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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 7 to 31 of 42. Go back in thread:
Posted by Squiggles on November 4, 2004, at 9:44:25
In reply to But to force neurology to take us, posted by Dinah on November 4, 2004, at 9:40:55
LOL! You know that thought may have
crossed the minds of many. I mean
would a depressive not want to change
places with a non-depressive?Thank God for political correctness.
Squiggles
Posted by shortelise on November 4, 2004, at 12:57:04
In reply to Re: But to force neurology to take us, posted by Squiggles on November 4, 2004, at 9:44:25
My T encourages me to exercise, to eat right, to take good care of my physical self. I think he's knows the importance of this. It never occured to me to ask him if he thinks I shouldbe taking supplements (I do) but I will ask him next time.
I do agree that neurology and endocrinology could work hand in glove with psychiatry. It's the way of the future.
ShortE
Posted by Squiggles on November 4, 2004, at 13:22:18
In reply to future, posted by shortelise on November 4, 2004, at 12:57:04
That's good advice. I intend to ask
about Metamucil for diarrhea for example,
when i see my doctor. [wonder what the
etymology of that is]; I find bran helps
pardoxically.When i feel a bit better i would like to
post some notes on my site of Dr. Schou's
Practical Guide for lithium - just notes.I know from reading his advice that diarrhea
can be a sign of toxicity and may elevate
the lithium blood levels.I find that the Brits. and Europeans recommend lower dosages of lithium than the Americans
and Canadians; N.A. practice also makes no distinction between men and women and age.Recently on BMJ they wanted to take the elderly
off lithium and change to another drug; it
never seemed to occur to them to lower the dose
instead.
Weight counts too for lithium,
as well as renal clearance, thyroid function,
and general health. I think it's time i got
a check up (2 yrs.);Oh yeah, exercise, and diet, but not too much
diet esp. keep potassium and salt up and steady.Squiggles
Posted by Tabitha on November 4, 2004, at 13:52:53
In reply to Psychiatry should be replaced with neurology, posted by Squiggles on November 3, 2004, at 15:41:33
> I think it's because symptoms having
> a cognitive or emotional form rather
> than a straighforward physical one, like
> seizures, are understood to belong to
> a spiritual entity, outside the realm
> of physical treatment or reach. Beneath
> it all is the historical division between
> mind and body. They are not separate --
> their connection is simply not understood
> because this is a still unsolved metaphysical problem.Yes.. and I've always thought it is somehow deeply threatening to accept a physical basis for the contents of our minds. We'd rather believe we have complete control over them.
Posted by Squiggles on November 4, 2004, at 13:59:32
In reply to Re: Psychiatry should be replaced with neurology » Squiggles, posted by Tabitha on November 4, 2004, at 13:52:53
Why threatening? If we control
epileptic seizures, why not depression?Squiggles
Posted by SLS on November 5, 2004, at 7:49:55
In reply to Psychiatry should be replaced with neurology, posted by Squiggles on November 3, 2004, at 15:41:33
The irony is that neurology was once replaced by psychiatry. Sigmund Freud started out his medical career as a neurologist interested in treating mental illness with drugs. He later abandoned this in favor of developing his model of psychoanalaysis.
- Scott
Posted by Squiggles on November 5, 2004, at 8:28:11
In reply to Re: Psychiatry should be replaced with neurology, posted by SLS on November 5, 2004, at 7:49:55
> The irony is that neurology was once replaced by psychiatry. Sigmund Freud started out his medical career as a neurologist interested in treating mental illness with drugs. He later abandoned this in favor of developing his model of psychoanalaysis.
>
>
> - Scott
There's so much literature on him on the net;
there was a time when i was a young student
in psychology, when i read a lot of his stuff.
