![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 37 to 61 of 61. Go back in thread:
Posted by Pennie Lane on August 24, 2001, at 22:38:43
In reply to Abuse of Prescription Medication, posted by Rosa on August 24, 2001, at 16:50:21
Rosa,
You probably already know the problems of abuse involving prescription medicine are not as simple as some replies to your post would indicate. But the problems of prescription drug abuse probaby cannot be solved by simply clicking to a narca-non site and contemplating certain prose, either. In part, the problems are cultural, and involve individuals' expectations and various views of what is considered "normal."
While some regulars at this site probably do have severe mental health problems, which in some cases have been improved by prescription medications, the correlation between etiology, diagnosis and treatment, in the mental health system at large, is tennuous and hardly consistent. The mental health system is used now, as it long has, as a place to bring family members who for whatever reason do not fit in, and where individuals can manipulate the systems to obtain the specific meds they prefer. The claim that anti-depressants and anti-psychotics are not often abused and therefore pyshciatric drugs are not commonly abused is a falacious argument. The claim that psych drugs help some people, therefore you should not be concerned about abuse in other situations is an indifferent and somewhat uncaring stance.
Oxycontin abuse is probably a poor example of abuse of prescription psych drugs. Oxycontin is a pain med, and most problems with Oxycontin stem from diversion or theft of legitimately prescribed dosages (including in some of the pending lawsuits.) Opiods of all sorts have long been diverted for unauthorized use, but psychiatric drugs also created the risk of diversion and abuse. The psychiatric drugs most likely to be abused include amphetamine-class drugs, and sedatives. The more respected a person is as a professional, the greater the likelihood that a doctor will trust their judgement and supply amphetamines or hypnotics based on casual complaints. Adult caretakers of youth, and caregivers for the elderly are also likely candidates for reporting symptoms that reflect the caregiver's personal preference for acceptable behavior instead of a legitimate psychiatric complaint.
Many psych drug abusers would seem to be the least likely; who would guess that the chief justice of the largest state court system in the United States would become a victim of his own abuse of prescription medications.
For anyone who is seriously interested in the problem of prescription drug abuse (and not for those interested in foisting moral judgements or for those anxious to defend their own choice of medications) former New York Chief Justice Sol Wachtler describes his experience with prescription drug abuse in "After the Madness."
A few excerpts from the Chief Justice's jailhouse memoire:
Introduction
(page 3, first words of book…) The facts of my case have been well publicized. I dwell on them not to excuse my wrongful conduct but to explain how I wound up in prison and how the abuse of drugs, even those legally prescribed, and untreated mental disorder, can destroy.
The decomposition of my life began slowly, almost imperceptibly. ...
(page 4) While suffering this profound depression, and not wanting to bear the stigma of seeing a psychiatrist, I attempted to self medicate. I was able to convince one doctor to prescribe Tenuate, an amphetaminelike drug I used to elevate my energy level and thereby mask my depression. (I took 1400 of them in a four month period). And because I could not sleep, I was able to convince another doctor to prescribe a hypnotic called Halcion (I took 280 of them during the same four months). Still another doctor gave me a prescription for Pamelor, an antidepressant. And there were others. All of these drugs taken by themselves have dangerous side effects. Taken together the reaction can be devastating. In my case it contributed to and exacerbated a diagnosed manic-depressive (bipolar) disorder.
(Page 7, from Watchler's post arrest psychiatric report by Doctors William A. Forsch (Cornell) and Frank T. Miller (Payne Whitney): “Judge Watchler’s severe mental illness is best categorized as drug induced and exacerbated bipolar disorder (manic depression).”
(page 9 before his arrest) ...I told the doctor only what I wanted to reveal...
(page 13) I was in Sedona, Arizona, to address the Nevada Bar Association. I couldn’t sleep. I had taken two Halcion and two Unisom and still I couldn’t sleep. Was it the three Tenuate I had taken that afternoon to keep me from depression? Maybe but at the time I didn’t think I really needed the sleep – what I needed was time to think....
