![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 4 to 28 of 28. Go back in thread:
Posted by curtm on May 9, 2006, at 19:40:52
In reply to never going to feel better, posted by llrrrpp on May 9, 2006, at 17:01:32
Hi and welcome to babble!
>> I started seeing T 7 weeks ago, because I knew that I couldn't make depression go away on my own. I was still going downhill, and was really worried about what would happen if I didn't seek treatment. I started medicine 1 week ago (cymbalta).
Don't be discouraged. It is very early in your treatment. Hang in there. Things will get better, undoubtedly.
Posted by Racer on May 9, 2006, at 20:52:35
In reply to never going to feel better, posted by llrrrpp on May 9, 2006, at 17:01:32
There's no heirarchy of suffering, you know. If you're miserable, you're miserable -- and that's just exactly as valid as any other suffering on the planet, whether that's from an inoperable tumor or chipped nail polish. Which is my way of saying, get right over thinking there's anything wrong with you for getting help now, rather than waiting.
In fact, feel good that you admitted there was a problem and sought help NOW, rather than living in denial for months, or years.
As for the meds, depression is a disease -- but it's also not a disease, so much as a label for a group of symptoms. My guess is that one day, if a true cause is ever found for depression, they'll find that there are actually numerous causes for it -- some from lowered serotonin, some cases from norepinephrine imbalance, etc. Which means that you gotta play drugstore cowboy. Ain't no way around that sad fact. (Unless you want to take an MAOI, which targets everything.) And it's agony, no doubt about it, to have started a new drug, experience the adjustment phase effects, and still feel wretched. I'm sorry you're going through it, but be assured -- you've got company in it, even if we're not living next door to you.
But don't discount telling some people near you -- you'd be surprised how many people go through this and are too ashamed to tell anyone. It could be that half the people you know are suffering depression and the AD Carousel. Maybe if you bring it up with someone you trust, you'll find that IRL support.
And therapy is great. But it's a good news/bad news thing -- it often makes things worse on the way to making things better. The good news, though, is that no matter how horrendously bad I feel walking out of my therapist's office, and no matter how hopeless I sometimes feel -- I also feel such a profound sense of relief to have exposed whatever that trigger was to light. You know that old slogan, "You're only as sick as your secrets?" It applies, when it comes to depression. (At least it has for me.) So, exposing those "shameful" secrets is healing, especially because many of them turn out to be much less shameful than I'd thought.
Welcome to Babble. Feel free to lean on the board, there's always someone willing to offer something. And good luck.
Posted by llrrrpp on May 9, 2006, at 21:18:13
In reply to Re: never going to feel better » llrrrpp, posted by Racer on May 9, 2006, at 20:52:35
What is "drugstore cowboy"? Is there a theme song I need to know? Tumbleweed, buffalo, pistol fights? Do i get to wear cowboy boots & plaid shirts?
Trying to learn some new jargon so I can hang with the cool kids :)
Racer, I have one buddy that I talk to about this stuff, but he was lucky and has had no side effects and a very good response from lexapro. I dont think he had as many physiological symptoms of depression as I did, either (significant weight loss and profound insomnia). Plus, he is pretty bad about staying in touch, and then I feel like a rejected loser in my more mopey states, forgetting that other poeple have busy lives. Well, I will keep trying. Its a little tough though to talk with my other friends, because I work with them too. i work with a bunch of ferocious gossips, who would love to chit chat about my odd behavior. i dont think im strong enough for that right now.
peace and good night :)
Posted by madeline on May 10, 2006, at 6:37:07
In reply to maybe I can be a cowboy while I wait?, posted by llrrrpp on May 9, 2006, at 21:18:13
Sorry, "playing drug store cowboy" is a research term I use quite frequently in the lab. It refers to just trying a host of drugs on a sample until you get the desired effect. For instance, if you want to know what antibiotic kills a certain bacteria, you culture the bacteria and then hit it with a host of antibiotics to see which one works.
