downing-orr - rethinking depression; why current treatments fail (1998)

[...]... with treatments for depression and that they beg the further questions as to why treatments for depression fail Namely: Why are the emotional symptoms of mood disorders, which lead to stigma, emphasized while the physical, motivational, and concentration disturbances associated with depression remain ignored? 2 Recognizing the gravity of the illness and the heightened risk of suicide among sufferers, why. .. mental breakdown and a moral weakness on their part Because they believe they deserve to suffer-which reflects both a cardinal symptom of depression and the attitudes of the mental health professionals-depressed people often fail to report problems with prescribed treatments to their physician In fad, many fail to seek help altogether Finally, another problern that perpetuates this cycle of ineffective... viewed with some caution While the advancements in treatments particularly from the newer antidepressant drugs should be a source of encouragement for depressed patients, studies point to some serious problems with these treatments that impair their effectiveness First; despite the availability of antidepressants, particularly the so-called "wonder" second-generation drugs, it is estimated that only around... antidepressant drugs, lack of progress in psychological therapy, and the stigma and shame associated with depressive illness The aim of this book is, therefore, to tackle the very important question: Why do current treatments fail? On the surface there are several immediate explanations that spring to mind In the first instance, although depression is a complex illness with physical, emotional, motivational, and... other diseases are not? 3 Why are depressed patients seen as morally inferior, emotionally unstable, and sometimes even blamed for their illness while those afflicted with other health problems, such as cancer, AIDS, or injuries resulting from destructive behavior, held less accountable? 1 In order to demonstrate further the reasons why current treatment strategies for depression fail, questionssuch as... and death So, rethinking the entire treatment process for depression-from conceptualization to diagnosis to therapy-is essential to improve the quality of patient care and the effectiveness of measures to combat the illness Although the basis of this book is a theoretical analysis and discussion, as both an academic and a practitioner, I believe that a dient case study best illustrates the current problems... problems in terms of both conceptualizing and diagnosing depression lead not only to stigma, but also to ineffective treatments that fail In the course of research, I found evidence that at the heart of the earlier explanations about the problems surrounding treatment effectiveness are the wide-ranging theoretical problems about the nature of depression Mostly, in evaluating the effectiveness of drug and... treating depression, particularly with the advent of antidepressant drugs, many patients are misdiagnosed and inevitably receive treatments that are of little use Figure 1 illustrates this process WHY MISINFORMATION ABOUT DEPRESSION ABOUNDS The question that needs to be addressed is why so much misinformation about depression abounds The illness is complex and this is obviously the main source of the problern... these current theories are really little more than temporary guidelines that may or may not stand the test of time However, when accepted as fact, they, in turn, become the basis for treatment PART ONE: CURRENT PROBLEMS IN UNDERSTANDING DEPRESSION This book addresses many of these queries and is divided into four parts The first part aims to clarify and make sense of the many inconsistencies currently... physiological causes of depression Current physiological and psychological theories about depression also fail to accept that depression can be a normal reaction to someone's personal circumstances In determining the causal nature of depression, theories tend to ignore the very real possibility that symptoms can be multicausal even in the same individual PART TWO: CURRENT PROBLEMS IN DIAGNOSING DEPRESSION