![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 19 of 19. This is the beginning of the thread.
Posted by poser938 on May 2, 2014, at 15:06:57
I got back from my inpatient stay a few hours ago. It was just a 3 day stay to try to clear my mind and get some things in order. And it was my 4th time being there in the past 2 years. It usually ends up being a good experience.
But I've been noticing something when I go there. Nearly everyone smokes. The unit holds 15 people, and when I first got there, it was only me and this other girl that didn't smoke. But she left a day before I did, leaving me to be the only one that doesn't smoke.
I didnt go around asking everyone if they smoke, but when they go on the 15 minute smoke break about every 2 hours, the ones who didn't smoke stayed inside.
Now you could think that they started smoking because of their high stress levels. But from what I've read, smoking actually increases stress over time. And many people that I know who smoke, often seem so stressed (such as my parents). It is like they create a temporary relaxation, especially when someone starts smoking, only to end up causing more problems that only smoking more can "fix".
But yeah, every time I go there, nearly everyone smokes.
It just makes sense that not only is smoking bad for your physical health, but also mental health.
Posted by Phillipa on May 2, 2014, at 16:38:26
In reply to Smoking increases mental illness risk??, posted by poser938 on May 2, 2014, at 15:06:57
For some it relaxes. Me never did reeved me up and made me dizzy.
I have seen that many patients with schizophenia, and bipolar severe do seem to smoke. I read it increases dopamine I think? Someone else will most likely know more. P
Posted by poser938 on May 3, 2014, at 23:14:07
In reply to Re: Smoking increases mental illness risk?? » poser938, posted by Phillipa on May 2, 2014, at 16:38:26
> For some it relaxes. Me never did reeved me up and made me dizzy.
>
> I have seen that many patients with schizophenia, and bipolar severe do seem to smoke. I read it increases dopamine I think? Someone else will most likely know more.This site won't let me copy and paste from the article, but its basically describing a study with 1,190 participants. And the ones who smoked were more likely to develop depression during the 11 year period that the study was done. And heavy smokers were the most likely to experience depression, while non-smokers were the least likely to develop depression during the 11 years.
Posted by Phil on May 4, 2014, at 12:53:09
In reply to Re: Smoking increases mental illness risk??, posted by poser938 on May 3, 2014, at 23:14:07
it's an imperfect world with imperfect people. most roped into smoking in their early teens. if it was a perfect world you or i wouldn't have been in psych wards in the first place. live and let live. preaching to smokers is the last way to help them. it's no one elses business in the first place. when i smoked, if people tried to educate me about my smoking got an education of their own. smokers are pretty smart people doing the best they can.
when i met these people i wondered, do you beat your kids, cheat on your partner, speed thru school zones, cheat at poker, lousy diet, etc
smokers were an easy target so non smokers could ignore their own.
Posted by Christ_empowered on May 4, 2014, at 14:15:46
In reply to Re: Smoking increases mental illness risk??, posted by Phil on May 4, 2014, at 12:53:09
as a former smoker (switched to vaping), I'd say its part of a cycle. Oxidative stress=more TD, more problems; stress=more need for nicotine. That's my take on it.
Also, chain smoking is associated with lower socioeconomic status (so is mental illness) and poorer dietary intakes of nutrients, so then you get considerably increased sickness and death.
Vapes for everyone!
Posted by Phillipa on May 4, 2014, at 18:51:42
In reply to Re: Smoking increases mental illness risk??, posted by Christ_empowered on May 4, 2014, at 14:15:46
From Nami
Home Hearts and Minds Smoking Cessation
| Print this page | Email this page
| Save to myNAMI
Smoking_Cessation
MainMedical Self-AdvocacySmoking & Substance AbuseHealthy EatingExerciseMindfulnessResourcesSmoking and Mental Illness
People living with mental illness have a very high rate of smoking. A study by The Journal of the American Medical Association reported that 44.3 percent of all cigarettes in America are consumed by individuals who live with mental illness and/or substance abuse disorders. This means that people living with mental illness are about twice as likely to smoke as other persons.A positive note is that people who live with mental illness had substantial quit-rates, which were almost as high as the group without mental illness. NAMI has led many changes in our mental health system─getting access to the tools to quit smoking is a way to improve the quality and quantity of life. Improving lives is a new advocacy pursuit.
