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What do you mean by a self-help manual for treatment of depression?</p>
<p>What would be the advice in this manual?
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<p>It would show all of the approaches in treating depression by therapy. Why constrain therapy strategies to therapists? (who will oftentimes only go with one therapy strategy)? It would also document studies showing the placebo effect wrt therapy (just talking about it with someone helps). </p>
<p>Many people are rather ignorant of such strategies, however, and still continue with self-defeating thoughts. </p>
<p>Now, maybe such books do exist. I'm probably sure that they do (after all - such books do exist for disorders like ADD). On the other hand, the veracity of the claims addressed in such books does have tremendous variance. A lot of therapies designed to "treat" ADD or autism are BS. It would help if some organization could at least help point out the therapies addressed in self-help books that are BS and the ones that are not BS.</p>
<p>Now - what we do know is that there are online support forums for mental illnesses. <a href="http://aspiesforfreedom.com%5B/url%5D">http://aspiesforfreedom.com</a>, <a href="http://www.addforums.com%5B/url%5D">http://www.addforums.com</a>, <a href="http://www.crazymeds.org%5B/url%5D">http://www.crazymeds.org</a>, etc. There are plenty of ones for depression as well. Now - the question is - how reliable are them? It depends on what they advise. Obviously most people on those forums are laypeople who should not be dispensing out medical advice. On the other hand - some of the people on such forums are clearly dissatisfied with the standard treatment procedures. </p>
<h1>There is some backlash against the massive prescription of antidepressants (there's a book published on this). The question is - is this backlash justified?</h1>
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As far as people reading research and self-prescribing, it is far better to find some research that you think pertains to your case and take it to your physician to discuss. </p>
<p>Obviously, physicians can't read all of the journals that are published. Research does not talk about all of the pros and cons, so it would be a mistake for a lay person to decide on self-treatment based on personal readings. </p>
<p>If you can't talk about it with a physician, it is probably not a legitimate use of the drug.
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<p>While research does not mention the pros or cons - the doctors often do not mention them either (they often just tell the patient "well here's one drug, go try it out for several weeks, report back with me in three weeks"). It can take several weeks to set up an appointment. And those several weeks can feel too long for someone with a mental illness. Especially one like depression (where it takes months for one to find a drug that "works"). Now, there's now research that shows that ketamine can alleviate the symptoms of depression for a week or two (and almost instantaneously). The question is - are doctors willing to prescribe ketamine soon after the publication of the research? When the person is extremely desperate? It's difficult to say. But the individual wants a quick and effective treatment, and could potentially commit suicide without such a quick and effective treatment. On the other hand, his self-prescriptions could also lead him into ruin. This probably constitutes the majority of self-help cases (in fact - the long waiting times are precisely the reasons why so many people resort to medicating themselves for ADD and depression).</p>
<p>Finally - we have to note that ADD and depression are traits along a continuum. ADD, for example, is a trait that has undergone selective advantage in a few populations in the past (source: Late June article of <a href="http://www.gnxp.com)%5B/url%5D">http://www.gnxp.com)</a>. However, it is clearly unadvantageous to many people in the modern age. The problem is - what about the person who is extremely distractible but who yet does not qualify for a diagnosis of ADD? What is he to do? He loves math, but does not have the attention span to pursue it effectively. Some people, of course, are able to get prescriptions through their doctors just for this reason (Paul Erdos was one - though he merely wanted to enhance performance). But some people are not. </p>
<p>ADD isn't a very well-defined illness. Since ADD tendencies tend to lie along a continuum - there is no fine distinction between ADD and not-ADD. Furthermore, people just along the line (mildly ADD, perhaps) might function well on day-to-day activities, but may be impaired when working on, say, university coursework.</p>
<p>I've personally seen the diagnostic criteria for mental illnesses. They rely HUGELY on anecdotal evidence. They're not precise. Hence why people who don't need amphetamines are prescribed amphetamines and why people who could do better with them are prescribed with them.</p>
<p>The issue is that amphetamines can help improve GPA irrespective of whether one has ADD or not. And even if one doesn't have ADD - well - the fact that they improve GPA mean that his attention span is hurting his GPA, so the amphetamines still help him.</p>
<p>The problem, of course, is that anyone can feign low attention span and abuse those drugs. This is a difficult issue in itself. All we can say is that some people are sufficiently desperate enough to acquire the drugs to help them with studying - such that they acquire them illegally. </p>
<p>Now, this is purely my opinion, but I do believe that "studying more" is a rationale in itself for getting a prescription for modafinil per se (modafinil is known for its mild side effects - alas it is Schedule IV just because it induces euphoria in a small number of cases). One person told the doctor that he needed it to cram for exams - and the doctor prescribed modafinil to him (he asked an expert if there was any good reason not to prescribe modafinil - there wasn't any). Now, some doctors are not willing to prescribe modafinil. Some are.</p>
<p>It wouldn't be such an issue if modafinil wasn't a controlled substance. But it is. I've read the research pertaining to it - there are no fatalities associated with modafinil - and the listed side effects on the FDA package inset are very light. </p>
<p>Is it fair? If the person wants to study more, by all means let him study more.</p>
<p>==
In any case - self-medication is done frequently enough to warrant mention in research journals. On average, it does more harm than good (however, there is variance in the group). On the other hand - self-medication is going to happen because people are desperate and because the traditional means of delivery are not perfect. The risks of a criminal record are not particularly high wrt acquiring drugs because both buyer and lender have incentives to keep the transactions as secret as possible.</p>