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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 51 to 75 of 102. Go back in thread:
Posted by SLS on August 14, 2006, at 8:00:50
In reply to Re: Is Kramer right?, posted by SLS on August 12, 2006, at 21:46:43
> > What he's actually saying, to paraphrase as best as I can understand, is that people prone to multiple bouts of depression are people who have a defect in brain repair.
>
> As opposed to a defect in brain regulation?
>
> I think the latter is closer to the truth.
Depression appears to be a complicated illness with a multiplicity of factors contributing to its induction and persistence. Right now, I still don't think that it is a defect in brain repair that is responsible for its induction. I believe this to be more a product of dysregulation in neurotransmission and circuitry. However, I can see how such a defect could contribute to its persistence. I guess the illness might progress as a self-reenforcing process, with the inability of the brain to recover from stress-induced cell loss hindering the reestablishment of healthy interactions between entire circuits. Still, this is probably a matter of a diminished rate of repair rather than its complete absence as has been demonstrated by the recovery of brain tissue seen with lithium and antidepressant use.
- Scott
Posted by willyee on August 14, 2006, at 9:58:09
In reply to Re: Is Kramer right?, posted by SLS on August 14, 2006, at 8:00:50
> > > What he's actually saying, to paraphrase as best as I can understand, is that people prone to multiple bouts of depression are people who have a defect in brain repair.
> >
> > As opposed to a defect in brain regulation?
> >
> > I think the latter is closer to the truth.
>
>
> Depression appears to be a complicated illness with a multiplicity of factors contributing to its induction and persistence. Right now, I still don't think that it is a defect in brain repair that is responsible for its induction. I believe this to be more a product of dysregulation in neurotransmission and circuitry. However, I can see how such a defect could contribute to its persistence. I guess the illness might progress as a self-reenforcing process, with the inability of the brain to recover from stress-induced cell loss hindering the reestablishment of healthy interactions between entire circuits. Still, this is probably a matter of a diminished rate of repair rather than its complete absence as has been demonstrated by the recovery of brain tissue seen with lithium and antidepressant use.
>
>
> - ScottVery encourgaging words,thanks
Posted by Dinah on August 14, 2006, at 10:26:39
In reply to Re: Is Kramer right?, posted by SLS on August 14, 2006, at 8:00:50
That's more or less what he says. That it's a cycle for some (not all) people. That some people have traits that protect them from neurological damage, and some people have the ability to repair the neurological damage, and some have neither.
I think he also says that neuroticism is a trait that is closely linked with depression, perhaps because both result from a lack of protection and of neurological resilience.
I'm already starting to forget what he says though. I need to read it again, or brush up on it. Or put it aside and never think of it again. :)
Posted by SLS on August 14, 2006, at 10:49:27
In reply to Re: Is Kramer right? » SLS, posted by Dinah on August 14, 2006, at 10:26:39
> That's more or less what he says. That it's a cycle for some (not all) people. That some people have traits that protect them from neurological damage, and some people have the ability to repair the neurological damage, and some have neither.
Hmm.
It sounds logical enough.
What does he claim is causing the damage to begin with? Is this damage a product of normal everyday living or is it abnormal and part of the disease process?
Gosh. I feel like I'm having you do a book report.
:-)
- Scott
Posted by Dinah on August 14, 2006, at 11:09:40
In reply to Re: Is Kramer right? » Dinah, posted by SLS on August 14, 2006, at 10:49:27
I'm definitely forgetting. :)
Ummm... I think he means environmental stress.
Things that psychologically inclined people think of as causing depression. Poor parenting, trauma, stress. He says those things do contribute to depression, but only in those who are biologically predisposed.
