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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 85 to 109 of 142. Go back in thread:
Posted by SLS on September 6, 2010, at 18:42:27
In reply to Re: disability - Proudfoot - SLS, posted by olivia12 on September 6, 2010, at 15:39:29
> and no one has been able to understand how meds/neurotrasmitters really work, why not just call it a day and move on? Is just IMO.
I would say that it will be impossible to move on without continuing to search for and finding understanding. With sufficient understanding, perhaps fewer people would remain disabled by mental illness.
- Scott
Posted by SLS on September 6, 2010, at 18:58:58
In reply to Re: disability - Proudfoot - SLS » SLS, posted by violette on September 6, 2010, at 15:03:23
> > "Actually, I was hoping that you would give me that answer. If more than 50 people have less than ideal environments, why is it that only 10 people will suffer from major depressive disorder? What are the differences between these people?"
> Imo, I think it has to do whether or not one developed a secure vs insecure attachment to the mother as an infant.I think you have missed my point. Perhaps I have missed yours. My point is that there is not a 1:1 relationship between bad environments and bad outcomes.
What percentage of people would you say develop an insecure attachment to the mother as an infant? What percentage of these people go on to develop MDD? What percentage of people with MDD had an insecure attachment? I don't have the answers to these questions, but I think they are important to ask.
- Scott
Posted by emmanuel98 on September 6, 2010, at 19:55:35
In reply to Re: disability - Proudfoot - SLS » violette, posted by SLS on September 6, 2010, at 18:58:58
I'm on the fence here. I had a terrible childhood/adolescence and had mood disorders all my life -- mostly severe mood swings lasting hours or days. But it wasn't until I was 50 that I experienced severe depression -- virtually comatose, sucidal, unable to do simple things like shower or wash the dishes for two months until I went into a hospital and was started on parnate. This I think was biological. Maybe my background made me more sucseptible and gave the depression themes and forms, but I truly feel like it was out of my physical control and that physical activities I had used to deal with moodiness had no effect at all on this depression. I think there's a biochemical piece to severe mood disorders which is independent of psychological histories.
This is similar, imho, to drug and alcohol addiction. For me, drug and alcohol addiction were very much associated with loneliness and emotional distress. But in AA, I have met people who have had perfect childhoods and loving parents who nevertheless became out of control addicts and alcoholics.
Posted by Phillipa on September 6, 2010, at 20:11:50
In reply to Re: disability - Proudfoot - SLS » morgan miller, posted by SLS on September 6, 2010, at 6:55:05
Scott my Mother had psoriasis which covered her whole body except hands and soles of feet. She spent her time in a bathtub to soak off the scales which covered our house. Psoriasis in considered and autoimmune disease and in turn caused rheumatoid arthritis also an autoimmune disease. Anyway since whole family anxiety I wonder if mental disorders could be autoimmune linked? As I and other family members also have thyroid disorder Hasimotos autoimmune, And diabetes autoimmune and in the family genes? Phillipa
Posted by Phillipa on September 6, 2010, at 20:15:07
In reply to Re: disability - Proudfoot - SLS, posted by violette on September 5, 2010, at 21:43:05
First guilt caused first panic attack then hasimotos thyroiditis took over. Phillipa
Posted by Phillipa on September 6, 2010, at 20:18:50
In reply to Re: disability - Proudfoot - SLS, posted by SLS on September 6, 2010, at 7:16:24
Scott I never did but shifts in hormones. Phillipa
Posted by violette on September 6, 2010, at 20:53:44
In reply to Re: disability - Proudfoot - SLS » violette, posted by SLS on September 6, 2010, at 18:58:58
Hi SLS,
They are important questions to ask...unfortunately, as you know, research cannot match reality and some concepts are more difficult to research than others...there are plenty of parents out there who 'seem' like good parents but the overprotection and intrusivness cause avoidant-like personalities (social anxiety) which then leads to major depression.
Then there are those who think they have no psychological problems or have never sought mental health treatment yet hurt those around them in a life of bitterness and denial. How do you find absolute connections if you cannot 'reach' those types of parents? Then there are those who had poor parenting, but perhaps had a mentor-like a grandparent with whom they were able to develop a healthy relationship...
