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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 4 to 28 of 95. Go back in thread:
Posted by Phillipa on August 4, 2008, at 10:51:41
In reply to Re: Some people don't want to believe. » SLS, posted by johnj on August 4, 2008, at 9:27:25
You said that so well. Yes for times in a person's life they need different things sometimes meds, sometimes treating the medical condition that is causing the mental anguish. I will always need something for my anxiety or quick trigger negative thoughts but also need to talk myself down. Even my pdoc says the thyroid loop is the basis of my problems and until it's straightened out which hopefully it will be I have to hang in there and try my best. I find learning about meds on this board is very educational. I'm thrilled that you were able after many trials to be med free . Congratulations on that. I hope one day minus the synthroid to join you. Hope you take this post in the positive way I mean to convey it to you. I also do a lot of talking with others and find so many on meds and then they get off and feel better. But then others will need something for life. As we're all different. And congrats again to you. Phillipa
Posted by linkadge on August 4, 2008, at 11:52:29
In reply to Some people don't want to believe., posted by SLS on August 4, 2008, at 5:24:19
Well, I think its fairly obvious that SLS thinks he is referring to me.
Surely you know that my stance on the efficacy (or lack thereof) of modern antidepressant agents is a little more complex that what you have stated.
It is important to realize how the pharmacudical industry has traditionally adulterated the procedure of obtaining quality data reagarding the efficacy and safety of modern psychotropics. To argue that it has always historically been an exact, rigorous and honest science is not true IMHO.
It really comes down to what you want to believe fundamentally. After that, you can find the data to support any stance you may choose.
It doesn't bother me that people beleve what they want to believe. It bothers me when, for whatever reason, people don't get the results that www.paxil.com says they should and then they come to internalize that problem.
Linkadge
Posted by Bob on August 4, 2008, at 12:03:09
In reply to Re: Some people don't want to believe., posted by dcruik518 on August 4, 2008, at 8:48:12
> It seems to me that most people here believe that meds can be helpful. That said, however, I think many people here have difficult or treatment resistant cases and they come here to seek advice above and beyond the easy first-year-resident kind of "ssri's work for everything" crap. If there's anger, it's anger at the large number of incompetent dopes who call themselves psychiatrists. We therefore have to educate ourselves and sometimes take matters into our own hands. More than any other of the medical specialities, psychiatry needs to be done democratically, not autocratically, and I think it's this need for dominance among the p-docs that leads to patient frustration as much as anything else. The top down model is bunk.
>
> ~DRC
>
>Well put, I must say.
Posted by Chris O on August 4, 2008, at 14:07:46
In reply to Some people don't want to believe., posted by SLS on August 4, 2008, at 5:24:19
I really think this is a great discussion. It's a debate I have in my head all the time. I believe that there is something dysfunctional about my brain or brain chemistry. And, I am open to any drug, method, treatment, belief, whatever, that helps it. However, even when psychiatrists do not use the "top down" approach, it's unnerving (for me, at least) putting all kinds of powerful chemicals in my body that are at best validated in one, two, or three month trials. At the same time, if they "work" and help me to live a more functional life, I am all for it. But in my two long-term trials with SSRIs, the results were...mixed. One time, they sort of worked; the next time they barely worked. Now, I am trying again, and open to "whatever works." But I hate the waiting, the not knowing if I should add or drop something, the feeling that the drugs "kind of work," but that the side effects are not worth it. We've all been down this road before, I think. And being the health conscious person I am, there's always the concern that the drawbacks of meds outweigh the gains (or that if I just exercise enough this horrible anxiety/depression I have will go away!) But at 41 years old and getting worse, I now realize that meds, for me, are probably the best viable option. I guess it's just a matter of getting the right one, or combo, or hoping for something better on the horizon.
