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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 17 to 41 of 74. Go back in thread:
Posted by Raisinb on March 24, 2012, at 22:53:21
In reply to This just in: psychiatry sucks, posted by Christ_empowered on March 24, 2012, at 15:16:41
Posted by Raisinb on March 24, 2012, at 22:54:45
In reply to Re: new pdoc says there 'are no answers' » raisinb, posted by sleepygirl2 on March 24, 2012, at 15:33:16
I Think so too, Sleepygirl. I do want to take meds; I just want the person prescribing them to be honest about the huge limitations of the profession.
Posted by Raisinb on March 24, 2012, at 23:00:43
In reply to Re: In defence of medications... » TiredofChemicals, posted by Shes_Initforthemoney on March 24, 2012, at 22:33:46
I think I'm someone who needs meds. I've just been frustrated by revolving door diagnoses, multiple pdocs who tell me, authoritatively, that I am THIS DISORDER, then the meds that are supposed to fix that disorder don't work or make things worse, then I read and read, and realize that most of the time they're talking out of their butts.
I found it oddly reassuring to meet a pdoc who admitted that they didn't know anything.
Interestingly, my mom had the exact opposite reaction. She was furious. She wants my doctors to relieve my suffering *now* and thinks it's irresponsible and uncaring to tell someone you don't have the answers. She said, "you've been in therapy for eight f****king years!"
Posted by Phillipa on March 25, 2012, at 0:10:01
In reply to Well, I didn't mean it to be an anti med thread., posted by Raisinb on March 24, 2012, at 23:00:43
Now that's a Mom!!!! Phillipa
Posted by sigismund on March 25, 2012, at 3:12:04
In reply to Well, I didn't mean it to be an anti med thread., posted by Raisinb on March 24, 2012, at 23:00:43
>I found it oddly reassuring to meet a pdoc who admitted that they didn't know anything.
Yes.
My psych shared not only his low opinion of psych drugs but his qualified opinion of humanity. We get on very well and I look forward to seeing him. He constantly amuses me, as when I was going to Vietnam and said I might be able to but tandospirone (relative of Buspar) OTC. He said 'Or something really useful like opium'. And 'We live under a Methodist dispensation.'
Posted by SLS on March 25, 2012, at 4:43:50
In reply to new pdoc says there 'are no answers', posted by raisinb on March 24, 2012, at 9:01:20
What is meant by the word "answer", anyway?
I have been so blessed. My current doctor has always had answers, even though most of them proved ineffective. In other words, my doctor never gave up on the idea that he could get me well. He always strove to come up with an idea for something different for me to try, even if it meant using an old drug in a new way. Sometimes, one of his answers was a simple "yes" when I asked him to try one of my answers.
The question that my doctor did not answer was the one I had learned not to ask.
"Will I ever get well?"
I believe that it is rarely true that there "are no answers". However, it is true that there "are no guarantees".
It is rarely true that one can guarantee that there will be no answers.
It turned out that one of my doctor's "answers" has produced a marked improvement in my condition that has lasted several months. Of course, there is no guarantee that this therapeutic response will continue. The only thing that is certain is that as I write this last sentence, I feel wonderful.
- Scott
Posted by linkadge on March 25, 2012, at 7:23:23
In reply to Re: new pdoc says there 'are no answers', posted by SLS on March 25, 2012, at 4:43:50
The only problem with them being honest, is that they risk loosing the placebo effect - and hence, most of their buisness.
Linkadge
Posted by SLS on March 25, 2012, at 7:29:53
In reply to Re: new pdoc says there 'are no answers', posted by linkadge on March 25, 2012, at 7:23:23
> The only problem with them being honest, is that they risk loosing the placebo effect - and hence, most of their buisness.
How often has the placebo effect worked for you?If never, then why not?
If so, then why did you not remain well?
- Scott
Posted by raisinb on March 25, 2012, at 12:04:40
In reply to Re: Well, I didn't mean it to be an anti med thread. » Raisinb, posted by Phillipa on March 25, 2012, at 0:10:01
Posted by raisinb on March 25, 2012, at 12:05:49
In reply to Re: new pdoc says there 'are no answers' » linkadge, posted by SLS on March 25, 2012, at 7:29:53
Posted by zazenducke on March 25, 2012, at 13:29:59
In reply to Re: new pdoc says there 'are no answers' » linkadge, posted by SLS on March 25, 2012, at 7:29:53
Scott how can you prove that the good feelings you are having now are NOT a placebo effect?