I'm sure you could think of dozens of other scenerios why it can't be proven.
http://www.heartcenteredtherapies.org/go/docs/Journal%205-1%20Attachment.pdf
There's some percentages in the article above. No one really knows, but attachment theory might be the best we have.
But I think it is possible that you could get closer to becoming well again one day if you ask yourself different questions:
Why place so much importance in rationalizing that some MI can be purely biological?
Why devote much time and energy to finding and defending any and every angle of this possibility?
When I find myself in some sort of pattern, like obsessing about psychology, it helps to explore the reasons behind it....
Posted by olivia12 on September 6, 2010, at 23:37:30
In reply to Re: disability - Proudfoot - SLS » olivia12, posted by SLS on September 6, 2010, at 18:42:27
> I would say that it will be impossible to move on without continuing to search for and finding understanding. With sufficient understanding, perhaps fewer people would remain disabled by mental illness.
>
>
> - ScottYes, I see your point, but isn't this one of those arguments that loops around itself? Like trying to decide which came 1st--the chicken or the egg or arguing that life begins at conception? I personally think it is a complex mix of genes/predisposition, as well as an environment ripe for mental illness. I think I tend to lean more on the side of biology though, as do most of these posts. I suppose we may never know...I did enjoy reading the different perspectives though.
Posted by SLS on September 7, 2010, at 5:06:06
In reply to Re: disability - Proudfoot - SLS » SLS, posted by Phillipa on September 6, 2010, at 20:11:50
> Scott my Mother had psoriasis which covered her whole body except hands and soles of feet. She spent her time in a bathtub to soak off the scales which covered our house. Psoriasis in considered and autoimmune disease and in turn caused rheumatoid arthritis also an autoimmune disease. Anyway since whole family anxiety I wonder if mental disorders could be autoimmune linked? As I and other family members also have thyroid disorder Hasimotos autoimmune, And diabetes autoimmune and in the family genes? Phillipa
Recent studies have shown that inflammation of the brain is associated with affective-spectrum (mood) disorders. I'm not absolutely sure about anxiety per se, but I guess it is possible.
- Scott
Posted by SLS on September 7, 2010, at 6:16:04
In reply to biology vs psychology » SLS, posted by violette on September 6, 2010, at 20:53:44
Hi.
I guess I like the idea of there being a spectrum of relative contributions of biology versus psychology in the pathogenesis of mental illness.
> I'm sure you could think of dozens of other scenerios why it can't be proven.
Whether or not it can be proven is a matter of awareness and perspective - opinion
> http://www.heartcenteredtherapies.org/go/docs/Journal%205-1%20Attachment.pdf
It looks like a nice article. Unfortunately, I couldn't read it all.
Do dogs and cats demonstrate maternal attachment?
We are animals, too.
Can there be any psychology without biology? Is the progression of attachment hard-wired into our programming?
> There's some percentages in the article above. No one really knows, but attachment theory might be the best we have.
I don't know about attachment theory as being the best explanation we have for understanding affective and anxiety disorders. However, it is an attractive model for understanding human development. Thanks for posting the link.
> But I think it is possible that you could get closer to becoming well again one day if you ask yourself different questions:
I wish this were true.
> Why place so much importance in rationalizing that some MI can be purely biological?
Because, for me, at this point in time, it is. I'm sure that for other people, this is their truth, too. I can't possibly be so unique. My PET scans showed near global hypofunction. Witnessing ultra rapid cyclicity with an invariable period of 11 days is very persuasive. Very. I don't need to have an explanation for anyone else except for me in order to pursue an effective treatment. However, it is nice to interact with others who have similar illnesses as I do. Hopefully, I will find my healing here as all of us share information, perspective. and emotional support.
> Why devote much time and energy to finding and defending any and every angle of this possibility?
You mean like psychotherapy? I've had quite a few years worth.
Although you have expressed in some of your previous posts what I consider to be a nicely balanced description of the interaction between biology and psychology, you abandon it here. You are spending a bunch of time and energy expounding the validity of a monolithic psychological basis for MDD and BD. Historically, I have expostulated the extant interaction between the biological and the psychological. That's why I wrote that silly little essay. In any event, I feel that your perspective is important to verbalize. I think it offers great insight that I'm glad I had the opportunity to read.
