![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 7 to 31 of 81. Go back in thread:
Posted by sigismund on December 18, 2010, at 13:39:15
In reply to *Not* Thinking in terms of meds, posted by linkadge on December 17, 2010, at 18:19:43
I simply don't have any hope that meds will lead to improvement for me.
So that is right....say hello to someone in the morning. A lot of people feel bloody awful anyway, and if they don't now, they will later.
Posted by ed_uk2010 on December 18, 2010, at 14:00:12
In reply to Re: *Not* Thinking in terms of meds, posted by sigismund on December 18, 2010, at 13:39:15
>Say hello to someone in the morning.
It's not morning (here, it's 8pm), but hello Sigi.
Posted by sigismund on December 18, 2010, at 14:46:45
In reply to Re: *Not* Thinking in terms of meds » sigismund, posted by ed_uk2010 on December 18, 2010, at 14:00:12
As one of my son's friends always says
'Hello Eddy. What a pleasant surprise.'
Posted by ed_uk2010 on December 18, 2010, at 15:52:27
In reply to Re: *Not* Thinking in terms of meds, posted by sigismund on December 18, 2010, at 14:46:45
> As one of my son's friends always says
>
> 'Hello Eddy. What a pleasant surprise.'How very civilised, even Dr. B would be impressed :)
Posted by linkadge on December 19, 2010, at 6:49:47
In reply to Re: *Not* Thinking in terms of meds » sigismund, posted by ed_uk2010 on December 18, 2010, at 15:52:27
Posted by SLS on December 19, 2010, at 8:29:27
In reply to *Not* Thinking in terms of meds, posted by linkadge on December 17, 2010, at 18:19:43
> Does anybody here find themselves continually thinking about all of their problems in terms of medications?
No. I attribute most of my impairments of cognitive function, an unrelenting states of anergia and anhedonia, and vegetative deficits; the results of which is a reduced ability to function in society and to remain independent despite having a neurobiolgical depressive disorder. The thing is, depressive illness is always visible and slapping you in the face; reminding you every moment of how sick you are.
I want all of this pain and frustration and impaired function to disappear and be replaced by the resolution and long-term remission of the depression. Since depression is usually the most prominent experience in the moment, it is all but impossible to ignore it without becoming entrenched in denial.
As I indicated, the affective and cognitive dysfunctions produced by depression is always a prominent and visible product of living in the moment. It is an impenetrable wall that one finds himself charging into it head first. It is a warping of consciousness. How can anyone ignore the hope of ending the pain through using drugs? So, yes, the endless experience of pain and frustration produces an endless craving for relief. Excruciating pain often yields desperation and thus a constant search for a cure.
- Scott
Posted by herpills on December 19, 2010, at 10:34:07
In reply to Sorry: stupid question for this group of (course) (nm), posted by linkadge on December 19, 2010, at 6:49:47
I didn't think it was a stupid question. I try to utilize as many non medication approaches as possible. But if I am having severe symptoms, going out to that coffee shop would not be an option. I have had such severe agoraphobia in the past it made me want to kill myself. I need some chemical support. Therapy is useless for me during acute symptoms. Now that I'm feeling better, I can go out and interact with people, which makes me feel even better. herpills
Posted by morgan miller on December 19, 2010, at 13:59:46
In reply to *Not* Thinking in terms of meds, posted by linkadge on December 17, 2010, at 18:19:43
>You know what I started doing the other day? Going to a local coffee shop in the morning. I just walked right in, bought a coffee and said good morning to a stranger. We talked. I go back there now and people know my name. Strange huh? Its sure a nice alternative to waking up and checking "babble" for more leads on the magic cocktail.
Linkadge
I totally agree with you. This made me laugh. All other babblers please don't take this personally, I was mostly laughing at myself as I am often guilty of checking Babble first thing in the morning. God I miss the days when I had no internet, no cell phone, and no car. I just woke up and either played my bass, when to the gym, played basketball, or hung out with my roommates.
I do think we get a little too obsessed with medications. I tend to be a little more obsessed with the internet and psychobabble and not getting my meds right, though that is a constant concern these days.