Posted by Bob on August 4, 2008, at 14:24:33
In reply to Great discussion. Empathize w/all posters! » SLS, posted by Chris O on August 4, 2008, at 14:07:46
> I really think this is a great discussion. It's a debate I have in my head all the time. I believe that there is something dysfunctional about my brain or brain chemistry. And, I am open to any drug, method, treatment, belief, whatever, that helps it. However, even when psychiatrists do not use the "top down" approach, it's unnerving (for me, at least) putting all kinds of powerful chemicals in my body that are at best validated in one, two, or three month trials. At the same time, if they "work" and help me to live a more functional life, I am all for it. But in my two long-term trials with SSRIs, the results were...mixed. One time, they sort of worked; the next time they barely worked. Now, I am trying again, and open to "whatever works." But I hate the waiting, the not knowing if I should add or drop something, the feeling that the drugs "kind of work," but that the side effects are not worth it. We've all been down this road before, I think. And being the health conscious person I am, there's always the concern that the drawbacks of meds outweigh the gains (or that if I just exercise enough this horrible anxiety/depression I have will go away!) But at 41 years old and getting worse, I now realize that meds, for me, are probably the best viable option. I guess it's just a matter of getting the right one, or combo, or hoping for something better on the horizon.
In addition to feeling sorry for myself a lot, I feel bad for my family and loved ones who struggle to deal with my situation. It can be brutal.
Posted by Sigismund on August 4, 2008, at 14:56:35
In reply to Some people don't want to believe., posted by SLS on August 4, 2008, at 5:24:19
Scott, my bias comes from the fact that the only medical intervention that helped me was nutritional medicine.
Professional neuroscientists?
Oh yes.
Posted by SLS on August 4, 2008, at 15:38:26
In reply to Re: You are refering to me?, posted by linkadge on August 4, 2008, at 11:52:29
> Well, I think its fairly obvious that SLS thinks he is referring to me.
I can't read your mind. You can't read mine. Let us not try to.
> It really comes down to what you want to believe fundamentally.
Yes. This is the problem. I think that what one *wants* to believe influences how they interpret the world. It is a question of attitude and perspective being imposed upon by emotional reasoning instead of deductive or inductive reasoning. *Wanting* to believe something does not make for objective and functional interpretation of evolving facts.
> After that, you can find the data to support any stance you may choose.
I don't think so. What is, is. Drugs work - human investigations verify this with objective observation and using statistics. I am, of course, biased because drugs do work for me and have made life wonderful and worth living. I can't be terribly unique in this regard. And this might be the crux of the matter. For those people whom drug therapy has been disappointing, there might be a bias towards disbelieving the utility of these treatments. However, given my personal success story, I would encourage those people whom prefer to believe that drugs are ineffective to pay more attention to cases like mine.
No guarantees.
- Scott
Posted by SLS on August 4, 2008, at 15:57:26
In reply to Re: Some people don't want to believe. » SLS, posted by Sigismund on August 4, 2008, at 14:56:35
> Scott, my bias
What exactly is your bias?
> comes from the fact that the only medical intervention that helped me was nutritional medicine.
I am not sure it follows from logic that because nutrition is effective, drugs are not. My position is not an either-or statement. It is simply that drugs work. What's the problem?
> Professional neuroscientists?
> Oh yes.I guess I have developed another bias towards the level of sophistication and intelligence at which these professionals function. I have had the privilege to be amongst them at the NIH, NYU, Harvard, and Columbia. I even got to see the rats of NIMH in action. Poor things.
- Scott
Posted by Sigismund on August 4, 2008, at 16:23:03
In reply to Re: Some people don't want to believe. » Sigismund, posted by SLS on August 4, 2008, at 15:57:26
>I am not sure it follows from logic that because nutrition is effective, drugs are not.
I didn't say that. They haven't helped me much though. Except for tianeptine.
Posted by Bob on August 4, 2008, at 16:27:52
In reply to Re: Some people don't want to believe. » Sigismund, posted by SLS on August 4, 2008, at 15:57:26
> > Professional neuroscientists?
> > Oh yes.
>
> I guess I have developed another bias towards the level of sophistication and intelligence at which these professionals function. I have had the privilege to be amongst them at the NIH, NYU, Harvard, and Columbia. I even got to see the rats of NIMH in action. Poor things.
>
>
> - Scott
>
>
>
>What do you mean by this? Are you biased for or against these scientists and the facilities?
Posted by Toph on August 4, 2008, at 17:02:22
In reply to Some people don't want to believe., posted by SLS on August 4, 2008, at 5:24:19
It seems that some of the disagreement comes from using generalities like "drugs work," Scott. Not all drugs work. Fortunately, like for you, mine do work for me. But I balance the side affects with the benefits to make the determination that Lithium works for me. I have to put up with diarrhea, dry mouth, and potential harm to my thyroid and kidneys in order to keep out of the psych ward. Since it has reliably done the latter for 25 years now I would say that it works.
