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Muhammed Ali

Cognitive Therapy Vs Medication For Depression

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I think all these depression and add/adhd medications are all destructive. They are beyond harmful and destroy your self. People take it because "doctors" prescribe these "medications" that come from mostly 3rd party makers who God knows what effects they possess. Its all a scam to destroy your mental state. People think without medications their life will not get better. But one day without it, they feel like hell, even thinking about suicide. It takes the mind into a deeper and darker hole. Wake up people, no matter how many "tests" show that it has some effects, million dollar companies who are spread wide across this dependency will not jeopardize their BUSINESS. Just like the hundreds of "donation research organizations" who take 90+ % of the donations and use it for anything but research or helping those who have the diseases. I am sure some of you on here have a decapitating mental state, and are only arguing for such medicines because you DEPEND on such garbage to have a "normal" day in life, or know people. Yet at the same time, every single day, you wonder why. I suggest everyone who takes such medicines to go off of them for just a week, see what happens. Your brain has been destroyed so much, that you are way worse then your initial "problem". No such "medicine", is legitimate.

 

I take it you're not a doctor or scientist of any kind. 

 

If you are not, you should stop giving medical advice, and not put doctors in quotation marks in such a condescending way.  No matter your viewpoint, there is no need to be disrespectful, especially towards relatively well meaning individuals who work hard (years of schooling and training) and try to follow established scientific protocol.  And if you disagree or have a different viewpoint, bring research forward.  And if you are not capable of doing so, stop the self righteous ranting.  And you can stop being condescending towards those who are suffering by labeling them as helpless addicts and apologists.

 

And I'm not even denying there is truth or partial truth in essence of what you are saying.  But you still rub me the wrong way (not just on here, but having read many of your posts in the past). 

 

If you replace doctors with clergy and medications with spiritual guidance, many atheist and nihilistic fools out there would concur with your above description of malicious snake oil salesmen. 

Edited by magma

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Depression affects each person in different ways, so symptoms caused by depression vary from person to person.And not all severe clinical types of depressions have suicidal ideation symptoms.

 

MOST would not be diagnosed with severe depression if they did not have suicidal ideation.  There are nine symptoms and you have to have at least 5 of them to be diagnosed. Some symptoms are more subjective.  Suicidal ideation is concrete and not dismissible. It pretty much locks in the diagnosis.

I take it you're not a doctor or scientist of any kind. 

 

If you are not, you should stop giving medical advice, and not put doctors in quotation marks in such a condescending way.  No matter your viewpoint, there is no need to be disrespectful, especially towards relatively well meaning individuals who work hard (years of schooling and training) and try to follow established scientific protocol.  And if you disagree or have a different viewpoint, bring research forward.  And if you are not capable of doing so, stop the self righteous ranting.  And you can stop being condescending towards those who are suffering by labeling them as helpless addicts and apologists.

 

 

+1

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I can speak for Germany,from what i know and most of the diagnosed with severe depression are not having necessarily suicidal ideation.But most have insomnia,lack of energy,feelings of guilt and worries everyday,weight loss or gain and so forth.The ones with suicidal ideation need medication,but they are not most within the diagnosed.

Edited by mina313

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I really am hoping that those who know very little about Clinical Depression are not steering family members and friends away from treatment due to prejudice and fear and assumptions of an area that they know very little about.  I have met soooo many people who refuse to acknowledge the severity of a loved ones condition due to pride and pure ignorance. Their need to be right trumps the sufferers need for quality of life or perhaps even life itself.

 

I met a husband and wife who told me that they refused to acknowledge the severity of their son's depression.  They felt that if they just got him moving and into a typical  everyday routine, (so that all was "normal") that he would eventually be normal.  They did not need medications or hospitalization; they felt they were counterproductive.  They took him home; he peacefully complied with what they wanted, and then killed himself 2 months later.  He was 14 years old.

 

They have made it their life's work to educate those who are faced with similar situations with their children and have funded a library so that others do not have the failed search that they did for information, in the mental health building of the Children's Hospital.  http://keltymentalhealth.ca 

 

In selecting a management course, all manners of treatments are presented and discussed and it is important to mesh these with the family's acceptance for specific treatments. The more knowledgeable that they are, the easier it is for them and for the treatment team.

