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Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1 to 12 of 12. This is the beginning of the thread.
Posted by clint878 on October 27, 2006, at 10:53:09
Most people are aware of people who support the "anti-psychiatry" movement, which claims that there are no mental illnesses and that society marginalizes people who don't act the way others do.
While I'm not sure I would agree with this rather simplistic assessment, there is one progression of iatrogenic events that they have mentioned that does sound like it may occur to some people.
It goes like this: someone becomes depressed (but not suicidal), and goes to see a psychiatrist after suffering for a few months. The psychiatrist prescribes an antidepressant. The patient takes the antidepressant, which causes mania. He then goes to the hospital for treament of the manic episode, and is prescribed an antipsychotic. The antipsychotic works partially, but causes tardive dyskinesia. The patient is then prescribed other antipsychotics to deal with the TD, and ends up with akathisia, along with the original depression, and the mania, AND the TD. Eventually he is so messed up he commits suicide rather than continue live in such a horrible state.
While I'd like to say that this stuff doesn't happen, I fear it does more often than is publicized. Are my fears unfounded?
Posted by dbc on October 27, 2006, at 11:42:05
In reply to Anti-psychiatry theory of iatrogenesis, posted by clint878 on October 27, 2006, at 10:53:09
> Most people are aware of people who support the "anti-psychiatry" movement, which claims that there are no mental illnesses and that society marginalizes people who don't act the way others do.
>Im not aware of anyone outside of scientology with any sort of degree or respect in intellectual/scientific circles that supports a anti-psychiatry movement.
Scientology belives that mental illness is caused by the ghosts of people who were sacrificed into volcanos a million years ago by an intergalactic space ruler. Need i say more?
(think im joking? search google for the word xenu)
Posted by ronaldo on October 27, 2006, at 12:41:10
In reply to Anti-psychiatry theory of iatrogenesis, posted by clint878 on October 27, 2006, at 10:53:09
Definition of Iatrogenic
Iatrogenic: Due to the action of a physician or a therapy the doctor prescibed. An iatrogenic disease may be inadvertently caused by a physician or surgeon or by a medical or surgical treatment or a diagnostic procedure. Puerperal fever (childbirth fever) was an iatrogenic infection; it was carried from one woman to another by the doctor before the days of antisepsis. If in the course of a procedure, an artery is nicked and bleeds, that is an iatrogenic accident.
The word "iatrogenic" comes from the Greek roots "iatros" meaning "the healer or physician" + "gennan" meaning "as a product of" = due to the doctor.
Thanks to MedicineNet.com
*************************
Posted by notfred on October 27, 2006, at 18:44:49
In reply to Anti-psychiatry theory of iatrogenesis, posted by clint878 on October 27, 2006, at 10:53:09
>
> It goes like this: someone becomes depressed (but not suicidal), and goes to see a psychiatrist after suffering for a few months. The psychiatrist prescribes an antidepressant. The patient takes the antidepressant, which causes mania.
This would indicate bipolar. Millions receive successful treatment for it. AP's are not first line meds for bipolar, though they are for manic phase (which can be deadly itself).
I think you are generalizing. People with decades of MI tend to have much more complex stories. Have you considered the outcome of not treating bipolar ? It has if not the higest rate of suicide amoung the MI's it not to the higest.
Posted by clint878 on October 27, 2006, at 22:07:52
In reply to Re: Anti-psychiatry theory of iatrogenesis, posted by notfred on October 27, 2006, at 18:44:49
Well, it is true that the person is bipolar, in this case. But would that person have become bipolar if not treated with an antidepressant? Some people [psycheducation.org] don't think so; in fact, they think irreversible harm is done.
> >
> > It goes like this: someone becomes depressed (but not suicidal), and goes to see a psychiatrist after suffering for a few months. The psychiatrist prescribes an antidepressant. The patient takes the antidepressant, which causes mania.
>
>
> This would indicate bipolar. Millions receive successful treatment for it. AP's are not first line meds for bipolar, though they are for manic phase (which can be deadly itself).
>
> I think you are generalizing. People with decades of MI tend to have much more complex stories. Have you considered the outcome of not treating bipolar ? It has if not the higest rate of suicide amoung the MI's it not to the higest.
>
>
>
>
Posted by fuchsia on October 28, 2006, at 6:52:05
In reply to Re: Anti-psychiatry theory of iatrogenesis, posted by clint878 on October 27, 2006, at 22:07:52
> Well, it is true that the person is bipolar, in this case. But would that person have become bipolar if not treated with an antidepressant? Some people [psycheducation.org] don't think so; in fact, they think irreversible harm is done.
>Take a functioning bipolar II, give them a few rounds of antidepressants and the illness takes off like wildfire. That's how it was with me anyhow. I really cannot believe that the course of my illness would have been this devastating if I hadn't had those treatments.
Given the _right_ treatment I might have benefitted rather than suffered. But what proportion of people get the right treatment to begin with?
