![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 26 to 50 of 63. Go back in thread:
Posted by bulldog2 on April 3, 2010, at 14:30:52
In reply to I think I just want control..., posted by linkadge on April 2, 2010, at 20:16:56
> I think my whole obsession with medications is just an attempt to get (or feel) more control over my life.
>
> Instead of just letting go, and not being such a control freak, I loom on pages like this for the wrong answers.
>
> LinkadgeI think at least for me, pursuit of the magic med combo that will bring remission ,brings about remission or at least a partial remission from the depression. I find a sense of happiness and excitement at times when reading about the meds or med that will about a remission from depression. So finally I put my combo together and start it and usually the combo works for a while until I stop it for some reason. Now I start the pursuit of the magic med combo again. Ah the chase is so exciting.
Posted by Dr. Bob on April 3, 2010, at 15:00:44
In reply to OCPD and overactivity of dopamine D2/D3 receptors, posted by sukarno on April 2, 2010, at 20:39:43
> It's interesting that you mentioned that about high dopamine activity when depressed.
Sorry to interrupt, but I'd like to redirect follow-ups regarding dopamine D2/D3 receptors to Psycho-Babble Neurotransmitters. Here's a link:
http://www.dr-bob.org/babble/neuro/20100223/msgs/942019.html
That'll be considered a new thread, so if you'd like to be notified by email of follow-ups to it, you'll need to request that there. Thanks,
Bob
Posted by bulldog2 on April 3, 2010, at 18:06:58
In reply to Re: I doubt I will ever fully recover, posted by linkadge on April 2, 2010, at 16:22:47
> This is not a radical statement. This idea has been suggested (and studied to some extent) before.
>
> Most depression gets better on its own within 6-12 months. But, people these days are taking SSRI's almost indefinately (on the assumption that they need them to prevent future episodes). The truth is more likely that they can't get off them.
>
> Linkadge
>
>
>
>
>I don't contest the statement. But in our society having a doc tell his patients you'll probably get better in 6-12 months would guarantee no following...Maybe ask people to wait several weeks may be tolerable but not 6-12 months...So what happens you wait 6-12 months and if you don't get better than ask for meds...Your brain has now been battered by depression for a half a year...I don't think that's a reasonable statrategy..
Posted by bulldog2 on April 3, 2010, at 18:09:59
In reply to Re: I doubt I will ever fully recover, posted by bleauberry on April 2, 2010, at 17:42:50
> There are countless syndromes, diseases, and symptoms that millions of people suffer from that just do not ever fully recover. Many in fact continue to progress. The best many can do is to slow the progression and ease the symptoms.
>
> We're talking diabetes, fibromyalgia, MS, parkinson's, chronic late lyme, kidney or liver pathology, heart disease, blood pressure, on and on and on. From the most common names to the most complicated.
>
> How is it that the syndrome or disease of MDD is any different? Because a minority of people experience temporary improvement or remission on a psych drug? When has it ever been a total cure that lasted a lifetime? I think rarely. It is a chronic condition with many possible causes. Even if we found the cause and removed it, how do we know that permanent damage has not already been done?
>
> For many people with longstanding depression and long histories of drug treatments, I think expecting a total cure is unrealistic. I do not however think the battle to attain it should stop. But it should be put into perspective. Expectations for the short term (the next 3 years) should be lowered, while longterm expectations remain high. If the next 3 years there is no improvement, then the short term goal for the next 3 years stays the same, but the longterm goal is still very high. The bar keeps moving.
>
> This allows us to live here and now. We aren't wasting a life by chasing someting that may never happen. It prevents frustration, disappointment, and further succumbing to the seductive power of the disease which would love to see us retreat to a couch or a bedroom forever.
>
> There needs to be acceptance that life is not a promised rose garden. From the day of birth we are destined to deteriorate little by little.
>
> To long for the good ole days is probably not a healthy thing. To accept the here and now for what it is and to make the best of it is healthy.
>
> Some of the happiest or most productive or most creative people I've ever witnessed were those with heavy crutches. But, and it's a big but, it only pertains to those who said, "Ok screw it, I got this heavy monster for the rest of my life but it aint gonna keep me on the couch any longer. I am stronger than this thing."
