Psycho-Babble Medication Thread 1073833

Shown: posts 1 to 25 of 30. This is the beginning of the thread.

 

What If We're Wrong About Depression?

Posted by Hugh on November 29, 2014, at 11:44:02

Ive always been struck by the fact that the treatment options did not seem to have dramatically improved over the course of decades, Dr. Canli told Op-Talk. I always had a feeling that somehow we seem to be missing the actual treatment of the disease.

He was intrigued by research showing a connection between depression and inflammation in the body, and he started to think about the known causes of inflammation among them pathogens like bacteria, viruses and parasites.

...

He believes researchers should compare tissue samples from depressed patients with those from non-depressed people, looking for evidence both of known pathogens and of new ones.

If successful, such a search could bring about big changes in depression treatment. Imagine if we had identified one or multiple pathogens that all are associated with major depression, Dr. Canli said. That could mean that at some point in the future a patient would present himself or herself at the doctors office and the first thing they would do is run a workup on the blood or stool sample to identify exactly which particular pathogens might be present, and then develop a very targeted treatment program to address exactly those.

One day, he suggests in his paper, research into infection and depression could even lead to a vaccine.

I think if we are open to new ideas and research approaches we should have a good chance of developing much better treatments for depression, he told Op-Talk. Im less hopeful that staying with the status quo is necessarily the way to go. Understanding how depression really works, for him, is key: I think we should try to really be innovative about discovering mechanisms. Once we can get at the mechanisms, I feel much more hopeful.

The complete article is here:

http://op-talk.blogs.nytimes.com/2014/11/26/what-if-were-wrong-about-depression

Dr. Canli's paper is here:

http://www.biolmoodanxietydisord.com/content/4/1/10

 

Re: What If We're Wrong About Depression? » Hugh

Posted by Phillipa on November 29, 2014, at 14:02:31

In reply to What If We're Wrong About Depression?, posted by Hugh on November 29, 2014, at 11:44:02

Do you have a facebook page? I ask as there is a facebook page where you can order your own labs. They also list the costs of each test you want to have done. And you paid and they write the prescription that is done at any lab corp around your area. And it bypasses insurance and doctors. If you want my real name so you can get this like on your page babblemail me. Phillipa (J B ) in real life

 

Re: What If We're Wrong About Depression? » Hugh

Posted by SLS on November 30, 2014, at 0:40:48

In reply to What If We're Wrong About Depression?, posted by Hugh on November 29, 2014, at 11:44:02

I think it is equally important to consider that inflammation might be the result of illness rather than its cause.

In bipolar disorder, hyperglutamatergic activity is seen in the frontal cortex. It seems to be the result of a deficiency in glial glutamate transporter (type 2) that would otherwise be able to clear synaptic glutamate. If this is an epigenetic phenomenon, I question the role that inflammation plays in the induction of glial transporter downregulation. To the contrary - excessive extracellular glutamate concentrations increase enzymes in the arachidonic acid cascade, leading to increases in neuronal inflammation in brain.

Genetic predisposition + chronic psychosocial stress -> epigenetic downregulation of glial glutamate transporter -> hyperglutamatergic state -> neurotoxicity -> arachidonic acid cascade response -> neuronal inflammation.

This scenario might not reflect reality, but it offers an alternate explanation whereby inflammation does not cause illness, but is the result of illness - much like inflammation is the result of a laceration injury produced by a sharp knife. We don't see inflammation picking up the knife and producing lacerations.

It is true that insect-borne pathogens can produce psychiatric symptom clusters, quite possibly via neuroinflammatory reactions. However, the similarities that exist in the symptomatologies of BD, MDD, SCH ADHD versus that of Lyme Disease. I do not think it is logical to assume that two people who present similar symptoms suffer from the same illness. Is the pathophysiology of BD the same as MDD, BD, or SCH?

It's 1:36 am, and my mind is getting mushy. I hope some of this made sense, even though other theories might offer more accurate


- Scott

 

Re: What If We're Wrong About Depression? » SLS

Posted by Phillipa on November 30, 2014, at 8:58:21

In reply to Re: What If We're Wrong About Depression? » Hugh, posted by SLS on November 30, 2014, at 0:40:48

So those last time tested band in the lymes test that remained positive although never had any of the symptoms of lymes disease could just be the IGG still showing positive for the bordelia sp?. I do know for myself that stress causes headaches which is inflammation of what? The brain or a muscle? So post stress the increase in the symptoms of stress is the body trying to eliminate the stress so to speak to bring one's homeostasis back into normal for the person? Scott you know too much for my brain to wrap itself around it all. Phillipa

 

Re: What If We're Wrong About Depression?Hugh/SLS » SLS

Posted by brynb on November 30, 2014, at 10:54:51

In reply to Re: What If We're Wrong About Depression? » Hugh, posted by SLS on November 30, 2014, at 0:40:48

I'm hopping on this thread half-awake, but I'm looking at Scott's formula (predisposition + chronic stress + variable?) and wonder how big a role conditioning, maybe OCD, playing the same loop in our conditioned heads over and over can be re-conditioned or un-conconditioned.