The Connection between Mental Illness and Smoking
There is no one single, certain reason why so many people who live with mental illness smoke. It may be a combination of brain effects, psychological effects and the social world in which we live.From a brain-based perspective, research is being done to determine if and how nicotine is involved in some of the brain's memory functions. If nicotine is a factor, then this could explain why so many people living with an illness like schizophrenia or other illness involving cognitive deficits may smoke. Even though smoking is thought to enhance concentration and cognition, the effects are short in duration.
Researchers and the medical community have a great deal to learn about how smoking impacts the brains of those living with mental illness. It is known that people diagnosed with schizophrenia often smoke before the onset of symptoms and that they smoke more often and inhale more deeply than smokers without schizophrenia.
While we still have a lot to learn about why people smoke, there is plenty of information to support the serious health risks of smoking. So while there may be good reasons why you were attracted to smoking, the key is to figure out ways to increase rates of quitting. Nicotine isn't a health problem on its own, but when smoked and combined with hundreds of other chemicals that are present in cigarettes the practice of smoking is toxic.
Psychologically, all addictions soothe cravings. People often find themselves relaxed and less tense when their addiction is fed. This is true of cigarette smoking. Smoking can also be part of a social norm, one where people in your social circle all hang out and smoke. Some people who live with mental illness learned to smoke in a hospital or in group-living settings. These examples help illustrate how the mental health culture needs to move forward to reduce the tie between socialization and smoking.
Facts About Smoking
People die from smoking-related illnesses. Every year, smoking kills about 200,000 people who live with mental illness. Smoking harms nearly every organ of your body and diminishes your overall health. Smoking is a leading cause of cancer and of cancer-related death.Smoking also causes heart disease, stroke and lung disease. With the increased risk of heart disease from second-generation atypical antipsychotic medications (SGAs), individuals living with mental illness must try to quit.
Inhaled cigarette smoke is made up of 4,000 chemicals, including cyanide, benzene, ammonia and carbon monoxide to name a few. There is no safe tobacco product, so switching to a smokeless or chew product will not eliminate your risk of smoking-related diseases.
People are finally waking up to the fact that smoking is a true health hazard, and people need to quit in order to live longer. More psychiatric facilities are going smoke-free, and NAMI is advocating for access to smoking cessation in outpatient settings.
State mental health commissioners and state medical directors are committed to changing the way the public mental health culture relates to smoking. Check out their toolkit (http://www.nasmhpd.org/general_files/publications/NASMHPD.toolkitfinalupdated90707.pdf) to see what policy changes and strategies they are using to create a healthier mental health system environment.
Second-hand Smoke
There are two types of second-hand smoke: mainstream smoke─the smoke that is exhaled by a smoker, and sidestream smoke─the smoke that comes from a burning cigarette, cigar or pipe. Second-hand smoke is inhaled by nonsmokers who are around smokers. It lingers in the air after cigarettes, cigars or pipes have been extinguished. Exposure to second-hand smoke is called involuntary smoking or passive smoking. Second-hand smoke can cause or exacerbate a wide range of adverse health effects, especially in children.Second-hand smoke has been classified by the EPA as a known carcinogen. It contains hundreds of chemicals, including formaldehyde, benzene, vinyl chloride, arsenic ammonia and hydrogen cyanide.
According to the American Lung Association, second-hand smoke causes almost 50,000 deaths in adult nonsmokers in the United States each year, including approximately 3,400 from lung cancer and as many as 69,600 from heart disease. It can also irritate the lungs causing coughing, wheezing, increased phlegm and a feeling of breathlessness. Children who are exposed have an increased risk of asthma attacks, ear infections and lung diseases (i.e., pneumonia and bronchitis).
To protect yourself and your family from second-hand smoke, do not allow anyone to smoke in your home. If you have loved ones or coworkers who smoke, make sure they know that you would prefer them to not smoke around you and your family. Do not smoke or allow others to smoke in your car. Choose restaurants and bars that are smoke-free. Make sure your child's day care, school and after-school programs are smoke-free. Finally, ask your employer, clubhouse, hospital or day program to create a smoke-free policy.
