![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by fenix on January 30, 2006, at 0:29:10
In reply to Redirect: the ultimate answer, posted by Dr. Bob on January 29, 2006, at 10:41:08
Well, when I meant the "ultimate answer" I was refering to leaving an ill and abusive environment that may be causing the depression/anxiety, etc. I didn't intend for it to be a faith thing or necessarily a social thing (except of course concerning relationships... I think that would be social? but I also meant family members concerned as well).
But I guess the "ultimate answer" has um... many answers.
Posted by Dinah on January 30, 2006, at 0:30:42
In reply to Re: Redirect: the ultimate answer, posted by fenix on January 29, 2006, at 11:04:57
"Social" is rather poorly named. It means more "general" than "social" and imho should probably be renamed "Community".
Posted by Tomatheus on January 30, 2006, at 0:34:58
In reply to Re: Help!! Bipolar, off meds, losing it, posted by fenix on January 29, 2006, at 5:03:22
Fenix,
See below for my responses to various sections of your post...
> Yes, when chemicals act in different ways they produce different actions. Different situations cause your body to respond in different ways, cause the neurochemistry to change, etc. When you are in a bad environment, your mind becomes ill of it, but not just your mind... your brain and its chemicals as well.
I don't doubt what you're saying at all. Your suggestion that a person's neurochemistry changes in response to different environmental stimuli is completely valid from my perspective, and it has lots of support in the psychiatric literature. To the extent that one feels "ill" (i.e., anxious or depressed) in response to environmental stimuli that are clearly anxiety-inducing or depressing, then I guess one can say (in a way) that one is feeling ill mentally. But when a person feels depressed in response to depressing environmental stimuli, this is not the sign of a depressive disorder. It's a sign of the body's ability to respond to environmental stimuli in a healthy, appropriate way.
You seem to understand the phenomena of feeling depressed, feeling anxious, and feeling traumatized in response to environmental stimuli quite well. But what you don't seem to realize is that there are individuals who experience true affective disorders (i.e., the "mood disorders": depression and bipolar disorder) and anxiety disorders. Individuals with affective disorders, for example, do not "feel" (mood-wise) in a way that is consistent with how the body and the brain would normally react to environmental stimuli. As I mentioned in a recent post (http://www.dr-bob.org/babble/20060122/msgs/603790.html), in the years that I tried treating my depression by making positive changes in my life and by going to therapy, I still felt depressed no matter how positive my surroundings were. There were times when everything inside of me was telling me that I should feel happy, but instead I'd feel depressed and couldn't even enjoy the things that I really liked the most. It is only now that I feel close to remission (thanks to being on the right med, even though it may require some augmentation) that I feel some joy when I know that I should be feeling joy and that I feel extreme despair only at the times when it is consistent with my environmental surroundings.
The member who started this thread (Catmint) stated in her post that she has bipolar disorder. Even though there is no question that environmental factors contribute to the way that bipolar disorder manifests itself in an individual, there is strong evidence in the psychiatric literature suggesting that bipolar disorder also involves one or more genetically mediated biochemical abnormalities -- in most bipolar patients, if not all of them. Between this board and other discussion forums and groups, I've read at least hundreds of posts from patients with various forms of bipolar disorder. And one of the most common trends that I see is that bipolar patients almost without exception do not do well without meds. The process of finding the right med or med combo is clearly very trying and frustrating. Sometimes it is unsuccessful. But generally, based on all the experiences I've read, patients with bipolar disorder fare significantly better with meds than they do without them.
> The whole thing is ridiculous about the imbalance, and this is where I will have to be more specific. It is not that a chemical imbalance doesn't happen, it is that drugs are not the answer, at least no the ultimate answer. The real problem is, you are in a trap, you are given drugs to cope in the trap, the suffocating box. The trap is the environment that you are in, what the environment is doing to you, it is established deeply in the survivalist nature of humans and of course in that of other living species.
If you're referring to the experiences of "feeling depressed," "feeling anxious," and/or "feeling traumatized" in direct response to environmental stimuli, then I agree with you that drugs are not the answer. But for patients who have psychiatric disorders that are characterized by abnormal and often disabling abnormalities in their emotional, cognitive, and/or behavioral responses to environmental stimuli, lifestyle changes and therapy are often insufficient.
> ... However, just leaving a certain place that you have been at for a very long time... can do profound things on you regardless of your past experiences. I know this from personal experience s myself, and not just me, but from various people that suffered from rape, incest, and other such things in there past.