I've been in a pretty bad place for a while now (off/on/OFF) and spoke to a Buddhist friend who I meditated with yesterday and he kinda kicked the NLP into me, if that makes any sense to anyone at all. "I'm fine." "I'm great." "How are You?" "I'm not special, not different." Etc...

I still don't have a diagnosis, though technically (for disability purposes) I've never had a definitive diagnosis--I've been MDD w/ GAD, possibly Bi2 or Soft Bipolar, and here and there I've even heard MDD with Borderline Personality Disorder kicked in the mix (statistically I pray that's not it).

I'm in a tenuous place right now. I don't want to take additional meds, but I need to right now to get through a rough spot. I'm on 400mg Tramadol (hits the glutamate receptors and apparently turns on a good/the "right" switch for me), 20mg Lexapro, 8mg Ativan and now 75mg Seroquel. Seroquel has really been taking "the edge" off for me.

As far as feeling Bipolar or "manic," my mania--if we must call it that--is simultaneous with my depression more often than not. It's more hyper activity/fast talk/pacing, and is often triggered by meds (Neurontin, painkillers, too high a dose of Tramadol, etc.).

I'm a bit foggy this morning, but Hugh, your post got me thinking (really on how to change myself and my approach to depression) and Scott, what the proper storm or breeding ground is--both of which make me believe, that albeit through the most arduous efforts, can we potentially rewire ourselves for the better? Am I wrong--is it the Seroquel speaking?

-b

 

Re: What If We're Wrong About Depression?Hugh/SLS

Posted by alexandra_k on November 30, 2014, at 17:59:19

In reply to Re: What If We're Wrong About Depression?Hugh/SLS » SLS, posted by brynb on November 30, 2014, at 10:54:51

I think people are trying, but they haven't been able to find a mechanism like that.

It was a happy day for psychiatry when it was discovered that a subset of psychotic patients had a bacterial infection - Syphilis. That a course of anti-biotics was an effective cure.

Or even that there was a relatively effective medication (lithium) for a subset of cases of mania.

Inflammation... Hormones... All the rage right now. Either those or quantum indeterminacies. If you don't understand x and you don't understand y then maybe the two are related? There might be some principle there... Something about the minimisation of mysteries...

 

Re: What If We're Wrong About Depression?Hugh/SLS » alexandra_k

Posted by Phillipa on November 30, 2014, at 20:25:30

In reply to Re: What If We're Wrong About Depression?Hugh/SLS, posted by alexandra_k on November 30, 2014, at 17:59:19

Did you know that the same test for lymes is the same as for syphilis? Phillipa

 

Re: What If We're Wrong About Depression? » SLS

Posted by Hugh on December 1, 2014, at 14:03:20

In reply to Re: What If We're Wrong About Depression? » Hugh, posted by SLS on November 30, 2014, at 0:40:48

> I think it is equally important to consider that inflammation might be the result of illness rather than its cause.

I think Dr. Canli would agree with you. He's arguing that bacterial infections or viral infections or parasites can cause inflammation, which in turn can cause depression. I suffer from an inflamed colon at times, and when my colon becomes inflamed, my depression worsens. When my colon improves, so does my depression. Last fall I suffered from bronchitis for several weeks. When my lungs were inflamed, I became severely depressed. As my lungs improved, so did my depression.

 

Re: What If We're Wrong About Depression? » Phillipa

Posted by Hugh on December 1, 2014, at 14:10:55

In reply to Re: What If We're Wrong About Depression? » Hugh, posted by Phillipa on November 29, 2014, at 14:02:31

> Do you have a facebook page? I ask as there is a facebook page where you can order your own labs.

No, I'm not on Facebook. I've used healthcheckusa and privatemdlabs to do blood tests.

 

Re: What If We're Wrong About Depression?Hugh/SLS » brynb

Posted by Hugh on December 1, 2014, at 14:48:29

In reply to Re: What If We're Wrong About Depression?Hugh/SLS » SLS, posted by brynb on November 30, 2014, at 10:54:51

> I'm in a tenuous place right now. I don't want to take additional meds, but I need to right now to get through a rough spot.

