![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 55. This is the beginning of the thread.
Posted by Squiggles on October 23, 2007, at 8:10:49
This sudden personality change that my
friend has undergone, having reduced and
then completely withdrawn her medication
for major depression may be withdrawal.Sometimes I wonder if there are anti-psychiatry
cults in our midst, who encourage people to
get off their drugs and replace them with
exercise, sweating, and co-therapeutic introspection. They have all kinds of theories,
non of them coming from a medical education, like
"exercise-induced endomorphins"-- well, how many
does it take? do they actually take a brain serum sample to compare it to antidepressants?
And other theories, like sweat that poison right out of your body cells. And other unsubstantiated beliefs. In some cases they know what they are doing, and that is why they are called cults. But in most cases their medical advice is just plain stupidity.To those who have carelessly persuaded mentally ill people to fall off the cliff, i have two small words for them:
F*** **F
Squiggles
Posted by Jamal Spelling on October 23, 2007, at 10:13:04
In reply to That Way Lies Madness, posted by Squiggles on October 23, 2007, at 8:10:49
In my own case, healthy lifestyle changes have given me better results than what medication ever did. I'm glad I've rid myself of the shackles of psychotropic medication. I'm a better person for it.
Jamal
Posted by Squiggles on October 23, 2007, at 10:15:23
In reply to Re: That Way Lies Madness, posted by Jamal Spelling on October 23, 2007, at 10:13:04
Good for you. Maybe you never had mental
illness. Not taking drugs and being well,
is a good test.Squiggles
Posted by Phillipa on October 23, 2007, at 10:57:19
In reply to Re: That Way Lies Madness, posted by Squiggles on October 23, 2007, at 10:15:23
Some lucky people have an isolated period of depression anxiety etc. For me excercise is the best for anxiety and depression but that is just me and I still need some med. Phillipa
Posted by Jamal Spelling on October 23, 2007, at 10:58:46
In reply to Re: That Way Lies Madness, posted by Squiggles on October 23, 2007, at 10:15:23
> Good for you. Maybe you never had mental
> illness.Indeed, that possibility exists. It may be true of many people who think they suffer from endogenous mental illness. The point I'm making is that certain people (I am one of them) find relief using a non-pharmacological approach, and you should respect our decision.
Jamal
Posted by Phillipa on October 23, 2007, at 11:49:08
In reply to Re: That Way Lies Madness, posted by Jamal Spelling on October 23, 2007, at 10:58:46
Jamal That's great happy for you. Others do have biochemical conditions requiring long time meds and therapy. I need both. Phillipa
Posted by linkadge on October 23, 2007, at 12:20:43
In reply to Re: That Way Lies Madness, posted by Jamal Spelling on October 23, 2007, at 10:58:46
The notion that an individual with a mental illness needs to be on medication or else they will remain sick is not really all that accurate.
In addition to that, there are many people who will remain sick in spite of the best conventional treatments.
For many people, current medications don't help, so it comes down to taking a medication that does nothing and produces a whole load of side effects, or simply taking nothing at all.
It baffles me that you seem to have a hard time beliving two things:
a) People cannot improve without the help of modern psychiatric medicinces.
b) People who improve without medications really have no illness at all.Clinical depression is a remitting disease. It usually remits within about 8 months to 1 year. That basically means that despite whatever gene a person has, or whatever biochemical abnormality an individual has, the brain is able to adjust and correct its problem over time. You don't give the brain enough credit.
I think the real reason that people like to discount the power of healthful lifestyles, stress reduction, exercise, and social support, is because it removes the guilt out of their decision to take medications, and sit on their
behind all day.Even an individual with a genetic disposition to high cholesterol or high blood pressure can make dramatic changes to either of those paramters through lifestyle changes.
>They have all kinds of theories,
>non of them coming from a medical education, like
>"exercise-induced endomorphins"-- well, how manyActually, there is considerable scientific literature on the antidepressant capacity of exercise.The fact that you don't believe in the medical basis to the antidepressant effects of exercise is a testament to your lack of interest in reading quality research on the topic. Exercise has the capacity to prompt many of the exact same changes as chemical antidepressant treatment. In a number of studies, exercise outperforms antidepressant treatments. In many studies exercise regiments reduce the risk of releapse into depression more thouroghly than chemical antidepressant treatments.