Shopping around for the the appropriate meds combo for depression strikes me a lot like playing drugstore cowboy in that way.
Is your primary "diagnosis" major depression? I'm a little concerned about the addition of seroquel in depression - I must admit. It's indicated for mania. Hmmm.
I would float that over on psychobabble (the meds board) and see what they think.
Posted by Larry Hoover on May 10, 2006, at 7:15:29
In reply to never going to feel better, posted by llrrrpp on May 9, 2006, at 17:01:32
Welcome, llrrrpp. How do you pronounce that? Do you have Martian blood, or did you marry into the bloodline?
> If I had cancer, I'd want to know about the biology of the illness. I feel like my doctors (T and pdoc working as a team) are giving me things to try and medicine to take, without telling me what to expect, or what's wrong with me.
Maybe there is a belief in them, about you, that you are competent to look after that part of the deal without too much of their help. An unspoken compliment. After all, you were wise enough to come here, and seek guidance.
> As a cognitive neuroscientist, I am happy to look up information on the internet,
Ahh! A fellow geekazoid. Tell us about your specialty?
> but I'm worried that I am biased and not objective. Much of the information I come across just makes me more anxious (so many of the studies are poorly designed and inconclusive, not to mention the conflicts of interest when a drug company is pushing their product and not publishing null results).
It sounds to me that you have a well-balanced sense of objectivity, to reach the conclusions with which you close out this quotation.
Yes, precisely, the studies are poorly designed. They are set up the way they are so that they can get the drug made legal. That is their primary task, to leap through hoops. The idea that they might actually be trying to learn something is ...well....quite civil of you to allow them. Any learning occurs by serendipity. Psych drugs are a business. They follow a business plan, not a treatment paradigm.
I'm not going to make any assumptions about what you've found or not found, online, so:
Best source of drug info, monographs: http://www.rxlist.com/
Always select the generic, once the drug is discovered in the results page. The monograph is attached to the generic link.Most all-around and detailed source of mental health information:
http://www.mentalhealth.com/
Doesn't limit itself to the DSM; includes not only ICD-10 literature, but also innovative hypotheses/treatmentsAlso, the entire Babble archives are more or less searchable by Google. Google will pull up lots of older material, but it misses things, for some reason.
Anyway, welcome aboard. Always great to see a fellow scientist around. I always learn stuff.
> I wish I had a buddy who was also feeling like a lab rat. The loneliness of it all is the worst.
If nothing else, my nascent friend, you're in a place where people can truthfully say, I think I know how you feel.
Lar
Posted by madeline on May 10, 2006, at 7:58:05
In reply to Re: I never say never » llrrrpp, posted by Larry Hoover on May 10, 2006, at 7:15:29
If I may, I am going to weigh in with my two cents.
I have a doctorate in pharmacology. I specialize in drug discovery and development. I am in academics, not big pharma. I want to comment on the following statement that you made.
"Yes, precisely, the studies are poorly designed. They are set up the way they are so that they can get the drug made legal. That is their primary task, to leap through hoops. The idea that they might actually be trying to learn something is ...well....quite civil of you to allow them. Any learning occurs by serendipity. Psych drugs are a business. They follow a business plan, not a treatment paradigm."
1. No clinical trial is ever perfect. Ever. The sample size simply can not be big enough to adequately predict the outcome. The FDA relies heavily on predictive statistics. We all know that there a lies, damn lies and statistics.
2. Never take a drug until it has been on the market for more than 5 years - 10 years is even better. This enables the field to do independent testing (and they do) and allows plenty of time for new side effects to come up. Do not be afraid of asking your pdoc how long a drug has been around.
3. Physicians are not pharmacologists. The drug companies do active recruiting to entice them to prescribe their meds. Patients have to be wary of this fact. There might be an older, safer drug that is just as effective. You have to do your own research.
4. Big pharma is not the evil empire. Yes they are in it to make money, but they help a lot of people. If it weren't for their capital resources, I can promise you, there would be a lot fewer options on the market today. Keep in mind big pharma discovered the SSRI's to begin with while most of the rest of the field was staggering in the dark.