Posted by Squiggles on October 28, 2006, at 7:27:41
In reply to Anti-psychiatry theory of iatrogenesis, posted by clint878 on October 27, 2006, at 10:53:09
There is no reason to believe that this
doesn't happen often. It happens in other
areas of medicine as well, so why not psychiatry.
However, it is hard to prove, and harder to
remember. That's why I was suggesting that
just confirming that A causes B on this board
would be really enlightening.I think doctors themselves would agree with you.
A conservative doctor will try to keep the meds.
to an as-needed-basis for this reason.Squiggles
Posted by clint878 on October 28, 2006, at 11:03:36
In reply to Re: Anti-psychiatry theory of iatrogenesis » clint878, posted by fuchsia on October 28, 2006, at 6:52:05
>Take a functioning bipolar II, give them a few rounds of antidepressants and the illness takes off like wildfire. That's how it was with me anyhow. I really cannot believe that the course of my illness would have been this devastating if I hadn't had those treatments.
After doing some more research, I'm not sure this view is proven either. I don't know what to believe. For example, recent journal articles suggest that the so-called "kindling theory" is not sufficient to explain the course of bipolar disorder.
And even if it were, then it could have been drinking caffeine or dealing with too much stress that would have caused the episodes instead of the antidepressants.
There's a problem when we talk about "harm" being done. Depression, untreated, causes harm to the brain and the heart, and other parts of the body. It's shown that there are fewer neurons in the brains of people who have been chronically depressed.
So would the damage caused by the untreated depression be better than the damage caused by the antidepressants, which eventually led to finding the correct treatment?
Posted by Squiggles on October 28, 2006, at 11:25:46
In reply to Re: Anti-psychiatry theory of iatrogenesis, posted by clint878 on October 28, 2006, at 11:03:36
> >Take a functioning bipolar II, give them a few rounds of antidepressants and the illness takes off like wildfire.
I have read that antidepressants can
make a bipolar brain worse. I can't recall
if this means before the onset of bipolar
manifestations or after, but certainly they
must mean after or while you are on an anti-bipolar drug. So the questions would
be:- is it interaction
- is it a trigger
- is it a cause?That's how it was with me anyhow. I really cannot believe that the course of my illness would have been this devastating if I hadn't had those treatments.
Do you mean that the treatments made your
bipolar state worse?
>
> After doing some more research, I'm not sure this view is proven either. I don't know what to believe. For example, recent journal articles suggest that the so-called "kindling theory" is not sufficient to explain the course of bipolar disorder."kindling theory" ah yes -- a very poetic term
(and taken from the firestorm model- btw, i am very sorry to hear of the firemen who died at the California fires).Yes, it is the theory that bipolar episodes
get worse with time, if not treated. It is
based on the analogy to epileptic fits which
get worse if not treated. I don't know if it's true. Certainly, Kraepelin did not think so. He observed the life course of manic-depressives over as long as 40 years, and found that there was great variability in frequency and and severity of mania and depression.
>
> And even if it were, then it could have been drinking caffeine or dealing with too much stress that would have caused the episodes instead of the antidepressants.It's a mystery i think -- it seems genetically based and the fact that the cycles are erratic rules out things like coffee, and diet, and even stress-- though of course stress is the last thing anybody needs who is mentally ill.
>
> There's a problem when we talk about "harm" being done. Depression, untreated, causes harm to the brain and the heart, and other parts of the body. It's shown that there are fewer neurons in the brains of people who have been chronically depressed.That may be because of the stress that these experiences bring on-- it's like being an explorer and going taking an Antarctic exploration.
>
> So would the damage caused by the untreated depression be better than the damage caused by the antidepressants, which eventually led to finding the correct treatment?Yes, i would say. Because it is very difficult to live with depression. Not only is the depression stressful, but the attempt to live a "normal" life-- that is a great challenge.
Squiggles
Posted by corafree on October 28, 2006, at 12:52:46
In reply to Anti-psychiatry theory of iatrogenesis, posted by clint878 on October 27, 2006, at 10:53:09
I'd think some upcoming generation would recognize this as a truth. Maybe we all have the precursors to different behaviors and when they are 'agitated by a medication' they present themselves.
Posted by Dr. Bob on October 28, 2006, at 13:06:00
In reply to Re: Anti-psychiatry theory of iatrogenesis, posted by dbc on October 27, 2006, at 11:42:05
> Scientology belives ...
Sorry to interrupt, but I'd like to redirect follow-ups regarding Scientology to Psycho-Babble Social. Here's a link:
http://www.dr-bob.org/babble/social/20061018/msgs/698487.html
Thanks,
Bob
Posted by Jost on October 28, 2006, at 14:23:28
In reply to Redirect: Scientology, posted by Dr. Bob on October 28, 2006, at 13:06:00
Well, I didn't think the discussion was about scientology, but maybe I was having my own separate discussion.
Where anti-psychiatry and scientology were not linked particularly. Ie scientology might be anti-psychiatric, but anti-psychiatry was by no means scientological.
Jost
This is the end of the thread.
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