>
> That's hard in depression. It means forcing oneself out of the comfort zone. It means forcing oneself to do things that are so hard they are almost impossible. A new hobby. Entering a church on a Sunday for the first time. Starting a job hunt. Exercising. Making dramatic changes in food choices. Playing mind exercise games. Hikes. All the stuff that totally sucks when depressed. Actually, the harder it is to do, probably the more we need to do it! The only thing stopping us is ourselves, not the depression.
>
> Over time we score enough wins that the brain partially recovers. We aren't as ill as we used to be. And it happened without drugs. Something healed with the right prodding.
>
> I think of people like Ace who scored a big and apparently permanent cure with Nardil. Others have stories of 8 years on zoloft, or 10 years on prozac. I know one person who went years on antipsychotics and everyone gave up on her. She started a whole new family of friends at a church, weaned off her drugs, and is basically normal now. Those stories are so rare though, that it reminds me of the rare Las Vegas jackpot winners, or the rare lottery winners, that makes all the rest of us thing we are next in line to be the next big winner. Very seductive thinking.
>
> Everyone's journey is different. But I think for many of us, our expectations are too high. We are not exempt from dealing with the troubles of life anymore than millions of other people with their diseases and syndromes. We are in fact probably much more fortunate than many of them who have already accepted their disease and moved on to more productive lives despite it.
>
> Don't get me wrong. I want a total cure. I will never give up fighting for it. But until then, beginning about 2 years ago, I did lower my short-term expectations because it allowed me to open a new chapter and say, "ok then, let's move forward despite it all, other people of lesser strength than me did it, so can I, life is too short for a couch of dreams."
>
> Since then I have discovered:
>
> I can go to work feeling like death, yet come home feeling like I won something...it was hard, I did it, I feel better than I did.
>
> My best music came from those times I was so depressed I had to force myself to hold the guitar. I had to force myself to stay with it for hours. Never during my good times did I make music that good. The music I made during good times didn't "touch" people as much. But the music I made when I would have rather committed suicide gives people goosebumps, and they certainly feel spiritual emotion in it.
>
> For someone else they would experience the same spiritual gift, except in some other way not a guitar.
>
> So there are actually good sides to depression. We see things others don't see. We can create things others can't. We can experinece bigger wins than others. We can help others in ways no one else can. There are unseen gifts.
>
> But it sucks. As does any disease. I keep fighting. I've scored enough wins over the monster I lost count a long time ago. I rule the monster now, it doesn't rule me. As long as it is with me, I am the boss, not it.
>Its the side effects of any illness that eventually kill us...so the better you manage illness side effects the less damage to the body even if theirs no cure
Posted by linkadge on April 3, 2010, at 18:13:50
In reply to Re: I doubt I will ever fully recover, posted by bulldog2 on April 3, 2010, at 18:06:58
>So what happens you wait 6-12 months and if you >don't get better than ask for meds...Your brain >has now been battered by depression for a half a >year...I don't think that's a reasonable >statrategy..
I do think its a reasonable strategy. The suicide rate has not dropped since the introduction of antidepressants. Sure, the good old fashoned way may be harder in the short term, but if most people recover without meds (which statistically they did), then you wouldn't have millions of people dependant on psychiatric drugs (which permanaently alter brain chemistry in their own right)
Linkadge
Posted by conundrum on April 3, 2010, at 19:01:56
In reply to Re: I doubt I will ever fully recover, posted by linkadge on April 3, 2010, at 18:13:50
Chemistry? Try physiology. Your number of transporters, receptors, and brain cells change from taking these drugs. Some would call structural changes brain damage.
Posted by Zyprexa on April 3, 2010, at 21:58:01
In reply to Re: I doubt I will ever fully recover, posted by bleauberry on April 2, 2010, at 17:42:50
I use to take the meds thinking some day i will be better. Little did I know it would never happen. You just keep taking the drugs as long as you want to be better. Its not a cure, and you will never recover and stop the meds. Unless you are realy lucky. I don't fool myself any more I just keep taking the drugs.
Posted by Justherself54 on April 3, 2010, at 22:28:03
In reply to I think I just want control..., posted by linkadge on April 2, 2010, at 20:16:56
I wish there was a right answer. I too would like some control over my mood.
