Differential responses to medications among Things that look like depression

• Evolutional Psychology/Anthropological Psychology by Ed Riemann LCSW, 1/2/97
  • (...)
    
    • Things that look like depression by James Brody, 1/12/97
      
      

James Brody wrote:

I wonder if there's a clinical difference between depression due to social rejection and that arising hopelessness? And, I wonder if there's a different response to various classes of antidepressants. Certainly, the SSRI's have effectiveness for lessening rejection feelings. I wonder if antidepressants with more of an adrenergic component would be effective for the hopelessness cases? Does anyone know of any data?

----------

You've asked some great questions here. The trouble is that the folks doing the psychopharmacology research have defined depression by a few scales, but without being informed about the innate affects. Thus, what gets called depression in the literature is really a heterogenous group of different things.

Donald F. Klein and his group was among the first to describe a group which they called a subset of depression and named Hysteroid Dysphoria. I always called this group Shame Based Dysphoria. Klein pointed out that this group tended to respond well to the MAOI's and poorly or not at all to the tricyclic antidepressants.

Both the MAOI's and the SSRI's have a shame modulating activity apart from their antidepressant activities. Little has been written on this. One of the few articles I am aware of was published in the Psychiatric Annals a few years back. I don't remember the exact issue, but I do have the article text available at my website: http://www.easy.com/goodwrench/annals1.html

Jim Pfrommer

• Shame/Guilt Modulation by James Brody, 11/24/97
• Non-specificity of treatments for depression by Mike Hall, Ph.D., 2/3/98