...And suddenly it came to me, a manically induced epiphany...
Posted by Phil on August 24, 2001, at 23:31:29
In reply to Re: Abuse of Prescription Medication » Rosa, posted by Pennie Lane on August 24, 2001, at 22:38:43
Was not trying to infer that Oxycontin was a psych drug. Just shootin the breeze. Probably should have mentioned Disco Bisquits; The late 70's wonder drug...Quaaludes. :-)
Posted by Rosa on August 25, 2001, at 7:49:36
In reply to Re: Abuse of Prescription Medication Penny Lane, posted by Phil on August 24, 2001, at 23:31:29
Is this board limited to sedatives, antidepressants, antianxiety drugs and antipsychotics?
Rosa
> Was not trying to infer that Oxycontin was a psych drug. Just shootin the breeze. Probably should have mentioned Disco Bisquits; The late 70's wonder drug...Quaaludes. :-)
Posted by Pennie Lane on August 25, 2001, at 11:41:48
In reply to Re: Abuse of Prescription Medication Penny Lane, posted by Rosa on August 25, 2001, at 7:49:36
Rosa:
re: "Is this board limited to sedatives, antidepressants, antianxiety drugs and antipsychotics?"
no, i don't think so, but that does cover a broad swath of psych drugs, and this board is focused on psych drugs. There has been discussion at times about whether psychiatric treatment can be discussed primarily from a pharmaceutical approach. I think a primary focus on medications tends to discount other factors that contribute to psychiatric complaints, but that is what PBSocial is supposed to be about. For my interests, the discussion there tends to be very social and casual. It is not as often focused on theoretical or scientific evidence of social/behavioral/cultural stressors that contribute to psychiatric problems.
The doc seems to have established a boundary here when he said this board (PB) does allow discussion of psychiatric drug abuse. For the sake of discussion, the abuse of Oxycontin, quaalude, GHB, rolfies, and other such drugs is interesting, but is not central to a discussion of psyhciatric drug abuse.
Sedatives and stimulants prescribed specifically for phsyciatric complaints are often abused, even by people in positions of authority, so discussion of abuse involving those drugs is particularly interesting. The abuse of other pshyc drugs, such as anti-depressents, is also very interesting, but can be problematic on this board. Some people are convinced, rightly or wrongly, that they have no personal issues but instead are effected by an exclusively biological disorder that is of an entirely different league than are psych symptoms related to a social situation or to life-stresses. I might disagree - people might feel they have enjoyed a normal youth, but might not realize how the norms they excepted effected their development, and what alternatives might have produced different results. So if you want to discuss that here, I might contribute, but you should know it has been a sensitive topic and if the discussion does not frequently touch on psych drugs, or maybe even if it approaches psych drugs from a critical angle, you might get booted over to PB.
Now, in the use and abuse of amphetamines, the topic would seem to fit here, but again, some people's opinion of the overall use of these drugs might be influenced by their own preference for amphetamines or by their need to defend the practice of ready access to psych drugs in general. (Or at least ready access for those who can afford access.)
Phil:
I didn't mean to insinuate that you were insinuating Oxycontin was a psych drug, though I realize it appeared to be the case. My intent was to focus on patterns of abuse that are particular to psych drugs. In most cases, those patterns involve selective reporting of symptoms intended to obtain prescriptions for a chosen drug, or in the misidentification of symptoms by caregivers who do not understand the social and behavioral complications effecting those they care for. Diversion and theft seems to be more of an issue with opiods than with psych drugs. People tend to obtain homemade amphetamines on the black market rather than through the medical community, and it is often arguable that their purpose is self-medication of the same symptoms for which a licensed practitioner would administer similar sympathomemetics.