I knew all about his ego, id, superego theories
and tried to apply it to my life and others';
i knew of his influences and had the Jung book
on Symbols and other psychoanalytic stuff,
including, influences on fine art. I was
really immersed in the stuff.But at that time I was not ill. So, it was
like a hobby.Later i became more interested in biological
psychology and especially, in the study of
perception.My present assessment of him is that he did
succeed in isolating mental and emotional
illness from medicine. I think he placed in
the sphere of anthropology at least, and
mythology at most.It would be interesting to see if there are
any links between his neurology studies and
later symbolism. I think not, but i have not
found any such links, except the sexual appetite
(libido) connected to the will - very Victorian
stuff.
Squiggles
Posted by Sad Sara on November 5, 2004, at 10:46:15
In reply to Psychiatry should be replaced with neurology, posted by Squiggles on November 3, 2004, at 15:41:33
First, I think you mean "psychology" and not "psychiatry", since psychiatry is exactly that... medicating mental disease.
I think you forget one thing, there is a lot of people who has been cured by psychotherapy only. There is even a few shcizofrenic people who has been cured from just psychotherapy (try reading 'Dantes Cure'). Psychotherapy has a lot less side effects than medical treatment.
But you do have a point. Medical research and medicine in general should have a bigger role in mental disease. It is inacceptable that a nurse can say "get over it and stop feeling sorry for yourself" to someone with a major depression.
On the other hand, it would also be nice if psychotherapy could be accepted of all as an effective therapy for some cases of mental disese, some of which are entirely similar to some that are not curable by psychotherapy only. Psychotherapy is not a therapy without flaws, but are medicine a therapy without flaws.....?
Posted by Sad Sara on November 5, 2004, at 10:48:58
In reply to Re: Psychiatry should be replaced with neurology, posted by alexandra_k on November 4, 2004, at 2:43:04
You are mixing a bit here... "Psychiatry" is a branch in medicine, I think you are thinking of Psychology.
> People worry a bit about whether psychiatry is a real science (just like physics, or more plausibly medicine) that deals with discrete and valid disorders. It is true that there is still so much that we don't know, but then people with epilepsy used to get it much harder too. I mean, epileptic fits used to be mistaken for demonic possession, and there is stuff about TLE personality. Most people would agree that mental disorder does have a neurological basis, but discovering the precise nature of that is pretty hard.
>
> I reckon the trouble comes from the message that it is a disorder of the mind or of thinking, and thus if you could change the way you think then you'd be ok. While there is clearly something to this telling someone this isn't the best way of showing them how to do this. And who knows whether it is thinking negatively that leads to depression, or whether it is depression that leads to negative thinking at any rate.
>
>
Posted by Squiggles on November 5, 2004, at 10:57:39
In reply to Re: Psychiatry should be replaced with neurology » Squiggles, posted by Sad Sara on November 5, 2004, at 10:46:15
> First, I think you mean "psychology" and not "psychiatry", since psychiatry is exactly that... medicating mental disease.
>
Yes, that's true. I speak of "psychiatry" in
the general non-biological sense in which it
is often practiced. Strictly speaking, psychiatrists must be doctors but not all psychiatrists, practice medicine.
> I think you forget one thing, there is a lot of people who has been cured by psychotherapy only. There is even a few shcizofrenic people who has been cured from just psychotherapy (try reading 'Dantes Cure'). Psychotherapy has a lot less side effects than medical treatment.
>Another book - sheesh! Well, i wish it were true;
i have not seen the statistics and i am doubtful.
I think psychotherapy may work for emotional
and social maladjustment.
> But you do have a point. Medical research and medicine in general should have a bigger role in mental disease. It is inacceptable that a nurse can say "get over it and stop feeling sorry for yourself" to someone with a major depression.I think medical investigation of the mind
and body is more objective.
>
> On the other hand, it would also be nice if psychotherapy could be accepted of all as an effective therapy for some cases of mental disese, some of which are entirely similar to some that are not curable by psychotherapy only. Psychotherapy is not a therapy without flaws, but are medicine a therapy without flaws.....?If it worked, people would take the horrid
drugs we have as an alternative, nor would
doctors give them.
