap praise on whoever pointed it out to me.

If it's something along the lines of "I don't understand this word." then I'm not going to change anything. I'm not going to yell at the person, for Christ's sake, I'm going to thank them for bringing their issue into focus.

Amuk
I did make the point that medication is genuinely helpful for some people. Believe me, I know the limitations of alternative therapies. I've argued this with everybody from monks to crystal polishers - the absolute pinnacle of the healing arts is a balance between eastern and western methods of diagnosis/treatment. I always promote balance, I thought I did so in the story too. I do have the distinct sense that drugs are being pushed to the exclusion of many other treatments, and that's not right at all.

That said, I want to know why you thought I was angry at someone? Chill out? I'm totally chill. I'm just really confused by the responses I've gotten.


Is that angry language in my post? It certainly wasn't meant that way. I'm really interested in knowing what's up with the story, and knowing what's up with the correspondence I've received regarding it, and I'm willing to make changes accordingly - but I need more information.

So..here's waiting for more info.

[edit on 5-4-2005 by WyrdeOne]

[edit on 5-4-2005 by WyrdeOne]



posted on Apr, 5 2005 @ 08:50 PM
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WyrdeOne,

I am not the one that voted that way. I see nothing wrong with the article. Nothing at all.

That's not the point. The point is that you are submitting a writing to a community of people who range from 13 to who knows what. They vary from American to Zimbabwe and all points north and south. You will get a no vote sometimes. The point, and I guess I didn't make it well enough the first time, is to ACCEPT THE COMMUNITY VOTE. Whether you think it is right or not. Some one - we're talking about one vote - thought there was something wrong. That was their vote.

For all you know they hit the wrong button, for pete's sake.

The higher road is to review your article, see if there is something to perfect, if not - shake it off and go on. But to lambast your reader because they may or may not have found something amiss...is not mature.

That was my ENTIRE point. It was my first point and it is now my official LAST point.

You have a wonderful article on a very important topic. By virtue of your own response the thread moved away from it, let's move back to that topic.



posted on Apr, 5 2005 @ 09:05 PM
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After eight weeks of treatment, response rates were 50 percent in the medication group, 43 percent in the cognitive therapy group and 25 percent in the placebo group. After 16 weeks of treatment, response rates were 58 percent for patients receiving either medication or cognitive therapy. Remission rates were 46 percent for patients receiving medication and 40 percent for those in the cognitive therapy groups.


From the study drugs were BETTER then psycotherapy, and with a sample of only 60 people the statistical margin of error is huge to only conlude that a larger group needs to be tested.

Right now I have no job, no place of my own, and no car. I do enough odd jobs to pay for my depression medication that I know works a LOT quicker then psycotherapy does, and is a lot cheaper.

And before you talk about state programs that provide free medication and couseling I have allready tried that route. Waiting list for medication was 6 months and Psycotherapist waiting list was over a year.

I voted no, mainly because this story has a unfair bias FYI, especially with my personal experaince



posted on Apr, 5 2005 @ 09:08 PM
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Originally posted by WyrdeOne
I really was honest about taking suggestions, I take criticism at face value, and if I think it will help, I'll use whatever suggestions people want to throw my way.


Really?!?!?

Well in that case........you are getting very sleeepy......you eyes are getting veeeeerryy hhhheeeaaavvvyy............


I voted yes btw......your coverage was so well done that I am stressed for a response other than a desire to repeat one of your own statements as I believe it to be a very valid point........


Originally posted by WyrdeOne
The universal human condition ties us all together, it drag us down or lift us up.



posted on Apr, 5 2005 @ 09:15 PM
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I took another look at the reply, which was apparently the problem (I heard differently from one source) and I removed the only part I could see as being misconstrued as insulting. It wasn't my intent, and I'm really sorry to have upset so many people. I was hoping to get more specific feedback, that's all. I waited a while, and when it wasn't forthcoming, I just decided to look again and remove one bit - it was a guess on my part and the mods involved may have been talking about something completely different.
I just don't know...