Beneath the blue suburban skies
I sit and meanwhile back.>
> Rosa
>
> > Was not trying to infer that Oxycontin was a psych drug. Just shootin the breeze. Probably should have mentioned Disco Bisquits; The late 70's wonder drug...Quaaludes. :-)
Posted by Zo on August 25, 2001, at 17:35:09
In reply to Re: Zo, posted by Phil on August 24, 2001, at 22:31:14
Thanks, Phil. I didn't mean to sound angry. Just meant, I don't come here to be to be "saved" by anybody. . but may not have been alert to subject matter of thread. Not too alert last few days. Of course it's worth discussing.
Zo
Posted by Phil on August 25, 2001, at 19:21:12
In reply to Re: Zo » Phil , posted by Zo on August 25, 2001, at 17:35:09
No big deal. Have to agree with Pennie Lane also.
And the fireman rushes in
From the pouring rain
Very strange
Posted by Marie1 on August 26, 2001, at 8:35:16
In reply to Re: Abuse of Prescription Medication » Rosa, posted by Pennie Lane on August 25, 2001, at 11:41:48
Pennie Lane,
What you have to say here about people thinking their depression has been caused solely by some neurotransmitter imbalance is interesting to me. I always thought my depression was purely biological, inherited from my looney tunes grandmother (I'm allowed; I too am "looney tunes :-)). My brother suicided, due to undiagnosed depression and that added to my theory about myself. Basically, I didn't feel that I had the stressors that typically contribute to a "situational depression". So went to g.p. and started Prozac, which luckily worked for me. This too reinforced the physiological depression theory. However, after 18 months in psychotherapy (after a bout of major depression), I'm beginning to wonder just how much of this illness really is bio-chemical. I also have abuse problems with alcohol and prescription meds. I've come to think my depression may be a combination of things, with a genetic predisposition to mental illness. Part of the problem is, I don't want to think my past was anything but normal. We weren't the Brady Bunch, but was it really that bad? Hard for me to say; that was my reality and I had nothing else to compare it to.
Anyway, I was curious if this is what you meant when you said "how the norms they excepted effected their development, and what alternatives might have produced different results."
I was also curious as to your background. Are you a psychologist or psychiatrist? Thanks for your thoughts.Marie
Underneath the blue suburban skies, I sit and meanwhile back at Pennie Lane....
Posted by Rosa on August 26, 2001, at 9:11:05
In reply to Re: Abuse of Prescription Medication » Pennie Lane, posted by Marie1 on August 26, 2001, at 8:35:16
I hope this will help explain how we are affected by the environment in which we grew up. Although this is a social issue, it leads to being prescribed medication in some cases.
Here are the characteristics we seem to have in common due to being brought up in an alcoholic or dysfunctional home.
a. We became isolated and afraid of people and authority figures.
b. We became approval seekers and lost our identity in the process.
c. We are frightened by angry people and any personal criticism.
d. We either become alcoholics, marry them, or both, or find another compulsive personality such as a workaholic to fulfill our abandonment needs.
e. We live life from the viewpoint of victims and are attracted by that weakness in our love and friendship relationships.
f. We have an overdeveloped sense of responsibility and it is easier for us
to be concerned with others rather than ourselves. This enables us not to
look too closely at our own faults.g. We get guilt feelings when we stand up for ourselves instead of giving in to others.
h. We become addicted to excitement.
i. We confuse love with pity and tend to "love" people who we can "pity" and "rescue".
j. We have stuffed our feelings from our traumatic childhoods and have lost
the ability to feel or express our feelings because it hurts so much (denial).k. We judge ourselves harshly and have a very low sense of self-esteem.
l. We are dependent personalities who are terrified of abandonment and will do anything to hold on to a relationship in order not to experience painful abandonment feelings which we received from living with sick people who were
never there emotionally for us.m. Alcoholism is a family disease and we became para-alcoholics and took on the characteristics of the disease even though we did not pick up the drink.
n. Para-alcoholics are reactors rather than actors.
(Adapted version) Tony A., 1977
Reprinted from WSO Newcomer, Page 2, with permission from Adult Children of
Alcoholics, World Service Organization,
P. O. Box 3216, Torrance, CA 90510
310/ 534-1815.
