![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 13 to 37 of 85. Go back in thread:
Posted by m3 on February 23, 2002, at 14:56:38
In reply to For Judy, posted by Dinah on February 23, 2002, at 13:42:58
<snip>
> I am a better mother because of therapy. I will never use my child as a therapist substitute or burden him with my problems. I will allow him the chance to be the child, one who doesn't have to worry about the well-being of his parents. I really wish that my parents had had therapists.
>Amen, Dinah. Even if we are all just sacks of chemicals (I tend to agree), we can notice that other people expressing their chemicals inappropriately can upset our own chemicals, especially when we are small children. Is this the only way our chemicals get out of whack? No. Sometimes they do their own thing and it really isn't situational.
But even so, why let our chemicals spew on other people who can't handle them, instead of using a trained chemical-spill technician?
My two cents, as someone who also wishes her parents had gone to therapists.
M3
Posted by mcd on February 23, 2002, at 15:19:28
In reply to Re: Very well said Anna Laura - for Old School » Dinah, posted by judy1 on February 23, 2002, at 10:14:57
For articulating my opinions much better than I could do, and for highlighting the difference between what Old School posted - "I don't..." and what he seems to really mean - "I won't..."
Mary
Posted by m3 on February 23, 2002, at 15:34:42
In reply to For Judy, posted by Dinah on February 23, 2002, at 13:42:58
Poster's remorse...
I didn't mean to hijack/usurp your insight. I just meant to agree, wholeheartedly.
m3
Posted by Dinah on February 23, 2002, at 18:46:57
In reply to Re: For Judy, posted by m3 on February 23, 2002, at 14:56:38
> Amen, Dinah. Even if we are all just sacks of chemicals (I tend to agree), we can notice that other people expressing their chemicals inappropriately can upset our own chemicals, especially when we are small children. Is this the only way our chemicals get out of whack? No. Sometimes they do their own thing and it really isn't situational.
>
> But even so, why let our chemicals spew on other people who can't handle them, instead of using a trained chemical-spill technician?
>
> My two cents, as someone who also wishes her parents had gone to therapists.
>
> M3M3, I love the metaphor! Especially the "trained chemical-spill technician". That is exactly how my husband and I think of my therapist. Thanks!
No need for poster's remorse at all. Jump in anytime. Please.Dinah
Posted by spike4848 on February 23, 2002, at 18:50:28
In reply to I dont relate well to the mental health community, posted by OldSchool on February 22, 2002, at 21:22:41
Hey Old School,
Yeah, we have talked about this before. The field of Psychiatry is wasting away, while Neurology is taking its place. The only way Psychiatrist can drum up business is convince patients that "medicines are bad and only covering up the problem" ..... basically making the public feel guilty about taking medications that are necessary for a *medical* disease-depression.
While I am going through my med trials to try and find something that doesn't have all the side effects of nardil, I have been seeing a social worker from the clinic I work at. After seeing and talking to me, he is convinced depression is a medical disease. He has asked me to speak, as a physician, to his group therapy patients about the *benefits* of meds. Can you believe that, a therapist is asking me to trash psychotherapy and plug meds. He has seen the light.
Spike
Posted by OldSchool on February 23, 2002, at 19:32:49
In reply to You won't believe this! » OldSchool, posted by spike4848 on February 23, 2002, at 18:50:28
> Hey Old School,
>
> Yeah, we have talked about this before. The field of Psychiatry is wasting away, while Neurology is taking its place. The only way Psychiatrist can drum up business is convince patients that "medicines are bad and only covering up the problem" ..... basically making the public feel guilty about taking medications that are necessary for a *medical* disease-depression.Oh God, I just hate psychiatry. I despise it...I could vomit all over myself thinking about how screwed up it is.
>
> While I am going through my med trials to try and find something that doesn't have all the side effects of nardil, I have been seeing a social worker from the clinic I work at. After seeing and talking to me, he is convinced depression is a medical disease. He has asked me to speak, as a physician, to his group therapy patients about the *benefits* of meds. Can you believe that, a therapist is asking me to trash psychotherapy and plug meds. He has seen the light.Well maybe being the person you are (arent you an MD?) this person realized this stuff is medical. Maybe something you told them just convinced them you are right. I just cannot believe with the severe symptoms I have had that some people honestly believe that talking will make things better...I mean its just beyond my comprehension. I just dont understand where these talk therapy/psychology people come from...do these people REALLY believe that makes serious mental illness any better?
