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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 24 of 24. This is the beginning of the thread.
Posted by deb on March 2, 2000, at 18:51:50
Hi everyone! I recently found this board and it is definitely where I need to be. For the past 14 years I have suffered with panic/anxiety and major depression. I have been medicated on and off since 1987. I was hospitalized in 1987, had an unhospitalized nervous breakdown in 1994 and another after the birth of my second child in June of 1998. Since June of 1998 I have been on paxil and buspar as well as xanax as needed. I have always been an optimistic person with a great sense of humor. I am a level headed, intelligent person and generally try to eat healthy and exercise. Since June of 1998 I have gained about 30 lbs on paxil and despite several attempts, cannot lose this weight. I have suffered numerous side effects from these drugs such as sexual dysfunction (haven't had a sex drive in YEARS and have been married for 10 years); weight gain and sluggishness. About one month my dr. weaned me off of paxil and started me on wellbutrin. After about 1 week of being drug free I had some heavy duty withdrawal....horrible, horrible, horrible. You name the symptom and I had it. So I recently went back on paxil (only 5 mgs) with the intention to wean off of it more slowly. The one thing I noticed in withdrawal was that without the drug I no longer felt "numb"....I actually cried (something that these drugs have not allowed me to do); I started to feel alive and passionate about things. However, the physical symptoms overwhelmed me and I started having panic attacks again. Anyway, I am seriously considering getting off of all of these drugs and have recently purchased some books on SSRI drug withdrawal. I am not quite convinced that my problems are biochemical and I feel that I might be able to "control" my anxiety and depression through nutrition and fitness as well as supplements. I do not understand how my problems can be labeled biochemical when no one has studied my brain or performed tests. It seems like such a bogus diagnosis with no medical basis. Anyway, I am educating myself on withdrawal and ways to cope with my problems without drugs. I used to believe that everything was biochemical but now I am beginning to have doubts. I have been slowly weaning myself off the wellbutrin and the buspar and have started again with withdrawal and these uncomfortable feelings. Does anyone out there have any thoughts on this? I could really use some advice.
Thanks
Deb
Posted by saint james on March 2, 2000, at 19:02:59
In reply to Psychiatric Drugs in General, posted by deb on March 2, 2000, at 18:51:50
> Hi everyone! I recently found this board and it is definitely where I need to be. For the past 14 years I have suffered with panic/anxiety and major depression. I have been medicated on and off since 1987. I was hospitalized in 1987, had an unhospitalized nervous breakdown in 1994 and another after the birth of my second child in June of 1998. Since June of 1998 I have been on paxil and buspar as well as xanax as needed. I have always been an optimistic person with a great sense of humor. I am a level headed, intelligent person and generally try to eat healthy and exercise. Since June of 1998 I have gained about 30 lbs on paxil and despite several attempts, cannot lose this weight. I have suffered numerous side effects from these drugs such as sexual dysfunction (haven't had a sex drive in YEARS and have been married for 10 years); weight gain and sluggishness. About one month my dr. weaned me off of paxil and started me on wellbutrin. After about 1 week of being drug free I had some heavy duty withdrawal....horrible, horrible, horrible. You name the symptom and I had it. So I recently went back on paxil (only 5 mgs) with the intention to wean off of it more slowly. The one thing I noticed in withdrawal was that without the drug I no longer felt "numb"....I actually cried (something that these drugs have not allowed me to do); I started to feel alive and passionate about things. However, the physical symptoms overwhelmed me and I started having panic attacks again. Anyway, I am seriously considering getting off of all of these drugs and have recently purchased some books on SSRI drug withdrawal. I am not quite convinced that my problems are biochemical and I feel that I might be able to "control" my anxiety and depression through nutrition and fitness as well as supplements. I do not understand how my problems can be labeled biochemical when no one has studied my brain or performed tests. It seems like such a bogus diagnosis with no medical basis. Anyway, I am educating myself on withdrawal and ways to cope with my problems without drugs. I used to believe that everything was biochemical but now I am beginning to have doubts. I have been slowly weaning myself off the wellbutrin and the buspar and have started again with withdrawal and these uncomfortable feelings. Does anyone out there have any thoughts on this? I could really use some advice.