_________________________________For further information about Adult Children of Alcoholics, go to the following URL:
www.adultchildren.org
> Pennie Lane,
> What you have to say here about people thinking their depression has been caused solely by some neurotransmitter imbalance is interesting to me. I always thought my depression was purely biological, inherited from my looney tunes grandmother (I'm allowed; I too am "looney tunes :-)). My brother suicided, due to undiagnosed depression and that added to my theory about myself. Basically, I didn't feel that I had the stressors that typically contribute to a "situational depression". So went to g.p. and started Prozac, which luckily worked for me. This too reinforced the physiological depression theory. However, after 18 months in psychotherapy (after a bout of major depression), I'm beginning to wonder just how much of this illness really is bio-chemical. I also have abuse problems with alcohol and prescription meds. I've come to think my depression may be a combination of things, with a genetic predisposition to mental illness. Part of the problem is, I don't want to think my past was anything but normal. We weren't the Brady Bunch, but was it really that bad? Hard for me to say; that was my reality and I had nothing else to compare it to.
> Anyway, I was curious if this is what you meant when you said "how the norms they excepted effected their development, and what alternatives might have produced different results."
> I was also curious as to your background. Are you a psychologist or psychiatrist? Thanks for your thoughts.
>
> Marie
>
> Underneath the blue suburban skies, I sit and meanwhile back at Pennie Lane....
Posted by Pennie Lane on August 26, 2001, at 12:59:22
In reply to Re: Abuse of Prescription Medication » Pennie Lane, posted by Marie1 on August 26, 2001, at 8:35:16
Marie1,
It seems that, whether adverse mental health symptoms are primarily biological or psychological, they are always both.
The nature/nurture question has been thoroughly tossed around on this board in several threads, directly and indirectly, until it seems major proponents of either view can articulate and incorporate in their own theories elements of the other view. If there is a middle ground, and I believe that there is, a loose consensus tends to evolve around the idea that inherited physiological factors can predispose some people to crumble when exposed to certain environmental stresses. Stressors can include social/family influence, nutritional deficits or disease. But a hybrid theory, I don't beleive, means any individual's symptoms can conclusively be said to be exclusively caused by nature or nurture. For all our study, we might be close to finding out, but we still don't know.
For me, the hybrid of inherited and environmental influences might provide an answer to prosecutors’ favorite line against psychiatric defenses, which says "Daddy abused Johnny's brother too, but Johnny's brother didn't go kill anybody. Johnny killed because he is bad, not because he was abused." Well, maybe Johnny's brother inherited a different genetic predisposition. Or, of course, maybe brother by chance and opportunity just developed a different coping style (or never got caught in his aggressive deeds).
If we allow for a hybrid of inherited and environmental factors, we reach another interesting question. When and where were the genetic traits introduced? An interesting lesson in genetic predisposition can be found in the population of HIV positive individuals. Some who test positive for HIV never develop AIDS symptoms and live much longer than those who develop symptoms. As a caveat, I don't believe, for all the billions in spending, that influences of lifestyle and immunosuppressive behaviors have been thoroughly documented. But what has been reported with general acceptance is that a group infected with the most common type of HIV in the United States and that is resistant to AIDS symptoms is predominately of European origin.
Well that's about a racist disease! But the genetic differences of Europeans, and of other cultures have played a major role in world history. Examples include the destruction by disease of native nations on the American continent when Europeans arrived (natives had not inherited immune sensitivity to European diseases) and perhaps the impact of tropical diseases on European travelers in more southern climes.
With HIV, the genetic trait that is theorized to predispose select individual to survive with HIV is believed to result for the era of the plague in Europe. The same trait that allowed some individuals to survive the plague is believed to predispose their descendants to survive HIV. And since they survived the plague, carriers of that trait now represent a greater portion of the European/American population than descendants of individuals who were not immune to bubonic plague.