Bryn,

I know you've done rTMS with Dr. Fruitman. You might see if he'd be willing to let you try rTMS with priming stimulation. Instead of receiving 10 hertz over the left prefrontal cortex (which you probably did), you'd have your right side treated. Priming stimulation means that you'd receive a brief exposure to 6 hertz, followed by a longer exposure to 1 or 2 hertz. This is sometimes more effective than the standard rTMS protocol. This article explains it:

http://www.chrysalistms.com/south-florida-tms-alternative-treatment-depression-dr-marsella-psychiatrist.html

Deep TMS is now available in NYC from these doctors:

http://www.brainsway.com/us/find-a-facility?distance[country]=us&distance[postal_code]=10018

I know of two neurofeedback clinicians in NYC who have very good reputations -- Mark Smith and Merlyn Hurd. Here are their sites:

http://www.neurofeedbackservicesny.com/newclients.html

http://www.nyneurofeedback.com

 

Re: What If We're Wrong About Depression?Hugh/SLS » Hugh

Posted by brynb on December 1, 2014, at 18:30:17

In reply to Re: What If We're Wrong About Depression?Hugh/SLS » brynb, posted by Hugh on December 1, 2014, at 14:48:29

Hugh-

Thanks as usual for your valuable info.

I'm strapped for cash & was unimpressed w tms/rtms.

Unfortunately, fruitman is nothing but an RX pad for me right now & it'll have to do.

Hope you're faring well :).

 

Re: What If We're Wrong About Depression?

Posted by Hugh on December 4, 2014, at 14:15:36

In reply to What If We're Wrong About Depression?, posted by Hugh on November 29, 2014, at 11:44:02

Here's another possible mechanism that causes depression:

http://www.medicalnewstoday.com/releases/285386.php

 

Re: What If We're Wrong About Depression? » Hugh

Posted by Phillipa on December 4, 2014, at 20:52:42

In reply to Re: What If We're Wrong About Depression?, posted by Hugh on December 4, 2014, at 14:15:36

Hence stress leads to depression . Phillipa

 

Re: What If We're Wrong About Depression? » Phillipa

Posted by Hugh on December 5, 2014, at 9:56:49

In reply to Re: What If We're Wrong About Depression? » Hugh, posted by Phillipa on December 4, 2014, at 20:52:42

It's how you handle stress that matters. I handle it very poorly, and avoid it whenever possible. But I have a sister who thrives on stress.

 

Re: What If We're Wrong About Depression? » Hugh

Posted by brynb on December 5, 2014, at 13:26:25

In reply to Re: What If We're Wrong About Depression? » Phillipa, posted by Hugh on December 5, 2014, at 9:56:49

I think that's a huge indicator. I shutdown; I simply can't cope w stress. And, it's become so entrenched neurologically I "feel/see" it before it hits, thus deepening my response further.

-b

 

Re: What If We're Wrong About Depression?

Posted by Phillipa on December 5, 2014, at 20:07:15

In reply to Re: What If We're Wrong About Depression? » Hugh, posted by brynb on December 5, 2014, at 13:26:25

Same here to me anticipatory anxiety. I almost create my own. I used to thrive also on stress but it was when working in nursing. I guess cause the stress was getting a patient well or solving a problem it was almost fun. How things changed . Phillipa

 

Re: What If We're Wrong About Depression? » brynb

Posted by SLS on December 5, 2014, at 20:11:56

In reply to Re: What If We're Wrong About Depression? » Hugh, posted by brynb on December 5, 2014, at 13:26:25

A lack of resilience has been linked to an overactive medial prefrontal cortex (mPFC). This might explain the efficacy of deep brain stimulation (DBS) to treat depression. "Stimulation" is a misnomer. DBS actually interrupts - or "jams" - neuronal signals to prevent overactivity.

Mindfulness training and regular meditation might be helpful. Both seem to reduce mPFC activity and the strength of neural connections there.

http://www.forbes.com/sites/alicegwalton/2014/05/28/brain-study-shows-why-stress-triggers-depression-in-certain-people/

Have you ever tried Lamictal or Topamax? I am guessing that drugs that reduce glutamatergic neurotransmission would help reduce mPFC overactivity, and thus, depression. I am also guessing that both of these drugs might work better when combinined with Abilify.


- Scott

 

Re: What If We're Wrong About Depression?

Posted by baseball55 on December 5, 2014, at 21:10:37

In reply to Re: What If We're Wrong About Depression? » brynb, posted by SLS on December 5, 2014, at 20:11:56

Stress is not an issue for me and never has been. I deal well with stress, am energized by it and find I rise to the stressful situation and am pleased with myself.

But I still have MDD. I do not feel stressed when I am depressed. I feel hopeless and avoid life, including stressful events that might, in fact, make me feel better.

