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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 33. This is the beginning of the thread.
Posted by SLS on May 14, 2009, at 15:58:37
The drugs currently available to treat mental illness are far from being ideal. There are often debates on Psycho-Babble questioning the magnitude of the efficacy of these drugs and their adverse effects. We really don't know very much about how these drugs work and what are the implications of taking them for an extended period of time.
The question arises as to what are our alternatives for treating mental illness but to use the currently available resources. Another important and constructive question is what is it that we can do to improve the treatments available to us.
- Scott
Posted by Phillipa on May 14, 2009, at 16:05:56
In reply to What are our alternatives?, posted by SLS on May 14, 2009, at 15:58:37
Good question Scott. Seriously with the changes effecting the whole of our health care system personally I feel we're in trouble. Hormones are an option, excercise, diet, some supplements if they work. Love Phillipa
Posted by 49er on May 14, 2009, at 18:03:53
In reply to What are our alternatives?, posted by SLS on May 14, 2009, at 15:58:37
> The drugs currently available to treat mental illness are far from being ideal. There are often debates on Psycho-Babble questioning the magnitude of the efficacy of these drugs and their adverse effects. We really don't know very much about how these drugs work and what are the implications of taking them for an extended period of time.
>
> The question arises as to what are our alternatives for treating mental illness but to use the currently available resources. Another important and constructive question is what is it that we can do to improve the treatments available to us.
>
>
> - ScottScott,
You're asking a great question but I am sensing that you feel that drugs are still the only choice.
Anyway, you might want to check this website out:
http://www.depressionisachoice.com/index.html
Before you make up your mind based on the title of the website, I would really keep an open mind. The website owner is a psychotherapist who has a history of manic depression in her family. Her father and brother have manic depression and she either has that or depression. I couldn't tell from the site.
Anyway, she was concerned about what meds did to her father and brother and decided against them. She became a psychotherapist to cure herself which isn't a surprise and can be harmful to patients. But it sounds like in her case, she really learned some great tools.
Anyway, some examples she gives are to not give in to the depression. For example, if you want to go to bed, don't do it.
I applied her theory today at work. I was suffering greatly from withdrawal symptoms and didn't want to go walking with my co-workers as I usually do at lunchtime. But I made myself do it and felt immensely better afterward.
I realize this may sound simplistic but I think this woman's point is that you have more power over a depression than you think you do.
Anyway, she provides an awful lot on her website for free.
Interestingly, her theories conflict with someone who has written this blog entry about what she does when she has mental breakdowns:
http://raynesworld.blogspot.com/2007/07/how-i-deal-with-mental-breakdowns.html
This person has gone from spending several years in mental institutions to a drug free life as director of a respite center in Georgia. People who are in crisis can come and stay as long as they want.
Which leads to my next point about needing more places like this for people who are in crisis who don't want to go to psych hospitals and be forced on meds.
Finally, let me talk about my experience as I use alot of self CBT. If I get a negative thought that I know is simply not productive, I simply tell myself to "cut the tape" because I don't want to go there. Again, it may sound simplistic but I have found from repeated practice that it really does work most of the time.
I also feel that a diet of Omega 3's is essential. Unfortunately, I seem to not be able to currently tolerate Omega 3 supplements so I have to make sure I eat fish high in omega 3 every day.
I hope I have shown that there are definitely non med alternatives. Even if you chose to stay on meds, the sites I have mentioned are still helpful.
49er
Posted by ricker on May 14, 2009, at 18:15:57
In reply to What are our alternatives?, posted by SLS on May 14, 2009, at 15:58:37
> Another important and constructive question is what is it that we can do to improve the treatments available to us.
Scott, I believe it's people like you that ultimately, will end up improving available treatment options.Many posters have, and will continue to write of their failures with certain medications.... their given right.
However, you may not realize, but I for one have gained a tremendous amount of insight from your post's which has helped me take positive steps with my treatment.
