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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 9 to 33 of 33. Go back in thread:
Posted by greywolf on May 14, 2009, at 20:46:08
In reply to What are our alternatives?, posted by SLS on May 14, 2009, at 15:58:37
I guess we just have to keep trying. It may take another year for my VNS to work, but I'll stick it out. Parnate may not work, so I'll take one of your suggestions or someone else's and run with that.
I just think it's important to keep discussing options, new developments, and offering support. A few of you--Scott and others--are particularly good at this, and it's helped me immensely.
Greywolf
Posted by ricker on May 14, 2009, at 20:51:27
In reply to Re: What are our alternatives?, posted by garnet71 on May 14, 2009, at 19:25:03
I've often wondered why the evolution, and medical advancement of mankind has been able to continuously develop?
Our bodies are, to a degree, interchangeable! We need an overhaul, transplant from another, what a luxury! But, everyone is stuck with his or her "brain", for life. So, when it comes to alternatives, mental health-care is limited in it's treatment choices. That sounds like an intimidating, and perhaps discouraging avenue for scientists.
Why invest time and money into the only part of our body that's "set for life"?
Our brains have built-in safety features in that our "thoughts / feelings" are limited in what we are capable of controlling.
Can you imagine if we thought about making our heart stop!!
Physically impossible...good safety feature. Unfortunately, I can't think my way out of depression so I guess the trade-off is something that leaves me a bit frustrated.
Maybe stem cell research will unlock the mystery?
Until then, I will continue to take my medicine along with my lumps. I feel very fortunate, lots of "good" drugs to try, if they don't help, I'm not going to die! Brain tumor...drugs don't help...well...
I can only hope and pray some miraculous drug or treatment will fall upon us, very soon.
Posted by Phillipa on May 14, 2009, at 21:07:24
In reply to Re: What are our alternatives?, posted by garnet71 on May 14, 2009, at 19:25:03
Garnet ask for a TPO panel for thyroid will show if hasimotos which I do definitely have. Love Phillipa
Posted by garnet71 on May 14, 2009, at 21:46:40
In reply to What are our alternatives?, posted by SLS on May 14, 2009, at 15:58:37
I should probably mention I have a lot of hope for the future. Now that it has become standard for health insurance companies to pay for mental health care, and more people are getting treatment to improve life quality, it seems drug companies have had more incentives to create drugs that work. (Should we thank drug company lobbyists for that? - maybe) Not to mention more disposable income with dual-income families that have grown since the 70s (though that can be certainly be argued right now). I still do believe that mental health research is a late evolver because of past stigma involved.
But there are still a lot of people who do not think ADD/ADHD exists--and educated people. There are still a lot of people who think depression or anxiety is something you can cure yourself, and that there is nothing biological about it, again, educated people. It's pretty surprising considering that 25% of the population has a mental illness in any given year, and that major depression is the leading cause of disability.
There are increasing health policy managemetn programs at universities, which brings in outside influences, and from a policy perspective, rather than only relying upon what doctors are taught at med school. Doctors are most likely not trained to run businesses from an economic or efficiency perspective, and do not specialize in management. They probably don't have time to train for political science and business to understand the dynamics of how businesses and government policies effect health care. I was considering getting my master's in health care management, but changed my mind at the last minute. I think it would be too frustrating to deal with politics, especially when so much changes every 4 or 8 years with presidential administrations. It would be back and forth.
Plus how many doctors have time for advocacy? I had one amazing psychotherpist who spent much of his free time doing advocacy work. He belonged to associations-but was actively involved, not just a memmber; spoke at events, wrote letters to the editor of newspapers on a regular basis....and more. A true gem. Unfortunatley, he was taken by pancreatic cancer.
More and more companies are allowing open access to information and increasingly engaging in collaboration to solve problems. I wouldn't be surprised if research would be handled this way in the near future.
Still, follow the incentives and you can pretty much derive a lot of implications that result.
