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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 64. This is the beginning of the thread.
Posted by deniseuk190466 on June 4, 2007, at 8:51:52
This is not my belief but the belief of author Dorothy Rowe who has written a lot of books on fear and depression. She also says that it's not chemical but it is biological which seems to be a bit of a contradiction in terms.
She also says that the Royal College of Psychiatrists are dropping any references to depression being a chemical problem.
So it seems that so called experts nowadays are veering towards depression being psychological (and in ones own control) than it is biological. Try telling that to the millions who have been helped and continue to take antidepressants.
I find this trend worrying. There seems to be a sudden trend towards thinking that CBT and other therapies are the way to go. Maybe because I'm so hellbent on finding a treatment that works. I'm prepared to be open minded about CBT but I go by my own past experiences, in the past medication worked for me and not therapy.
Denise
Posted by Squiggles on June 4, 2007, at 9:33:27
In reply to Depression is not a chemical inbalance, posted by deniseuk190466 on June 4, 2007, at 8:51:52
I just recently found a paper that proposes
a new model for explaining affective disorders:
focusing on blood flow and neural network communication (reminiscent of one of the old vascular theory that Kraepelin's colleagues wrote about). The language does appear to elimininate the "chemical imbalance" theory of mental illness, but i think that a physiological explanation is not necessarily exclusive of a chemical one. [a paper by David King]As for talk therapy, i think it would be very useful if it were done in conjunction with your doctor's participation, and not as something distinct from your physiological state and life, as it is done now.
Squiggles
Posted by Squiggles on June 4, 2007, at 9:43:48
In reply to Re: Depression is not a chemical inbalance, posted by Squiggles on June 4, 2007, at 9:33:27
http://www.nature.com/nrn/journal/v6/n3/full/nrn1629.html
this is the article-- I apologize that I got the author wrong; i was remembering another article i read just before it;
Nature Reviews Neuroscience 6, 241-246 (March 2005) | doi:10.1038/nrn1629
Opinion: Is mood chemistry?Eero Castrén1 About the author
-----------
Squiggles
Posted by Phillipa on June 4, 2007, at 10:04:22
In reply to Re: Depression is not a chemical inbalance/NATURE » Squiggles, posted by Squiggles on June 4, 2007, at 9:43:48
I don't know if CBT works just startig it but so far ad's don't work for me. I am paralyzed with fear and mine was anxiety based maybe for some? I don't know Love Phillipa
Posted by linkadge on June 4, 2007, at 10:17:55
In reply to Re: Depression is not a chemical inbalance/NATURE, posted by Phillipa on June 4, 2007, at 10:04:22
Just because a drug makes you feel better does not mean you are chemically imballenced.
Illegal drugs make anybody feel better, but they may not have had a chemical imballence to begin with.
Linkadge
Posted by Squiggles on June 4, 2007, at 10:19:00
In reply to Re: Depression is not a chemical inbalance/NATURE, posted by Phillipa on June 4, 2007, at 10:04:22
> I don't know if CBT works just startig it but so far ad's don't work for me. I am paralyzed with fear and mine was anxiety based maybe for some? I don't know Love Phillipa
Many people are afraid of psych meds; i am, lol.
But there are alternatives like herbal substitutes--maybe you could try that, along with CBT.Squiggles
Posted by FredPotter on June 4, 2007, at 18:38:59
In reply to Re: Depression is not a chemical inbalance/NATURE, posted by Squiggles on June 4, 2007, at 10:19:00
I believe that the only herbal products that do anything at all are illegal
Posted by LlurpsieNoodle on June 4, 2007, at 20:55:43
In reply to Re: Depression is not a chemical inbalance/NATURE » Squiggles, posted by FredPotter on June 4, 2007, at 18:38:59
I'd just like to thrown in a couple pennies to this discussion.
By reframing depression (and other affective disorders) as psychological problems/struggles/imbalances whatever-- This does not imply that they are under one's control.
Many psychological processes are NOT under one's conscious control. perception of sounds, vision, understanding speech, fluency of reading... etc.
Furthermore, there is ample evidence that there are profound changes in brain morphology as a result of affective disorders. Things like smaller hippocampi in those with chronic anxiety disorders like PTSD, under and overactivity in the right and left prefrontal cortex for depression. Changes in the ratio of white matter to grey matter.
The brain is a plastic organ. Once certain patterns of thought are practiced over and over again (like the pattern of thinking about one's worthlessness, or the pattern of not considering the beauty in ones immediate surroundings) the synapses and neurons supporting those thoughts and associations will become stronger.