I'm not defending the status quo, could it be improved? ABSOLUTELY! But I think no matter how many improvements are made, there is no replacing an informed consumer.
Maddie
Posted by llrrrpp on May 10, 2006, at 8:24:25
In reply to I never say never - advice from a pharmacologist » Larry Hoover, posted by madeline on May 10, 2006, at 7:58:05
Wow, this is getting spicy!
Lar. wanted to know my specialty. Well, the cogn. neuroscientist in me does functional brain imaging of language development. (fMRI).
Also, llrrrpp is actually an acronym. l.l.r.r.r.p.p., and lacking the full translation (confidential), I leave it up to my readers to use their vivid imaginations to fill in the blanks.
As far as statistics & research, well, I agree that depression is probably a heterogeneous disorder, and as such, perhaps we are dealing with several subtypes, if not several completely different disorders altogether. Maddie brings up an excellent point that independent field testing is definitely advantageous in terms of figuring out when, how and why to use different treatments (including therapy). I have a pretty strong faith in my pdoc, in this regard. He's won awards and has a lot experience as a researcher and a practitioner. I think he's pretty creative, and a nice person, but when someone who's at the top of his/her field acknowledges huge gaps in the literature, indeed in basic knowledge of mechanism of the disorder and the treatments, it's pretty scary. At any rate, thanks for your insights, and for the links to more information.
I think my next line of business, aside from getting my neurotransmitters tweaked, is to figure out exactly what therapy is all about. I'm not sure what my goals are, and what exactly I'm supposed to be talking about for 50 minutes once a week. For a while my main objective was to avoid crying at all costs. Well, the floodgates opened a few weeks back, so that silly goal has been abandoned. I feel like T and I are still getting to know each other. Part of me definitely resists sharing the darker twisted side with a relative stranger, but part of me desparately wants to get better and get on with what's left of my life. I'm pretty sure that we're working with a short-term therapy model, probably CBT, but my T is not completely wedded to any therapeutic approach.
Any thoughts?
Posted by curtm on May 10, 2006, at 9:08:43
In reply to I never say never - advice from a pharmacologist » Larry Hoover, posted by madeline on May 10, 2006, at 7:58:05
>> 3. Physicians are not pharmacologists. The drug companies do active recruiting to entice them to prescribe their meds. Patients have to be wary of this fact. There might be an older, safer drug that is just as effective. You have to do your own research.
** Do physicians recieve any "cut-backs" or discounts based on their volume of prescribing the newest drugs?
Posted by madeline on May 10, 2006, at 9:14:12
In reply to Re: I never say never - advice from a pharmacologist » madeline, posted by curtm on May 10, 2006, at 9:08:43
They can receive "rewards" for being the highest prescriber of a drug. It depends on the company, the drug etc... They range from trips to a new "effexor" pen.
However, I would like to point out that the vast majority of physicians that I know are very very ethical, moral people.
In fact, most of them hate the "drug reps" that continually visit their offices, hospitals etc...
At the hospital that I am affiliated with there are entire wards where drug reps are simply banned.
If you have concerns about a particular doc, ask them. Be sure you don't sound accusatory in any way though, as most docs are very sensitive about this and are again, very ethical very moral people.
Maddie
Posted by Poet on May 10, 2006, at 9:19:10
In reply to never going to feel better, posted by llrrrpp on May 9, 2006, at 17:01:32
Hi llrrrpp,
I've been taking seroquel for insomnia for a month and so far so good. Ambien completely stopped working and gabitril left me twitching, but wide awake. Seroquel is usually prescribed for bipolar or psychotic disorders, but anything that stops my racing thoughts long enough to knock me out is okay with me.
I've been taking effexor XR for two years and can't honestly say if it is still doing anything for me. I tapered down my dose (I know, not smart, but ex pdoc was over medicating me) and new pdoc (Dr. Clueless) is now helping me taper off it completely. I guess time will tell.