Posted by SLS on April 3, 2010, at 23:25:53
In reply to Re: I think I just want control... » linkadge, posted by Justherself54 on April 3, 2010, at 22:28:03
> I wish there was a right answer. I too would like some control over my mood.
I have no doubt that the exposure to many antidepressants produces changes in brain structure and function that may be irreversible. One indication that this occurs is the observation that many drugs display the phenomenon of "poop-out". People often develop a refractoriness to the therapeutic effects of a drug once that drug is discontinued and later restarted. Something must be different.
I am not sure what better choices there are but to take a risk and try the psychiatric drugs that currently exist and hope that we respond to them in ways that are observed to reduce pain and suffering in a great many people.
Statistics have a habit of changing depending on who presents them. I have read that the rate of suicide in some countries has decreased since the advent of the SSRIs in 1987. It is suggested that the media attention paid to Prozac and the epidemiology of depression produced an increase in the number of people seeking treatment, and thus a decrease in the number of suicides. I guess the question worth asking is what the rate of suicide would be in the absence of antidepressant treatment. It had already been increasing prior to the inventions of phenelzine and imipramine. Thereafter, it remained static and later decreased.
I cherry-picked this one:
http://www.suicide.org/suicide-statistics.html#death-rates
- Scott
Posted by sukarno on April 3, 2010, at 23:54:59
In reply to Re: I think I just want control..., posted by SLS on April 3, 2010, at 23:25:53
I'm not sure if this would belong here or in alternative since it is more accepted these days as a standard form of treatment, but have any of you tried light therapy (using a light box)?
It has been proven in double-blind studies to help depression, not only seasonal affective disorder.
Sometimes severely depressed inpatients are forced to wake up after 5 hours of sleep and then are administered light therapy. The combination of sleep deprivation and light therapy brings about a rapid improvement in relief of depression.. much quicker than drugs or ECT.
Posted by SLS on April 4, 2010, at 0:16:09
In reply to Re: I think I just want control..., posted by sukarno on April 3, 2010, at 23:54:59
Hi.
Thanks for the suggestion. I will keep it in mind.
- Scott
> I'm not sure if this would belong here or in alternative since it is more accepted these days as a standard form of treatment, but have any of you tried light therapy (using a light box)?
>
> It has been proven in double-blind studies to help depression, not only seasonal affective disorder.
>
> Sometimes severely depressed inpatients are forced to wake up after 5 hours of sleep and then are administered light therapy. The combination of sleep deprivation and light therapy brings about a rapid improvement in relief of depression.. much quicker than drugs or ECT.
Posted by bulldog2 on April 4, 2010, at 11:40:22
In reply to Re: I doubt I will ever fully recover, posted by linkadge on April 3, 2010, at 18:13:50
> >So what happens you wait 6-12 months and if you >don't get better than ask for meds...Your brain >has now been battered by depression for a half a >year...I don't think that's a reasonable >statrategy..
>
> I do think its a reasonable strategy. The suicide rate has not dropped since the introduction of antidepressants. Sure, the good old fashoned way may be harder in the short term, but if most people recover without meds (which statistically they did), then you wouldn't have millions of people dependant on psychiatric drugs (which permanaently alter brain chemistry in their own right)
>
> LinkadgeA couple questions to clarify your post. There's a bit of confusion here.
1. Do you have a link to this study or the name of the study?
2. What criteria did they use for determining who would participate in this study?
3. I believe your study said most get better. Define most as I guess that could mean anywhere from 51% to 99%.
4. Was this I guess what is termed double blind study? If so what were the results on both sides.
Now just some of my own opinions. You said most get better and therefore some don't get better. This means someone has waited 6-12 months to get better and hasn't gotten better and now its a year later. So now the doctor will dispense meds?
I don't think you understood what I was getting at. Even if your study turns out to be correct I don't think most patients would put up with a doctor who practiced that way. I go to my doc and have been in the blackest depression for several months and I'm looking for some relief. My doc pats me on the back and tells me that this mental anquish will most likely subside after 6 to 12 months. Now he tells me that if I don't feel better after a year to come back again and we'll look at some meds to help me out. Now hang in there he smiles at me. Now after the nurses have pried my hands off Dr. X's throat I would start going to other doctors who would medicate me immediately.