I'm glad that you were able to find some relief from the suffering that you were experiencing by leaving a place that seems like it was associated with some negative experiences in your life. And it's even better that you've been able to find the relief that you've found without having to stay on meds indefinitely. But as I'm sure you're aware, everyone is different. What worked for you won't necessarily work for someone else. I know that I personally spent years blaming less-than-ideal working conditions, busy schedules, and countless other people, places, and things in my environment for causing me to feel as terribly as I did when I was depressed and not taking any meds. But then, no matter what changes I'd make to try doing more things that I knew I liked and fewer things that caused me great distress, my depression did not get better. There was nothing terribly wrong with my life when my depression fully set in -- certainly no trauma to speak of -- it was the way that I was responding to things (mostly cognitively and emotionaly) that was the problem. And I tried just about as many things as I could to try to address this problem before seeking psychopharmacological treatment. Unfortunately, nothing worked. And for years, the meds that I was taking didn't give me what I would consider to be even an adequate partial response. But now, I think I have at least one of the right meds in place, and I actually feel like I'm not too far from remission.
Tomatheus
Posted by Racer on January 30, 2006, at 0:34:58
In reply to Re: Help!! Bipolar, off meds, losing it, posted by fenix on January 29, 2006, at 5:03:22
>
> The whole thing is ridiculous about the imbalance, and this is where I will have to be more specific. It is not that a chemical imbalance doesn't happen, it is that drugs are not the answer, at least no the ultimate answer. The real problem is, you are in a trap, you are given drugs to cope in the trap, the suffocating box. The trap is the environment that you are in, what the environment is doing to you, it is established deeply in the survivalist nature of humans and of course in that of other living species.This is the only part I'm going to respond to.
The research I've read pretty well agrees that bad situations will trigger a depressive episode in those who are susceptible to depression. But those same environmental triggers will not trigger depression in those without that underlying susceptibility. Even the researcher in NZ who found the "depression gene" a while back said that having adequate social support could mitigate stressful situations in those with the genetic predisposition to depression. Genes are not destiny, in other words. But in an environment that contains the sorts of stresses that trigger depression, in the absence of that support, in individuals with a genetic predisposition to depression, depression will be triggered.
That doesn't happen to people who do not have this susceptibility. Yes, everyone can become unhappy, dissatisfied with their lives, frustrated by their situations, etc. That's normal. Depression, though, is different from unhappiness. It's different from being stressed out.
And depression is also a disease that tends to have an active phase of about nine months for most episodes, so doing nothing can often improve things if you give it enough time. Of course, you can do a lot of damage to your life in those nine months, but if you choose not to take drugs, you can assume that you'll feel a bit better inside a year. Of course, depression is also an episodic disease, so you're likely to experience another depressive episode if you choose to take this route.
Psychotherapy will also improve things. It is one flavor of that social support that can help those with a tendency towards depression to avoid becoming depressed when confronted by triggering events.
But the bottom line to all of this is that, for many people, medications are part of successfully treating depression. The medications work for many people, they help alleviate needless suffering, and they make it possible for those of us who suffer depression to function.
More to the point, though, this board is about providing support and education about these medications. Perhaps you truly believe that you are offering that -- but in a community in which the members are here because we have chosen to take medications to treat our mental illnesses, don't you think it might be a bit less than truly supportive to state that medications are not going to help us? Many of us here already feel helpless, we don't need to get more of it from outside.
I'm glad if you've found the answer FOR YOU in treating whatever ailed you. I'm glad it worked for you. I'm glad you had the options to get out of your situation and that it was enough to cure your ills.
That ain't an option for a lot of people, and it would be respectful to keep that in mind.
And I wonder, based on your posting name, if you see this place as a henhouse?
Posted by fenix on January 30, 2006, at 0:34:59
In reply to I strongly disagree » fenix, posted by Racer on January 29, 2006, at 17:16:43
> >
> > The whole thing is ridiculous about the imbalance, and this is where I will have to be more specific. It is not that a chemical imbalance doesn't happen, it is that drugs are not the answer, at least no the ultimate answer. The real problem is, you are in a trap, you are given drugs to cope in the trap, the suffocating box. The trap is the environment that you are in, what the environment is doing to you, it is established deeply in the survivalist nature of humans and of course in that of other living species.
