![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 50 to 74 of 74. Go back in thread:
Posted by SLS on March 26, 2012, at 15:19:21
In reply to Re: new pdoc says there 'are no answers', posted by TiredofChemicals on March 26, 2012, at 14:41:52
> kidding, I really have to study all that is written to begin to understand what is being said. I admit too that, I have to blow the dust off the ol' Websters as there are words being used here that I am unfamiliar with.
>
> I'm being educated. I appreciate it.
>
> Regards
I am genuinely happy that you feel that way.I don't intend to "dumb-down" everything I have to say. How pretentious that would be. The people here deserve better than that. Besides, I genuinely believe that everyone here is capable of learning things. I am always delighted when I see one of us "laymen" (including me) digest facts and become capable of synthesizing their own ideas using them. Knowing facts is valuable, but not nearly as valuable as applying oneself to gain true understanding using them.
I know that a dictionary comes in handy. It is a bit of a balancing act. When I address individual posters, I try to take into consideration where I think they are along their journey to self-education and understanding. I would rather be understood than to seem pedantic and have nothing I write be understood. There is no lack of intelligence here - only a disease that convinces us otherwise about ourselves.
I use a dictionary, too. Some very impressive words are being thrown about at Psycho-Babble.
- Scott
Posted by SLS on March 26, 2012, at 19:50:25
In reply to Re: new pdoc says there 'are no answers' » SLS, posted by zazenducke on March 26, 2012, at 8:46:28
> Frederick Quitkin noted in his studies that placebo responders will report feeling improved earlier, often in week 1, compared to active treatment. In addition placebo responders more often relapse early, often by week 4.
Andrew A Nierenberg, Frederic M Quitkin, Charlotte Kremer, Martin B Keller, and Michael E Thase
http://www.nature.com/npp/journal/v29/n5/full/1300405a.html
I think this is a very well done article.
Check out the bibliography.
- Scott
Posted by zazenducke on March 26, 2012, at 20:00:01
In reply to Re: new pdoc says there 'are no answers' » zazenducke, posted by SLS on March 26, 2012, at 9:44:45
> > > > Believing the placebo argument is spurious of course would enhance the chances that one would obtain a robust placebo response.
>
> What I meant to say is that the the high rate of placebo response evident in more recent investigations of major depressive disorder is used by some people to promulgate a thesis that antidepressants are ineffective. I believe this is a spurious argument.
>Now I understand what you are saying but I don't agree.
> > The placebo effect depends on the person who receives the placebo not realizing it is a placebo.
>
> I think the placebo effect depends upon the understanding that the assignment of placebo versus active treatment is randomized. Sometimes, an active placebo is used to fool people that they are being given the active treatment.DEFINITION The placebo effect is a positive therapeutic effect claimed by a patient after receiving a placebo believed by him to be an active drug. I was talking about individuals not studies.
>
> > If you take a pill and believe the studies which show the relief afforded by this pill are caused by the placebo effect it cannot act as a placebo.
>
> Sorry. I don't understand what you are saying here.
>Again I am talking about individuals. If an individual takes a pill which he believes produces relief by placebo effect then he does not believe the pill is an active agent which is required by the definition.
> > > The placebo "response" rate decreases as the degree of severity of depression increases. What are your thoughts on this observation?
>
> Quite simply, I believe this means that the likelihood of selecting people who truly have the disease being investigated is greater. People who are eligible for the study will exhibit severe psychomotor retardation, cognitive impairments, slow thinking and speech, profound anergia, etc. These people are likely to have the MDD illness. People with less severe depressions will more often be representitive of conditions other than MDD and that are more responsive to psychosocial influences.
>
> Frederick Quitkin noted in his studies that placebo responders will report feeling improved earlier, often in week 1, compared to active treatment. In addition placebo responders more often relapse early, often by week 4.
>
> You synthesize very logical and insightful propositions. It might be instructive for you to have more facts to work with to refine those propositions. I think you will find that the issue is rather complex. It is somewhat difficult to find relevant investigations and articles that are objective in approach.