For example, did you ever contact a dermatologists office to get a skin cancer screening, and found out the wait is 3 months? That's because every teenager in the city is there for acne treatment--it is covered by most insurances now. Incentives. Only 2 decades ago, only teens with severe acne went to the dermatologists. Maybe some of this could be treated OTC. There are lots of incentives for specializing in dermatology, and less incentives for general practice. Psychiatrists, if this rank still stands correct, are the 2nd most likely to be sued for malpractice after OB/GYNs. This alone has lots of implications, some possibly lead to offering less effective treatments, or denial of off label/experiemental treatments. Incentives...That's where policymakers come in to solve problems. Unfortuantley, education usually isn't as important when it comes to what it takes to get elected. So, in many ways, it's our own fault--the people we choose to elect to run our government and make our laws....it's systematic. At any rate, everything unspirals to one thing--money.
Posted by Sigismund on May 15, 2009, at 1:19:36
In reply to Re: What are our alternatives?, posted by garnet71 on May 14, 2009, at 21:46:40
>I should probably mention I have a lot of hope for the future.
I should probably mention that I don't.
Posted by garnet71 on May 15, 2009, at 20:06:49
In reply to Re: What are our alternatives?, posted by Sigismund on May 15, 2009, at 1:19:36
Well here Sigi, I'll give you some of my optimism: *#$^@%*%^@^#@^@%^!@*
Not too much, we don't want to be *blindly* optimistic....but really, life is much more enjoyable when optimism is daily food. You can even turn most bad situations, well probably not tragedies, into GOOD ones. That's how I survived all these years anyway......
Posted by Sigismund on May 15, 2009, at 21:25:33
In reply to Re: What are our alternatives?, posted by garnet71 on May 15, 2009, at 20:06:49
You might be right?
Apparently the War on Drugs is over because the government does not want to wage war (or give the appearance of it) against its own people.
I never would have expected that.
Posted by tensor on May 16, 2009, at 2:30:28
In reply to What are our alternatives?, posted by SLS on May 14, 2009, at 15:58:37
Hi Scott,
I recently purchased and read this book:
http://www.amazon.com/Conquering-Depression-Anxiety-Through-Exercise/dp/1591021928/ref=sr_1_1?ie=UTF8&s=books&qid=1242458254&sr=8-1So exercise have become a part of my treatment. If you have not read it I can warmly recommend it. It's professional and balanced, it's not claiming that depression is a choice or that exercise is a replacement for drugs. The author does say that in some cases exercise can relieve symptoms fully or partially, and he always back up his theories and claims with a study or a research report.
I'm currently in a depressive episode, and from experience I know that only time can put me in remission, or actually make the drugs work. Currently the drugs do not work, no matter how I switch or combine.
/Mattias
Posted by Neal on May 16, 2009, at 3:23:09
In reply to What are our alternatives?, posted by SLS on May 14, 2009, at 15:58:37
Scott,
As I understand your question; what are the alternatives to the standard Pharma meds?Maybe we could make a list of anything that has been claimed to be efficacious by someone somewhere.
St. John's Wort
DHEA
Suboxone
Sam-e
fish-oil
?????I'm sure there are a lot more . . .
Posted by tensor on May 16, 2009, at 4:01:43
In reply to Re: What are our alternatives?, posted by Neal on May 16, 2009, at 3:23:09
Has someone here actually noticed an improvement with fish-oil. I mean the fatty acids are essential but as with vitamins, if there is no proven deficiency will there be any sign of improvement? I have never noticed any. IMHO, it's more like, can help, can't hurt.
/Mattias
Posted by SLS on May 16, 2009, at 5:07:22
In reply to Re: What are our alternatives?, posted by Neal on May 16, 2009, at 3:23:09
> Scott,
> As I understand your question; what are the alternatives to the standard Pharma meds?Any and all alternatives are important to acknowledge and evaluate. Just like prescription drugs, I imagine that each suggestion will not be a panacea, but you never know. It is easy to give into the temptation of using one's own experience with a particular treatment to suggest it as a generalizable phenomenon. I still do it sometimes. I think it helps to regard the word "depression" as representing a great many conditions.
> Maybe we could make a list of anything that has been claimed to be efficacious by someone somewhere.