I guess I just feel that there is a lot of wasted energy in the mental health field. Its hard to articulate sometimes. As for the Nardil/MAOI thing I am not really qualified to talk about that as Ive never taken an MAOI except for very briefly and didnt give it a chance. Im scared to take the older irreversible MAOIs, I developed hypertension as a result of trying Parnate briefly. I had a very mild hypertensive crisis on Parnate and its just too much for me to handle. I do know MAOIs are the best antidepressants, useful for refractory depression. I have read all about it and I dont really think there are any antidepressants that come close to the efficacy of MAOIs.
The only thing that probably equals or surpasses the efficacy of MAOIs is ECT, but ECT doesnt usually last so I guess you come back to the MAOIs. As far as alternative meds, the only thing I can think of is possibly high dosage Effexor. have you ever tried that? Its quite effective. Like going to 375 mg Effexor. Some people have gone higher than that, even though you have to watch out of blood pressure probs at super high doses. Like combine high dose Effexor with high dosage Remeron...thats a potent combo Stephen Stahl dubbs "California Rocket Fuel" because its some potent stuff. And if that doesnt get you to remission try adding Lamictal to it.
Id say thats the closest modern class drug combo I have read about that is comparable to the MAOIs. High dose Effexor plus Remeron plus Lamictal. Some strong shit that would be.
Also, as long as you dont have an addiction history in your past, there is always plain old amphetamines. Ritalin, dexedrine, etc. Combining speed with Effexor or an SSRI is a useful combo for some.
Unfortunately while this polypharmacy stuff seems to work great for others, I have had major problems with polypharmacy and dont seem to be able to do that.
The one thing Im thinking about besides ECT is maybe ordering some moclobemide from overseas. But I know Im not supposed to talk about that on this board. I have read about moclo and feel comfortable taking that drug...it sounds pretty safe compared to the older MAOIs. Im also HOPING this selegiline MAOI patch will be FDA approved soon.
take care,
Old School
Posted by spike4848 on February 23, 2002, at 20:47:37
In reply to Re: You won't believe this!, posted by OldSchool on February 23, 2002, at 19:32:49
>I just dont understand where these talk therapy/psychology people come from...do these people REALLY believe that makes serious mental illness any better?
Study after study shows moderate to severe depression does *NOT* respond to therapy .... only medication. And some of these new meds are terrible .... only good for those individuals with depression "light" .... the patients say they feel blue or that they cried twice last week because their cat died. Real Depression is inability to feel ANYTHING, retarded motor activity, insomnia/hypersomnia, decrease cognition .... SSRI's/serzone won't do squat for that.
> Unfortunately while this polypharmacy stuff seems to work great for others, I have had major problems with polypharmacy and dont seem to be able to do that.
Tried effexor to 375mg .... nothing, tried lamictal .... nothing. So now I got zoloft/klonopin/neurontin combo going with about 50% relief .... added provigil to that but felt wired/panicky/then hard crash at night. My next trial will be zoloft/klonopin/neurontin with low dose selegine (MAO-B inhibition dose range). I think that combo mimics the action of nardil (zoloft for serotonin, klonopin for GABA, neurontin for GABA, seligine for dopamine and norepinephrine). After that I am throwning in the towel and going back to nardil. Unforunately with nardil I gain 30 lbs, need heavy duty sleeping pills for insomnia, become inpotent .... there goes my chances of having a normal relationship with a women .... there goes marriage. But aleast I will be back into the world and off the web.
Your Friend,Spike
Posted by Willow on February 23, 2002, at 21:12:21
In reply to Re: You won't believe this!, posted by OldSchool on February 23, 2002, at 19:32:49
"Can you believe that, a therapist is asking me to trash psychotherapy and plug meds."
Once during an appointment with my psychologist, I was thinking out loud about quiting effexor, when the vehemence of his answer, no, made my jaw drop.
> I just dont understand where these talk therapy/psychology people come from...do these people REALLY believe that makes serious mental illness any better?
What is the harm? There are different "forms" of talk therapy. I can't say that any medication has helped me through a crisis the way my psychologists have. No medication has been able to curb chronic suicidal thoughts, though talking and thinking through why they come, and learning through these processes has helped.