But could this tendency toward cultural influence in natural selection apply to mental health problems? I think so. Maybe, sometime back around Charlemagne, give or take a thousand years or more, people who kept to themselves, succumbed to authority and presented other symptoms listed in the WSO list Rosa posted - maybe people genetically predisposed to those behaviors were more likely to successfully reproduce. Certainly through the Inquisition, individuals of European origin who might have been genetically predisposed to individuality, self-direction and originality were not favored in the unnatural selection process that determined matters of survival in the dungeons and fiery pyres of that day. Similar processes might have favored certain traits in other groups, but I don't want to go any further out on thin ice by suggesting specific genetic traits that might inhabit minority populations. And it is hard if not impossible at this time to determine how much of most behavioral traits might be genetic or culturally determined.
Whether symptoms are primarily a product of genetic or environmental influences, our choices of treatment might be the same. It's not like genetic causes imply chemical fixes and environmental causes imply psychological fixes. Psychological help might assist us in coping with primarily genetic traits. Medications might help us in coping with primarily environmentally induced symptoms.
The challenge, at least in gleaning some guidance from a forum such as this one, is to assimilate what can be learned from others without letting others paint you into a corner in an effort to defend their own choices. For you and I to discuss environmental causes of symptoms might be threatening to others who are convinced their symptoms are exclusively genetic and can only be treated with medications. But the goal here, I think, is to assist individuals interested in sharing some control over their choice of treatment. To that end, nobody's authoritative argument based on their own experience should outweigh your authority to reach conclusions based on the entire body of evidence available to you.
Am I a psych? …ologist or …iatrist? Sure. As payment for my services, please send a check, with the "pay to" line blank, to this anonymous New York City post office box...
Not. At least not of the credentialed (and trained) professional variety. Like many people who visit discussions such as this, I believe that I have as much right to develop opinions based on the entire body of evidence available to me as do working professionals. I think we would all do well to be better informed consumers and less trusting of elite caregivers whose interests can be directed as much by market forces (or political environment) as they are by concern for the suffering of their clients.
Posted by Mitch on August 26, 2001, at 12:59:49
In reply to A Social Issue? » Marie1, posted by Rosa on August 26, 2001, at 9:11:05
> I hope this will help explain how we are affected by the environment in which we grew up. Although this is a social issue, it leads to being prescribed medication in some cases.
>
> Here are the characteristics we seem to have in common due to being brought up in an alcoholic or dysfunctional home.
>
> a. We became isolated and afraid of people and authority figures.
>
> b. We became approval seekers and lost our identity in the process.
>
> c. We are frightened by angry people and any personal criticism.
>
> e. We live life from the viewpoint of victims and are attracted by that weakness in our love and friendship relationships.
>
> g. We get guilt feelings when we stand up for ourselves instead of giving in to others.
>
> k. We judge ourselves harshly and have a very low sense of self-esteem.
>Rosa,
Interestingly, half of these traits appear to be paraphrased criteria (DSM-wise) for social anxiety disorder. What if a LOT of people with substance abuse really are just social phobics that need specific treatment for that disorder? We know that our brain gets "rewired" in a more *rewarding* way when we interact with others in a positive benevolent manner. When "normal" people feel malaise or boredom they tend to seek out company to relieve the blues. The process becomes "self-correcting" and they tend not to become ill. Individuals with anxiety/depressive disorders often become isolated and can abuse drugs/alcohol instead. I heard somewhere that dopamine dysfunction in the brains of people with social anxiety/depression tends to perpetuate isolation. Perhaps the reason CBT can be effective is it "resets" your false assumptions about others and *confirms* the new more rational assumptions through the experience of social group "projects", resulting in brains gets *rewired* and the reward system "fixed". What if Alanon, Narcanon, church, sports/games, etc. fundamentally are therapeutic mechanisms to keep individual brains functioning properly through modulation of dopamine/reward systems?
M.