Smoking's Effects on Symptoms and Medications
Research shows that people living with mental illness do not have worse symptoms after they quit. It is understandable that this is a concern with quitting smoking. Quitting is hard work, and it may take many efforts to be successful. Be sure to get support, talk with your doctor, set a quit date and explore the tools for success (Link to tools for success section) that are available to help you quit.If you are a smoker and you quit, you can usually get the same treatment results from lower doses of psychiatric medications. Smoking increases the breakdown of medicines in your body, so smokers need to take higher doses to get the same results as someone who does not smoke. Without cigarettes you may need to take less medication. An additional benefit is that a dose reduction will likely reduce side effects of medicines, such as weight gain and other side effects.
Smoking and Diabetes
It is very hard to live with more than one medical problem. Diabetes is a big issue for many people who live with mental illness and, like smoking, it increases the chances of early death. The two problems together are twice as dangerous. Smoking is very bad for diabetes; the two together worsen all risks. For instance, smoking and diabetes increases your chances of having a heart attack 11 times higher than the general population. Be sure to talk with your health care provider about how to manage these risks and how to prioritize your self-care efforts.
Posted by phidippus on May 4, 2014, at 20:34:41
In reply to Smoking increases mental illness risk??, posted by poser938 on May 2, 2014, at 15:06:57
Nicotine, the active psychoactive ingredient in cigarettes exerts a wide range of psychological effects. It is both a stimulant and a relaxant. When a cigarette is smoked, nicotine-rich blood passes from the lungs to the brain within seven seconds and immediately stimulates the release of many chemical messengers such as acetylcholine, norepinephrine, epinephrine, arginine vasopressin, serotonin, dopamine, and beta-endorphin. At low doses, nicotine potently enhances the actions of norepinephrine and dopamine in the brain, causing a drug effect typical of those of psychostimulants. At higher doses, nicotine enhances the effect of serotonin and opiate activity, producing a calming, pain-killing effect.
Nicotine has varied positive effects on the brain: A study has shown a protective effect of nicotine itself on neurons due to nicotine activation of α7-nAChR and the PI3K/Akt pathway which inhibits apoptosis-inducing factor release and mitochondrial translocation, cytochrome c release and caspase 3 activation. There is evidence that nicotine itself has the potential to prevent and treat Alzheimer's disease. Studies have indicated that nicotine can be used to help adults suffering from autosomal dominant nocturnal frontal lobe epilepsy. The same areas that cause seizures in that form of epilepsy are responsible for processing nicotine in the brain.
Research at Duke University Medical Center found that nicotine may improve the symptoms of depression. Nicotine appears to improve ADHD symptoms. Some studies have focused on benefits of nicotine therapy in adults with ADHD. Nicotine (in the form of chewing gum or a transdermal patch) has been explored as an experimental treatment for OCD. Small studies show some success, even in otherwise treatment-refractory cases. ~ WikipediaI can find no evidence that smoking or nicotine worsens mental illness.
Eric
Posted by poser938 on May 5, 2014, at 4:47:29
In reply to Re: Smoking increases mental illness risk?? » poser938, posted by phidippus on May 4, 2014, at 20:34:41
Its just a hunch I got after seeing many people with mental health problems who also smoke. Especially considering all the ill effects it has on your body. I figured I'd post this since most people only see smoking as only effecting certain parts of your body from your neck down.
I've seen smoking diminish the vitality of too many loved ones, as well as take my grandmas life. Smoking is basically just a social norm, and I'd love to see it not have that status anymore. I've never exactly been addicted to anything before, so I can't say I understand addiction. But I believe society will only benefit if fewer people see getting addicted to cigarettes as a good idea. Smoking wouldn't be anywhere near the problem that it is if it didn't keep people coming back for more and more.
And yeah, I've noticed that describing the horrible effects that smoking has on ones health has no effect on ones desire to smoke after they're already addicted.
Posted by alexandra_k on May 5, 2014, at 20:42:20
In reply to Re: Smoking increases mental illness risk??, posted by poser938 on May 5, 2014, at 4:47:29
cigarettes are often used to reward inpatients - like they are in prison. something of a currency... nursing staff use them as incentives for compliance... this especially used to be the case... 60's... skinnerian techniques of behavioural change. of course people have to be motivated by them in order for those techniques to be effective... nurses (and others) encouraged that, though....
even when i was on the ward... one had to go to ward meeting in order to get ones cigarettes... and / or one had to take ones medication before one got ones cigarettes... if one was being a bit of a problem they'd take them from you for 'safe keeping' and you'd go on rations... then they'd ignore you or give depending on how complient you were...