Just an observation of human nature. Many will not wait a week for a cold to go away before asking for antibiotics which do not even work on a cold. (let alone wait 6-12 months )
Most doctors also will not practice this way if they wish to keep people coming to them for treatment.NOW!! if science can figure out which depressive types will resolve on their own and which will not than we have a statistic that is meaningful. That way those who will not resolve on their own can get started now on treatment.
Right now to many symptoms are lumped under depression and treated in a standard way which I believe creates many failures. I believe depression is a group of diseases that probably requires a group of different treatments and in some cases no meds but psycotherapy.Myth No 1. Antidepressants are addictive. They may be for some and I am not questioning that. But I have cold turkeyed my ads many times without a problem. I continue to try new med combos in pursuit of that elusive remission. I also have had friends and acquaintences stop their ads after they were no longer needed without any withdrawal issues.
Myth No 2. Suicide rate. I personally don't believe you can take one statistic and use that to determine wether meds are effective or not effective. You need a myriad of personality measurements before and after to see if the med is effective. There could be other factors in one's life that could lead to suicide. Chronic debiliting disease, chronic pain etc. It is a myth that depression is the only reason one would committ suicide.
So let's look at your comments.In my opinion they're really more opinion than hard science which is okay.
1. It may be a reasonable strategy for you but a 6-12 month waiting period would not be a reasonable for me or many others. I guess it's a matter of choice.
2. The statement about the suicide rate not dropping. That's a hard one to prove. As I stated above you can't take this one meaurement and judge antidepressants based on that. Depression is to complex to be judged on one thing and we can't be sure how accurate the measurements were from the 1950's. More than likely they were undercounted in the 1950s.
3. You mention the old fashioned way. You really could make that statement about modern medicine in general. Probably the majority of symptoms that we go to the doctor about would resolve on their own and in far shorter time than 6 to 12 months. If you think about it maybe we should withhold medical treatment on most illnesses and just wait and see if the sick person becomes well on their own. If the person dies, while that may be tragic there is an upside. Only the strongest survive and live to breed and we end up with a more robust society.
So you may have come up with a strategy that is better for society in general but we just have to expand it to include all illness and in the process weed out the physically and mentally unfit.
> I do think its a reasonable strategy. The suicide rate has not dropped since the introduction of antidepressants. Sure, the good old fashoned way may be harder in the short term, but if most people recover without meds (which statistically they did), then you wouldn't have millions of people dependant on psychiatric drugs (which permanaently alter brain chemistry in their own right)
Posted by sukarno on April 4, 2010, at 13:20:25
In reply to Re: I doubt I will ever fully recover » linkadge, posted by bulldog2 on April 4, 2010, at 11:40:22
I guess the good thing I can report is that - in the days when I wasn't couped up at home and had a car and would drive everyday - getting exposure to plenty of natural sunlight and social activities pretty much eliminated any depressive symptoms I had. Even if I felt bad at night, a long drive (200 miles round-trip) with the sunroof open at night and nice music playing would also bring relief. I loved to be on the road. Staying in one place tends to trigger my depression.
The best relief I ever obtained without drugs was when I was delivering newspapers early in the morning as the sun was rising. It was about an hour of physical activity and that exercise along with the early morning sun markedly reduced my anxious and depressive symptoms. I felt like a new person and it only got better the longer I kept doing that. I had to give it up though when the weather became far too cold (sub-zero).
So, thinking of this, even though this was back in the 1990s when I had a car (which I don't now and haven't had one for 9 years), gives me hope that I don't really _need_ drugs to overcome my depression.
It is just that this situation is driving me nuts and I need pills to get through it. (living in a dark house.. weather too hot to venture outside... not knowing the local language enough to develop social bonds with people... no car... stuck inside all the time on my computer)
I hope that someday I can get out of this country or at least find a higher elevation where the weather is far cooler (unfortunately those areas are populated by the wealthy expatriates so I can't afford to live there).
