Posted by Dr. Bob on September 12, 2001, at 17:00:33
In reply to Re: Psychiatry and Neurology, posted by Dr. Bob on September 12, 2001, at 16:59:40
[Posted by NLFAmerica on September 12, 2001, at 16:34:53]
> Why is it that two diseases that both involve abnormal amounts of the neurotransmitter dopamine are treated by two different types of doctors? By that I mean schizophrenia and Parkinsons disease. In schizophrenia there is generally acknowledged to be too much dopamine, whereas in Parkinsons the problem is too little dopamine. One is treated by psychiatry (schizophrenia) and the other is treated by Neurology (Parkinsons). Why is that? Is it perhaps because schizophrenia is a "scarier" disease than Parkinsons disease? Is it perhaps because in the past schizophrenics were considered to be freaks and just institutionalised and thrown away by society?
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> The fact of the matter is that both of these diseases are basically opposite ends of the pole, yet both involve serious biological changes in the brain and CNS. Personally I believe schizophrenia should be viewed in the exact same light as Parkinsons disease and should thus be considered a bona fide neurological disease and treated by neurologists.
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> In severe clinical depression four things generally happen. Patients develop serious negative changes in sleeping, eating and sex drive cycles. They also oftentimes develop serious cognitive problems such as difficulty focusing, remembering, thinking clearly, making decisions, etc. All of the above are Central Nervous System controlled ie; "brain controlled." Sleeping is a brain/CNS controlled thing. So is appetite and sexual drive and function. Cognition is without a doubt brain controlled. Thus clinical depression is in reality also a type of Neurological disease.
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> In the most effective depression treatment available, psychiatrists seek to induce generalized seizures in severely depressed individuals. As time and ECT sessions go by, the seizure threshold goes up. As the seizure threshold goes up, many depressed patients seem to do better. Same thing is being found for the new VNS or Vagus Nerve Stimulation implant which was originally developed to treat refractory epilepsy. Now its being researched by a handful of forward thinking neuropsychiatrists as a treatment for refractory depression. And guess how it works? By pushing up the seizure threshhold...the same thing ECT does, but without causing the seizure. Hmmmmmmmmm, wow it seems there is a big relationship to severe mental illness and Neurology and the brain.
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> Seems like the handwriting is on the wall folks.
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> Isnt it time to just cut thru the crap and begin looking at mental illness for what it really is? not mysterious psychological mumbo jumbo but in fact genuine medical illnesses? This wont happen as long as psychiatry is the main provider for mental health. Psychiaty needs to be absorbed into Neurology before serious mental illness will begin being viewed as bona fide brain based medical problems.
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> Keep in mind Im talking about the more serious forms of mental illness here. I have no problem with the typical dysthymic depressed person going to a social worker to talk. Thats fine. But what about that person who has SEVERE major depression, manic depression, schizophrenia, treatment resistant depression or severe OCD? Im sorry, but I dont think psychiatry does that hot of a job at treating these folks. Getting a mere response to drugs and getting to 50% is one thing. Getting a consistent full remission and staying that way is totally another. I dont believe psychiatry does all that great of a job at achieving full remissions for many patients with more severe mental illness. And I believe much of the reason for this is the lack of rigorous Neurologically based approaches in psychiatric diagnosis and treatments. Just my personal opinion.
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> Psychiatry needs to be absorbed by Neurology, severe mental illness needs to begin being viewed as neurological (brain) problems and the psychology stuff needs to be trashed. Then maybe more people would begin getting the real treatment they need and more people with severe mental illness would achieve FULL and CONSISTENT Remission and not just a response.
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> NLF of American Mentally Ill
poster:Dr. Bob
thread:11262
URL: http://www.dr-bob.org/babble/social/20010909/msgs/11264.html