> Thanks
> Deb
James here....I think you are totally wrong about the biochemical neature of mental illness.
j
Posted by deb on March 2, 2000, at 19:27:29
In reply to Psychiatric Drugs in General, posted by deb on March 2, 2000, at 18:51:50
why do you think i am wrong on this point?
Posted by saint james on March 2, 2000, at 19:33:58
In reply to Re: Psychiatric Drugs in General, posted by deb on March 2, 2000, at 19:27:29
> why do you think i am wrong on this point?
James here....
Although you may not be aware of it, there is a large body of medical lit (brain scans and other studies) that prove medical basis for mental illness. This info is of course on the net.
j
Posted by deb on March 2, 2000, at 19:41:41
In reply to Psychiatric Drugs in General, posted by deb on March 2, 2000, at 18:51:50
James - i can imagine that you are probably thinking that i am simply uneducated on mental illness and that i am making totally unfounded generalizations with respect to the biochemical theory of mental illness. i am not. please understand that i have suffered for years with mental illness. fortunately, my illness has not been as debilatating (sp?) as biopolar, schizophrenia, ocd....i have suffered with anxiety/panic and major depression and it has sucked! i can almost understand that there is a biological basis for the aforementioned illnesses (excluding anxiety/panic and depression); however, i know that environmental factors contributed to my mental illness and my lack of coping mechanisms allowed them to snowball. i had a messed up childhood and have always been sort of hyper/anxious all of my life - but how can my doctor tell me that MY illness is biologically based when no tests have been performed and his assertion is based solely on my description of my symptoms and how come we have no studies of long term effects of these drugs? i am 35 years old and i am scared as hell that the end result of me taking these drugs for so many years may manifest itself when i am much older and there i'll be ...stuck with a fucked up brain...(pardon my french)...there is so much that scientists and doctors do not know about the human brain and i can't help but think that maybe people like us are guinea pigs...i have been going back and forth with myself on this entire issue....meds or no meds? will i be better off feeling my feelings or simply numbing them? how much of my personality has been altered as a result of these drugs?
Posted by saint james on March 2, 2000, at 19:44:06
In reply to Re: Psychiatric Drugs in General, posted by deb on March 2, 2000, at 19:41:41
You seem to have already made up your mind so good luck.
j
Posted by deb on March 2, 2000, at 19:48:28
In reply to Re: Psychiatric Drugs in General, posted by saint james on March 2, 2000, at 19:44:06
James - please don't shut me out here, ok? i came here for some sound advice on making an extremely difficult decision. i came here to open the topic up for discussion in the hope that i would find some answers for myself. i am at a crossroads and don't know which path to take and after years and years of believing the whole biochemical theory, i am beginning to have doubts and before i make any rash decisions with respect to my mental health, i thought i would do a little more research.
Posted by phillybob on March 2, 2000, at 20:26:27
In reply to Re: Psychiatric Drugs in General, posted by deb on March 2, 2000, at 19:48:28
Hey, deb, check out my post "last night a dj saved my life" above for some of my thoughts.
James, which came first, the chicken or the egg? Unless someone has monitored the brain of a someone from birth whose physical and environmental conditions, prenatal and thereafter, were all ideal but this someone still became mentally ill, how can anyone be sure that it is purely biological? I have not researched this at all but I we all know that there are changes in the brain caused by mental illness. The question is what causes the mental illness?!
Think about it. If anyone has any writings or sites to suggest, I too would be appreciative.
Posted by saint james on March 2, 2000, at 20:37:54
In reply to Re: Psychiatric Drugs in General, posted by deb on March 2, 2000, at 19:48:28
> James - please don't shut me out here, ok
James here....
OK, sorry, you came here for help...thats good. You seem to be a thoughtful person and I am letting other issues make me snappy toward you, again sorry.
