[askvictor]

This analysis look at effects over 8 weeks. The first four weeks on antidepressants you're feeling terrible due to onset side effects (on top of your depression). Once that settles, you feel better. But there is no way to tell if you feel objectively better than before the medication started.

[grzm]

> "But there is no way to tell if you feel objectively better than before the medication started."

Would you elaborate at what you mean here? Two reads I have are either (a) you're getting at whether feelings like this are subjective, which is true definitionally but seems to me to be uninteresting, or (b) assessment tools (such as the Beck inventory) are imprecise, which is also true, but can still provide some basis for comparison. Or something else that I'm missing?

That said, I would like to see a longer time scale to see if the changes are maintained.

[markroseman]

Statistically, rating scales typically used in these studies have been validated as showing effect, and clinical interviews can pick up a lot of things. That said, it's normally hard for you to be able to look back eight weeks and subjectively compare how you feel then and now. Usually it's not the person being treated, but those around them (family etc.), who notice the improvements first.

[askvictor]

I think you mean objectively not subjectively.

In any case, looking back that 8 weeks and comparing to now, _after you've just been through 4 weeks of hell_, you'll report that you're feeling a lot better, even if you've only returned to the same level you were before starting the meds.

Are there studies that use family/etc as the basis for their data? That would be a lot more valuable, as long as they also include a control.

The studies also need to look a lot longer than 8-12 weeks, partly due to the onset side effects, but also as a lot of depression is caused by a stress event that passes and resolves in a few months. It is interesting that a placebo has a positive effect (not as large as the meds); I wonder if they measured the effect of no treatment at all.