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Dr. Bob is Robert Hsiung, MD,
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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
Posted by linkadge on June 7, 2007, at 14:08:20
In reply to Re: Depression is unfortunate brain chemistry, posted by Iansf on June 7, 2007, at 13:49:55
>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.
The best one can conclude is that the drug *may* have been responsable.
>How else can you measure the effectiveness of an >antidepressant except by observing your mood >before and after taking it?
Well, improved mood after placebo would look very much like the placebo was responsable until you find out it was placebo.
>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.Its not logical. Especially since when it comes to depression, the placebo is statistically as/more effective than an active drug! By your logic, we have proven that placebo's work, which they don't. (it is the mind that is working).
So long as the patient knows he or she going to begin taking a drug, there is no way to know the degree of placebo effect that will follow.
Linkadge
Posted by Iansf on June 8, 2007, at 1:04:12
In reply to Re: Depression is unfortunate brain chemistry, posted by linkadge on June 7, 2007, at 14:08:20
> Its not logical. Especially since when it comes to depression, the placebo is statistically as/more effective than an active drug! By your logic, we have proven that placebo's work, which they don't. (it is the mind that is working).
>
> So long as the patient knows he or she going to begin taking a drug, there is no way to know the degree of placebo effect that will follow.
>
> Linkadge
>By that line of thinking, there's no way to know if ANYTHING works for anything because it could be the placebo effect. If you do cognitive therapy and your depression goes away, how do you know it's the therapy and not the placebo effect? If you get ECT and the depression goes away, how do you know it's not the placebo effect? How do you ever know it's not the placebo effect?
But the fact is the placebo effect rarely, if ever, lasts for a long period, whereas antidepressants do. Maybe not for everyone, but for many people they do. I took Prozac, Luvox and Parnate for two to four years each, and during the periods I took them I was not depressed. How many people with long-term depression get relief from placebos for that long a time?
In addition, I took Lexapro, Celexa and Citalopram. I expected them all to work, but none did. I also tried SAMe, fish oil and various other over-the-counter supplements, and none worked. Why would the placebo effect happen with some drugs but not others?
You might as well throw science out the window if you're not willing to accept a link between cause and effect that shows up consistently and repeatedly.
John
Posted by linkadge on June 8, 2007, at 11:14:45
In reply to Re: Depression is unfortunate brain chemistry » linkadge, posted by Iansf on June 8, 2007, at 1:04:12
>By that line of thinking, there's no way to know >if ANYTHING works for anything because it could >be the placebo effect.
I'm just saying that the statistical rate of placebo response should always be presented and digested alongside the "presumed" rate of antidepressant response.
>If you do cognitive therapy and your depression >goes away, how do you know it's the therapy and >not the placebo effect? If you get ECT and the >depression goes away, how do you know it's not >the placebo effect? How do you ever know it's >not the placebo effect?
You don't.
>But the fact is the placebo effect rarely, if >ever, lasts for a long period, whereas >antidepressants do.
That is debatable.
>In addition, I took Lexapro, Celexa and >Citalopram. I expected them all to work, but >none did.The placebo effect is more than expectation.
>I also tried SAMe, fish oil and various other >over-the-counter supplements, and none worked. >Why would the placebo effect happen with some >drugs but not others?
Timing.
>You might as well throw science out the window >if you're not willing to accept a link between >cause and effect that shows up consistently and >repeatedly.
I am not throwing science out the window, cause this isn't science. Science has not proven that antidperessants work. The sum of all clinical trials fails to show this.
A flawed method of gathering data will produced flawed results. There needs to be more forms of data verification in clinical trials. Active placebos, blinded placebo crossovers, active agent challenge etc etc. Even then, this would not proove anything, it would only strengthen or weaken the case.
Linkadge
Posted by Squiggles on June 8, 2007, at 11:36:42
In reply to Re: Depression is unfortunate brain chemistry » Iansf, posted by linkadge on June 8, 2007, at 11:14:45
.... There needs to be more forms of data verification in clinical trials. Active placebos, blinded placebo crossovers, active agent challenge etc etc. Even then, this would not proove anything, it would only strengthen or weaken the case.
>
> Linkadge
>There needs to be better drugs, then you would not have to verify, reverify and unverify the placebo effect. Just as you take an aspirin when you have a common headache, and feel better, so would a "clean" AD that alleviates your mood would be accepted and taken repeatedly. Belief in the efficacy of a drug is very much dependent on its tolerable effect. Placebo effects are comparatively weak in the face of a powerful and and "feel good" drug.
>
>
>
>
Posted by Quintal on June 8, 2007, at 18:16:53
In reply to Re: Depression is unfortunate brain chemistry » linkadge, posted by Squiggles on June 8, 2007, at 11:36:42
Which brings me back to opiates. Why is the opiate deficiency theory of depression not widely upheld given their rapid and almost universal antidepressant effect? Codeine fulfils the criteria for ideal an antidepressant that you outlined there. It makes just as much sense as claiming dysregulation/deficiency in other neurotransmitter systems is the underlying cause of depression. Even the psychosomatic aches and pains that are common in depression could be held up as evidence of a hypoactive opiate system. But the mood lift after taking opiates doesn't prove that there was ever anything wrong with the opiate system to begin with, because the same person would probably also feel better after taking Esterene for example (a slow-release version of crack cocaine).