The mechanisms by which the brain feels natural joy may atrophy or be short-circuited in depression.
The good news is that life experiences have the potential to change the activity in one's brain, the way that our brain activates in response to stimuli, and the way that we process information.
Such experiences may include therapy, or exercise, or meditation, or getting out of a bad relationship, or changing professions to something more satisfying.
I don't think that CBT is right for everyone. I know that when I'm really depressed, the last thing I want or need is challenging homework that I dread and dread and dread.
But the kind of therapy that I received when I was really depressed, (also in subsequent episodes) was supportive therapy that helped me realize that bad thoughts would not kill me. That no hope today doesn't necessarily mean that there will never be anything worth living for. What helped me in therapy was someone who listened and told me that I was only human for having feelings like this. Someone that I could talk about my daily stresses with and who wouldn't judge me harshly (as I do myself).
So here's a little monist logic
Therapy can help many people change the way they think about themselves
Therapy can help many people find relief from their current sufferings
Therapy can change the way we think and feel.
All behavior is a result of the functioning of the body (brain included).
The human mind is a product of very complicated biology, 99% of which is still not understood.
There are certain ways in which human minds work (psychology)
There are certain patterns in the brain (neurobiology) such as messenger systems, networks, metabolism, neurotransmitters, electical signals, different layers of tissue)
The mind (and it's disorders) cannot be reduced to only one element of neurobiology (i.e. neurotransmitters)
Relatedly: Because therapy changes thinking (the mind) therapy *must* be affecting the biology of the system. Ideally, therapy can lead to lasting changes in the biology of the brain.
fluctuations in the concentrations of neurotransmitters can also lead to changes in the brain, changes that can be measured in vitro, and for many people changes that can be measured in vivo.
I think that's enough of a monologue. Sorry for getting so excited. neuroscience is so sexy. if only it didn't involve so many rats and cell preparations...
-Ll
Posted by Phillipa on June 4, 2007, at 21:08:59
In reply to Re: Depression is not a chemical inbalance/NATURE, posted by Squiggles on June 4, 2007, at 10:19:00
Squiggles what are the herbal supplements? I'm going to e-mail you . I hope that okay Love Phillpa
Posted by Squiggles on June 4, 2007, at 21:10:39
In reply to And not all psychol. probs are under one's control, posted by LlurpsieNoodle on June 4, 2007, at 20:55:43
Party-pooper :-):"We shall go on to the end, we shall fight in France, we shall fight on the seas and oceans, we shall fight with growing confidence and growing strength in the air, we shall defend our Island, whatever the cost may be, we shall fight on the beaches, we shall fight on the landing grounds, we shall fight in the fields and in the streets, we shall fight in the hills; we shall never surrender, and even if, which I do not for a moment believe, this Island or a large part of it were subjugated and starving, then our Empire beyond the seas, armed and guarded by the British Fleet, would carry on the struggle, until, in God's good time, the New World, with all its power and might, steps forth to the rescue and the liberation of the old."
Posted by Quilter on June 4, 2007, at 22:04:18
In reply to And not all psychol. probs are under one's control, posted by LlurpsieNoodle on June 4, 2007, at 20:55:43
An excellent post, Dr. Noodle!
Quilter
Posted by Iansf on June 4, 2007, at 23:07:46
In reply to Depression is not a chemical inbalance, posted by deniseuk190466 on June 4, 2007, at 8:51:52
I think researchers, theorists, psychiatrists et al should focus simply on what works, whether it works for everyone or just a few, and leave it at that. But so many of them insist on maintaining their view is right and all others are wrong. If cognitive therapy works for some people, fine. If medication works for some people, fine. If religion works for some people, fine. Because one approach sometimes works, that doesn't mean all other approaches are wrong. Maybe the etiology of mood disorders varies from one person to another. Maybe it is a chemical imbalance in Jim but totally psychological in Jane and a neurologic mixup in Jasper. Maybe psychotherapy is the most effective treatment for Sarah, while meds work best for Sam and electroconvulsive therapy works best for Stella. It would be nice to have one best approach for everybody, but I don't see evidence that any single approach works for everyone.
Posted by elanor roosevelt on June 5, 2007, at 0:25:58
In reply to Depression is not a chemical inbalance, posted by deniseuk190466 on June 4, 2007, at 8:51:52
No, In the US there is a slowly growing understanding that it is brain chemistry, not lack of fortitude and character, that plays a very central role in chronic depression.