Squiggles
Posted by Sad Sara on November 5, 2004, at 10:58:46
In reply to Re: Psychiatry should be replaced with neurology, posted by Squiggles on November 4, 2004, at 7:13:43
Oh, and to be really looking at details, neurology is a subject in psychology too, not only medicine. Psychologists are taking part in all kinds of brainscanning and neurological diagnosing (as for example alzheimers, eplilepsy, closed brain injury and the effect of brain injury).
Some part of psychology is not as much a "pseudo science" as some wants it to be :-)
But as I said, you are totally, right, medicine (not only in the sense of medication, but medical science in general) need a lot bigger place in mental disease. But to give mental disease just as important place as physical disease is also a matter of the people in a societys opinions... one of the effects of democracy is that it is the masses that get to choose the order. If the masses agree that mental disease is shameful and/or not a part of physical disease, that will be reflected in the research, rules and standads in that society.
There is no such thing as a perfect social system, democracy has it's flaws too- just as every other system invented. But maybe future can invent a perfect system that is fair for everyone? Who knows....
Posted by Squiggles on November 5, 2004, at 11:01:24
In reply to Re: Psychiatry should be replaced with neurology, posted by Sad Sara on November 5, 2004, at 10:58:46
Your general approach is appreciated.
Notice, though, that nobody gets
political over ingrown toenails.Squiggles
Posted by Sad Sara on November 5, 2004, at 11:10:27
In reply to Re: Psychiatry should be replaced with neurology, posted by Squiggles on November 5, 2004, at 10:57:39
I would not refer to statistics, because I would not let statistics guide my life. If statistics show that it's a bigger chance that I get cured for lets say depression by taking antidepressives, I would still like to know about other treatments..... and if I could successfully be cured from something else that has no side effects I would like to try that first, even though there is slightly less chance that that will work.
You know, there is even statistics lead over people who has been cured of psychotherapy only. Just because MORE people get cured from medicines, doesn't mean that should be the only cure tried, or the only cure available. There are many studies showing that both depression, anxiety, certain sleeping disorders, personality disorders and hypomania has been cured by pure psychodynamic therapies. Just because the statistics show that less is cured by psychodynamic therapies than medical therapies doesnt mean that psychotherapy is invaluable.
I don't think there is statistics lead over schizofrenics cured by psychotherapy only, becaus ethere isn't many cases. I just used is an an example from the extreme. But it DOES exist references to cases of schizofrenics who has gotten cured by pure psychodynamic therapies in scientific litterature, so it does exist even if it is rare. I think it is important to keep thing slike that in mind, because truly it would be better if psychotherapy could be developed into a stage higher up than it is now.
Do also keep in mind that studies has shown that depressed people that are cured of psychotherapy only shows the exact same changes in the brains as people who are cured by SSRI. For me that means that psychotherapy must be good for something.
I think people would take horrid drugs anyway, otherwise: why are so many people still taking the horrid drugs when they have no or little effect on their mental disease or give side effects that is just as bad as the original mental disease?
Posted by Squiggles on November 5, 2004, at 11:20:16
In reply to Re: Psychiatry should be replaced with neurology » Squiggles, posted by Sad Sara on November 5, 2004, at 11:10:27
..........
> I think people would take horrid drugs anyway, otherwise: why are so many people still taking the horrid drugs when they have no or little effect on their mental disease or give side effects that is just as bad as the original mental disease?Sad Sara,
I hope that you are successful in trying something
like psychotherapy. I don't know what your
diagnosis or depression is like.
You ask above why are people still taking the
horrid drugs when they have- little
- no
- or worse effects than the disease;
And I think it's because, once you are on the
drugs,- you will be worse getting off
- your doctor cannot or will not get you off
- your biochemical state has become so used to
being on the drugs that it's risky to get off- or you may get off only to find that you were
sick after all, and become very ill;Good reasons to stay on if your dr.
had reason to put you on them, right;Squiggles
Posted by Squiggles on November 5, 2004, at 11:27:59
In reply to Re: Psychiatry should be replaced with neurology, posted by Squiggles on November 5, 2004, at 11:20:16
> Sad Sara,
>
Sorry, One more reason to take and stay
on your drugs:- IF YOU DO SUCCEED IN WITHDRAWING, GETTING
BACK ON SOME DRUGS (e.g. Lithium) may no work
again the same way. Playing with drugs like
this all your life, is not only tiresome but
dangerous and very stressful. Stability is
the best that medicine can offer now.Squiggles
Posted by Sad Sara on November 5, 2004, at 11:55:33
In reply to Re: Psychiatry should be replaced with neurology, posted by Squiggles on November 5, 2004, at 11:20:16
>
> ..........
