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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 6 to 30 of 30. Go back in thread:
Posted by alexandra_k on November 30, 2014, at 17:59:19
In reply to Re: What If We're Wrong About Depression?Hugh/SLS » SLS, posted by brynb on November 30, 2014, at 10:54:51
I think people are trying, but they haven't been able to find a mechanism like that.
It was a happy day for psychiatry when it was discovered that a subset of psychotic patients had a bacterial infection - Syphilis. That a course of anti-biotics was an effective cure.
Or even that there was a relatively effective medication (lithium) for a subset of cases of mania.
Inflammation... Hormones... All the rage right now. Either those or quantum indeterminacies. If you don't understand x and you don't understand y then maybe the two are related? There might be some principle there... Something about the minimisation of mysteries...
Posted by Phillipa on November 30, 2014, at 20:25:30
In reply to Re: What If We're Wrong About Depression?Hugh/SLS, posted by alexandra_k on November 30, 2014, at 17:59:19
Did you know that the same test for lymes is the same as for syphilis? Phillipa
Posted by Hugh on December 1, 2014, at 14:03:20
In reply to Re: What If We're Wrong About Depression? » Hugh, posted by SLS on November 30, 2014, at 0:40:48
> I think it is equally important to consider that inflammation might be the result of illness rather than its cause.
I think Dr. Canli would agree with you. He's arguing that bacterial infections or viral infections or parasites can cause inflammation, which in turn can cause depression. I suffer from an inflamed colon at times, and when my colon becomes inflamed, my depression worsens. When my colon improves, so does my depression. Last fall I suffered from bronchitis for several weeks. When my lungs were inflamed, I became severely depressed. As my lungs improved, so did my depression.
Posted by Hugh on December 1, 2014, at 14:10:55
In reply to Re: What If We're Wrong About Depression? » Hugh, posted by Phillipa on November 29, 2014, at 14:02:31
> Do you have a facebook page? I ask as there is a facebook page where you can order your own labs.
No, I'm not on Facebook. I've used healthcheckusa and privatemdlabs to do blood tests.
Posted by Hugh on December 1, 2014, at 14:48:29
In reply to Re: What If We're Wrong About Depression?Hugh/SLS » SLS, posted by brynb on November 30, 2014, at 10:54:51
> I'm in a tenuous place right now. I don't want to take additional meds, but I need to right now to get through a rough spot.
Bryn,
I know you've done rTMS with Dr. Fruitman. You might see if he'd be willing to let you try rTMS with priming stimulation. Instead of receiving 10 hertz over the left prefrontal cortex (which you probably did), you'd have your right side treated. Priming stimulation means that you'd receive a brief exposure to 6 hertz, followed by a longer exposure to 1 or 2 hertz. This is sometimes more effective than the standard rTMS protocol. This article explains it:
Deep TMS is now available in NYC from these doctors:
http://www.brainsway.com/us/find-a-facility?distance[country]=us&distance[postal_code]=10018
I know of two neurofeedback clinicians in NYC who have very good reputations -- Mark Smith and Merlyn Hurd. Here are their sites:
Posted by brynb on December 1, 2014, at 18:30:17
In reply to Re: What If We're Wrong About Depression?Hugh/SLS » brynb, posted by Hugh on December 1, 2014, at 14:48:29
Hugh-
Thanks as usual for your valuable info.
I'm strapped for cash & was unimpressed w tms/rtms.
Unfortunately, fruitman is nothing but an RX pad for me right now & it'll have to do.
Hope you're faring well :).
Posted by Hugh on December 4, 2014, at 14:15:36
In reply to What If We're Wrong About Depression?, posted by Hugh on November 29, 2014, at 11:44:02
Here's another possible mechanism that causes depression:
Posted by Phillipa on December 4, 2014, at 20:52:42
In reply to Re: What If We're Wrong About Depression?, posted by Hugh on December 4, 2014, at 14:15:36
Hence stress leads to depression . Phillipa
Posted by Hugh on December 5, 2014, at 9:56:49
In reply to Re: What If We're Wrong About Depression? » Hugh, posted by Phillipa on December 4, 2014, at 20:52:42
It's how you handle stress that matters. I handle it very poorly, and avoid it whenever possible. But I have a sister who thrives on stress.