I admire the passion and courage you display on a daily basis.... you're a fighter with a mission. I'm certain many others have benefited from your commitment to "solving the brain flu" so to speak.
So, as I mentioned earlier, doing what you have been doing, has and will continue to improve treatment options available to us.
Regards, Rick
Posted by SLS on May 14, 2009, at 18:39:45
In reply to Re: What are our alternatives? » SLS, posted by 49er on May 14, 2009, at 18:03:53
> I hope I have shown that there are definitely non med alternatives.
Yes. Nice post. Thank you.
> Even if you chose to stay on meds, the sites I have mentioned are still helpful.I'll give them a look-see.
- Scott
Posted by SLS on May 14, 2009, at 18:41:41
In reply to Re: What are our alternatives? » SLS, posted by ricker on May 14, 2009, at 18:15:57
Gosh.
Thanks, Rick.
- Scott> > Another important and constructive question is what is it that we can do to improve the treatments available to us.
>
>
> Scott, I believe it's people like you that ultimately, will end up improving available treatment options.
>
> Many posters have, and will continue to write of their failures with certain medications.... their given right.
>
> However, you may not realize, but I for one have gained a tremendous amount of insight from your post's which has helped me take positive steps with my treatment.
>
> I admire the passion and courage you display on a daily basis.... you're a fighter with a mission. I'm certain many others have benefited from your commitment to "solving the brain flu" so to speak.
>
> So, as I mentioned earlier, doing what you have been doing, has and will continue to improve treatment options available to us.
>
> Regards, Rick
>
>
Posted by bleauberry on May 14, 2009, at 18:59:05
In reply to What are our alternatives?, posted by SLS on May 14, 2009, at 15:58:37
> The drugs currently available to treat mental illness are far from being ideal.
That is because they miss the fact that most mental illnesses are not caused by a brain problem, but instead by a body problem (opinion). They are attached. One affects the other directly. The brain has a large bullseye on it for anything else awry in the body. Fix the physical problem, the brain assault goes away, and it is no longer a mental condition, and actually never was. That's how I see it. Any of the below problems will cause mental illnesses that do not respond well or completely to manipulating neurotransmitters or receptors.
The problem however is that modern medicine is ill equipped to find what is wrong. If it is simple and basic, it will be found. But how about Lyme disease...easily missed even if someone has it. Yeast toxins...easily missed or never even considered because outward symptoms are often not seen. Suboptimal thyroid function in the face of apparently "normal" lab values (extremely too broad, too generalized, and not viewed in context of the other related hormones). The 24 hour cortisol curve is below the average reference value of various labs. Gluten intolerance. Cassein intolerance. Other gut inflammatory conditions allowing unprocessed large molecules to enter the blood system on a journey to the brain. Molds and fungus in the person's residence. Mercury and lead accumulation in the nervous system where it will stay for 30 years unless chelated out. Various viruses. Genetic flaws or roadblocks involving one or more essential vitamins.
All of the above are hard to diagnose and many need to be treated blindly, with the blind treatment itself being the diagnostic tool to either pinpoint a possible suspect or rule it out. To rely on what modern medicine views as clinically proven in 2009 to diagnose something is a guarantee of failure.
Medicine is and always has been an art, a practice, a set of hunches, try this, try that. Over decades a body of knowledge is cemented, but it is always changing and evolving and growing at a rate faster than medical schools, journals, and "provers" can keep up with.
While we become imbedded in the try-this try-that strategy of psychiatric meds, it astounds me we don't do the same for bodily things that directly cause brain function to be impacted. It astounds me how almost everyone is convinced the brain and body are separate entities without connection.
>
> The question arises as to what are our alternatives for treating mental illness but to use the currently available resources.Our currently available resources are limited to brain altering drugs that sometimes work to reverse or block from the brain whatever the phsyical problem is doing, or to aggravate it even worse. As with the blind diagnostics, the psych med treatments are also blind.