It is just that EVERYTHING I read
points to biological origin for most mental illnesses. To me it is a no brainer. I admit there is no test individuals can take to prove
their brains are messed up (yet) but just because
you cannot prove something (or dis prove) does not mean it is true. My body does not lie to me.YOu can find meds that do not limit your feelings; I did. I take Effexor XR and Remeron and don't have any flattening of affect...i don't feel drugged. Keep on looking with the help of a good doc. Although I do not know you, generally I would say that someone who has had breakdowns and been in the hospital needs ongoing treatment.
I agree that some mental illness is purely psychological in nature, resulting from some tramatic event in life. However we now know that if people are in tramatic or stressful places for a long time they will exibit depression that has a biological cause. Also, AD's don't work at all
on normal people but do on the depressed and as there meds effect neuro chems is seems a slam dunk
to realize the biological basis for much of this. Many medical conditions do not have a test to prove you have a condition but people are Dx'ed with whatever condition.j
Posted by William on March 2, 2000, at 20:57:09
In reply to Re: Psychiatric Drugs in General, posted by phillybob on March 2, 2000, at 20:26:27
At one time people with a thyroid problem were
diagnosed with a mental illness. It is becomeing
clear their are endocrine glands thoughout our
bodies secreting numerous hormonal protiens that
are likely the cause for many mood disorders.
It could be to little of something to much of
something or not being secreted in the proper
rythmn. In my opinion it is scandalous that it
is taking so long for the endocrine system to
be understood. I guess the company's have been
making so much with the ad's and they probably
could always see that adjusting a persons endocrine system would likely not be as
profitable.
Posted by Sarah on March 2, 2000, at 20:57:22
In reply to Re: Psychiatric Drugs in General, posted by saint james on March 2, 2000, at 20:37:54
I definitly believe my ADD is biological. I grew up in a Irish Catholic family the youngest of seven, there was a fair share of dysfunction, but all in all a big happy loving family. I have also had no trauma in my life. I have seen everyone of my siblings on some kind of AD at one time or another, actually everyone of us are on something right now.(and no trauma for them, either) If that is not chemical in nature, I don't know what is!!
Posted by phillybob on March 2, 2000, at 21:01:37
In reply to Re: Psychiatric Drugs in General, posted by Sarah on March 2, 2000, at 20:57:22
Good point, Sarah. This can be like a tennis match. Nature, 15; Nurture, 15.
Posted by Cam W. on March 2, 2000, at 23:47:47
In reply to Re:Depression - A little more technical, posted by Cam W. on March 2, 2000, at 23:38:02
Deb - Depression occurs when the mechanism with which the body deals with stress has 'broken down'. The HPA axis is this mechanism for the body's 'fright or flight' reaction to stress. The hypothalamus releases a hormone called the corticotropin releasing hormone (CRH) into the hypophyseal (sp?) portal blood system and CRH stimulates the pituitary gland to release adrenocorticotropin releasing hormone (ACTH) (and beta-endorphins) into the body's bloodstream. The ACTH stimulates the adrenal gland (on top of the kidneys) to dump cortisol into the blood stream. The cortisol distributes to organs of the body increasing blood flow to muscles and heightening awareness and decreasing blood flow to non-essential organs (eg stomach, intestines). This prepares the body to 'flee' or 'fight' in a stressful situation. The released cortisol also acts as a negative feedback system to shut off the flow of CRH in the hypothalamus and ACTH in the pituitary. Thus, slowing the body again by turning off the HPA axis.
If this HPA axis is left 'on' due to constant stress (eg abuse) or if it shocked (eg death of a loved one) the feedback system breaks down. The hypothalamus and/or the pituitary do not respond to the 'turn off' signal of the cortisol. This is possibly due to a down regulation or lowering of the concentation of glucorticoid receptors in these two brain areas. Thus, cortisol is continually being dumped into the bloodstream, keeping your body in a high state of arousal. Eventually the stress on the body reduces serotonin levels and skews norepinephrine levels, manifesting itself into the symptoms we call depression (eg lethargy, sleeplessness, etc.).
One can be genetically predisposed to having an sensitive HPA system that breaks down under less stress than would happen in someone without the predisposition. Also, adverse early life events (eg physical or mental abuse) can sensitize the HPA axis to break down easier. So, no matter if a depression is caused by nature or nuture (or both - usually) the result in a biochemical breakdown in the body causing what we call depression.