Posted by brynb on December 5, 2014, at 13:26:25
In reply to Re: What If We're Wrong About Depression? » Phillipa, posted by Hugh on December 5, 2014, at 9:56:49
I think that's a huge indicator. I shutdown; I simply can't cope w stress. And, it's become so entrenched neurologically I "feel/see" it before it hits, thus deepening my response further.
-b
Posted by Phillipa on December 5, 2014, at 20:07:15
In reply to Re: What If We're Wrong About Depression? » Hugh, posted by brynb on December 5, 2014, at 13:26:25
Same here to me anticipatory anxiety. I almost create my own. I used to thrive also on stress but it was when working in nursing. I guess cause the stress was getting a patient well or solving a problem it was almost fun. How things changed . Phillipa
Posted by SLS on December 5, 2014, at 20:11:56
In reply to Re: What If We're Wrong About Depression? » Hugh, posted by brynb on December 5, 2014, at 13:26:25
A lack of resilience has been linked to an overactive medial prefrontal cortex (mPFC). This might explain the efficacy of deep brain stimulation (DBS) to treat depression. "Stimulation" is a misnomer. DBS actually interrupts - or "jams" - neuronal signals to prevent overactivity.
Mindfulness training and regular meditation might be helpful. Both seem to reduce mPFC activity and the strength of neural connections there.
Have you ever tried Lamictal or Topamax? I am guessing that drugs that reduce glutamatergic neurotransmission would help reduce mPFC overactivity, and thus, depression. I am also guessing that both of these drugs might work better when combinined with Abilify.
- Scott
Posted by baseball55 on December 5, 2014, at 21:10:37
In reply to Re: What If We're Wrong About Depression? » brynb, posted by SLS on December 5, 2014, at 20:11:56
Stress is not an issue for me and never has been. I deal well with stress, am energized by it and find I rise to the stressful situation and am pleased with myself.
But I still have MDD. I do not feel stressed when I am depressed. I feel hopeless and avoid life, including stressful events that might, in fact, make me feel better.
Maybe for some people, stress leads to depression. But not for me.
Posted by SLS on December 6, 2014, at 6:13:25
In reply to Re: What If We're Wrong About Depression?, posted by baseball55 on December 5, 2014, at 21:10:37
> Stress is not an issue for me and never has been. I deal well with stress, am energized by it and find I rise to the stressful situation and am pleased with myself.
>
> But I still have MDD. I do not feel stressed when I am depressed. I feel hopeless and avoid life, including stressful events that might, in fact, make me feel better.
>
> Maybe for some people, stress leads to depression. But not for me.
It definitely can, though. This is especially true in adolescence, where chronic anxiety is sometimes considered prodromal to depression. However, a lack of resilience is not necessarily the result of any one extant stressful situation. It can occur as a "learned helplessness" that yields depression in anticipation of inescapable tasks or situations, especially when exposure to the stressor is repeated.There is no ONE depression. Depression has many presentatons, and, perhaps, many psychoneurologial etiologies. I don't doubt that you experience eustress that enhances your ability to perform. I also don't doubt that you have sucessfully resisted becoming passive and avoided surrendering yourself to unwelcome challenges.
I avoid life because I have very little energy to move about and have nothing to say in social situations. I experience anxiety - which is probably amplified by my illness - because I feel so uncomfortable staring into space while being mute and unresponsive to other people. I shut down when I cannot extricate myself from such circumstances. For the moment, the shocks are inescapable. I become very passive. I give up. I have lost resilience.
Resilience is not equivalent to the absence of anxiety. Resilience can diminish in the absence of anxiety.
- Scott
Posted by Twinleaf on December 6, 2014, at 8:44:38
In reply to Re: What If We're Wrong About Depression? » baseball55, posted by SLS on December 6, 2014, at 6:13:25
Scott, this might be a time to consider therapy, which I know you have had in mind previously. A good relationship with one can truly heal that loss of social confidence which is vital for everyone.