What would change for you if that could be proven?
I join with the others in wishing you only the best and may the Lord restore to you the years lost to the locusts.
> > The only problem with them being honest, is that they risk loosing the placebo effect - and hence, most of their buisness.
>
>
> How often has the placebo effect worked for you?
>
> If never, then why not?
>
> If so, then why did you not remain well?
>
>
> - Scott
Posted by LostBoyinNCReturns on March 25, 2012, at 13:39:45
In reply to new pdoc says there 'are no answers', posted by raisinb on March 24, 2012, at 9:01:20
There are still things to try. Many are non psychiatric.
For starters, have you seen a good sleep medicine specialist, one who is board certified in sleep medicine? Preferably a pulmonary based sleep specialist. Even mild sleep apnea can have profound negative effect on your mood, cause anxiety and the sleep deprivation sleep apnea causes has even been found to sometimes cause psychosis.
Being diagnosed with sleep apnea and getting put on CPAP moved me from the "hardcore" TRD category to the "able to work and much more normal" category. Im telling you, CPAP changed my life. Again, even if it is MILD sleep apnea, TREAT IT with CPAP if you have a mood disorder!
Also, a full battery endocrinology workup, I pushed some of my doctors years ago and found out I have low testosterone. CPAP seems to have increased my T levels a little, but it is still in the extreme low normal ranges. Thyroid is the other biggie.
Also, mild anemia can cause nasty chronic fatigue that is oftentimes overlooked and ignored by both GP docs and by psychiatrists. Vitamin D deficiency is also something that can cause low mood.
There are so many things that you can get checked out for, the odds are at least one of them will come back negative and your psychiatrist will act embarrassed about it when you tell them. Mine did.
Relying on psychiatry only is like relying upon the federal government, it is a joke. You have to combine psychiatry with other branches of medicine, sleep medicine, endocrinology, GP docs to get results. It takes a lot of work, a lot of money and a lot of medical testing and seeing a lot of specialists. And you have to do it yourself, your Pdoc will almost never refer you to the specialists you need to see.
Eric
Posted by LostBoyinNCReturns on March 25, 2012, at 13:50:57
In reply to Re: This just in: psychiatry sucks, posted by TiredofChemicals on March 24, 2012, at 20:28:05
That has been my experience, overall. So you have to take matters into your own hands. A really good place to start is with a consultation with a good pulmonary based sleep specialist and a sleep study. If you have even mild sleep apnea or something like RLS or PLMD, and then take meds on top without treating the apnea with CPAP, it is like building a house without a sturdy foundation built first underneath.
Same analogy goes with ANY endocrinology problem you might have, thyroid, type II diabetes, low testosterone.
Same analogy goes for anemia, iron deficiency (even mild deficiency), vitamin D deficiency (very common, scientists believe most Westerners are vitamin D deficient), B-12 deficiency.
If you have any of this stuff, your response to meds is most likely to be lackluster.
Finally, if your life situation just plain sucks, if your environment just is absolutely awful, if you have severe financial problems, vocational problems, relationship or family problems, then yeah you are probably gonna be basically an unhappy person no matter what you do. So you gotta change your environment for a positive one while hitting it hard with every biological treatment there is that you should be getting. And the odds are your shrink will ONLY focus on the psych aspects and will ignore or even resentful of any physical problems that cause mood problems, like CPAP for sleep apnea.
Eric
Posted by Lou Pilder on March 25, 2012, at 15:12:44
In reply to Re: new pdoc says there 'are no answers' » SLS, posted by zazenducke on March 25, 2012, at 13:29:59
> Scott how can you prove that the good feelings you are having now are NOT a placebo effect?
>
> What would change for you if that could be proven?
>
> I join with the others in wishing you only the best and may the Lord restore to you the years lost to the locusts.
>
>
>
>
> > > The only problem with them being honest, is that they risk loosing the placebo effect - and hence, most of their buisness.
> >
> >
> > How often has the placebo effect worked for you?
> >
> > If never, then why not?
> >
> > If so, then why did you not remain well?