it is hard to know whether mental illness results causes (so to speak) smoking - or whether smoking causes (so to speak) mental illness... one possibility is that people take up smoking because they find it somewhat effective in managing pre-clinical symptoms of mental illness.
the same applies to mj and alcohol.
i think that smoking helped medicate me for a number of years. certain symptoms became much more prominent now that i've quit. i have problems with being overwhelmed by stimuli that aren't particularly strong or obnoxious to most people. smoking... desensitised me in some way. like how beating my body pretty severely in the gym desensatizes me to touch and to the physical proximity most others like to be at smoking desensitised me to obnoxious odours and tastes... and it sort of focused... weird body complaints of i knew not what... into a fairly obvious hacking smokers cough.
killing me... made me sorta kinda somewhat better.
go figure.
Posted by poser938 on May 6, 2014, at 14:28:21
In reply to Re: Smoking increases mental illness risk??, posted by alexandra_k on May 5, 2014, at 20:42:20
There are many reasons why people start smoking. My mom and dad say they basically started smoking because so many people around them smoked. And that it was "cool".
We often ponder on the causes of mental illnesses, and
I see no reason why it shouldn't be seriously considered that chronic inhalation of burnt particulates filled with many, many chemicals could result in mood problems.Hmph
Posted by phidippus on May 6, 2014, at 16:21:07
In reply to Re: Smoking increases mental illness risk??, posted by poser938 on May 6, 2014, at 14:28:21
Again, studies show that that nicotine can treat depression, OCD and ADHD.
Eric
Posted by alexandra_k on May 6, 2014, at 16:42:10
In reply to Re: Smoking increases mental illness risk?? » poser938, posted by phidippus on May 6, 2014, at 16:21:07
nicotine patches have been prescribed to help prevent alzheimer's and parkinson's, too. for people at high risk. to some effect.
i see no reason why a bunch of things aren't involved in the production of mental illness. sure, why not add smoking to the list. then add not smoking to the list for people who find that quitting smoking results in episodes...
if everything is involved... it is almost like... nothing is.
Posted by poser938 on May 6, 2014, at 17:14:12
In reply to Re: Smoking increases mental illness risk??, posted by alexandra_k on May 6, 2014, at 16:42:10
It would be much better if nicotine were the only thing people were getting in their bodies when they smoke.
(Hopefully this link works on regular computers)
http://www.cdc.gov/tobacco/data_statistics/sgr/2010/consumer_booklet/chemicals_smoke/?mobile=nocontentTobacco smoke contains a deadly mix of more than 7,000 chemicals. Hundreds are toxic. About 70 can cause cancer. Here are some of the chemicals.
Cancer-Causing Chemicals
Formaldehyde: Used to embalm dead bodies
Benzene: Found in gasoline
Polonium 210: Radioactive and very toxic
Vinyl chloride: Used to make pipes
Toxic Metals
Chromium: Used to make steel
Arsenic: Used in pesticides
Lead: Once used in paint
Cadmium: Used to make batteries
Poison Gases
Carbon monoxide: Found in car exhausts
Hydrogen cyanide: Used in chemical weapons
Ammonia: Used in household cleaners
Butane: Used in lighter fluid
Toluene: Found in paint thinners
I'm curious as to how inhaling these chemicals can effect the brain? Or the hormones in the body?
Posted by alexandra_k on May 6, 2014, at 20:27:27
In reply to Re: Smoking increases mental illness risk??, posted by poser938 on May 6, 2014, at 17:14:12
they prescribe patches or gum rather than smoking as a nicotine delivery mechanism.
with respect to the other things...
it would be freaking complicated to say...
one would have to try them individually and then together in varying combinations. one would need to experiment with different dosages because pretty everything ranges from 'no effect' at low enough dose' to 'kills ya' at high enough. one would need to test particular tasks... and / or to do longitudinal studies...
i suspect there is something else chemically active in cigarettes that helped medicate me. i was informed about a person who managed to quit smoking by replacing cigarettes with the gum. as in... they would cut up the nicotine gum into 6 squares and have a square every time they would normally have a cigarette. make their cuppa and go hang with the smokers even and chew while hanging out with them. i thought that that seemed possible for me in a way that simply quitting did not.
it was freaking hard to quit smoking. not hard to quit the gum. it could be that i never managed to get a comperable dose sorted out but i really don't think that was it. it could be psychological but i don't think that was it, either.
there are people around here who have pretty cool looking vaporisers and they use them a lot more like... how one would smoke a pipe. they seem to find that more of an actual substitution. i've never tried it, though, so i don't know.
