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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 65 to 89 of 97. Go back in thread:
Posted by linkadge on July 1, 2009, at 16:00:14
In reply to Re: ECT - Zeba (My Take)...))Ant-Rock » Rdragon, posted by Zeba on June 30, 2009, at 23:41:30
Thats the problem with the whole ECT thing. People justify their fears about having it with some sort of grandiose belif that ECT is the "big gun". "This is my answer". They've generated this little place in their brain in which ECT sits upon this big pedistal. This association is flawed. The efficacy of ECT is overblown, and new statistics suggest that between nonresponse and relasepe 80% will be back to where they started within about 6 to 8 months.
Linakdge
Posted by linkadge on July 1, 2009, at 16:03:54
In reply to Re: ECT - Zeba (My Take)...))Ant-Rock, posted by SLS on July 1, 2009, at 4:26:43
>What seems to slip by peoples's attention, is >that being very treatment resistent to >antidepressant medication makes for a reduced >prognosis that ECT will work.
Bingo.
Thanks for bringing this point up. Nonresponse to pharmalogical antidepressants is a strongish predictor of failure for ECT. So if you have failed many chemical AD's and think that ECT is your ticket, you may want to think again. This is, of course, contrary to what many people consider the prime application of ECT.
Linkadge
Posted by Phillipa on July 1, 2009, at 19:47:18
In reply to Re: ECT - Zeba (My Take)...))Ant-Rock » SLS, posted by linkadge on July 1, 2009, at 16:03:54
So after reading Scott's list is there a real answer? Phillipa
Posted by Ant-Rock on July 1, 2009, at 20:28:49
In reply to Re: ECT - Zeba (My Take)...))Ant-Rock, posted by linkadge on July 1, 2009, at 16:00:14
Linakdge
"80% will be back to where they started within about 6 to 8 months."
In 6 to 8 months, 100% Who get no help from meds/therapy will get progressively worse and wish they were dead, or worse, act on their wish.
Look, I always respect your posts on this board, and I'm not trying to start a war here.
All I'm saying is that my shrink is an experienced and compassionate person, who actually is jaded with the big pharma mentality.He has offered me ECT for years, and I resisted. Actually I have no immediate plans to try it yet,\
but if he tells me he has several succesful professionals who have benefitted greatly from it, why woudn't I believe him. He's also had zero ect patients with permanent memory problems.Anthony
Posted by SLS on July 1, 2009, at 23:08:54
In reply to Re: ECT - Linakdge, posted by Ant-Rock on July 1, 2009, at 20:28:49
I know you have been working and working and working to get well. It sounds like your doctor has your best interests in mind.
Have you discussed with your doctor:
1. Unilateral vs. bilateral vs. bitemporal?
2. High dosage vs. low dosage?
2. Unilateral left or unilateral right?
I don't know what to think about ECT anymore. I do think that *some* people come to blame ECT for memory difficulties that are, in fact, symptoms of the depressive illness itself. I know one person that I believe fits in this scenario. However, it is hard to ignore the horror stories that are present on the Internet. I would like to believe that ECT is safe. I do not know anyone personally who has had ECT and reported a horror story.There is one person who posts here who was excited to have ECT performed on him. He reporting having a bad experience with it. I don't know if there are any residual memory or cognitive issues with him, but he is quite vocal about his bad experience with ECT. Yet, I have met people who do well on ECT. Many of these folks do go for maintenance treatments. In this regard, it is really no different than treatment with medication. If you don't take them every day for maintenance, you relapse.
Without researching the latest and greatest protocols in ECT, I guess I would go for high-dosage unilateral right and try to avoid bilateral.
Like I said, I can neither endorse nor condemn ECT as a treatment. I am very ambivalent regarding this.
My only recommendation to you is that you research the recent advances in ECT protocols and discuss what you find with your doctor. At least you will feel more confident in whatever decisions you reach. If you have already reached a decision, then forgive my butting in.
Good luck to you.
- Scott
Posted by Zeba on July 2, 2009, at 0:26:16
In reply to Re: ECT » Ant-Rock, posted by SLS on July 1, 2009, at 23:08:54
I had a compasionate Pdoc and ECT doc too. They said they were actibg in my best interests. I had 7 right unilateral treatments at 5 imes the seizure threshold level. I had 2 treatments per week instead of the typical 3 per week, and still I ended up with documented damage per neuropsychological testing. I am just now starting rehab. I was diagnosed with ECT coghnitive decline. Parnate worked for me in the past but the pdoc wanted me to do ECT.