>
> St. John's Wort
> DHEA
> Suboxone
> Sam-e
> fish-oil
> ?????
>
> I'm sure there are a lot more . . .Thanks for the suggestions.
- Scott
Posted by SLS on May 16, 2009, at 5:11:39
In reply to Re: What are our alternatives? » Neal, posted by tensor on May 16, 2009, at 4:01:43
> Has someone here actually noticed an improvement with fish-oil. I mean the fatty acids are essential but as with vitamins, if there is no proven deficiency will there be any sign of improvement? I have never noticed any. IMHO, it's more like, can help, can't hurt.
I didn't expect much from fish oil the first time I tried it. Immediately after my first dose, I felt a strange type of energization. It lasted for less than a two days, but it struck me that there is something pharmacological going on with fish oil besides it serving the brain as a nutritional supplement. I'm not sure, though.
- Scott
Posted by 49er on May 16, 2009, at 5:57:35
In reply to Re: What are our alternatives? » Neal, posted by tensor on May 16, 2009, at 4:01:43
> Has someone here actually noticed an improvement with fish-oil. I mean the fatty acids are essential but as with vitamins, if there is no proven deficiency will there be any sign of improvement? I have never noticed any. IMHO, it's more like, can help, can't hurt.
>
> /MattiasGreat question.
When I was on them, I never felt the dramatic improvement that other people have reported. But since I have discontinued them due to agitation, I think they were doing something positive.
Maybe I just haven't found the right brand or the right combination to get the best result. As an FYI, getting omega 3 from food just doesn't cut it as a replacement. I thought it did in a previous post I wrote but now I am wondering.
I am going to be switching to a supplement that I think is less activating. Then I will try the fish oil capsules again to see if this combination will work.
It really is trial and error as I have had no luck with alternative practitioners. I don't want to get off topic but just because I have railed against mainstream psychiatry doesn't mean I have any love for most alternative folks.
49er
Posted by desolationrower on May 16, 2009, at 21:14:33
In reply to Re: What are our alternatives?, posted by Neal on May 16, 2009, at 3:23:09
> Scott,
> As I understand your question; what are the alternatives to the standard Pharma meds?
>
> Maybe we could make a list of anything that has been claimed to be efficacious by someone somewhere.
>
> St. John's Wort
> DHEA
> Suboxone
> Sam-e
> fish-oil
> ?????
>
> I'm sure there are a lot more . . .um you're aware there is an entire board called 'alternative' at dr-bob? lets not reinvent the wheel...
-d/r
Posted by Michael Bell on May 17, 2009, at 0:20:24
In reply to What are our alternatives?, posted by SLS on May 14, 2009, at 15:58:37
The brain has the remarkable feature of elasticity. It is ever-learning, ever-changing. Thought processes and beliefs are literally pathways in the brain that have been formed over time. Therapy allows you to challenge your belief systems and literally create new pathways in your brain. The important thing to remember is that therapy actually results in physical changes in your brain, just as medication does.
Posted by sowhysosad on May 17, 2009, at 4:12:54
In reply to Re: What are our alternatives? Therapy, posted by Michael Bell on May 17, 2009, at 0:20:24
> The brain has the remarkable feature of elasticity. It is ever-learning, ever-changing. Thought processes and beliefs are literally pathways in the brain that have been formed over time. Therapy allows you to challenge your belief systems and literally create new pathways in your brain. The important thing to remember is that therapy actually results in physical changes in your brain, just as medication does.
I'd imagine that's more true of therapy which changes thought systems - like CBT and Psychology of Mind - than it is of traditional Freudian psychoanalysis.
In fact, I know at least one study provided evidence of changes in the brain after CBT.
Posted by greywolf on May 17, 2009, at 4:13:53
In reply to Re: What are our alternatives? Therapy, posted by Michael Bell on May 17, 2009, at 0:20:24
Some non-med alternatives are VNS, ECT, and therapy.I have a VNS implant, but we're not yet at a frequency level where a therapeutic benefit would be expected.