Sometimes the brain might actually be the problem. A genetic flaw, receptor deformity, wires not connected, dead tissue, stuff like that. Treatment is blind.
The best resource anyone has is to study, study, study...everything! Not just psych treatments. Study things that impact the brain and the relatively easy ways, and most of them inexpensive, to test on your own if they are valid concerns in your case or not.
And of course many resources are simply lifestyle choices. Is the diet heavy on pizza and sugars, or is it heavy on raw veggies? Is there heavy exercise (relative for each person) being observed several times a week? Is the sleep-wake cycle being maintained as regular as a clock? Not that any of these will heal someone, but they make any pills and any treatments work better, and can actually help to reverse whatever the physical or mental problem actually is. In other words, I think a portion of mental illness we see these days is a direct result of a negligent lifestyle. We the sicker ones have to put huge emphasis on this, where the young and healthy don't...yet...wait till they get a little older, then they'll see what happens.
Other than self-study and self-direction with a cooperative MD, we really don't have any resources, other than a few dozen mysterious brain altering molecules praised by the FDA gods.
All that said, we've all witnessed people reborn into new lives with ADs, APs, benzos, stimulants, and mood stabilizers. When they work, they really work. Why or how, we'll never know.
Full circle back to the beginning. Blind diagnosis and blind treatment, those are our resources. I just think we exceedingly exaggeratedly omit everything from the neck down or anything we or our doctor don't know about. After all, it is human nature to be "down on what we are not up on".
Posted by garnet71 on May 14, 2009, at 19:25:03
In reply to Re: What are our alternatives?, posted by bleauberry on May 14, 2009, at 18:59:05
I agree with Bleauberry that it's more systematic than anything. Does anyone remember years ago, many health insurance policies did not cover mental health (and I don't mean just therapy)--or only covered 50%? Why? Maybe some are still like that today-i don't know.
Some of it probably has to do with stigma; at this day and age, it unbelievable it still exists. People with mental disorders have historically been treated as defective human beings--cast out.
Have a heart attack in the street-and you will be rescued by stangers and get every test imaginable. Have a mental breakdown, and people on the street would stare at you, until a lone rescuer arrives. Then you are confined to a hospital and given shots of halidol.
"Over decades a body of knowledge is cemented, but it is always changing and evolving and growing at a rate faster than medical schools, journals, and "provers" can keep up with."
This is more of a big deal than we realize, really. The problem has begun to be addressed (well, talked about). The emergence of subdisciplines might help. There is a field called neuroendocronology. But it's interesting my endocronologist knew nothing about any research articles that have implications for long-term SSRI use on the endocrine system. How can an endocronologist be trained, educated, and keep up with - say - the neuroscience journals, in addition to their own field? I also noticed most of them specialize in diabetes only. I called around. Many would not even see me without a referral from a primary care physician, although it turned out that I have hypothyroidism, and who knows what else if i could afford the rest of the tests prescribed. For all I know I could have Hashimitos.
I think we need a research supercomputer invented by some brilliant team of computer scientists, statisticians, programmers, mathematicians and doctors to organize and keep up with the information. I also believe the interdisciplanary methods and education that are emerging are key, and trends show this is growing. It seems silly that medicine focuses on seperate systems when everything is interrelated. The cost to have 'teams' would be huge, however. Who is going to pay for it?
It's changing, but remarkably slowly. But i do believe it's more systematic than anything.
Posted by greywolf on May 14, 2009, at 20:46:08
In reply to What are our alternatives?, posted by SLS on May 14, 2009, at 15:58:37
I guess we just have to keep trying. It may take another year for my VNS to work, but I'll stick it out. Parnate may not work, so I'll take one of your suggestions or someone else's and run with that.
I just think it's important to keep discussing options, new developments, and offering support. A few of you--Scott and others--are particularly good at this, and it's helped me immensely.
Greywolf
Posted by ricker on May 14, 2009, at 20:51:27
In reply to Re: What are our alternatives?, posted by garnet71 on May 14, 2009, at 19:25:03
I've often wondered why the evolution, and medical advancement of mankind has been able to continuously develop?