> Thought I'd add my $0.02. - Cam W.
Posted by William on March 3, 2000, at 0:32:53
In reply to Re: Psychiatric Drugs - A little more technical, posted by Cam W. on March 2, 2000, at 23:33:50
The HPA axis is just one part of this Huge
endocrine system. Post partum depression, PMS and
other mood disorders are more likely caused by
an androgen imbalance,or circadian phase shift.
It is so poorly understood it is pathetic.
Posted by juniper on March 3, 2000, at 1:10:14
In reply to Re:Third time lucky - I hope - Read this one, posted by Cam W. on March 2, 2000, at 23:47:47
if all the research on the nature/nurture debate has revealed anything, it is that this is not a black or white case. causes of depression (or any mental illness) are myriad. while some people may have been born with a gene or genes that set them up for depression from the beginning regardless of circumstance, it seems that others are born with a predisposition for the disorder, which, in simplistic biochemical terms, means that these people are born with the genes that contribute to depression. these genes may lay dormant and not "turn on" until an environmental (death, rejection, abuse, stress) or physical (puberty, pregnancy) triggers them to do so. and genes do not make people depressed, genes code for the production of proteins which then go about the complicated processes of creating neurotransmitters and hormones and neuromodulators.
to complicate matters further, you could say all depression is biologically based as feelings and emotions when broken down are neuronal firings. it sounds stark, but this is what an emotion is, and this makes emotions no less mysterious or painful or subjective. whether you choose to treat depression with medication or therapy or soul searching or spirituality, the emotions and feelings composing the depression will only change as your neurons and their neurotransmitters do (because on a reduced level they are one and the same). for you to feel differently, something in your brain needs to change. (studies have shown that talk therapy can be very effective in eliciting the same neuronal changes in the brain as medication) how you bring about this change is an individual choice, and when this change is so hard to bring about anyway, i don't see how anyone could tell you your choice is wrong. i feel you should follow your heart and try what intuition tells you....if this is without medication, know that if this way isn't working for you, medication is always an option.there have been no studies on the long term effects of psychoactive drugs as the regulated use of these drugs is relatively new. the first antidepressants and antianxiety drugs came out in the 1950s (when testing was not as important or understood as it is now) and SSRIs arose in the 1980s.....there just hasn't been enough time to discover long term effects.
as for better off feeling your feelings or numbing them...i think that this depends on the feelings and their purpose. some uncomfortable or sad or anxious feelings are normal in reaction to events or hormonal swings, and these feelings can tell us something, they can be warning signs for danger (physical or emotional). but when these feelings start popping up wily nily as a reaction to the most insignificant stimuli, they lose their value and effectiveness. (asthma is when the body attacks not only major foreign invaders, but also tiny foreign bodies--like dust or pollen. this attack is not useful and ultimately detrimental to the body. so it is with feelings.)i understand your worries of 20 years down the road finding that these drugs have caused some irreversible damage to our brains....i am 23 and have been on and off medications for almost half my life....but knowing what i know even with the uncertainties of the long term, i still choose to take medication because i can be who i think i really am on medication....it is not a matter of altering my personality, but of reclaiming some of the passions and clarity and control i had before the DSM entered my life.
whatever your choice, it is YOUR choice, and i wish you the best of luck in it.
juniper
Posted by judy on March 3, 2000, at 1:10:46
In reply to Psychiatric Drugs in General, posted by deb on March 2, 2000, at 18:51:50
Having been on scores of drugs, I came to the same conclusion as you. I met several psychiatrists who referred to the APA as the American Pharmaceutical Association, and agree the billions drug companies have invested in advertisements (how many paxil commercials are out there) have skewed the whole profession. There is an excellent site for anxiety called Tapir on the net and a link to Dr. Shipko's site PDI (Panic Disorder Institute). He is a psychiatrist and neurologist and you will find him sympathetic to your views. I have no doubt that drugs can help some people- I'm the first to admit that neuroleptics have stopped more than one of my manic episodes- but I feel they are overused. I think you should try a drug free approach and see if it works for you- please taper very slowly, I like the 10%/week rule, and you'll find the withdrawals aren't quite as intense. Keep posting and let us know how it goes- I wish you the best of luck.
