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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 22 to 46 of 48. Go back in thread:
Posted by Lou Pilder on June 29, 2010, at 7:07:33
In reply to The biology of depression: Wolkowitz brings hope, posted by Rosy Crucifiction on June 27, 2010, at 12:25:28
Friends,
If you are considering posting in this thread or parallel threads,I am requesting that you watch this short video.
Lou
Here is how you can see the video.
A. Bring up Google
B. Key in:
[youtube, prescribed drugs To Prescribers]
the caps are needed where you see them and if more than one video comes up, this is a short video with the date Feb 5, 2009
Posted by Lou Pilder on June 29, 2010, at 7:37:20
In reply to Re: The biology of depression: Wolkowitz brings hope, posted by linkadge on June 28, 2010, at 14:08:43
> Well, the stress model of major depression is still only theoretical. It may not explain why some of us experience recurrent depression in the absence of significant life stress.
>
> In the flinders animal model of depression, hippocampal neurogenesis is actually increased. In this model, theraputic nortriptyline or citalopram actually lowers hippocampal neurogenesis. Also, in animal models, escitalopram has no effect on hippocampal neurogensis.
>
> Also, this does not explain why ECT or sleep deprivation can induce rapid improvement in depression. Theres not enough time here for new brain cells to mature and become funtioning.
>
> LinkadgeLinkage,
Thank you for posting the above. I see that it shows judgment, critical thinking and more. I would like for you to look at some of the threads now on the admin and faith boards and if you could post your views there, I would appreciate it.
Lou
Posted by Lou Pilder on June 29, 2010, at 7:49:51
In reply to Re: The biology of depression: SLS » violette, posted by inanimate peanut on June 28, 2010, at 22:08:23
> If that's the case, though, what explains bipolar switching? When I took Geodon, I went from deathly depressed to 100% well in less than 24 hours. Surely according to your theory my brain was still just as worn down from the stress as it was before I took the Geodon. There are obviously also people with bipolar disorder who switch from depression to normalcy or mania without any medication or other reason. How do you explain that?
inanimate peanut,
Thank you for the post above.
Lou
PS...I also like your posting name and I hope that you never are a salted.
Lou
Posted by jade k on June 29, 2010, at 14:11:29
In reply to Re: The biology of depression, posted by violette on June 29, 2010, at 2:37:01
I liked the video, however I was diappointed at the end (why I am looking forward to the final episode: the cure)
This thread makes my brain hurt, however,
I have seen a Bi-polar 1 "switch".
I have seen an epileptic "switch".
I felt my brain "switch" from normal to a major depression in a very short time. I felt it "switch" back to full remission twice, (although short lived). Beyond frustration.
My feeling is that some of us are simply prewired and at risk for a mental health illness, and environmental stresses (physical and/or mental) usually cause the "switch" effect.
To explain major depression without a stressor, maybe that indivual's threshold is very low (more nature, less nurture involved.)
~Jade
Posted by violette on June 29, 2010, at 17:50:26
In reply to The biology of depression: Wolkowitz brings hope, posted by Rosy Crucifiction on June 27, 2010, at 12:25:28
Hey Everyone-
After revisiting this thread, I realized how OCD I've been about trying to get others to look more closely at the emotional side of mental disorders or a more holistic approach and how my behavior is inappropriate.
I have known my underlying motivations for this behavior for quite some time, but after coming back to this thread, seeing my last post and thinking - I can't believe I wrote all that - was a wake up for me to seriously address my behavior on this forum instead of pushing it to the back of my awareness as I had been doing.
Although I had alreaady known from the thought level, that this has gotten out of hand, I didn't actually emotionally feel-experience (which I associate with "truly knowing") the extent and implications of the problem. Until now. And for me, awareness seems to be a precursor to change.
This is not the best venue for me and I am truly sorry if I have been overtly or covertly pushy with any of my psychology related views and beliefs to anyone here.
Anyway, thank you all for the discussions...I have learned alot from you all and gained additional insights about myself from using this forum, but I must be going now. Take care everyone-I wish the best for you all.
Posted by jade k on June 29, 2010, at 23:38:24
In reply to ...hope, beliefs, views (I'M DONE), posted by violette on June 29, 2010, at 17:50:26
WHAT??!!
