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Dr. Bob is Robert Hsiung, MD,
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Posted by SLS on August 20, 2005, at 8:32:05
In reply to Hey folks, it's not just the MEDS, posted by DoYouKnowHim? on August 20, 2005, at 3:28:39
Hi.
In my opinion:
> However, I am worried that many people in here think that their solution is a pill. It is, but it isn't.For some people, the entire solution is a pill. Believe it or not, there are people floating around out there who are without significant psychological or emotional issues who are just waiting patiently for someone to fix the last thing getting in their way - abnormal brain physiology.
> What I mean is the meds are a great first step. But you must also be active in therapy.
Perhaps *you* must, but you are in no position to speak for anyone else. I hate to be so curt, but it is offensive to me that someone should place in front of me an imaginary psychological obstacle. This might not apply to you, but I become especially contemptuous when people do this to be better able to rationalize the existence of their own psychological obstacles.
> You must change your thinking.I must do no such thing.
You'd be surprised just how much a remission from an endogenous depression can change one's thinking overnight with only a single medication.
> Ideally, the meds calm you and your mind down enough where you can finally focus on re-training your mind.
Sort of.
Yes, very often, the abnormal brain physiology of major depression or bipolar depression, or anxiety disorders prevents one from focusing optimally on and process psychotherapy (should they need it) due to the negative influences these disorders have on thought and mood.
Ideally, the meds do what they do and help people where they need to be helped. Some people don't need to be "calmed". They do not experience anxiety at all, and are, in fact, slow-thinking and vegetative because of their endogenous depression. There is no dysphoria or melancholia - only anergia and psychomotor retardation. Learning is slowed and progress is hampered regardless of what mental task is laid before them. It is not specific to psychotherapy.
> Meds without therapy is just not realistic.
Declaring that meds without therapy is just not realistic is just not realistic. Nor is it accurate. In fact, I find it personally offensive and sabotaging that everyone suffering from a mental illness is deemed somehow psychologically incompetent that they can't work out on their own the same issues that exist for those without mental illness.
What is mental illness?
- Scott
Posted by willyee on August 20, 2005, at 11:08:31
In reply to Hey folks, it's not just the MEDS, posted by DoYouKnowHim? on August 20, 2005, at 3:28:39
I totaly disagree.WHY? Well the industry wants to have us believe the likly theory behind DEPRESSION and their MEDS is some sort of chemical imbalance,meaning a PHYSCIAL disorder.
So if thats the case then as in PARKINSON disease,or SEIZURES,or MIGRAINES,where there is something physcialy wrong in the brain,how can one expect talk therapy to "fix" depression???
If we are to believe the chemical imbalance theory,then i ask would u send a parkinson patient to talk therpay,hell no u would get him meds and get it fast.Would u send a person with seizures to talk therapy,yeah if u wanna kill them,if ur in the midts of a migraine im sure ur head would still be pounding after u leave.
I look at like this,clinical depression is a pyshical disease that needs pyhsical treatment,how well of treatment offers do we have now,well i wont speak highly of that.But depression doesent excuse a person from getting caught up in the problems of everyday life.And anyone with depression knows problems are MAGNIFIDE 10 FOLD when u are depressed.
So i see therapy useful to help people manage external problems WHILE dealing with depression.To help people raionalise the severity of the problems they are having since their depression might have them seeing every problem as a life trauma.
Also therapy just helps some people simply feel good,u dont need to be depressed to enjoy someone listenintg to u with a caring ear.
Now again this is just MY OPINION,but if depression is a CHEMICAL IMBALANCE,albeit serotion,dopamine or whatever have u,then it should be treated with the severety of such,as are other pyhsical brain disorders.
And with this being the case,well then it is down right DANGEROUS,AND MALPRACTICE to have someone using thrapy to treat instead of medicine,they are in need of REAL HELP.
I although a therapist can help,i DONT BUY FOR A SECOND that a 45 min talk session with anyone other than jesus can "change" brain patterns,thats absurd to me.
Thank you for the ear,this post is in general and to no one in particular,and is meant to insult no one just i feel quite strong on it.
Posted by SLS on August 20, 2005, at 11:24:36
In reply to Re: Hey folks, it's not just the MEDS, posted by willyee on August 20, 2005, at 11:08:31
> So i see therapy useful to help people manage external problems WHILE dealing with depression.To help people raionalise the severity of the problems they are having since their depression might have them seeing every problem as a life trauma.
This is so true. I have used psychotherapy in the past to help deal with the pressures that my biological depression places on my psychological constitution.