I've been in therapy for 3 1/2 years and can't recognize my own progress, but T sees it and people here see it, so it must exist.
I guess what I'm saying is I understand the search for what will work and the bumps along the way.
Welcome to babble. You'll like it here.
Poet
Posted by Racer on May 10, 2006, at 10:03:33
In reply to Re: I never say never - advice from a pharmacologi, posted by llrrrpp on May 10, 2006, at 8:24:25
> I feel like T and I are still getting to know each other. Part of me definitely resists sharing the darker twisted side with a relative stranger, but part of me desparately wants to get better and get on with what's left of my life. I'm pretty sure that we're working with a short-term therapy model, probably CBT, but my T is not completely wedded to any therapeutic approach.
>
> Any thoughts?Our new marriage counselor asked me how long I've been seeing my T, and I said, "it's been a year." She said, "That's a long time." I said, "That's so funny -- I feel as though we're just getting started!" It's a funny thing about therapy, it can hit you like that -- only getting started after a year, for example.
(NB: we have done a fair bit of work in that year. It's just that we've kinda hit our stride now.)
This has been a very interesting thread. And LLRRRPP, I wish you the best
Posted by Larry Hoover on May 10, 2006, at 10:59:37
In reply to I never say never - advice from a pharmacologist » Larry Hoover, posted by madeline on May 10, 2006, at 7:58:05
I do appreciate hearing all that you have said here, Maddie. I spent a few years under contract for one of the big NGOs, basically being the ultimate critic of all published work in specific and narrowly-defined environmental realms. My work permitted them to ask the right questions, you see. Things get changed when you ask the right questions, the right way. About one third of the studies I examined absolutely failed to support the published conclusions. Another third of the studies were suggestive, but inconclusive, notwithstanding the conclusions published (methodology/analysis problems). I'm feeling generous to offer that the remaining one third advanced our knowledge in any way. I do sometimes revive the cynical critical viewpoint in discussions here. Many mountains of opinion have been generated in response to molehills of data, and the culture we currently populate often allows the substitution of the opinion over the data themselves. An example is dietary advice. You don't know what to eat any more.
You've given excellent advice, that waiting a few years for experience with a new drug to come into existence, before joining with the rest of the guinea pigs, is preferable. To verify all the information you gather. To become an informed consumer. I think we're lucky, though, to have the training and experience to make those informed decisions.
I did not mean to vilify big pharma. The drug studies that are used to obtain FDA approval were never designed to collect data about e.g. suicide or suicidal ideation, as an example. They were designed to demonstrate efficacy. They were designed to demonstrate a significant difference in treatment outcomes, based on some a priori standard. We ought not to fault these studies for failing to do that which they were not designed to do.
Drug companies could not make the discoveries that they do without the cash generated from patented research that also made it to market. That cash funds the ablest minds in the world, not only in their own laboratories, but academics, too. But it also funds marketing. And accountants. And all the suits on Wall St. And, in the end, it is the accountants that make the decisions, IMHO. In the end, it all comes down to money.
I'm reminded of a conversation I had with a professor who discovered that certain people with mood disorders are especially sensitive to the artificial sweetener, aspartame. His preliminary work was suspended, for ethical reasons, as the adverse effects were pronounced. In the aftermath, he was unable to obtain funding for any follow-up work. Moreover, none of his recurrent research grants were funded again, after the existing terms expired. Without funding, he was effectively "retired". It's all about the money.
I came by my cynicism honestly, but I did not mean to generalize my opinion quite so literally. I apologize for any ill feelings arising from my remarks.
Lar
Posted by Larry Hoover on May 10, 2006, at 11:12:19
In reply to Re: I never say never - advice from a pharmacologi, posted by llrrrpp on May 10, 2006, at 8:24:25
> Wow, this is getting spicy!
