RANDOM TOUGHTS …DEPRESSION: The 9-question survey many doctors use to diagnose depression was actually created by an antidepressant manufacturer

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The most dangerous thing any adult can do today
is walk into a psychiatrist’s office —Dr Peter Breggin,
American psychiatrist

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Well, blow me down. Who'da thunk it?

Altho someone should have, what with the explosion of prescriptions for anti-d's starting in the early nineties, and like a snowball rolling downhill, gathering adherents and momentum as it careened recklessly along.


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Prozac opened the floodgates, and Drs, psychiatrists, psychologists, psychotherapists, dermatologists, naturopaths with a prescribing partner, dentists, opthalmologists, you name it, anyone with a prescription pad and the legal right to use it just poured thru, in a huge, roiling, constantly cresting wave, until now, SSRIs remain THE MOST prescribed psychiatric medication in the US.


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Impacting an estimated 300 million-plus people,
depression is the most common mental disorder, generally affecting women more often than men, but the scales seem to be rebalancing now and the gender difference is getting smaller and smaller.

Antidepressants are the most prescribed psych med, followed closely by anti-anxiety medications like Xanax and Ativan or any other benzo that can be justified, legally speaking, followed by mood stabilizers. Anti-psychotics bring up the rear, altho with impressive numbers.


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For a lucky few, these drugs are miraculous life-savers., allowing them to live something closer to normal lives, and to escape the ripping, rending, tearing clutches of the horrors of what ails ‘em.



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But for the rest of twenty-four percent (24% !!!) of Americans who are currently taking some form of psychiatric medication (which actually explains a lot ) the story can be waaaaaaay darker and more painful.….and can last a very, very, looooooong time. Sometimes for the rest of their lives. And those lives can be shortened dramatically by suicide or attempted suicide, which is a not entirely infrequent result ….

I often wondered when the naturally occurring human responses to catastrophe, calamity, extended pain and illness, isolation, and the many and various slings and arrows of outrageous fortune, like depression, suddenly became a mental illness. As tho any other response to those circumstances wouldn’t have been bizarre, and in truth, truly insane.

Now I know.



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Here are the 9 questions, developed by the marketer who first dreamed up the idea for what later became the PHQ-9 — the quick tool that ultimately made many primary care doctors more comfortable prescribing antidepressants from exam rooms worldwide — was a "marketing man" working for Pfizer.

Howard Kroplick convinced the company to invest in the pricey research required to develop the now-ubiquitous questionnaire. The rise of questionnaires like the PHQ-9 has led to more anti-depressant prescriptions than any BigPharma company could possibly have dreamed of prior to its creation.

Whether for better or for worse, well ….. that’s an open question …



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S
OOOOO …… HERE’S THE QUESTIONNAIRE DEVELOPED TO DETERMINE THE QUALITY OF YOUR FUTURE, AND MAY THE FORCE BE WITH YOU ….GOOD LUCK ….
  1. Little interest or pleasure in doing things
  2. Feeling down depressed and hopeless
  3. Trouble falling or staying asleep, or sleeping too much
  4. Feeling tired or having little energy
  5. Poor appetite or overeating
  6. Feeling bad about yourself or that you’re a failure or have let your family down
  7. Trouble concentrating on things like reading a newspaper or watching TV ....
  8. Moving or speaking so slowly that other people have noticed. Or the opposite, being so fidgety or restless that you’ve been moving around a lot more than usual...
  9. Thoughts that you would be better off dead, or of hurting yourself.

Comments

Thanks for this, @YippeeKi YOW !! I imagine we have all answered these questions. I remember my first time, when I thought responding honestly would make sense, given that I had found a doctor who was at least discussing ME/CFS as a possible diagnosis with me. I foolishly expected that he would see the obvious: that my positive responses to numbers 2, 3, 4 5, 7 were directly related to a biological condition that had gone undiagnosed--and me dismissed with it --for years.

Silly.

If you are interested in a critique of the structure that helped spawn the mess Yippee describes, this is worth a read. On the state of the profession of psychiatry, by a radical and incisive member thereof.
 
Like you @Jyoti , I mentally answered all nine questions, and immediately realized that it wasnt the M.E. at all !!! I was just .... depressed. Down. Unhappy. Feeling low. Below psychological par. And here I'd wasted all this time, thinking there was something really wrong with me......