> > I think people would take horrid drugs anyway, otherwise: why are so many people still taking the horrid drugs when they have no or little effect on their mental disease or give side effects that is just as bad as the original mental disease?
>
> Sad Sara,
>
> I hope that you are successful in trying something
> like psychotherapy. I don't know what your
> diagnosis or depression is like.
>
>
> You ask above why are people still taking the
> horrid drugs when they have
>
> - little
>
> - no
>
> - or worse effects than the disease;
>
> And I think it's because, once you are on the
> drugs,
>
> - you will be worse getting off
>
> - your doctor cannot or will not get you off
>
> - your biochemical state has become so used to
> being on the drugs that it's risky to get off
>
> - or you may get off only to find that you were
> sick after all, and become very ill;
>
> Good reasons to stay on if your dr.
> had reason to put you on them, right;
>
> Squiggles
Good reason to try something else than medicines first, I think.
Posted by Sad Sara on November 5, 2004, at 11:59:30
In reply to Re: Psychiatry should be replaced with neurology, posted by Squiggles on November 5, 2004, at 11:27:59
BTW
If you contact Leigh McCullough Vaillant at Harvard University I am sure she can give you an overview over psychotherapies effects contra medical effects. She has cured a lot of depressed people that did NOT have any positive effects of their medication. She has also made a lot of people so well that they don't need their medication anymore.
Posted by Squiggles on November 5, 2004, at 12:01:33
In reply to Re: Psychiatry should be replaced with neurology, posted by Sad Sara on November 5, 2004, at 11:55:33
Hindsight is very powerful.
I hope you succeed without meds.
Squiggles
> Good reason to try something else than medicines first, I think.
Posted by Sad Sara on November 5, 2004, at 12:15:30
In reply to Re: Psychiatry should be replaced with neurology, posted by Squiggles on November 5, 2004, at 12:01:33
Please don't misunderstand me Squiggles, I do believe that for a lot of people there is no other option than medicine, I just say that we shouldn't forget that there exist other options that are good. I'm not saying at all that I would never use medications, or anything in that direction. Some people that has been healed from psychotherapy alone might feel hurt, or feel that they are accused of lying, or feel that their mental disease is not important if your words are picked up as "medication is the only thing valuable enough to be used for treating mental disease", if you understand what I mean.
Posted by Squiggles on November 5, 2004, at 12:17:56
In reply to Re: Psychiatry should be replaced with neurology, posted by Sad Sara on November 5, 2004, at 11:59:30
> BTW
>
> If you contact Leigh McCullough Vaillant at Harvard University
...........Thank you. I wish i had the nerve. I take
only 3 drugs, only one of which is truly
a psych drug, and i almost killed myself
trying to get off the anxiolytic.I've been on lithium for 25 years. I think
that presents a challenge to any doctor.Perhaps others can benefit from your support.
Squiggles
Posted by Squiggles on November 5, 2004, at 12:25:13
In reply to Re: Psychiatry should be replaced with neurology, posted by Sad Sara on November 5, 2004, at 12:15:30
> Please don't misunderstand me Squiggles, I do believe that for a lot of people there is no other option than medicine, I just say that we shouldn't forget that there exist other options that are good. I'm not saying at all that I would never use medications, or anything in that direction. Some people that has been healed from psychotherapy alone might feel hurt, or feel that they are accused of lying, or feel that their mental disease is not important if your words are picked up as "medication is the only thing valuable enough to be used for treating mental disease", if you understand what I mean.