Moving on.

Here's some more information for anybody interested -

www.businessweek.com...
Apparently this new drug cuts heavy drinking in alcoholics by signifigant amounts (when administered in tandem with counseling), and since alcohol is a prime motivator in many cases of depression, that could be very good news for depressive alcoholics.

Many people turn to alcohol as a remedy for depression, not realizing it will worsen their sadness in most cases, and while providing some measure of temporary forgetfullness, does nothing to fix the root causes of their depression. The alcohol that's used to make people feel better about their feelings, often ends up altering their feelings and making perspective hard to come by. It's been said alcohol is a key to unlock emotions, I'm pretty sure this is accurate. If you are happy, you may be happier drunk. If you are sad, you will most likely be a maudlin drunk. Of course, sometimes the emotions amplified are the undercurrents, the unexpressed emotions that don't get a lot of air time usually. For example, some people who aren't violent at all when sober, become dangerously confrontational when drunk. The effects of alcohol on people seems about as diverse as the people themselves.

There is a fundamental difference in the way Eastern and Western medicines treat conditions for the most part - Western medicine tends to treat symptoms, while Eastern medicine treats auses, usually by treating the organs.

There is much to be said for either one alone, but both in tandem is very powerful, and the definition of the word 'holistic' in my opinion. I think mental health is no different than physical health in terms of needing maintenance, prevention, and treatment for acute malfunctions.

My main problem with introducing pure capitalism into healthcare is that making money from illness and keeping people healthy are mutually exclusive. They are tasked with doing both, and it's clearly impossible.



posted on Apr, 5 2005 @ 09:42 PM
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Cognitive Behavioral Therapy is the therapy involved in this matter. CBT was has been around for in one form or another for a long time and it is the only therapy that has been proven in quantitative studies to be efficacious in the treatment of depression.

Contrary to what has been stated here, anti-depressants are not designed for long term use for most patients. Studies going back as far as the fifties have shown that most episodes of depression will abate without any intervention whatsoever.

This study is not going to affect the appropriate use of anti-depressants significantly, in my opinion, nor should it. What it should do is to limit the practice of general practitioners prescribing anti-depressants to patients who complain of sadness without first ordering a psychological work-up to determine if psychotropics are indeed indicated and the idiotic idea that children with behavioral problems can be "fixed" with the right medication.

Cognitive Behavioral Therapy is more than just a therapeutic intervention, it is a restructuring of the individual's thought processes. The common assumption about depression is that we think and act the way we feel. CBT asserts that we feel the way the think and act. Accordingly, depression is the effect of distortions of thinking that cause us to think negatively about ourselves, which, not surprisingly, causes us to feel bad.

Identifying these distortions of thought and learning strategies to combat them is something that almost anyone can do for himself with the right training and therapy.

Feeling Good by David Burns, MD has been around for at least twenty years and is the best presentation available for the layman that I know of.

There will always be those whose depression is acute enough to require medication and hospitalization and those who suffer from Bipolar are not likely to be "cured" by any kind of therapy alone, but for those who suffer from short term simple depressive episodes, CBT may be all they need to overcome their episode and to avoid depressive episodes in the future.

We can also expect that there will be much dissent from those therapists who do not employ CBT (yet) and psychiatrists whose stock-in-trade is medication and maybe even general practitioners who feel that many patients who will refuse psychiatric treatment will readily take an anti-depressant prescribed by the "family doctor."

This is both good news and bad news. It is good news if it results in an increase of CBT therapists and referrals of patients to such therapy. It is bad news if insurance companies get on the bandwagon and start making it difficult for MDs to practice without undue intrusion by the bean counters. MDs have already been spooked by the DEA over pain medications and too many people are suffering from chronic pain without proper medication because of it.