Edited by Maryaam

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I will not share here if i am a "professionel" in this field or not.I am not against medication,specially when it is about suicidal ideation,or biological causes. But I'm against medication when there is not necessarily a need for it.There are also very effective other treatments than antidepressants for people who are suffering from this ill system we are living in.

Edited by mina313

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http://journal.frontiersin.org/Journal/10.3389/fpsyg.2012.00117/full

“Patients should be informed that current research suggests that unless they have very severe depression, the symptom reducing effects of antidepressants are modest and are not considered clinically significant.”

 

http://www.huffingtonpost.com/dr-peter-breggin/antidepressants-long-term-depression_b_1077185.html

 

That man writes for $$ and a review on Huffington Post kind of emphasizes that.  Long term therapeutic exposure to any drug (including aspirin or Tylenol) is hard on your body.

 

 

http://articles.mercola.com/sites/articles/archive/2014/09/11/adhd-antidepressants.aspx

“A study in the January 2010 issue of The Journal of the American Medical Association (JAMA) concluded that there is little evidence that SSRIs (a popular group of antidepressants that includes Prozac, Paxil, Zoloft, and others) have any benefit to people with mild to moderate depression.”

 

Mild to moderate depression is another discussion. But no psychiatrist, when dealing with a major or severe depressive patient is going to rule out medications. As I mentioned before, it is a potentially fatal illness.

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http://journal.frontiersin.org/Journal/10.3389/fpsyg.2012.00117/full

“Patients should be informed that current research suggests that unless they have very severe depression, the symptom reducing effects of antidepressants are modest and are not considered clinically significant.”

 

"Patients should also be advised that antidepressants might trigger even more severe depressive episodes when they are discontinued. All patients should be advised of the possible bleeding risks, and physicians should exercise particular caution in prescribing these drugs in conjunction with other diuretic or anti-thrombotic medications."

 

 

That man writes for $$ and a review on Huffington Post kind of emphasizes that.  Long term therapeutic exposure to any drug (including aspirin or Tylenol) is hard on your body.

 

people who are depressed, especially life term depression, is for LIFE, hence they will be on the meds LONG TERM.

 

 

But no psychiatrist, when dealing with a major or severe depressive patient is going to rule out medications. As I mentioned before, it is a potentially fatal illness.

 

Does severe depression not stem from mild depression? Does it not get worse? of course it does. What lead them to the severity?

Edited by PureEthics

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I think it goes back to understanding the definition of clinical depression.  It is hard to separate the meaning of the word we have learned  for general use and the meaning of Clinical Depression in the medical sense.  

 

This is a valid point. You are formally trained in this area, and your definition of severe depression would be different to the understanding of it as held by those who are not. Although I must point out that in the post you quoted I said: "most cases of depression". I only mentioned severe depression in the first post.

 

The study used the following to define severe depression: 

 

Inclusion criteria were: diagnosis of MDD according to DSMIV criteria, age 18 to 70 years, English speaking, and willingness and ability to give informed consent. Consistent with the TDCRP’s definition of “more severely depressed,” all included patients had scores of 20 or higher on the modified 17-item HDRS at the screen and baseline visits, separated by at least 7 days.

https://psychology.sas.upenn.edu/system/files/DeRubeis%20AGP%202005%20CT%20vs%20ADM.pdf

 

 

You made reference to the DSM criteria in another post. I will paste the nine points for the benefit of those of us who are not familiar with them:

 

1. Depressed mood most of the day, nearly every day, as indicated either by subjective report (e.g., feels sad or empty) or observation made by others (e.g., appears tearful)   

2. Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day (as indicated either by subjective account or observation made by others) 

3. Significant weight loss when not dieting or weight gain (e.g., a change of more than 5% of body weight in a month), or decrease or increase in appetite nearly every day 

4. Insomnia or hypersomnia nearly every day 

5. Psychomotor agitation or retardation nearly every day (observable by others, not merely subjective feelings of restlessness or being slowed down) 

