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Dr. Bob is Robert Hsiung, MD,
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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
Posted by linkadge on June 5, 2007, at 15:42:36
In reply to Re: And not all psychol. probs are under one's con » Squiggles, posted by linkadge on June 5, 2007, at 15:41:59
Posted by LlurpsieNoodle on June 5, 2007, at 18:42:19
In reply to Re: To Linkadge » deniseuk190466, posted by Meri-Tuuli on June 5, 2007, at 12:41:05
> 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.
>Thanks- I think you said it much better than Dr. Noodle herself :)
I only add that there is empirical research that therapy (and meditation, etc) can change brain functioning. Just because a treatment works on the psychological level does not preclude it from causing lasting physiological changes as well.
-Ll
Posted by Squiggles on June 5, 2007, at 18:48:46
In reply to Re: To Linkadge + Meri-T » Meri-Tuuli, posted by LlurpsieNoodle on June 5, 2007, at 18:42:19
But to make an impression on the brain
it would have to be long-term and constant.
This is how children learn behaviour and
language, etc. When they are adults and
get therapy, it is rarely more than 1 hr
per month or so.Also, note how learning becomes more difficult
as people age. The cut-off age for effortlessly
picking up a language is about 12 yrs. of age.
This is biologically predetermined stuff.But as a palliative comfort i understand that
therapy can be helpful to go through rough times.Squiggles
Posted by LlurpsieNoodle on June 5, 2007, at 19:03:56
In reply to Re: Depression is unfortunate brain chemistry » Squiggles, posted by linkadge on June 5, 2007, at 15:16:06
> 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.
-maybe we define control differently. I think that in order to gain control over some problem, one first has to recognize it as a problem, or a source of suffering. Then one has to figure out what the options are for relieving the source of suffering. Then one has to take steps to access resources. Finally, one has to have some level of trust in the treatment, or else the body will use some of it's powerful placebo effects to convince itself that the treatment is ineffective.
>
> 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.OR- popping a pill may help you get out of bed to get your work done, to pay for groceries (with healing blueberries!) and get to therapy on time.
For some people- myself, at times- medication has helped me not kill myself. At other times, medication has helped me deal with the more psychotic elements of intense PTSD flashbacks, dissociation, depersonalization.
I guess I don't necessarily view popping pills as an either/or scenario. It can be a supplement, a boost to changing one's thinking, behavior and lifestyle.
Of course you're right that a menu of pills does not allow one to choose a different personality or change one's maladaptive reactions to difficult situations... In my opinion THAT's the real challenge I face everyday.
> 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??Well... I don't know about your looks :) but maybe popping a pill would give you a little more oomph to coordinate your clothing, do your hair, and act more kindly towards yourself and others. That kind of stuff can help your relationships. If you suffered from terrible anxiety and withdrawal, a pill could help you escape from your house more often (if only to seek further treatment!)
>
> 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.I guess my pdoc never medicated me enough to turn me into a zombie, so I don't really know what this would be like. (my therapist and husband never thought I was a desensitized zombie either, in case you were wondering if I had selective amnesia!)
> 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.
Link, I'm so sorry that you've had that experience. I know that what you speak of is true for you, and I don't wish to invalidate your experience by talking about my own. I hope you stay on this board, to provide your views and opinions, which are very much worth considering.
> 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.
>
:) That smile made me feel happier too. no pill popping involved!> 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.
And recovery from stroke is more likely with occupational and physical therapy...
>
> Linkadge
>-Ll
Posted by LlurpsieNoodle on June 5, 2007, at 19:10:21
In reply to Re: To Linkadge + Meri-T, posted by Squiggles on June 5, 2007, at 18:48:46
I'm an advocate of psychotherapy (yeah, it only took me 6 months to realize it, but here I am)
> But to make an impression on the brain
> it would have to be long-term and constant.
> This is how children learn behaviour and
> language, etc. When they are adults and
> get therapy, it is rarely more than 1 hr
> per month or so.I'm lucky because I am able to get 2 hrs of psychotherapy a week, and I have phone access in case of crisis. It's slow going for sure, though. Old habits die hard.
> Also, note how learning becomes more difficult
> as people age. The cut-off age for effortlessly
> picking up a language is about 12 yrs. of age.
> This is biologically predetermined stuff.Some kinds of learning are available to even old folks like me :) It might even take an adult brain in order to really assess one's strengths and weaknesses and solve psychological problems effectively... perhaps...
>
> But as a palliative comfort i understand that
> therapy can be helpful to go through rough times.you bet!
>
> Squiggles-Ll
Posted by Iansf on June 5, 2007, at 19:18:21
In reply to Re: Depression is unfortunate brain chemistry » Squiggles, posted by linkadge on June 5, 2007, at 15:16:06
> 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.
>I've taken numerous antidepressants. None of them made me a zombie or desensitized me, at least not in a negative way. I was less sensitive to criticism, but I did not lose my ability to empathize with others or feel moved by events. Your characterization of how these drugs work grossly misrepresents many people's experiences. The ADs you've taken may have had that effect on you, but they definitely don't have that effect on everyone. Your argument in this regard is highly flawed.