Posted by Pennie Lane on August 26, 2001, at 13:49:17
In reply to Re: Abuse of Prescription Medication » Pennie Lane, posted by Marie1 on August 26, 2001, at 8:35:16
For all my profundity and rambling, I probably didn’t answer your question about, “if this is what you meant when you said ‘how the norms they excepted effected their development, and what alternatives might have produced different results.’"
Yes, that is essentially what I meant. Even if depression usually or sometimes involves a genetic bio-chemical factor, or a socially influenced bio-chemical factor, it remains to be answered whether that factor would produce depression in all circumstances. A person might be predisposed by birth or experience to a behavioral trait that would be acceptable in other cultural surroundings, but which is unacceptable and leads to depression in a particular culture. The depression could be a secondary expression. Depression has often been found to be a secondary symptom of another undiagnosed unperceptual impairment. The ease of identifying a common secondary symptom - depression - might interfere with more difficult efforts to identify a wide variety of unique primary factors that contribute to depression.
In another culture, the required physical activity (which tends to produce serotonin) or the social environment might not aggravate a depressive trait the same way our culture does. A comparison would be diabetes – some people never develop diabetes on a traditional indigenous diet, but are more genetically inclined than others to develop diabetes when they switch to a diet high in carbohydrates and starches. The inherent dopamine needs of individuals whose genetic history included a culture dependant on foods rich in dopamine precursors might incline them to reward deficit symptoms when they change diets – they might be predisposed to alcoholism (or to abuse of prescription meds) as a way of tweaking their dopamine activity.
I’m not saying I think depression is primarily genetic or situational in origin across the board. And I’m not saying meds or psychological therapy are the best treatment for symptoms of either origin. What I am saying is things are not as simple as they seem, and any combination of therapy, social activity, professionally directed medication or self-medication might prove helpful for any given individual’s unique set of symptoms and circumstances.
Posted by gilbert on August 26, 2001, at 23:27:24
In reply to Re: Abuse of Prescription Medication, posted by Pennie Lane on August 26, 2001, at 13:49:17
Well the same old story about how taking meds violates the integrity of working your 12 step program. I have been sober 15 years from cocaine and vodka. I have been on xanax for the last 3 years...it has literally saved my life. After 10 years sober and suffering from severe panic and agoraphobia I was suicidal. I got help and meds and my life is wonderfull. The big book allows for medical use of medication which most people in AA and NA seem to read past or miss. The founder of the 12 steps Bill W. suffered from such severe depressions that he experimented with LSD after he had been sober many years so even the founder knew that those of us who are dual diagnosed I.E. addicts and panic or depressives would need medical attention. I have been put through hell trying to take "program acceptable drugs" to feel like I fell inbetween the lines and suffered needlessly. I do not get high off my xanax, I do not get thrown in jail, I do not run from bar to bar looking for quick sex....although I am older now so it would be more like slow sex, I feel normal for the first time in my life. I just came back from vacation and was able to drive across the Mackinaw bridge panic free for the first time in years. Thank God for modern science. When Rosa has been sober for a few more years she may realize that alcohol and valium was only a symptom of her illness and hopefully she will be able to get by without meds.....but I see tons of people at AA meetings who are suffering needlessly due the stigma of taking these drugs. Panic disorder and depression kill just like alcoholism the only difference is mental illness hasn't hit the chic status that addiction has. We just don't get the parade of movie stars on Larry King saying how they are fighting mental illness but boy if they get clean they run for those cameras.
Gil
Posted by Marie1 on August 27, 2001, at 7:40:15
In reply to Re: Abuse of Prescription Medication, posted by Pennie Lane on August 26, 2001, at 13:49:17
Pennie Lane,
Thank you. All of this is very interesting to me. As the mother of two daughters, it's important to me to grasp what I can about my illness, as the genetic predisposition is obviously quite strong in my family. My brother's suidice shocked us all deeply (even myself; I hadn't "been there, done that" yet). My remaining siblings (there were seven of us originally) don't seem to have inherited mentall illness, at least on the surface. But one sister is a former heroin addict and another brother just recently died from complications of obesity, which he has had all his life. I always wondered about that too. What was it about my brother that he turned to food as a coping mechanism? Why didn't I? How much control did he have over his body? That his life was made miserable by his physical condition is undeniable; how fucking unfair if he really had no recourse.