>
> Lar. wanted to know my specialty. Well, the cogn. neuroscientist in me does functional brain imaging of language development. (fMRI).Ahhh. Broca and Wernicke. Probably some occipital lobe stuff. Can you map e.g. learning a second language?
> Also, llrrrpp is actually an acronym. l.l.r.r.r.p.p., and lacking the full translation (confidential), I leave it up to my readers to use their vivid imaginations to fill in the blanks.
I wouldn't know where to begin. And I still haven't got a pronunciation. It would be interesting, if you joined the rest of us in Toronto in ten days time. How you would do that. "Hi, I'm ......? Here's a napkin. Sorry about that."
> As far as statistics & research, well, I agree that depression is probably a heterogeneous disorder, and as such, perhaps we are dealing with several subtypes, if not several completely different disorders altogether. Maddie brings up an excellent point that independent field testing is definitely advantageous in terms of figuring out when, how and why to use different treatments (including therapy). I have a pretty strong faith in my pdoc, in this regard. He's won awards and has a lot experience as a researcher and a practitioner. I think he's pretty creative, and a nice person, but when someone who's at the top of his/her field acknowledges huge gaps in the literature, indeed in basic knowledge of mechanism of the disorder and the treatments, it's pretty scary.Forgive me, but I disagree. The man knows enough to be humbled. You are very lucky.
> At any rate, thanks for your insights, and for the links to more information.
You're welcome.
> I think my next line of business, aside from getting my neurotransmitters tweaked, is to figure out exactly what therapy is all about. I'm not sure what my goals are, and what exactly I'm supposed to be talking about for 50 minutes once a week.
That, right there, sounds like a good topic.
> For a while my main objective was to avoid crying at all costs. Well, the floodgates opened a few weeks back, so that silly goal has been abandoned. I feel like T and I are still getting to know each other. Part of me definitely resists sharing the darker twisted side with a relative stranger, but part of me desparately wants to get better and get on with what's left of my life.
You couldn't pay a friend enough to do what a good therapist can do for you. Your friends are grateful that you've hired someone.
> I'm pretty sure that we're working with a short-term therapy model, probably CBT, but my T is not completely wedded to any therapeutic approach.
>
> Any thoughts?Embedded.
Glad to know you.
Lar
Posted by B2chica on May 10, 2006, at 11:31:21
In reply to Re: I never say never - advice from a pharmacologi » llrrrpp, posted by Larry Hoover on May 10, 2006, at 11:12:19
llrrrpp
> > Lar. wanted to know my specialty. Well, the cogn. neuroscientist in me does functional brain imaging of language development. (fMRI).
>
> Ahhh. Broca and Wernicke. Probably some occipital lobe stuff. Can you map e.g. learning a second language?just reading an article about fmailial als and FTD (frontotemporal dementia) linked to certain crhomosome, do you do any work with language disorders? as a result of late onset diesease such as als or ftd? the cognitive impairments by als is very small but quite interesting, only seen a few cases myself usually quite emotianally labile and uncooperative. but the combination between language disorders and affective disorders is quite intriguing to me.
> > And I still haven't got a pronunciation. It would be interesting, if you joined the rest of us in Toronto in ten days time. How you would do that. "Hi, I'm ......? Here's a napkin. Sorry about that."ROTFLOL!!!!!
b2c
Posted by llrrrpp on May 10, 2006, at 13:44:49
In reply to llrrrpp and LarH, posted by B2chica on May 10, 2006, at 11:31:21
Well, I'm very much on the other end of the "developmental spectrum" I actually study language acquisition in young children. So, I'm pretty useless when it comes to aging-related issues in psychopathology and neuropathology and communicative disorders (sorry).
In regard to a question from Lar, it's my understanding that the cortical representation of 2nd languages acquired early is highly overlapping with the primary language, whereas 2nd languages acquired later have more non-overlapping areas in the cortex. Having said that, any complex function like language draws on large distributed networks, i.e. networks related to processing sounds, processing faces, processing meaning and symbols, memory, and problem solving. 1st and 2nd languages by and large will show very similar patterns of activation in neuroimaging studies.