- Scott
Posted by lynn970 on August 20, 2005, at 12:49:12
In reply to Hey folks, it's not just the MEDS, posted by DoYouKnowHim? on August 20, 2005, at 3:28:39
If you are diagnosed with clinical depression. Is it strictly biological? Does wrong thinking bring on the chemical imbalance.
Posted by Dr. Bob on August 20, 2005, at 12:54:51
In reply to Re: Hey folks, it's not just the MEDS, posted by willyee on August 20, 2005, at 11:08:31
Posted by SLS on August 20, 2005, at 12:57:26
In reply to Re: Hey folks, it's not just the MEDS, posted by lynn970 on August 20, 2005, at 12:49:12
> If you are diagnosed with clinical depression. Is it strictly biological? Does wrong thinking bring on the chemical imbalance.
GREAT QUESTION!!!
This is a repost that might help:
-----------------------------------------------
BIOLOGY OR PSYCHOLOGY?
The best answer to this question may be "either and both".
Many of us here have been diagnosed as having a mental illness. Mental illnesses are NOT mental weaknesses. The diagnoses that we are most familiar with include:1. Major Depression (Unipolar Depression)
2. Bipolar Disorder (Manic Depression)
3. Dysthymia (Minor Depression)
4. Seasonal Affective Disorder (SAD)
5. Schizophrenia
6. Schizo-Affective Disorder
7. Obsessive-Compulsive Disorder (OCD)
8. Post-Traumatic Stress Disorder (PTSD)All of these disorders have one thing in common. They are not our fault. Each has both biological and psychological components. We all begin our lives with a brain that is built using the blueprints contained within the genes we inherit from our parents. Later, hormones change the brain to prepare it for adulthood. The brain can be changed in negative ways by things such as drugs, alcohol, and injury. The brain is also changed by the things we experience.
How we think and feel are influenced by our environment. Probably the most important environment during our development is that of the family, with the most important time being our childhood. We all have both positive and negative experiences as we travel through life. How we are as adults is in large part determined by these positive and negative experiences. They affect our psychology, our emotions, and our behaviors. All of us can be hurt by unhealthy negative experiences.
Some of us are also hurt by unhealthy brains. Medical science has long recognized that many mental illnesses are biological illnesses. Even Sigmund Freud, who we know for his development of psychoanalysis, proposed a role for biology in mental illness. The first solid evidence for this concept in modern times came with the discovery of lithium in 1947. Lithium was found to cause the symptoms of bipolar disorder (manic- depression) to disappear completely, allowing people to lead normal lives. Lithium helps to correct for the abnormal biology that is the cause of bipolar disorder. Later biological discoveries included the observations that the drug Thorazine (an antipsychotic) successfully treated schizophrenia, and that Tofranil (an antidepressant) successfully treated depression. Again, these drugs help to correct for the abnormal biology of the brain that accompanies these illnesses.
What about psychology? What role does it play in mental illness? This can be a two-way street. The abnormal biology that occurs with some mental illnesses affects our psychology – how we think, feel, and behave. On the other hand, our psychology can also affect our biology. As we now know, the emotional stresses and traumas we experience change the way our brains operate. This is especially true of things we experience during childhood. These stresses can trigger the induction of abnormal brain function that leads to major depression, bipolar disorder, schizophrenia, and other major mental illnesses. In order for this to happen, however, there must be a genetic or some other biological vulnerability to begin with.
Unfortunately, there are still too many people who cannot bring themselves to believe that the most common mental illnesses are actually brain disorders. However, the vast majority of our top researchers in psychiatry and neuroscience do.
The National Institutes of Health, the federal government’s official repository of medical research, has made available to the public free publications describing the current research into psychiatric disorders. They include descriptions of the biological and psychological aspects of major mental illness. Each of their press releases and research publications begin by stating emphatically that these are indeed brain disorders.
http://www.nimh.nih.gov/publicat/depresfact.cfm
It is important to understand that not all psychological and emotional troubles are biological in origin. Again, we are all products of our environments – family, friends, enemies, school, work, culture, climate, war, etc. Environments that are unhealthy often produce unhealthy people. This, too, is not our fault.
In conclusion, regardless of the cause of our mental illnesses, it is important that we treat both the biological and the psychological. We will all benefit most if we do.
Posted by Empathy on August 20, 2005, at 13:19:15
In reply to Re: Hey folks, it's not just the MEDS, posted by SLS on August 20, 2005, at 12:57:26
I wish everybody suffering could have good therapy... sadly it just isn't possible for everyone.