The problem is, when we go out to the coffee shop and feel so uncomfortable that we can't really fully enjoy it and get the most out of the experience, we then start to say, "Damn, no matter what efforts I make, I don't seem to feel right without the right medication". I think most people here are hyper-focused on medication because they have tried getting out, exercising, and doing other positive things without a consistent positive response and consistent relief of symptoms.
Linkage, have you ever thought that maybe the things you struggle with are not as severe as many people here? I'm not minimizing your pain, and from some of the things you've said here, it sounds like you have been suffering in a pretty bad way for a long time. Still, I have heard you speak of being able to go run and get relief, something I and many others here cannot do. Maybe some of your issues with being able to enjoy life to it's fullest are not related as much to medication treatment as taking a proactive role in making life changes, who knows. I'm starting to ramble and I'm not sure if I'm making myself clear. Please don't take anything I said the wrong way.
I think you make a valid point that maybe there are other things we need to be doing than solely depending on medication to make us better. I think there are some here though that may not be able to make changes that further contribute to enriching their lives until they are at least at 60 or 70 percent relief of symptoms.
Posted by morgan miller on December 19, 2010, at 14:01:13
In reply to Re: Sorry: stupid question for this group of (course) » linkadge, posted by herpills on December 19, 2010, at 10:34:07
> I didn't think it was a stupid question. I try to utilize as many non medication approaches as possible. But if I am having severe symptoms, going out to that coffee shop would not be an option. I have had such severe agoraphobia in the past it made me want to kill myself. I need some chemical support. Therapy is useless for me during acute symptoms. Now that I'm feeling better, I can go out and interact with people, which makes me feel even better. herpills
I didn't think it was a stupid question either. I understand why you said it being that this is a medication board, but for that reason I believe the question was appropriate.
Posted by violette on December 19, 2010, at 15:59:20
In reply to Sorry: stupid question for this group of (course) (nm), posted by linkadge on December 19, 2010, at 6:49:47
Addressing this question to this particular group seemed the opposite of a 'stupid question'. If anything, maybe an opportunity for people to ask themselves that question (and not necessarily answer it here)....but i was suprised it was you that asked!!
Compulsive thinking/reading about medications, their effects, and associated behavior you described can be a good temporary strategy to avoid painful emotions AND forming relationships which can bring with them fears of rejection and other painful feelings. But when the behavior endures, it can become maladaptive, preventing sme from actually addressing emotional sources of symptoms.
We all have unique ways to prevent negative emotions from surfacing; to deal with our neurosis; the problem is, for some, is that what the mind does to block out negative emotions tends to also block out positive emotions such as joy. The result can be (again for some) ahedonia, lack of motivation-dysthymia. Those symptoms, after time, can lead to a major depression-sometimes referred to a double depression. There's a lot researched and written about the effects of emotions on the nervious system in attachment psychology. People do need love and human connection to prosper.
Then again, like Morgan said, sometimes people end up in a catch 22 situation where symptoms can prevent them from thriving via social connections-the very thing that can sometimes lead people on a track to wellness again, especially if your depressive symptoms could be best described as dysthmia (as opposed to sadness/crying). Hope can be the catalyst, maybe, to the desired goal of mental well-being.
And we do sometimes take the simple things in life for granted.
Posted by linkadge on December 19, 2010, at 18:20:54
In reply to Re: *Not* Thinking in terms of meds » linkadge, posted by SLS on December 19, 2010, at 8:29:27
>How can anyone ignore the hope of ending the >pain through using drugs? So, yes, the endless >experience of pain and frustration produces an >endless craving for relief. Excruciating pain >often yields desperation and thus a constant >search for a cure.
Because most of us just sit around, googling this medication or that medication, feeding into this pathetic loop of desire, trial, faiure, repeat.
The brain is more capable of adapting if you put it in the right situations. Some of us here spend so much time establishing to ourselves and others just how "sick" we are. It seems like part of "us" doesn't exist anymore. When we sit here and put all of our hope in the next medication, we don't really work much at building the brain circuits that really work on beliving in ourselves again.
There is something to be said for just "doing things". Instead of waiting for a drug to give use the "motivation" to get up and do something interesting, why not just doing it, whether or not we think we will enjoy it? We have babbied ourselves.