- Scott
Posted by morgan miller on September 7, 2010, at 12:39:41
In reply to Re: disability - Proudfoot - SLS » morgan miller, posted by SLS on September 6, 2010, at 6:55:05
> > > > Scott, I really think that rarely ever and maybe never have mental illness developed solely out of biology.
> > >
> > > It is difficult to separate the individual from its environment when observing it.
> > >
> > > Line up 100 people. How many of them do you think will have an ideal developmental environment?
> > >
> > >
> > > - Scott
> >
> >
> > Not many, maybe a few out of 100. I know you didn't really expect me to answer that, you were just making a point. Just thought I'd chime in on what I thought.
>
> Actually, I was hoping that you would give me that answer. If more than 50 people have less than ideal environments, why is it that only 10 people will suffer from major depressive disorder? What are the differences between these people?
>
> To further amplify my point, why are other stress-induced or stress-exacerbated illnesses considered biological and not psychological? Psoriasis is a biological disease. Even simple relaxation techniques can be of help. Some researchers even believe that psychotherapeutic interventions can be effective, although I would guess that it is people with psychosocial stressors that would benefit most.
>
>
> - ScottI understand what you are saying, and believe me, I think there is a major biological component in chronic depression and other mental illness. If there were 100 people that developed in a far less than ideal environment, and only 20 of them suffered from chronic obtrusive recurring mental illness, this would probably mean that all of those 20 people were genetically predisposed to mental illness in some way. So, I think I have not made myself clear here-I believe just about everyone that suffers from mental illness was born with a genetic predisposition. The point I have been trying to make is, that if people born with a genetic predisposition to mental illness(and frankly I think some of those are simply people that are very sensitive and sensitive to their environment), are brought up in an ideal loving nurturing environment, the likeliness of them suffering from mental illness is GREATLY reduced and possible completely eliminated. Does that clear my beliefs/feelings on the subject up a bit?
Morgan
Posted by morgan miller on September 7, 2010, at 12:55:04
In reply to Re: disability - Proudfoot - SLS, posted by SLS on September 6, 2010, at 7:16:24
> > Ed,
> >
> > I see that scenerio as well. I always think the 2 are intertwined-not one vs the other...not either or...i think it's always some component of both. thats just my opinion but i like that you brought up that scenerio as no one else did.
>
> Actually, this is either-or thinking. You suggest that there is no such thing as an entirely biological mental illness. I believe that at least three scenarios can manifest.
>
> 1. 100% biological
> 2. 100% psychological
> 3. 100% interactive
>
> I don't understand why you would want to limit yourself to scenario number 3. Is there scientific evidence to exclude 1 and 2?
>
> Why is it that such a high proportion of females experience menstrual cyclic mood shifts beyond their control? What's that all about?
>
>
> - ScottI don't believe there is conclusive scientific evidence for any theory on mental illness. I think this will take many more years for us to come to any kind of solid concrete conclusion. I do know that I, all of the therapists with PhD's in clinical psychology I have been in contact with, and all of the psychiatrists I have been in contact with, believe that there is a psychological/environmental component nearly 100 percent of the time. This does not mean that therapy is the answer as much of the damage to and disruption of the development of one's chemical/physiological biology started years ago and at this point may require psychiatric treatment. I've said this before, our development-physiologically, chemically, psychologically-is very dependent on what occurs between the ages of 2 and 4 years old. What happens during these years can alter the course of how our minds work and how we operate for the rest of our lives. If you believe in this, you have to believe that there is a very good chance environment/nurture played a major role in the development of our mental illness. That's not to say that we still are not continued to be heavily influenced and affected during the rest of our childhood and adolescence. Still, we always have to consider the impact these early crucial years of development have on us and if anything does happen that negatively alters the course of our development emotionally and chemically, it will be very difficult to undo. Sorry if I'm rambling hear.
Scott, I really believe in prevention of mental illness, and I believe the only real way to help prevent mental illness is to have wonderful, nurturing, loving parents that offer a very sound, stable, and properly structured environment. Without this, mental illness will be free to develop and wreak havoc in the lives of those predisposed to it.