[edit on 05/4/5 by GradyPhilpott]



posted on Apr, 5 2005 @ 10:04 PM
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Originally posted by GradyPhilpott
Contrary to what has been stated here, anti-depressants are not designed for long term use for most patients. Studies going back as far as the fifties have shown that most episodes of depression will abate without any intervention whatsoever.


Agreed, they're not designed for long term use, but what happens in my experience goes something like this; Patient complains, doctor medicates. Patient feels better, doctor reccomends lowering dosage/or patient isn't helped, and the dosage is upped. After a while, the patient may feel better, and want to kick the costly pill habit, or, they might develop tolerance and start feeling worse (perhaps psychological, environmental, or just physiological response to the increased salt in the brain - sometimes manifested in lethargy, other times mania, it depends on the individual brain and whatever response 'it' thinks is best, or tries first)

There's a lot of people who can't separate sadness from depression, and that leads to overmedication and unnecessary medication, IMO. Doctors say this as well, but many of them simply acquiese to the patient to move them along. Doctors used to be able to give sugar pills, especially to young people, and it usually helped. Nowadays they'd get their pants sued off if the patient found out.



This study is not going to affect the use of the appropriate anti-depressants significantly, in my opinion, nor should it. What it should do is to limit the practice of General Practitioners prescribing anti-depressants to patient who complain of sadness without first ordering a psychological work-up to determine if psychotropics are indeed indicated and the idiotic idea that children with behavioral problems can be "fixed" with the right medication.


We can only hope, right?



..general practitioners who feel that many patients who will refuse psychiatric treatment will readily take an anti-depressant prescribed by the "family doctor."


Is it just me or this a recent problem? When I was growing up, if the doctor told you something you didn't like, you grudgingly accepted their decision, or simply ignored it and went somewhere else. Now it seems like patients are telling doctors how to do their jobs! Is it just me, or is that a new phenomenon?



It is bad news if insurance companies get on the bandwagon and start making it difficult for MDs to practice without undue intrusion by the bean counters.


Do you mean the insurance companies won't cover therapy, or will urge doctors to presribe therapy instead of medication even in cases where medication could prove useful? Could you clarify?



MDs have already been spooked by the DEA over pain medications and too many people are suffering from chronic pain without proper medication because of it.


My experience with chronic pain is a mind over matter issue, and the drugs do nothing to help with that. The body should, in most instances, be able to reestablish the threshold, or resize the measuring stick of what is painful, after suffering for some time with severe pain.

I think painkillers are the least helpful of ALL medications, generally, because they do nothing to treat the source of the pain, they only limit the awareness of the problem by dulling our internal sensors. I think in most cases people (understandably) elect for painkillers over risky surgery, but there are alternatives.

Acupuncture has proven quite effective in treating pain, so has meditation. Those cases where pain is debilitating should be medicated accordingly I suppose.

I take it you have some experience with chronic pain Grady? I know it's harder for people to get drugs now, in some cases, because doctors aren't willing to put themselves at risk in cases where people are faking illness or exagerating symptoms to 'get their fix', but I was under the impression that if you really needed it, and especially if you have a history with your doctor, they wouldn't hesitate - assuming of course the medication is helpful and the doctor is a good one.

I don't know..it seems like bad doctors are a huge problem. Bad medications are also a major issue. Bad patients too...

Lots of bad apples in every barrel are making the whole harvest seem sour...

So are there any suggestions as to what can be done at a legislative or education level to fix these problems?

One problem with med school is that the students are told to get the answers right, and so they study and they pass. They're not trained, or perhaps not capable in many cases, or truly absorbing and processing the information. It seems like there is a right/wrong mentality in med school (everywhere else too huh?) as opposed to a "let's figure this out a number of different ways" mentality.

Would a modification of curriculum help? Perhaps maintenance tests to renew liscenses - tests that are more complicated and multi-faceted?

Edit to reply to responses I missed.