Posted by Phillipa on December 6, 2014, at 9:01:43
In reply to Re: What If We're Wrong About Depression?, posted by baseball55 on December 5, 2014, at 21:10:37
I was that way till the stress burned out my thyroid and then couldn't handle stress. I will get a spurt to again venture into the waters and test my stress level and it knocks me back further even if it has a good outcome. For some reason the Yes I did it is non existant now. I simply burned out and that's it. But that part of me that is inside somewhere and used to be able to handle stresses of all kinds doesn't want to die. Phillipa
Posted by Hugh on December 6, 2014, at 17:47:28
In reply to Re: What If We're Wrong About Depression? » Hugh, posted by brynb on December 5, 2014, at 13:26:25
The stressful events I've been through have taken a lot out of me. "Feel the fear and do it anyway" has been terrible advice for me.
Posted by Twinleaf on December 6, 2014, at 17:54:05
In reply to Re: What If We're Wrong About Depression? » baseball55, posted by Phillipa on December 6, 2014, at 9:01:43
I disagree. There are a range of things you can choose to do to moderate stress, such as meditation, changing stressful interpersonal situations, rTMS, tianeptine, increasing your benzo doses moderately or engaging in genuinely helpful therapy (it could be DBT or interpersonal).
I think you may be discouraging newcomers and younger less knowledgable readers needlessly, as well as closing off constructive options for yourself. Even if you choose not to do anything, it wouldn't be accurate to convince others that there are no constructive options.
Posted by Phillipa on December 6, 2014, at 19:25:59
In reply to Re: What If We're Wrong About Depression? Phillipa » brynb, posted by Hugh on December 6, 2014, at 17:47:28
Hugh same here I heard this more than once from therapists and pdocs throughout the years and all it did was make me worse. Increasing meds isn't healthy either. The latest studies on benzos and other meds are all over the internet. Phillipa
Posted by Phillipa on December 6, 2014, at 20:19:28
In reply to Re: What If We're Wrong About Depression? » Hugh, posted by Phillipa on December 6, 2014, at 19:25:59
http://www.newyorker.com/magazine/2014/01/27/the-prisoner-of-stress
Posted by baseball55 on December 6, 2014, at 21:07:27
In reply to Re: What If We're Wrong About Depression? » baseball55, posted by SLS on December 6, 2014, at 6:13:25
Scott - I am sorry life is so hard on you. I was not aware that you felt so alone around others. Have you ever worked with a therapist? A good therapist might be able to help you find things to say and feel more comfortable. My DBT therapist used to coach me on how to approach people, build friendships - what to say, how to act. A lot of it felt overwhelming at first, but the feeling of loneliness was overwhelming too. So little by little, I took small steps, got better at being with people without drugs or alcohol to make me feel more at ease. It's taken several years. But it has worked for me. Maybe it can for you.
Posted by Christ_empowered on December 6, 2014, at 22:07:10
In reply to What If We're Wrong About Depression?, posted by Hugh on November 29, 2014, at 11:44:02
..then it won't be a psychiatric problem. General practitioners and/or specialists will take over treatment.
Posted by SLS on December 7, 2014, at 1:37:00
In reply to if they develop blood work..., posted by Christ_empowered on December 6, 2014, at 22:07:10
> ..then it won't be a psychiatric problem. General practitioners and/or specialists will take over treatment.
Not so fast. There are tests for thyroid function, but many cases are complex, and still need an endocrinologist to treat them effectively. Although identified by a simple blood test, many cases of diabetes defy the skills of the average GP. Why would psychiatric illness be any different?
Are you turned-off by the term "psychiatric" when describing your illness? If so, how do you define it, and what are your objections to using it to categorize psychobiological disorders? Stigma? Unfortunately, stigma often dissuades me from using the term around most people.
- Scott
Posted by SLS on December 7, 2014, at 1:44:39
In reply to Re: What If We're Wrong About Depression? » SLS, posted by baseball55 on December 6, 2014, at 21:07:27
Thank you both for your concern and thoughtful advice. It has been a few years since my last course of psychotherapy (eclectic IPT). Perhaps it's time to consider resuming it. I am seeing a new doctor for a consultation on Monday. I'll let you know what happens.
- Scott
Posted by Twinleaf on December 7, 2014, at 8:29:06
In reply to Thanks. » Twinleaf » Baseball55, posted by SLS on December 7, 2014, at 1:44:39
I do hope you find someone with whom you develop a great connection - I thnk that is the magical part. It's worth looking until you do. Baseball was incredibly lucky in finding great people right away. I, on the other hand, should have listened to my intuition more and looked more thoroughly.
Do keep us informed.
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