Morgan
Posted by morgan miller on September 7, 2010, at 13:01:50
In reply to Re: disability - Proudfoot - SLS » SLS, posted by violette on September 6, 2010, at 15:03:23
> "Actually, I was hoping that you would give me that answer. If more than 50 people have less than ideal environments, why is it that only 10 people will suffer from major depressive disorder? What are the differences between these people?"
>
> Imo, I think it has to do whether or not one developed a secure vs insecure attachment to the mother as an infant. I posted a study about attachment in the psycho forum...not that it is a key study or anything (but it's detailed); people's maladaptive traits later in life are strongly correlated with infant attachment..also, the child's attachment style can be accurately predicted, not 100 percent of course) by the attachment style of the parent.
>
> I think if you have a healthy/secure infant attachment-to use this as an example-you might be one of the holocaust survivors who did not live life in a state of mental illness....I totally agree Violette, more and more we are learning how important it is for a child to have a strong healthy bond with it's mother. There is new research coming out saying how much of an impact physical contact has on a child's development. Again, if a child is predisposed to mental illness and has a "cold" mother that is not able to express love through emotion and physical contact, it is much more likely that that child's predisposition will develop into something much worse than what it would have been with a loving nurturing "warm" mother. And again, it is possible, given the right bond with the mother and a continued healthy positive environment and experience through adolescence, that child may not ever really struggle with depression, anxiety, ocd, etc., though they will likely experience it at times.
Morgan
Posted by morgan miller on September 7, 2010, at 13:07:55
In reply to Re: disability - Proudfoot - SLS » violette, posted by SLS on September 6, 2010, at 18:58:58
One more point, sorry if I'm being annoying : )
Even those that are not genetically predisposed to mental illness, that have also experienced and developed in a disruptive environment, will still struggle in some aspect in life. This is most likely to be evident in their ability to achieve success in careers and in relationships, especially intimate/romantic relationships.
Posted by morgan miller on September 7, 2010, at 13:26:34
In reply to biology vs psychology » SLS, posted by emmanuel98 on September 6, 2010, at 19:55:35
> I'm on the fence here. I had a terrible childhood/adolescence and had mood disorders all my life -- mostly severe mood swings lasting hours or days. But it wasn't until I was 50 that I experienced severe depression -- virtually comatose, sucidal, unable to do simple things like shower or wash the dishes for two months until I went into a hospital and was started on parnate. This I think was biological. Maybe my background made me more sucseptible and gave the depression themes and forms, but I truly feel like it was out of my physical control and that physical activities I had used to deal with moodiness had no effect at all on this depression. I think there's a biochemical piece to severe mood disorders which is independent of psychological histories.
>
> This is similar, imho, to drug and alcohol addiction. For me, drug and alcohol addiction were very much associated with loneliness and emotional distress. But in AA, I have met people who have had perfect childhoods and loving parents who nevertheless became out of control addicts and alcoholics.Emmanuel98, do you think it is possible the depression and sadness was always lurking deep beneath the surface, basically underlying depression that you could not necessarily feel, and then at some point this inner sadness/depression came out and took hold in a way it never had before?
>But in AA, I have met people who have had perfect childhoods and loving parents who nevertheless became out of control addicts and alcoholics.
I hate to sound cynical here but there are many many people that claim to have had a perfect childhood and loving parents that had far from that. We have to consider what and how people define things. To them, it may have appeared to be and felt like a perfect childhood. To them, their parents may seemed to be the most loving parents they could have ever asked for. Don't get me wrong, I think AA is great, but there are so many people that go there and distract themselves with love from God and never really take the time to dissect and analyze their childhood and face the demons that may have drove them to addiction in the first place. There is a reason why denial is THE most powerful coping mechanism the human race has in it's arsenal. Can you really trust the word of someone who masked their pain and escaped reality through alcohol and drugs? Again, not trying to be cynical, just realistic. Most people idolize their parents, defending them and putting them up on a pedestal, saying they were great when in reality they really were not. Many do not realize what it truly takes to be a great parent. What many think is great is really sub par.
Posted by Dinah on September 7, 2010, at 13:48:38
In reply to Re: disability - Proudfoot - SLS, posted by morgan miller on September 7, 2010, at 12:39:41
> The point I have been trying to make is, that if people born with a genetic predisposition to mental illness(and frankly I think some of those are simply people that are very sensitive and sensitive to their environment), are brought up in an ideal loving nurturing environment, the likeliness of them suffering from mental illness is GREATLY reduced and possible completely eliminated. Does that clear my beliefs/feelings on the subject up a bit?