I had good therapy, but it wasn't with the first, second or third doctor that I tried - there are a lot of unhelpful therapists out there that are a waste of money. I finally found someone, but if I didn't have excellent insurance, I would have never been able to afford the $120 an hour it costs to talk with him.
A lot of people have limited assets and their first priority is medication. Hopefully, they can find some kind folks to listen to them and help them discuss their feelings and maybe some helpful books to read to substitute a bit for actual therapy.
Posted by lynn970 on August 20, 2005, at 13:23:21
In reply to Re: Hey folks, it's not just the MEDS, posted by SLS on August 20, 2005, at 12:57:26
I have had some traumatic experiences as a child and yet the trauma was not as bad as what many people have.
My 5 year old, on the other hand has a wonderful life. She does show symptoms of depression.
I have family members on antidepressants also. The trauma I experienced as a child may have just intensified my predisposition to depression/anxiety/OCD
THANKS FOR YOUR INSIGHT.
Posted by lynn970 on August 20, 2005, at 13:26:58
In reply to SLS that was very informative., posted by lynn970 on August 20, 2005, at 13:23:21
I am afraid that I shouldn't have said that my 5 year shows symptoms of depression. I don't know if she does. Her feelings get hurt so easy. I pray that she does not inherit a chemical imbalance from me.
Posted by ed_uk on August 20, 2005, at 13:55:48
In reply to Hey folks, it's not just the MEDS, posted by DoYouKnowHim? on August 20, 2005, at 3:28:39
I was concerned that you might be feeling attacked. I do hope you're not :-)
Kind regards
~Ed
Posted by Empathy on August 20, 2005, at 14:25:59
In reply to Re: Hey folks, it's not just the MEDS » DoYouKnowHim?, posted by ed_uk on August 20, 2005, at 13:55:48
I hope they don't feel attacked either - all thoughts are valuable and this particular poster seems to try to present a sense of BALANCE and I think that is important.
Posted by Declan on August 20, 2005, at 14:49:39
In reply to Re: Hey folks, it's not just the MEDS, posted by Empathy on August 20, 2005, at 14:25:59
When my mother was depressed she was in a terrible state, 9 months in a psychhospital, drugs, ECT maybe 10 times, agitated depression.
The thing was that she saw her problems (for want of better word!) in an exclusively moral light. And everyone dealing with her went to great efforts to treat the depression as an illness. So there was this disjunction.
I really felt she needed someone to talk to seriously about what she should and should not feel guilty for. She couldn't have done therapy though. And her doctors were not equipped to talk about moral failings. (They *had* moral failings, all too clear to me....like coming late to see her and having her called out from a meal for an appointment with no explanation or apology).
This experience made me think that the question of fault and blame is not easy to resolve. Anyway what I tried to do was talk about the moral side of things with her, which was easy because it was what she brought up. I think on Good Friday she said to me that whatever wickedness she had done in her life she had been punished for and that we had all suffered enough. All very intense.This is just a fragmentary reflection on the mind/brain, moral/chemical imbalance thing that crops up from time to time.
Declan
Posted by linkadge on August 20, 2005, at 15:25:33
In reply to Re: Hey folks, it's not just the MEDS, posted by SLS on August 20, 2005, at 8:32:05
Posted by linkadge on August 20, 2005, at 15:26:37
In reply to Re: Hey folks, it's not just the MEDS, posted by willyee on August 20, 2005, at 11:08:31
Posted by willyee on August 20, 2005, at 19:23:29
In reply to Re: Hey folks, it's not just the MEDS » DoYouKnowHim?, posted by ed_uk on August 20, 2005, at 13:55:48
I agree,i tried to make sure no one took my post personaly,it was a general posting directed at no one in particular,also it was MY view.
I understand the complexity of the disease,and i am happy for anyone who manages to get relieaf period,the way in which each person finds relieaf is no where as important as getting better,and i personaly wish i could make us all "BETTER" with the snap of a finger!
Posted by Glydin on August 21, 2005, at 1:45:43
In reply to Hey folks, it's not just the MEDS, posted by DoYouKnowHim? on August 20, 2005, at 3:28:39
I am respectful of your right to your opinion. I do disagree that your opinions were true for me. Perhaps it would have been better if you had made your statements as opinions in lieu of blanket statements of generalizations applicable to all?
I come from a very convential medical model background and I believed the combo of meds and therapy was essential... until... I tried the combo for several years. I won't go into the specifics, but I reached a different opinion after I had my experiences. But, I would not begin to tell anyone else what was REQUIRED for them - I think it's a very individual decision.