My father's illness I would consider severe. The medication he has taken has threatened his physical health and the illness itself has affected his well-being. Of us who post on this board, I would consider our lives from marginally to moderately touched by mental health issues. I would be hard pressed to call them severe. But then again this is just one of my many opinions.
BEST WISHES
Willow
Posted by spike4848 on February 23, 2002, at 21:13:45
In reply to Screw Therapy! » OldSchool, posted by spike4848 on February 23, 2002, at 20:47:37
Old School,
Oh yeah ... there is a great medication for depression light .... it is called "placebo". LOL.
Spike
Posted by christophrejmc on February 23, 2002, at 22:50:15
In reply to Re: Screw Therapy!, posted by spike4848 on February 23, 2002, at 21:13:45
Well... I have double depression -- dysthymia since age nine, and recurrent MDD since age fourteen. (I think I would trade my "fake" depression for my "real" depression; at least I would get some breaks in between.) Psychotherapy has only been helpful since finding someone I could really talk to. It may not cure my depression, but it does help. I also think that therapy can be wrong for some people (regardless of severity), and that some therapists can be wrong for certain patients.
If depression is neurochemical, and feelings are neurochemical, then changing certain feelings can affect neurochemistry. It's unlikely that antidepressants work by increasing the concentration of neurochemicals, rather it is probably the secondary (tertiary, etc.) effects of a change in neurochemicals. I think the same is true of thoughts and feelings; a slight change in one feeling may affect another feeling, affecting another, etc. It's not necessary for one to have a therapist to change (or modify) their thoughts and feelings, but it does help if you allow it to.
I don't see why it matters if one sees a neurologist or a psychiatrist. I don't know of many psychiatrists who do psychotherapy, so it's basically a matter of who's shoveling out the Prozac. What can a neurologist tell me that a psychiatrist cannot?
-christophre (get me away from here, I'm dying)
Posted by Bob on February 24, 2002, at 0:22:23
In reply to Re: You won't believe this!, posted by OldSchool on February 23, 2002, at 19:32:49
> Unfortunately while this polypharmacy stuff seems to work great for others, I have had major problems with polypharmacy and dont seem to be able to do that.
==================================================I have to agree here. Polypharmacy hasn't exactly been a panacea for me either. I have enough trouble tolerating one of the drugs alone, let alone something like Remeron and Effexor together.
Posted by spike4848 on February 24, 2002, at 7:55:27
In reply to The Cactus Where Your Heart Should Be, posted by christophrejmc on February 23, 2002, at 22:50:15
> I don't see why it matters if one sees a neurologist or a psychiatrist. I don't know of many psychiatrists who do psychotherapy, so it's basically a matter of who's shoveling out the Prozac. What can a neurologist tell me that a psychiatrist cannot?A neurologist understands the various functions of each part of the brain and how they interaction. They also understand the pathophyisiology of brain disease (and depression is a brain disease). So they are much better equipt to finally uncover the cause of depression and how to sucessfully treat it, whether it be with meds, ECT, VNS, etc.
Psychiatrists have *NO* working knowledge of the brain, and therefore have know way determining the cause of depression. So they basically just "shovel" out what ever med the pharmaceutical company gives them. And these companys often give out medications that are marginally effective for depression. SSRIs and serzone are such meds, often giving patient only partial relief. I know many patient who took SSRI for years with little success, and once they started a TCA/MAOI they finally felt relief. So these people suffered for years on SSRIs and lost many years of there life. It is really sad.
Unforunately, many pdoc are brainwashed into only prescribing SSRIs and effexor. I have heard some pdoc state they will never prescribe a TCA/MAOI. That is malpractice!
Hope this answered your question.
Spike
Posted by trouble on February 24, 2002, at 8:18:55
In reply to Re: Webster's dictionary definition of Psychiatry, posted by OldSchool on February 23, 2002, at 12:03:00
Hi Old School,
I don't know if your question is rhetorical or not, so if not kindly indulge the following. Or not!
I suspect the answer to your question as to why we're treated by psychiatry and not neurology is, in part political, as in who ultimately "claimed" us, who "won" or "got stuck with" our patronage. Because you're on the right track, Old School, neurologists WERE the first to treat people for psychiatric disorders.