6. Fatigue or loss of energy nearly every day 

7. Feelings of worthlessness or excessive or inappropriate guilt (which may be delusional) nearly every day (not merely self-reproach or guilt about being sick) 

8. Diminished ability to think or concentrate, or indecisiveness, nearly every day (either by subjective account or as observed by others) 

9. Recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific plan, or a suicide attempt or specific plan for committing suicide 

 

 

Five of these symptoms have to be observed and must persist for two months if a person is to be considered clinically depressed. On the HDRS scale a person can be considered severely depressed if they score 2 on three of the 17 questions and 1 on the rest. From a layperson's perspective, I must admit that I do have doubts about these criteria (assuming that they would result in medication). If a person is to be given medication on meeting the requirements of these criteria, then it does make me feel a bit uneasy. This is regardless of how the criteria are implemented in reality. 

Edited by Muhammed Ali

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I am sure some of you on here have a decapitating mental state, and are only arguing for such medicines because you DEPEND on such garbage to have a "normal" day in life, or know people. Yet at the same time, every single day, you wonder why. I suggest everyone who takes such medicines to go off of them for just a week, see what happens. Your brain has been destroyed so much, that you are way worse then your initial "problem". No such "medicine", is legitimate.

seems like you are speaking from personal experience. I am glad going off it helped you. I know a psychiatrist, who tells me stories, depending on the person, some can gradually go off it, some cannot, it all depends on other surroundings too.

Edited by monad

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Try entering the rounds of oncologists if you want to see severe and polarized.  No field wants to accept status quo - that is stagnation.   We would not be progressing with out constant debate and discussion.

 

Thank you for that information. I know almost nothing about oncology.

 

Debate and discussion is important. However sometimes the differences can arise from people having different backgrounds and even agendas. E.g. it is no surprise that the biologists who reject Darwinian evolution tend to be inclined towards religion.

 

In matters where there are big differences the common people have the right to know about them.

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seems like you are speaking from personal experience. I am glad going off it helped you. I know a psychiatrist, who tells me stories, depending on the person, some can gradually go off it, some cannot, it all depends on other surroundings too.

 

Alhamduillah I am blessed by Allah not to fall into this rubbish mentality of so called "depression". I dont believe it and never will. Thank God a thousand times, for this life He has given me and I will always be thankful to my lord by doing as He commands. Spiritually and Mentally, Islam is the solution.

 

Edit: Let me tell you, I have learned a lot from my family and those less fortunate in the world. How they struggle and strive no matter what hits them, yet they are always grateful and smiling. Why is it they dont have depression? Tell me. Why does many in the west have it, but not the dirt driven africans living with nothing, war torn and hungry by the day? You see, for example, my family has lots of shaheed and they have had it quite rough, but the way they live and continue to live with the grace of Allah in their hearts and faces, is my strive my source..

Edited by PureEthics

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To be honest ,from most of your posts you sound like you have it. Well lets hope you have not dug a hole for your self.

 

My God, the uninterrupted flow of Thy graciousness hast distracted me from thanking Thee! The flood of Thy bounty has rendered me incapable of counting Thy praises! The succession of Thy kind acts has diverted me from mentioning Thee in laudation! The continuous rush of Thy benefits has thwarted me from spreading the news of Thy gentle favours! This is the station of him who confesses to the lavishness of favours, meets them with shortcomings, and witnesses to his own disregard and negligence. Thou art the Clement, the Compassionate, the Good, the Generous, who does not disappoint those who aim for Him, nor cast out from His courtyard those who expect from Him! In Thy yard are put down the saddlebags of the hopeful and in Thy plain stand the hopes of the help-seekers! So meet not our hopes by disappointing and disheartening and clothe us not in the shirt of despair and despondency!

 

http://www.duas.org/sajjadiya/dua74.htm

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Thanks, you proved me right.

 

Anyways Dua Nudba, two translation, most common one.

 

Where is the "awaited saviour" who will set the have-nots and the depressed on their feet? Where is the "The Hope" who will put and end to tyranny and oppression?

