![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1 to 25 of 85. This is the beginning of the thread.
Posted by OldSchool on February 22, 2002, at 21:22:41
My depression is more of a biological kind of depression. I never have understood this fascination and interest others seem to have with psychology stuff, therapy, "issues" and whatnot. I never was into that before my depression and Im into it even less now. My only "issues" are that I cant sleep normally and feel like shit all the time. And that I have cognitive problems that makes working very difficult.
I dont understand why the mental health community is so into "feelings" and "issues" and talk therapy. To me the handwriting is on the wall...all this stuff is another illness thats all. I oftentimes wonder if many of the complaints concerning mental healthcare is due to the fact this field is way off in left field, on a wild tangent. By that I mean the mental health field is too focused on "behavior" and not on the biological underpinnings of these problems.
I feel too much time and energy is wasted on "woody allen syndrome" than real mental illness. I also feel that its a very bullshit kind of thing that mental health professionals try to do to us...diagnose us by talking to us. I feel that these problems are more complicated than this. Im just very skeptical of all things psychology and all things mental health related.
Old School
Posted by Anna Laura on February 22, 2002, at 23:05:42
In reply to I dont relate well to the mental health community, posted by OldSchool on February 22, 2002, at 21:22:41
> My depression is more of a biological kind of depression. I never have understood this fascination and interest others seem to have with psychology stuff, therapy, "issues" and whatnot. I never was into that before my depression and Im into it even less now. My only "issues" are that I cant sleep normally and feel like shit all the time. And that I have cognitive problems that makes working very difficult.
>
> I dont understand why the mental health community is so into "feelings" and "issues" and talk therapy. To me the handwriting is on the wall...all this stuff is another illness thats all. I oftentimes wonder if many of the complaints concerning mental healthcare is due to the fact this field is way off in left field, on a wild tangent. By that I mean the mental health field is too focused on "behavior" and not on the biological underpinnings of these problems.
>
> I feel too much time and energy is wasted on "woody allen syndrome" than real mental illness. I also feel that its a very bullshit kind of thing that mental health professionals try to do to us...diagnose us by talking to us. I feel that these problems are more complicated than this. Im just very skeptical of all things psychology and all things mental health related.
>
> Old SchoolI think you're right, even though some people with depression have personality traits which make them more prone to stress, the latter triggering or even worsening depression directly. It's like a vicious cycle, you know. Sometimes therapy might help to break this cycle by re-shaping and molding certain traits related to stress thus affecting depression in the long run.
Moreover, some people develop disfunctional personality traits (such as learned helpessness, pessimism and so forth) after long term chronic depression: therapy might be helpful in these cases by working on these features that could concurr in maintaining your depression.
I don't think therapy can affect you chemically, unless you suffer from a very mild form of depression (more a personality trait rather then a chemical imbalance in this case, even though both aspects are very often intertwined).
Nonetheless, support and and a rewened optimism could help you to reach out for what you need in order to cure your depression (medical cure and alternatives you weren't thinking of as depression was clouding your thoughts).
Posted by susan C on February 22, 2002, at 23:41:35
In reply to Re: I dont relate well to the mental health commun, posted by Anna Laura on February 22, 2002, at 23:05:42
Posted by Dinah on February 23, 2002, at 0:47:54
In reply to Re: I dont relate well to the mental health commun, posted by Anna Laura on February 22, 2002, at 23:05:42
Anna Laura put things very well and I agree completely with what she said.
Plus, you know, not all mental illness is depression. Anxiety often involves distorted thinking, what if thinking, etc. that can be addressed in therapy. And learning relaxation techniques often helps control the anxiety, minimizing the amount of medication needed.
And sometimes ruminations are involved in various disorders. With ruminations it helps immensely to have someone to talk to so that the ruminations lose some of their power. The thread above pointed out the importance of having someone with whom to share the forbidden thoughts. Someone who will understand and not overreact. Family members and friends are usually just not equipped to deal with this.
And sometimes there is fallout from mental illness that affects your quality of life. And it helps to have an objective outsider to sort those things out. You know, many people with other types of illnesses also seek out therapy. Cancer, AIDS, strokes - all these illnesses can also cause problems (frustration, anger, relationship problems) that can be helped by therapy. Why should "mental" illnesses be any different?