> my behavior is inappropriate.
No it isn't
>
> I have my underlying motivationsDon't we all
> but after coming back to this thread, seeing my last post and thinking - I can't believe I wrote that
Gee, I wish I had a penny for every time I've said that
>
> This is not the best venue for meI can respect that and you should go if its harmful to you
> and I am truly sorry if I have been overtly or covertly pushy with any of my psychology related views and beliefs to anyone here.
You're entitled to your opinions like everyone else!
>
> Anyway, thank you all for the discussions...I have learned alot from you all and gained additional insights about myself from using this forumCool
I think you should stay. You'll wear yourself out, and then it won't seem overwhelming. Just a thought ;-)
~Jade
Posted by SLS on June 30, 2010, at 5:36:57
In reply to ...hope, beliefs, views (I'M DONE), posted by violette on June 29, 2010, at 17:50:26
I don't think your interactions here have been at all inappropriate. I don't think it is necessary for you to leave PB to find a balance that suits you. It is a never-ending pursuit. If anything, your contributions might have helped others to synthesize a perspective that works better for them.
- Scott
Posted by linkadge on June 30, 2010, at 7:14:38
In reply to Re: The biology of depression: SLS » violette, posted by inanimate peanut on June 28, 2010, at 22:08:23
I think its simply brain metabolism. Perhaps stress depleted a neurotransmitter which would help regulate that activity. In this case the drug might compensate for that and dampen the overactive circutry on its own.
I believe that in chronic, recurrent depression, it is something about the brain structure itself which allows for overactive / underactive brain regions which are hard(er) to alter.
Linkadge
Posted by linkadge on June 30, 2010, at 7:17:47
In reply to Re: The biology of depression: SLS, posted by topcatclr on June 28, 2010, at 23:19:11
>One makes you to stupid and the other makes you >to tired, to obsess!
That may well be. They are very blunt treatments. But, the fact that the core hellish mood (not simply obsessing) can completely subside is the point.Linkadge
Posted by linkadge on June 30, 2010, at 7:23:50
In reply to Re: The biology of depression: SLS » topcatclr, posted by violette on June 29, 2010, at 0:21:35
>if your brain is too tired, you wouldn't have >much mental energy for emotions to manifest >since you are using all that energy to merely >function.
In depression, the brain is always "too tired", yet it does find a way to continue to ruminate. The theraputic effects of sleep deprivation is more than simply being too tired.
In Parkinsons disease, for instance, it has been known for a long time, that sleep deprivation can actually improve (substantially) the tremors and other symptoms with the disease. Some patients can perform tasks after the SD day that they would not normally be able to perform. The other thing too, is that bipolars can actually go manic after sleep deprivation.
This hints to more than the simply being 'too tired' hypothesis. The effect in Parkinons, mania and depression hints at a possible dopaminergic mechanisms to SD.
Linkadge
Posted by PartlyCloudy on June 30, 2010, at 11:24:59
In reply to ...hope, beliefs, views (I'M DONE), posted by violette on June 29, 2010, at 17:50:26
(Hi, nice to almost meet you.)
I think it's very important to realize our own limitations here on the boards. It took me a long time to discover my own and it was a terribly painful journey.
I wish you well and please feel welcome to return at any time when you feel comfortable to do so. Your contributions are appreciated!
PartlyCloudy, a sometime poster here
Posted by jade k on June 30, 2010, at 11:30:13
In reply to Re: The biology of depression: SLS, posted by linkadge on June 30, 2010, at 7:23:50
> In Parkinsons disease, for instance, it has been known for a long time, that sleep deprivation can actually improve (substantially) the tremors and other symptoms with the disease. Some patients can perform tasks after the SD day that they would not normally be able to perform. The other thing too, is that bipolars can actually go manic after sleep deprivation.
So you're saying that when a person who is bipolar becomes manic, the cause might not be the trigger of sleep deprivation, as in exhaustion, SD can actually cause changes in dopamine activity which in turn triggers the "episode" of mania?I saw sleep deprivation pull someone I know out of a significant depression. How long that lasted, I don't recall. Its never worked for me.