> >
> >
> > - Scott
>
> zzduck,
You wrote,[...how can you prove...NOT a placebo effect?...].
You have introduced an important concept here. It is a concept that marketers have used for hundreds of years. The people selling the stuff would go from town to town and advertise that they are selling "alligator oil" and by taking it one would be cured of baldness. They would have smiling ladies and men with hair that they pay to make people think that they were once bald and grew hair. They say in their presentation that you take it for 2 weeks and then you will see results. And they have a person that really grew hair after taking the alligator oil give their testimonial. Now this is before television.
So a lot the bald people in the town buy the allligator oil and take it twice a day with meals. And days later a lady sees that he has hair growing where he was bald. She claims that the alligator oil made her grow hair. But unbeknownst to her, she had a condition that caused baldness that went away on its own and the alligator oil was not what caused his hair to grow back, for none of the other people in the town grew hair. But by knowing the succsess of the one person, which they thought was caused by the alligator oil, they thought that they had to keep taking it longer. So they kept taking it and unbeknownst to them there was an addictive constituant in the bottle of alligator oil. So they went to the next town to find the huckster and buy more of the alligator oil to avoid the withdrawal. Each day they had the hope of growing hair and as thousands of people bought the huckster's bottles of alligator oil, there became by chance, others that grew hair because their loss of hair was due to a medical condition that went away on its own, but they thought that the alligator oil was what caused their hair to grow. So over thousands of people, a few grew hair and they became the testimonials for the huckster and appeared in the shows to tell peiple that they grew hair from the alligator oil. Some people even grew hair by what is like a {conversion reaction} sort of like a placebo but different. But the alligator oil had no constituant in it to cause hair to grow, only an addictive substance to make people keep buying it. This was usually alcohol.
Now when you see the smiling faces on the television commercials, remember the huckster.
See you later, (redacted by respndent).
Lou
Posted by TiredofChemicals on March 25, 2012, at 16:04:13
In reply to Re: you have to look outside of psychiatry, posted by LostBoyinNCReturns on March 25, 2012, at 13:39:45
> There are still things to try. Many are non psychiatric.
>
> For starters, have you seen a good sleep medicine specialist, one who is board certified in sleep medicine? Preferably a pulmonary based sleep specialist. Even mild sleep apnea can have profound negative effect on your mood, cause anxiety and the sleep deprivation sleep apnea causes has even been found to sometimes cause psychosis.
>
> Being diagnosed with sleep apnea and getting put on CPAP moved me from the "hardcore" TRD category to the "able to work and much more normal" category. Im telling you, CPAP changed my life. Again, even if it is MILD sleep apnea, TREAT IT with CPAP if you have a mood disorder!
>
> Also, a full battery endocrinology workup, I pushed some of my doctors years ago and found out I have low testosterone. CPAP seems to have increased my T levels a little, but it is still in the extreme low normal ranges. Thyroid is the other biggie.
>
> Also, mild anemia can cause nasty chronic fatigue that is oftentimes overlooked and ignored by both GP docs and by psychiatrists. Vitamin D deficiency is also something that can cause low mood.
>
> There are so many things that you can get checked out for, the odds are at least one of them will come back negative and your psychiatrist will act embarrassed about it when you tell them. Mine did.
>
> Relying on psychiatry only is like relying upon the federal government, it is a joke. You have to combine psychiatry with other branches of medicine, sleep medicine, endocrinology, GP docs to get results. It takes a lot of work, a lot of money and a lot of medical testing and seeing a lot of specialists. And you have to do it yourself, your Pdoc will almost never refer you to the specialists you need to see.
>
> EricI gotta get my CPAP working again..... I keep telling my self that anyways. I never got use to it in the beginning.
Posted by Lou Pilder on March 25, 2012, at 16:52:29
In reply to Lou's response-plehseaboh » zazenducke, posted by Lou Pilder on March 25, 2012, at 15:12:44
> > Scott how can you prove that the good feelings you are having now are NOT a placebo effect?
> >
> > What would change for you if that could be proven?
> >
> > I join with the others in wishing you only the best and may the Lord restore to you the years lost to the locusts.
> >
> >
> >
> >
> > > > The only problem with them being honest, is that they risk loosing the placebo effect - and hence, most of their buisness.