Jehosephat
First off, I agree wholeheartedly with your point about needing a larger study. Second of all, I'm sorry to hear about your personal situation - I hope everything works out. Most of us in America are just barely getting by, or not making it at all. I know the social programs are bad, in most cases really long and stressfull, so that's obviously not a good thing for people who need treatment for depression. I think sweeping changes are in order.

We need politicians who aren't afraid, who aren't compromised by corporate affiliation, and who are willing to do whatever it takes to house, feed, and provide clean water to everyone. The rest we can figure out on our own I think. I've talked about this at length in other topics, I don't want to get into it too much here. Given the current state of affairs, it's not at all surprising that people are looking for the quickest fix. I wonder if drugs are the quickest fix by coincidence or by design?

Also, you're right, the story was biased (on my end) to some extent. I should have paid closer attention. I read the remission rate in the study, and for some reason thought it meant recidivism, or return of the symptoms.
It was an error on my part, and a stupid one at that. The title should have been something like, New Study: Drugs Not Much Better Than Therapy. I do stand behind my comments about mind over matter, and alternative therapies being advantageous in many instances where drugs have failed, and of course diet and breathing will do wonders. These are statements made from personal experience, and extensive reading and discussion with both traditional western doctors and more spiritually conscious eastern practitioners.

People think I'm full of manure when I say breathing right eliminates most health problems, but it's the truth. I've never heard of a more effective single treatment. And it's free, best of all. Eating right plays a huge part, and eating the right foods at the right time is especially important. Food, in its various forms, contains all of the compounds our bodies need to function properly. Knowing what to eat, how much to eat, and when to eat it, is like being your own doctor. Most pharmaceuticals are synthetic approximations/modifications of naturaly occuring salts and proteins (as far as I know).

But even the most devout and knowledgeable monk or shaman should know when it's time to go in for surgery. Wisdom in medicine is knowing when to wait it out, when to medicate, and when to cut - oh, and where and how too, but that goes without saying.


I can't give medical advice, all I can do is give suggestions for delicious dishes that may help specific ailments.
That's not against the law yet is it? The power of placebo continues to astound me. Sometimes rates as high as 50% from everything from cancer to hangovers. It's amazing the power our minds have.

Memory Shock
Sure...quote one of my sentences with two spelling errors.




Wise guy...

hehehe

Good lord..would you look at the size of this post? I'm gonna restrain myself from writing any more. This is getting ridiculous.


[edit on 5-4-2005 by WyrdeOne]

[edit on 5-4-2005 by WyrdeOne]



posted on Apr, 5 2005 @ 10:59 PM
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Originally posted by WyrdeOne

Do you mean the insurance companies won't cover therapy, or will urge doctors to presribe therapy instead of medication even in cases where medication could prove useful? Could you clarify?



About a decade ago, HMOs began refusing to pay for long-term psychotherapy and sorely limited the length of treatment. This revolutionized the entire approach to psychotherapy, because without insurance coverage, therapists would be out of business in a hurry.

I only used chronic pain as one instance in which accountants and law enforcement have intruded into medical practice to a negative effect. The problem is much more widespread than pain management. Physicians also feel that having the number of tests they can order for a patient limited exposes them to a greater risk of malpractice lawsuits because they are more likely to miss one disorder or the other or misdiagnose a disorder and as you may know, malpractice insurance in the United States is so high that MDs are packing up and leaving the states where the costs are the highest and leaving specialties that are high risk or limiting procedures that increase liability.

HMOs are good in theory and for most folks most of the time they are sufficient and cost effective. However, they have made the practice of medicine much more difficult and have put the squeeze on patients with severe and chronic disorders by either refusing to pay for procedures or limiting the length of treatment.

For example:



Long ago, before the days of managed care, there were two opposing forces at work in the field of health care. One was the insurance company which depended upon profits for its survival. Since profits meant taking in more money in premiums than were paid out in claims, medical insurers did there best to limit the amount of money they had to spend on their clients. Strategies included having large deductibles, excluding elective or routine care, denying coverage for certain types of procedures and excluding coverage for preexisting conditions.