Trying not to get kicked off of this message board over to the social board, I pose the following question to you all: what do you think the mechanisms are that might relate talk therapy to decrease in depression symptoms. Particularly mysterious to me is the idea that bitching about my dissertation advisor to a relative stranger for 50 minutes once a week might improve my appetite.
Perhaps it's a matter of changing the bias for activation of negative memories, negative self-attributions, guilt and shame, and replacing these with ideas that I'm worthy and clever, and capable. But why would this affect my appetite? Is it mediated through activation of stress? Is it mediated through bypassing the anxiety circuit? I mean sometimes anxiety and stress are a good thing (It's adaptive to be scared of a pit bull, and perhaps by analogy, a thesis advisor?)
Okay, a teaser: llrrrpp is short for
l.lapiderroodyroodyrexlapexlapoo. Gesundheit! This was the nickname bestowed upon me by my dad, who has a communication disorder, incidentally...Sorry I can't go to Toronto. Even if I could go, I might run into my pdoc, who is going to the conference. and then he might find out my alter ego. FriGhteNinG!!
Posted by B2chica on May 10, 2006, at 14:14:44
In reply to Re: llrrrpp and LarH, posted by llrrrpp on May 10, 2006, at 13:44:49
without giving too much info here i know a few folks working in language acquisition (information processing and such) but i've never gotten too much into it, i prefer late onset and primarily motor speech disorders.
to your question posed, i've often wondered if there is an acoustic component to talk therapy affecting depressive symptoms, almost like some link between sensation of certain frequencies and affect....i'd personally like to see a study using acoustic therapy with three sub-groups, MDD, BP and Schizophrenia and use acoustic therapy with 1)white noise, 2)pink noise and 3)brown noise and a voice using a low fund. freq. and measure their 1)irritibility/relaxation moods before and after, their 2)clearness of thought and their 3)comprehension (subjective and objectively). and their speech production (open-ended and specified reading tasks)
am i way off in space here?
if you know anyone that's interested...babblemail me.and i thought that b@tching about your advisor at LEAST once a week was kinda a requirement to get through the program???
llrrrp, suprisingly i think i pronounced it right the first read through??!!
-you funny.
b2c.
Posted by Larry Hoover on May 10, 2006, at 14:25:07
In reply to Re: llrrrpp and LarH, posted by llrrrpp on May 10, 2006, at 13:44:49
> Trying not to get kicked off of this message board over to the social board, I pose the following question to you all: what do you think the mechanisms are that might relate talk therapy to decrease in depression symptoms. Particularly mysterious to me is the idea that bitching about my dissertation advisor to a relative stranger for 50 minutes once a week might improve my appetite.
I think you're overthinking. ;-)
There is something therapeutic in giving voice. The actual act of saying what I'm feeling.
It cannot be substituted for.
Thinking the same thought is not useful.
It comes in the voicing.
Typing, or writing, both also express the very same thing, if done well.
And, in having a compassionate listener.
Giving voice, and compassionate listener.
I honour me, and I have witness thereto.
And, in the doing, also comes the real opportunity, to run with a stream of consciousness.
Those represent serendipitous extras.
When the streams flow.Lar
Posted by curtm on May 10, 2006, at 14:37:26
In reply to Re: llrrrpp and LarH » llrrrpp, posted by B2chica on May 10, 2006, at 14:14:44
>> i'd personally like to see a study using acoustic therapy with three sub-groups, MDD, BP and Schizophrenia and use acoustic therapy with 1)white noise, 2)pink noise and 3)brown noise and a voice using a low fund. freq. and measure their 1)irritibility/relaxation moods before and after, their 2)clearness of thought and their 3)comprehension (subjective and objectively). and their speech production (open-ended and specified reading tasks)
** I don't know about all these "noises" but I do know that I would be a excellent person to test because I am very susceptible to noise. My moods are either caused or influenced by noise. I can be irritated by some noise one time and relaxed by the same noise another time. I think I might be talking about noise different than you are. (Brown Noise to me would represent someone talking shint.)If I am feeling good, some soft noise or plasant music, like Pinback or Fleetwood Mac, relaxes me. If I am feeling irritable or anxity, then something heavier like Static-x or Godsmack relaxes me. Really.
