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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by radish on January 22, 2019, at 19:50:46
https://www.goodreads.com/book/show/34921573-lost-connections
The writer who is not a medical professional purports that anxiety and depression has overwhelmingly social and environmental causes related to modern life/late capitalism/past traumas/negative life circumstances instead of the brain chemical model.
And he is of the opinion that antidepressants are no better than placebo and cannot and have never worked for people. He thinks depressed and anxious people need to change their lives, or more broadly, that society must change, for these illnesses to improve on a mass scale. I agree, however. He does not discuss the many other numerous classes of drugs that genuinely help people. It's rather glib to imply masses of people don't have endogenous brain issues because it implies they need not seek medical care/treatment. There can be an endogenous brain issue as the intermediary mechanism between a cause (say, genetics or life factors) and the presenting symptoms.
Posted by alexandra_k on January 24, 2019, at 19:15:31
In reply to Has anyone read the book Lost Connections, posted by radish on January 22, 2019, at 19:50:46
I haven't read it, but what you say about it, is interesting.
> The writer who is not a medical professional purports that anxiety and depression has overwhelmingly social and environmental causes related to modern life/late capitalism/past traumas/negative life circumstances instead of the brain chemical model.
They don't need to be one or the other.
For example, cholrea is caused by a cholera bug. People get cholrea after being exposed to the cholera bug. We can give people anti-biotics to kill the cholera bug, and there we go, we have fixed up their cholrea.
But cholrea bugs get into people when their water supply is contaiminated by inadequately treated toilet waste. So industrialisation and urban intensification results in people beign exposed to the cholrea bug. We can fix up some social problems to mean people aren't exposed to the cholrea bug, and there we go, we have fixed up the cholera.
Suppose that people are anxious because of urbanisation and so on... The ills of modern life... Living in these stressful environments where people are often powerless to get their very real needs met is something that can alter their brain chemistry and weaken their immune system. When people live in environments that are physiologically stressful their body needs to expend more energy to achieve homeostatis (to keep temperature regulated or whatever) and that results in cut-backs for other systems... like for immune system surveillance.
> And he is of the opinion that antidepressants are no better than placebo and cannot and have never worked for people.Placebo is pretty effective. If 20 or so percent of people say they feel better after having a placebo asprin or a placbo antianxiety or antidepressant then... I'd take the placebo and hope I'm one of that group. It might be a slightly different story if I were taking out a second mortage on my family home to afford the placebo... But placebo effect vs real effect... They're both the same, to me.
> He thinks depressed and anxious people need to change their lives, or more broadly, that society must change, for these illnesses to improve on a mass scale.
Yeah, I agree, too. I've recently been reading World Health Organisation stuff on ill health and disability and United Nations stuff on the Sustainable Development Goals. And the focus seems largely (to me) to be on powerlessness. How many people simply don't have the power to obtain the resources they need / the things they know are good for them.
On the other hand...
I remember time I spend in hospital and some of the people there. Some of them, it seemed to me, were ill in a different way. I mean, some of them did have the things they seemed to need and also had good people in their lives. Of course I didn't know them really really well and did not talk to them deeper or over a longer period of time so it might be that things weren't so good for them if I looked deeper...
But it seems to me that just as some people are born or develop some kind of... Defect or abnormality... A limb that isn't there or doesnt' grow / develop normally... It makes sense that that could happen to neural regions or certain kinds of neurones or receptors or whatever. From a genetic abnormality or an enzyme decificiency or whatever. Something that won't be put right with having a high quality environment.
I think these sorts of cases were supposed to be what psychiatry is for / is about, really.
But then things sort of branch out from there... Because the presentation can (superficially anyway) look a lot like people who got there from enviornmental problems, mostly.
Like how some medical disorders can imitate people who are high on or detoxing from alcohol or illicit drugs.
So can be hard to know what's going on / what is likely to sustainably put it right.
Posted by baseball55 on January 25, 2019, at 16:31:41
In reply to Has anyone read the book Lost Connections, posted by radish on January 22, 2019, at 19:50:46
Haven't read it. But I'm not sure how much capitalism has to do with mental illness. Sounds a little too Thomas Szasz for my taste.
But I do agree that depression/anxiety have strong psycho-social components better treated with therapy and self-care than with drugs. Social anxiety, in particular, seems to me entirely a psycho-social disorder (and I say this as someone who had very bad social anxiety). However, there is a biological component as well, at least in my experience. Sometimes there is no trauma, no unhappiness, no trigger that cause people's mood to plummet. That certainly is the case for me. Something just goes awry in whatever networks in the brain affect mood.
So drugs are needed to alter the dysfunction in the brain. Maybe not the drugs we have available today, but finding something that lifts depression reliably and in most people and is not addictive is the holy grail of psychiatry.
Glen Gabbard calls mood disorders bio-psycho-social disorders. I think that sums it up.
> https://www.goodreads.com/book/show/34921573-lost-connections
>
> The writer who is not a medical professional purports that anxiety and depression has overwhelmingly social and environmental causes related to modern life/late capitalism/past traumas/negative life circumstances instead of the brain chemical model.