Posted by judy on March 3, 2000, at 1:35:42
In reply to Re: Psychiatric Drugs in General-Deb, posted by judy on March 3, 2000, at 1:10:46
When I announced my decison to stop meds on this forum, dxed bipolar 1, rapid cycling and PAD, I met with a great deal of oppositon. I tried not to take it personally and was greatly impressed with the wealth of knowledge- both medical and pharmaceutical- on this forum. Which probably keeps me returning, I learned a great deal and ultimately the choice is yours. It really does help to have other people's experiences and views.
Posted by Cam W. on March 3, 2000, at 6:47:02
In reply to musings on drugs, posted by juniper on March 3, 2000, at 1:10:14
Juniper - Well put. The way our medications work to treat disorders is like trying to fix a watch with an icepick. A note on the SSRIs - The first of the 'SSRI babies'; babies born to moms who were taking Prozac. So far no Charlie Mansons (or, at least no more than normal), but I'd like to see these kids turn 25 or 26 (when synaptic pruning is basically over) before rendering a decision on long-term effects. As with the tricyclics, I have seen some studies that say there is an increased risk of bipolar disorder in the children of mothers who were taking these, but the evidence isn't strong.William - As for neuroendocrine systems and mood. Yes, we don't know everything, but we are beginning to put the picture together. We know something of estrogen's neuroprotective effects, vasopressin's role is mood and stress, and a little on melatonin's role in serotonin regulation. The HPA axis is a major player in stress regulation in the body, with other neuroendocrine systems playing lesser (but still important) roles. Many of these systems are the body's checks and balances, so that gross deviations from the norm are minimized. When one or more of these systems is dysregulated, one may manifest a mental illness. By the way, mental illness are only a psychiatric problem until we figure out what causes them, then they become a medical problem (eg syphilis and pellagra were once psychiatric disorders). To say that we don't understand these system, therefore don't use medications is silly. Medications interfere with these dysregulations and allow the afflicted, in many cases, to have the ability to be able to alleviate many of their symptoms. This has led many people out of the dark recesses of depression (myself included) and has helped them return to society as productive members again. Medications do have their place in psychiatry; cognitive-behavioral therapy sometimes cannot do it all. Both methods have their place.
Medications alone are never the answer. There are no cures is pharmacy, only bandages. Talk therapy resulting in a change in mind-set is essential for recovery. The change in mind-set is changing the chemical mix of the body inducing remission or sometimes resolution.
Another $0.02 - Cam W.
Posted by deb on March 3, 2000, at 18:31:30
In reply to Re: musings on drugs, posted by Cam W. on March 3, 2000, at 6:47:02
Wow! I was so impressed by all of the feedback you guys gave me. You all are so well read on the topic of depression, ADs, etc. and some of you (Cam W.) sound like professionals in the field. I am going to take into consideration all of your advice before I make a decision about my meds. Yes, I have been in the hospital (1986) but have never ever been suicidal (thank god). I then had a nervous breakdown in 1994 as a result of having "too much on my plate"...a full time job, school at night full-time and a small child to care for (although I know that there were other factors involved in my breakdown); my last and hopefully final nervous breakdown took place right after the birth of my daughter in 1998 and was caused by some heavy duty postpartum depression. I can say, gratefully, that I have never felt the urge to end my life. I have always possessed a fighting, sort of survival instinct and I get angry at my illness which makes me more productive in combating it. I also have found that reading, reading, reading and educating myself on my illness makes a world of difference. Thanks for the input and I plan on hanging around here for a while if you'll have me
Deb.
Posted by Cam W. on March 3, 2000, at 19:28:03
In reply to Thanks so much for all of your input......more, posted by deb on March 3, 2000, at 18:31:30
Deb - Stick around. You have much first hand knowledge of depression that you will be able to share with newcomers. Hope to read you soon, - Cam W.