The other day, I was walking down the street, moping to myself about how darn depressed I was, how I had no hedonic function, how nothing ever seemed interesting anymore and bla bla bla bla.
To make a long story short, I slipped on the snowey edge of a massive hill, slid down, cracked though the edge of the ice, and was up to my waste in freezing cold water. Fighting for my life in the swift current, I managed to grab hold of a nearby bush and pull myself to safety. The freezing water through my cloths forced me to sprint faster than I thought possible up the ravine and back down the road (1.5km) to safety. I nocked on the door of a nearby house and a friendly individual took me in and helped me warm up and get back home.
The event scarred the hell out of me, but guess what? I "snapped" out of my "clinical treatment resistant depression" for the time being.
Instead of me sitting around moping about how dumb and pathetic I am, I was thrown into a situation which forced me to be witty without bothering to think.
Depression creates a preception of incapacity that we only feed by spending ours on boards like this. Drug companys and psychiatrists spend their lives establishing this disease. Why not just start believing in ourselves once again?
Linkadge
Posted by Phillipa on December 19, 2010, at 18:30:17
In reply to Re: *Not* Thinking in terms of meds, posted by linkadge on December 19, 2010, at 18:20:54
For me now older I blame all symptoms on my brain when the symptoms could be due to a physical cause. Right now worried badly as felt faint earlier when bike riding. And see endo tomorrow almost hope he will find my thyroid off as have so tired and just uninterested in people, places, things I feel like a robot. I do know what you mean. Especially when changes in meds do nothing hope for me dies. Phillipa
Posted by linkadge on December 19, 2010, at 18:44:40
In reply to Re: *Not* Thinking in terms of meds, posted by morgan miller on December 19, 2010, at 13:59:46
>The problem is, when we go out to the coffee >shop and feel so uncomfortable that we can't >really fully enjoy it and get the most out of >the experience, we then start to say, "Damn, no >matter what efforts I make, I don't seem to feel >right without the right medication".
It doesn't matter if you fully enjoy it or not. We are so focused on needing to enjoying things. Its all about me, what will this do for me? I was feeling miserable last week and wanted to take the day off. I didn't take the day off, I went to work and felt miserable most of the day. But, after I was done I felt great. I didn't just give up and call it quits on the day.
I do believe there is something wrong with depressed individuals, but I believe we feed the illness. When we are told that "it is all in our heads", part of us dies. When we believe this, we stop working on trying to feel better and want to sit back and expect the medications do all the work (which they never will). And when something small goes wrong, we have to "change medications" or augment with this or that.
>I think most people here are hyper-focused on >medication because they have tried getting out, >exercising, and doing other positive things >without a consistent positive response and >consistent relief of symptoms.
Nothing will being consistent symptom relief.
>Linkage, have you ever thought that maybe the >things you struggle with are not as severe as >many people here?
I don't think that is anything you are qualified (me being here, and you being there) to question.
I think that I have had some severe problems, but I think that there are beneficial brain regions that can be strenthened, if you care to strenthen them.
Did you know that practicing juggling for a month significantly increases grey matter volume in certain areas of the brain? Even the process of "acting" well, when you are not feeling well, probably helps to strenthen the circuits involved in normal emotional function. I think the worst thing you can do is *give up* on engaging potentially adverse situations just because you don't like the way they make you feel.
If you continue to throw yourself in situations that put you outside of your comfort zone, your brain will grow, adapt and respond. If you sit around and expect drugs to fix all your problems, your brain will atrophy.
>Still, I have heard you speak of being able to >go run and get relief, something I and many >others here cannot do.
B*llsh*t. You don't want to do it. If there was a crazy axe murderer chasing you, you'd move. Quit thinking about what makes you feel good. Just do it, and watch yourself respond.
Linkadge
Posted by linkadge on December 19, 2010, at 18:50:47
In reply to Re: Sorry: stupid question for this group of (course), posted by violette on December 19, 2010, at 15:59:20
My belief is that after you have gone through the medication merry go round, pick the one or two medications that help the best and then take them for a year and forget about it.
Don't have any energy? Ask a good friend do drive you out to the middle of nowhere and leave you to find your way home.