I have my mind set on a country more affordable to travel to such as Australia or New Zealand. New Zealand would be preferable due to its relatively cool climate year round (especially in the southern part). I could then venture out, make friends since we all speak English and get better without drugs.This is the thought that keeps me going. I feel though that light therapy is the only thing that has kept me going. Stablon is far too weak on its own when living in a dark house and also being isolated from society. I'm sure Stablon would be efficacious if one was able to venture out and socialise with others.
Posted by Sigismund on April 4, 2010, at 15:36:49
In reply to situational depression may be my problem, posted by sukarno on April 4, 2010, at 13:20:25
>I have my mind set on a country more affordable to travel to such as Australia or New Zealand. New Zealand would be preferable due to its relatively cool climate year round (especially in the southern part). I could then venture out, make friends since we all speak English and get better without drugs.
Ha! Well. Maybe. But not if you're me. Although, as you say, New Zealand, maybe right down the bottom.
Why don't you learn Bahasa Indonesian (or whatever it's called) while you're there?
Just a few words of Vietnamese and I'd feel different.
Posted by sukarno on April 4, 2010, at 21:29:21
In reply to Re: situational depression may be my problem » sukarno, posted by Sigismund on April 4, 2010, at 15:36:49
I can get by in Malaysia and socialise as they will mix English with their native language, but Indonesians don't do that. I've found it so difficult to learn the language despite being here for 7 years. I can read it (if its formal), but when it comes to conversation, I just can't pick up on it. People talk to fast. When they see that you can speak even a few words of their language they will go "full blast" on you with all the slang and rapid speech. lol.. you won't understand any of it.
Even the ones that speak some English don't seem to understand me even if I speak slowly and clearly in English. hmm...
Posted by ed_uk2010 on April 5, 2010, at 11:20:23
In reply to Re: I doubt I will ever fully recover, posted by linkadge on April 3, 2010, at 18:13:50
Link,
I think your computer is infected with a virus or some kind of malware. I keep getting spam emails from your email address, which are obviously not being sent by you, so I assume they are being generated by a computer program which has infected your computer. Perhaps you could run an antivirus program?
Ed
Posted by Phillipa on April 5, 2010, at 19:43:35
In reply to For Linkadge, posted by ed_uk2010 on April 5, 2010, at 11:20:23
Link same here. Phillipa from you
Posted by Katgirl on April 6, 2010, at 10:07:42
In reply to For Linkadge, posted by ed_uk2010 on April 5, 2010, at 11:20:23
Hi Linkadge-
I'm so sorry for your struggles. I know I often have some of the same thoughts. I DO think my brain has been damaged by withdrawal to Paxil and that I will never be the same after all the drug trials, BUT I still believe that the brain/body does have incredible healing powers. I was in a deep, dark suicidal can barely walk, can't feed myself or sleep depression for over two years. rTMS helped me to start crawling out of that and now several years later I am doing much much better. Am I back where I was before taking Paxil. No. But I am at least not in constant agony anymore. My life is still limited greatly by my disease (mainly by anxiety and fatigue at this point) but I am hoping some better medications that I can take will come out during my lifetime. (Currently I am unmedicated). For me I try to do everything I can to take care of myself: stay on a sleep schedule, exercise, eat well, try to get together socially with people if I have any energy left after work. I have been sick with a horrible virus for four weeks, and my ability to exercise etc has been hampered, so now I start to get scared about the depression returning if I can't get physically better enough to get back on my schedule!! Take care!
Posted by Meltingpot on April 6, 2010, at 15:21:35
In reply to I doubt I will ever fully recover, posted by linkadge on April 2, 2010, at 14:08:08
Hi Linkadge,
From my own experience.
My depression/anxiety started at the age of 17 (although I thought I was physically ill at the time) After a year of going back and forth to the hospital convinced I was dying of some awful uknown disease I stopped bothering and sort of plodded on with my life. From the age of 17 to 24 I didn't have a boyfriend, hardly went out and had very little drive or passion for life, inspite of the fact I was considered very attractive and intelligent.
Then at the age of 24 my symptoms seemed to get worst. I was convinced I had a lung disease, I even went to see a lung specialist who just told me off for smoking and made me feel even worst.
Then after breaking down in my doctors office and crying he put me on prothiaden (a tryciclic). From that moment onwards I never looked back (until now) and my life suddenly seemed to start again. It felt miraculous really.