The behavioral neurologist said I was vulnerable to damage given my history of two concussions in my youth plus one later, Also, I have a family history of Parkinson's on both sides of the family. Any history of head trauma puts you at greater risk.
ECT is a crap shoot. Be very careful I have had depression on and off for 30 some years. It is hell to end up depressed and brain damaged. I have short period of no depression, but it always seems to come back. The answer is to perervere and keep on going.
Other things to try I guess would be herbal treatments, exercise, and acupuncture.
Posted by SLS on July 2, 2009, at 2:07:05
In reply to Re: ECT » SLS, posted by Zeba on July 2, 2009, at 0:26:16
Wow. It's stories like yours that have convinced me to no longer endorse ECT as a treatment.
Thanks for adding the additional predisposing factors that might have increased your risks for ECT cognitive damage.
I'm sorry that this had to happen to you.
- Scott> I had a compasionate Pdoc and ECT doc too. They said they were actibg in my best interests. I had 7 right unilateral treatments at 5 imes the seizure threshold level. I had 2 treatments per week instead of the typical 3 per week, and still I ended up with documented damage per neuropsychological testing. I am just now starting rehab. I was diagnosed with ECT coghnitive decline. Parnate worked for me in the past but the pdoc wanted me to do ECT.
>
> The behavioral neurologist said I was vulnerable to damage given my history of two concussions in my youth plus one later, Also, I have a family history of Parkinson's on both sides of the family. Any history of head trauma puts you at greater risk.
>
> ECT is a crap shoot. Be very careful I have had depression on and off for 30 some years. It is hell to end up depressed and brain damaged. I have short period of no depression, but it always seems to come back. The answer is to perervere and keep on going.
>
> Other things to try I guess would be herbal treatments, exercise, and acupuncture.
Posted by Meltingpot on July 2, 2009, at 14:51:35
In reply to Re: ECT - Zeba (My Take)... » Zeba, posted by Ant-Rock on June 29, 2009, at 12:58:12
Hi Anthony,
Just wanted to say that I have also tried rTMS to no avail. Actually when I was having it my mood was better than it is now but that was because the Seroxat was having more of an affect.
However, I do know somebody who has had ECT and is now having rTMS and he told me that they have both helped his depression. His depression is more Atypical though so not sure if that has anything to do with it. He is also on Parnate.
Denise
Posted by Meltingpot on July 2, 2009, at 15:26:03
In reply to Re: ECT » SLS, posted by Zeba on July 2, 2009, at 0:26:16
Zeba,
So are you saying that somebody who is suffering from depression with daily, hourly, minute by minute suicidal thoughts might benefit from herbal therapies or accupuncture?
I know a lot of people on this board think herbal therapies and alternative treatments have a place, maybe they help to kill time whilst the person is waiting for the drug to kick in but to even suggest that they might help as a stand alone therapy is, in my view, dangerous condescending. People waste so much time and money on these things and it makes me so angry.
If you think that herbal therapies and accupuncture are helpful as stand alone treatments then to be honest I would not take heed of your opinion on anything. Some people I know who can't get out of bed with their depression would laugh at your suggestion of exercise!
I know that talk therapy has helped you and like I said before you obviously had issues that needed to be talked about but many people with depression do NOT have psychological issues that need to be addressed and for them therapy is useless, it's only helps in the sense that it gives a person a chance (once a week) to vent.
Denise
Denise
Posted by SLS on July 2, 2009, at 17:18:01
In reply to Re: ECT - Zeba, posted by Meltingpot on July 2, 2009, at 15:26:03
Hi Denise.
I'm glad that I wasn't the object of your anger, although I can easily understand your rationales and empathize completely with your desperation.
> So are you saying that somebody who is suffering from depression with daily, hourly, minute by minute suicidal thoughts might benefit from herbal therapies or accupuncture?
Herbs, food supplements, and exercise never did a damned thing for me except to reduce the thickness of my wallet.
What I find frustating and angering is when people assume that their experience with depression is the same as everyone else's. With good intentions, they make suggestions that might work for them, but without taking into account how much different and more severe depression can be in other people.
- Scott
Posted by Ant-Rock on July 2, 2009, at 19:50:08
In reply to Re: ECT - Ant-Rock, posted by Meltingpot on July 2, 2009, at 14:51:35
> Hi Anthony,
>
> Just wanted to say that I have also tried rTMS to no avail. Actually when I was having it my mood was better than it is now but that was because the Seroxat was having more of an affect.