>
> This hints to more than the simply being 'too tired' hypothesis. The effect in Parkinons, mania and depression hints at a possible dopaminergic mechanisms to SD.
>
> Linkadge
>
>
~Jade
Posted by Dinah on June 30, 2010, at 13:35:28
In reply to Re: The biology of depression » linkadge, posted by jade k on June 30, 2010, at 11:30:13
A friend and I were talking about this recently.
Have they done any studies with the idea that it is the shock to the brain, the reset sort of, that is beneficial?
That would also explain why medications can seem to work for brief periods of time. It's not so much that it poops out but that it was the change that was effective, the jolt to the brain, rather than the medication supplying some needed chemical?
I shamefacedly admit that I sometimes use sleep deprivation to put myself into a state of high productivity when I need to meet a deadline.
Posted by jade k on June 30, 2010, at 13:58:00
In reply to Re: The biology of depression, posted by Dinah on June 30, 2010, at 13:35:28
> A friend and I were talking about this recently.
>
> Have they done any studies with the idea that it is the shock to the brain, the reset sort of, that is beneficial?Probably, but it sounds right to me, that is, in some cases I think a "reset" is needed. My doc said to me after an acute, sudden bout with mdd that he wanted to "shake my brain up" lol. Startled me a little but I think that was what he meant, hit the reset button.
>
> That would also explain why medications can seem to work for brief periods of time. It's not so much that it poops out but that it was the change that was effective, the jolt to the brain, rather than the medication supplying some needed chemical?Could be. I'm fairly (very) ignorant about alot of this, I post mostly from my own experiences. I've never had a med work then "poop out". I've always quit due to side effects. I'm (as of yesterday) on a new combo that I'm excited about. I'll post about it if it seems promising!
>
> I shamefacedly admit that I sometimes use sleep deprivation to put myself into a state of high productivity when I need to meet a deadline.Why shamefacedly? We do what we gotta do, lol.
Nice to hear from you,
~Jade :-)
Posted by Phillipa on June 30, 2010, at 14:03:59
In reply to Re: The biology of depression » Dinah, posted by jade k on June 30, 2010, at 13:58:00
Interesting thread I feel definitely stress triggers and always has any depression in myself. Now others can't speak for. Phillipa
Posted by linkadge on June 30, 2010, at 19:15:02
In reply to Re: The biology of depression » linkadge, posted by jade k on June 30, 2010, at 11:30:13
>So you're saying that when a person who is >bipolar becomes manic, the cause might not be >the trigger of sleep deprivation, as in >exhaustion, SD can actually cause changes in >dopamine activity which in turn triggers >the "episode" of mania?
Exactly, if sleep deprivation simply exhausted depression by causing extreme sedation, then you'd expect it to have an antimanic effect, or an antipsychotic effect which it doesn't. There is a proposed "psychostimulant" like effect of sleep deprivation, in which dopaminergic activity is increased. There are interactions between melatonin, adenosine, MAO-B. Sleep deprivation can also cause surges in thyroid hormonses (in responders). Some people stay awake for periods of time to get a high, or even to promote hallucinations. Some people might use "all-nighters" as a form of self medication. Some people with ADHD, claim that they are most productive at early hours of the morning. In animals, sleep deprivation increases dopaminergic receptor sensitivity, and can prevent depression induced by social defeat.
Sleep deprivation can also be pro-convulsant, which is also consistent with an antidepressant, or promanic effect.
>I saw sleep deprivation pull someone I know out >of a significant depression. How long that >lasted, I don't recall. Its never worked for me.
No, it doesn't work for everbody. For me, sleep deprivation can kill the profound anhedonia I get with depression. If you stay up the entire night, there is something "different" about the world the next day. Something mystical and otherworldly about things. Sometimes, the combination of sleep deprivation and ativan can be really effective, since I tend to become a little overanxious if I lose sleep. It seems to make sleep deprivation a little easier to handle.
Linkadge
Posted by jade k on June 30, 2010, at 19:33:16
In reply to Re: The biology of depression, posted by linkadge on June 30, 2010, at 19:15:02
> >So you're saying that when a person who is >bipolar becomes manic, the cause might not be >the trigger of sleep deprivation, as in >exhaustion, SD can actually cause changes in >dopamine activity which in turn triggers >the "episode" of mania?