Posted by Sherry on March 4, 2000, at 13:17:13
In reply to Re: Thanks so much for all of your input......more, posted by Cam W. on March 3, 2000, at 19:28:03
Thanks Deb, the can of worms you opened up was some of the best discussion I have ever seen on this forum (I haven't been here too long) I learned a lot. >
> Deb - Stick around. You have much first hand knowledge of depression that you will be able to share with newcomers. Hope to read you soon, - Cam W.
Posted by bigbertha on March 5, 2000, at 4:07:47
In reply to Re: musings on drugs, posted by Cam W. on March 3, 2000, at 6:47:02
> The way our medications work to treat disorders is like trying to fix a watch with an icepick.
What an analogy - ouch! But so true; however, every generation stands on
the "shoulders of giants",yet remains frustrated with its impotence
(unless you work for Pfizer!) while searching for answers.Which is why
discoveries and rapid utilization for illness such as polio is all the
more outstanding. I am humbled by persons such as Dr. Salk, who refused
extraordinary compensation for his work, as he believed it belonged to the world.
And major kudos to most researchers, many who sacrifice the big bucks and possibly
their health (not too many correspondence courses for microbiologists, et al).
Some places pay even POST-DOCTORAL bodies less than $30,000/yr. Which is why
I want to BARF every time I hear about the latest multi-zillion dollar salary of
----- ------ (your choice). And that goes double for CEO's who exterminate companies, etc.
Sorry to soapbox, but there it is.
> Medications alone are never the answer. There are no cures is pharmacy, only bandages. Talk therapy resulting in a change in mind-set is essential for recovery. The change in mind-set is changing the chemical mix of the body inducing remission or sometimes resolution.And here's another money issue brought to by some "cutting-edge, cutting corners"
insurance corps. I needed desperately to dump some very troubling issues, but felt so
embarrassed and ashamed that I could never speak with anybody until I was medicated
correctly. I have been in therapy for about 6 months. These sessions aren't cheap but
have made all the differance. I truly believe that they will be the reason I will
eventually be able to function med-free. Since insurance companies' #1 financial wailing
pertains to prescription coverage, you'd think they would all offer talk-therapy as
potential program to cut future costs.
bb
Posted by Tom on March 6, 2000, at 16:13:05
In reply to Re: Psychiatric Drugs in General, posted by saint james on March 2, 2000, at 19:33:58
> > why do you think i am wrong on this point?
>
> James here....
>
> Although you may not be aware of it, there is a large body of medical lit (brain scans and other studies) that prove medical basis for mental illness. This info is of course on the net.
>
> jThe word "prove" is a little strong. I would use the word "suggest" ...
Posted by Renee N on March 8, 2000, at 23:19:15
In reply to Thanks so much for all of your input......more, posted by deb on March 3, 2000, at 18:31:30
Welcome, Deb!
It's only fair to warn you that even more than amphetamines, this place is addicting. I too believe that to "read, read, read..." is the way to go when faced with something I don't know much about. You wouldn't believe the amount of information I read while pregnant. I had never been around babies much. {:0
I have never been offered talk therapy. My psychiatrist works in an office full of therapists, so I don't understand. I majored in psychology in college. At the time I was studying, there was a definite bias for behavioral treatments of problems, rather than psychoanalytical or pharmaceutical. I bought into this way of thinking wholeheartedly. I thought psychiatrists were terrible for using drugs as the answer to every mental health problem. I was young, naive, and gullible. I hope that with age comes wisdom, or at least a healthy dose of skepticism! Now that I have asked for help with my attention and memory problems, the ONLY help I'm offered by professionals is pharmaceutical. I feel cheated. I believe HMOs do not understand that their costs for drugs and hospitalizations might be reduced if they offered more comprehensive outpatient treatment options for mental health. Not only are they cheating us, but themselves, also... Renee NP.S. I agree with your assessment of the brain power and knowledge base here! I am almost embarrassed to "admit" that I have a B.A. in psych, because I don't know or remember(How do those Jeopardy players recall facts they heard once in highschool?)nearly the amount of useful psychobiological information as half the Babblers here who may or may not have taken one psych class in their lives. But, please, don't let it intimidate you. They have just as much heart as brains...
This is the end of the thread.
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