Our bodies are, to a degree, interchangeable! We need an overhaul, transplant from another, what a luxury! But, everyone is stuck with his or her "brain", for life. So, when it comes to alternatives, mental health-care is limited in it's treatment choices. That sounds like an intimidating, and perhaps discouraging avenue for scientists.
Why invest time and money into the only part of our body that's "set for life"?
Our brains have built-in safety features in that our "thoughts / feelings" are limited in what we are capable of controlling.
Can you imagine if we thought about making our heart stop!!
Physically impossible...good safety feature. Unfortunately, I can't think my way out of depression so I guess the trade-off is something that leaves me a bit frustrated.
Maybe stem cell research will unlock the mystery?
Until then, I will continue to take my medicine along with my lumps. I feel very fortunate, lots of "good" drugs to try, if they don't help, I'm not going to die! Brain tumor...drugs don't help...well...
I can only hope and pray some miraculous drug or treatment will fall upon us, very soon.
Posted by Phillipa on May 14, 2009, at 21:07:24
In reply to Re: What are our alternatives?, posted by garnet71 on May 14, 2009, at 19:25:03
Garnet ask for a TPO panel for thyroid will show if hasimotos which I do definitely have. Love Phillipa
Posted by garnet71 on May 14, 2009, at 21:46:40
In reply to What are our alternatives?, posted by SLS on May 14, 2009, at 15:58:37
I should probably mention I have a lot of hope for the future. Now that it has become standard for health insurance companies to pay for mental health care, and more people are getting treatment to improve life quality, it seems drug companies have had more incentives to create drugs that work. (Should we thank drug company lobbyists for that? - maybe) Not to mention more disposable income with dual-income families that have grown since the 70s (though that can be certainly be argued right now). I still do believe that mental health research is a late evolver because of past stigma involved.
But there are still a lot of people who do not think ADD/ADHD exists--and educated people. There are still a lot of people who think depression or anxiety is something you can cure yourself, and that there is nothing biological about it, again, educated people. It's pretty surprising considering that 25% of the population has a mental illness in any given year, and that major depression is the leading cause of disability.
There are increasing health policy managemetn programs at universities, which brings in outside influences, and from a policy perspective, rather than only relying upon what doctors are taught at med school. Doctors are most likely not trained to run businesses from an economic or efficiency perspective, and do not specialize in management. They probably don't have time to train for political science and business to understand the dynamics of how businesses and government policies effect health care. I was considering getting my master's in health care management, but changed my mind at the last minute. I think it would be too frustrating to deal with politics, especially when so much changes every 4 or 8 years with presidential administrations. It would be back and forth.
Plus how many doctors have time for advocacy? I had one amazing psychotherpist who spent much of his free time doing advocacy work. He belonged to associations-but was actively involved, not just a memmber; spoke at events, wrote letters to the editor of newspapers on a regular basis....and more. A true gem. Unfortunatley, he was taken by pancreatic cancer.
More and more companies are allowing open access to information and increasingly engaging in collaboration to solve problems. I wouldn't be surprised if research would be handled this way in the near future.
Still, follow the incentives and you can pretty much derive a lot of implications that result.
For example, did you ever contact a dermatologists office to get a skin cancer screening, and found out the wait is 3 months? That's because every teenager in the city is there for acne treatment--it is covered by most insurances now. Incentives. Only 2 decades ago, only teens with severe acne went to the dermatologists. Maybe some of this could be treated OTC. There are lots of incentives for specializing in dermatology, and less incentives for general practice. Psychiatrists, if this rank still stands correct, are the 2nd most likely to be sued for malpractice after OB/GYNs. This alone has lots of implications, some possibly lead to offering less effective treatments, or denial of off label/experiemental treatments. Incentives...That's where policymakers come in to solve problems. Unfortuantley, education usually isn't as important when it comes to what it takes to get elected. So, in many ways, it's our own fault--the people we choose to elect to run our government and make our laws....it's systematic. At any rate, everything unspirals to one thing--money.