>
> Exactly, if sleep deprivation simply exhausted depression by causing extreme sedation, then you'd expect it to have an antimanic effect, or an antipsychotic effect which it doesn't. There is a proposed "psychostimulant" like effect of sleep deprivation, in which dopaminergic activity is increased. There are interactions between melatonin, adenosine, MAO-B. Sleep deprivation can also cause surges in thyroid hormonses (in responders). Some people stay awake for periods of time to get a high, or even to promote hallucinations. Some people might use "all-nighters" as a form of self medication. Some people with ADHD, claim that they are most productive at early hours of the morning. In animals, sleep deprivation increases dopaminergic receptor sensitivity, and can prevent depression induced by social defeat.
>
> Sleep deprivation can also be pro-convulsant, which is also consistent with an antidepressant, or promanic effect.
>
> >I saw sleep deprivation pull someone I know out >of a significant depression. How long that >lasted, I don't recall. Its never worked for me.
>
> No, it doesn't work for everbody. For me, sleep deprivation can kill the profound anhedonia I get with depression. If you stay up the entire night, there is something "different" about the world the next day. Something mystical and otherworldly about things. Sometimes, the combination of sleep deprivation and ativan can be really effective, since I tend to become a little overanxious if I lose sleep. It seems to make sleep deprivation a little easier to handle.
>
> LinkadgeThanks, it all makes better sense to me now.
~Jade
>
Posted by Hombre on June 30, 2010, at 22:56:41
In reply to Re: The biology of depression » linkadge, posted by jade k on June 30, 2010, at 19:33:16
Does anyone who has been depressed for along time "switch" to long term remission? I believe that one can switch to a hypomanic or even manic mood and back to depressed, but if the depression has gone on long enough to cause changes to the body and mind, can one just "switch" to remission with the right medication or therapy? Can we really consider hypomania or mania as a long-term solution?
Posted by jade k on June 30, 2010, at 23:37:19
In reply to Re: The biology of depression, posted by Hombre on June 30, 2010, at 22:56:41
Is this posted to me?
> Does anyone who has been depressed for along time "switch" to long term remission?
Certainly people "switch" to remission because its happened to me. I have seen people report/post long term remission using meds like Nardil and Parnate, I geuss I can't speak to what other posters ideas of a "switch" is in terms of time. For me, go to bed depressed, wake up in remission is a "switch". A bipolar 1 person can "switch" in less than an hour, sometimes looks instant.
> I believe that one can switch to a hypomanic or even manic mood and back to depressed, but if the depression has gone on long enough to cause changes to the body and mind, can one just "switch" to remission with the right medication or therapy?
In some cases I believe the answer is yes, with the right med. Especially in a person whose major depression came on suddenly (within say 24 hours).
> Can we really consider hypomania or mania as a long-term solution?
I'm not sure what you mean by that. Are you referring to an "artificial" fix, say with illegal drugs, narcotics, etc.?
My current treatment is a little outside the box and my hope is that it will "switch" me back to myself (meds, nutrition, exercise, etc). I geuss for me only time will tell. I feel good now :-)
I really don't know about a person who slowly becomes depressed, say months or years to get to MDD. That was not my experience.
~Jade
Posted by violette on July 1, 2010, at 12:10:17
In reply to Re: ...hope, beliefs, views (I'M DONE) » violette, posted by PartlyCloudy on June 30, 2010, at 11:24:59
Thanks Jade, Partly Cloudy, SLS for your kindess.
I think my behavior has been unacceptable to me. But the insight was a huge relief. After truly experiencing then conveying that feeling, for the first time in over a year, I was able to work at my computer for several hours without checking any mental health websites....
The OCD urge just disappeared. Then I got more insights after thinking about the long post I wrote on this thread--psychotherapy, which allows intense emotions to surface, is integrating the split off emotions that were buried as a child through defense mechanisms--integrating the emotions with my thoughts, which affects my actions.
I realized that the inight here occured when my left brain thinking (I knew why, from the thought/rational side, why I was doing this) was joined by my right brain-emotion I felt when coming back here and saying I can't believe I said that.... I FELT the motivations rather than only the thought of it.