I've recently had ECT during a crisis. Not my style and I won't be going back to it.
I've been in therapy for both depression and OCD for several years. I can honestly say that it may not be a cure, but my therapist sure has helped me through some rough times.
Group therapy doesn't appeal to me, but it's apparently helpful to others.
Greywolf
Posted by Neal on May 17, 2009, at 5:18:01
In reply to Re: What are our alternatives? Therapy, posted by greywolf on May 17, 2009, at 4:13:53
Therapy is great; not doubt about it; if you can find the right therapist, and either have great insurance or a lot of money.
I see a lot of substances mentioned on the alternative board: 5htp, Calcium, magnesium, Niacin, Argenine, Kava-Kava, Green Tea, Cystein, Chromium Picolinate, B-6, B-12, etc.
We don't have to be that rigid. We can talk about alternative "medications" on this board too. We're talking abstractly about them. The big picture in terms of what's out there, not details about them.
A lot of people on this board are saying the standard pharma meds doesn't work for them and I think Scott has a point that an evaluation of alternatives is a subject that needs airing on the board that everyone goes to.
for instance, therapy was brought up, and I think that was a great thought. we tend to forget that as an alternative.
BTW - I can attest that Niacinamide is a great sleep aide for me.
Posted by 49er on May 17, 2009, at 6:02:41
In reply to Re: What are our alternatives? Therapy, posted by Neal on May 17, 2009, at 5:18:01
Hi Neal,
<<Therapy is great; not doubt about it; if you can find the right therapist, and either have great insurance or a lot of money. >>
I totally agree.
When I was severely depressed which I now realize was the result of being cold turkeyed off of Prozac after my dose had been doubled, I was in therapy.
To make a long story short, this therapist was able to get me back to work. I didn't really appreciate how great she was until I started tapering off of meds and having withdrawal symptoms.
She was the type of person that didn't allow you to feel sorry for yourself. At the time, I would rebel every now and then but looking back, she was exactly what I needed.
<<We don't have to be that rigid. We can talk about alternative "medications" on this board too. We're talking abstractly about them. The big picture in terms of what's out there, not details about them.>>
Exactly! People also might forget to check the withdrawal board.
Also, we shouldn't forget that the options aren't just meds or supplements. It can be a combination.
<<BTW - I can attest that Niacinamide is a great sleep aide for me.>>
That is great to hear. Can you tell me how much you take and which brand?
I am in a situation where if I cut down my supplements, I sleep great. But then it impairs my functioning.
And as I previously mentioned, I have had no luck with alternative practitioners.
Thanks!
49er
Posted by floatingbridge on May 17, 2009, at 16:35:39
In reply to Re: What are our alternatives? » SLS, posted by ricker on May 14, 2009, at 18:15:57
> > Another important and constructive question is what is it that we can do to improve the treatments available to us.
>
>
> Scott, I believe it's people like you that ultimately, will end up improving available treatment options.
>
> Many posters have, and will continue to write of their failures with certain medications.... their given right.
>
> However, you may not realize, but I for one have gained a tremendous amount of insight from your post's which has helped me take positive steps with my treatment.
>
> I admire the passion and courage you display on a daily basis.... you're a fighter with a mission. I'm certain many others have benefited from your commitment to "solving the brain flu" so to speak.
>
> So, as I mentioned earlier, doing what you have been doing, has and will continue to improve treatment options available to us.
>
> Regards, Rick
>
>What a kind and true thing to write.
Respectfully,
Candace
Posted by floatingbridge on May 17, 2009, at 16:46:59
In reply to Re: What are our alternatives? Therapy, posted by Michael Bell on May 17, 2009, at 0:20:24
> The brain has the remarkable feature of elasticity. It is ever-learning, ever-changing. Thought processes and beliefs are literally pathways in the brain that have been formed over time. Therapy allows you to challenge your belief systems and literally create new pathways in your brain. The important thing to remember is that therapy actually results in physical changes in your brain, just as medication does.
Yes, more than we know. But it's tough going, this therapy work, is it not? Good therapy, exercise and meds--I just can't seem to do without meds. Sigh. I'm enjoying reading this thread and wanted to chime in.
