Best posts on depression?

March 24, 2008 4:15 PM

Which is the best thread/comment related to depression on AskMe?

There have been a million threads/comments on AskMe related to depression so I don't want to start up another one. I figured that asking for people to point me toward what they figure to be a standout thread or a specific comment would be more helpful.

Yes, I did a search and was overwhelmed by all of the posts/comments, which is why I am here in MetaTalk.

I appreciate any suggestions.

Thanks.

posted by PinkButterfly to MetaFilter-Related at 4:15 PM (34 comments total)

I was going to suggest searching (but you mention you tried) but yeow, I had no idea there were 473 posts mentioning "depression".
posted by mathowie (staff) at 4:20 PM on March 24, 2008

PB: the boiled down advice is:
1. seek therapy or other one-on-one counseling for help in breaking bad thought patterns that keep you depressed; make and keep therapy appointments; if you don't click with the first therapist, don't give up on the idea of therapy but find a new therapist to try
2. maybe seek meds; different ones work for different people
3. exercise; this doesn't have to be as hard as you might think
4. be around people (a job with people; housemates; a visit to the coffeeshop once a day); online doesn't count for this
5. shower, dress and get out of the house every day for at least a little while.
6. eat enough but not way too much; eat reasonable food rather than all junk food or all contrived restrictive-diet food
7. sleep a reasonable amount; if you are sleeping more than 10 hrs a day, make routines with help from others that will help you break out of that pattern
8. don't make up excuses for why you can't do any of 1-7; making up excuses to stay depressed is a big part of depression
posted by LobsterMitten at 4:31 PM on March 24, 2008 [21 favorites]

This is the most favorited post tagged with depression by Anonymous. This all-time most favorited Anonymous askme seems to closely relate to depression as well.
posted by desjardins at 4:35 PM on March 24, 2008

I humbly re-submit my contribution to the topic.
posted by brautigan at 4:49 PM on March 24, 2008

Here are a few nice comments from:
malapropist
nanojath (and some others in that thread are very good, if the question "why do I deserve to be happy when others are unhappy?" ever bothers you)
scody

Some practical ones:
how can I get cheap therapy?
what's a psychologist appointment like?
what if I feel ok (not depressed) on the day of my therapy appointment?
posted by LobsterMitten at 4:52 PM on March 24, 2008

I'd be curious if we could collect the top 25 most-asked AskMe questions, distill them into a "10-important-points" format, and tack them on the sidebar somewhere for easy access. Searching becomes overwhelming sometimes, and this would be a handy Haughey's Almanac to save time on some good and basic nuggets.
Thoughts?
posted by Dizzy at 4:54 PM on March 24, 2008 [2 favorites]

I nominate LobsterMitten's top eight above as a good starting point for that.
posted by tkolar at 4:59 PM on March 24, 2008

This sounds like a job for a wiki FAQ (Frequently AskMe'd Questions)
posted by 0xFCAF at 5:06 PM on March 24, 2008

Palms.
Grease.
Who?
How?
posted by Dizzy at 5:10 PM on March 24, 2008

Weird that depression doesn't make the Frequestly Asked list, considering. Somebody get on that.
posted by mumkin at 5:15 PM on March 24, 2008

tack them on the sidebar somewhere for easy access.

The wiki is better for long term easy access. I suggest someone whip up a list of good threads, add some summed up info like what LM listed above and I think it would be a useful addiion.

I started a page. Remember that there is a (simple) math problem to solve if you're editing a page.
posted by jessamyn (staff) at 5:32 PM on March 24, 2008 [1 favorite]

I've always thought that OmieWise has a history of excellent comments related to antidepressants and depression. This post in particular springs to mind.

mdn also has some wise things to say. This comment has stuck with me, though perhaps it's not entirely appropriate, as it's a rebuke to others who charge the OP with being depressed.
posted by painquale at 6:18 PM on March 24, 2008

Eh. Omie has an axe to grind about anti-depressant research and marketing. Not that he's necessarily wrong, but he's very biased on the topic.
posted by tkolar at 6:27 PM on March 24, 2008

(as am I, of course. And I must admit that having family members directly involved in anti-depressant research makes me a bit cranky about some of the accusations of sloppy science that get tossed around)
posted by tkolar at 6:30 PM on March 24, 2008

Omie's got the science to back up his axe. He's definitely got strong opinions, but I think they're pretty considered.
posted by jessamyn (staff) at 6:31 PM on March 24, 2008

Is there a way to cull the most favorited comments linked to AskMe questions related depression? (Or any other topic?)