>
> This is the only part I'm going to respond to.
>
> The research I've read pretty well agrees that bad situations will trigger a depressive episode in those who are susceptible to depression. But those same environmental triggers will not trigger depression in those without that underlying susceptibility. Even the researcher in NZ who found the "depression gene" a while back said that having adequate social support could mitigate stressful situations in those with the genetic predisposition to depression. Genes are not destiny, in other words. But in an environment that contains the sorts of stresses that trigger depression, in the absence of that support, in individuals with a genetic predisposition to depression, depression will be triggered.
>
> That doesn't happen to people who do not have this susceptibility. Yes, everyone can become unhappy, dissatisfied with their lives, frustrated by their situations, etc. That's normal. Depression, though, is different from unhappiness. It's different from being stressed out.
>
> And depression is also a disease that tends to have an active phase of about nine months for most episodes, so doing nothing can often improve things if you give it enough time. Of course, you can do a lot of damage to your life in those nine months, but if you choose not to take drugs, you can assume that you'll feel a bit better inside a year. Of course, depression is also an episodic disease, so you're likely to experience another depressive episode if you choose to take this route.
>
> Psychotherapy will also improve things. It is one flavor of that social support that can help those with a tendency towards depression to avoid becoming depressed when confronted by triggering events.
>
> But the bottom line to all of this is that, for many people, medications are part of successfully treating depression. The medications work for many people, they help alleviate needless suffering, and they make it possible for those of us who suffer depression to function.
>
> More to the point, though, this board is about providing support and education about these medications. Perhaps you truly believe that you are offering that -- but in a community in which the members are here because we have chosen to take medications to treat our mental illnesses, don't you think it might be a bit less than truly supportive to state that medications are not going to help us? Many of us here already feel helpless, we don't need to get more of it from outside.
>
> I'm glad if you've found the answer FOR YOU in treating whatever ailed you. I'm glad it worked for you. I'm glad you had the options to get out of your situation and that it was enough to cure your ills.
>
> That ain't an option for a lot of people, and it would be respectful to keep that in mind.
>
> And I wonder, based on your posting name, if you see this place as a henhouse?Concerning my posting name, it is the name of my pet iguana. I am not sure as to what this henhouse is you are speaking of however.
I know that medicine helps people, it can also harm them as well. But why limit yourself to just that one solution? If you have the power you should ask yourself "are there things that are happening in my surroundings and environment everday that could be contributing to the way I feel?". It may be so, but I have some more thinking to do about things that are difficult, in other words, past experiences.
For instance, you could leave a bad environment, but you take the traumatic memories with you no matter where you go.
I know what it feels to be helpless, and that is why I turned to medicine three years ago, however, it was my mistake because of the harm it did to me. I came to realize that what was causing my problems was my surroundings. And thus, problem solved. No more depression and no more anxiety.
Something that is most disturbing to me is that many people start these medicines without prior knowledge of what the drugs are and their risks. And from my experience, many doctors won't tell you these things either.
"That ain't an option for a lot of people, and it would be respectful to keep that in mind." I know it isn't, but what if it was? That is my point.
Posted by fenix on January 30, 2006, at 0:34:59
In reply to Re: Help!! Bipolar, off meds, losing it » fenix, posted by Tomatheus on January 29, 2006, at 15:24:21
Yes, I feel there is something wrong though. It cannot be that one would just become depressed for no reason outside the fact that chemicals just started to get messed up in your brain. Just doesn't make sense to me.
There has to be some sort of stimuli, maybe it is unconscious in many people.
This is all very frustrating, I wish I had the energy to read all the reaserach and studies done on various things regarding psychological disorders, then maybe I could combine my findings with my belief in the survivalist nature of human beings.
It simply makes no sense to me for a human to become depressed for no reason outside of the chemical. It seems to contradict the importance of the survival of the self and species. There must be a specific environmental stimulus (whether past, present or what is feared to come)that causes one to feel in such ways... it is a confusing puzzle.
Drug companies must hate me.
Posted by Tomatheus on January 30, 2006, at 0:34:59
In reply to Re: Help!! Bipolar, off meds, losing it, posted by fenix on January 29, 2006, at 18:50:05
Fenix,
I'm going to respond to your post by quoting something that Racer said earlier in this thread:
[=====beginning of quote=====]
"Since we know that other metabolic disorders, such as diabetes, are caused by chemical imbalances in the body, I will believe that mood disorders are caused by a chemical imbalance in the brain. Unless or until someone *proves* that the brain is *not* subject to the same sorts of metabolic disruptions as other organs of the body, it just makes more sense to me to assume that the brain *is* subject to those disruptions, and therefore that mood disorders include a chemical imbalance in the brain as part of their etiology."