Posted by linkadge on August 4, 2008, at 17:11:03
In reply to Re: You are refering to me? | No., posted by SLS on August 4, 2008, at 15:38:26
>I don't think so. What is, is. Drugs work -
So do placebos.
>human investigations verify this with objective >observation and using statistics. I am, of course, biased because drugs do work for me and have made life wonderful and worth living.
I see.
>I can't be terribly unique in this regard. And >this might be the crux of the matter. For those >people whom drug therapy has been disappointing, >there might be a bias towards disbelieving the >utility of these treatments.
>However, given my personal success story, I >would encourage those people whom prefer to >believe that drugs are ineffective to pay more >attention to cases like mine.
No offence, but your sucess story is full of strange twists and turns, at least thats how it comes across here.
Linkadge
Posted by Justherself54 on August 4, 2008, at 17:15:40
In reply to Re: You are refering to me? | No., posted by SLS on August 4, 2008, at 15:38:26
>For those people whom drug therapy has been disappointing, there might be a bias towards disbelieving the utility of these treatments.
After 25 years on and off meds and a diagnosis of bipolar, coupled with the fact that every AD in whatever class has pooped out on me between 6 months and a year, I think I have the right to a bit of bias...however I have to keep plugging along...'cause the alternative is...well...not good...
Do I think there is value in a nutritional approach? Of course I do. I'm just too fat, unmotivated and apathetic to get into that mode...
Jaded Justy
Posted by linkadge on August 4, 2008, at 17:20:50
In reply to Re: Some people don't want to believe. » SLS, posted by Bob on August 4, 2008, at 16:27:52
>I guess I have developed another bias towards >the level of sophistication and intelligence at >which these professionals function. I have had >the privilege to be amongst them at the NIH, >NYU, Harvard, and Columbia. I even got to see >the rats of NIMH in action. Poor things.
You keep quoting these institutions as if its supposed to mean something. Sure they're smart that doesn't mean that they're always right or that they're in hot presuit of anything that will amount to anything. If your claim to fame is coming into contact with a bunch of people that their entire day studying monoamine uptake mechanisms then its time to move on.
I got to meet David Healy, so whats your point?
Linkadge
Posted by Justherself54 on August 4, 2008, at 17:51:57
In reply to Re: Some people don't want to believe., posted by linkadge on August 4, 2008, at 17:20:50
I know you two like a good debate, that's obvious..however, whenever I have posted to a thread where you are debating I tend to feel ignored and hesitant to post. I feel hostility...could be just how I'm feeling today...had to voice it..
Posted by SLS on August 4, 2008, at 18:18:53
In reply to Re: Some people don't want to believe. » SLS, posted by Bob on August 4, 2008, at 16:27:52
>
> > > Professional neuroscientists?
> > > Oh yes.
> >
> > I guess I have developed another bias towards the level of sophistication and intelligence at which these professionals function. I have had the privilege to be amongst them at the NIH, NYU, Harvard, and Columbia. I even got to see the rats of NIMH in action. Poor things.> What do you mean by this? Are you biased for or against these scientists and the facilities?
I tend to like these people and what they do.
- Scott
Posted by SLS on August 4, 2008, at 18:34:44
In reply to Re: Some people don't want to believe., posted by Toph on August 4, 2008, at 17:02:22
Hi Toph.
> It seems that some of the disagreement comes from using generalities like "drugs work," Scott.
Well, they do.
Of course, some people are more treatable with these drugs than others.
> Not all drugs work.
Name one FDA approved antidepressant that doesn't work. Even trazodone works for some people.
How many people with depression must a drug not work for before we deem it ineffective?
I don't understand what the big deal is. Drugs work for at least 85% of people. Drugs work. This is not generalization. It is fact. That doesn't sound too complicated a statement to interpret. Besides, it was not the point of my thread to demonstrate that Scott is right about anything regarding the efficacy of current treatments. It was about outlook and expectations, and how these impact upon the compliance of people with treatment, and thus their chances for success.
- Scott
Posted by SLS on August 4, 2008, at 18:37:21
In reply to Re: Some people don't want to believe., posted by linkadge on August 4, 2008, at 17:20:50
> I got to meet David Healy, so whats your point?