So where do I sign up?
Posted by B2chica on May 10, 2006, at 15:46:17
In reply to Re: llrrrpp and LarH » B2chica, posted by curtm on May 10, 2006, at 14:37:26
hehe, just had to post this for you curtm...
i hadn't heard this before but??? somehow i just don't think it's true.
http://www.bwgen.com/presets/desc475.htm
seriously though, there is a site that you can click on the link and hear white, brown, pink and other noise. these three we use the most in experiments with speech.
http://www.answers.com/topic/colors-of-noisei think moods are greatly influenced by environmental noise and i wish there was more research on that.
Gotta love godsmack!
lately i've really been into house music, i think cuz i've kinda got that stuff going on in my head anyway and that music seems to drown it out pretty good. and when i'm going totally nuts and all else fails there is my ever loved radiohead...works everytime!if i could ever get anything going i'll let you know...don't hold your breath, i'm really not that ambitious.
later curtm
b2c.
Posted by llrrrpp on May 10, 2006, at 17:31:35
In reply to Re: llrrrpp and LarH » curtm, posted by B2chica on May 10, 2006, at 15:46:17
my therapist thinks I'm feeling this way because of anxiety about my treatment, not because of the treatment itself. haha.
So let me see if I get this right: anxiety and depression cause physical illness (in my case weight loss and insomnia) which lead me to seek treatment. Treatment causes anxiety, which causes psychosomatic symptoms (in my case anxiety, disorientation, and more insomnia and appetite loss) which cause me to seek treatment for "side effects" I'm totally going crazy. haha.
and now, brown noise for the "digestive side effects". what fun :) I was laughing out loud. I need a little non-medicinal help in that department. Who cares if it's just a placebo effect?
Posted by madeline on May 10, 2006, at 17:50:16
In reply to Re: llrrrpp and LarH » llrrrpp, posted by Larry Hoover on May 10, 2006, at 14:25:07
I also think that the relationship that you form with your therapist helps to alleviate depression.
Evolutionarily, I think we are hard wired to bond with people and for a lot of us, those bonds didn't form correctly or were interrupted etc...
Loneliness is so common in depression.
When we begin to relate with our T's, then I really think that there is a physiological response that sort of "soothes and stimulates" our brain, because that relation is such a natural thing for humans to do.
I think this is why the drugs and the therapy work so well together, the physiology, psychology and pharmacology all come into synch.
Posted by pegasus on May 12, 2006, at 19:44:18
In reply to Re: llrrrpp and LarH » llrrrpp, posted by Larry Hoover on May 10, 2006, at 14:25:07
> There is something therapeutic in giving voice. The actual act of saying what I'm feeling.Yeah. And along with that, I would say that being heard is a big part of why therapy helps. I know that the first time in my life that I ever felt truly listened to was in therapy. And I loved it! My therapist seems to actually be interested in *me*. Even my husband, who is a gem, doesn't really listen to me just for the sake of hearing me. He's always got his own agenda, as do I with him. But in therapy, I can count on having a real person actually want to hear all of what I have to say. Whoa!
I think it's related to the attachment we have (or not) to our parents. Maybe if we have really healthy attachment to our parents, and they are interested in *us* and want to hear and respond to us, maybe we wouldn't end up needing therapy so much. Maybe that lack is what therapy is providing. Helping us develop past the point that we could as kids, because didn't get what we needed from our imperfect parents.