Posted by Squiggles on June 5, 2007, at 0:30:50
In reply to Depression is unfortunate brain chemistry, posted by elanor roosevelt on June 5, 2007, at 0:25:58
> No, In the US there is a slowly growing understanding that it is brain chemistry, not lack of fortitude and character, that plays a very central role in chronic depression.
I agree with you, but I understand that
everyone has the right to believe what
they choose. That's American too. :-)
Posted by Squiggles on June 5, 2007, at 9:42:23
In reply to And not all psychol. probs are under one's control, posted by LlurpsieNoodle on June 4, 2007, at 20:55:43
> I'd just like to thrown in a couple pennies to this discussion.
>
> By reframing depression (and other affective disorders) as psychological problems/struggles/imbalances whatever-- This does not imply that they are under one's control.
>
> Many psychological processes are NOT under one's conscious control. perception of sounds, vision, understanding speech, fluency of reading... etc.
>
> Furthermore, there is ample evidence that there are profound changes in brain morphology as a result of affective disorders. Things like smaller hippocampi in those with chronic anxiety disorders like PTSD, under and overactivity in the right and left prefrontal cortex for depression. Changes in the ratio of white matter to grey matter.
>
> The brain is a plastic organ. Once certain patterns of thought are practiced over and over again (like the pattern of thinking about one's worthlessness, or the pattern of not considering the beauty in ones immediate surroundings) the synapses and neurons supporting those thoughts and associations will become stronger.
>
> The mechanisms by which the brain feels natural joy may atrophy or be short-circuited in depression.
>
> The good news is that life experiences have the potential to change the activity in one's brain, the way that our brain activates in response to stimuli, and the way that we process information.
>
> Such experiences may include therapy, or exercise, or meditation, or getting out of a bad relationship, or changing professions to something more satisfying.
>
> I don't think that CBT is right for everyone. I know that when I'm really depressed, the last thing I want or need is challenging homework that I dread and dread and dread.
>
> But the kind of therapy that I received when I was really depressed, (also in subsequent episodes) was supportive therapy that helped me realize that bad thoughts would not kill me. That no hope today doesn't necessarily mean that there will never be anything worth living for. What helped me in therapy was someone who listened and told me that I was only human for having feelings like this. Someone that I could talk about my daily stresses with and who wouldn't judge me harshly (as I do myself).
>
> So here's a little monist logic
>
> Therapy can help many people change the way they think about themselves
>
> Therapy can help many people find relief from their current sufferings
>
> Therapy can change the way we think and feel.
>
> All behavior is a result of the functioning of the body (brain included).
>
> The human mind is a product of very complicated biology, 99% of which is still not understood.
>
> There are certain ways in which human minds work (psychology)
>
> There are certain patterns in the brain (neurobiology) such as messenger systems, networks, metabolism, neurotransmitters, electical signals, different layers of tissue)
>
> The mind (and it's disorders) cannot be reduced to only one element of neurobiology (i.e. neurotransmitters)
>
> Relatedly: Because therapy changes thinking (the mind) therapy *must* be affecting the biology of the system. Ideally, therapy can lead to lasting changes in the biology of the brain.
>
> fluctuations in the concentrations of neurotransmitters can also lead to changes in the brain, changes that can be measured in vitro, and for many people changes that can be measured in vivo.
>
> I think that's enough of a monologue. Sorry for getting so excited. neuroscience is so sexy. if only it didn't involve so many rats and cell preparations...
>
> -Ll----------------------------------
Actually, i agree with a lot of what you say.
But when the depression or psychosis is endogenous, even if only transient rather than genetic (as for example in soldiers returning from the atrocities of war), medication is mandatory. The therapy helps the person through, but alone will not reverse any biological changes in the brain-- whether they are from life tragedies or brain disease. And remember many brain diseases presenting with depression are not of the "neurological type". There are brain tumours, metabolic disorders, infections, hypoxic conditions, etc.So, i would say that the entire medical picture should be taken into consideration and kindness, and compassion are always necessary in suffering. Also, when all conditions in someone's life are going OK and all of a sudden she has a stroke and then depression, you can see that this is an example of a reactive brain state.
So, I agree with you, but I would not exclude drugs. Infact, drugs are helpful, no matter what the condition in comparison to therapy. A kind word, a sympathetic ear, an understanding of the situation, can all be provided by a good doctor. It does not require specialized therapy treatment.