Linkadge
Posted by linkadge on December 19, 2010, at 19:01:25
In reply to Re: Sorry: stupid question for this group of (course), posted by linkadge on December 19, 2010, at 18:50:47
Did you know that stress increases the level of a chemcal called isatin? Isatin is a highly potent monoamine oxidase A/B inhibitor. It also inhibits acetycholinsterase!
Hmm, when you push / stress yourself, your brain releases an MAOI! (with potentially procognative effects) What an interesting concept? MAOIs......yes, the most potent class of chemical antidepressants currently known to man..... Adversity boosts the production of natural antidepresants.
Thats all I am saying here. If you sit around expecting the energy and motivation to just magically come to you, you may be sitting around forever. Put yourself in a situation which gets you out of your comfort zone, and your brain might actually suprise you.
Linkadge
Posted by SLS on December 19, 2010, at 20:11:28
In reply to Re: *Not* Thinking in terms of meds » linkadge, posted by SLS on December 19, 2010, at 8:29:27
The intense focus of a patient on the science and clinical application of psychotherapeutic agents can, at first, seem like an obsession. This is really a survival mechanism. It is the aversion to never-ending pain that produces never-ending study. If doctors have not been able to fix us, what better choice do we have but to dedicate all of our focus and energies into finding a cure? It is only logical for one to invest themselves in finding a way to end a painful and empty existence.
- Scott
Posted by morgan miller on December 19, 2010, at 20:58:50
In reply to Re: *Not* Thinking in terms of meds, posted by linkadge on December 19, 2010, at 18:44:40
>B*llsh*t. You don't want to do it. If there was a crazy axe murderer chasing you, you'd move. Quit thinking about what makes you feel good. Just do it, and watch yourself respond.
That's not true at all in my case, I literally can't. I have too many physical issues. Believe me, my physical issues that keep me from running have zero to do with my agitation, anxiety, depression, or other bipolar symptoms.
Really, after all this time on here complaining about antidepressants you are now telling me to just go do it and don't focus on what makes me feel better? Dude, come on.
You seem to like getting angry with me, as if I am always out on the attack to get you. Or maybe you do this with others here as well, and I just don't notice it because it is all about me. I was just telling you how things appeared here, not that I actually claimed to know you or what is really going on with you.
Posted by morgan miller on December 19, 2010, at 21:03:31
In reply to Re: Sorry: stupid question for this group of (course), posted by linkadge on December 19, 2010, at 18:50:47
> My belief is that after you have gone through the medication merry go round, pick the one or two medications that help the best and then take them for a year and forget about it.
>
> Don't have any energy? Ask a good friend do drive you out to the middle of nowhere and leave you to find your way home.I agree with the first part. But the second, not so sure about that. I may have thought that way a few years ago, but now, for the first time in my life, no matter what I try or do, I feel like complete sh*t half of the time. I now truly understand fatigue. When fatigue comes from a physiological source, when your body simply is not functioning properly, there is not much you can do except to try to get to the bottom of the cause and treat it.
Posted by Maxime on December 19, 2010, at 22:06:28
In reply to Re: Sorry: stupid question for this group of (course), posted by morgan miller on December 19, 2010, at 21:03:31
My depression is so bad that my pdoc has requested that I contact him *every day* to give him an update.
Yet I hold down 3 jobs (only 1 full time), I do volunteer work and I take care of my mom who has Alzheimers. I have been accused by doctors ( in the past) that I must not be truly depressed if I do the things that I do. My response has always been, imagine what I COULD do if I didn't suffer from BP type II, anxiety, PTSD and MS. I do all these things and yet at night, or when I am in the car I cry and cry because everything hurts. Every part of my body hurts, and the depression takes over.
So I don't think that doing all these things helps my depression, it just allows me to push the pain further down inside me which is probably the MOST unhealthy thing for anyone to do. I cry A LOT. I cut a LOT. I shake a lot.
And I wish I could go into a coffee shop and sit down like a normal person and have a coffee. But my anxiety is too great to do that. I've tried, but at the most I have lasted 3 minutes.
Posted by morgan miller on December 20, 2010, at 0:47:53
In reply to Re: *Not* Thinking in terms of meds, posted by morgan miller on December 19, 2010, at 20:58:50
>Really, after all this time on here complaining about antidepressants you are now telling me to just go do it and don't focus on what makes me feel better? Dude, come on.
