Hi, Quick question: Here in the UK CBT has had a high profile for a very long time (and I can vouch for its effectiveness). The stock advice from psychiatrists here for depression is "Here are some meds. If they work, they will give you a stable platform to stand on while you do the rest of the work you need to do to get yourself better", by this meaning lifestyle stuff (diet, exercise, sleep), therapy if necessary, CBT and so on. No psychiatrist has EVER told me that all I need to do, period, is take anti-depressants and mood stabilisers.

The debate here tends to be trying to make the general public understand that therapy alone isn't sufficient for everyone, and that depression and bipolar disorder are a real illnesses. The emphasis on the medical condition side of things is to try and get Joe Public to see that it's not a case of being "a bit down" or having "some personal issues" - it's a genuine and disabling affliction that the sufferer can't just think themselves out of. Something like 37% of all Member of Parliament here apparently still think that depression is not an illness - ie that sufferers just need to pull themselves together and they will be fine.

Where meds come is that some of us are far enough up a certain creek to also need help from medication as well. I'm in that lucky 30% for whom the extra help works.

Is it the case in the USA that the medical culture is much more meds-oriented for depression and bipolar disorder? If so isn't that a bit odd given that the USA seems to be so keen on therapy generally?

I thought this was a great show. While I did not see the end of it (I fell asleep), I was so impressed that the show used functional people, interviewed kind, concerned, family members and broke down many stigmas that main stream media generally pushes into onto the public regarding mental illness.

Philip-you are correct in saying that CBT was not addressed which is too bad. For me, those I have seen use it as a type of therapy and all the papers I have written about it in school over the past year, have lead me to believe it is the cutting edge form of therapy. Refoucing anxiety and behavior instead of figuring out the root problem for months and months seems more productive and a more efficiant way to wellness, especially given the unfair coverage in mental health benefits.

I agree with you on most of your points, but the thing that really got to me and made me turn the show off halfway through was the narrator's voice. Maybe it's a stupid and superficial reason, but I felt like I was watching a police/crime drama.

Actually, no... It reminds me of the narrator of that show where people get into life threatening situations because they did something stupidly dangerous. I can't think of the title... anyone know what I'm talking about?

RE:"the claim that Depression (and depression) are more untreated than treated in our culture. The show offered no evidence to back this assertion."

I didn't see the show, but did they mention the un-mentionable? Suicide rates and the rates of compleated etc? I think thats the evidence you wanted and have written about here a few times. They can't talk about female vs male and color of the skin as this would put a hole in the medical model of depression.

Treatment implies medicine that is working, a brain chemical imbalance fixed etcetera. VS people on (or withdrawing from drugs that supposedly have no withdrawl effects) psychiatric mind altering chemicals, who then act foolishly/impulsively/emotionally instead of rationally and then attempt suicide or act emotionally-physically violent.

Big can of worms there on who is responsible for ones actions.

Thank you for reviewing the show. I didn't want to watch it because my husband came into to me study and said, "Jane Pauley is on TV and saying 'Depression is a disease like diabetes.'"
"Oh, brother," I thought, "not another story pounding into public's heads that they 'gotta take their meds.'"
So, I read your review with interest your.

You have a great blog.
I am writing a blog on how I became better. It involved weaning off meds, taking supplements and finding purpose in my life."

I feel like we are fighting an uphill battle. Everyday more and more people are convinced that they need to take meds for their "lifelong, chronic illness."

You covered all the main points very well. I would add that all of those interviewed had more than adequate financial resources unlike a majority of people faced with mental illness. Even the young black man was fortunate enough to have the backing and support of a successful mentor. While these stories are moving and touching, the sheer numbers of those struggling to just live let alone pay for therapy and drugs was not examined at all. The costs of psychiatric care and wellness are staggering. The lack of parity in mental health was mentioned but not highlighted.

And the complications of bi-polarity with its many hideous faces was not addressed. While I understand that this was a basic primer on depression, it is more than obvious to those of us who have struggled with the issues that more in-depth programs need to follow up.

By the way, I often read your very thoughtful postings and commend you for your research and thorough reporting. Thank you.