..... said no one on this site, ever.

Thanks for letting me know I wasn't the only one ....:):):) :hug:
 
Do you know what the relation is of this big pharma - driven questionnaire is to the Beck Depression Inventory (BDI) The BDI devised by Aaron Beck, a psychologist, had been the leader in clinical psychology to screen for depression; there was both a long and a short version. The BDI came under accurate scrutinizing and criticizing by Marty Seligman, an academic psychologist, but the BDI is still used in many places despite it’s many problems. Even on BDI , those who are chronically ill often score in the depressed range even when not because of the many physical questions like appetite, weight, and energy

So even the bdi is very problematic as far as i know that at least evolved independently of drug $ , so was wondering what role that established questionnaire played in the development of this one- and one has to wonder why they didnt just use the short form of the BDI which at least has studies to help validate it in some situations

@Jyoti i have an amusing story for you relateed to that. Will tell when have more energy (oh no. Low on energy? I guess i must be delressed. Wheres my ssris (which would kill me by the way given i cant break down monoamines already) .
 
@vision blue
Both the Beck-created BDI and the PHQ-9 are highly suspect, and for the same reasons, altho the PHQ-9 more obviously so.

Starting in the mid-to-late 90’s, pharma companies started moving in on medical schools, providing generous funding for research, then providing ‘suggestions’ for class curriculums and later, textbooks, then offering their usual array of lucrative speaking engagements and free trips to attractive or exotic locations for various ‘conferences’ to the Deans of medical schools and cooperative professors, especially those with a high public profile.

Research studies are largely funded by them, with over $83 BILLION dollars spent on R&D for new drugs by just a handful of pharma companies, and it’s hard not to believe that for that kind of money, the results might not be pretty much a foregone conclusion. Important information is often left out of final research reports, like the effects of anti-d’s after the two to four week period covered in most research, because those results are less supportive of their benefits, and often contradictory of the initial positive short-term results.

Even the National Institutes of Health (NIH) get a respectable amount of funding from Big Pharm, again, often thru “research” grants and studies …. as, I might add, I’ve read that the FDA does as well. Which explains the numerous drugs that have been rapidly moved thru the approval process, but removed from the market very slowly, even in the face of dozens, if not hundreds, of deaths.

So when the BDI gets relatively high marks from the NIH, I’m less than impressed. While it serves a purpose, I think that the main one is selling more anti-d’s, with the patient’s welfare being at best, secondary. You’ll have to come to your own conclusions regarding this, and it’s getting harder and harder to find real input, with search engines being scrubbed of negative or even marginally realistic input.
 
It’s hard to find put because back then financial disclosures of the conflict of interest sort. were not required. So even if we look at the initial pub, lmay not be able to rule it out. Usually funding sources for stidies were listed which woukd be interesting, but if not there, Woukdnt definitively rule it out

Not surpriaed by any of it. Clinical Medicine is not science, The journal JAMA comes to mind. Many think this is a reputable science journal. HA. Its the mouthpiece of political forced in public health. All invited all special interest groupd. But these days you have to disclose and reading the lostings for authors is good for a laugh. These authors get money from the largest group of special interests that I’ve ever seen in one place

Beck did believe in his BDI and so many viewed this guy as hod likr til the younger proper academics and scientists came along, whonthemselves now are old and giving way to several bew generations.

Yes one of the questions especially on the 7 questionnaire is atrocious and harmful
 
My first encounter with THE BROCHURE....

I was at the gynocologist, having a severe pain in what might be my left ovary.

Nothing involving the nine questions ever came up. But he hands me this BROCHURE with happy ladies. Perplexed, I tossed it out. (PAXIL I think)

Another decade later, I visit the white coat woman (Physicians Assistant). She stares, her fingers on her laptop. I'm there discussing all this inflammatory swelling of my mouth, lips tongue, teeth, throat.

She keeps telling me I should try this Zoloft.

After four years, OK FINE. Two days of Zoloft poisoning - three months to recover.

And frankly I came to hate that woman in the white coat.
 
But these days you have to disclose and reading the lostings for authors is good for a laugh.
I know, right? I remember reading a "research" report on the value of collagen over gelatin. I was in a discussion here on PR with someone about that, who swore that collagen was infinitely superior to gelatin .... go figure. Collagen IS gelatin, just more processed.

