Talk:Major depressive disorder

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To-do list for Major depressive disorder: edit · history · watch · refresh · Updated 2014-11-20

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Depression out of the shadows?

I have some doubts if the link to "Depression out of the shadows show" Depression, out of the shadows is appropriate. It features infamous Charles Nemeroff who took ~2 million from pharmaceutical companies without reporting it, "authored" ghost written articles, argued (we now know why) against the FDA antidepressant - suicide link warnings, and is not really a credible source by any stretch of imagination. The documentary was criticized by the Columbia Journalism Review (see here , by other mental health advocates for giving disproportionate time to ECT and mentioning CBT only in passing, and at best deserves only "C" grade, for example . Stanford Wellsphere.org holds similar opinion . Should we keep it or delete it? Is there anything better around to replace it? The Sceptical Chymist (talk) 12:25, 25 November 2009 (UTC)

This one encompasses anxiety and stress along with depression, but no discussion of depression would be complete without mention of these comorbid and/or causal factors. The man behind this film is an MD and a published researcher, and looks reliable to me--certainly a great deal more reliable than Nemeroff. Cosmic Latte (talk) 15:52, 25 November 2009 (UTC)

Unjustified use of fair use image

File:Long term depression.jpeg

Depression is frequently a recurrent, sometimes chronic, disorder. (Illustration by Lucy Bristow.)

This image makes no sense to me as an explanation of depression. The picture is not explained in the text, as is required by the fair use criteria for a copyrighted image. Therefore, I don't think fair use of this justified. Regard, —mattisse (Talk) 22:20, 10 December 2009 (UTC)

I completely agree.--Garrondo (talk) 22:32, 10 December 2009 (UTC)

Glad to receive agreement! The image was not in the article when it passed FA. I am quite sure it would have been removed then as there is no rationale for using it. . It is a relatively new addition to the article and I cannot even figure out what it is saying about depression! Regards, —mattisse (Talk) 22:47, 10 December 2009 (UTC)

To me it just looks like some lying in bed sleeping at night.--Literaturegeek | T@1k? 00:26, 11 December 2009 (UTC)

What is that big orange-yellow thing to the right with tentacles? In any event, what does it describe about depression that cannot be expressed in words? Since it is a fair use image violating a copyright, the standards for inclusion are very high. Regards, —mattisse (Talk) 00:34, 11 December 2009 (UTC)

Ha, I dunno, I thought a cat at first for some weird reason but then when I looked closer I got even more confused. I think that it should be deleted for the reasons you gave as well as the picture not being easily related to depression. If a better picture is found I guess it could be considered for addition.--Literaturegeek | T@1k? 00:37, 11 December 2009 (UTC)

By all means. I was just trying to address the inadequacy of the Van Gogh image. To paraphrase LG "To me it just looks like some man with hangover sitting in a chair." The Sceptical Chymist (talk) 11:57, 11 December 2009 (UTC)

That was very...shall we say, clever. Even so, the picture is kinda nightmare-ish and seems to fit the mood. Not enough that I'd put it back in the article, but still perhaps enough to shed some light on the van Gogh piece: It seems (at least to some) to be intuitively appropriate, even if doesn't seem to fit so well on more articulable grounds. Not that this is (or isn't) ideal--it's just hard to figure out how better to illustrate the entirety of an abstract idea like MDD. Cosmic Latte (talk) 20:37, 12 December 2009 (UTC)

Yes, everybody (myself included) agrees that Van Gogh is inadequate but we have nothing better. While it may seem "intuitively right" to you, this illustration creates an incorrect impression of a typical depression patient as a desperate penniless male.

As a person who's had depression for the past 4 years, I personally can't think of a better image that illustrates what it feels like 90.193.86.134 (talk) 04:40, 26 February 2010 (UTC)

The questions asked above equally apply to the Van Gogh picture. "What does Van Gogh describe about depression that cannot be expressed in words?" "This image makes no sense to me as an explanation of depression. The picture is not explained in the text" "As I looked closer I got even more confused." "What is that falling-apart floorboards thing?" What does it mean? Why the the walls are dirty? What is that supposed to say about people with depression?! ;))

On the other hand, Lucy Bristow's picture is an "intuitively right" symbol of chronic depression for Jules Angst, BMJ editors and yours truly. The Sceptical Chymist (talk) 01:44, 13 December 2009 (UTC)

Of course the selection is going to be somewhat arbitrary; but as long as it's at least reasonably plausible, it (whatever "it" is) may be the best one can do to illustrate a concept that's almost impossible to illustrate. Unless, of course, we'd rather go with a yellow frowny face that has a speech bubble saying, "Hi, I have major depressive disorder!" :-) Cosmic Latte (talk) 16:55, 13 December 2009 (UTC)