Peg
Posted by llrrrpp on May 12, 2006, at 22:34:41
In reply to Re: llrrrpp and LarH » Larry Hoover, posted by pegasus on May 12, 2006, at 19:44:18
This is all very interesting. Something at my last session with T kind of freaked me out. I asked him point-blank "so, what's our plan here? what are we doing"? He replied, "Well, for now I'm just here to be supportive of you and help you through this difficult time. I think that over the last 2 weeks, the therapy and medication itself has been traumatic, and you're still getting over that. Once your crisis is over, the *real work* can begin"
Holy Moly, so all the "blah blah" about my stress and my life and my family has all been a grand prelude? It's been an introduction? Oh boy. This is going to be really hard. I don't know if I'm strong enough to give voice to things that have been covert so long that they're calcified. I'm not sure I want anyone listening to this. At times T is listening kindly and nodding, other times he really challenges me and tells me very bluntly that I'm mistaken or misled. I can never tell when supportive-listening-T will morph into challenging-in-your-face-impatient-T. I don't think I'm strong enough to handle this. What's more is that my memory is so screwed up right now that I'm not sure what's a real memory and what's a confabulation. I find it really hard to concentrate and keep up a coherent stream of thought in everyday life (cognitive impairment due to major depression), and the face to face dialog is a major cognitive load. Taxing to my limited resources. Well, at least T seems invested and motivated to help me recover. He seems confident that I will get better. That's reassuring.
Posted by Larry Hoover on May 13, 2006, at 8:24:57
In reply to Re: llrrrpp and LarH » Larry Hoover, posted by madeline on May 10, 2006, at 17:50:16
> I also think that the relationship that you form with your therapist helps to alleviate depression.
>
> Evolutionarily, I think we are hard wired to bond with people and for a lot of us, those bonds didn't form correctly or were interrupted etc...
>
> Loneliness is so common in depression.I'm sure that's also a big part of a successful therapeutic relationship. But, my guy didn't just hang a shingle. He spend five (or more) years learning how to do what he does.
I love to talk about my life with my friends, but the kind of stuff I needed to work on was not the substance that I would impose on any friendship. It would have been unfriendly to even begin.
Therapists serve a new role. One not anticipated by our social evolution, I would think.
> When we begin to relate with our T's, then I really think that there is a physiological response that sort of "soothes and stimulates" our brain, because that relation is such a natural thing for humans to do.
>
> I think this is why the drugs and the therapy work so well together, the physiology, psychology and pharmacology all come into synch.Absolutely so.
I'm not going to be able to ignore, though, the fact that it was my therapist who helped me to see the precise effects of my atypical childhood period.
I agree with all you have said, but at least in my case, there is a lot more to it.
Lar
Posted by llrrrpp on May 13, 2006, at 8:50:09
In reply to Re: llrrrpp and LarH » madeline, posted by Larry Hoover on May 13, 2006, at 8:24:57
Yes, I definitely don't want to unload this stuff on my friends. That would be unkind at best, and destroy all my relationships at worst. I also appreciate the acumen and insight that the therapist brings to the session. It's just so painful. Seriously, I would rather have thoracic surgery than to lay all this out on the table and sort through it and try to put the pieces together. humpty-dumpty style. Why do I have to feel so miserable in order to make progress?
One thing from my cognitive psychology classes that comes to mind is this simple maxim about long-term memory: "Every act of recall leads to re-encoding". That is, that everytime we recall an episode or a fact, we re-interpret it. By re-interpreting it, we can place it into a different category and form new associations and create new meaning. Usually I think about this principle in terms of eye-witness testimony -- by asking a witness to recall an incident, she will necessarily be changing the memory simply by recalling it over and over. Certain details will be emphasized. Leading questions can create false memories, and the net result is a distortion from reality. I suppose, however, that this principle might apply to my current state of affairs. I have had a profound negative bias for the last few months. Everything is rotten and hopeless. Naturally I only access memories that are associated with these dark feelings. Sadly, the memories of events that have transpired in the last few months are similarly tainted. Hopefully T will help me reinterpret these memories and move them towards a more-neutral, less-biased place.
This is the end of the thread.
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