Squiggles
Posted by deniseuk190466 on June 5, 2007, at 11:30:27
In reply to Re: Depression is not a chemical inbalance/NATURE, posted by linkadge on June 4, 2007, at 10:17:55
Hi Linkadge,
Yes I agree with what you are saying but there is definately something physically wrong somewhere with the brain of some depressed people, especially those who depression is non-reactive. I don't believe that it has to be a case of there being some deep rooted psychological reason. Or maybe I just choose not to.
Would you suggest that everybody who is on medication for depression/anxiety come off it and try to sort themselves out with therapy alone?
Denise
Posted by deniseuk190466 on June 5, 2007, at 11:56:59
In reply to Re: Depression is not a chemical inbalance, posted by Iansf on June 4, 2007, at 23:07:46
I agree but it is when meds, therapy don't work properly that the patient is left with this nagging self doubt and is made to feel worse when certain so called experts are so emphatic in their views.
I recently attended a day care centre where they seemed to hold the view that anyone who wasn't bipolar or Schitzophrenic but just depressed and anxious wasn't suffering from a legitimate illness that should be treated with medication.
The Professor who ran the day care centre told one lady with depression/anxiety that she was on far too much medication (she was on a tricyclic, a small amount of Lorazepam and a small amount of Zyprexa) and that most of his colleagues would not treat her because she was on too much. I don't think that made her feel too good. He also told her that she needed to go out and find a job (what she told me anyway. Now this lady had been quite happy as a housewife for many years, it was only when she came off meds and had a relapse and tried to go on them again but they didn't work as well that she ended up having to go to this Day Care Centre. My question is "why should this lady have to suddenly make dramatic life changes in order to try and fight this depression/anxiety when there are lots of happy housewifes out there who don't have to suddenly change their lives.
For myself, I don't want to have to cope with my depression or cope with my anxiety, I just don't want it full stop and I will continue to search for medical treatments. I am doing therapy as well but if that doesn't work then I don't want to feel that in some way I was at fault for it not working or that I wasn't trying hard enough.
Denise
Posted by deniseuk190466 on June 5, 2007, at 11:59:40
In reply to Depression is unfortunate brain chemistry, posted by elanor roosevelt on June 5, 2007, at 0:25:58
Hi Elanor,
A friend of mine heard was listening to a radio program which seemed to suggest that in the States there is now a trend to get as many people off antidepressants as possible and give them CBT instead.
Maybe she got it wrong though.
Denise
Posted by Meri-Tuuli on June 5, 2007, at 12:41:05
In reply to To Linkadge, posted by deniseuk190466 on June 5, 2007, at 11:30:27
Hiya
But what I think Dr Noodle is trying to say (well maybe not) is that okay, having, say, bad life experiences or even bad thoughts, can 're-wire' your brain and therefore the chemicals in it which is then clearly a physical change. So, literally, what you think/feel/experience in consious/unconsious can change your hard wiring for the better or worse.
And I think that in the US there is a MASSIVE trend for popping pills for depression - just look at what some of the combos that some posters here from America are on. There's no way in hell that British pdocs would prescribe those kinds of combos - in fact you neatly illustrated it in your post about the lady at the day centre.
So.
But I believe we should all try and make ourselves better!
Posted by linkadge on June 5, 2007, at 14:55:30
In reply to And not all psychol. probs are under one's control, posted by LlurpsieNoodle on June 4, 2007, at 20:55:43
Thats exactly the problem. Neuroscience is so sexy cause it is, in may ways, a product of the imagination.
The idea that you can be whatever you want with the help of a pill can be very distructive.
Seeing as we are far away from this reality, we can really only poke around in ways too crude for much good.
Just the fact that oftentimes withdrawl can make us feel worse than when we started a med is proof that the brain is trying to counteract these pills.
IMHO, we are not getting to the root of any problem, we are just pumping the brain full of mental steroids that can provide a relatively short term boost to get over problems.
People are so fascenated by effect. Just because coffee makes you feel better doesn't mean you have a coffee deficiancy.
Pleasure works in gradients.
Linkadge
Posted by Squiggles on June 5, 2007, at 15:06:15
In reply to Re: And not all psychol. probs are under one's control, posted by linkadge on June 5, 2007, at 14:55:30
We are not in control of our biological
disabilities, just because we are conscious.There seems to be no problem in understanding
this if you have a concussion, but if it's depression it seems to be removed from the realm of the mind-body interaction.Is this a problem with a belief in an insubstantial soul as a distinct entity from the body perhaps? Is this where we part ways?