>
> However, I do know somebody who has had ECT and is now having rTMS and he told me that they have both helped his depression. His depression is more Atypical though so not sure if that has anything to do with it. He is also on Parnate.
>
> DeniseThank you Denise,
My depression is also more Atypical.
Maybe there is some hope.Anthony
Posted by Sigismund on July 2, 2009, at 20:36:14
In reply to Re: ECT - Zeba » Meltingpot, posted by SLS on July 2, 2009, at 17:18:01
>What I find frustating and angering is when people assume that their experience with depression is the same as everyone else's. With good intentions, they make suggestions that might work for them, but without taking into account how much different and more severe depression can be in other people.
You are of course right. I have no idea what depression means. Not really. You ask someone and they say 'depressed mood' and you ask 'what's mood?' and they say 'emotional tone...the glass is half empty rather than half full' (which is pretty lame now I see it in front of me). My therapist said (in a not unkind way, I'm sure) that depression was the rag bag of psychiatry, meaning I suppose that it was what was left over after the other diagnoses had been filled.
Posted by morganpmiller on July 2, 2009, at 20:50:34
In reply to Re: ECT - Zeba, posted by Meltingpot on July 2, 2009, at 15:26:03
Umm, I would argue that we all have some kind of psychological issue that contributed to our genetic predisposition developiing into something worse than it may have been minus any psychological issues. Look, we ALL have issues. To say that you do not or that some people with depression do not sounds a whole lot like classic denial to me. Even the majority of psychiatrists most likely adhere to the biopsychosocial dynamic that explains the majority of mental illness.
I'm sorry, none of us were simply born depressed miserable souls. It blows my mind that there are still people out there that do not think their childhood had anything to do with their depression. If you know anything about psychology and how a child's brain/psyche develops, you know that between the ages of 2 to 4 years old are crucial to how a child develops emotionally. Often we think we had this great childhood and great parents. First, there is no way we can remember what was going on when we were 2, 3, and 4. Second, it is common for us to be protective of our parents and put them on a pedestal, even if they made some mistakes. Third, we just don't realize what it takes to raise an emotionally healthy child. There are things that we may think are no big deal, but in reality, they may have been very detrimental to our emotional development. Fourth, there is this wonderfully powerful coping mechanism called denial.
Zeba,
>
> So are you saying that somebody who is suffering from depression with daily, hourly, minute by minute suicidal thoughts might benefit from herbal therapies or accupuncture?
>
> I know a lot of people on this board think herbal therapies and alternative treatments have a place, maybe they help to kill time whilst the person is waiting for the drug to kick in but to even suggest that they might help as a stand alone therapy is, in my view, dangerous condescending. People waste so much time and money on these things and it makes me so angry.
>
> If you think that herbal therapies and accupuncture are helpful as stand alone treatments then to be honest I would not take heed of your opinion on anything. Some people I know who can't get out of bed with their depression would laugh at your suggestion of exercise!
>
> I know that talk therapy has helped you and like I said before you obviously had issues that needed to be talked about but many people with depression do NOT have psychological issues that need to be addressed and for them therapy is useless, it's only helps in the sense that it gives a person a chance (once a week) to vent.
>
> Denise
>
> Denise
Posted by SLS on July 2, 2009, at 21:38:37
In reply to Re: ECT - Zeba, posted by morganpmiller on July 2, 2009, at 20:50:34
> Umm, I would argue that we all have some kind of psychological issue
Hi. My name is Scott. You don't really know me, but I imagine you would argue that you do.
> that contributed to our genetic predisposition developiing into something worse than it may have been minus any psychological issues.
> Look, we ALL have issues.
Please see above.
You know, depression is not depression is not depression.
I bet your depression is different than my depression. If it were the same, I doubt you would have posted this. I don't think it is valid to generalize one's own depression to that of everyone else on the planet.
While it is my ardent belief that psychosocial stresses often precipitate the onset of some mental illnesses, I don't feel that it is a necessary trigger. This might be particularly true of bipolar depression. I would say that most everyone has stresses in their lives, much of which has more to do with surviving on a day to day basis rather than suffering from some sort of psychological entanglement. I don't believe that one needs to have a pathological psychological "issue" in order to provide the physiological stresses that can precipitate these illnesses.
> I'm sorry, none of us were simply born depressed miserable souls.