I don't think that many people any more think that therapy can be a substitute for medication - not since effective medications were discovered. Although certain types of therapy have a good track record with things like OCD and phobias. But therapy can be a life-saving adjunct to medication. Especially since medications are a long way from perfect. Medications just aren't sufficient in and of themselves for many people.
I do understand that you don't see the purpose of therapy. That comes through very clearly. And if it doesn't offer anything you need, that's fine. But I don't quite understand your anger. People who are depressed for other than purely "biological" reasons are in no less pain. What do you mean by "Woody Allen syndrome" and why does it anger you so? Can you imagine any reason for "mental health problems" other than whining self indulgence (which is what I am assuming you mean by Woody Allen syndrome - please correct me if I'm wrong) or "biological" depression. Can you see any other alternatives? Severe trauma perhaps?
I like you Old School and I enjoy your posts. I heard a request to understand in your post and I am trying as best I can to explain my perspective. Perhaps you could explain the parts of your perspective that I don't quite understand. Perhaps we will never agree on the topic, but perhaps we can come to learn something from each other, even if it's only learning to see things from another point of view.
Posted by Zo on February 23, 2002, at 1:29:35
In reply to I dont relate well to the mental health community, posted by OldSchool on February 22, 2002, at 21:22:41
Well, the fact is, despite your nick, you are ahead of your time. The idea that we are mostly biology is soooo upsetting to people who've invested lives and careers and selves in the idea that talk can cure. Keep in mind how freakin' lousy meds were, for any kind of depression until very, very recently. When talk was the only hope, of course people pinned their hopes on talk. And there's a lot to be said for really good, deep, accepting and ennobling human exchange. The problem is, people who haven't been there do NOT understand that, for example, when I was in extreme psychic pain, Jesus Himself could have reappeared and it wouldn't have interested me. Unless, of course, He had offered a cure.
It was like years of keeping weekly appointments to discuss the extreme and unrelenting pain of a broken leg--when what was really needed was a cast and a pair of crutches until it healed.
Zo
Posted by judy1 on February 23, 2002, at 10:14:57
In reply to Re: Very well said Anna Laura - for Old School, posted by Dinah on February 23, 2002, at 0:47:54
Thank you Dinah for expressing your thoughts so well- I began to reply and found myself so angry (as I did with Old School's reply in the case of the Mom killing her children). I would be dead without therapy, just as I would without medication. I guess I just can't understand this either/or thinking- judy
Posted by OldSchool on February 23, 2002, at 11:07:54
In reply to Re: I dont relate well to the mental health commun » OldSchool, posted by Zo on February 23, 2002, at 1:29:35
> Well, the fact is, despite your nick, you are ahead of your time.
I think so also
The idea that we are mostly biology is soooo upsetting to people who've invested lives and careers and selves in the idea that talk can cure.
Yes, and quite frankly I enjoy pissing off these people. Telling them that we are basically "nothing but a sack of chemicals." Because basically its the truth.
>. The problem is, people who haven't been there do NOT understand that, for example, when I was in extreme psychic pain,
Uh...this is my whole entire point. My depression is not just "extreme psychic pain." Its a physical type illness that has destroyed basic bodily functions I used to take for granted and didnt even think about before depression. Sleeping, eating, weight, sex and cognition problems. Whats that got to do with "psychic pain?" My experience has been more of a real disease. Of course, my depression has been much more severe than most others I believe and maybe this is why I cant relate to these talk therapy people.
My severe depression has been more like a head injury than "psychic pain."
I also feel irritation towards the talk therapy/psychology crowd because I feel that this group is misleading people into thinking severe mental illness is a "psychological" problem when in reality its mostly a neurological problem. I feel this psychology/therapy stuff is a lie...a big lie. That we are all suffering from very real and very physical brain based illnesses, which are interpreted instead as mere "psychological" or "emotional" problems. That is irritating to me.
I just feel that the basics are not being covered effectively in the mental health world. I dont understand why we all are not being diagnosed and treated by Neurologists rather than psychiatrists.
