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Re: Lack of pleasure: the cause of all mental illness?

Posted by bulldog2 on July 31, 2009, at 18:47:55

In reply to Lack of pleasure: the cause of all mental illness?, posted by linkadge on July 25, 2009, at 15:59:48

> I was thinking about it and I have a hypothesis, that a lack of pleasure is the cause of all/most mental afflictions. When I say pleasure, I don't mean that selfish crack like hedonic overdrive, I mean the good pleasure (opiates?), where you just want to settle down and enjoy the moment.
>
> For instance,
>
> depression -
> obvious
>
> dysphoric mania -
> too much drive not enough settle down and feel ok in the moment
>
> anxiety -
> too much pain, not enough pleasure (opiates have antianxiety properties)
>
>
> OCD -
> fueled by anxiety
>
> PTSD -
> inability to turn off bad memories
> increasing pleasure would either diminsh bad memories or put a positive spin on them
>
> euphoric mania -
> this one may be the exception. I think this is cause by simultanious high motivation and high pleasure. But, I think if you increased pleasure further, you would counterballance hypermotivation and end the mania (opiates actually have anitmanic effects)
>
> schizophrenia -
> another possible exception, opiates do have antischiozphrenic effects in some case studies.
> but this may be due to their effects on glumamte metabolism
>
> Note: all the SSRI's and TCA's have opioid like effects. Not that I am necessarily condoning opiates for mental illness.
>
>
> Linkadge

There is a theory that some people who are depressed exhibit some disruption of the opioid part of the brain. They not only show lack of depression but also a greater sensitivity to pain.
These indiviuals respond to opiates and their depression is lifted. We must note that some normal individuals (not depressed) claim that opiates do not affect their mood. So it is reasonable to assume that some depressed people have malfunctioning opioid systems.
There is some evidence that tcas activate opioid parts of the brain through descending norepinephrine and serotonin pathways. For some reason tcas work much better for chronic pain than the ssris.

I do feel that opiates can be a valid treatment for depression without waiting weeks for them to work. The patient has to learn not to chase the euphoria which will lead to addiction. Once the euphoria is gone at a particular dose the patient can still receive an antidepressant effect from the opiate.

I have been on oxycodone 10 mg 4 times a day for several months. The euphoria has long since gone away but the ad response still is fairly gone.

My p-doc and I are thinking of adding parnate to this mix as I had a partial response to parnate before. I think this might be a synergistic mix.

Oh and I also take neurontin 1200 mg twice a day. Works very well with the oxycodone.
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poster:bulldog2 thread:908530
URL: http://www.dr-bob.org/babble/20090721/msgs/909527.html