I'd agree with that. Although I'd guess that an ideal loving and nurturing environment is rare. Most parents and most kids have to get by with good enough. Especially since, if genetics does play a large role, parents might be struggling with the same genetic tendencies.
Pressure on parents is huge. How can parents be ideal unless they themselves are perfectly well adjusted? How many perfect parents can there be out there? When my son was born, I resolved to try my hardest to be what he needed but I also resigned myself to the likelihood that in thirty years he might well be talking to a shrink about all the ways I messed up.
I was likely born with an oversensitive nervous system, making me prone to easy arousal and slow return to baseline. My parents chaotic environment, perhaps influenced by their own easy arousal and slow return to baseline, didn't help. But I see many of the same traits in my son. My home now is nothing at all like the one I grew up in. Not at all chaotic. I see some differences in him that result from the different environment. I see more ability in him to cope with a highly sensitive nervous system, and perhaps even to see the value in it. He's more resilient than I was. Certainly my husband and I have likely done things to exacerbate traits he already had, as well as things that might mitigate them.
I have to say that the idea that even slight misattunements or a coolish mother can cause mentally illness in children rather makes me wonder why anyone, aside from the enormously confident, chooses to have children at all...
I think I need to believe in the good enough mother.
Posted by SLS on September 7, 2010, at 14:13:11
In reply to Re: disability - Proudfoot - SLS » morgan miller, posted by Dinah on September 7, 2010, at 13:48:38
I guess we'll have to disagree to agree. ;-)
It seems that we agree that a stressful environment can contribute to the pathogenesis of mental illness - just as it can contribute to heart disease. The brain is just another organ capable of operating anomalously when challenged.
- Scott
Posted by SLS on September 7, 2010, at 14:16:03
In reply to Re: disability - Proudfoot - SLS » Dinah, posted by SLS on September 7, 2010, at 14:13:11
Sorry.
Posted by morgan miller on September 7, 2010, at 14:31:31
In reply to Re: disability - Proudfoot - SLS » morgan miller, posted by Dinah on September 7, 2010, at 13:48:38
Dinah, if we always settle on the "good enough mother" or "good enough" parents, will we ever strive to do what we need to do to be better parents? Don't you think we need to have a certain awareness of what it takes to be a really good parent so that we do not accept just being average or "good enough"?
>Pressure on parents is huge. How can parents be ideal unless they themselves are perfectly well adjusted?
This is exactly why we need more awareness and more services available to people so that they can have a better chance of taking it upon themselves to do what they need to do to nurture themselves closer to the better adjusted individual they would have been if their parents were better adjusted people.
>Especially since, if genetics does play a large role, parents might be struggling with the same genetic tendencies.
Like I said before, the genetics that predisposed the parents to struggle with their own mental illness, are less likely to be a disruptive factor in their lives and their ability to parent, if they are nurtured properly, be it by their parents, or, eventually by themselves through intensive therapy.
Morgan
Posted by morgan miller on September 7, 2010, at 14:32:55
In reply to Re: disability - Proudfoot - SLS » Dinah, posted by SLS on September 7, 2010, at 14:13:11
> I guess we'll have to disagree to agree. ;-)
>
> It seems that we agree that a stressful environment can contribute to the pathogenesis of mental illness - just as it can contribute to heart disease. The brain is just another organ capable of operating anomalously when challenged.
>
>
> - ScottCheers brotha : )
Morgan
Posted by SLS on September 7, 2010, at 14:43:21
In reply to Re: disability - Proudfoot - SLS, posted by morgan miller on September 7, 2010, at 13:07:55
Are people afraid of the idea that their wonderfully creative minds are nothing more than a manifestation of a bounded physical object, and that this object sometimes develops a biological illness?
I am not afraid of the idea that my illness be completely psychological. In fact, I welcomed that possibility when I was first diagnosed with MDD. I much rathered that my psychological discomfort should be within my power to control. In other words, I was very angry when I discovered that no amount of psychotherapy - no amount of work and effort on my part - would get me well. Imagine my surprise when 2 weeks of drug therapy would accomplish what 2 years of psychotherapy did not.
