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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 22 of 22. This is the beginning of the thread.
Posted by sleepygirl2 on November 5, 2013, at 22:36:06
It's pretty clear that my t is pro meds and my group t is anti meds.
Since I am ambivalent regarding meds, this makes for a confusing time.
My pdoc is naturally pro meds, but has been tapering down my med amounts over time.
Group t said I'm going with someone else's agenda.
My agenda is sanity.
I don't like this predicament.
Posted by sigismund on November 6, 2013, at 0:48:19
In reply to Pro-meds verses anti-meds therapists, who's right?, posted by sleepygirl2 on November 5, 2013, at 22:36:06
>Group t said I'm going with someone else's agenda.
But that is not so, IMO. You are ambivalent, and why not?
Your group t is just suggesting you are allowing your psych (or whoever) to set your agenda.
I would just find that irritating if I were you.
How do you find your group?
Posted by Dinah on November 6, 2013, at 8:13:56
In reply to Pro-meds verses anti-meds therapists, who's right?, posted by sleepygirl2 on November 5, 2013, at 22:36:06
I tend to agree with Sigi. I find it often true that those who mention someone else's agenda aren't agenda-free themselves. It seems to me a good group therapist should *ask* about your own agenda and your own feelings about medications.
Now, if it is a recurring thing for you to talk about disliking medications and feeling pressured by your pdoc, that is a different matter. She is then responding to your own statement of feelings.
But you know, the important thing is never what others think about something that really affects only yourself. It's perfectly ok to let someone know you understand their feelings about something, and appreciate their concern, and will certainly consider their words. But that you'll do what you think is best for yourself and you'd appreciate it if they would respect that.
For myself, I like the idea of balance. I try to take as few medications as I can to be stable.
Posted by Phillipa on November 6, 2013, at 9:08:55
In reply to Re: Pro-meds verses anti-meds therapists, who's right? » sleepygirl2, posted by Dinah on November 6, 2013, at 8:13:56
I agree with Dinah. Not a member of a therapy group but find this dispute on babble also. Phillipa
Posted by SLS on November 6, 2013, at 10:08:38
In reply to Pro-meds verses anti-meds therapists, who's right?, posted by sleepygirl2 on November 5, 2013, at 22:36:06
> my group t is anti meds.
In what way? What exactly does your group T say about psychiatric medications?
> Since I am ambivalent regarding meds, this makes for a confusing time.
I'm sure it does.
Difficult cases of hypertension in congestive heart failure can take a great deal of experimentation with different drugs in order to establish a polypharmaceutical regime that will produce improvements. This tactic saved my grandmother's life and allowed her to live to age 99. She took 7 different drugs. It seems bizarre to me that it is so easy for someone to laud the miracles of modern medicine except for in psychiatry. I think some psychotherapists are emotionally committed to their craft and would like to believe that there is no psychiatric malady that they can't fix. I have encountered such people. They can be damaging.
Psychopharmacology and psychotherapy are not in conflict with each other. Both are can be uniquely effective for different psychiatric conditions. In addition, combining the two modalities of treatment can yield better results than either one alone, but not always.
If you have ever responded well to psychiatric pharmacotherapy, then it would be hard to take seriously the maligning of medications by anyone.
- Scott
Posted by sigismund on November 6, 2013, at 12:40:31
In reply to Re: Pro-meds verses anti-meds therapists, who's right? » sleepygirl2, posted by Dinah on November 6, 2013, at 8:13:56
Well, you haven't been happy taking meds (right?) but you do take them and thus I assume you feel you need them. Goodness me, it's not morphine you are taking :)
Posted by sleepygirl2 on November 6, 2013, at 23:05:32
In reply to Re: Pro-meds verses anti-meds therapists, who's right? » sleepygirl2, posted by sigismund on November 6, 2013, at 0:48:19
> >Group t said I'm going with someone else's agenda.
>
> But that is not so, IMO. You are ambivalent, and why not?Thank you. Yes, that's it.
> Your group t is just suggesting you are allowing your psych (or whoever) to set your agenda.
Medications are, by nature, my pdocs agenda, but he will go with my decisions. It's why I've tapered down on them.
> I would just find that irritating if I were you.
I do, it's too much of an assumption.
> How do you find your group?
Helpful, at times.
Thanks, Sigi :-)
Posted by sleepygirl2 on November 6, 2013, at 23:11:10
In reply to Re: Pro-meds verses anti-meds therapists, who's right? » sleepygirl2, posted by Dinah on November 6, 2013, at 8:13:56
> I tend to agree with Sigi. I find it often true that those who mention someone else's agenda aren't agenda-free
themselves.Good point :-)
>It seems to me a good group therapist should *ask* about your own agenda and your own feelings about medications.