If a chemical antidepressant does it, so does exercise. Here are some of the many researched topics pertaining to the modes of mood modification chronic exercise treatment.
Increase in endorphen production
Increase in monoamines (serotonin, norepininephrine, dopamine, traces amines like PEA)
Regulation of genes coding for HPA axis function.
Modulation of stress induced cortisol function.
Improvements in sleep archetecutre
Improvements in glucose utilization
Endocannabanoid (anandamide) increase
Enhancement of hippocampal neurogenesis (far in excess of that produced by antidepressant treatment)
Enhanced responsivness of monoamine receptors.
Dramatic enhancement of endogenious nerve growth factors (BDNF, GDNF, BCL-2, FGF-2, NGF, CDNF)
Enhanced responsivness in forced swim tests
Enhanced neuropeptide function (ie neuropeptide Y)
Increased Limbic gabaergic function
Improvements in thyroid function
Prevention of age related reduction in temporal lobe density
Increase in mitochondrial and cellular resilliance protiens ie HSP (heat shock protein)
Documented antidepressant effects in clinical trials.There are many other studies too that support the ability of exercise to maintain mental health. For instance, if you inject a parkinson's disease inducing toxin into a sedentary animal it will induce parkinsons, but if you do the same to an animal that chronically exercises, the same toxin will do considerably less dammage, probably owing to exercise induced neuroprotective mechanisms.
The list goes on and on. The fact is that if exercise could be bottled and sold as a pill, it would be the single most profitable drug ever designed. I think it is abundantly clear that exercise can exert a powerful antidepressant effect for many people, and the scientific research is there to back it up. Perhaps it will not *work* for everbody, but I would be willing to bet that there would be no case of depression that would not benifit in some way. Nobody would ever expect a chemical antidepressant to work for everbody either. Ie I woudn't go around saying that because Wellbutrin didn't work for me that it is not a real antidepressant, and that anybody who benifits from Wellbutrin didn't really have a problem to begin with just because it clearly doesn't target "true" biochemical depression.Is Huntington's disease not a real disease?? Huntingon's is as biochemical as it comes, but there is plenty of research showing that exercise dramatically reduces the onset time and sevarity of motor symptoms, and generally is an effective way to retard disease onset. So there you go.
Linkadge
Posted by Squiggles on October 23, 2007, at 14:11:28
In reply to Re: That Way Lies Madness, posted by Jamal Spelling on October 23, 2007, at 10:58:46
> > Good for you. Maybe you never had mental
> > illness.
>
> Indeed, that possibility exists. It may be true of many people who think they suffer from endogenous mental illness. The point I'm making is that certain people (I am one of them) find relief using a non-pharmacological approach, and you should respect our decision.You are free to choose your own way. If you are not mentally ill or made a mistake and found a better way, consider yourself lucky because these drugs are hard to live by for some people, like chemotherapy. As for me, as long as you are not my SO or someone who *has* been diagnosed but chooses to reject medication, and does not go on a shooting rampage at a college, it is non on my business.
Squiggles
>
> Jamal
Posted by linkadge on October 23, 2007, at 14:26:14
In reply to Re: That Way Lies Madness » Jamal Spelling, posted by Squiggles on October 23, 2007, at 14:11:28
>You are free to choose your own way. If you are >not mentally ill or made a mistake and found a >better way, consider yourself lucky because >these drugs are hard to live by for some people, >like chemotherapy.
Again, you are making the false assumption that because a person gets better without medication that they did not have a real mental illness.
You sound like the FDA "Only a drug can cure prevent or treat an illness"
Linkadge
Posted by Squiggles on October 23, 2007, at 14:41:02
In reply to Re: That Way Lies Madness, posted by linkadge on October 23, 2007, at 12:20:43
> The notion that an individual with a mental illness needs to be on medication or else they will remain sick is not really all that accurate.
Really? Depression and bipolar disorders and schizophrenia all have a majority of age onset.