And you know this, how? (Leaving the soul out of this)
> It blows my mind that there are still people out there that do not think their childhood had anything to do with their depression.
Please speak for yourself. Indeed, that is who you are really speaking of, isn't it? I am sorry your childhood was such that it brought depression into your life.
*I* would argue that some people have an emotional investment in the idea that "we all have issues" in order to explain their own depressions. It is a form of denial. It is difficult for these people to accept that even healthy minds can become the victims of unhealthy brains. They might be afraid to admit that they might be the only one with a troubled mind.
I'm OK, your OK.
- Scott
Posted by Zeba on July 2, 2009, at 23:22:06
In reply to Re: ECT - Zeba, posted by Meltingpot on July 2, 2009, at 15:26:03
So why does your pdoc think ECT is not for you??
Also, I do not agree that one can have depression and not have psychological issues. We are not a brain with no connection to thoughts, feelings, and perceptions.
I have had depression since childhood, and so it is not a simple matter of some sort of mild depression. I actually hung myself at age eight. I know what it is to be depressed, very depressed, believe me.
Zeba
Posted by Zeba on July 2, 2009, at 23:25:03
In reply to Re: ECT - Zeba » Meltingpot, posted by SLS on July 2, 2009, at 17:18:01
I wasn't saying it would work - herbs, etc. I was only adding to the list of possibility of things people could try. So, I will get the heck out of this babble stuff again. Goodbye and good luck to all. Gees, why did I come back.
Zeba
Posted by SLS on July 3, 2009, at 4:48:33
In reply to Re: ECT - Zeba » SLS, posted by Zeba on July 2, 2009, at 23:25:03
> I wasn't saying it would work - herbs, etc. I was only adding to the list of possibility of things people could try. So, I will get the heck out of this babble stuff again. Goodbye and good luck to all. Gees, why did I come back.
I'm sorry if I sounded overly cynical about the use of alternate treatments for depression. I'm really not. It was not my intention to brush you and your suggestions off at all. It was my intention only to comment on my own experience. I have tried various food supplements, herbs, rotation diets for food allergies, and medical foods. Then again, I have also tried most of the PDR's offerings for bipolar depression.
I hope you don't leave so soon.
- Scott
Posted by Sigismund on July 3, 2009, at 14:38:13
In reply to Re: ECT - Zeba » Zeba, posted by SLS on July 3, 2009, at 4:48:33
The magic of consciousness carries with itself the possibilities of difficulty. [There is a very interesting interrogation in Crime and Punishment where both characters are saying more or less what they mean while being twice ironic (or so I felt) about the meaning of their words, and therefore I felt trapped in some kind of unreality.] It is clear enough that for whatever reasons, people find themselves in the most extraordinary and difficult psychic positions. Since nothing works at all well anyway (as far as I can see) it seems pointless to argue about what is causing it.
My 2 bob's worth.
Posted by Sigismund on July 3, 2009, at 15:05:47
In reply to Re: ECT - Zeba, posted by Sigismund on July 3, 2009, at 14:38:13
I liked it in one of Bergman's films where the psychiatrist advises the distressed patient
'Count to 10'.
Posted by Zeba on July 3, 2009, at 20:22:16
In reply to Re: ECT - Zeba, posted by Sigismund on July 3, 2009, at 15:05:47
When you have been brained damaged from ECT, nothing seems funny anymore. It's hard.
Zeba
Posted by jhj on July 7, 2009, at 0:20:08
In reply to Re: ECT - Zeba » Zeba, posted by SLS on July 3, 2009, at 4:48:33
HiI am from India and 30 years old. I am suffering from dysthymia,GAD,Social Phobia for years now. I have tried Imipramine,Clomipramine, Sertraline, Escitalopram, Paroxetine,Fluoxetine,Venlfaxine,Milnacipran,Duloxetine,Mirtazepine,Bupropion,Amisulpride,Levosulpiride,Resperidone,Pregabalin,Gabapetin,Clonezapam,Alprazolam, Chlordiazepoxide and some other drugs. I have not tried MAOIs since they are not availbale in India.I have not improved at all on these drugs. What are the options I am having? Can ECT work in anxious depression?
Regards,
jhj
Posted by morganpmiller on July 9, 2009, at 0:03:41
In reply to Re: ECT - Zeba, posted by SLS on July 2, 2009, at 21:38:37
>Hi. My name is Scott. You don't really know me, but I imagine you would argue that you do.