>
>
> - ScottScott if you change the definition of MDD then the studies don't prove anything either way. They're irrelevant. The whole definition is so subjective. And then evaluating results with self reporting and checklists by clinicians based on their judgement with no objective tests or lab results etc etc
You may be right though.
Sorry I was unclear.
Posted by SLS on March 26, 2012, at 21:04:54
In reply to Re: new pdoc says there 'are no answers', posted by zazenducke on March 26, 2012, at 20:00:01
> Scott if you change the definition of MDD then the studies don't prove anything either way.
Are you saying that *I* have changed the definition of MDD?
- Scott
Posted by TiredofChemicals on March 26, 2012, at 21:09:36
In reply to Re: new pdoc says there 'are no answers', posted by zazenducke on March 26, 2012, at 20:00:01
I had the placebo effect for ten years just having a caring and nice psychiatrist. The meds didn't do sh*t but I, at least, felt "cared for."
I would probably still be under his care if life events hadn't changed.
My decision to stop taking psychiatric drugs was not entirely my own decision. I was forced to move away from where he practiced.
I also could not afford to see a psychiatrist on a regular basis which, really did not impact me negatively.Different family dynamics, for me, has been one of the biggest positive impacts as to a better overall state of well being.
Posted by SLS on March 26, 2012, at 21:14:17
In reply to Re: new pdoc says there 'are no answers', posted by TiredofChemicals on March 26, 2012, at 21:09:36
> I had the placebo effect for ten years just having a caring and nice psychiatrist. The meds didn't do sh*t but I, at least, felt "cared for."
>
> I would probably still be under his care if life events hadn't changed.
>
> My decision to stop taking psychiatric drugs was not entirely my own decision. I was forced to move away from where he practiced.
> I also could not afford to see a psychiatrist on a regular basis which, really did not impact me negatively.
>
> Different family dynamics, for me, has been one of the biggest positive impacts as to a better overall state of well being.
This is all good stuff. I hope your life heads in the direction you want it to while remaining drug-free. If I could, I would do the same.
- Scott.
Posted by TiredofChemicals on March 26, 2012, at 21:40:44
In reply to Re: new pdoc says there 'are no answers' » TiredofChemicals, posted by SLS on March 26, 2012, at 21:14:17
Scott, I have posted it before but I will post it again so that I can remain on a (hopefully) trustworthy basis here, I thought I did anyways.
I recently had a traumatic injury so I am prescribed pain medications. The pain medications impact my mood significantly. So, as it is now, I am posting "under the influence."
My doctor has also prescribed Lyrica to treat neuropathic pain. As it turns out, the Lyrica is helping to manage nerve spasms that have been affecting my life since around 2006 or so.
I have been exhaustively searching for something to help me to manage these spasms for the last couple of years. It is a godsend that has also affected my mood greatly.
My state of well being has been greatly impacted for the better for only the last month or so.
I am still experiencing and relishing the great relief that the Lyrica has provided for the nerve spasms that have plagued me since 2006! It has changed my life!
So, wait until I am off the pain medications and we will see where I am at. I am a pretty miserable person when not under the influence and totally drug free.
Posted by TiredofChemicals on March 26, 2012, at 21:54:17
In reply to Re: new pdoc says there 'are no answers' » TiredofChemicals, posted by SLS on March 26, 2012, at 21:14:17
> > I had the placebo effect for ten years just having a caring and nice psychiatrist. The meds didn't do sh*t but I, at least, felt "cared for."
> >
> > I would probably still be under his care if life events hadn't changed.
> >
> > My decision to stop taking psychiatric drugs was not entirely my own decision. I was forced to move away from where he practiced.
> > I also could not afford to see a psychiatrist on a regular basis which, really did not impact me negatively.
> >
> > Different family dynamics, for me, has been one of the biggest positive impacts as to a better overall state of well being.
>
>
> This is all good stuff. I hope your life heads in the direction you want it to while remaining drug-free. If I could, I would do the same.
>
>
> - Scott.
Maybe I should stop posting altogether or start an opiate responder thread of my own. I am sorry if I have mislead people.All that I have posted has been truthful up to this point however.