Psychiatry didn't come around until the end of the 18th century. A genetic perspective was present from the beginning. Psychiatrists, or "alienists", hung out in asylums, and didn't treat the unconfined.
There was a fight basically, btwn neurologists and psychiatrists over who gets the office-based psychotherapy market share. Incidentally I loved your Woody Allen remark, I can't stand him being the cultural paradigm of the mental patient, one more weary stereotype for me to shoulder. ARGH. In the vernacular he represents "subthreshold" disorders, or in lay terms "high lucrative."
Psychoanalysis is one example of psychiatry's flight from science into fashion, there have been others, all well documented. But the enduring departure from biology, known as "romantic psychiatry" (or "psychsocial") emphasizes one's personal history and social environment. Do you think there is a place for this in therapy or not?
The way I see it, neurologists treated madness first, neurosyphilis being the leading cause of mental illness at the turn of the century. Psychiatry, which started out all neurological steered itself toward the money, ie Woody Allen's inner journey on the couch. Neurologists wanted no part of that, after all neurosyphyilis shows up under the microscope, neurosis does not.
Am I boring you? I'm boring myself. Not even sure what I'm talking about at this point, but rest assured it's an age-old question my friend. Is there such a thing as a mind (psyche)? Can we ever know the answer to that? The prudent clinician keeps one foot in the biology camp and the other in the psychosocial camp, aka the "biopsychosocial model". IMHO it seems to me that it's always us crazies who insist on the dogmatic either/or position.
trouble
> Psychiatry: "The branch of medicine concerned with the study, treatment and prevention of disorders of the mind, including psychosis and neurosis, emotional maladjustments, etc."
>
> Now Ive got to ask you something. Just what exactly is a "disorder of the mind?" Why are we all being told depression is a medical problem? And that our "brain changes when we develop mental illnes?" But the focus with psychiatry is on the outward behaviors dealing with the "mind." I just dont get it. Seems stupid to me. When the problem isnt the "mind" its your brain and nervous system. All thoughts, feelings, moods and emotions originate from your brain, which is a tangible, physical, bodily organ. The brain is nerve tissue.
>
> Now let me give you the Webster's dictionary definition of Neurology.
>
> Neurology: "The branch of medicine dealing with the nervous system, its structure, and its diseases."
>
> LOL Now if all thoughts, moods, feelings, etc. originate with the brain, which is a major part of the nervous system, and depression is a disease of the brain to be treated with medication, WHY is it that mental illness is not treated by Neurology? Instead of psychiatry. Seems to me that Psychiatry is kind of stupid...focused more on the outward behaviors of people, when the real problem is diseased brains and nervous systems. This would be like a microbiologist trying to study AIDS without a microscope and only being allowed to study AIDS by going with what they can see with the naked eyeball, looking and talking to the AIDS victim.
>
> I have a problem with the usual mental health community because I feel that they are way off in left field, on a wild tangent studying psychology things, when the real problem is Neurological disease.
>
> Maybe this is the reason why I do not relate to the typical, usual mental health spiel. Because I can see thru it all and realize what BS it is.
>
> Old School
Posted by trouble on February 24, 2002, at 8:37:35
In reply to Re: You won't believe this!, posted by Willow on February 23, 2002, at 21:12:21
Willow, I'm curious about your opinion about the majority of the pb community being marginally or moderately afflicted.
Can you talk more about this impression?Thanks, trouble
Posted by OldSchool on February 24, 2002, at 10:36:36
In reply to Neurologists versus Psychiatrists » christophrejmc, posted by spike4848 on February 24, 2002, at 7:55:27
>
> > I don't see why it matters if one sees a neurologist or a psychiatrist. I don't know of many psychiatrists who do psychotherapy, so it's basically a matter of who's shoveling out the Prozac. What can a neurologist tell me that a psychiatrist cannot?
>
> A neurologist understands the various functions of each part of the brain and how they interaction. They also understand the pathophyisiology of brain disease (and depression is a brain disease). So they are much better equipt to finally uncover the cause of depression and how to sucessfully treat it, whether it be with meds, ECT, VNS, etc.This is exactly correct and what I have been saying. Im SICK of going to psychiatrists and telling them I have all these sleeping, energy level, eating, sex drive and cognition problems and its taken in a psychological context. I have figured out most psychiatrists do not medically understand mental illness very well beyond a basic, descriptive approach. Its sickening.