Yes, but I feel like I should've been clearer. The thing is, that I'm not all clear on the matter. I am reluctant to give up all the meds, but maybe that's unnecessary hesitation.
> Now, if it is a recurring thing for you to talk about disliking medications and feeling pressured by your pdoc, that is a different matter. She is then responding to your own statement of feelings.
My pdoc has been tapering down the meds at my request.
I do feel an influence by both my pdoc and t regarding meds, in the pro med direction, but I know there's no ill intent there.> But you know, the important thing is never what others think about something that really affects only yourself. It's perfectly ok to let someone know you understand their feelings about something, and appreciate their concern, and will certainly consider their words. But that you'll do what you think is best for yourself and you'd appreciate it if they would respect that.
Yeah, I think I'll have to clarify.
> For myself, I like the idea of balance. I try to take as few medications as I can to be stable.
I like that idea.
Thanks, Dinah :-)
Posted by sleepygirl2 on November 6, 2013, at 23:23:09
In reply to Re: Pro-meds verses anti-meds therapists, who's right? » sleepygirl2, posted by SLS on November 6, 2013, at 10:08:38
Thanks, Scott.
I've stated to my group t that I'd just like to get off all meds.
I'm not sure he gets why I went on them in the first place. He didn't know me then. No one is making me take them, I just want to function. Whether I could do that just as well as I already do without them remains in question. I don't think I need to tell you that getting off meds is a challenge in itself, even without the symptoms that they were meant to address.I had mentioned that I'd like to try to get pregnant. I asked my pdoc if there was anything I could stay on, because getting off everything feels daunting. He said he'd like to consult with another pdoc if I wanted to stay on something. He didn't force the matter. I said to group T that I'd rather not get a consult, that I'd rather just get off of everything, and that's true. What is also true is that they've helped me function.... Maybe?
Confusing...
I do see my pdoc too more than is necessary, but I've been willing to do that, because I don't want another pdoc. If I stop seeing my pdoc, I want it to be because I'm off meds.
I guess I wasn't clear to group t.
Posted by sleepygirl2 on November 6, 2013, at 23:24:02
In reply to Re: Pro-meds verses anti-meds therapists, who's right?, posted by sigismund on November 6, 2013, at 12:40:31
:-)
I like how you think, Sigi.
You make sense.
Posted by sigismund on November 7, 2013, at 12:30:46
In reply to Re: Pro-meds verses anti-meds therapists, who's right? » sigismund, posted by sleepygirl2 on November 6, 2013, at 23:24:02
If I came here and said 'I am taking morphine and I need help' (if only!) you would know in advance the EXACT nature of my ambivalence. 'He is addicted to morphine, he loves it, he hates being addicted blabitty blah'. Well, there is less reward with psych drugs and much less addictiveness. So I don't know the exact nature of your ambivalence, but you never seem to have been entirely happy with Lamictal and Effexor, and sometimes irritable (because of or in spite of the drugs), but less so recently.
I would be annoyed to be treated as someone who had bought her psych drs line including hook and sinker. I would feel under-rated.
Though when I think back, a long way back, I was able to produce justifications for taking various psych drugs (Valium, Melleril) that to me now are just laughable.
Posted by SLS on November 8, 2013, at 9:14:23
In reply to Pro-meds verses anti-meds therapists, who's right?, posted by sleepygirl2 on November 5, 2013, at 22:36:06
Here is an VERY OLD post of mine that you might find helpful:
-------------------------------------
BIOLOGY OR PSYCHOLOGY?
The best answer to this question may be either and both.Most of us here at Psycho-Babble have been diagnosed as having a mental illness. Mental illnesses are not mental weaknesses. The diagnoses that we are most familiar with include:
1.Major Depressive Disorder (MDD; Unipolar Depression)
2.Bipolar Disorder (BD; Manic Depression)
3.Dysthymia (Minor Depression)
4.Seasonal Affective Disorder (SAD)
5.Schizophrenia
6.Schizoaffective Disorder
7.Obsessive-Compulsive Disorder (OCD)
8.Post-Traumatic Stress Disorder (PTSD)
9.Generalized Anxiety Disorder (GAD)
10.Panic Disorder
All of these disorders have one thing in common. They are not our fault. Each disorder has both biological and psychological components. We all begin our lives with a brain that is built using the blueprints contained within the genes we inherit from our parents. Later, hormones change the brain to prepare it for adulthood. It is continually being changed by the things we experience. The brain determines the mind as the mind sculpts the brain. Unfortunately, the brain can also be changed in negative ways by things such as drugs, alcohol, injury, and chronic stress.How we think and feel are influenced by our environment. Probably the most important environment during our development is that of the family, with the most important time being our childhood. We all have both positive and negative experiences as we travel through life. How we are as adults is in large part determined by these positive and negative experiences. They affect our psychology, our emotions, and our behaviors. All of us can be hurt by unhealthy negative experiences.