> > >
> > >
> > > How often has the placebo effect worked for you?
> > >
> > > If never, then why not?
> > >
> > > If so, then why did you not remain well?
> > >
> > >
> > > - Scott
> >
> > zzduck,
> You wrote,[...how can you prove...NOT a placebo effect?...].
> You have introduced an important concept here. It is a concept that marketers have used for hundreds of years. The people selling the stuff would go from town to town and advertise that they are selling "alligator oil" and by taking it one would be cured of baldness. They would have smiling ladies and men with hair that they pay to make people think that they were once bald and grew hair. They say in their presentation that you take it for 2 weeks and then you will see results. And they have a person that really grew hair after taking the alligator oil give their testimonial. Now this is before television.
> So a lot the bald people in the town buy the allligator oil and take it twice a day with meals. And days later a lady sees that he has hair growing where he was bald. She claims that the alligator oil made her grow hair. But unbeknownst to her, she had a condition that caused baldness that went away on its own and the alligator oil was not what caused his hair to grow back, for none of the other people in the town grew hair. But by knowing the succsess of the one person, which they thought was caused by the alligator oil, they thought that they had to keep taking it longer. So they kept taking it and unbeknownst to them there was an addictive constituant in the bottle of alligator oil. So they went to the next town to find the huckster and buy more of the alligator oil to avoid the withdrawal. Each day they had the hope of growing hair and as thousands of people bought the huckster's bottles of alligator oil, there became by chance, others that grew hair because their loss of hair was due to a medical condition that went away on its own, but they thought that the alligator oil was what caused their hair to grow. So over thousands of people, a few grew hair and they became the testimonials for the huckster and appeared in the shows to tell peiple that they grew hair from the alligator oil. Some people even grew hair by what is like a {conversion reaction} sort of like a placebo but different. But the alligator oil had no constituant in it to cause hair to grow, only an addictive substance to make people keep buying it. This was usually alcohol.
> Now when you see the smiling faces on the television commercials, remember the huckster.
> See you later, (redacted by respndent).
> Lou
>
> Friends,
The influence of advertising in television is enormous. But it is what is not seen in the commercials that could cost one their life or get a life-ruining condition or addiction.
Here is a commercial that I would like interested members to view.
Lou
To view this video;
A. Pull up Google
B. Type in:
[youtube, Pharmaceutical drug commercials]
Usually the first...time is 3 min...posted on Feb 12 2009...animation
Posted by zazenducke on March 25, 2012, at 17:22:30
In reply to Re: Most psychiatrists are lazy, posted by LostBoyinNCReturns on March 25, 2012, at 13:50:57
I would stop using aspartame if you haven't already.
Posted by emmanuel98 on March 25, 2012, at 18:24:55
In reply to Re: Most psychiatrists, posted by zazenducke on March 25, 2012, at 17:22:30
This is essentially what my p-doc says. I have a mood disorder, he says, call in bipolar 3c or whatever you want. We have tried various medications with various success (AAPs worked great but made me very fat. DBT has helped a lot. This was something he insisted upon, believing that if meds don't work or work well enough, it helps to learn to control your reaction to your mood swings.
Posted by SLS on March 25, 2012, at 19:00:46
In reply to Re: new pdoc says there 'are no answers' » SLS, posted by zazenducke on March 25, 2012, at 13:29:59
> Scott how can you prove
I didn't know I was supposed to prove anything.
> that the good feelings you are having now
How kind of you to notice.
> are NOT a placebo effect?
What's your opinion?
> What would change for you if that could be proven?
Nothing.
> I join with the others in wishing you only the best and may the Lord restore to you the years lost to the locusts.
Thanks.
- Scott
Posted by SLS on March 25, 2012, at 19:09:09
In reply to Re: Most psychiatrists, posted by emmanuel98 on March 25, 2012, at 18:24:55
> believing that if meds don't work or work well enough, it helps to learn to control your reaction to your mood swings.
Yes. I found that to be very important in my fight to stay alive. CBT was very helpful in this regard.
- Scott
Posted by zazenducke on March 25, 2012, at 19:31:39
In reply to Re: new pdoc says there 'are no answers' » zazenducke, posted by SLS on March 25, 2012, at 19:00:46
> > Scott how can you prove
>
> I didn't know I was supposed to prove anything.