Posted by poser938 on May 6, 2014, at 21:55:55
In reply to Re: Smoking increases mental illness risk??, posted by alexandra_k on May 6, 2014, at 20:27:27
> they prescribe patches or gum rather than smoking as a nicotine delivery mechanism.
>
> with respect to the other things...
>
> it would be freaking complicated to say...
>
> one would have to try them individually and then together in varying combinations. one would need to experiment with different dosages because pretty everything ranges from 'no effect' at low enough dose' to 'kills ya' at high enough. one would need to test particular tasks... and / or to do longitudinal studies...
>
> i suspect there is something else chemically active in cigarettes that helped medicate me. i was informed about a person who managed to quit smoking by replacing cigarettes with the gum. as in... they would cut up the nicotine gum into 6 squares and have a square every time they would normally have a cigarette. make their cuppa and go hang with the smokers even and chew while hanging out with them. i thought that that seemed possible for me in a way that simply quitting did not.
>
> it was freaking hard to quit smoking. not hard to quit the gum. it could be that i never managed to get a comperable dose sorted out but i really don't think that was it. it could be psychological but i don't think that was it, either.
>
> there are people around here who have pretty cool looking vaporisers and they use them a lot more like... how one would smoke a pipe. they seem to find that more of an actual substitution. i've never tried it, though, so i don't know.Yep Alexandra, you're right. That other effect that smoking has is Mono-Amine Inhibition (MAOI). I think this effect is weak compared to MAOI antidepressants. But this effect combined with nicotine makes the mood effects more substantial, than just nicotine replacement therapy alone.
Posted by Phillipa on May 7, 2014, at 19:40:48
In reply to Re: Smoking increases mental illness risk??, posted by poser938 on May 6, 2014, at 21:55:55
Poser how come smoking always wired me and made me feel horrible? P
Posted by phidippus on May 7, 2014, at 19:47:04
In reply to Re: Smoking increases mental illness risk?? » poser938, posted by Phillipa on May 7, 2014, at 19:40:48
Smoking releases adrenaline, which can make you shaky and anxious.
Eric
Posted by poser938 on May 8, 2014, at 15:45:13
In reply to Re: Smoking increases mental illness risk?? » Phillipa, posted by phidippus on May 7, 2014, at 19:47:04
http://www.bmj.com/content/348/bmj.g1151
AbstractObjective To investigate change in mental health after smoking cessation compared with continuing to smoke.
Design Systematic review and meta-analysis of observational studies.
Data sources Web of Science, Cochrane Central Register of Controlled Trials, Medline, Embase, and PsycINFO for relevant studies from inception to April 2012. Reference lists of included studies were hand searched, and authors were contacted when insufficient data were reported.
Eligibility criteria for selecting studies Longitudinal studies of adults that assessed mental health before smoking cessation and at least six weeks after cessation or baseline in healthy and clinical populations.
Results 26 studies that assessed mental health with questionnaires designed to measure anxiety, depression, mixed anxiety and depression, psychological quality of life, positive affect, and stress were included. Follow-up mental health scores were measured between seven weeks and nine years after baseline. Anxiety, depression, mixed anxiety and depression, and stress significantly decreased between baseline and follow-up in quitters compared with continuing smokers: the standardised mean differences (95% confidence intervals) were anxiety −0.37 (95% confidence interval −0.70 to −0.03); depression −0.25 (−0.37 to −0.12); mixed anxiety and depression −0.31 (−0.47 to −0.14); stress −0.27 (−0.40 to −0.13). Both psychological quality of life and positive affect significantly increased between baseline and follow-up in quitters compared with continuing smokers 0.22 (0.09 to 0.36) and 0.40 (0.09 to 0.71), respectively). There was no evidence that the effect size differed between the general population and populations with physical or psychiatric disorders.
Conclusions Smoking cessation is associated with reduced depression, anxiety, and stress and improved positive mood and quality of life compared with continuing to smoke. The effect size seems as large for those with psychiatric disorders as those without. The effect sizes are equal or larger than those of antidepressant treatment for mood and anxiety disorders.
Posted by phidippus on May 8, 2014, at 16:32:40
In reply to Smoking Cessation eases Depression, posted by poser938 on May 8, 2014, at 15:45:13
Very interesting.
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.