Some of us are also hurt by unhealthy brains. Medical science has long recognized that many mental illnesses are actually biological disorders. Even Sigmund Freud, who we know for his development of psychoanalysis, proposed a role for biology in mental illness. He was, after all, a neurologist. The first solid evidence for this concept in modern times came with the discovery of lithium in 1947. Lithium was found to cause the symptoms of bipolar disorder (manic-depression) to disappear completely, allowing previously disabled people to lead normal lives. Lithium helps to correct for the abnormal neurotransmission in the brain that is the cause of bipolar disorder. Subsequent medical discoveries included the observations that the drug, Thorazine (an antipsychotic), successfully treated schizophrenia, and that Tofranil (an antidepressant) successfully treated depression. Again, these drugs help to correct for the abnormal biology of the brain that accompanies these disorders.
What about psychology? What role does it play in mental illness? This can be a
two-way street. The abnormal biology that occurs with some mental illnesses affects our psychology how we think, feel, and behave. On the other hand, our psychology can also affect our biology. As we now know, the emotional stresses and traumas we experience change the way our brains operate. This is especially true of things we experience during childhood. These stresses can trigger the induction of abnormal brain function that leads to major depression, bipolar disorder, schizophrenia, and other major mental illnesses. In order for this to happen, however, there must be a genetic or some other biological vulnerability to begin with.Unfortunately, there are still too many people who cannot bring themselves to believe that the most common mental illnesses are actually brain disorders. However, the vast majority of our top researchers in psychiatry and neuroscience do.
The U.S. National Institutes of Health (NIH), the federal governments official repository of medical research, has made available to the public free publications describing the current research into psychiatric disorders. They include descriptions of the biological and psychological aspects of major mental illness. Each press release and research publication begins by stating emphatically that these are indeed brain disorders.
It is important to remember that not all psychological and emotional difficulties are biological in origin. Again, we are all products of our environments family, friends, enemies, school, work, culture, climate, love, war, etc. Environments that are unhealthy often produce unhealthy people. However, this, too, is not our fault.
In conclusion, regardless of the cause of our mental illnesses, it is important that we treat both the biological and the psychological. We will all benefit most if we do.
- Scott
Posted by baseball55 on November 8, 2013, at 19:39:27
In reply to Re: Pro-meds verses anti-meds therapists, who's right? » sleepygirl2, posted by SLS on November 8, 2013, at 9:14:23
When I started seeing a p-doc for therapy and meds, he said that I had symptoms of PTSD, because I had had a traumatic childhood. I really didn't get this. My childhood was not so bad, my father not nearly as abusive as other children's. I asked my sister -- was our childhood really that bad? She said two soldiers can have the same experiences and one gets PTSD and the other doesn't. She said that the combination of my temperament, my father's violence and the very troubled relationships I had with my siblings (including her and my brother who bullied me terribly) made things much harder for me than for her.
Glen Gabbard write about a bio-psycho-socio perspective on mental illness. Biological temperament and genetic personality traits increase susceptibility. But psycho -social issues give depression and anxiety content, lead to ruminations that send people (me, at least) into downward spirals.
Some people (including the author of the article you sent a link to the other day) regard this bio-psycho-social model as so much mush. I find it helpful. I was moody as a child and I think that worsened the already fraught relationships with my family. My siblings were more sunny and able to navigate more effectively. But I think if I had grown up in a less hostile environment, I would have still been moody, but less susceptible to severe, suiclidal depressions.
Posted by sigismund on November 8, 2013, at 20:58:19
In reply to Re: Pro-meds verses anti-meds therapists, who's right? » SLS, posted by baseball55 on November 8, 2013, at 19:39:27
People who have known special love in a comfortable way in their early childhood, like Freud and our exPM Keating, talk about always feeling some sense of immunity against the insults of life. Keating said 'It has been like wearing a teflon suit. It hits me but none of it affects me.' And Freud said something about the son who has been a prince having that feeling forever.
Posted by Phillipa on November 8, 2013, at 21:15:55
In reply to Re: Pro-meds verses anti-meds therapists, who's right?, posted by sigismund on November 8, 2013, at 20:58:19
What about if you basically raised yourself as Mother was sick the whole time and when you were in the house had she had temper tampers and threw things at me and blamed me for her illness. But then when I was a Mother I realized that the cortisone did it to her and not me so I knew it wasn't my fault? Does this count for something? Phillipa
Posted by SLS on November 8, 2013, at 22:22:50
In reply to Re: Pro-meds verses anti-meds therapists, who's right? » SLS, posted by baseball55 on November 8, 2013, at 19:39:27
> Glen Gabbard write about a bio-psycho-socio perspective on mental illness. Biological temperament and genetic personality traits increase susceptibility. But psycho -social issues give depression and anxiety content, lead to ruminations that send people (me, at least) into downward spirals.