- Scott
Posted by morgan miller on September 7, 2010, at 16:09:39
In reply to Re: disability - Proudfoot - SLS » morgan miller, posted by SLS on September 7, 2010, at 14:43:21
> Are people afraid of the idea that their wonderfully creative minds are nothing more than a manifestation of a bounded physical object, and that this object sometimes develops a biological illness?
>
> I am not afraid of the idea that my illness be completely psychological. In fact, I welcomed that possibility when I was first diagnosed with MDD. I much rathered that my psychological discomfort should be within my power to control. In other words, I was very angry when I discovered that no amount of psychotherapy - no amount of work and effort on my part - would get me well. Imagine my surprise when 2 weeks of drug therapy would accomplish what 2 years of psychotherapy did not.
>
>
> - Scott
>Realizing the benefits of therapy usually takes much longer than just a few years. Also, if therapy is going to work, it usually requires an open mind, a ton of hard work, breaking down of all barriers/coping mechanisms, etc. The thing about therapy is, it isn't as much a treatment for depression as it is a way to get to the bottom of the sadness and anxiety inside, deal with underlying anger(which believe it or not, we all have some of), and learn to love ourselves a build back our self esteem to what it should be. Through doing all of this, hopefully we will be less depressed and more equipped to deal with depression.
Scott, do you think your brain scans showing obvious dysfunction/malfunction, are a result of the cumulative damage of years of depression, manic episodes and anxiety caused by both biological and psychological/environmental factors? Do you think it is possible you had a much healthier better functioning brain when you were born and that early on your brain's healthy development may have been disrupted by environmental factors?
Posted by violette on September 7, 2010, at 16:12:48
In reply to Re: biology vs psychology » violette, posted by SLS on September 7, 2010, at 6:16:04
SLS:
I'm not interested in the answers to those questions-not because i'm not interested in what you have to say-but because i was hoping YOU would be interested in the answers!
psychology vs biology:
Prior psychotherapy-for 5 years-total waste of time. It was like going swimming each week-but never once going in the water! But those therapists were much like the lifeguard-were interested in my wellness, but did relatively little...worse, none of them had ever had gone in the water before themselves....
Everyone defends against emotional pain; some people build temporary walls as needed...but some people build a thick wall and end up carrying it around with them...until it eventually becomes part of their identity...and sometimes will remain for the rest of their lives...and sometimes those with the thickest walls are protecting raw vulnerability, often those who are kind, compassionate...extra sensitive and empathetic.
Some therapists will let you sit there with those walls and even help you build them thicker! Then again, maybe some people are better off merging with the wall and keeping them permanently.
My therapist said it would be great if everyone could change from simply taking a pill rather than investing the time and money for therapy...medications can help manage symptoms, maybe the rest of your life if you are lucky, but unfortunately, the only thing even close to a cure right now is psychotherapy. But you have to find the type willing to push you in the damn pool, the same type who will then swim in the pool with you.
No more chicken/egg conversations for me-I'm off to swim! Bye!!!
Posted by morgan miller on September 7, 2010, at 16:21:04
In reply to Re: biology vs psychology, posted by violette on September 7, 2010, at 16:12:48
>Everyone defends against emotional pain; some people build temporary walls as needed...but some people build a thick wall and end up carrying it around with them...until it eventually becomes part of their identity...and sometimes will remain for the rest of their lives...and sometimes those with the thickest walls are protecting raw vulnerability, often those who are kind, compassionate...extra sensitive and empathetic.
This is oh so true, and sort of sad. Good post violette.
Posted by Dinah on September 7, 2010, at 16:54:45
In reply to Re: disability - Proudfoot - SLS » Dinah, posted by morgan miller on September 7, 2010, at 14:31:31
> Dinah, if we always settle on the "good enough mother" or "good enough" parents, will we ever strive to do what we need to do to be better parents? Don't you think we need to have a certain awareness of what it takes to be a really good parent so that we do not accept just being average or "good enough"?
http://www.pbs.org/parents/special/article-expectations-goodmother.html
I think acknowledging that we can't be perfect at mothering is good modeling for our children, who are unlikely to be perfect themselves.
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