Simple as can be: until you prove the brain is fundamentally different from other organs, let's assume that it's fundamentally similar, and thus subject to metabolic disruptions that cause chemical imbalances."
[=====end of quote=====]
So, similar to what Racer said, it makes just as much sense to believe that a person's brain can function in a less-than-optimal way because of one or more genetic factors (which can be compounded by environmental stresses, normal hormonal changes, and other factors) as it does to believe that any other organ or bodily system could also function less than optimally for reasons that are at least partially genetic. And with respect to less-than-optimal brain functioning, nobody seems to ever question the fact that conditions such as mental retardation and autism are genuine brain disorders. Mental retardation would certainly seem to contradict the "importance survival of the species," as you put it, and so would any genetically mediated physical illnesses. So why should psychiatric illnesses such as depression, anxiety, and bipolar disorder be any different?
Tomatheus
Posted by Phillipa on January 30, 2006, at 1:17:07
In reply to Re: Help!! Bipolar, off meds, losing it » fenix, posted by Tomatheus on January 30, 2006, at 0:01:30
Okay I see enviorment in this thread but also chemical imbalances so I'm confuesed as to why this is on Social? Anyone else. Fondly, Phillipa
Posted by Maynerd on January 30, 2006, at 3:10:02
In reply to Re: Help!! Bipolar, off meds, losing it, posted by fenix on January 29, 2006, at 18:50:05
"It simply makes no sense to me for a human to become depressed for no reason outside of the chemical. It seems to contradict the importance of the survival of the self and species. There must be a specific environmental stimulus (whether past, present or what is feared to come)that causes one to feel in such ways... it is a confusing puzzle."
Different psychological disorders have different physiological/environmental/social interaction levels, but all do appear to play a part in these disorders. For some it is almost all environment and social, for others it is almost purely physiological in nature.
Being manic-depressive (I hate the bipolar label)I have experienced enough to feel strongly that a physiological component is definately there, although it seems that external triggers seem to also be a component of starting an episode off. Going into manic and episodes for weeks or months at a shot even though the environment was changed suggests it is more than environment. Becoming seriously depressed when there was nothing in my life that should have triggered such a thing is also something that has made me think brain chemistry as well. Finally, rapid cycling when life around me was staying the same was a sure fire indicator that something not emotional or mental was wrong. I felt like my mind was being shaken back and forth and I had no control.
I have heard that my brain couldn't keep its chemistry in balance properly, it would detect the deficiency and would work to compensate. However, it doesn't know when to stop and causes an overabundance of the chemical/neurotransmitter this time. This back and forth cycle is what rapid cycling is I was told. It makes sense, no psychological counselling could stop it from happening, the only thing that got it under control was lithium. Don't get me wrong, counselling has been tremendous help with recognizing and dealing with triggers in my environment, but it had to be supplimented with medication.
Not all disorders require meds, but some do. It helps to remember that our feelings are created through electro-chemical signals in our bodies, not some mystical place outside our bodies. Hormones and neurotransmitters and their release can be affected by our environment, thoughts, AND faulty genes or transmission system. A faulty gene can cause a person a world of distress and make them experience thoughts and feelings that their environment had no part in creating.
Posted by Tomatheus on January 30, 2006, at 22:58:37
In reply to Re: Help!! Bipolar, off meds, losing it, posted by Phillipa on January 30, 2006, at 1:17:07
> Okay I see enviorment in this thread but also chemical imbalances so I'm confuesed as to why this is on Social? Anyone else. Fondly, Phillipa
Phillipa,
I originally posted this message on the meds board (under the "Help!! Bipolar, off meds, losing it" thread, as the title indicates), but Dr. Bob redirected it here. My guess is that he didn't want the debates about chemical imbalances and whether or not meds are the "ultimate answer" to take over the thread, which did not begin as a debate-oriented thread at all.
Tomatheus
Posted by TexasChic on January 31, 2006, at 19:37:19
In reply to Re: Help!! Bipolar, off meds, losing it, posted by fenix on January 29, 2006, at 18:50:05
This is the end of the thread.
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