Perfect!
I TOTALLY agree with this.
> Some people (including the author of the article you sent a link to the other day) regard this bio-psycho-social model as so much mush.
Do you recall what article that was? I would like to review it.
As far as I'm concerned, you have great insight into biopsychosocial dynamics. I hope that you decide stay with Psycho-Babble for awhile. You have much to contribute.
- Scott
Posted by SLS on November 8, 2013, at 22:42:54
In reply to Re: Pro-meds verses anti-meds therapists, who's right? » sigismund, posted by Phillipa on November 8, 2013, at 21:15:55
> What about if you basically raised yourself as Mother was sick the whole time and when you were in the house had she had temper tampers and threw things at me and blamed me for her illness. But then when I was a Mother I realized that the cortisone did it to her and not me so I knew it wasn't my fault? Does this count for something? Phillipa
This probably qualifies as being "developmental PTSD".
http://www.positivehumandevelopment.com/developmental-ptsd.html
Neglect and lack of attachment is sometimes more influential than physical abuse in the evolution of mental illness. You had both.
How about looking into using prazosin 6 - 20 mg/day to address both anxiety and depression? You would have to start at 1.0 mg h.s. and titrate gradually from there so as to help prevent dizziness. One can take more at night. However, I divide my dosage of prazosin into 3 doses. It has a relatively short half-life. When taken this way depression and anxiety can be greatly reduced all day long.
http://www.ncbi.nlm.nih.gov/pubmed/?term=ptsd+prazosin+daytime+depression
- Scott
Posted by sigismund on November 9, 2013, at 17:36:11
In reply to Re: Pro-meds verses anti-meds therapists, who's right? » sigismund, posted by Phillipa on November 8, 2013, at 21:15:55
>Does this count for something?
Well, I dunno, a lot of us are somewhat sick much of the time. Handling it gracefully is good. As is a good excuse. It's difficult.
Posted by sigismund on November 9, 2013, at 17:42:36
In reply to Re: Pro-meds verses anti-meds therapists, who's right? » Phillipa, posted by SLS on November 8, 2013, at 22:42:54
>Neglect and lack of attachment is sometimes more influential than physical abuse in the evolution of mental illness.
Yeah, I agree. Babies fed but totally neglected go into the wonderfully named 'marasmic states'. Anglo-Saxon culture in the past prized neglect as a building block of manliness. The famous instance of the father who, not wanting to spoil his son, restricted physical contact to a handshake on Sunday mornings. The man who, dying, says to his mother 'Mother, I am going to die now. Could you please leave the room.' Another man who dying, when his mother wishes to make amends says 'Mother, no. Please don't.' All true stories. I think. It was a reaction to the French Revolution and the need for stability and cannon fodder.
Posted by baseball55 on November 9, 2013, at 18:55:30
In reply to Re: Pro-meds verses anti-meds therapists, who's right? » baseball55, posted by SLS on November 8, 2013, at 22:22:50
> Do you recall what article that was? I would like to review it.
I don't recall. Maybe it wasn't you who sent it. But it was something on how psychiatry needed to be more scientific.
>
> As far as I'm concerned, you have great insight into biopsychosocial dynamics. I hope that you decide stay with Psycho-Babble for awhile. You have much to contribute.
>
Thanks. That means a lot coming from you. When I first started therapy and had overwhelming transference issues, I read Glen Gabbard's books. Can't recall the names. Both on psychodynamic therapy written for psychiatry residents. Amazing and insightful.
>
> - Scott
>
Posted by baseball55 on November 9, 2013, at 19:06:07
In reply to Re: Pro-meds verses anti-meds therapists, who's right?, posted by sigismund on November 9, 2013, at 17:42:36
> >Neglect and lack of attachment is sometimes more influential than physical abuse in the evolution of mental illness.
>
I felt this very strongly after reading What is the What? by Dave Eggars. About one of the lost boys of Sudan. This boy goes through horrors and amazing physical deprivation, yet comes out alright because he had strong and loving caretakers. I had a student who was one of the lost boys and managed to graduate college. Some people have an inner strength they can draw upon. It might be good parenting or it might be some resilience in their personalities.I have two nephews who grew up with a psychotic, alcoholic mother. She abandoned them and left them with my brother, who did a pretty good job raising them. But the youngest was really effected by the craziness of his early childhood. The older boy was this total extrovert who caught adult's attention and got the help and support he needed. He is now doing extremely well.
Posted by 10derheart on November 9, 2013, at 22:00:44
In reply to Re: Pro-meds verses anti-meds therapists, who's right?, posted by baseball55 on November 9, 2013, at 19:06:07
This is the end of the thread.
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