In this respect they are very much like other genetically-keyed biological developments. One example, is adolescence and all the hormonal changes attending that period. It is usually between 10-14. In the case of schizophrenia, around 18, in bipolar around 28, in depression, can be any time, but usually earlier than the above. Alzheimer's and Parkinson's, later in life, usually above 50.>
> In addition to that, there are many people who will remain sick in spite of the best conventional treatments.That's because we don't know everything yet. Some illnesses are successfully treated because they have found the right drug. That took years of research.
>
> For many people, current medications don't help, so it comes down to taking a medication that does nothing and produces a whole load of side effects, or simply taking nothing at all.Taking nothing at all is worse than taking something that has some effect, though not the best effect.
>
> It baffles me that you seem to have a hard time beliving two things:
>
I don't care if you're baffled. I have witnessed tragedies in my life and i have read extensively on mental illness and the statistics are, that it is baffling that you should let people remain ill and ruin their lives or self-medicate with alcohol or street drugs, or worse kill themselves or others.> a) People cannot improve without the help of modern psychiatric medicinces.
These illnesses may be cyclical but they do not terminate like the flu. They are brain diseases which must be corrected, like meningitis, or enchephalitis, for example.
>
> b) People who improve without medications really have no illness at all.That's because the majority do not improve. Once you have manic-depression, your brain has changed neurologically. It doesn't go back to its pre-sick stage through a miracle or on its own.
You may suffer something else which is misdiagnosed, resulting from stress, and that group will be used by the anti-psychiatry brigade to prove their point. But that group is small and an exception.>
> Clinical depression is a remitting disease. It usually remits within about 8 months to 1 year. That basically means that despite whatever gene a person has, or whatever biochemical abnormality an individual has, the brain is able to adjust and correct its problem over time. You don't give the brain enough credit.Remitting, only when it is exogenously causes, as in grief for example. If it is a brain change, it's a crapshoot to wait and see if and when there will be a self-healing process of the brain.
>
> I think the real reason that people like to discount the power of healthful lifestyles, stress reduction, exercise, and social support, is because it removes the guilt out of their decision to take medications, and sit on their
> behind all day.Yeah, that will be $100 dollars please -- 'your neighbourhood palm reader'.
>
> Even an individual with a genetic disposition to high cholesterol or high blood pressure can make dramatic changes to either of those paramters through lifestyle changes.Dramatic -- you give credit to bean sprouts, but not to a genetic predisposition to some of these problems. Diet and exercise help, but blood pressure and cholesterol are not mental disorders, though they like everything else in the body can effect the brain.
>
> >They have all kinds of theories,
> >non of them coming from a medical education, like
> >"exercise-induced endomorphins"-- well, how many
>
> Actually, there is considerable scientific literature on the antidepressant capacity of exercise.The fact that you don't believe in the medical basis to the antidepressant effects of exercise is a testament to your lack of interest in reading quality research on the topic. Exercise has the capacity to prompt many of the exact same changes as chemical antidepressant treatment. In a number of studies, exercise outperforms antidepressant treatments. In many studies exercise regiments reduce the risk of releapse into depression more thouroghly than chemical antidepressant treatments.Well, go ahead and exercise. In mixed states and mania, some patients exercised themselves to death because they could not stop. That's called psycho-motor agitation. And you visit some mental health hospitals and see the patient who cannot stop moving without drugs. Some cannot stop masturbating, or picking at their skin, or pacing up and down the halls, or talking until they are hoarse. It's not a pretty sight.
Your references may be good clinical articles, and exercise is good for anyone, but years of medical research have been devoted to treating with medication. I would exercising as a cure is not mainstream. But if it helps you, you are lucky.
Squiggles
>
Posted by unbottled on October 23, 2007, at 15:06:06
In reply to Re: That Way Lies Madness » linkadge, posted by Squiggles on October 23, 2007, at 14:41:02
I suppose diabetes sufferers might get better
if they ditch their insulin and start jogging
more?The problem is that some folks are
nostalgic for nineteenth century non-answers.
Accusations of meds takers as "sitting on
their behinds" is a dead giveaway.Yes, we're finding that bottom-up improvement
of the body improves the brain / mind to a
surprising degree. But this is nothing compared
to the improvements that can happen as a direct
result of taking medications that correct
actual imbalances in the brain / mind.Both and each. Not either or. Please.