Posted by pulse on August 14, 2006, at 11:23:34
In reply to Re: Is Kramer right? » notfred, posted by laima on August 12, 2006, at 18:56:36
> Hope so--I'm hoping for that plasticity--if Kramer is asserting that's not possible, I think that would be a tad irresponsable of him. After all, there ARE people who manage to overcome their depression or at least keep it in remission or under control. Again, haven't read any of his books- but I'm bewildered what, other than sensationalism, would motivate anyone to write anything remotely along the lines of 'depressed people are all doomed due to permanently damaged brains'- if that is what he's saying. It almost seems that believeing something like that could in itself be a predictor of staying depressed. I'm more interested to take a closer look at Lindage's list about neurogenesis, and do anything I can, whenever I can manage, to go against atrophy.
my therapist just finished this book and is very impressed with it. she made a big point of bringing it up in 1 of our latest sessions.
in no way does she feel that it's saying anything close to 'depressives are all doomed. etc.'
she's a fan of kramers; she read his 'listening to prozac' when it 1st came out, so she wanted to see his latest takes on depression.
i'm his fan also, and since i can no longer take any ads, i'm sure this book will be of at least some help to me.
Posted by Aphrodite on August 14, 2006, at 11:35:26
In reply to Re: Is Kramer right? » Dinah, posted by SLS on August 14, 2006, at 10:49:27
Not really pertinent, but this stuck with me from the book:
He makes an interesting but brief side note about German psychiatry's interest in the role of scrupulosity in mood disorders -- he states that they've conducted studies that show people with in-born, clear rules of ethics and what is right and wrong are much more likely to develop depression.
Posted by Dinah on August 14, 2006, at 11:37:48
In reply to Scrupulosity » SLS, posted by Aphrodite on August 14, 2006, at 11:35:26
Well, that's me. In fact scrupulosity OCD is part of my diagnosis.
Posted by pulse on August 14, 2006, at 11:46:22
In reply to Re: Optimistic part » Phillipa, posted by laima on August 13, 2006, at 23:57:24
> Oh yes- that's the other book I was referring to in earlier posts- I never read it- I picked it up a few times, but somehow just couldn't get into it. I have no idea if I was being fair or not, but in my mind I always blamed Kramer for the prozac rucous of that era...Do you remember that stuff and all those jokes???
i was one of those miracle prozac patients. have moderately severe to very severe mdd, recurrent. i did most definitely feel better than well.
it did burn me up that ppl w/out depression were demanding prozac. also the prozac jokes. however, i never blamed peter kramer. he was, unfortunately, used as a too convenient scapegoat for the entire bruh haha.
remember prozac was the first of the newer gen. ads when it came out in 1986. this WAS a big deal. as an aside, i still believe the tcas to be more effective - for me - than ANY of the newer ads....or combos.
Posted by laima on August 14, 2006, at 11:51:24
In reply to Re: Is Kramer right? » laima, posted by pulse on August 14, 2006, at 11:23:34
> > Hope so--I'm hoping for that plasticity--if Kramer is asserting that's not possible, I think that would be a tad irresponsable of him. After all, there ARE people who manage to overcome their depression or at least keep it in remission or under control. Again, haven't read any of his books- but I'm bewildered what, other than sensationalism, would motivate anyone to write anything remotely along the lines of 'depressed people are all doomed due to permanently damaged brains'- if that is what he's saying. It almost seems that believeing something like that could in itself be a predictor of staying depressed. I'm more interested to take a closer look at Lindage's list about neurogenesis, and do anything I can, whenever I can manage, to go against atrophy.
>
> my therapist just finished this book and is very impressed with it. she made a big point of bringing it up in 1 of our latest sessions.
>
> in no way does she feel that it's saying anything close to 'depressives are all doomed. etc.'
>
> she's a fan of kramers; she read his 'listening to prozac' when it 1st came out, so she wanted to see his latest takes on depression.
>
> i'm his fan also, and since i can no longer take any ads, i'm sure this book will be of at least some help to me.
>Oh- actually we got a better understanding about this book later in the thread.
Posted by laima on August 14, 2006, at 11:55:45
In reply to Re: Optimistic part » laima, posted by pulse on August 14, 2006, at 11:46:22
No- the entire fuss wasn't Kramer's fault- but he sure seemed to ride the wave, and he was often the person media picked out for comments. That book of his was mentioned all over the place.
> > Oh yes- that's the other book I was referring to in earlier posts- I never read it- I picked it up a few times, but somehow just couldn't get into it. I have no idea if I was being fair or not, but in my mind I always blamed Kramer for the prozac rucous of that era...Do you remember that stuff and all those jokes???
>
> i was one of those miracle prozac patients. have moderately severe to very severe mdd, recurrent. i did most definitely feel better than well.