 

adjective
1.
sad and gloomy; dejected; downcast.
2.
pressed down, or situated lower than the general surface.
3.
lowered in force, amount, etc.
4.
undergoing economic hardship, especially poverty and unemployment.
5.
being or measured below the standard or norm.
6.
Botany, Zoology. flattened down; greater in width than in height.
7.
Psychiatry. suffering from depression.
 
Many in the west have it, because its progressive, in terms of the medical field to identify it. In the eastern cultures it is stigma. Want to see the conditions of mental health patients in eastern or less developed countries. Google it. It is very nice of you to show your faith, but generally you come of as very inept, a young parrot and possibly why it causes annoyance to many readers.

There is a difference in family members having it rough or poor people and the person it self. You have not learned anything from the less fortunate, you have just observed at face value, you have not lived it or been around them. Those that have will give you a different reality. Having a shaheed is different, then some young boy or girl having to prostitute them selves to make food for their families, or being sexually abused and keeping it quiet. Or family members having to beg or eat garbage to survive.  I suggest if you have not seen it at face value, experienced it, or worked with any of these types, do not speak on it, you come of as condescending and I fear, the lord you praise so much, will take you to account for it, by making you experience it, and it won't be a pretty sight. One of the fundamentals of humanity is empathy to understand the opposite, not parroting how great God is.

Edited by monad

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Here is something interesting from that study:

 

On the whole, these findings do not support the current American Psychiatric Association guideline, based on the TDCRP, that “most (moderately and severely depressed) patients will require medications.” It appears that cognitive therapy can be as effective as medications, even among more severely depressed outpatients, at least when provided by experienced cognitive therapists.

(superscripts removed)

 

 

https://psychology.sas.upenn.edu/system/files/DeRubeis%20AGP%202005%20CT%20vs%20ADM.pdf

 

Allah knows better.

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This is a valid point. You are formally trained in this area, and your definition of severe depression would be different to the understanding of it as held by those who are not. Although I must point out that in the post you quoted I said: "most cases of depression". I only mentioned severe depression in the first post.

 

The study used the following to define severe depression: 

 

 

You made reference to the DSM criteria in another post. I will paste the nine points for the benefit of those of us who are not familiar with them:

 

 

Five of these symptoms have to be observed and must persist for two months if a person is to be considered clinically depressed. On the HDRS scale a person can be considered severely depressed if they score 2 on three of the 17 questions and 1 on the rest. From a layperson's perspective, I must admit that I do have doubts about these criteria (assuming that they would result in medication). If a person is to be given medication on meeting the requirements of these criteria, then it does make me feel a bit uneasy. This is regardless of how the criteria are implemented in reality. 

 

That is from the DSM-IV.  The DSM-V has been out for a year or two now – and is a little more specific although the site http://www.psnpaloalto.com/wp/wp-content/uploads/2010/12/Depression-Diagnostic-Criteria-and-Severity-Rating.pdf  where you got your DSM-IV criteria from has a table just below it that gives an indication of the differences between moderate and severe - which I think is helpful.

 

Here is a readable form of the criteria from the DSM-V:

 

 Criteria for Major Depressive Episode: DSM-5

 

A. Five (or more) of the following symptoms have been present during the same 2- week period and represent a change from previous functioning; at least one of the symptoms is either (1) depressed mood or (2) loss of interest or pleasure.

 

Note: Do not include symptoms that are clearly due to a general medical condition, or mood-incongruent delusions or hallucinations.

• Depressed mood most of the day, nearly every day, as indicated by either subjective report (e.g., feels sad or empty) or observation made by others (e.g., appears tearful). Note: In children and adolescents, can be irritable mood.

• Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day (as indicated by either subjective account or observation made by others).

• Significant weight loss when not dieting or weight gain (e.g., a change of more than 5 percent of body weight in a month), or decrease or increase in appetite nearly every day. Note: In children, consider failure to make expected weight gains.

• Insomnia or hypersomnia nearly every day.

• Psychomotor agitation or retardation nearly every day (observable by others, not merely subjective feelings of restlessness or being slowed down).

• Fatigue or loss of energy nearly every day.