Not asking for a pony, just curious.
posted by jeanmari at 7:17 PM on March 24, 2008

He's definitely got strong opinions, but I think they're pretty considered.

I think his annoyance with the overselling of both the efficacy and understanding of antidepressants tends to result in a bias in terms of what research he is drawn to and what he presents here.

I can point to five studies showing a statistically significant difference between anti-depressants and placebo for every one he produces claiming they're the same.
posted by tkolar at 7:54 PM on March 24, 2008

In which case, you're both just data-mining to support preconceived positions.

Is there, in fact, a well-conducted, peer-reviewed meta-study?
posted by flabdablet at 9:37 PM on March 24, 2008

I second flabdablet's call!
posted by painquale at 9:59 PM on March 24, 2008

Is there, in fact, a well-conducted, peer-reviewed meta-study?

It's not clear how you can do a "well-conducted" meta-study. Meta-studies are more an exercise in statistics than gathering experimental results.

There are, however, peer-reviewed meta-studies that arrive at varying conclusions that run from "worse than/equal to placebo" to "statistically significant effect" to "forget fluoride, let's put Prozac in the water supply". (admittedly that last conclusion was much more popular in the nineties).

Personally I don't really care for meta-studies -- particularly for psychological studies as they inevitably compare apples to oranges. The experimental methodology, subject pool, environment, etc. change significantly even for the same researchers across multiple studies. It's practically impossible to control for all the variables in even a single study -- IMHO, jumbling a bunch of studies together leads to less clarity, not more.
posted by tkolar at 10:07 PM on March 24, 2008

In which case, you're both just data-mining to support preconceived positions.

BTW, you could say that about any well-informed debate on any topic. I don't think anyone is being intellectually dishonest here; there's enough contradictory data out there that reasonable people can disagree.
posted by tkolar at 10:28 PM on March 24, 2008

I'm going to suggest that if enough people make suggestions here, the answer will be this thread. AM I BLOWING YOUR MIND?
posted by stavrosthewonderchicken at 10:47 PM on March 24, 2008

Jumbling a bunch of studies together as opposed to, say, only taking notice of those studies whose outcomes support our own positions? I can see how we could get plenty of clarity doing that, but how much objective fact would we reveal?

It seems to me that characterising meta-studies as "jumbling a bunch of studies together" is the same kind of disappointing rhetorical device as dismissing evolution as "just a theory" or human-induced global warming as "still debatable".

It further seems to me that if reasonable people can disagree on matters of purported fact while maintaining their intellectual honesty, then those reasonable people ought to exercise a little intellectual humility, reassess their positions, and agree on "we don't really know".

But enough handwaving. Here's a recent metastudy that concludes that "Drug–placebo differences in antidepressant efficacy increase as a function of baseline severity, but are relatively small even for severely depressed patients. The relationship between initial severity and antidepressant efficacy is attributable to decreased responsiveness to placebo among very severely depressed patients, rather than to increased responsiveness to medication."

Which variables, in particular, do you consider insufficiently well controlled in this metastudy (or, indeed, in the underlying studies that shape the main conclusion)?
posted by flabdablet at 11:07 PM on March 24, 2008 [1 favorite]

It seems to me that characterising meta-studies as "jumbling a bunch of studies together" is the same kind of disappointing rhetorical device...