http://findarticles.com/p/articles/mi_m1200/is_n25_v136/ai_8207099/pg_3Q
Posted by Phillipa on June 8, 2007, at 19:20:54
In reply to Re: Depression is unfortunate brain chemistry » linkadge, posted by Iansf on June 8, 2007, at 1:04:12
None of them ever worked for and contrary to what some think I have been on theraputic doses many times for extended periods. Love Phillipa I have no faith in them
Posted by leo33 on June 8, 2007, at 20:25:23
In reply to Re: Depression is not a chemical inbalance, posted by Iansf on June 4, 2007, at 23:07:46
After reading the whole thread I believe noodle's post and Iansf's post describe the argument the best and most open minded. If there is anything that I have learned in the 15 plus years of dealing with this is one size does not fit all! CBT can work for some and not others. For some drugs work better than others. We are all made from different experiences and environments as well as biology, this is the reason why there is not a standard treatment that works for everyone. It is also the reason why people find treatment so ineffective when they try to follow a specific pattern for treatment, i.e. prescribe an SSRI for first line treatment for most cases.
If you live for another 30 years it will be commonplace to have our brains enhanced by nano technology just to stay competetive in the working world.
Just my two cents.
Leo
Posted by Squiggles on June 8, 2007, at 20:55:40
In reply to Re: Depression is not a chemical imbalance, posted by leo33 on June 8, 2007, at 20:25:23
I've read this analysis so many times, and
for me, rather than englightening me, just
fortifies the darkness that covers this area
of medicine.Notice, that when a gall bladder is to be removed, there is little gnashing of teeth and hand-wringing over how we are all different, and
how we cannot expect the same results for this particular patient.
Squiggles
Posted by linkadge on June 9, 2007, at 14:11:40
In reply to Re: Depression is unfortunate brain chemistry » linkadge, posted by Squiggles on June 8, 2007, at 11:36:42
>There needs to be better drugs, then you would >not have to verify, reverify and unverify the >placebo effect. Just as you take an aspirin when >you have a common headache, and feel better, so >would a "clean" AD that alleviates your mood >would be accepted and taken repeatedly. Belief >in the efficacy of a drug is very much dependent >on its tolerable effect. Placebo effects are >comparatively weak in the face of a powerful and >and "feel good" drug.
I'm sorry I don't understand.Linkadge
Posted by Squiggles on June 9, 2007, at 15:39:20
In reply to Re: Depression is unfortunate brain chemistry, posted by linkadge on June 9, 2007, at 14:11:40
> I'm sorry I don't understand.
>
> Linkadge
>
>Never mind... it's all on the wrong track.
I've made a mistake-- human error.
Posted by jerrypharmstudent on June 10, 2007, at 4:07:25
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
> 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
>
"> The idea that you can be whatever you want with the help of a pill can be very distructive. "And a group of psychiatrists denying medications do not help and that depression is a lapse in character and will (which is basically what they are saying) is VERY VERY dangerous.
How many of us have tried to educate friend, family, etc about depression NOT being "all in our heads" - fighting the stigma that we can snap out of it?
IF we all have psychological control over our depression (which i do believe we have to SOME degree) then why aren't we all better? If we just THINK we're better - POOF MAGIC! No more depression! How easy was that?
It infuriates me to think that there are doctors out there who believe depression is purely psychological and that CBT is the only way to "cure" it. Which is quite a hypocrisy - how many studies have shown CBT to be as effective as an SSRI? Quite a lot actually which would point to the "chemical imbalance" theory. If we change our thinking we CHANGE our brain neurotransmitters.
CBT is an invaluable tool for depression and other mental illnesses - I'm not saying everyone needs to be on a pill. But the pill augments the therapyt and visa versa.
As someone posted - the brain is plastic and we are NOT in control of MANY of our brain's "psychological" processes. There are numerous studies showing differing brain physiology in those with a mental illness - as there are MRI's and PET scans showing abnormal concentrations of neruotransmitters in certain key areas of the brain in those with mental illness = chemical imbalance.
Although we are using somewhat "crude" methods of treating mental illness - neuroscience is not ALL stabbing in the dark. Yeah we don't know why ECT works for some people - but it can be a LIFESAVER. Why do some people repsond to Prozac and others Effexor? Why are millions still treatment resistant? We don't know - however, that does not equate to a conclusion that depression is purely voluntary psychological "imbalances" under our control.
I've been in therapy for 15 years. Why haven't I been cured?!? Have I just seen all the wrong therapists?! Same goes for the medical side of things -have I just been seeing all the wrong psychiatrists?!
I strongly believe that depression and other mental illnesses are part environmental and part genetic abnormalities. If it were purely psychological (which -actually what DOES that mean?!) - then a hypnotist should be able to pop use all out of our misery - right??? Or we are all pathetic, weak willed, unmotivated, lazy fakers WANTING to be depressed?? I don't think so.
Who here has not tried, prayed, done EVERYTHING in his or her power to SNAP out of being depressed?? Who here has had to FAKE being cheerful simply so others would be more at ease with us and not have to deal with our "problems??" According to what this group of psychiatrists say - then we should have all been healed by now....right????
Like I said - I don't advocate popping a pill for all cases - but to trash those with mental illness with this "it's all psychological" slap in the face disgusts me.
My opinion.
Jerry
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