Posted by SLS on August 21, 2005, at 7:40:29
In reply to Hey folks, it's not just the MEDS, posted by DoYouKnowHim? on August 20, 2005, at 3:28:39
Hi.
I'm sorry that my reaction to your post seemed so harsh. As you can see, it becomes an emotionally charged issue whenever the biology versus psychology of depression becomes a focal point. It is hard to make everyone happy when one attempts to make sweeping generalizations, regardless of how well-intentioned.
It goes without question that your post was well intentioned. As far as projecting the experiences of the self onto others, I am often guilty of the same thing. If I feel that I have found an answer for myself, I almost assume that it will be the answer for others as well. Unfortunately, depression is a single word describing a heterogenous population of suffers, and there is not yet clear specificity at delineating depressive subtypes such that treatments can be determined for each one. Even when two cases of depression look exactly the same, they may respond to surprisingly different treatments.
I like the concept of "depressive pressure". Depressive pressure can be the presence of a chronic psychosocial stress for which psychotherapy and/or environmental change are the best alternatives to reduce. Depressive pressure can take a toll on the brain such that it causes it to malfunction in biologically succeptible individuals. For some people whom respond adequately to antidepressants, future relapses despite continued treatment (known as medication break-through) becomes likely if the depressive pressure created by psychosocial stress remains unmitigated. Psychotherapy here would go a long way to help prevent this from happening, although it is no guarantee. However, the removal of the depressive pressure through psychotherapy is often a well-designed strategy. Unfortunately, the more depressive episodes one experiences, the deeper the biological illness digs into the brain. Subsequent recurrences often occur even in the absence of psychosocial stress. For these people, medical treatment might be both necessary and sufficient.
Another good use of psychotherapy is to clean up the mess left in the wake of an extended depressive episode. Biological depression warps thoughts and feelings. It changes the way people think and behave. It can lead to erroneous perceptions and conclusions about the self and the outside world that psychotherapy can often address.
Another good use of psychotherapy is to help prevent too much of a mess from developing in the first place and allowing the depressed individual to function as well as the biological illness permits. However, when appropriate, it is most helpful that the psychotherapist acknowledge and actually *believe* that the depression is biological. To proceed otherwise can sabotage the efforts of the sufferer to work with the depression as the therapist may convey upon them unreasonable expectations and neglect insights targeted at the reality of the illness. When used properly, psychotherapy can help the sufferer of a biological depression better understand the dynamics of the illness, accept their temporary limitations, reduce anxiety and stress, and prevent suicide.
The sincerity of your concern for the suffering of others and your enthusiasm to share your ideas as to how to reduce it comes through very powerfully in your post. I'm sorry if this has been neglected in the replies you have received.
I wish you continued success following the path of healing you have chosen. It would help a great many people were you to continue to share your experiences in the future. I hope you have not been discouraged from doing so.
Be well.
- Scott
Posted by Emme on August 21, 2005, at 8:40:35
In reply to Hey folks, it's not just the MEDS, posted by DoYouKnowHim? on August 20, 2005, at 3:28:39
- Therapy is good for many. Maybe even most. I wouldn't make a blanket statement that everyone needs it.- I have benefitted from CBT and could continue to benefit. I won't negate the value of counseling. I have also been surprised at how much negative, distorted thinking has floated away when the meds work well. My thinking needs less "adjustment". I believe such a change in thinking is every bit real and valid as improvement from talk therapy.
- As someone pointed out, some don't need calming. They need perking up.
- Possible uses of therapy (mostly already stated, but I'll go ahead and register my opinion).
1) Dealing with your baggage. Heck, half the population could probably use that, depressed or not.
2) Managing psychosocial stressors in your everyday life. Also, managing the basics of living when you are in a bad way. That might not require continued therapy if you feel you've gotten the hang of good coping skills.
3) I agree with everyone else about coping with the mess and stress created by your disorder.
4) Keeping tabs on you. Having someone with a practiced eye keep track of your ups and downs, alert your pdoc if you're heading downhill, and provide input that might be helpful for diagnosis. I have found this to be very important.- I believe that meds without therapy is realistic for some. It may be most realistic after becoming stabilized on appropriate meds (or being able to discontinue meds) and/or after having had some support in therapy for any of the above reasons.
Posted by Empathy on August 21, 2005, at 13:38:07
In reply to Re: Hey folks, it's not just the MEDS » DoYouKnowHim?, posted by SLS on August 21, 2005, at 7:40:29
Wow... that was an excellent post. Thanks.