Im looking for a brain expert...instead what I get is some asshole who dx's me with the psychology based DSM manual and puts me on brain chemistry altering medications.
>
> Psychiatrists have *NO* working knowledge of the brain, and therefore have know way determining the cause of depression. So they basically just "shovel" out what ever med the pharmaceutical company gives them. And these companys often give out medications that are marginally effective for depression. SSRIs and serzone are such meds, often giving patient only partial relief. I know many patient who took SSRI for years with little success, and once they started a TCA/MAOI they finally felt relief. So these people suffered for years on SSRIs and lost many years of there life. It is really sad.This has been my impression over the years. Psychiatrists know jack shit about the brain. They know all about the "mind" however. I dont get it...its beyond me. Hell Im confused.
>
> Unforunately, many pdoc are brainwashed into only prescribing SSRIs and effexor. I have heard some pdoc state they will never prescribe a TCA/MAOI. That is malpractice!Well I only go to my psychiatrist nowadays to get antidepressants prescribed to me. I do not listen to much of what they tell me anymore, because they've been so wrong before. And because gradually I have figured out psychiatry is heavily BS. Again, its the lack of neurological science rigor and the emphasis on "behaviors" and psychology crap that has made me totally lose respect for the mental health field as it currently exists.
If you have any doubts about what Im talking about, just get your Websters dictionary out and look up the official definitions of psychiatry and neurology. Which branch of medicine would you prefer to be working on your severe mental illness? Someone who actually is interested in and studies brain/neuroscience? Or someone well steeped in psychology BS?
Old School
Posted by OldSchool on February 24, 2002, at 10:42:50
In reply to Freud was a Neurologist, posted by trouble on February 24, 2002, at 8:18:55
Freud was a Neurologist in title and name only. The technology available in his time was extremely crude by today's standards. In Freud's day the technology available was simply not sufficient to study, research and learn about the brain and CNS. There were no computers back then, no diagnostic imaging equipment beyond X-ray machines, no SPECT scans, there was no NASA type space technology back then as there is now.
So Freud did the best he could do considering the technology of his day. And he invented psychobabble. Which just happened to attract all the freaks in the world. Freudian BS. And sometimes Freud prescribed the best drugs available at that time, like cocaine, opiates, etc.
Give me a break, Freud was no real Neurologist. Freud was more psychologist than Neurologist.
Old School
Posted by spike4848 on February 24, 2002, at 10:56:06
In reply to Re: Neurologists versus Psychiatrists, posted by OldSchool on February 24, 2002, at 10:36:36
And back to the "psychiatrist are lazy", in medical school most students who went on to psychiatry were at the bottom my class or foreign graduates and wanted to go into psych because of the easy lifestyle. One person actually told me, "I am doing Psychiatry and I will never get sued .... do you think they will believe someone who is CRAZY over me."
I personally do not wanted to be treated by someone who is an underachiever and lazy by nature.
Spike
Posted by trouble on February 24, 2002, at 12:15:58
In reply to Re: Freud was a Neurologist, posted by OldSchool on February 24, 2002, at 10:42:50
Posted by Krazy Kat on February 24, 2002, at 14:40:11
In reply to Was it something I said? (nm), posted by trouble on February 24, 2002, at 12:15:58
Absolutely not!! Your post was wonderful. Old School sems to "have a chip on each shoulder" as Russel Crowe so aptly put it in "A Beautiful Mind."
Posted by OldSchool on February 24, 2002, at 14:44:58
In reply to Psychiatrists are Lazy .... again! » OldSchool, posted by spike4848 on February 24, 2002, at 10:56:06
> And back to the "psychiatrist are lazy", in medical school most students who went on to psychiatry were at the bottom my class or foreign graduates and wanted to go into psych because of the easy lifestyle. One person actually told me, "I am doing Psychiatry and I will never get sued .... do you think they will believe someone who is CRAZY over me."
>
> I personally do not wanted to be treated by someone who is an underachiever and lazy by nature.