• Feelings of worthlessness or excessive or inappropriate guilt (which may be delusional) nearly every day (not merely self-reproach or guilt about being sick).

• Diminished ability to think or concentrate, or indecisiveness, nearly every day (either by subjective account or as observed by others).

• Recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide.

 

B. The symptoms cause clinically significant distress or impairment in social, occupational or other important areas of functioning.

 

C. The symptoms are not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition (e.g., hypothyroidism).

 

Source: DSM-V

http://www.nami.org/Content/NavigationMenu/Intranet/Homefront/Criteria_Major_D_Episode.pdf

 

Also, many mental illnesses have a co-morbid (or associated illness or condition) as well – pre-existing medical conditions, substance abuse, acquired brain injury, developmental disorders, prolonged stress, etc.  Mental illness is complex and varied and can have many mitigating factors.  I could go into a long list of them, but if the primary dx is not accepted as valid, there is no point. However, I just want to again stress that this is a potentially fatal illness (a substantial number are not diagnosed till a suicide attempt – sorry cant remember how many) and warning signs should be heeded.  Early intervention leads to the best prognosis – that is, returning to his/her community as a functioning member.

Thank you for that information. I know almost nothing about oncology.

 

Debate and discussion is important. However sometimes the differences can arise from people having different backgrounds and even agendas. E.g. it is no surprise that the biologists who reject Darwinian evolution tend to be inclined towards religion.

 

In matters where there are big differences the common people have the right to know about them.

 

You are welcome.  The health care field has sooo many passionate researchers and they often become embroiled in their belief in a certain area that they stimulate "lively" (euphemism) discussion.

 

There is no barrier to information to anyone with access to the internet.  We should become as knowledgeable as we possibly can and be self advocates for our health care.

 

However, we should also respect the work (whether we choose to agree or disagree) of researchers that work every day, every week and every month in that field. They have more hands on education, training and experience than we ever will.  A lot of lay opinions are mixed with sources from entertainment articles, misguided individuals who have the media attention (such as celebrities) and cultural attitudes. We need to recognize the difference. Medical researchers are in the area because they are committed and at least somewhat altruistic - they could make tons more money in private practice.  

Edited by Maryaam

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Five of these symptoms have to be observed and must persist for two months if a person is to be considered clinically depressed. 

 

Have I misunderstood the criteria? It appears that it meant bereavement is an exception unless the symptoms last 2 months. The symptoms without bereavement must be present within a two week period. The criteria is more liberal than I thought. If a person has points 1, 2, 3, 4 & 6 in a two week period then they are clinically depressed?

 

The bereavement criterion is excluded from DSM-5.

That is from the DSM-IV.  The DSM-V has been out for a year or two now – and is a little more specific although the site http://www.psnpaloalto.com/wp/wp-content/uploads/2010/12/Depression-Diagnostic-Criteria-and-Severity-Rating.pdf  where you got your DSM-IV criteria from has a table just below it that give

 

I got it from here http://www.psnpaloalto.com/wp/wp-content/uploads/2010/12/Depression-Diagnostic-Criteria-and-Severity-Rating.pdf

And I knew that DSM-5 was out.

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Here is something interesting from that study:

 

 

https://psychology.sas.upenn.edu/system/files/DeRubeis%20AGP%202005%20CT%20vs%20ADM.pdf

 

Allah knows better.

 

That is the crux of the article and I totally agree that CBT is very effective once a patient is ready for it and committed to the process. It is a LOT of work.  They are not clear in the article whether their sample were on meds before entering CBT and then went off of them for the CBT - that would be interesting to know.  Remember this is one publication out of 10's of thousands and all will be strong in their particular statement.  The patients I saw during my internship would not have been functional enough to start CBT.  Anyway, it is great that you have an interest in this area.  My information is from my studies, internship and ongoing reviews in this field but I am not practising in Clinical Psychology.  I work with children with developmental disabilities (my preferred area) and occasionally with children who have acquired brain injury, so I am certainly no expert in this field.

