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Re: Depression HURTS » 49er

Posted by SLS on October 30, 2010, at 8:50:04

In reply to Re: Depression HURTS » SLS, posted by 49er on October 30, 2010, at 6:31:21

> > Hi.
> >
> > http://www.psychiatrist.com/pcc/brainstorm/br6304.htm
> >
> > There are a bunch more. Pain is a putative symptom of depression.
> >
> >
> > - Scott
>
> I think we have to be careful about assuming that everything is due to someone's mental health label.

Yes. I'm sure that Dr. Stahl, being a trained medical doctor, embraces the idea that, invariably, all pain is caused by depression. NOT.

> See, this blog entry by a psychiatrist who definitely is not anti-meds.

> http://lockupdoc.com/2010/05/psychiatric-patients-with-medical-illness-may-not-be-taken-seriously/

I invite you to read the literature you refer to. The word "depression" appears nowhere in the text. It is unfortunate that the mentally ill should not be treated seriously when they have physical complaints. This might be the result of depressed patients presenting with pain but without any other organic condition to be found. Instead of recognizing that pain could be a symptom of depression, they are sent home without a diagnosis and without treatment. I believe this is precisely what Dr. Stahl would like to see remedied. That's all.

> Dr. Stahl is another one of those professionals who isn't exactly bias free.

What do you mean by this? What exactly has Stahl done to deserve disparaging remarks? The blog intimates wrong-doing, but does not provide details or proof of this.

I have followed much of Stahl's work for over a decade. I like him. If you have not read his work, perhaps doing so would provide you with a better idea as to the quality of his work. Sometimes, you must judge the work on its own merits rather than presume knowledge of the author's motivations. Being payed by drug companies for lectures and other services rendered can give the appearance of bias and impropriety. However, it doesn't prove it. There are people working on ways to mitigate this. It is difficult to find funding for pure research.

> http://carlatpsychiatry.blogspot.com/search/label/Steven%20Stahl

I performed several literature searches on Google using various combinations of keywords. The only hit that comes up repeatedly intimating ethical breaches by Dr. Stahl is the one you linked to. Perhaps you will have better luck. Use "stephen m stahl" as keywords, including the quotes. Let's go cherry-picking.

> Please understand I don't disagree that pain can be a part of depression.

That is the only point to be made by Stahl in the Brainstorm piece. He never states that all pain experienced by people is due to mental illness. He does offer a physiological mechanism by which 5-HT/NE reuptake inhibitors can address depression-induced hyperalgesia.

> But what I found disturbing about his article is there is no attempt to even distinguish situations in which pain might not have anything to do with depression.

I guess Stahl relies to a degree on the education level of his readers. There are myriad reasons why someone can experience pain. We all learn that as children. I don't think Stahl set out to list every medical condition ever recorded for which pain is a symptom. His thesis was to describe the existence of pain as a symptom of depression, just in case anyone remained ignorant of this fact.

> That could be very costly to someone's life.

Medical mistakes often can be.


- Scott


Some see things as they are and ask why.
I dream of things that never were and ask why not.

 

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