Now you know i didn't say or mean that;
to the contrary i said, I hope that psychotherapy
works for you; moreover, i said that if it
does work, it's better than putting up with
the side effects of drugs that many people
experience.I wish I were in your fresh position to try it
without meds.To your health;
Squiggles
Posted by alexandra_k on November 5, 2004, at 13:52:35
In reply to Re: Psychiatry should be replaced with neurology, posted by Sad Sara on November 5, 2004, at 10:48:58
> You are mixing a bit here... "Psychiatry" is a branch in medicine, I think you are thinking of Psychology.
Nope, I meant psychiatry. The DSM is a psychiatric classification system that lists different mental disorders according to syndrome. There is dispute around whether the current disorders / syndromes are discrete and valid. Some people prefer a symptom approach, so that the focus of research is individual symptoms such as delusions or hallucinations rather than greater syndromes which are diagnosed on the basis of a patients meeting some prescribed threshold for displaying a certian number of symptoms. There is a concern that by taking syndromes as the basic unit of research the clinical samples are too heterogeneous as different people may meet criteria on the basis of displaying different symptoms. A consequence of this may be that we miss interesting generalisations that apply to subjects with the same symptom, such as hallucinations or delusions.
Posted by Sad Sara on November 5, 2004, at 14:18:24
In reply to Re: Psychiatry should be replaced with neurology » Sad Sara, posted by Squiggles on November 5, 2004, at 12:25:13
> > Please don't misunderstand me Squiggles, I do believe that for a lot of people there is no other option than medicine, I just say that we shouldn't forget that there exist other options that are good. I'm not saying at all that I would never use medications, or anything in that direction. Some people that has been healed from psychotherapy alone might feel hurt, or feel that they are accused of lying, or feel that their mental disease is not important if your words are picked up as "medication is the only thing valuable enough to be used for treating mental disease", if you understand what I mean.
>
>
> Now you know i didn't say or mean that;
> to the contrary i said, I hope that psychotherapy
> works for you; moreover, i said that if it
> does work, it's better than putting up with
> the side effects of drugs that many people
> experience.
>
> I wish I were in your fresh position to try it
> without meds.
>
> To your health;
>
> Squiggles
>Ah oki ;)
I think I'm getting too paranoid of being misunderstood, hehe.Sara
Posted by Sad Sara on November 5, 2004, at 14:24:23
In reply to Re: Psychiatry should be replaced with neurology » Sad Sara, posted by alexandra_k on November 5, 2004, at 13:52:35
> > You are mixing a bit here... "Psychiatry" is a branch in medicine, I think you are thinking of Psychology.
>
> Nope, I meant psychiatry. The DSM is a psychiatric classification system that lists different mental disorders according to syndrome. There is dispute around whether the current disorders / syndromes are discrete and valid. Some people prefer a symptom approach, so that the focus of research is individual symptoms such as delusions or hallucinations rather than greater syndromes which are diagnosed on the basis of a patients meeting some prescribed threshold for displaying a certian number of symptoms. There is a concern that by taking syndromes as the basic unit of research the clinical samples are too heterogeneous as different people may meet criteria on the basis of displaying different symptoms. A consequence of this may be that we miss interesting generalisations that apply to subjects with the same symptom, such as hallucinations or delusions.
>
Ok, then I understand what you mean too. Though both DSM IV-R and ICD are both used among psychiatrists and psychologist, and a lot of poeple seem to think that because psychologists don't have a medical background they are more a pseudo science than psychiatry. Which at some apsects could be true, and on other aspect could be false.There is lamost the same amount of cons as pros in using a diagnostic manual as DSM, but it is important to keep that discussion up so its a greater chance that a better diagnositc manual can be made.
I think I misunderstood you because the beginning of the thread was mixing psychology with psychiatry, I apologize correcting something that was not wrong :-)
Posted by Sad Sara on November 5, 2004, at 14:58:35
In reply to Re: Psychiatry should be replaced with neurology, posted by Squiggles on November 5, 2004, at 12:17:56
>
> Thank you. I wish i had the nerve. I take
> only 3 drugs, only one of which is truly
> a psych drug, and i almost killed myself
> trying to get off the anxiolytic.