And when you dig into the deeper search on the research site, you discovered that half of the dozen 'authors' workd for a company that manufactures high-priced collagen powders, the rest worked at the University that apparently was getting funding from the large manufacturer, based on their positive findings about collagen powder...

It's enough to make a girl truly, truly, deeeeeeply cynical. Which would explain my fondness for Ambrose Bierce and Mark Twain ....

And the diff in getting ANY real nitty-gritty on things anymore versus before isnt just because in the way-back they didnt hvae to disclose, it's that in the right-now they have to disclose, but using a pencil with a very large cyber eraser, which they put to work, like, immediately ....

But it's ggood to know that Beck truly believed in this questionnaire. Right or wrong, that still puts him several steps above The Others ....
 
My first encounter with THE BROCHURE....
Ahhh, yes. The Brochure .. And sooooo mnay of them. And the puzzled, then angry look on Drs faces when you say, "Golly, thanks, but ...no ..."
She keeps telling me I should try this Zoloft.

After four years, OK FINE. Two days of Zoloft poisoning - three months to recover.

And frankly I came to hate that woman in the white coat.
With excellent reason. I've said this vefore in other threads, but Drss with any ethics and/or decency will admit that they know virtually nothing about the more subtle levels of how the brain works, and how it works with the CNS and neuro transmitters. They can quote chapter and verse on the functions of the muscarinic vs the nicotinic systems, or what happens in the Krebs Cycle, but none of it explains The Great Why-What-How ....

The story about correcting diminished or defective serotonin to explain the need for SSRI's?

Yup. Also invented by the scientifically trained sales staff at, probably, Prozac/Pfizer. And Drs generally know this, and go right on prescribing psychoactive drugs that can, if you're unlucky, have some really really horrible effects on your brain and your life.

all this pills the humans consume? willy nilly? where do they go? down the drain, out the pipe and into the river and into the ocean and into all the animals
I agree. As great a thread t our plant in it's quieter, more hushed up way, as climate change ....
 
correction- I do not hate her. I disliked her poor handling of my case.
Trust me. You're entitled. She wasn't looking up sigs and symptos, she was checking out the benefits pages for prescribing various anti-d's .....

There's a diff between the kid of deep, fuming, red-hot hate that's very personal, and the milder, you-stupid-biatch-why'd-you-do-that-what-in-God's-name-did-they-teach-you-in-med school .... more like a venting valve that a corrosive element that's going to eat away your soul and humanity ....
 
You're entitled. She wasn't looking up sigs and symptos

I never did succeed in getting records from that office, despite trying.

Recently, I participated in my first Patient Portal Experience (reading doctor comments online, actually seeing ones test results, altho of course the faxed results include illegible fax paper damage to the data).

I found it very unsettling reading the doctors comments (in this case, it was the ENT appointment, and him describing how he "convinced me" to get the test.)

OH WHATEVER. Then I try to imagine what that woman wrote in my chart, because I went there for any number of years and got NOWHERE NOWHERE at all.

But what if she wrote crap and I could GO AFTER HER?

___
I see nothing in my UCLA portal from my oncologist. So the ENT wrote endless notes and this one doesn't write notes?
 
I see nothing in my UCLA portal from my oncologist. So the ENT wrote endless notes and this one doesn't write notes?
Drs are usually notoriously late posting notes. I try to cut them some slac for being overburdened by paper work from hospitals, nsurance cos, required notes, etc etc etc .... but even with all that ....
But what if she wrote crap and I could GO AFTER HER?
Yeah. Good luck. They WROTE the malpractice laws, any they're impossible. For one thing, you have one year (or at least that's the way it was a few years ago) to open a lawsuit following the indicents). Sometimes you can get one year after you became aware of them, but that requires an atty to argue your case, just to establish that you have a case. After that, you have to prove your case. And this is all on your dime, mind you, not sure how many attys will take you on contigency unless the doctor removed your left arm instead of your left kidney .... it's incredibly difficult ....

So dont stress over that. Just go on quietly hating what she did to you, and if by some chance the notes do turn up, get an atty, like, FAST ....

OH CRAP-A-DOODLE-DOOOO .... I did it again.... I wrote this to you yesterday afternoon, thought I'd actually posted it (I was battling thru pretty bad fatigue and a stumpy brain) and left it here in my reply window .... hopefully, better late than never, and my apologies for the lag ....
 