>
> it did burn me up that ppl w/out depression were demanding prozac. also the prozac jokes. however, i never blamed peter kramer. he was, unfortunately, used as a too convenient scapegoat for the entire bruh haha.
>
> remember prozac was the first of the newer gen. ads when it came out in 1986. this WAS a big deal. as an aside, i still believe the tcas to be more effective - for me - than ANY of the newer ads....or combos.
Posted by pulse on August 14, 2006, at 12:28:13
In reply to Scrupulosity » SLS, posted by Aphrodite on August 14, 2006, at 11:35:26
now you've really got my attention re: the germans and their conviction of scrupulousness re: 'extreme' morality of right vs. wrong.
boy, am i ever locked into that!
this is wild because i just asked my therapist how she felt about the notion of - i'll call it - a more, to much more, 'fluid' type of morality.
i asked because it has become more than obvious to me that my moral views exert an enormous amount of stress on me. btw, i'm quite liberal and anything but a fascist; i'm a realist who used to be an idealist. i so wish i could get back to the idealist, but i believe i'm simply too damaged by life events, NOT of my own making, for that to be possible.
i feel my moral pressures to be quite damaging, yet it's such a catch 22, because 'to thine own self be true' has literally saved my life. i can't see a way to reconcile the two.
pulse
Posted by pulse on August 14, 2006, at 12:29:47
In reply to Re: Is Kramer right? » pulse, posted by laima on August 14, 2006, at 11:51:24
sorry, my bad. i see that better understanding now.
pulse
Posted by laima on August 14, 2006, at 13:15:51
In reply to Re: Is Kramer right? » laima, posted by pulse on August 14, 2006, at 12:29:47
> sorry, my bad. i see that better understanding now.
>
> pulseNo problem- the whole thread got pretty confusing for awhile, and did a lot of evolving.
Posted by linkadge on August 14, 2006, at 17:34:08
In reply to Re: Optimistic part » linkadge, posted by cecilia on August 13, 2006, at 20:51:30
I guess you are right. I suppose if some moron is able to find some reason they think a person is responsable for their own cancer, they feel less anxious about getting it themselves.
Its a self serving bias to assume that the rules are different for onelself.
Linkadge
Posted by linkadge on August 14, 2006, at 17:36:58
In reply to Re: Optimistic part » linkadge, posted by laima on August 14, 2006, at 0:01:51
>You'd be surprised- it's happened to a friend >of mine who is battleing brain tumours. It's >happened to her a lot- people directly and >indirectly accusing her of unhealthy living and >such.
Wow, thats intense. I didn't think such people existed.
Linkadge
Posted by linkadge on August 14, 2006, at 17:58:13
In reply to Re: Is Kramer right?, posted by SLS on August 14, 2006, at 8:00:50
>Still, this is probably a matter of a >diminished rate of repair rather than its >complete absence as has been demonstrated by >the recovery of brain tissue seen with lithium >and antidepressant use.
If you inject BDNF direclty into the hippocampus of an animal, it acts virtually the same as an antidepressant does. Ie certain growth factors have direct antidepressant effect.
Some of the ideas about how antidepressants work has been speculation though. Yes they may increase neurogenesis, but the idea that they increase BDNF has not been consistenly shown, nor has it been directly shown that antidepressants actually make a depressed brain look more normal. In terms of antidepressants, tianeptine shows superior ability to protect against the consequences of unavoidable stress.
One study compared tianeptine to fluoxetine and concluded that while tianeptine provided neuroprotection against cortisol, fluoxetine provided no such effect.
I think there has been a lot of jumping on bandwagons, and assumptions. Some of these theories have been based on research, and other has just been filling in the blanks (assuptions).
I still think its too early to say that antidepressants actually do "reverse" the damamge caused by depression. They may grow new brain cells, but like manjii said, this is only part of the picture.
Linkadge
Posted by linkadge on August 14, 2006, at 18:01:02
In reply to Re: Is Kramer right? » Dinah, posted by SLS on August 14, 2006, at 10:49:27
>What does he claim is causing the damage to >begin with? Is this damage a product of normal >everyday living or is it abnormal and part of >the disease process?
I think his speculation is that two people could be subjected to the same stressfull event. One person may recover more poorly than the other. This single event may not be sufficiant to produce a depressive episode, but as the events accumulate, one person may become increasingly susceptable to even minor stressors.