On the other side were physicians who were paid a fee for their services. They made money by practicing medicine and so they had every incentive to see as many people as often as possible and, if their specialty was a surgical one, perform as many operations as possible.

This system of checks and balances had its problems, but at least patients knew that their doctor was their advocate. If their insurance company decided to deny a surgery which their physician said was necessary, the doctor could get on the phone and argue with the insurance company, secure in the knowledge that the worst that they could do to him was refuse to pay. His contract was with his client, not his client's insurance company, and as long as the client was happy, the doctor-patient relationship was safe.

Then managed care came along. It gave up the right to apply large deductibles and to exclude preexistent conditions and routine health care in exchange for the right to control the way that doctors practice medicine.

How do HMOs control physicians? Lots of ways. Some contracts have "gag clauses" which prevent a doctor from discussing treatment alternatives which the HMO does not cover with a patient or from criticizing the HMO or its decisions. For instance, if a young woman has aggressive breast cancer with four affected lymph nodes, her physician may not be allowed to suggest the experimental treatment option of bone marrow transplantation since her HMO does not cover experimental treatments.

HMOs also gain power through sheer size. If one HMO dominates a certain market, it can drive an uncooperative physician out of business simply by dropping him from its plan. Since the contract between the patient and the HMO specifies that the HMO will cover only those services which are provided by its own physicians, the patient will have to see a new doctor or pay for his visits with his preferred doctor out of his own pocket.

www.dfw.net...

www.dfw.net...




[edit on 05/4/6 by GradyPhilpott]



posted on Apr, 5 2005 @ 11:57 PM
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Okay, now I understand. Thanks for that.


The situation with insurance is out of control. Doctors are afraid to help their patients.

But it wasn't right before either, because scam artists masquerading as doctors hurt people and caused untold suffering.

So we need to find the happy medium, or somehow standardize diagnosis, maybe take the human element out of it. What if all health concerns were referred to computers for analysis and treatment recomendations?

A mildly inteligent computer could assess levels, history, and habits, along with genetics, and come to a very good answer, and it could do so without labor intensive man hours in the lab.

An interesting side note I just stumbled on..

Breast feeding increases IQ in children.
and...
Anti-depressants preclude breast feeding.
so...
Heavily medicated populations should expect steadily decreasing IQs if depression is a heritable trait, which it appears to be.

More evidence for the conspiracy theory? Or just an unfortunate side effect of a well-intentioned medical discovery?

Also... An interesting point in favor of psychotropics...

Apparently, they seem capable of stimulating the growth and distribution of brain cells to the hippocampus, which governs learning.

so...

There may be a really important use for these substances in our culture, but perhaps we need to focus more on dose and individual physiology which might warn of complications.

I was reading through this page (that's where I got the above two tangents), and happened on all sorts of interesting, if relatively unsupported tidbits. The organization of thoughts on this page is..chaotic. But the information presented is very interesting.
www.2blowhards.com...



posted on Apr, 6 2005 @ 12:43 AM
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One thing that throws this research off, is that the "patients" have been given something to look forward to by means of the "therapy".

Having something to look forward too decreases the level of any depression.

Second, just having someone to talk to who isn't going to worry to death over you, who is detached from your problems, who isn't going to blame themselves or express emotional distress over your problems also decreases any level of depression. Most people who are depressed lack this "support mechanism" which leads further down the path of depression.

If they wanted to really see if "cognitive therapy" was better than drugs, they should have had a third group of people who simply went to some activity group for 50 minutes twice a week and studied them as well, something like choir practice, or aerobics, etc.

I couldn't help feel sorry for the placebo group, here they are suffering from depression, and they are getting absolutely no help other than a pretend drug, man that is cruel, and dangerous. If their serotonin levels dipped dangerously low a few of them couldn't have ended up window diving.
But my guess is they didn't study anyone who was in a dangerously depressed state.



[edit on 6-4-2005 by Legalizer]



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