>I certainly wasn't suggesting you were "supposed" to prove anything.
> > that the good feelings you are having now
>
> How kind of you to notice.I was very happy to see you reporting that you felt well. I've always tried to treat you kindly. I'm glad I succeeded.
>
> > are NOT a placebo effect?
>
> What's your opinion?I don't know. I don't think anyone really does. Because how can you really prove it with something like depression for which nobody even knows the cause? I know I feel way better not using aspartame and I have no way of knowing if that's a placebo effect but if it is I welcome it. I also know that every time I start it again I feel the same kind of better when I quit. Would I have the same reaction in a blind test? I don't know. Can I prove it helps the depressed feelings? No not anymore than I can prove the depressed feelings exist.
>
> > What would change for you if that could be proven?
>
> Nothing.Sometimes I get the idea that some people believe it somehow lessens the reality of their pain if it is relieved by a placebo. I think if I believed I was cured by a placebo I'd be fascinated and also hope that the placebo effect could be evoked with something that would cause the least harm to myself and to others who might be inclined to try it themselves because of my experience. I also think it would fascinate me on a psychological level-probably because I have had way too much therapy;)
Posted by linkadge on March 25, 2012, at 19:46:52
In reply to Re: new pdoc says there 'are no answers' » linkadge, posted by SLS on March 25, 2012, at 7:29:53
>How often has the placebo effect worked for you?
>If never, then why not?
>If so, then why did you not remain well?Back in the late 90's I think celexa may have worked. Then I learned that they don't work, and they just stopped working.
Linkadge
Posted by SLS on March 26, 2012, at 6:11:11
In reply to Re: new pdoc says there 'are no answers', posted by linkadge on March 25, 2012, at 19:46:52
> >How often has the placebo effect worked for you?
> >If never, then why not?
> >If so, then why did you not remain well?
>
> Back in the late 90's I think celexa may have worked. Then I learned that they don't work, and they just stopped working.
>
> Linkadge
How do you account for amitriptyline?Listen, I don't mean to attack you so much as challenge your statement. I believe that the current backlash against antidepressants using the placebo argument is, for the most part, spurious.
- Scott
Posted by zazenducke on March 26, 2012, at 6:56:27
In reply to Re: new pdoc says there 'are no answers' » linkadge, posted by SLS on March 26, 2012, at 6:11:11
>
>
>
> Listen, I don't mean to attack you so much as challenge your statement. I believe that the current backlash against antidepressants using the placebo argument is, for the most part, spurious.
>
>
Believing the placebo argument is spurious of course would enhance the chances that one would obtain a robust placebo response. Which would be helpful if the placebo was harmless. But the chemicals marketed by the pharmaceutical companies cause a great deal of harm to a great many people as well as a great deal of profit for the companies.
Posted by SLS on March 26, 2012, at 7:19:16
In reply to Re: new pdoc says there 'are no answers' » SLS, posted by zazenducke on March 25, 2012, at 19:31:39
> > What's your opinion?
> I don't know. I don't think anyone really does.Well, the placebo effect has not remained unexplored in science. Dr. Frederick Quitkin performed some formal investigations of the placebo effect. He addressed its phenomenology and quantizisation. If you are interested, you can find his writings on the Web. Also, I have written quite a bit regarding the placebo phenomenon and what I believe to be its unintended inflation statistically resulting from poor screening for Major Depressive Disorder (MDD). The issue of placebo effect is complex and deserves more consideration than what I am disposed to give it here.
> Because how can you really prove it with something like depression for which nobody even knows the cause?
If you mean that the precise cascade of biological events involved in the evolution of MDD have not yet been elucidated, I would agree. If you mean that there is no evidence of any sort indicating that MDD does indeed represent a biologically driven pathology, I would disagree.
> Sometimes I get the idea that some people believe it somehow lessens the reality of their pain if it is relieved by a placebo.
Treatment with placebo is not necessarily "no treatment". With depression investigations, there is often quite a bit of emotional support present in the environment of the study. Sometimes, interacting with the personel administering the study is the first true positive human connection made by the patient since the onset of their illness. This is indeed therapeutic psychologically. Does this inflate the statistics for placebo response? You bet.
* "Depression" is not synonymous with "Major Depressive Disorder".
- Scott
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