>
> Spike
My problem with psychiatry, and the entire mental health profession in general, is that these people just are barking up the wrong tree. Where is the Neurology? Where is the brain science behind this stuff? I dont think there is any. I just have a problem with the whole entire way this stuff is thought of. Thats my beef.Im like "HEY...I am physically sick here. My illness is real." And the typical response you get is its a "psychological" problem, then the next time you turn around you read pharmaceutical company ads for antidepressants claiming that depression is a medical problem, controllable via medication. LOL
If its a medical problem, then WHY are we being diagnosed with psychology?
Ive noticed that the researchers into this new depression treatment stuff like VNS, rTMS and functional neuroimaging refer to these problems as "Neuropsychiatric disease." I think thats a step in the right direction. But Id really like to see the psychiatric word dropped completely.
Words like "psychiatric," "psychological," "emotional," and most of all "behavioral" should all be dropped totally by the mental health community. Instead these problems should be referred to as "Neuropsychiatric" problems or hell just "Neurological" problems.
I cringe with irritation when I see signs advertising mental health clinics or hospitals that have "behavioral" in them. Makes me wanna puke. I guess my medical illness of major depression is a "behavioral" problem huh? LOL
We all have "behavioral" problems because we cant sleep good, lose weight without trying, lose our sex drives and become stupid as shit from cognitive deterioration! LOL HAHAHAHAH!!!
Old Schol
Posted by trouble on February 24, 2002, at 15:53:13
In reply to Re: Psychiatrists are Lazy .... again!, posted by OldSchool on February 24, 2002, at 14:44:58
Hey Old School,
Are you looking for answers here?
> If its a medical problem, then WHY are we being diagnosed with psychology?
If you've had it w/ discussion and just want to bark that's one thing. But if you're still open to argument for the sake of discovery, then hey, there's a lot of material to cover in the above question.
> Words like "psychiatric," "psychological," "emotional," and most of all "behavioral" should all be dropped totally by the mental health community.
I'm against these words myself, how their usage is contrived to make the consumer stand up and salute whatever's behind their invocation. They're so amorphous and empty, no one knows what these words mean, which, uh, I take it that was your point.I also go ballistic when the word behavioral is used to promote indivudual well-being; my initial reflex being F*CK YOU!, the word behavioral being way too close to the directive BEHAVE for my tastes.
I will also raise heck when they start "improving" my negative cognition, negative having shown itself the more accurate point of view in studies done on reality testing. I think it's significant that I have NEVER characterized my cognition as negative, (or positive), I wish the psychologists would "own" this one, but that would mean admitting their problematization of something in me they don't like, and them having the one true solution of course.
Nice work if you can get it.That's not to say I'm inflexible on these views, just very forbidding when the best-selling authors come to call.
Sorry if I failed to give you something to rail against, I'll try to do better next time.
love, trouble
>
> We all have "behavioral" problems because we cant sleep good, lose weight without trying, lose our sex drives and become stupid as shit from cognitive deterioration! LOL HAHAHAHAH!!!
>
>
>
>
> Old Schol
Posted by noa on February 24, 2002, at 16:43:46
In reply to Re: For Judy, posted by OldSchool on February 23, 2002, at 14:46:26
And I think there is something wrong with either-or thinking.
Our brains and the illnesses we have, are complex. Each of our brain illnesses, though called the same thing, might be quite different. What we call "depression" might in fact be a heterogeneous group of illnesses yet to be understood. And our brains are certainly quite complex and unique.
The relationship between "nature" and "nurture" is only beginning to be understood, but there IS enough knowledge at this point in time to lead us to not think of it as either-or.
Nature and nurture, psychological/emotional experience and physiology/neurology are constantly interacting and mutually influential. For each of us, the degree to which our psychology or our neurology is the most reasonable point of entry for intervention, is going to be different.
The science/art of therapy is inexact for sure, but so is the science/art of psychopharmocology (The author of Noonday Demon likens it to a game of dart board).
For some, medication only is the treatment of choice. For others, therapy only is the treatment of choice. For others still, a combination of the two is the treatment of choice. And there are many reasons for choosing one approach or another--all based on the needs of the individual.
And, a comprehensive plan of treatment isn't just limited to therapy/and or medication. There may be other aspects to the treatment, like exercise, diet modifications, developing more social support, practicing meditation, etc. What works for me isn't necessarily going to work for you and vice versa, just as this is the case with our choice of which medication to take and how much.