Hey Scott, I don't know you and I would not argue that I do. There is a common denominator with pretty much everyone on this planet; we simply did not get what we needed when we were developing. There are a very few lucky people out there that did, unfortunately most of us did not. And, if we were at all predisposed to having issues with depression, we were also going to be that much more likely to develop issues with depression due to the lack of proper nurture in our childhood. Now, most of us would argue that our parents are wonderful people and there was nothing wrong with our childhood. On the surface often times this may appear to be the case. You see, we all have this wonderfully powerful little coping mechanism called Denial. Besides, there is no way we could possible know what was happening at the crucial developmental ages of 2,3, and 4 when we really really needed things to be going right for us. We needed our mother's nurture and we needed it consistently. We also needed that nurture to be pure. If our mother had any of her own bouts with depression and anxiety, you can be damn sure we were the ones picking up on all of that, absorbing it like a dry sponge. That sticks with us. We could not get rid of how that effected our development emotionally and it was not just going to go away with time. The wiring that takes place during those years is permanent and the only thing to do is to get in some form of play therapy as children or other therapy as we get older.
>I don't feel that it is a necessary trigger. This might be particularly true of bipolar depression.
I understand why you feel this way. I used to think this also. Unfortunately it simply is not true. I know it is a much easier way of thinking about our afflictions. Then we don't have to face the fact that anything could have been done to prevent our disorder from developing to the point that it has. When I was hospitalized for my first major mixed episode a year and a half ago, one of the doctors and a few of the nurses talked about the factors that contributed to bipolar episodes. They spoke of people going their entire lives without having a major episode because they were able to avoid the triggers/stresses that would bring such an episode. I believe you are born with bipolar. I just believe that given the right environment and circumstances, bipolar does not have to develop into what it does for so many people. I think it is dangerous and counterproductive to think turn our eyes away from the possibility that many mental disorders can be prevented and they are maybe only 50 percent genetic. If we don't give this possibility a chance, then we will never feel the need to do what we could do to prevent people from suffering the way they do.
>> I'm sorry, none of us were simply born depressed miserable souls.
And you know this, how? (Leaving the soul out of
this)If all of us could go back to early childhood and remember exactly how we felt most of the time, I believe, we would find that we were pretty damn content. You're right, I don't know this for sure. It just makes sense to me. I wish everyone could remember their childhood with such detail. I really do not understand why it is so hard, knowing how fragile we are, to see how we would need so much, especially those of us that are more sensitive, in order to develop into emotionally healthy adults. The human mind and psyche are entirely too complex. It doesn't make sense to me that people brush off what happens in our development as a major factor in our ability to be happy and form positive relationships as we get older. Denial is the only thing I can come up with. It protects us from facing the painful truth, but prevents from making the progress we so desperately need(all of this is so much easier said than done of course).
> It blows my mind that there are still people out there that do not think their childhood had anything to do with their depression.
>Please speak for yourself. Indeed, that is who you are really speaking of, isn't it? I am sorry your childhood was such that it brought depression into your life.
I've already addressed this I think. I will say that there was a well know doctor at John's Hopkins University that said it is and has been part of the human condition that parents have failed over and over again to be able to give their children what they need. I wish I had the exact name of the doctor and the exact quote. You don't have to have a terrible childhood to have not gotten what you really needed as a child. It could be as simple as you never knowing your father, in which case your mom probably struggled some if she did not find another man to be happy with. It could be that our mother spent the first two years with us and then went to work and we ended up spending most of our time with strangers in a kindercare. Maybe our mom was always there doing everything a mom should do but she was emotionally distant. Something like this is very intangible so it's hard for people to believe that it could affect us. Please have an open mind, I and many mental health professionals believe that emotional distance has a very damaging impact on a child. Like I said before, as children, and often as adults-depending on how sensitive/empathic you are, we are like dry sponges absorbing everything. Well how could emotions that were not really being expressed be transferred in such a way??? Again, please have an open mind to the possibility that they are.
