Posted by yxibow on January 13, 2007, at 2:37:23
In reply to Re: Do people feel medications help or mask sympto, posted by SLS on January 12, 2007, at 21:02:08
> > I seem to have this question? Since with drug addiction they say its just masking the symptoms. Don't the psych drugs do the same?
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> Drugs of abuse are not antidepressants and don't work the same. Drugs of abuse can sometimes mitigate symptoms of depression or "mask" them to some degree, but the underlying depressive illness persists.
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> > It seems like there is no cure just temporary relief until it poops out and then more drugs. Just wondering what people think?
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> For me, antidepressants do not mask symptoms. They make the the whole disorder disappear. What's the difference? I'm sure there will be people to challenge me on this, but it is more than just a question of semantics. Simply masking symptoms does not account for things like the reversal in the abnormal brain structure seen in depression when remission is achieved with antidepressant treatment.
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> When mood illness is stabilized with therapeutic medication, addicts find it much easier to abstain from substance abuse.
I would agree with the above. I think we've beaten a dead horse, donkey, elephant, and several endangered species on the discussion of the model of biochemical disorders and psychiatry and medication and come full circle again.So again we dig... Well, there will be people who will steadfastly have their own opinions and that's what free will is in countries that allow it. Numerous PET scan studies have shown changes in brain chemistry in depression, OCD, schizophrenia, etc.
It is my belief that in order to escape the stigma of "mental illness", the world at large, or at least the western world at this point in time, we have to recognize that mental disorders have biological origins. They may have environmental factors that trigger them but ultimately it all ends up in the neurotransmitters, and how they differ in some way in certain people, genetically, or otherwise. Do we really want paltry caps on mental health care insurance ?
It really doesn't matter actually if you believe it or not, because an environmental belief of depression can be shown to be biochemical also -- the outside world affects a person, which in turn, sets off a chain of reactions in the brain, etc. How do you type on the keyboard here? You have a thought, which triggers a neurotransmitter message to the part of the brain involved in processing movement and in turn you type something out.
Anyhow, that is just a long lead-in to helping and masking. I currently suffer from a fairly rare life-affecting but not life-shortening strong Somatiform disorder and have for the past five years, mostly involving an inability to filter out visuality as much as the rest of the world does in microseconds (i.e. traffic lights are brighter, etc.) For the first part of the treatment, it was to prevent suicide (which may still have breakthrough issues) and to see how far medications, and eventually psychotherapy as well, could help things. They have not been without side effects I've never seen in previous disorders or medications I've never dreamed of taking. But while they blunt things as much as the disorder itself blunts myself from the world, they have enabled me to get to a point where I am at a "guarded" or partially-treated point that I can function in the world. If I were asked about my treatment I would say, I wouldn't be talking to you today standing here without the countless medications and hours of therapy that I've had.Now comes the harder part. Reducing the medications to a minimum effective dose (MED), to see whether I can tolerate a lower dose and still not have symptoms from the past. We don't know what will happen. I do know that there have been stages of withdrawal and temporary odd symptoms that creep in and back out again.
To a degree, the medications may be masking things -- if that is all they are doing, I am saddened, I never signed up for this, it just struck suddenly sometime around November 17, 2001. But I still have my mind. I may have an equivalent to a physical handicap but my intelligence is still here, despite the lethargy of medicine and the pain of disorder.
From a psychodynamic point of view, the fewer the medications the greater the chance that inside therapy may get to the core of Somatiform disorders, which are anxiety expressed completely as a bodily manifestation -- and are not malingering as thought in the past -- in fact pseudoseizures are the most common (there are facticious disorders but those are only a subclass.)
So the object here is a model of greater functioning in the world, slowly, by occupying time with life-affirming activities, that may push some of the disorder out of my mind. Or so my multiple doctor(s) think. Hope does come from within and it takes a lot to believe in it when old symptoms come crashing back in and in the past , when things were moving rapidly "better", I could tolerate what now I am used to more "normal" existence and find old symptoms less tolerable.
So I can't say whether they have helped or masked. In this case only time may say.When I had my breakout of OCD at 17 (well I had it at 12, and variations up to 17, but the worst came then) and was hospitalized, it wasn't really until the end of treatment that I took an SSRI. And Prozac helped with things, and may have made it easier to continue behaviour therapy which was already well under way. I think that for OCD, except for pure obsessions which are hard to fight (I still have garbage nonsense that goes on a track in my brain at times), medications are a help, but they should be accompanied by behaviour therapy. In fact, behaviour therapy alone can be a treatment for less severe OCD if one follows a plan well.
But in the end, with serious biochemical disorders like schizophrenia (I take neuroleptics for dopamine blockade but I am not psychotic -- it is Somatiform NOS, not otherwise specified and falls sort of in the OC Spectrum range) and bipolar, and MDD (which I have, even if it is secondary to the disorder), one may have to take medications, whether they mask, or help the disorder for many years. My parents -- myself, I ask, well you can't take medication for life.. and I certainly don't wish to be on polypharmacy. But for some disorders, especially for those that cannot be managed by therapy alone, severe schizophrenia, etc., one may have to be on a variety of medication for many years because this is the best we have in 2007. We don't have brain surgery on the sub nanometer level and I don't think most all of us would sign up for psychosurgery.
This question often comes up with people who are being treated for anxiety, depression, OCD, or both, with SSRIs, and decide to discontinue their medication only to discover that they felt better on them. I know that I have had that experience with SSRIs for dysthymia and the like.
Now, Phillipa brought up a point which I think relates to the fact that during a person's lifetime, they are likely to face a traumatic event in the life cycle that we all live in. For them, maybe just an SSRI for a while will help them cope with a traumatic event, and then they can discontinue it and perhaps follow up with some therapy as well and move through another phase in their lives. For them, it isn't an endogenous disorder per se. It is for an instance, but it isn't genetic, and it doesn't mutate and change form over a lifetime. It just is a temporary fork in life.
For others, with clinical lifetime disorders, I believe that medications both can mask and help, purely mask, purely help, or any of a combination of the above.
That's my 2c anyhow- tidings
Jay
poster:yxibow
thread:721825
URL: http://www.dr-bob.org/babble/20070107/msgs/721897.html