Don't have the energy to rephrase this at the moment, just want to say that I was feeling a bit frustrated at the time(over a few different things, one being my life) and I would not normally have expressed myself in this way towards you.
>You seem to like you are always getting angry with me, as if I am always out on the attack to get you. Or maybe you do this with others here as well, and I just don't notice it because it is all about me. I was just telling you how things appeared here, not that I actually claimed to know you or what is really going on with you.
Same goes for this statement as well.
I hope you understood my sentiments without taking things too personally.
Morgan
Posted by bleauberry on December 20, 2010, at 5:39:22
In reply to *Not* Thinking in terms of meds, posted by linkadge on December 17, 2010, at 18:19:43
I think pbabble does tend to highlight an OCD-like behavior amongst most of us....obsessed with meds.
I totally support meds, but I think we too often lose context and perspective. In only rare cases do we see a pill(s) restore someone to who they wish to be.
That's why I tend to think in terms of the whole body and total health, not becoming engrossed with only the outward symptoms we see from the brain being impacted. In that regard, I have a fair amount of OCD. :-)
Clinical trials and anecdotal evidence do not support the kind of faith and hope that most of us put into meds.
No one ever had a deficiency of prozac. But for sure they do have a deficiency of neurotransmitter production, methylcobabaline, p5p, gut integrity, methyl groups, cortisol, immune system, anti-inflammatory; and sometimes an overabundance of things like heavy metals, fungi, and bacteria. All of the drugs we focus our lives on do nothing on any of these issues.
For sure though, IMO, the right med combined with a comprehensive multi-pronged strategy can restore people from the dark more reliably than a med alone.
Posted by SLS on December 20, 2010, at 5:51:55
In reply to Re: Sorry: stupid question for this group of (course), posted by Maxime on December 19, 2010, at 22:06:28
> My depression is so bad that my pdoc has requested that I contact him *every day* to give him an update.
What is it about your current mental state that worries your doctor?
Do you come to feel suicidal without a mood-congruent intensification of depression?
> Yet I hold down 3 jobs (only 1 full time), I do volunteer work and I take care of my mom who has Alzheimers. I have been accused by doctors ( in the past) that I must not be truly depressed if I do the things that I do.
Some doctors can be very ignorant of the widely variable presentations of the same depressive illness. Unless this variability is fully appreciated by the clinician, people are bound to fall through the holes present in the current inadequacies of diagnosis.
> So I don't think that doing all these things helps my depression, it just allows me to push the pain further down inside me which is probably the MOST unhealthy thing for anyone to do.
I guess this is a statement that can only display exactitude when describing your personal experience with depression. Depression has many faces. Pervasive feelings of sadness, anhedonia, apathy, lack of self-esteem, and self-hatred. However, when anergia, psychomotor retardation and amotivation become prominent in the presentation of depression, holding 3 jobs is impossible. For me to compare my inability to hold 1 job to your ability to maintain 3, it might at first appear that you are not as severely depressed as I am. However, you may experience an intensity of psychic pain that I do not. Comparing is tempting. It is only natural to want to evaluate another's depression in order to better understand your own. I believe that there is an effort made by some people to find vindication for their perceived "failures" and difficulties in life. To look for examples of depression that appear similar one's own, and whose "failures" in life are comparable, one realizes that depressive illness is real, ,debilitating, and not a demonstration of laziness. Even if true, it doesn't feel good for a persoon to think that their depression is the most severe or refractory to treatment. It is very likely that there exists someone in the world whose illness is worse than yours. If you are lucky, you might extract some gratitude from recognizing that your depression is not. I have witnessed people stricken with what is perhaps the most horrendous display of depression. The classic endogenous melancholic depression with severe psychomotor retardation causes the suffer to fold back in on themselves. People with this subtype of depression often remain fixed in one position for hours for lack of energy and inertia. At her mother's request to wait on me and serve me a glass of water, my eyes filled up with tears. To my anger and disgust, I witnessed her daughter walk across the kitchen, expending all of what precious energy she could muster in order to take just one step. She was dead inside. Within a few months, she was dead outside, too. To learn of her suicide filled me with profound sadness. It wasn't fair that someone should endure such torture; so much that life was deemed less valuable than death.