The recent PBS special on the brain (The Secret Life of the Brain) did a good job, imho, in its 4th episode, of illustrating just how intricately connected are feelings and thoughts and psychological experiences and physiology. They used PTSD to illustrate this--how the interplay between physiology and psychology lead to symptoms and how the interplay between the two can be harnessed in treating the symptoms.
We are complex creatures and the complexities of our our brains function is something we are only beginning to understand. For me, the either-or approach just doesn't fit. It is true that I am so grateful for my medications--without them I would be dead. But if I were just on medication and not in therapy, I'd probably be dead too. And without therapy, I certainly would not be able to work through just how much this illness has caused me to suffer. Or to be able to take better charge of my life. Both forms of treatment have been essential for me in my recovery process. But I recognize that what works for my treatment may not be the thing that works for your treatment, and I fully respect that--we are each so unique that it would be impossible for me to assume that what works for me would necessarily be what works for you. I hope that you will be able to recognize that, too, and not dismiss the value of what has been valuable in my treatment, just because it is not necessary or valuable in your treatment.
Posted by noa on February 24, 2002, at 16:57:54
In reply to You won't believe this! » OldSchool, posted by spike4848 on February 23, 2002, at 18:50:28
See, to me, it didn't sound like the therapist is asking you to "trash" psychotherapy---it sounds to me like he is asking you to join the two forms of treatment for stronger effect!
I also am starting to wonder about how geography plays into this. I find myself wondering where y'all live that you are meeting psychiatrists who only like to do therapy! That is very different from my experience! Sure, there are some here and there who do therapy and very little medication, but most psychiatrists I've heard of are doing a lot of psychopharm and very little therapy. Has been this way for about a decade.
Or therapists who have had their heads in the sand for the past few decades and have a bad attitude about depression being a medical illness??? Not in my experience! On the contrary, most I've encountered see their role as providing what is often part of a total treatment plan that involves medication when indicated.
Every so often, I hear about therapists who do have a bad attitude about meds. A friend of mine extricated herself from a bad therapy situation in which the therapist's philosophy was that if you take medication you are avoiding the real issues and if you need medication you should be seeing a psychiatrist instead of her. She even communicated this philosophy in her printed literature. Personally, I think it is malpractice, but the way she actually worded the statement in print can be defended legally.
But for the most part, I think that therapist is not the norm in today's mental health world, at least as I've experience it. So that is why I asked about geography.
Posted by noa on February 24, 2002, at 17:11:12
In reply to Re: You won't believe this!, posted by OldSchool on February 23, 2002, at 19:32:49
>>I just cannot believe with the severe symptoms I have had that some people honestly believe that talking will make things better...
You are right. With my symptoms, too, talking would NOT make it better. Not without medication, anyway. But with medication, for me, the medication makes it better, but not better enough in the sense that there are things that medication cannot help me accomplish in the process of recovering from depression that therapy can and does.
But if you have had what sounds like an incredibly frustrating experience of working with professionals who suggested that therapy would suffice for you, then I understand the anger that I sense in your posts. That kind of thing can really be maddening, as though people are telling you that the incredible pain you are suffering will go away if you would only just work harder in therapy. That kind of thing is crazy making, to be sure. (but, per my previous post, don't discount the value of therapy just because you've had the misfortune of this kind of crazymaking treatment by some therapists).
The truth is that while I strongly believe that therapy can be a powerful healing part of treatment for some people, I know that for many of us, it is impossible to find it useful without establishing some kind of minimum "floor" of neurochemical functioning. For many of us, when we are very depressed, talking is pretty useless except to establish basic safety and support structures to get us through the low-functioning time. As successful as I believe therapy has been for me, it would not be so without my medication (and vice versa).
And it sounds like you are having a rough time finding the right formula of meds. I know from experience how frustrating and demoralizing that process can be. Many times, I thought it impossible to find something that would work for me, and it took a long time, but it did happen. For whatever that's worth. I guess I'm trying to be encouraging--keep the quest going.
Posted by Dinah on February 24, 2002, at 17:13:05
In reply to Re: To each his own...., posted by noa on February 24, 2002, at 16:43:46
That was a wonderfully articulate and well thought out post, noa.
Thanks!
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