Squiggles
Posted by linkadge on June 5, 2007, at 15:16:06
In reply to Re: Depression is unfortunate brain chemistry, posted by Squiggles on June 5, 2007, at 0:30:50
I think it is human tendancy to want to blame ones problems on something other than what is within ones controll.
To play the devils advocate, fat people like to believe that their genes control their weight more than their will power.
While there are truths to both sides of the argument, I don't see that anybody's depressive mood is completely out of ones own controll.
Whenever you pop a pill, you fail to learn possable coping strategies that may end up helping you more effectively and more thoroughly in the long run.
I am case and point.
I got depressed, I popped pills, I felt better. But, History not learned from is bound to be repeated. Did popping zoloft help me learn to do math better. Did popping zoloft get me a job? Did popping the latest SSRI make me new friends, improve my looks, make me more popular, make me younger, fix health problems, make me straight, remove unsightly body hair, fix relationships with my parents??
Just because you take a chemical filter, and develop a temporary selective amnesia to lifes difficulties doesn't mean the future is guarenteed to be rosey.
Thats why most of these drugs don't work is because they just desensitize you to everything.
They work by making you a zombie, and desensizing you to everything.Sure the latest drug may give you a little more energy, may take the edge off, but then the next time a problem comes around you have one less coping stratety, and you become like me.
Drugs start a paradigm shift from hell. Why am I now on this board? Because every problem I have I think of solving in terms of a pill. Instead of waking up and tacking my problems head on, I run to the doctor and ask for the next power pill that will do everything for me.
I don't believe that anyones problems are purely biological. Petting a dog can will cause a detectable rise in serotonin livels. Experience affects chemistry just as much as chemistry affects experience.
Even people with diseases such as epilepsy (whos origins are almost never attribted to character flaw) can do things to influence the frequency of seizures.
Linkadge
Posted by linkadge on June 5, 2007, at 15:24:37
In reply to To Linkadge, posted by deniseuk190466 on June 5, 2007, at 11:30:27
I am not saying that depression is always due to a underlying psychological cause, I am just saying that some people use this "biochemical argument" to become lazy in other aspects of ones walk to better mental health.
Just like my dad. He pops his cholesterol pills saying that his high cholesterol is purely genetic, while he guzzles them down with a T-Bone steak with sour cream.
I know it is possable to be this way cause I am this way too.
I know that some things definately help my depression such as exercise, eating better, going to church (social events), talking with family, spending time to try an relax, etc etc. But wouldn't it be nice if I could continue to be a workaholic, eat whatever I wanted, be more antisocial, lie on the couch, and have prozac pull me out?
Clearly, even some of the best doctors and psychiatrists know that meds are only just one tool.
Why do you think there are multiple sections of this website? (Ie social, alternative, etc)
Linkadge
Posted by Squiggles on June 5, 2007, at 15:25:48
In reply to Re: Depression is unfortunate brain chemistry » Squiggles, posted by linkadge on June 5, 2007, at 15:16:06
Well, this is what Pastor Benny might think too.
http://www.ratbags.com/rsoles/index.html
But I'm afraid we have very diverse views on what
causes mental illness.Good luck.
Squiggles
Posted by linkadge on June 5, 2007, at 15:41:59
In reply to Re: And not all psychol. probs are under one's con » linkadge, posted by Squiggles on June 5, 2007, at 15:06:15
I would say that the number one cause of depression in the world today is stress.
Anything that can help reduce stress will probably have a strongly favorable impact on the outcomes of many depressive disorders.
For instance, exercise is for many people, an effective antidepressant. Exercise performs comparably, or outperforms drugs in many studies.
Exercise counteracts the negative effects of stress on brain placiticiy and repair, it can improve wellbeing more effectivly (for many) than drugs can.
>We are not in control of our biological
>disabilities, just because we are conscious.We do have control (perhaps not full control) over our mental state.
If you notice, the majortiy of research into depressive illnesses at present, are with regards to overcoming the negative effects of stress on brain placticiy and repair. Anything that can counteract the negative effects of stress are likely help depression.
We need to love more, care more, and do more things to help ourselves and eachother recover.
Just the fact that the placebo performs (more often than not) better than active drugs, tells us that most of us do have it in ourselves to recover (at least at a level on par with the latest wonderdrug)
>There seems to be no problem in understanding
>this if you have a concussion, but if it's >depression it seems to be removed from the realm >of the mind-body interaction.I am not saying that a concussion is not biological. I am also not saying depression is not biological.
I *am* saying that when it comes to depression at present, the brain is statistically just as capable of healing itself than the latest wonderdrugs are.
Linkadge
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