Depression must surely have many faces. Who can keep up with them all? The DSM? In my opinion, the sections of this diagnostic manual devoted to the descriptions of MDD and BD are primitive and embarrassing to read. It is no wonder that so many patients have little faith in the accuracy of a doctor's diagnosis. For now, resolving a workable diagnosis for an individual is an ongoing process, and often involves trial-and-error in the same way as does choice of treatment.
- Scott
Posted by SLS on December 20, 2010, at 6:09:50
In reply to Re: *Not* Thinking in terms of meds, posted by bleauberry on December 20, 2010, at 5:39:22
> I think pbabble does tend to highlight an OCD-like behavior amongst most of us....obsessed with meds.
I think you would glean more respect for the phenomenology of the mental illness known as "OCD"; a psychobiological illness that can prevent people from functioning in any milieu. There is a difference the meanings of the words "obsessive", "compulsive", and obsessive compulsive personality disorder (OCPD), and true OCD.
On a forum such as Psycho-Babble, I think it is critically important not to make the same mistakes of ignorance that are still perpetrated in the general population when it comes to mental illness. We owe it to ourselves to be careful with how we use clinical nomenclature.
- Scott
Posted by Alexanderfromdenmark on December 20, 2010, at 10:22:30
In reply to *Not* Thinking in terms of meds, posted by linkadge on December 17, 2010, at 18:19:43
> Does anybody here find themselves continually thinking about all of their problems in terms of medications?
>
> It seems like this is almost an OCD like behavior where we have learned to convince ourselves that the only solution for our mysery is to tweak this med or that.
>
> We are like drug addicts who have become so focused on a single chemical solution, that we fail to believe in the possibility that anything but a new medication can provide any sense of happiness, stability or well being in our lives.
>
> You know what I started doing the other day? Going to a local coffee shop in the morning. I just walked right in, bought a coffee and said good morning to a stranger. We talked. I go back there now and people know my name. Strange huh? Its sure a nice alternative to waking up and checking "babble" for more leads on the magic cocktail.
>
> Linkadge
>
>
>
>Linkadge I think it is great if you are finding a more straight forward strategy that is working for you. I agree it is unwise to expect there to be some magic fix all. However I can say that I've tried to improve in every possible way for many many years, before I even tried my first medication. As my conditions gets worse and more severe, it is next to impossible to simply snap out of it.
Posted by bleauberry on December 20, 2010, at 17:44:11
In reply to Re: *Not* Thinking in terms of meds » bleauberry, posted by SLS on December 20, 2010, at 6:09:50
> > I think pbabble does tend to highlight an OCD-like behavior amongst most of us....obsessed with meds.
>
> I think you would glean more respect for the phenomenology of the mental illness known as "OCD"; a psychobiological illness that can prevent people from functioning in any milieu. There is a difference the meanings of the words "obsessive", "compulsive", and obsessive compulsive personality disorder (OCPD), and true OCD.
>
> On a forum such as Psycho-Babble, I think it is critically important not to make the same mistakes of ignorance that are still perpetrated in the general population when it comes to mental illness. We owe it to ourselves to be careful with how we use clinical nomenclature.
>
>
> - Scott
>
>But Scott, you just got finished saying in another post how inaccurate and embarrassing labels are that they require trial and error like the treatment itself does.
I wasn't approaching this particular thread with heavy seriousness. Kind of a refreshing off the wall topic Link threw out there that served a good purpose of distracting from the usual routines.
Obsessive Compulsive behavior. We can tease and twist these words all we want, and it will be done differently even by doctors, but it is what it is and really doesn't need a sophisticated explanation.
In our case here at pbabble, the difference is that I do not see it as being a disorder with most of us. OC without the D. One who is ill cannot help but be consumed with the suffering and the ways to get out of it. That's not a disorder. That is pure human defense and survival. But, it is still obsessed by a dictionary definition, and that person often makes compulsive decisions and choices. It's all part of the human journey when chronic illness is intertwined, but I don't see that as a disorder in any way.
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