Squiggles is right to be angry. Sometimes
meds are only a crutch, but you don't kick the
crutch away because you want suffering to
be proof of wicked behavior.And sometimes meds work. My medication has
allowed me to become a pretty good athelete.
I'm coordinated better, and enjoy it. All my
years of exercise before meds only strengthened
a false sense of "doing the right thing".
Posted by Squiggles on October 23, 2007, at 15:18:15
In reply to Re: That Way Lies Madness, posted by unbottled on October 23, 2007, at 15:06:06
Thanks unbottled,
I picked up on the "sit on your *ss and just
take meds -- easy way out" line too.If only this person knew what i risked in
trying to get off my meds. On the clonazepam
experiment, i was out of it with a some kind
of seizure or stroke for a month and a half.
On the lithium, i had to experiment with the
doses, almost burning my brain to get stable
after a bad batch from a different pharmacy.
On a thyroid adjustment i got hyperthyroidism
and it took 6 months before i could sleep more
than 5 hrs max per night, with heart palpitations and sweating. I would sleep in my clothes in case i had to go to ER for a heartattack. On the Xanax addiction, I would shake at every social occasion and had panic attacks for 10 yrs. I did not know what it was, but i managed to withdraw.
I have gastro effects which are very embarrassing.And throuhgout my work and school life, the side effects have made my life very constricted. I used to be another person. I lost a lot. I am
now stable, but have to watch my treatment.So, this person does not know what he or she
is talking about. I rely on my dr. who has medical reasons to believe i am bipolar and need the meds. If i don't take them, i am not only a burden to myself, but to everyone around me as well.Squiggles
Posted by unbottled on October 23, 2007, at 16:14:45
In reply to Re: That Way Lies Madness » unbottled, posted by Squiggles on October 23, 2007, at 15:18:15
"Lost a lot". No kidding. When I hear
of things like exercise dramatically
changing a person's life for the better,
I will cheer for them. But I know for
sure in advance, no matter their method
or enthusiasm, that they know squat
about drama or having their
life changed.I think I've not been listening to
you Squiggles.
Posted by Jamal Spelling on October 23, 2007, at 16:42:45
In reply to Re: That Way Lies Madness, posted by unbottled on October 23, 2007, at 15:06:06
> Both and each. Not either or. Please.
I quite agree. Ironically this thread was started writing that pharmaceuticals are the only way to treat mental illness, that it is wrong to discontinue a pharmaceutical regimen, that other treatments are useless, and that people who suggest differently should **** ***. Or something to that effect.
I am not aware that the use of pharmaceuticals was discouraged anywhere in this thread. Certainly the point that I made was that not everybody who use medication necessarily need to be medicated. I do not dispute that there are legitimately mentally ill individuals who benefit substantially from medication. Having said that, there are many individuals who can and do benefit substantially from healthy lifestyle changes, sometimes to the point of no longer needing medication. I am one of them, and I know of others in my immediate circle of acquaintances. And if the need ever arises, I will not hesitate to go back onto a pharmaceutical regimen, but for now, I am doing well without it.
Did I ever have a chemical imbalance in my brain? Probably. Did that imbalance respond to medication? Absolutely. Was that imbalance endogenous? In my case, I don't think so. I now hypothesize that much of my depression and fatigue is due to poor breathing while asleep. I intend to have my nasal obstruction surgically corrected later this year; in the mean time, a nasal decongestant before bed does wonders for my waking up feeling refreshed. Reducing my sugar intake seems to have stabilized my mood substantially. Counseling and a variety of self-help books have taught me good emotional hygiene. Fish oil and methylating agents stimulate me more than what 150 mg of daily Wellbutrin did. Etc., etc., etc.
The point is that some people can manage without medication, and that choice should be respected.
I also feel that doctors are too quick to diagnose endogenous mental illness without first eliminating other possible physiological causes of the patient's condition. Two different doctors had told me, based on my persistent low mood, that I needed to stay on antidepressants for the rest of my life, that I simply had poor brain chemistry and that was simply the way it was. They were both well-intentioned but ultimately wrong.
