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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 15 of 15. This is the beginning of the thread.
Posted by linkadge on July 25, 2009, at 15:59:48
I was thinking about it and I have a hypothesis, that a lack of pleasure is the cause of all/most mental afflictions. When I say pleasure, I don't mean that selfish crack like hedonic overdrive, I mean the good pleasure (opiates?), where you just want to settle down and enjoy the moment.
For instance,
depression -
obviousdysphoric mania -
too much drive not enough settle down and feel ok in the momentanxiety -
too much pain, not enough pleasure (opiates have antianxiety properties)
OCD -
fueled by anxietyPTSD -
inability to turn off bad memories
increasing pleasure would either diminsh bad memories or put a positive spin on themeuphoric mania -
this one may be the exception. I think this is cause by simultanious high motivation and high pleasure. But, I think if you increased pleasure further, you would counterballance hypermotivation and end the mania (opiates actually have anitmanic effects)schizophrenia -
another possible exception, opiates do have antischiozphrenic effects in some case studies.
but this may be due to their effects on glumamte metabolismNote: all the SSRI's and TCA's have opioid like effects. Not that I am necessarily condoning opiates for mental illness.
Linkadge
Posted by SLS on July 25, 2009, at 16:16:39
In reply to Lack of pleasure: the cause of all mental illness?, posted by linkadge on July 25, 2009, at 15:59:48
> Note: all the SSRI's and TCA's have opioid like effects.
What is the mechanism behind this?
Thanks.
- Scott
Posted by Sigismund on July 25, 2009, at 16:54:34
In reply to Lack of pleasure: the cause of all mental illness?, posted by linkadge on July 25, 2009, at 15:59:48
The gerbils are certainly more sedate and civilised.
Posted by linkadge on July 25, 2009, at 17:13:00
In reply to Re: Lack of pleasure: the cause of all mental illness? » linkadge, posted by SLS on July 25, 2009, at 16:16:39
>What is the mechanism behind this?Not sure, the TCA's and venlafaxine have direct / indirect effects on mu, delta and kappa opioid receptors.
The SSRI's also have effects on the opiate system, but I'm not sure if there is a specific class effect here.
Linkadge
Posted by seldomseen on July 25, 2009, at 18:27:54
In reply to Lack of pleasure: the cause of all mental illness?, posted by linkadge on July 25, 2009, at 15:59:48
I think using the same logic, that mental illness is the source of lack of pleasure. The two are definately associated, but it's hard to say in which direction, if any, the causal diagram would flow.
Posted by Phillipa on July 25, 2009, at 21:26:21
In reply to Re: Lack of pleasure: the cause of all mental illness? » linkadge, posted by seldomseen on July 25, 2009, at 18:27:54
For some opiods do work I'm one as when hurt and on them felt wonderful. Isn't there a med that does the same thing? If so name please. My box of meds is overflowing with practically all the SSRI's that I never took. Phillipa
Posted by manic 666 on July 26, 2009, at 3:29:51
In reply to Re: Lack of pleasure: the cause of all mental illness?, posted by Phillipa on July 25, 2009, at 21:26:21
cool cartoon sig
Posted by Alexanderfromdenmark on July 27, 2009, at 11:10:52
In reply to Lack of pleasure: the cause of all mental illness?, posted by linkadge on July 25, 2009, at 15:59:48
> I was thinking about it and I have a hypothesis, that a lack of pleasure is the cause of all/most mental afflictions. When I say pleasure, I don't mean that selfish crack like hedonic overdrive, I mean the good pleasure (opiates?), where you just want to settle down and enjoy the moment.
>
> For instance,
>
> depression -
> obvious
>
> dysphoric mania -
> too much drive not enough settle down and feel ok in the moment
>
> anxiety -
> too much pain, not enough pleasure (opiates have antianxiety properties)
>
>
> OCD -
> fueled by anxiety
>
> PTSD -
> inability to turn off bad memories
> increasing pleasure would either diminsh bad memories or put a positive spin on them
>
> euphoric mania -
> this one may be the exception. I think this is cause by simultanious high motivation and high pleasure. But, I think if you increased pleasure further, you would counterballance hypermotivation and end the mania (opiates actually have anitmanic effects)
>
> schizophrenia -
> another possible exception, opiates do have antischiozphrenic effects in some case studies.
> but this may be due to their effects on glumamte metabolism
>
> Note: all the SSRI's and TCA's have opioid like effects. Not that I am necessarily condoning opiates for mental illness.
>
>
> Linkadge
>
I would say no. But Anhedonia plays a large in depression and assoctiated disorders. Other things that play a part in mental ilness can be too much attachtion to pleasure(addiction). I know before I was treated with SSRI's, I could feel pleasure from some things, but that I was also overly attachted to those pleasures. Now I have pretty bad anhedonia and it sucks big time. But I wouldn't say that's the sole cause of my depression.I would say trying to treat depression without treating anhedonia will never create real remession.
Posted by linkadge on July 27, 2009, at 12:58:30
In reply to Re: Lack of pleasure: the cause of all mental illness?, posted by Alexanderfromdenmark on July 27, 2009, at 11:10:52
>much attachtion to pleasure(addiction).
Thats not the kind of pleasure I am talking about. True pleasure leaves you satisfied, not wanting more.
Linkadge
Posted by Zana on July 28, 2009, at 16:11:37
In reply to Re: Lack of pleasure: the cause of all mental illness?, posted by linkadge on July 27, 2009, at 12:58:30
For me it's not doing things that would give me pleasure, living a meaningful life, doing things that would give me pleasure and I think it's a symptom of depression and perpetuates it as well. It's a real double bind, for me. I can't seem to get into gear to do things that would give me pleasure or satisfaction and as long as I don't do these things, I am going to be depressed. It's a terrible bind.