>
> And he is of the opinion that antidepressants are no better than placebo and cannot and have never worked for people. He thinks depressed and anxious people need to change their lives, or more broadly, that society must change, for these illnesses to improve on a mass scale. I agree, however. He does not discuss the many other numerous classes of drugs that genuinely help people. It's rather glib to imply masses of people don't have endogenous brain issues because it implies they need not seek medical care/treatment. There can be an endogenous brain issue as the intermediary mechanism between a cause (say, genetics or life factors) and the presenting symptoms.
Posted by alexandra_k on January 27, 2019, at 14:52:46
In reply to Re: Has anyone read the book Lost Connections, posted by baseball55 on January 25, 2019, at 16:31:41
> Haven't read it. But I'm not sure how much capitalism has to do with mental illness. Sounds a little too Thomas Szasz for my taste.
I used to hate-on Szasz. But I read something of his a bit more recently, and I started to think that he was maybe on to something. That being said -- he was pretty prolific over his lifetime and he said really rather a lot of things. It might be that I found different things that he said the second time around.
I think he was NYU. I mean, I thought he was a bit of a crank to start with -- but I don't think you get to be a crank at NYU? Or maybe something about keeping your enemies even closer...
> But I do agree that depression/anxiety have strong psycho-social components better treated with therapy and self-care than with drugs. Social anxiety, in particular, seems to me entirely a psycho-social disorder (and I say this as someone who had very bad social anxiety). However, there is a biological component as well, at least in my experience. Sometimes there is no trauma, no unhappiness, no trigger that cause people's mood to plummet. That certainly is the case for me. Something just goes awry in whatever networks in the brain affect mood.
Yeah. Plenty of people say they find something like that. Or find something seasonal. And they don't find that trying to figure out inner psychology stuffs helps, at all.
Things were different for me. A lot of my early... Upset... Was a Harry Harlow monkey sort of an upset. I did engage in a lot of help-seeking behavior from psych services, I suppose. Because that was what was wrong and I guess that was obvious to them. Then, over time, I did have some good influences in my life (including supportive therapists) and I came to internalise a bunch of stuff that a lot of other people got more of earlier on. And then my struggle became mostly about lack of resources to attain the things I needed. Mostly - to get away from other people who were similarly lacking in and needy of good influences. Or to get away from other people who were living out their dysfunction. Space away from them so I could find my... Inner better self. Try and develop in positive ways. Study when I need / want / can bear it. Sleep when I am tired. Not be required to play mother to them.
And now I suppose I am struggling to try and integrate into something... I don't know. We will see...
> So drugs are needed to alter the dysfunction in the brain. Maybe not the drugs we have available today, but finding something that lifts depression reliably and in most people and is not addictive is the holy grail of psychiatry.
Yeah.
I wonder if it's like trying to find the cure for 'immune disorders' or 'enzyme disorders' or 'blood disorders'. I mean to say that there are so freaking many of them... With very different proximal causes.
I mean... Things to do with mood could be: Under-developed (mass) of a neural region, over-developed (mass) of a neural region, excess of receptor type 9758 subtype 84729583, lack of receptor 8574 subtype 7479245849... You get the idea.
The greatest progresses in treatments are ones that seem to fix things up pretty great for a really small number of people. That's partly why Med is hard. Lots and lots and lots of different disorders -- that could be (well, relatively) easily fixed with the right treatment. In certain countries where treatments are available, anyway.
But less of the en-masse cure-all.
I mean... Methamphetamine tends to make people immediately feel good. Or there is that brain stimulation of the pleasure centre that is so good all you will want to do it keep hitting the button for more of that over and over and over. But that isn't really the cure... Not 'feel good' but 'don't feel so gosh darned awful anymore'.
Or shock treatment.
Or lithium.
They were sort of en masse feel-goods. The shock treatment came from the observation that epileptics tended to have a boost in mood after their seizures so they got to wondering if inducing seizures intentionally might help other people too (at least that's what they said they were doing in shocking people).
Those sort of en-masse cure-alls.
But they don't seem to quite get at it...
Posted by sigismund on January 27, 2019, at 17:24:10
In reply to Has anyone read the book Lost Connections, posted by radish on January 22, 2019, at 19:50:46
Yep, I read most of that and also Chasing the Scream. I didn't finish either. It was right, but not particularly interesting. Lost connections is about the necessity of community, and therefore atomisation under the current economic system. Capitalism has existed for much longer than atomisation.
Posted by sigismund on February 4, 2019, at 16:01:40
In reply to Re: Has anyone read the book Lost Connections, posted by sigismund on January 27, 2019, at 17:24:10
I think this is better. There are a heap of good ministers of religion in the USA.
https://www.counterpunch.org/2019/02/01/the-high-human-cost-of-liberal-resentment/
Posted by Radish on February 5, 2019, at 19:12:41
In reply to Re: Has anyone read the book Lost Connections, posted by sigismund on February 4, 2019, at 16:01:40
> I think this is better. There are a heap of good ministers of religion in the USA.
>
> https://www.counterpunch.org/2019/02/01/the-high-human-cost-of-liberal-resentment/What is this article about roughly?
Posted by sigismund on February 6, 2019, at 23:59:50
In reply to Re: Has anyone read the book Lost Connections, posted by Radish on February 5, 2019, at 19:12:41
Ummm, well.......parts of ourselves unrecognised and unaccepted, projected onto appropriate scapegoats, the culture of resentment and the way in which the cruelty of the current neoliberal system where people have no intrinsic value except money wise......something along those lines?
It's only an essay.
This is the end of the thread.
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