>
> I've been on lithium for 25 years. I think
> that presents a challenge to any doctor.
>
> Perhaps others can benefit from your support.
>
> SquigglesI don't know if you get lithium for mania, but if you do, I must say that with some diseases relieving symptoms quick is more important than searching for a cure without side effects. If you enter a manic state, it can be devastating to just try psychotherapy and no medications, and that is of course also valid for other mental problems.
You know yourself best (at least one usually know oneself best), you have to choose what is best for you from the options you have...
But I still HAVE to come with the argument that studies have shown that the absolute most efficient therapy is a combination of medications and psychotherapy, I hope you don't feel like I am nagging now.
If you want, I can tell you a small part of my own story with anxiety... (later I found out I had the diagnose GAD with panick attacks).
When my father died went into major depression, with it came anxiety, that stayed just as intense whether my depression was major or minor the next years. It paralyzed me. I did not understand what it was, I thought I had a physical disease. But I didn't manage to go to the doctor to ask. I couldn't go outside the door. I mostly sat in the corner of my apartemnet and stared out in the room, terrified thatsomeone would call, look in my window or knock on my door. I was simply deadly scared that someone would notice that I existed, I don't know why (but who said that you have to understand your madness to be mad- I really felt that I was mad, though I don't like that word). This lasted for almost a year. It intruded my studies, my relationships, my social world. I could not think about getting the mail (30 second walk away from my door), if I had to go shopping food I would need six hours to prepare (which included throwing up of pure anxiety). At some point I managed to go to the doctor.The doctor told me that I was 'stressed', then he explained how that affected my body so that I got sick. Then he sent me home sayng that he couldn't do anything because I was 'not' sick! If I had been more depressed at that moment, I would have killed myself of the prospect of not having anyone to cure me. I did not know how to come in touch with a psychologist (the doc did not tell me how, nor did he advice me to), and considering how much it had costed me to get to the doc... looking up a psychlogist and go to regular apointments was not an option.
So I went home. And because my main problem was anxiety, and not depression, I was furious (I had a pretty bad temper, probably one of the reasons I made it that far despite my mental problems). I cried, I was angry, I vomited of hopelessness. After a few days I had thought about it, decided that there was no one there to help me, and I had to make a choice. Did I want to continue living the way I did, or did I want to get back my own life, or did I want to die. I did not want to continue the way I did, but i didn't want to die either. I found myself all the books I could about anxiety... but NOT about how to treat it. Just 'what is it'. I had to agree at some point that the doctor was right, only that the label was 'anxiety' and not 'stress'. I decided to take control over the situation, and very carefully I started forcing myself to do all the tings I was scared of. Repeating mantras in my head to distract me. It took me almost three years. But then I could not only go shopping and get the mail, I could take a bus, go to the movies etcetc. I learned later that what I had been using was "exposing therapy" (Im not sure of the word in English?), which is one of the most efficient therapies in treating anxiety. If I had been with a therpaist he could probably have cured my anxiety a lot faster, but for me what was important was to get rid of the anxiety.
Of course this would not work for everyone, but sometimes it is worth trying? I am quite happy that the doctor didn't give me benzodiazepines for example, even though I think he could have helped me a bit more than he did. It is now 5 years ago since I declared myself not bothered by anxiety anymore, and I haven't had one panick attack, and hardly ever felt anything resembling GAD. I still don't like big open space with lots of people, but I don't feel fear when crossing that space. But the last year I have been using anti depressives because my depression seems not to be curable with any of the psychotherapies that has been tried so far. I do not stop using psychotherapy even though I am on medications... simply because I feel that the depression has been twisting the thoughts in my head so much that I need guidance in making them good and healthy for me. And more, but I wont bore you with that...
But maybe you understand that I value both psychotherapies and medications, I didn't mean to glorify psychotherapy as such :-)
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Dr. Bob is Robert Hsiung, MD,
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