Linkadge
Posted by linkadge on August 14, 2006, at 18:03:57
In reply to Scrupulosity » SLS, posted by Aphrodite on August 14, 2006, at 11:35:26
"he states that they've conducted studies that show people with in-born, clear rules of ethics and what is right and wrong are much more likely to develop depression."
Thats because you need a degree of "I just dont give a sh*t" to survive this world.
Linkadge
Posted by laima on August 14, 2006, at 18:04:54
In reply to Re: Optimistic part » laima, posted by linkadge on August 14, 2006, at 17:36:58
Yes, when she first got the tumour, people were sympathetic. Then she had surgery to have it removed, but it grew back. This happened several times now. Besides chemo, she was put on some nasty hormones, which made her look haggard. And next thing you know, numerous people who she thought were her friends were lecturing her about how she looks bad and should be taking better care of herself, no wonder the tumour was coming back, and so on. Mercy if she ever wanted to have a single beer or something (it was ok per her doctor)...people would react like she was chain-smoking crack.
I think you have a good observation- if people blame others for their illnesses, they get to somehow distance themselves or reassure themselves that it could never happen to them. Maybe they even get to excuse themselves from staying compassionate through a long-term difficult situation.
> >You'd be surprised- it's happened to a friend >of mine who is battleing brain tumours. It's >happened to her a lot- people directly and >indirectly accusing her of unhealthy living and >such.
>
> Wow, thats intense. I didn't think such people existed.
>
> Linkadge
>
Posted by linkadge on August 14, 2006, at 18:07:55
In reply to Re: Optimistic part » laima, posted by linkadge on August 14, 2006, at 17:36:58
I don't understand "better than well". When such an occurance happens how can one not stop and ask....is this safe??
I mean, illegal drugs make you feel better than well too.
I think it is evident (for many people who wanted on the "feeling better than well" bandwagon) that even this does not come without conseqence.
Do you know of anybody (who isn't bipolar) who still feels better than well after 20 years of taking the drug ?
Linkadge
Posted by linkadge on August 14, 2006, at 18:10:04
In reply to Re: Optimistic part, posted by linkadge on August 14, 2006, at 18:07:55
>Do you know of anybody (who isn't bipolar) who still feels better than well after 20 years of taking the drug ?
Because to be honest, I hear a lot of...at first the drug made me feel great, now all I want to do is sleep and shovel those little tiny white powdered donuts all day long.
p.s. I know I'm making no sence, but clearly I have many opinions about these drugs.
Linkadge
Posted by Phillipa on August 14, 2006, at 19:11:24
In reply to Re: Is Kramer right? » SLS, posted by linkadge on August 14, 2006, at 18:01:02
That's what happened to me. Love Phillipa
Posted by Phillipa on August 14, 2006, at 19:14:34
In reply to Re: Optimistic part » linkadge, posted by laima on August 14, 2006, at 18:04:54
Another reason doctors become doctors or nurses nurses to keep the bad illnesses away from them.Love Phillipa, ps it doesn't work
Posted by laima on August 14, 2006, at 20:30:38
In reply to Re: Optimistic part, posted by linkadge on August 14, 2006, at 18:07:55
"Better than well"-- a problem, for sure. I think Kramer or one of his critics came up with that phrase when they were so optimistic about the wonders of prozac that even non-depressed people wanted to take it- to feel "better than well". There were stories about perfectly well people asking their doctors for it in order to enhance their lives. It was obviously a controversial notion even then-and was the inspiration for tons of jokes. And remember, the drug was so new that the longer-term side effects and poop-out we know about now weren't known about then. And I personally don't know anyone who lasted 20 years doing well on prozac, either! Funny, it's reminiscent of the days when they thought cocaine was a wonder tonic...
> I don't understand "better than well". When such an occurance happens how can one not stop and ask....is this safe??
>
> I mean, illegal drugs make you feel better than well too.
>
> I think it is evident (for many people who wanted on the "feeling better than well" bandwagon) that even this does not come without conseqence.
>
> Do you know of anybody (who isn't bipolar) who still feels better than well after 20 years of taking the drug ?
>
>
> Linkadge
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