Maggie

Huh. I'm surprised you didn't mention the discussion segment of the show afterwards. Did you catch that? I was probably harsh last night but then again, I ended up in a foul mood after the show.

Yes, I agree that the show went for the medico-pharmaco story that "Depression is an illness," which of course leads to the only appropriate treatment being meds. This theme especially bothered me when they presented the topic of ptsd. First, they get credit for providing someone (I can't remember who) noting that ptsd eventually wears you down so much, that people with ptsd often end up with depression. This is important because depressive symptoms should routinely spark the suspicion of ptsd. So that was good. However, the 'bad' followed right on the heels, as a comment portraying psychotherapeutic interventions as some new idea. I can't remember exactly how it was worded - we can see on the rebroadcasts. Something like: "we have new technologies" for processing emotional events. My guess is that commentor was referring to EMDR? The effective treatments for ptsd span far beyond meds and EMDR, and are not new.

Again, these stories on tv, including the pbs-type documentaries really inquire and edit to portray someone suffering from a disease. They rarely get to the great range of psychosocial factors - ruminative thoughts, catastrophizing thoughts, poor social skills, low social involvement, external locus-of-control, addictions, persistent financial difficulties, traumatizing incidents, etc. Thus, the documetary portrayal falls short when trying to convey the benefits of psychotherapeutic interventions - when you look at my list, it makes sense that psychosocial interventions work - CBT, exercise, social activation, behavioral activation, group supportive therapy, social skills training, etc.

I found it real interesting how they wheeled the ECT patient on a gourney in for her treatment. Trying to protray it as a "real" medical procedure. Most people never even change out of their street clothes.
I also found it interesting they only showed the womans feet. I guess showing her biting down on a mouth guard during the siezure would have conflicted their claim that a lot has changed over the years with ECT.
It was also interesting how we didn't see this woman getting a painkiller for headache afterwards. This woman didn't even look like she had just woke up from being under general anathesia. Interesting too how there was no mention of the long term (premenate) damage to ones memory.
The show to me sounded like one big infomerical trying to sell depression as a real medical disease. It seemed to me a lot of time (at least the portion I watched) showed Psychiatry trying to look like real medical doctors who have come a long ways in treating depression.
To bad the reality is, they still don't know shit and until they start listening to the patients and stop medicating the shit out of everyone, in 50 years we will all being watching another show where the shrinks are stating "we have learned so much and we are almost there, stay on your med's".

The problem with this PBS show, as I see it, is the way they made all the mental health workers seem so kind, warm, concerned and competent.

Actually, I read one time that, among a shrink's patients, 40% are visiting this shrink to have him help with problems caused by another shrink.

The anti-psychiatric movement is big. Strange that we don't have an anti-dental movement considering how much people hate to visit a dentist. Food for thought.

Honestly, the only thing I'm curious about after reading all of the reviews and comments; which I appreciate, due to not watching the program;is what the hell was that guys kitchen like?

LMAO.

Stephany, it was a gorgeous marble kitchen. Something like you'd see out of a segment on Oprah. I found this picture from Boston.com. You can see a bit of the kitchen behind him.

Ha ha! thank you Marissa!

Yuck, luckily I didn't watch this show. I think there was a new episode of Bones on at the same time. What I don't get is how all of this "depression, is real it's not in your head, it's a disease" crap misses this point - if you are telling me depression is a "brain disease" and as far as I know all people's brains are in our heads, then you are saying in the most brutal and evil way possible that depression is all in your head, depression caused by weakness, etc. That line of thinking has been disproven so many times and yet it's so pervasive. Some people here love to cling to it, I used to accept it with no questions myself but it's not compassionate, it's horse sh*t.

Didn't catch the show (I'm blissfully TV-less) but thanks, Philip, for your analysis. Guess they didn't mention how many people become manic as a result of depression treatment, huh? Every shrink I've been on the other side of the desk from claims this effect is merely "unmasking" or "uncovering" latent bipolar disorder. I like unprovable assertions as much as the next guy, but this seems to me to be really a stretch.