Posted by Sigismund on May 15, 2009, at 1:19:36
In reply to Re: What are our alternatives?, posted by garnet71 on May 14, 2009, at 21:46:40
>I should probably mention I have a lot of hope for the future.
I should probably mention that I don't.
Posted by garnet71 on May 15, 2009, at 20:06:49
In reply to Re: What are our alternatives?, posted by Sigismund on May 15, 2009, at 1:19:36
Well here Sigi, I'll give you some of my optimism: *#$^@%*%^@^#@^@%^!@*
Not too much, we don't want to be *blindly* optimistic....but really, life is much more enjoyable when optimism is daily food. You can even turn most bad situations, well probably not tragedies, into GOOD ones. That's how I survived all these years anyway......
Posted by Sigismund on May 15, 2009, at 21:25:33
In reply to Re: What are our alternatives?, posted by garnet71 on May 15, 2009, at 20:06:49
You might be right?
Apparently the War on Drugs is over because the government does not want to wage war (or give the appearance of it) against its own people.
I never would have expected that.
Posted by tensor on May 16, 2009, at 2:30:28
In reply to What are our alternatives?, posted by SLS on May 14, 2009, at 15:58:37
Hi Scott,
I recently purchased and read this book:
http://www.amazon.com/Conquering-Depression-Anxiety-Through-Exercise/dp/1591021928/ref=sr_1_1?ie=UTF8&s=books&qid=1242458254&sr=8-1So exercise have become a part of my treatment. If you have not read it I can warmly recommend it. It's professional and balanced, it's not claiming that depression is a choice or that exercise is a replacement for drugs. The author does say that in some cases exercise can relieve symptoms fully or partially, and he always back up his theories and claims with a study or a research report.
I'm currently in a depressive episode, and from experience I know that only time can put me in remission, or actually make the drugs work. Currently the drugs do not work, no matter how I switch or combine.
/Mattias
Posted by Neal on May 16, 2009, at 3:23:09
In reply to What are our alternatives?, posted by SLS on May 14, 2009, at 15:58:37
Scott,
As I understand your question; what are the alternatives to the standard Pharma meds?Maybe we could make a list of anything that has been claimed to be efficacious by someone somewhere.
St. John's Wort
DHEA
Suboxone
Sam-e
fish-oil
?????I'm sure there are a lot more . . .
Posted by tensor on May 16, 2009, at 4:01:43
In reply to Re: What are our alternatives?, posted by Neal on May 16, 2009, at 3:23:09
Has someone here actually noticed an improvement with fish-oil. I mean the fatty acids are essential but as with vitamins, if there is no proven deficiency will there be any sign of improvement? I have never noticed any. IMHO, it's more like, can help, can't hurt.
/Mattias
Posted by SLS on May 16, 2009, at 5:07:22
In reply to Re: What are our alternatives?, posted by Neal on May 16, 2009, at 3:23:09
> Scott,
> As I understand your question; what are the alternatives to the standard Pharma meds?Any and all alternatives are important to acknowledge and evaluate. Just like prescription drugs, I imagine that each suggestion will not be a panacea, but you never know. It is easy to give into the temptation of using one's own experience with a particular treatment to suggest it as a generalizable phenomenon. I still do it sometimes. I think it helps to regard the word "depression" as representing a great many conditions.
> Maybe we could make a list of anything that has been claimed to be efficacious by someone somewhere.
>
> St. John's Wort
> DHEA
> Suboxone
> Sam-e
> fish-oil
> ?????
>
> I'm sure there are a lot more . . .Thanks for the suggestions.