Posted by SLS on March 26, 2012, at 22:04:20
In reply to Re: new pdoc says there 'are no answers', posted by TiredofChemicals on March 26, 2012, at 21:54:17
> Maybe I should stop posting altogether
Now, that's silly.
> or start an opiate responder thread of my own. I am sorry if I have mislead people.
You have not misled anyone. You are simply reporting your experiences. If you felt the need to amend your descriptions, you are demonstrating a great deal of fidelity - something that I hold in high esteem and hope that I can duplicate for myself. You are not untrustworthy. The worst thing you can be accused of is an unintentional incompleteness in presenting your entire life story in a single post. :-)
> All that I have posted has been truthful up to this point however.
And by amending your descriptions, you remain truthful. Right?
- Scott
Posted by TiredofChemicals on March 26, 2012, at 22:12:44
In reply to Re: new pdoc says there 'are no answers' » TiredofChemicals, posted by SLS on March 26, 2012, at 22:04:20
And by amending your descriptions, you remain truthful. Right?
What I have said has been true.
That's my story and I'm sticking to it lol.;-)
Posted by zazenducke on March 27, 2012, at 6:45:50
In reply to Re: new pdoc says there 'are no answers' » zazenducke, posted by SLS on March 26, 2012, at 21:04:54
> > Scott if you change the definition of MDD then the studies don't prove anything either way.
>
> Are you saying that *I* have changed the definition of MDD?
>
>
> - ScottAre you saying that?
Or are you saying participants in study were misdiagnosed?
Then the researchers were incompetent who cares about the results?Or are you saying the study was not done on people who were diagnosed with MDD? Then why are we trying to make it relevant?
Or would you like to talk about the weather? I would ! Nice seeing you again!
Posted by SLS on March 27, 2012, at 8:12:23
In reply to Re: new pdoc says there 'are no answers', posted by zazenducke on March 27, 2012, at 6:45:50
> > > Scott if you change the definition of MDD then the studies don't prove anything either way.
> >
> > Are you saying that *I* have changed the definition of MDD?
> >
> >
> > - Scott
>
> Are you saying that?Absolutely not. It does take a bit of reading to come to understand the various faces that the one ubiquitous word "depression" describes. Severe MDD includes the symptom clusters that I outlined in my previous post. There are psychological, behavioral, and biological fingerprints that aid in its accurate diagnosis and effect treatment. I posted something a little further down on the board presenting a synopsis of MDD. You will find words like "psychomotor retardation" in there.
http://www.minddisorders.com/Kau-Nu/Major-depressive-disorder.html
"Psychomotor retardation (slowed thinking, speech, body movements) or agitation (inability to sit still, hand-wringing,"
"Problems with clear thinking, concentration, and decision-making. "
These are considered vegetative symptoms.
> Or are you saying participants in study were misdiagnosed?
Yup.
> Then the researchers were incompetent who cares about the results?Yup.
> Or are you saying the study was not done on people who were diagnosed with MDD? Then why are we trying to make it relevant?
I think it is also important to see if antidepressant drugs are helpful for people who report feeling depressed, but who don't suffer from MDD or BD. Studies that disallow severe cases of depression so that dysthymia and other cases of mild to moderate depression be studied are valuable. These people are no less ill. What about complicated bereavement? BPD? Depressive thought style? Situational? Psychodynamically challenged? Etc.
> Or would you like to talk about the weather? I would ! Nice seeing you again!
:-)
You are a wealth of intelligence and creativity. I don't always understand your motivations, but it is sure a challenge for me to "get it". I would probably lose a game of chess with you, whether it be on a chess board or a forum for debate. You are tough.
- Scott
Posted by Dinah on March 27, 2012, at 9:34:20
In reply to new pdoc says there 'are no answers', posted by raisinb on March 24, 2012, at 9:01:20
FWIW, my best experiences have been with this type of pdoc. My last pdoc might have said something of the sort. My favorite quote from him was that medications have side effects, and not taking medications has side effects, and it was my choice which side effects I preferred. He was very down to earth and results oriented.