Zana
Posted by hyperfocus on July 28, 2009, at 17:44:24
In reply to Lack of pleasure: the cause of all mental illness?, posted by linkadge on July 25, 2009, at 15:59:48
I would say pain or hurt instead of lack of pleasure, but yes if you feel like you are unable to take pleasure in things for whatever reason it can be very stressful and traumatic. And yes when I experience hypomania the anxiety and intrusive thoughts and other symptoms get turned down a lot. I've never read an MI sufferer who wasn't helped greatly in some form by opiates.
Posted by morganpmiller on July 30, 2009, at 22:27:18
In reply to Lack of pleasure: the cause of all mental illness?, posted by linkadge on July 25, 2009, at 15:59:48
You don't think this is oversimplifying the cause/causes of mental illness?
Posted by bulldog2 on July 31, 2009, at 18:47:55
In reply to Lack of pleasure: the cause of all mental illness?, posted by linkadge on July 25, 2009, at 15:59:48
> I was thinking about it and I have a hypothesis, that a lack of pleasure is the cause of all/most mental afflictions. When I say pleasure, I don't mean that selfish crack like hedonic overdrive, I mean the good pleasure (opiates?), where you just want to settle down and enjoy the moment.
>
> For instance,
>
> depression -
> obvious
>
> dysphoric mania -
> too much drive not enough settle down and feel ok in the moment
>
> anxiety -
> too much pain, not enough pleasure (opiates have antianxiety properties)
>
>
> OCD -
> fueled by anxiety
>
> PTSD -
> inability to turn off bad memories
> increasing pleasure would either diminsh bad memories or put a positive spin on them
>
> euphoric mania -
> this one may be the exception. I think this is cause by simultanious high motivation and high pleasure. But, I think if you increased pleasure further, you would counterballance hypermotivation and end the mania (opiates actually have anitmanic effects)
>
> schizophrenia -
> another possible exception, opiates do have antischiozphrenic effects in some case studies.
> but this may be due to their effects on glumamte metabolism
>
> Note: all the SSRI's and TCA's have opioid like effects. Not that I am necessarily condoning opiates for mental illness.
>
>
> LinkadgeThere is a theory that some people who are depressed exhibit some disruption of the opioid part of the brain. They not only show lack of depression but also a greater sensitivity to pain.
These indiviuals respond to opiates and their depression is lifted. We must note that some normal individuals (not depressed) claim that opiates do not affect their mood. So it is reasonable to assume that some depressed people have malfunctioning opioid systems.
There is some evidence that tcas activate opioid parts of the brain through descending norepinephrine and serotonin pathways. For some reason tcas work much better for chronic pain than the ssris.I do feel that opiates can be a valid treatment for depression without waiting weeks for them to work. The patient has to learn not to chase the euphoria which will lead to addiction. Once the euphoria is gone at a particular dose the patient can still receive an antidepressant effect from the opiate.
I have been on oxycodone 10 mg 4 times a day for several months. The euphoria has long since gone away but the ad response still is fairly gone.
My p-doc and I are thinking of adding parnate to this mix as I had a partial response to parnate before. I think this might be a synergistic mix.
Oh and I also take neurontin 1200 mg twice a day. Works very well with the oxycodone.
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Posted by linkadge on July 31, 2009, at 19:23:11
In reply to Re: Lack of pleasure: the cause of all mental illness?, posted by bulldog2 on July 31, 2009, at 18:47:55
Norepinephrine transporter deficiant mice are supersensitive to the analgesic effects of opiates (for whatever reason).
Linakdge
Posted by sanders on March 25, 2011, at 10:45:49
In reply to Re: Lack of pleasure: the cause of all mental illness? » linkadge, posted by seldomseen on July 25, 2009, at 18:27:54
Holy cow it all got erased. Ok Betty Ford Center about 15 years ago-"scientists have found a difference in the pleasure center of the brain of future alcoholics before they take their first drink, they have less pleasure than people who never become alcoholics." The Bible mentions "God's pleasure" many times. He/they are "I am that I am" or free to do good, just because. Jesus' prayer-"Thank you for hiding the truth from those that think they are so wise and revealing it only to little children, but it pleased you to do it this way, father."(whatever that word means, I've never been a father) A liter of kittens we had- all were normal except one kitten, he was always wandering around looking for something, could not get much pleasure from socializing and meowed with anger at no one. My "sinner" friends say "that sounds like me." He was not aggressive toward others, I believe he had no viable target and was only running from the pain for 2-3 months before he was given away. I can remember using pictures and being a daydreamer to escape the pain since I was 7 yo. Heaven and Christianity made me fly. My sister told me I needed external stimuli as an infant and would rock from one foot to the next in my playpen when older. Stem cell treatment sounds good to me, I don't understand why psychosurgeries target different parts of the brain and not always the pleasure center. As I was reading the book Conversations with God II, the author says "God is going to speaak through you now," I said "give babies a pleasure pill so it doesn't evolve." Evolve into the DSM I guess. Of course I can't use this info except to hope that actual babies are to have pleasure and be ill from pain seldomly like normal functioning humans. I have deaths, suicides, decapitations, molestation claims, lives of loved ones spent in prison, victims of society, and people who's brain victimizes society in my life and would like to stop it. I have 3 suicide attempts also. Altruism is possible because of the magnitude of this issue and strong stimulants. I will be in a rage tomorrow, I hope not, but when I have nothing (depressed) I get rage. I understand that with strong stimulants I am medicating with pictures still. The opiate solution reminds me of "chasing the dragon" or increased number of receptors I guess. What about alternating stimulants and opiates?
This is the end of the thread.
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