- Scott
Posted by SLS on May 16, 2009, at 5:11:39
In reply to Re: What are our alternatives? » Neal, posted by tensor on May 16, 2009, at 4:01:43
> Has someone here actually noticed an improvement with fish-oil. I mean the fatty acids are essential but as with vitamins, if there is no proven deficiency will there be any sign of improvement? I have never noticed any. IMHO, it's more like, can help, can't hurt.
I didn't expect much from fish oil the first time I tried it. Immediately after my first dose, I felt a strange type of energization. It lasted for less than a two days, but it struck me that there is something pharmacological going on with fish oil besides it serving the brain as a nutritional supplement. I'm not sure, though.
- Scott
Posted by 49er on May 16, 2009, at 5:57:35
In reply to Re: What are our alternatives? » Neal, posted by tensor on May 16, 2009, at 4:01:43
> Has someone here actually noticed an improvement with fish-oil. I mean the fatty acids are essential but as with vitamins, if there is no proven deficiency will there be any sign of improvement? I have never noticed any. IMHO, it's more like, can help, can't hurt.
>
> /MattiasGreat question.
When I was on them, I never felt the dramatic improvement that other people have reported. But since I have discontinued them due to agitation, I think they were doing something positive.
Maybe I just haven't found the right brand or the right combination to get the best result. As an FYI, getting omega 3 from food just doesn't cut it as a replacement. I thought it did in a previous post I wrote but now I am wondering.
I am going to be switching to a supplement that I think is less activating. Then I will try the fish oil capsules again to see if this combination will work.
It really is trial and error as I have had no luck with alternative practitioners. I don't want to get off topic but just because I have railed against mainstream psychiatry doesn't mean I have any love for most alternative folks.
49er
Posted by desolationrower on May 16, 2009, at 21:14:33
In reply to Re: What are our alternatives?, posted by Neal on May 16, 2009, at 3:23:09
> Scott,
> As I understand your question; what are the alternatives to the standard Pharma meds?
>
> Maybe we could make a list of anything that has been claimed to be efficacious by someone somewhere.
>
> St. John's Wort
> DHEA
> Suboxone
> Sam-e
> fish-oil
> ?????
>
> I'm sure there are a lot more . . .um you're aware there is an entire board called 'alternative' at dr-bob? lets not reinvent the wheel...
-d/r
Posted by Michael Bell on May 17, 2009, at 0:20:24
In reply to What are our alternatives?, posted by SLS on May 14, 2009, at 15:58:37
The brain has the remarkable feature of elasticity. It is ever-learning, ever-changing. Thought processes and beliefs are literally pathways in the brain that have been formed over time. Therapy allows you to challenge your belief systems and literally create new pathways in your brain. The important thing to remember is that therapy actually results in physical changes in your brain, just as medication does.
Posted by sowhysosad on May 17, 2009, at 4:12:54
In reply to Re: What are our alternatives? Therapy, posted by Michael Bell on May 17, 2009, at 0:20:24
> The brain has the remarkable feature of elasticity. It is ever-learning, ever-changing. Thought processes and beliefs are literally pathways in the brain that have been formed over time. Therapy allows you to challenge your belief systems and literally create new pathways in your brain. The important thing to remember is that therapy actually results in physical changes in your brain, just as medication does.
I'd imagine that's more true of therapy which changes thought systems - like CBT and Psychology of Mind - than it is of traditional Freudian psychoanalysis.
In fact, I know at least one study provided evidence of changes in the brain after CBT.
Posted by greywolf on May 17, 2009, at 4:13:53
In reply to Re: What are our alternatives? Therapy, posted by Michael Bell on May 17, 2009, at 0:20:24
Some non-med alternatives are VNS, ECT, and therapy.I have a VNS implant, but we're not yet at a frequency level where a therapeutic benefit would be expected.
I've recently had ECT during a crisis. Not my style and I won't be going back to it.
I've been in therapy for both depression and OCD for several years. I can honestly say that it may not be a cure, but my therapist sure has helped me through some rough times.
Group therapy doesn't appeal to me, but it's apparently helpful to others.
Greywolf
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