Respect for exposure.
- Scott
Posted by SLS on August 4, 2008, at 18:43:47
In reply to Re: You are refering to me? | No. » SLS, posted by linkadge on August 4, 2008, at 17:11:03
> No offence, but your sucess story is full of strange twists and turns,
How so?
> at least thats how it comes across here.
To everyone, or just you?
- Scott
Posted by SLS on August 4, 2008, at 18:48:29
In reply to Re: Some people don't want to believe. Linkage/SLS, posted by Justherself54 on August 4, 2008, at 17:51:57
> I know you two like a good debate,
For me, this isn't an academic exercise. It really isn't a hell of a lot of fun either.
> whenever I have posted to a thread where you are debating I tend to feel ignored and hesitant to post.
At first, I was surprised that you should feel that way, but I guess I can understand. The hostility is unfortunate, and it is very uncomfortable to witness.
- Scott
Posted by SLS on August 4, 2008, at 18:56:13
In reply to Re: Bias and drug therapy, posted by Justherself54 on August 4, 2008, at 17:15:40
> After 25 years on and off meds and a diagnosis of bipolar, coupled with the fact that every AD in whatever class has pooped out on me between 6 months and a year, I think I have the right to a bit of bias...
I hope you didn't infer from my postings that you had no such right or even legitimate reasons to feel the way you do. I didn't think I came off that way. I apologize if I did.
> however I have to keep plugging along...'cause the alternative is...well...not good...
So, if a drug doesn't work for more than 6 months, it doesn't work? I think it demonstrates, minimally, that you are treatable, and have a good chance to remain well.
Which drugs have worked for you in the past? Which combinations?
- Scott
Posted by linkadge on August 4, 2008, at 19:16:52
In reply to Re: Some people don't want to believe. » linkadge, posted by SLS on August 4, 2008, at 18:37:21
>Respect for exposure.
Its not always a good idea to let idealization of an individual get in the way of an unbiased interpretation of what they are asserting, thats the first step to flawed science. "They are from such and such a university, well then, what they say must be correct".
Linkadge
Posted by Sigismund on August 4, 2008, at 19:29:42
In reply to Re: Some people don't want to believe., posted by linkadge on August 4, 2008, at 17:20:50
It may not be the scientists' fault that the drugs are as bad as they are.
It may be that psych drugs have to be unpleasant to discourage drug abuse/malingering/etcetc.
Posted by gardenergirl on August 4, 2008, at 19:30:35
In reply to Some people don't want to believe., posted by SLS on August 4, 2008, at 5:24:19
If y'all are going to go down the same road with the same outcome, have you considered taking it outside? I like having you both around, not blocked.
Respectfully,
gg
Posted by linkadge on August 4, 2008, at 19:34:32
In reply to Re: You are refering to me? | No. » linkadge, posted by SLS on August 4, 2008, at 18:43:47
>How so?
Well, for somebody who has been miraculously and gloriously affected by the workings of these drugs, it doesn't seem like you have had any form of sustained efficacy from any one drug. You're periodically talking about how things aren't working for you the way they once did, and how your brain has adapted to the effects of many of the medications you take. It just seems to me that when you feel good, you start to jump into this "idealization mode" where you seem to overassert the efficacy of these meds and the extent to which modern psychiatry can help any one individual. When you're not feeling so hot, it seems that you start to doubt the overall utility of many of these meds and talk in (what appears to me) to be a more grounded mannor about the benifits and drawbacks of meds. On the one hand you unequivically and liberally advocate the use of the genotoxic TCA's and on the other you write posts that makes me think you are concerned about the possable genetic dammage that you yourself may have sustained.
You don't often tell people about the psychotic/ manic reaction you had to drugs like nortyptaline in the past. Wonder drugs don't make people manic and/or psychotic. Yet, I don't think you consider yourself bipolar as you are not taking maintainance doses of any mood stabilizer. As such, I don't know how you could be convinved about your diagnosis and subsequently I don't know how you could be so convinved that you really are being treated optimally.
Everybody's got a story to tell and nobody who frequents this board is perfectly well IMHO. Perhaps you think that if you can convince others that medications work, you can convince yourself?
Linkadge
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