The prothiaden stopped working the same five years later and I stopped them but I never felt as bad as I had at the age of 24 so I don't think the prothiaden made things worst, if anything, it sort of fixed me.
9 years ago I stopped Seroxat and after three fairly normal years my depression and anxiety resurfaced and since then nothing has worked very well.There are many people who take antidepressants for a while and then come off them and go back to feeling "Normal" again. Antidepressants don't seem to have harmed them.
Like you, I'm now in a catch 22 situation where I can't seem to live with antidepressants and I can't live without them. I don't feel well on them and I feel absolutely horrible off them. However, unlike you, I don't think the medication has made things worst. I don't think it helps that much anymore but I don't think it has made things worst. In fact I can't see how they could of made things any worst.
I felt pretty bad between the age of 17 to 24 and during that time I never really got better just worst. In a way I was glad I did get worst because if I hadn't then I would never have been put on medication.
I wish you wouldn't blame the medication for making you worst because that (in a way) is like blaming yourself for taking them in the first place.
Denise
Posted by conundrum on April 6, 2010, at 16:18:07
In reply to Re: I doubt I will ever fully recover, posted by Meltingpot on April 6, 2010, at 15:21:35
Thats true about blaming yourself. I wish I never took prozac. When I was 16 my mom and her psych thought I should take it. I wish I never had so I usually end up blaming my mom or myself for not just lying and hiding the pills somewhere.
Or never telling anyone that I felt bad.I feel stupid with a poor memory, and concentration, and blunted after taking that drug, never felt that way before. I used to play the guitar and was on my way to becoming a professional musician. Now I'm just sitting in a boring temp job, because I have no drive, and gain no reward from attempting more difficult tasks and have trouble concentrating.
None of this existed before taking prozac.
Posted by bulldog2 on April 6, 2010, at 17:51:53
In reply to I doubt I will ever fully recover, posted by linkadge on April 2, 2010, at 14:08:08
> I am just being honest with myself. I don't think I will ever fully recover. I don't have the same brain I started with 10 years ago when I got myself onto this ride of psychiatric drugs.
>
> LinkadgeWell based on your posts it would seem your best strategy would be to stop the meds. The mind has a very strong homestatis going on. It will try to get back to where nature and genetics intended you to be. If you theory about meds ruining your life is correct than staying off meds would seem to be the best way to go. The longer off meds the closer you will get back to your original unmedicated state.
Posted by linkadge on April 6, 2010, at 18:30:42
In reply to For Linkadge, posted by ed_uk2010 on April 5, 2010, at 11:20:23
Yes, I am aware of that issue. I appolgize. It is not on my computer (from what I understand about reading up on this issue). The activity happens independantly of the computer. An issue with hotmail?? I dunno. All I can say is sorry. I've got the best anti-virus/spyware stuff installed.
Linkadge
Posted by Phillipa on April 6, 2010, at 20:09:19
In reply to Re: For Linkadge, posted by linkadge on April 6, 2010, at 18:30:42
Thanks for letting me know Phillipa
Posted by ed_uk2010 on April 7, 2010, at 13:50:11
In reply to Re: For Linkadge, posted by linkadge on April 6, 2010, at 18:30:42
> Yes, I am aware of that issue. I appolgize. It is not on my computer (from what I understand about reading up on this issue). The activity happens independantly of the computer. An issue with hotmail?? I dunno. All I can say is sorry. I've got the best anti-virus/spyware stuff installed.
Hi Link,
Don't be sorry. It doesn't bother me at all. I just wanted to let you know in case you had a problem with spyware which might potentially damage your computer.
Posted by meltingpot on April 8, 2010, at 8:18:23
In reply to Re: I doubt I will ever fully recover » Meltingpot, posted by conundrum on April 6, 2010, at 16:18:07
Conundrum/Linkadge
I only went back on Antidepressants because I felt so bad that I felt I just could not continue to go on like that. I was in a bad state before I started them again and although I'm in a very bad state when I stop them, I don't blame them for the way I am today, although I don't think theyve done me much good long term this time round but then what would have? Suicide?
Anwyay, if you both honestly believe you could have got better with just therapy why didn't you go down that route?
Denise
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