So, in writing that post, I realized this is why psychotherapy is so effective for me--and, how insights arise--when the left brain joins with the right brain, the true insight occurs-the insight which allows for the underlying urges/impulses/behavior to stop or change. The repeated emotional feeling promoted in psychodynamic therapy is what's causing the real change; it's integrating my mind and self.
There are too many triggers for me here as far as the medication board and administration board, which was influencing me. So I'll be alright just sticking with psychology, instead of writing here or on admin. The motivations went away. I'm really delighted and relieved. Except I'm excusing myself for this post so that others may understand the background and why I felt so strongly about this.
One trigger has been when people don't believe that emotions affect mental health. This is personal to me since my mother has caused me great harm in not recognizing she has emotional problems. This has nothing to do with anyone here, it's my issue; but unfortunately, I was concerned that acting out on my issue was affecting people here because I know I have been trying to (sometimes covertly) coerce others to look at emotions--even when they didn't express their interest in doing so.
Since I see how when I had dissociated in the past, or had semi-psychosis-an emotion always caused the brain change rather than the other way around. I guess you have to experience it for yourself to understand. Sometimes after feeling certain painful emotions, my brain is flooded with what feels like opiates, endorphins, or whatever chemical....so the chemical change in my brain is always AFTER the emotion....not before..so it is difficult for me to always read personal views that an emotional reaction such as depression for example-could ONLY come after the chemical/neuro changes rather than the possibility that it might come before. I couldn't possibly know if that's true or not, but that has been a trigger for me to write certain things. Again, this is my issue so I realized I was getting excessive about wanting others to look more at emotions. And I don't want my behavior to affect others in an adverse way.
This has been very positive for me. There is more to the OCD stuff than just that one trigger, but it mostly comes from there. However, the OCD urges to write comments on Medication and Administration have stopped..but I did have to let you know where I was coming from. Yes, there are just too many triggers in those areas for me, and I don't want other people to be affected by my 'issues'...Thanks for understanding!
Violette
Posted by jade k on July 1, 2010, at 19:47:07
In reply to Re: The biology of depression, posted by linkadge on June 30, 2010, at 19:15:02
Just one more thing if you're still around...
>
> Sleep deprivation can also be pro-convulsant, which is also consistent with an antidepressant, or promanic effect.I know from experience that the above is true. But in the case of siezure activity and mania that presents as rage, is it still SD/dopamine related? If not, fatigue and exhaustion don't seem to fit as both conditions (siezure, manic-rage) look like a kind of hyper active state has been triggered.
So what has the SD caused in these cases (if not dopamine activity)?
>>
> If you stay up the entire night, there is something "different" about the world the next day. Something mystical and otherworldly about things.YES! I've experienced that too a few times. (babies cured me of it)
~Jade :-)
>
> Linkadge
>
Posted by inanimate peanut on July 2, 2010, at 19:06:52
In reply to Re: The biology of depression, posted by Dinah on June 30, 2010, at 13:35:28
That's interesting, because that would explain why NOTHING causes switching in me anymore. I used to be able to use sleep deprivation, extreme stress, exercise, a new med, etc. to switch out of severe depression. Now at the same time we can't seem to find a med that works, the other "jolts" don't work either. Maybe my brain just doesn't have the potential to be jolted and switched anymore, by meds or anything else. That's just depressing.
Posted by linkadge on July 2, 2010, at 19:56:52
In reply to Re: The biology of depression » linkadge, posted by jade k on July 1, 2010, at 19:47:07
>I know from experience that the above is true. >But in the case of siezure activity and mania >that presents as rage, is it still SD/dopamine >related? If not, fatigue and exhaustion don't >seem to fit as both conditions (siezure, manic->rage) look like a kind of hyper active state has >been triggered.
>So what has the SD caused in these cases (if not >dopamine activity)?
Hard to say - I really don't know enough. There is more involved in the AD effect of sleep deprivation than just dopamine augmentation.
A boost in thyroid (as can occur with SD) would augment serotonergic / noradrenergic function. Thyroid can sometimes increase irritability. Studies suggest that SD increases the firing of DRN serotonergic neurons. This could increase irritability and / or the feelings of imperitiveness / goal directedness. I think there is some effect (slowing) on glutamate reuptake which could have an AD / proconvulsant effect. SD tends to be a PET activator, although decreases in limbic metabolism have also been noted too.