>*I* would argue that some people have an emotional investment in the idea that "we all have issues" in order to explain their own depressions. It is a form of denial. It is difficult for these people to accept that even healthy minds can become the victims of unhealthy brains. They might be afraid to admit that they might be the only one with a troubled mind.I could also argue that some people have an emotional investment in the idea that their "psychological entanglements" or emotional issues do not play any part in their mental illness/depression/anxiety, even if it is a mild case. I think I started to make an argument for this above. If our childhood had nothing to do with our struggles, than we ever have to deal with the possibility of being angry with our parents. We are already angry enough that we have to deal with depression in the firs place. If our depression has anything to do with unresolved issues from childhood, we might have to face that fact that we have to go to therapy on top of taking medication in order to have a better chance of finally getting a grip. How much would that suck. After we spent our entire lives struggling with this awful illness and trying to find the right medication, we now might have to do all of this really hard work to get to the bottom of and address somethings in our subconscious that may have contributed to making our depression worse. It actually does make sense why people would have an "emotional investment" in thinking that what happened in early development and childhood has nothing to do with their depression. Then they simply don't have to deal with any more pain. Let's face it, often times the truth is painful.
On a bit of a side note. I'm not sure if you are aware that even such mental illnesses as schizophrenia are often triggered by early trauma. Yes the genetic predisposition is there. What many don't realize is that often times this predisposition is just that. Traumatic childhood experiences along with early drug use are often the triggers that set a person predisposed to schizophrenia into their first psychotic episode.
Have you ever heard of the biopsychosocial explanation for mental illness? You know it is becoming THE explanation for the development of most mental illness. All I am saying is that it may not be good for anyone with any kind of mental illness(maybe with the exception of someone who has developed full blown psychosis and can't return to reality) to rule out the idea that much much more is contributing to their struggle than a genetic predisposition(there is no evidence of a direct genetic cause that is solely responsible anyway, hence why they call it a predisposition).
Scott, I have read some of your posts and I can tell your a good person. I'm sure you are very smart. We are both bipolar and we both know how much it sucks the big one. I know you were defending the previous poster that I was responding to, and I can appreciate that. I get the sense that you were also defending yourself. Your post sounded a bit heated. And, I guess mine did as well. Anyway, we may have to just agree to disagree on this one. Unless I started a post on the therapy section. Blah blah blah
Take Care,
Morgan
Posted by morganpmiller on July 9, 2009, at 5:13:02
In reply to Re: ECT - Zeba, posted by morganpmiller on July 9, 2009, at 0:03:41
I have to apologize for my inability to effectively articulate and express my thoughts right now. My brain is seriously impaired.
Scott, one question, did you ever get relief from exercise after medications were helping you considerably? If you were 75 percent better, did exercise help you get to 85 or 90 percent? Were you ever stabilized on meds and had one bad day and went to the gym, got a great workout and felt much better afterward? I'm just curious because you made is sound like exercise has never given you relief from your depression. It surprised me that's all.
Posted by SLS on July 9, 2009, at 8:25:37
In reply to Re: ECT - Zeba, posted by morganpmiller on July 9, 2009, at 0:03:41
That was a great post.
I would agree with you in that there is often a psychosocial stress that creates a substrate upon which a biological potential is realized. This might even be true of the majority. Even homozygous twins are not necessarily concordant in their presentation of a mental illness. That leads me to believe that epigenetic factors are involved in the evolution of the resultant pathological phenotypes. Events in the womb might even come into play.
I think I understand the paradigm that you are suggesting. It has always been my belief that the majority of pathological presentations are the result of an interaction between biology and psychology (nature and nurture) Still, I would be careful when attempting to establish the presence of a trend by creating generalizations that are all-inclusive. You cannot know the experiential history of everyone who displays a major mental illness. When you search for imperfection in growth environments, you are likely to find it. It seems to me that your paradigm is really a thought experiment that can be bolstered by saying that "we all have issues" because none of us had a perfect growth environment. It might make sense to consider depression as a spectrum of the contributions of the biological and the psychological. I believe that there are cases that occupy one pole or other; either all psychogenic or all biogenic. Most will be found somewhere in the middle with various combinations of nature and nurture involved in the evolution of the illness.
All in all, I actually agree with you. I just do not think that every single case of MDD or BD occupies the center of the affective spectrum. In fact, I think that there are enough occupants at either end such that they need to be understood and treated very differently clinically. It is sabotage to tell someone at the biogenic end of the spectrum that they must have had psychological issues to become ill in the first place, and that they might have to resolve them through psychotherapy before they can become healthy. I would say that "we all have stress", rather than "we all have issues".
The affective spectrum is simply a thought experiment on my part. I have no data to present in order to support it.
- Scott
Posted by SLS on July 9, 2009, at 8:42:28
In reply to Re: ECT - Zeba, posted by morganpmiller on July 9, 2009, at 5:13:02
Exercise never made a difference for me. My training regiment was primarily intense strength training.
- Scott
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