Candace
Posted by raisinb on May 17, 2009, at 17:18:02
In reply to Re: What are our alternatives? Therapy, posted by floatingbridge on May 17, 2009, at 16:46:59
Yes, I'm a firm believer in therapy. Even though I just as firmly believe my depression is biological, it's caused me to develop dysfunctional ways of coping and behaving--mainly because I have always been so worried about having breakdowns that I avoid difficult situations and big life decisions.
Medication has taken a lot of that fear away, and it has significantly accelerated my progress in therapy. The best therapy can be gut-wrenchingly hard. The depressed person needs help to get through it. I think both are necessary.
I'm also a big believer in mild exercise and meditation, though I do not practice them as often as I should. I can say that the periods I've meditated regularly have been the most peaceful, productive times in my life.
Through time and work, I think even the most treatment-resistant illness can be managed through these tools. Medication is one piece, but we can't rely solely on it.
The most important thing is to listen to our bodies and illnesses and the effects different interventions have on them. The science of antidepressants right now is rudimentary, at best, and doesn't take into account complex individual differences. That means we have to assess ourselves. Exercise helps some, doesn't help others. Likewise with meditation and a variety of different meds. And maybe something works for you at a particular time and doesn't later. Know thyself.
It's vital to keep working on all these things when we're in remission, too. Depression takes away the ability to do so and the hope that drives change.
Posted by Neal on May 18, 2009, at 0:27:51
In reply to Re: What are our alternatives? Therapy » floatingbridge, posted by raisinb on May 17, 2009, at 17:18:02
Raisinb,
I liked your post.
> Yes, I'm a firm believer in therapy. Even though I just as firmly believe my depression is biological, it's caused me to develop dysfunctional ways of coping and behaving--mainly because I have always been so worried about having breakdowns that I avoid difficult situations and big life decisions.
That, in my opinion, is one of the hardest things about the problem. It causes you to edit yourself down and perhaps play it safe; not saying there aren't very good reasons for doing so at times, but it's very hard sitting on the sidelines and being judged by others as not a high achiever.
>
> Medication has taken a lot of that fear away, and it has significantly accelerated my progress in therapy. The best therapy can be gut-wrenchingly hard. The depressed person needs help to get through it. I think both are necessary.I agree. Both are usually necessary, not for everyone, but for most with moderate to heavy symptoms. But if financial considerations force a decision between one or the other, I'm glad to have the meds.
>
> The most important thing is to listen to our bodies and illnesses and the effects different interventions have on them. The science of antidepressants right now is rudimentary, at best, and doesn't take into account complex individual differences. That means we have to assess ourselves. Exercise helps some, doesn't help others. Likewise with meditation and a variety of different meds. And maybe something works for you at a particular time and doesn't later. Know thyself."Know Thyself" is what's carved on some Greek temples and they were some intelligent people.
> It's vital to keep working on all these things when we're in remission, too. Depression takes away the ability to do so and the hope that drives change.
And remission can sometimes be conditional; heavy or unexpected stress can bring on symptoms. Hopefully if we "know thyself" and "know the disease", and the other things you mention, we'll live life to the full.
Posted by Amelia_in_StPaul on May 18, 2009, at 15:37:00
In reply to Re: What are our alternatives?, posted by bleauberry on May 14, 2009, at 18:59:05
That was a great post Bleauberry. Well said. I agree with it all, wholeheartedly. Because of these forums, I am going to get myself tested for wheat and dairy insensitivity. Already my doctor (a fibromylagia specialist, which I have) has suggested (because of some vitamin deficiencies that showed up) that I may have leaky gut syndrome. Can you believe that, an MD? She is very special.
Posted by Elanor Roosevelt on May 23, 2009, at 21:00:23
In reply to Re: What are our alternatives?, posted by Sigismund on May 15, 2009, at 1:19:36
> >I should probably mention I have a lot of hope for the future.
>
> I should probably mention that I don't.I would like to mention that I have lost hope once again
This is the end of the thread.
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