I very much disagree. There are fields in which meta-studies are very useful -- the more objective the underlying data, the more reliable they are. In a field where the measuring instrument is groups of human beings attempting to interpret the DSM, the underlying data is highly subjective. When the groups of people know each other and interact regularly, you can make some assumption that their interpretations will line up -- take 47 different studies and that assumption goes to pieces.

Which variables, in particular, do you consider insufficiently well controlled in this metastudy (or, indeed, in the underlying studies that shape the main conclusion)?

Well, let's see.

Ignoring for the moment the variance in diagnosing the severity of a depression, we have this lovely little gem from the meta-study: Out of a total of 47 clinicial drug trials, "The use of other psychoactive medication was reported in 25 trials."

Please explain to me how this isn't apples and oranges? Or for that matter what sort of methodology was applied in those 25 trials to control for other psychoactive medication?
posted by tkolar at 11:44 PM on March 24, 2008

stavrosthewonderchickenI'm going to suggest that if enough people make suggestions here, the answer will be this thread. AM I BLOWING YOUR MIND?

Thanks for the suggestions so far. Does anyone have any other specific posts/comments to point out?
posted by PinkButterfly at 12:02 AM on March 25, 2008

Heh... the comments on that study are entertaining reading. The authors dropped in with a followup response that included:

A first class of replies characterized our review as reaching conclusions that do not square with clinical practice. Representative of these statements are comments from Vargas that “Doctors and patients know what works and what does not” and Werner that “Clinical practice plus millions of content patients can’t be that wrong” (Jewett and Dales provide similar comments). Contrary to these claims, we can imagine similar statements being said in centuries past about bloodletting, lizard’s blood, crocodile dung, pig's teeth, putrid meat, fly specs, frog’s sperm, powdered stone, human sweat, worms, spiders, furs, feathers, and all of the other treatments that were once widely used [...]

posted by tkolar at 12:11 AM on March 25, 2008

Oh wow, the comments pretty much tear that study to shreds.

In particular they point out the fact that the trials that they're basing their conclusions on are at most 6 weeks long. A reasonable number of the modern anti-depressants are *expected* to take 6 or more weeks to kick in.
posted by tkolar at 12:25 AM on March 25, 2008

Oh, and speaking of subjective interpretations there was an interesting BMJ editorial regarding the study.
posted by tkolar at 12:41 AM on March 25, 2008

That's very helpful - thanks.

I'd be interested in OmieWise's take on this, too.

Tkolar, are you aware of any decent studies comparing the effectiveness of antidepressant medications to that of regular exercise, for moderately depressed patients?
posted by flabdablet at 1:16 AM on March 25, 2008

Tkolar, are you aware of any decent studies comparing the effectiveness of antidepressant medications to that of regular exercise, for moderately depressed patients?

The only area of depression research I have any specific knowledge (and little enough at that) of is around anti-depressant trials.
posted by tkolar at 1:41 AM on March 25, 2008

I had no idea there were 473 posts mentioning "depression".

Seems to me I saw a suggestion in one of the Metatalk thread about a support group for Mefites who suffer from depression/anxiety. My feeling is a lot of people post questions not just because they want answers, they want some kind of affirmation that they're not alone and stories of how other people are dealing with it.

I'm sure there are a bazillion support groups on the interwebs, but if anyone wants to do an off-site private list thing (Yahoo groups?), I'd be willing to set it up. With the obvious caveat of no medical advice given to anyone, see a dr/therapist, etc., etc. Also, I'd need one or two co-moderators with privileges in case I get busy/run over by a truck.

Let me know if there's any interest in this sort of thing :-)
posted by Marie Mon Dieu at 4:50 AM on March 25, 2008

Is there, in fact, a well-conducted, peer-reviewed meta-study?

The National Institute for Clinical Excellence provides several
posted by PeterMcDermott at 9:22 AM on March 25, 2008

Probably this one.
posted by sgt.serenity at 12:07 PM on March 25, 2008

I see that there are tabs for sorting search results by date and relevance, may be another tab for sorting by favorites?
posted by oneirodynia at 2:13 PM on March 25, 2008