My worst experiences were with pdocs with complete belief that medications did provide cures.
Humility in medicine impresses me. Unless he came across as considering it hopeless of course.
Posted by ron1953 on March 27, 2012, at 13:11:40
In reply to Re: new pdoc says there 'are no answers' » TiredofChemicals, posted by SLS on March 26, 2012, at 15:19:21
"When I address individual posters, I try to take into consideration where I think they are along their journey to self-education and understanding."
And there lies my main problem with many of your posts, particularly the ones directed to me - you take into consideration things that you cannot possibly know. You know absolutely nothing about my "journey", yet you take liberties thinking that you do. Just stick to your pedantic, over-intellectualized posts and let the chips fall where they will.
And if you're genuinely interested in what I actually think about these matters of institutionalized mental health care, read "Commonsense Rebellion" and "The Psychopath Test", just two examples of writings that have not informed my opinions so much as confirming long-help suspicions. These are writings that are much more eloquent than I can express in my own words.
Posted by SLS on March 27, 2012, at 14:21:45
In reply to Re: new pdoc says there 'are no answers', posted by ron1953 on March 27, 2012, at 13:11:40
> "When I address individual posters, I try to take into consideration where I think they are along their journey to self-education and understanding."
>
> And there lies my main problem with many of your posts, particularly the ones directed to me - you take into consideration things that you cannot possibly know. You know absolutely nothing about my "journey", yet you take liberties thinking that you do. Just stick to your pedantic, over-intellectualized posts and let the chips fall where they will.It would shock the hell out of you to learn just how little time I spend thinking about your journey.
- Scott
Posted by ron1953 on March 27, 2012, at 14:27:13
In reply to Re: new pdoc says there 'are no answers' » ron1953, posted by SLS on March 27, 2012, at 14:21:45
> It would shock the hell out of you to learn just how little time I spend thinking about your journey.Not at all - I suspect as much time as I spend thinking about yours. But I really don't need to anyway, because I'm really quite familiar with the journeys of college-type regurgitators who are thoroughly mired in faulty paradigms.
Posted by SLS on March 27, 2012, at 15:00:12
In reply to Re: new pdoc says there 'are no answers', posted by ron1953 on March 27, 2012, at 14:27:13
>
> > It would shock the hell out of you to learn just how little time I spend thinking about your journey.
>
> Not at all - I suspect as much time as I spend thinking about yours. But I really don't need to anyway, because I'm really quite familiar with the journeys of college-type regurgitators who are thoroughly mired in faulty paradigms.
>Self-agrandizing cynical narcissists always say that about me. That's just an observation I have made over the years. Of course, I don't know whether or not you fit into that catergory.
Don't worry.
- Scott.
Posted by ron1953 on March 27, 2012, at 15:08:25
In reply to Re: new pdoc says there 'are no answers' » ron1953, posted by SLS on March 27, 2012, at 15:00:12
> Self-agrandizing cynical narcissists always say >that about me. That's just an observation I have >made over the years. Of course, I don't know >whether or not you fit into that catergory.I suppose that depends on whether you think the DSM is a valid piece of work, as opposed to the piece of dreck that it really is.
Posted by ron1953 on March 27, 2012, at 15:42:16
In reply to Re: new pdoc says there 'are no answers', posted by ron1953 on March 27, 2012, at 15:08:25
I believe that science is defined more by what it DOESN'T know than what it does. The pdoc cited in this thread appears to reflect this, and has the balls and compassion to tell it straight to a patient. Along with Santa Claus and The Easter Bunny, myths about science's all-knowing status pervade, and the pompous (and wealthy) medical/psychaitric industry continues to convince people that all of their discomforts can be fixed, especially with medication. Do I blame the industry? Not really. I ultimately blame the fools who don't have the temerity to question the status quo. There are certainly people who need and benefit from psychiatric treatment, but there are also certainly those for whom such treatment is unnecessary, or worse, actually damaging. I wonder about the folks who have undergone treatment for several years to no avail, yet never seem to ask, "What's wrong with this picture?". They continue to beat the same dead horse. I admire and respect a realistic practitioner who discourages knee-jerk treatment to every poor soul who shows up at his office.