Maybe for some people, stress leads to depression. But not for me.

 

Re: What If We're Wrong About Depression? » baseball55

Posted by SLS on December 6, 2014, at 6:13:25

In reply to Re: What If We're Wrong About Depression?, posted by baseball55 on December 5, 2014, at 21:10:37

> Stress is not an issue for me and never has been. I deal well with stress, am energized by it and find I rise to the stressful situation and am pleased with myself.
>
> But I still have MDD. I do not feel stressed when I am depressed. I feel hopeless and avoid life, including stressful events that might, in fact, make me feel better.
>
> Maybe for some people, stress leads to depression. But not for me.

It definitely can, though. This is especially true in adolescence, where chronic anxiety is sometimes considered prodromal to depression. However, a lack of resilience is not necessarily the result of any one extant stressful situation. It can occur as a "learned helplessness" that yields depression in anticipation of inescapable tasks or situations, especially when exposure to the stressor is repeated.

There is no ONE depression. Depression has many presentatons, and, perhaps, many psychoneurologial etiologies. I don't doubt that you experience eustress that enhances your ability to perform. I also don't doubt that you have sucessfully resisted becoming passive and avoided surrendering yourself to unwelcome challenges.

I avoid life because I have very little energy to move about and have nothing to say in social situations. I experience anxiety - which is probably amplified by my illness - because I feel so uncomfortable staring into space while being mute and unresponsive to other people. I shut down when I cannot extricate myself from such circumstances. For the moment, the shocks are inescapable. I become very passive. I give up. I have lost resilience.

Resilience is not equivalent to the absence of anxiety. Resilience can diminish in the absence of anxiety.


- Scott

 

Re: What If We're Wrong About Depression? » SLS

Posted by Twinleaf on December 6, 2014, at 8:44:38

In reply to Re: What If We're Wrong About Depression? » baseball55, posted by SLS on December 6, 2014, at 6:13:25

Scott, this might be a time to consider therapy, which I know you have had in mind previously. A good relationship with one can truly heal that loss of social confidence which is vital for everyone.

 

Re: What If We're Wrong About Depression? » baseball55

Posted by Phillipa on December 6, 2014, at 9:01:43

In reply to Re: What If We're Wrong About Depression?, posted by baseball55 on December 5, 2014, at 21:10:37

I was that way till the stress burned out my thyroid and then couldn't handle stress. I will get a spurt to again venture into the waters and test my stress level and it knocks me back further even if it has a good outcome. For some reason the Yes I did it is non existant now. I simply burned out and that's it. But that part of me that is inside somewhere and used to be able to handle stresses of all kinds doesn't want to die. Phillipa

 

Re: What If We're Wrong About Depression? Phillipa » brynb

Posted by Hugh on December 6, 2014, at 17:47:28

In reply to Re: What If We're Wrong About Depression? » Hugh, posted by brynb on December 5, 2014, at 13:26:25

The stressful events I've been through have taken a lot out of me. "Feel the fear and do it anyway" has been terrible advice for me.

 

Stress doesn't have to be permanent

Posted by Twinleaf on December 6, 2014, at 17:54:05

In reply to Re: What If We're Wrong About Depression? » baseball55, posted by Phillipa on December 6, 2014, at 9:01:43

I disagree. There are a range of things you can choose to do to moderate stress, such as meditation, changing stressful interpersonal situations, rTMS, tianeptine, increasing your benzo doses moderately or engaging in genuinely helpful therapy (it could be DBT or interpersonal).

I think you may be discouraging newcomers and younger less knowledgable readers needlessly, as well as closing off constructive options for yourself. Even if you choose not to do anything, it wouldn't be accurate to convince others that there are no constructive options.

 

Re: What If We're Wrong About Depression? » Hugh

Posted by Phillipa on December 6, 2014, at 19:25:59

In reply to Re: What If We're Wrong About Depression? Phillipa » brynb, posted by Hugh on December 6, 2014, at 17:47:28

Hugh same here I heard this more than once from therapists and pdocs throughout the years and all it did was make me worse. Increasing meds isn't healthy either. The latest studies on benzos and other meds are all over the internet. Phillipa

 

Re: Interesting thoughts please long article

Posted by Phillipa on December 6, 2014, at 20:19:28

In reply to Re: What If We're Wrong About Depression? » Hugh, posted by Phillipa on December 6, 2014, at 19:25:59

http://www.newyorker.com/magazine/2014/01/27/the-prisoner-of-stress


Go forward in thread:


Show another thread

URL of post in thread:


Psycho-Babble Medication | Extras | FAQ


[dr. bob] Dr. Bob is Robert Hsiung, MD, bob@dr-bob.org

Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.