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However, we should also respect the work (whether we choose to agree or disagree) of researchers that work every day, every week and every month in that field. They have more hands on education, training and experience than we ever will.  A lot of lay opinions are mixed with sources from entertainment articles, misguided individuals who have the media attention (such as celebrities) and cultural attitudes. We need to recognize the difference. Medical researchers are in the area because they are committed and at least somewhat altruistic - they could make tons more money in private practice.  

 

Do the big companies not make a lot of money from these drugs? I have a friend who used to work at a major British radio station. He said that he was given gifts for allowing famous celebrity psychiatrists/medics such as Raj Persaud to speak on his show. He said they often came on to promote a product.

 

I have years of experience in my own field and I know of 'laypersons' who are more knowledgeable than me. In my workplace I am seen as the expert. It's not impossible for a layperson to become very knowledgeable. 

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Have I misunderstood the criteria? It appears that it meant bereavement is an exception unless the symptoms last 2 months. The symptoms without bereavement must be present within a two week period. The criteria is more liberal than I thought. If a person has points 1, 2, 3, 4 & 6 in a two week period then they are clinically depressed?

 

The bereavement criterion is excluded from DSM-5.

 

I got it from here http://www.psnpaloalto.com/wp/wp-content/uploads/2010/12/Depression-Diagnostic-Criteria-and-Severity-Rating.pdf

And I knew that DSM-5 was out.

Practitioners still refer to DSM-IV for assistance as the diagnosis is subjective. There are many who don't like the DSM-V - especially in the Autism Spectrum Disorder (ASD) area as there is always a differing opinion about everything! I thought the table below the DSM-IV criteria might be helpful.

 

The criteria have to be significant and causing impairment. Not speaking to someone is huge. Not eating is huge. Not bathing is huge. Totally isolating is huge. Planning a suicide is huge.  What they are trying to say is that it is not a fleeting thought - it has to be consistent and sustained over a period of time. 

Do the big companies not make a lot of money from these drugs? I have a friend who used to work at a major British radio station. He said that he was given gifts for allowing famous celebrity psychiatrists/medics such as Raj Persaud to speak on his show. He said they often came on to promote a product.

 

I have years of experience in my own field and I know of 'laypersons' who are more knowledgeable than me. In my workplace I am seen as the expert. It's not impossible for a layperson to become very knowledgeable. 

 

I am not saying you cannot become very knowledgable - you become an expert when you can consistently illustrate that your treatment methods work - I was trying to say that you need to recognize the difference of other areas of information that you have been fed growing up and into your adult years.  Practitioners take course work on being able to separate the two.  You also need to respect the lifelong work of others without dismissing it out of hand.

 

Pharmaceutical companies make TONS of money and have marketing campaigns second to none and they give out freebees to practitioners all the time. 

 

Educational research monies are scrutinized as to their source, however. 

Edited by Maryaam

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They are not clear in the article whether their sample were on meds before entering CBT and then went off of them for the CBT - that would be interesting to know.  

 

This is also what occurred to me, but they seem to hint that the patients were not on medication prior to CT. Or maybe their patients were not so severe in depression?

 

Sister I have to apologise for not elaborating at times.

The criteria have to be significant and causing impairment. Not speaking to someone is huge. Not eating is huge. Not bathing is huge. Totally isolating is huge. Planning a suicide is huge.  What they are trying to say is that it is not a fleeting thought - it has to be consistent and sustained over a period of time. 

 

Excuse my ignorance - where does it specifically say this?

Edited by Muhammed Ali

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This is also what occurred to me, but they seem to hint that the patients were not on medication prior to CT. Or maybe their patients were not so severe in depression?

 

Sister I have to apologise for not elaborating at times.

 

Excuse my ignorance - where does it specifically say this?

 

It says in the DSM-V - every day - it is implied that it is recurrent.  There is much more to a diagnosis than that list.  I have been involved in patient interviews (just observed) and the practitioner explores each of those areas very thoroughly (sometimes over several sessions) and then debriefs, discusses and gets feedback (sometimes "lively") from other professionals - usually a multi-disciplinary group of health and allied health practitioners - in a meeting called rounds. Together, they establish a list of possible diagnoses and then over a period of time try to rule them out.  That is the process behind a definitive diagnosis.

Edited by Maryaam

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