Yeah. Good luck. They WROTE the malpractice laws, any they're impossible

I probably signed all those rights away, years ago. (you agree to mediating disputes; I've extensive experience in mediation; where you will get nothing out of the process but personal more sleepless nights...)
 
@Rufous McKinney

I came to hate that woman in the white coat.
correction- I do not hate her. I disliked her poor handling of my case.

Oh no! How can you possibly edit
One of the absolute best sentences I have seen in a long time (not counting of course yippees tongue twisting masterpeces.

I mean jeez which is better for the final sentence of the chapter in your memoir entitled The Woman in The White Coat (was her name Wilkie by any chance?) . :I cane to hate that woman in the white coat. Vs. “i disliked her poir handling of her case”. Come on, no contest.

Ive never seen the brochure people refer to.

I did once tho have a televisit for w very swollen very red wrist. Coukd see it across the room. I used r AmWell televisit and after showingbit to him filled him in on some medical history since the complexity was relevent to figuring out what this was (later thought by a rheum to be palindromic rheumatism). The doc said whenever I see peoppe with many disorders...wait for it....I waited for the insight...whenever i see people with many disorders, i think they need to see a psychiatrist. Huh? I was there for a very swollen angry wrist- i wasnt even reporting on an invisible symptom

I know the genuinely deep soul sucking furry resentment bitterness of which you (yippee) speak- the stuff where youve witnessed the usually hidden truly dark side of what it means to be human and youvwish you could not see it, had not seen it, the way most have been lucky not to see it, but you cant unring the bell.
 
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I mean jeez which is better for the final sentence of the chapter in your memoir entitled The Woman in The White Coat (was her name Wilkie by any chance?) . :I cane to hate that woman in the white coat. Vs. “i disliked her poir handling of her case”. Come on, no contest.

laugh

I should have paid more attention when the office manager took me aside, and sat me at her desk and said, do you understand you are not seeing a physician?

(she was the PA, I"d already dismissed the GPs there for past poor performance)
the brochure people refer to.

everybody is smiling, nicely dressed, and correctly medicated....
The doc said whenever I see peoppe with many disorders...wait for it....I waited for the insight...whenever i see people with many disorders, i think they need to see a psychiatrist. Huh?

the cleverest thing we ever did was decide to pick an illness nobody will treat, or even believe exists. Its a brilliant plan, isn't it?

And then you can get lots of attention from your friends you never see any longer? And your family can write you out of the will.

Yes and you can enjoy your only medication isn't covered by your valueble insurance, because its off label!

I note here, that my recent visits to get some real tests in a real hospital for a "real disease" (one you can now tell folks about, and receive sympathy cards)....nobody wears white coats.

so the Woman In the White Coat....(is a fakir)
 
the entire reason to get a psychiatrist is to find yourself a Jungian.
I agree ... well, if any of them are still actually practicing psychiatry and not prescrib-atry .... I've always had a soft spot for Jung, as opposed to my relative contempt for so many of Freud's beliefs, tho not all .... he did some truly ground-breaking work in terms of trying to understand the human psyche, but when we got to the naturally-imposed prevalence of female hysteria, and then, when it suited his purposes (he loved a good cigar or three a day) "Sometimes a cigar is just a cigar ..." I moved on ....
 
I can't read everything right now and I want to. :(

Anyway, this beta blocker I started recently is lowering my bp and consequently causing me to feel physically depressed.

I wonder if psychs ever even think to have the patient track bps at home before putting them on the anti-d's. I wonder how many of them just have low bps most of the time.
 
Slightly older research paper: https://pubmed.ncbi.nlm.nih.gov/24445302/
concludes by saying, "The study's data support an intriguing hypothesis that a portion of treatment-resistant depression in fact may be undiagnosed CFS or other chronic viral infection."

Uh...duh...ya, think???

Wish we could say to "experts" like this:

That's what we've been telling ya!!!!
 
Wish we could say to "experts" like this:

That's what we've been telling ya!!!!
Yeah, that'll happen right after they admit that some forms of depression are just a natural and necessary reaction to the painful crap that life can throw at 'ya, like the loss of a loved one, or profound financial issues, chronic illnesses, etc.

And that's going to happen ..... hmmmm ..... lemme check my calendar here ....yeah, the Twelveth of Never ....
 

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YippeeKi YOW !!
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