> Squiggles is right to be angry.
Why?
Jamal
Posted by Squiggles on October 23, 2007, at 16:51:48
In reply to Re: That Way Lies Madness, posted by Jamal Spelling on October 23, 2007, at 16:42:45
Well, i'm not really angry. I am sorry
my writing comes across that way. If i
remember exercise, and vitamins and
stuff like that was being proposed as
an alternative to meds for mental illness.And i wish to stress that the question
of numbers is important: how many are
mentally ill and need meds, and how many
are not, and take meds anyway.When mental illness strikes, it is evidently
and indubitably different, surprising the
person himself/herself sometimes. As for the
causes, there may some as you say which are
not endogenous, and a preliminary study into
that is usually part of the course. I would
like to my faith in doctors though, and say that
when they see what looks like manic-depression,
it IS manic-depression, and the med works, then
that is the best you can get from mental health care today.Squiggles
Posted by Jamal Spelling on October 23, 2007, at 17:08:15
In reply to Re: That Way Lies Madness » Squiggles, posted by unbottled on October 23, 2007, at 16:14:45
> "Lost a lot". No kidding. When I hear
> of things like exercise dramatically
> changing a person's life for the better,
> I will cheer for them. But I know for
> sure in advance, no matter their method
> or enthusiasm, that they know squat
> about drama or having their
> life changed.There are many failed suicide victims - people who clearly understand about drama and suffering and all - who go on to live happy and successful lives unmedicated. Beware to assume that your suffering has been worse than that of others.
Jamal
Posted by Jamal Spelling on October 23, 2007, at 17:29:04
In reply to Re: That Way Lies Madness » Jamal Spelling, posted by Squiggles on October 23, 2007, at 16:51:48
> If i remember exercise, and vitamins and
> stuff like that was being proposed as
> an alternative to meds for mental illness.Indeed. I'm not quite sure what's wrong with proposing alternatives to medication. Other alternatives to medication might be ECT, VNS, etc. At no point was it stated in this thread that it is wrong to use medication. There is indisputable evidence that exercise, as well as certain vitamins and minerals, are beneficial in the treatment of depression. Lithium itself is an elemental mineral, atomic number 3, after hydrogen and helium. The single most effective psychoactive substance that I have ever taken was a supplement called SAMe. The effects were dramatic and pronounced, far more so than the Zoloft, Celexa and Wellbutrin that I have used over the years. As far as I'm aware, SAMe is a prescription antidepressant in Italy, so it's a case of one man's terrorist being another man's freedom fighter.
Jamal
Posted by Jamal Spelling on October 23, 2007, at 17:43:18
In reply to Re: That Way Lies Madness » Squiggles, posted by unbottled on October 23, 2007, at 16:14:45
> "Lost a lot". No kidding. When I hear
> of things like exercise dramatically
> changing a person's life for the better,
> I will cheer for them. But I know for
> sure in advance, no matter their method
> or enthusiasm, that they know squat
> about drama or having their
> life changed.As opposed to what? If a person reports that exercise benefited them dramatically, then it's fake, but if it's medication that benefited them then their suffering must have been real?
Jamal
Posted by Jamal Spelling on October 23, 2007, at 17:46:47
In reply to That Way Lies Madness, posted by Squiggles on October 23, 2007, at 8:10:49
> do they actually take a brain serum sample to compare it to antidepressants?
Of course not. Just like they don't take brain serum samples from depression patients to measure the efficacy of antidepressant medication.
Jamal
Posted by Jamal Spelling on October 23, 2007, at 17:54:23
In reply to Re: That Way Lies Madness, posted by unbottled on October 23, 2007, at 15:06:06
> The problem is that some folks are
> nostalgic for nineteenth century non-answers.The problem is that some folks are nostalgic for 1960s non-answers. You know, like treating obesity with amphetamines and then counteracting the overstimulation with barbiturates. Or like treating the "belligerent old senile" with chlorpromazine.
This statement of mine is of course completely stupid, about as stupid as your statement that using non-pharmaceutical interventions for mental illness is nostalgia for nineteenth-century non-answers.