Most of us have been conditioned (or at least encouraged) to blindly obey "experts" with long lists of credentials, and to ignore our own inner voices. And that has has sad effects all over the place.
Perhaps practitioners such as the one this thread is about do many a great service in discouraging an endless regimen of medically chasing one's own tail.
Scientology and other anti-psychiatry philosophies may not have it all correct, but they ask some rather pertinent questions, as does Lou Pilder.
Posted by Dr. Bob on March 27, 2012, at 21:32:02
In reply to Re: new pdoc says there 'are no answers', posted by ron1953 on March 27, 2012, at 13:11:40
> your pedantic, over-intellectualized posts
Please don't post anything that could lead others to feel accused or put down.
But please don't take this personally, either, this doesn't mean I don't like you or think you're a bad person, and I'm sorry if this hurts you.
I do hope that you choose to remain a member of this community and that members of this community help you, if needed, to avoid future blocks. If you want to be proactive, you could ask another poster to be your civility buddy:
http://www.dr-bob.org/babble/faq.html#buddies
It's up to you to decide whom you interact with. Sometimes interacting with others may be frustrating, staying civil may be a challenge, and new skills may help. If you're open to developing new skills (which I realize may not be why you came in the first place), that's another way in which you may be supported by other posters.
More information about posting policies and tips on alternative ways to express yourself, including a link to a nice post by Dinah on I-statements, are in the FAQ:
http://www.dr-bob.org/babble/faq.html#civil
http://www.dr-bob.org/babble/faq.html#enforceFollow-ups regarding these issues should be redirected to Psycho-Babble Administration. They, as well as replies to the above post, should of course themselves be civil.
Thanks,
Bob
Posted by Raisinb on March 28, 2012, at 21:48:59
In reply to Re: new pdoc says there 'are no answers' » raisinb, posted by Dinah on March 27, 2012, at 9:34:20
Yes, I felt that the humility and honesty were worth a second visit, which I'll attend in a couple of weeks.
Posted by sigismund on March 31, 2012, at 1:57:40
In reply to Re: new pdoc says there 'are no answers', posted by linkadge on March 25, 2012, at 7:23:23
>The only problem with them being honest, is that they risk loosing the placebo effect - and hence, most of their buisness.
They become much more attractive, especially to those who have stopped looking for hope and are just passing the time.
Posted by JohnLA on March 31, 2012, at 17:41:59
In reply to Re: new pdoc says there 'are no answers' » linkadge, posted by sigismund on March 31, 2012, at 1:57:40
>They become much more attractive, especially to those who have stopped looking for hope and are just passing the time.
sigismund- could you explain further what you mean here?
thanks.
john
Posted by sigismund on March 31, 2012, at 20:24:36
In reply to @sigismund, posted by JohnLA on March 31, 2012, at 17:41:59
Well sure, John.
When I was 20 I very much wanted there to be some kind of hope given by this secular priesthood. I moved from psychiatry where it was a bit thin on the ground (this is 40 years ago before people became excited over pharmacology) to psychoanalysis which still had a bit of oomph left in it back then. I needed there to be hope. But what I needed was, I can see now and I intuited then, was something like a new upbringing. Getting someone like me hooked on benzos was not much of an advance. There are better things which older societies would have taken for granted, activities and kinds of carefully managed friendships.
Now I am 60. When I see my psych neither of us is talking about hope. If there are any useful interventions we will make them if we can figure them out. Prazosin and trimipramine at the moment. Mainly we share a sense of despair, about the world today. That is precious to me and makes me think I was being too flip when I talked about just passing the time. Right now I am reading Joe Bageant "Waltzing at the Doomsday Ball". It is so funny. It shouldn't be, but he makes it so.
Posted by phidippus on April 3, 2012, at 18:57:23
In reply to new pdoc says there 'are no answers', posted by raisinb on March 24, 2012, at 9:01:20
What a goof.
Eric
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
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.