Old School
Posted by OldSchool on February 23, 2002, at 12:03:00
In reply to Re: I dont relate well to the mental health commun, posted by Anna Laura on February 22, 2002, at 23:05:42
I dont relate well to the usual mental health community because I think they have the wrong ideas about what we all are suffering from. Let me give you the Webster's dictionary definition of Psychiatry.
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 Dinah on February 23, 2002, at 13:32:12
In reply to Re: I dont relate well to the mental health commun, posted by OldSchool on February 23, 2002, at 11:07:54
> Yes, and quite frankly I enjoy pissing off these people. Telling them that we are basically "nothing but a sack of chemicals." Because basically its the truth.
>Oh I am so sorry Old School. I misunderstood the title of your post to be an invitation to dialogue. But you know ranting is terribly therapeutic. In fact many people, including myself, actually pay professionals to listen to us rant. That way we won't burden our friends and family or hurt or anger those who feel differently. But I won't interrupt you with any further replies. I apologize for the misunderstanding. Perhaps it would help to prevent further confusion if you changed the post title to "I have no desire to relate well to the mental health community" or something along those lines.
I'm sorry if it disappoints you, but I am not one bit "pissed off" by your point of view. It doesn't bother me at all to be told that "we are nothing but a sack of chemicals." In fact I consider that part of the miraculous nature of life - that so many different types of people can come from such a similar sack of chemicals.
And I still quite enjoy reading your posts. In fact, I wish I could introduce you to my father. You two would really enjoy each other. And I quite like my father and enjoy listening to him. But I won't bother you any further by replying to your posts.
Best wishes,
Dinah
Posted by Dinah on February 23, 2002, at 13:42:58
In reply to Re: Very well said Anna Laura - for Old School » Dinah, posted by judy1 on February 23, 2002, at 10:14:57
> Thank you Dinah for expressing your thoughts so well- I began to reply and found myself so angry (as I did with Old School's reply in the case of the Mom killing her children). I would be dead without therapy, just as I would without medication. I guess I just can't understand this either/or thinking- judy
You are very welcome Judy. I'm glad that someone got something out of a post I labored so long over. I try not to engage in either/or thinking but I have reason to understand it very well. And there's no point in being upset over it.
I'm not sure if I would be dead without therapy, or meds for that matter; it may be true or may not. But I do know this beyond any shadow of a doubt.
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.
Thanks again,
Dinah
Posted by Bob on February 23, 2002, at 14:00:45
In reply to Re: I dont relate well to the mental health commun, posted by OldSchool on February 23, 2002, at 11:07:54
> Uh...this is my whole entire point. My depression is not just "extreme psychic pain." Its a physical type illness that has destroyed basic bodily functions I used to take for granted and didnt even think about before depression. Sleeping, eating, weight, sex and cognition problems. Whats that got to do with "psychic pain?" My experience has been more of a real disease. Of course, my depression has been much more severe than most others I believe and maybe this is why I cant relate to these talk therapy people.
>
> My severe depression has been more like a head injury than "psychic pain."==================================================
Old School:
I often have this thought also. It seems that most others I have talked to do not seem to grasp the depth of my pain, both psychic and physical. Maybe 12 to 15 years ago, I could have said I was an indulgent whiner, but no more. I have degraded quite significantly.
Posted by OldSchool on February 23, 2002, at 14:46:26
In reply to For Judy, posted by Dinah on February 23, 2002, at 13:42:58
I try not to engage in either/or thinking but I have reason to understand it very well. And there's no point in being upset over it.
>
>There is nothing wrong with either/or thinking sometimes. In this particular case its actually appropriate. Its totally appropriate to totally reject the current situation in mental health, with its emphasis on outward behaviors, psychology, psychology based diagnosis and lack of neurological science rigor.
This therapy stuff teaches you to compromise too much, to just go along and accept things the way they currently are. I dont accept that and do not agree with it. I do not accept a situation that I see as fundamentally flawed...and I see psychiatry as basically fundamentally flawed. Sometimes either/or thinking motivates people to change things...to become politically active. Thats what we need here...the mentally ill need to become politically active and take control of things.
Psychiatry...gag...makes me wanna vomit all over myself. Id rather be a either/or thinker than a sheep.
Old School
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
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Dr. Bob is Robert Hsiung, MD,
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