Posted by dennison on January 27, 2002, at 16:58:58
Hi-found this short abstract I liked it's theory regarding idea of incomplete recovery from depression as a function of "chronic functional impairment". Which I firmly believe sustains the depression or causes a relapse after perhaps "some initial" relief is achieved !!!! (((functionality)) If functionality is lost or not regained, depression will manifest itself again or only be partially treated, as lack of drive and ambition will surely lead to inability to fully reintegrate and assume normal activities, afterall "apathy" and "isolation" and inabilty to achieve any meaningful goal, certainly aren't anything to look forward to are they:):).
Shelton RC, Tomarken AJ.
Psychiatr Serv 2001 Nov; 52(11):1469-78ABSTRACT
Even though a variety of treatments are available for depression, many patients experience an incomplete response, resulting in chronic functional impairment. The authors present a therapeutic heuristic that derives, in part, from a body of research that suggests that symptoms of mood disorders can be separated into three distinct components: somatic anxiety, which is most prominent in anxiety disorders, such as panic; anhedonia or low positive affect, which is most specific to depression; and general distress, which is present with both anxiety and depressive disorders. General distress and somatic anxiety appear to be significantly modulated by serotonin, and serotonergic drugs may exert their effects most significantly on these symptoms. On the other hand, positive affect, the dimension of reward-oriented motivation and enjoyment, appears to be most dependent on dopamine and, indirectly, norepinephrine. Thus a theoretical heuristic can be derived on the basis of the predominance of residual symptoms. Serotonergic agents would be chosen for monotherapy or augmentation for symptoms of distress. Alternatively, catecholaminergic drugs would be the first choice for anhedonia and decreased motivation.
poster:dennison
thread:91772
URL: http://www.dr-bob.org/babble/20020124/msgs/91772.html