I know that when I miss a night of sleep, I get really driven to completely finish whatever it was that was bothering me enough to keep me up.
I personally think the efficacy of the MAOI's is partially due to the profound disruption of sleep cycles. I remember on parnate, I could only sleep about 3-4 hours and it was very broken. I started to become mildly psychotic and paranoid - scarry feelings. But at the same time it was great. I had never had such a complete resolution of anhedonia.
Linkadge
Posted by linkadge on July 2, 2010, at 20:24:20
In reply to Re: The biology of depression » Dinah, posted by inanimate peanut on July 2, 2010, at 19:06:52
>That's interesting, because that would explain >why NOTHING causes switching in me anymore. I >used to be able to use sleep deprivation, >extreme stress, exercise, a new med, etc. to >switch out of severe depression. Now at the same >time we can't seem to find a med that works, the >other "jolts" don't work either. Maybe my brain >just doesn't have the potential to be jolted and >switched anymore, by meds or anything else. >That's just depressing.
Hmm. I think the brain has to feel legitimately threatened in order to get that jolt. For some people, its a near death experience like a car accident. With drugs, part of the problem they don't work for me is that I doubt their effectivenss. 10 years back I really believed they could do something, now I just think they are placebos.
The older you get, and the more you have seen, the harder it is to feel threatened. Plus, I think the brain becomes somewhat desensitized to novelty.
Some things I have done to try and restore the jolt:
1) Fasting / meal skipping
2) Extreme nutritional binges
3) Exercise
4) Cold showers
5) Stay up all night drinking coffee
6) Walk the whole day
7) NMDA antagonists (magnesium / zinc etc)
8) insulin sensitizers, ALA, chromium, cinnamon
9) anticholinergics while listening to strange
new age music
10) turmeric
11) fo-ti (herbal MAO-B inhibitor) + plus coffee
12) fo-ti + anticholinergic (very strange)
13) anitcholingeric + methylphenidate
14) stimulating right hemisphere with a hand heald speaker magnet (I stand behind this), though nobody believes me that this does anything - try it.
15) melatonin (seems to have a potent restorative effect)etc.
I think the meal skipping is a good one. For me its a great way to get back into the zone.
If you start to do too much of this, people think you're bipolar. Perhaps bipolar is just extreme depression coupled with a hypervigilant side which tries (usually ineffectively) to blow the depression away.
Linkadge
Posted by jade k on July 2, 2010, at 20:56:15
In reply to Re: The biology of depression, posted by linkadge on July 2, 2010, at 20:24:20
>
> Hmm. I think the brain has to feel legitimately threatened in order to get that jolt. For some people, its a near death experience like a car accident. With drugs, part of the problem they don't work for me is that I doubt their effectivenss. 10 years back I really believed they could do something, now I just think they are placebos.
>
> The older you get, and the more you have seen, the harder it is to feel threatened. Plus, I think the brain becomes somewhat desensitized to novelty.
>
> Some things I have done to try and restore the jolt:
>
> 1) Fasting / meal skipping
> 2) Extreme nutritional binges
> 3) Exercise
> 4) Cold showers
> 5) Stay up all night drinking coffee
> 6) Walk the whole day
> 7) NMDA antagonists (magnesium / zinc etc)
> 8) insulin sensitizers, ALA, chromium, cinnamon
> 9) anticholinergics while listening to strange
> new age music
> 10) turmeric
> 11) fo-ti (herbal MAO-B inhibitor) + plus coffee
> 12) fo-ti + anticholinergic (very strange)
> 13) anitcholingeric + methylphenidate
> 14) stimulating right hemisphere with a hand heald speaker magnet (I stand behind this), though nobody believes me that this does anything - try it.
> 15) melatonin (seems to have a potent restorative effect)
>
> etc.
>
> I think the meal skipping is a good one. For me its a great way to get back into the zone.
>
> Linkadge
Wait...didn't we have a board intervention for you? You have six pack abs and zero body fat?
No more meal skipping for you ;-P~Jade
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