Posted by Declan on August 21, 2005, at 13:45:12
In reply to Re: Hey folks, it's not just the MEDS » DoYouKnowHim?, posted by SLS on August 21, 2005, at 7:40:29
Hey Scott, thankyou.
That was a great post in many ways.
Declan
Posted by KaraS on August 21, 2005, at 16:13:39
In reply to Re: Hey folks, it's not just the MEDS » DoYouKnowHim?, posted by Emme on August 21, 2005, at 8:40:35
>
> - Therapy is good for many. Maybe even most. I wouldn't make a blanket statement that everyone needs it.
>
> - I have benefitted from CBT and could continue to benefit. I won't negate the value of counseling. I have also been surprised at how much negative, distorted thinking has floated away when the meds work well. My thinking needs less "adjustment". I believe such a change in thinking is every bit real and valid as improvement from talk therapy.
>
> - As someone pointed out, some don't need calming. They need perking up.
>
> - Possible uses of therapy (mostly already stated, but I'll go ahead and register my opinion).
> 1) Dealing with your baggage. Heck, half the population could probably use that, depressed or not.
> 2) Managing psychosocial stressors in your everyday life. Also, managing the basics of living when you are in a bad way. That might not require continued therapy if you feel you've gotten the hang of good coping skills.
> 3) I agree with everyone else about coping with the mess and stress created by your disorder.
> 4) Keeping tabs on you. Having someone with a practiced eye keep track of your ups and downs, alert your pdoc if you're heading downhill, and provide input that might be helpful for diagnosis. I have found this to be very important.
>
> - I believe that meds without therapy is realistic for some. It may be most realistic after becoming stabilized on appropriate meds (or being able to discontinue meds) and/or after having had some support in therapy for any of the above reasons.
>
Yours was a really good post too. Succinct yet dead on.k
Posted by john berk on August 21, 2005, at 16:43:57
In reply to Too Bad All This Wasn't Known Years Ago, posted by Phillipa on August 20, 2005, at 21:13:02
Hi phillipa!! i am sorry you suffered last night, i hope today is brighter for you, i read your thread on the writing board, it was powerful, and you are right, no one should be made to feel that way!! please be well, your friend...john
Posted by Jedi on August 22, 2005, at 2:54:33
In reply to Re: Hey folks, it's not just the MEDS, posted by SLS on August 20, 2005, at 8:32:05
Hi Guys,
I have suffered through at least three major depressions and a level of dysthymia my entire adult life. After trials with many different combinations of medications, my first major depression ended like a flash of light after four weeks on 75mg of Nardil. I am sure not saying it is like this for everybody, but my depression is a biological disease of the brain. In a period of one or two days my thinking took a 180 degree turn. All of my problems that were insurmountable suddenly became "No Problem". I believe that no amount of therapy could have done this for me. Everyone is different. I know people that their childhood and developement years were full of abuse and trama. These environmental issues had a huge effect on their level of functioning. However, before my first major depression hit at about age 40, I was a highly functioning adult. I built my own computer networking business and owned at least fifty rental properties. The depression took that wealth away. I believe that if the doctors would of quit taking me off Nardil, the only med that worked, I could have enjoyed a much quicker recovery. Now with at least three major depressions, I will be on meds the rest of my life. I don't like the idea of that, but the alternative is worse.
Jedi
Posted by Dr. Bob on August 22, 2005, at 22:34:20
In reply to Re: SLS that was very informative., posted by lynn970 on August 20, 2005, at 13:26:58
> I am afraid that I shouldn't have said that my 5 year shows symptoms of depression...
Sorry to interrupt, but I'd like to redirect follow-ups regarding 5 year olds to Psycho-Babble Parents. Here's a link:
http://www.dr-bob.org/babble/child/20050817/msgs/545423.html
Thanks,
Bob
Posted by adamCanada on August 23, 2005, at 12:21:13
In reply to Hey folks, it's not just the MEDS, posted by DoYouKnowHim? on August 20, 2005, at 3:28:39
UM for some ppl it is all MEDS.
Mental illness is mental illness. I got mine from vitamin A overdose. I cant just put on a positive mood to cure the mind torture that unables me to function. I needed a med to save my life and paxil did it.
You cant cure cancer with Talk Therapy. You cant cure real Mental Illness with Talk therapy. There are many different forms of so called depression. And mine isn't the 'oh dear bad things happening in my life' kind. It is something wrong in my brain.
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Dr. Bob is Robert Hsiung, MD,
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