P.S.: The BMJ is a far more reliable source than I, so perhaps the Bristow picture is, after all, the better one. Cosmic Latte (talk) 16:58, 13 December 2009 (UTC)

Onset

Early in the article it states that the usual onset is in one's thirties. I'm curious about this, because I have read, from numerous sources, that the most common time for an episode of Major Depressive Disorder is in one's early twenties. Furthermore, of those that suffer an episode in their early twenties, it is very common to suffer a second episode in their early thirties. (Exactly like Abraham Lincoln.) I have always read that the most common time for the onset of all mental illnesses is in one's early twenties. Is anyone else familiar with this? —Preceding unsigned comment added by 68.82.204.61 (talk) 22:41, 30 December 2009 (UTC)

Agitation (Restlessness)

Agitation is an obligated depressive symptom. Of their stamping it reaches from internal restlessness (subclinical agitation) to psychomotor restlessness (agitated depression). With suspicion on a light or moderately depressive disorder should be always asked for internal restlessness to secure the diagnosis. --H.-P.Haack (talk) 01:28, 9 March 2010 (UTC)

Why have you placed this here? Looie496 (talk) 19:52, 9 March 2010 (UTC)

This edit was made earlier today. It does add some relevant information (especially with regard to agitation) that the article doesn't yet contain. However, I reverted this addition because its sole source was another open wiki. I don't mind that it's self-published, but I would say that a featured article should adhere strictly to WP:RS and other guidelines. If anyone can provide a citation of a third-party RS, please do. Cosmic Latte (talk) 17:19, 10 March 2010 (UTC)

Deep Brain Stimulation for Depression

I think this utility must be added given that there is solid research into DBS for treatment resistant depression. An excellent peer-reviewed research article can be found here: http://www.biomedcentral.com/1756-0500/3/60/. I tried to add this subject to this entry, but it was reverted by SandyGeorgia. Since wiki reflects more than one editor's view, I would like to hear from you all on this. If you choose, simply "undo" the revision made by SandyGeorgia. Thank you. Basrblog (talk) 18:46, 13 March 2010 (UTC)

Please see WP:MEDRS, WP:UNDUE, and note that this article is a featured article, so the standards for inclusion are high. Unless recent, major reviews mention DBS, it shouldn't be included here, and then, we need to stick with what major overviews say. A review of a specific issue, on a small sample, is not the same as a major review of the broader topic of Major depressive disorder and due weight must be given to what is included in this (already long) article. Is DBS mentioned in a recent broad review article on MDD? Also, do you have a COI? I notice that you are sourcing Lakhan on many articles, and you recreated similar content at Brain Blogger as an editor several years who had a COI. What is your relationship to Brain Blogger and Lakhan? SandyGeorgia (Talk) 18:59, 13 March 2010 (UTC)

DBS has been mentioned in a number of comprehensive reviews, and there is solid evidence that it works in some situations where nothing else does, but it is still an experimental treatment and is unlikely to play more than a minor role in treatment in the near future, because it requires implanting electrodes into the brain, with all the risks that entails even when performed with the greatest care. I have a recollection that DBS was actually mentioned in this article at one time (back when there was an "alternative treatments" section), but apparently it has been dropped. Looie496 (talk) 04:13, 14 March 2010 (UTC)

IF anything is added, I suggest wording be based on a major review of MDD, not to Lakhan, based on the history of COI editing from the various GNIF and Brain Blogger accounts, and the perhaps undue weight given DBS by Brain Blogger-- I'd like to see what truly independent, major overviews have to say (I know what they say wrt Tourette's, and I suspect it's similar). I suspect it's an exceedingly minor treatment possibility, so doesn't belong here, but I'm not aware of recent reviews in this topic. SandyGeorgia (Talk) 14:47, 14 March 2010 (UTC)

PMID 16490412 is one broad review that discusses the topic -- there are others, but none that claims the method is ready for wide application. The most in-depth reviews have involved Helen Mayberg as a co-author; she is highly reputable but can't be considered neutral because she has been heavily involved in the research. Looie496 (talk) 17:52, 14 March 2010 (UTC)

That's my concern: DBS is a cash cow, with limited application. SandyGeorgia (Talk) 18:44, 14 March 2010 (UTC)

What are your credentials to make such commentary? Also, do you think antidepressants or vegas stimulators aren't a cash cow? There seems to be plenty of research into DBS for mood disorders. There should be some mention regardless of whom one chooses to cite... 71.106.22.254 (talk) 03:14, 18 March 2010 (UTC)

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