as small as a world and as large as alone

2:18pm August 18, 2014

madeofpatterns:

chordatesrock:

madeofpatterns:

chordatesrock:

madeofpatterns:

treating everyone with certain symptoms as though depression is the only possible explanation is seriously, seriously harmful

Particularly when it involves deciding not to listen to them, on the grounds that they’re too depressed to have insight. But not only then.

People act like false positives are harmless. they’re not.

Depression treatment has actual effects, which can be extremely harmful for people who have different problems (or people who have kinds of depression that don’t respond well to that kind of treatment)

Ignoring other explanations is *also* not harmless. because people who have the kinds of symptoms that lead to depression diagnosis have *some* kind of serious problem. And treating it as depression when it isn’t means you’re not treating the actual problem. Which isn’t harmless.

Depression is an important problem. It’s also important to be aware that not everything that flags positive for depression on screenings is actually depression.

If anything, primary neurotransmitter imbalance might be one of the least urgent of the possible explanations: abuse can escalate, nutritional deficiencies can get worse, thyroid conditions affect other body systems as well… and it’s harder and slower to check for neurotransmitter problems, since the available test seems to be “give meds, wait several weeks, if it doesn’t work rule out the possibility that you just need different meds or a higher dose”.

It’s also complicated by the fact that antidepressants can be helpful even if someone’s primary problem *isn’t* primary neurotransmitter imbalance. But relieving some depressive symptoms doesn’t eliminate the need to rule out other problems.

And, as you said, they aren’t something like homeopathy that can’t do any harm, either.

Basically medical treatment is complicated and it’s entirely sensible to spend twelve years training people to do it.

Yes, exactly.

And also it’s entirely sensible that people have to get continuing education and get recertified in their specialty every 10 years (at least, some specialists do).

But there are things that go really badly wrong, frequently, even with people who have a lot of professional training. And approaches to depression are definitely one of them.

(along with, say, correctly identifying depression as a psych symptom but ignoring mania because you’re not looking for it).

And like, one of the major depression screening tools actually *is* made by a drug company.

One thing that bothers me a lot about psych screening tests is that a lot of them have a number of physical symptoms on them, and if you have a lot of physical symptoms that’s supposedly meaning that you’re having ‘somatic symptoms’ just because it happens to be a psych test that you encountered the questions on.  I sometimes lie about physical symptoms when I know it’s a psych test, because I don’t want to be flagged as having physical symptoms stemming from a psych problem when that’s not where they’re coming from at all.  I recently had to take a test like that as part of a survey on trans issues and I was glad they had a commentary section at the end, I gave them an earful about that part.

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