Jamal
Posted by Jamal Spelling on October 23, 2007, at 18:03:21
In reply to That Way Lies Madness, posted by Squiggles on October 23, 2007, at 8:10:49
> Sometimes I wonder if there are anti-psychiatry
> cults in our midst, who encourage people to
> get off their drugs and replace them with
> exercise, sweating, and co-therapeutic introspection.Co-therapeutic introspection: yes, they are called psychologists.
They have all kinds of theories,
> non of them coming from a medical education, like
> "exercise-induced endomorphins"-- well, how many
> does it take?How many serotonins does it take to treat depression, huh Squiggles? Or how many dopamines? How many norepinephrines? Tell me, what exactly is the neurochemistry of your condition, bipolar disorder? Can you quantify it the way you expect others to quantify their treatments?
Jamal
Posted by Deputy Racer on October 23, 2007, at 18:20:49
In reply to Re: That Way Lies Madness » linkadge, posted by Squiggles on October 23, 2007, at 14:41:02
> Taking nothing at all is worse than taking something that has some effect, though not the best effect.
>
> it is baffling that you should let people remain ill and ruin their lives or self-medicate with alcohol or street drugs, or worse kill themselves or others.
>
> Remitting, only when it is exogenously causes, as in grief for example.
>
> Yeah, that will be $100 dollars please -- 'your neighbourhood palm reader'.
>Please don't post anything which could lead others to feel accused or put down, no matter how much you may disagree with their stance. Please be sensitive to those who have experienced remission from non-situational depression without the use of drugs. This world has room for a variety of experiences, and it is important to respect that variety.
If you or anyone else has any questions regarding the posting guidelines at this site, please read the FAQ, located at http://www.dr-bob.org/babble/faq.html#civil Follow ups to this administrative action should be directed to the Administration board and should themselves be civil.
Dr Bob has ultimate authority over all administrative issues at this site, and may choose to revise or reverse any actions taken by a deputy.
Deputy Racer
Posted by Squiggles on October 23, 2007, at 18:21:00
In reply to Re: That Way Lies Madness » Squiggles, posted by Jamal Spelling on October 23, 2007, at 18:03:21
> > Sometimes I wonder if there are anti-psychiatry
> > cults in our midst, who encourage people to
> > get off their drugs and replace them with
> > exercise, sweating, and co-therapeutic introspection.
>
> Co-therapeutic introspection: yes, they are called psychologists.
>
> They have all kinds of theories,
> > non of them coming from a medical education, like
> > "exercise-induced endomorphins"-- well, how many
> > does it take?
>
> How many serotonins does it take to treat depression, huh Squiggles? Or how many dopamines? How many norepinephrines? Tell me, what exactly is the neurochemistry of your condition, bipolar disorder? Can you quantify it the way you expect others to quantify their treatments?
>
> JamalWell, this is not exactly bedtime reading, but:
http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1525098
they do know something about the neurochemistry
of Beepers.Squiggles
Posted by Jamal Spelling on October 23, 2007, at 18:23:21
In reply to Re: That Way Lies Madness » unbottled, posted by Squiggles on October 23, 2007, at 15:18:15
> So, this person does not know what he or she
> is talking about.Linkadge is one of the most knowledgeable posters on this board. This is a fact.
Jamal
Posted by Deputy Racer on October 23, 2007, at 18:24:17
In reply to Re: That Way Lies Madness, posted by linkadge on October 23, 2007, at 12:20:43
>
> I think the real reason that people like to discount the power of healthful lifestyles, stress reduction, exercise, and social support, is because it removes the guilt out of their decision to take medications, and sit on their
> behind all day.Please don't post anything which could lead others to feel accused or put down, and please be sensitive to others, which includes not implying that taking medications want to "sit on their behind all day."
If you or anyone else has any questions regarding the posting guidelines at this site, please read the FAQ, located at http://www.dr-bob.org/babble/faq.html#civil Follow ups to this administrative action should be directed to the Administration board and should themselves be civil.
Dr Bob has ultimate authority over all administrative issues at this site, and may choose to revise or reverse any actions taken by a deputy.
Deputy Racer
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Dr. Bob is Robert Hsiung, MD,
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