Posted by linkadge on June 6, 2007, at 6:39:26
In reply to Re: Depression is unfortunate brain chemistry » linkadge, posted by Iansf on June 5, 2007, at 19:18:21
>I've taken numerous antidepressants. None of >them made me a zombie or desensitized me, at >least not in a negative way. I was less >sensitive to criticism, but I did not lose my >ability to empathize with others or feel moved >by events. Your characterization of how these >drugs work grossly misrepresents many people's >experiences. The ADs you've taken may have had >that effect on you, but they definitely don't >have that effect on everyone. Your argument in >this regard is highly flawed.
If it were only my individual case then I'd be inclined to believe you. Unfortunately the emotional desensitization that often occurs with SSRI's or SNRI's is quite widespread. Even so much that prominant authors such as Healy have felt compelled to coment.One logical fallacy people often fall into is that if I got better while taking the drug, then the drug must be responsable.
Its the same kind of logical fallacy that draws people to continue using rabits feet, q-ray bracelets, etc, etc.
Linkadge
Posted by Squiggles on June 6, 2007, at 8:07:29
In reply to Re: Depression is unfortunate brain chemistry, posted by linkadge on June 6, 2007, at 6:39:26
The emotional desensitization is part of
the treatment- a bad side effect. It is
unfortunate that we don't have better drugs
(though some are better than others).However, have you taken into consideration the
*sensitization* that untreated depression and
manic-depression and schizophrenic psychosis brings? I would say it is far worse, for the person undergoing these conditions and for those near him.Don't you think that the best possible drug is a better alternative than no drug at all?
Squiggles
Posted by linkadge on June 6, 2007, at 14:31:23
In reply to Re: Depression is unfortunate brain chemistry, posted by Squiggles on June 6, 2007, at 8:07:29
>However, have you taken into consideration the
>*sensitization* that untreated depression and
>manic-depression and schizophrenic psychosis >brings? I would say it is far worse, for the >person undergoing these conditions and for those >near him.But a great deal of the type of depression I have seen involves severe anhedonia where people feel inable to experience emotion drive or pleasure. Sometimes the SSRI's just make these things worse.
Perhaps they are effective at making the patient complain less.>Don't you think that the best possible drug is a >better alternative than no drug at all?
Perhaps for some. I tend to think that treatment is better than no treatment. I think a pill is better than no pill, but not necessarily that drug is better than no drug.
Just my 2 cents
Linkadge
Posted by Jedi on June 6, 2007, at 20:12:58
In reply to Re: Depression is unfortunate brain chemistry, posted by linkadge on June 6, 2007, at 14:31:23
...
> Perhaps for some. I tend to think that treatment is better than no treatment. I think a pill is better than no pill, but not necessarily that drug is better than no drug.
...
For me, at my worst, the medication is way better than none. My disease is treatment resistant, chronic, atypical, double depression with anxiety. When you can't get out of bed or off the floor, it is pretty hard to make progress. SSRIs and SNRIs only added to the amotivation. And any kind of talk therapy doesn't have a chance if you can't crawl to the session. At several points, if not for my kid and MAOIs, I would not be among you.
Just me,
Jedi
Posted by deniseuk190466 on June 7, 2007, at 10:54:40
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
Hi Linkadge,
I agree with what you are saying but I don't think it is a case of people "popping pills in order to be what ever they want to be".
When I first ever started taking antidepressants at the age of 24, I'd never even heard of them, didn't know or think I was depressed. I just wanted relief from being tired all the time, feeling suffocated, waking up early dreading the day ahead. I was feeling like this inspite, of working, swimming like a mad woman, doing constant breathing exercises, meditating. Then the Doctor prescibed a pill which took all those symptoms away and lifted my mood (I wasn't expecting my mood to lift at all) and I couldn't quite believe it when it did.
I never took antidepressants to be what ever I wanted, I took them to relieve a lot of distressing symptoms and they did completely. When I came off them I never felt as bad as I had done before going on them so far as I am concerned when ADs work well they do heal your brain in some way, maybe not permanently but they do something good, well I feel anyway.
Denise
Posted by deniseuk190466 on June 7, 2007, at 11:03:03
In reply to Re: Depression is unfortunate brain chemistry » linkadge, posted by Iansf on June 5, 2007, at 19:18:21
Hi,
I have to agree totally with you totally on that one. When antidepressants truly work they make you feel more alive, more empathy, more passionate etc. They definately don't make you feel like a Zombie.
It's only when they don't work properly that you get the zombie like feelings.
Denise
Posted by Iansf on June 7, 2007, at 13:49:55
In reply to Re: Depression is unfortunate brain chemistry, posted by linkadge on June 6, 2007, at 6:39:26
> One logical fallacy people often fall into is that if I got better while taking the drug, then the drug must be responsable. Its the same kind of logical fallacy that draws people to continue using rabits feet, q-ray bracelets, etc, etc.
>
> Linkadge
>I don't see why it's a logical fallacy to equate feeling better with taking the drug if indeed you do feel better after taking the drug and feel worse when not taking it, particularly if this happens consistently. How else can you measure the effectiveness of an antidepressant except by observing your mood before and after taking it? If taking a particular med consistently coincides with lessening or elimination of depression and not taking that med does not consistently coincide with lessening or elimination of depression, then it's indeed logical to equate the taking of the med with the termination of depression.
John
Posted by linkadge on June 7, 2007, at 14:02:26
In reply to To Linkadge, posted by deniseuk190466 on June 7, 2007, at 10:54:40
All I am saying is that a lot of depression is due to the fact that life sucks, rather than vice versa.
Linkadge
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