I have also wondered just why so many people (it seems) have developed depression during the 20th century. I know it was around before then, but these days it seems to be epidemic. I think this may be in part due to: 1. the relatively sedentary life style of people in this computer and labor-saving machinery age. We all know that consistent exercise contributes to healthy brains, but it's difficult to get exercise while going about the business of living, unless it's a scheduled activity; and 2. (and I even hesitate to post this) spirituality. Many of us, disturbed by the hypocrisy and self serving of many organized religions, have abandoned spirituality all together.
Okay, enough of my rambling, I'm off to work while the kids are enjoying (! :-)) their first day at school. Yeah!!!Marie
> For all my profundity and rambling, I probably didn’t answer your question about, “if this is what you meant when you said ‘how the norms they excepted effected their development, and what alternatives might have produced different results.’"
>
> Yes, that is essentially what I meant. Even if depression usually or sometimes involves a genetic bio-chemical factor, or a socially influenced bio-chemical factor, it remains to be answered whether that factor would produce depression in all circumstances. A person might be predisposed by birth or experience to a behavioral trait that would be acceptable in other cultural surroundings, but which is unacceptable and leads to depression in a particular culture. The depression could be a secondary expression. Depression has often been found to be a secondary symptom of another undiagnosed unperceptual impairment. The ease of identifying a common secondary symptom - depression - might interfere with more difficult efforts to identify a wide variety of unique primary factors that contribute to depression.
>
> In another culture, the required physical activity (which tends to produce serotonin) or the social environment might not aggravate a depressive trait the same way our culture does. A comparison would be diabetes – some people never develop diabetes on a traditional indigenous diet, but are more genetically inclined than others to develop diabetes when they switch to a diet high in carbohydrates and starches. The inherent dopamine needs of individuals whose genetic history included a culture dependant on foods rich in dopamine precursors might incline them to reward deficit symptoms when they change diets – they might be predisposed to alcoholism (or to abuse of prescription meds) as a way of tweaking their dopamine activity.
>
> I’m not saying I think depression is primarily genetic or situational in origin across the board. And I’m not saying meds or psychological therapy are the best treatment for symptoms of either origin. What I am saying is things are not as simple as they seem, and any combination of therapy, social activity, professionally directed medication or self-medication might prove helpful for any given individual’s unique set of symptoms and circumstances.
Posted by Marie1 on August 27, 2001, at 7:47:32
In reply to A Social Issue? » Marie1, posted by Rosa on August 26, 2001, at 9:11:05
Rosa,
I'm not sure about this list as it applies to me, although some of these charateristics I can relate to. Obviously, we're all different people with different genetic makeup and life experiences, so I think it's impossible to come up with a list of personality characteristics that apply to all who may have had a less than desirable childhood. But interesting, nevertheless.Marie
> I hope this will help explain how we are affected by the environment in which we grew up. Although this is a social issue, it leads to being prescribed medication in some cases.
>
> Here are the characteristics we seem to have in common due to being brought up in an alcoholic or dysfunctional home.
>
> a. We became isolated and afraid of people and authority figures.
>
> b. We became approval seekers and lost our identity in the process.
>
> c. We are frightened by angry people and any personal criticism.
>
> d. We either become alcoholics, marry them, or both, or find another compulsive personality such as a workaholic to fulfill our abandonment needs.
>
> e. We live life from the viewpoint of victims and are attracted by that weakness in our love and friendship relationships.
>
> f. We have an overdeveloped sense of responsibility and it is easier for us
> to be concerned with others rather than ourselves. This enables us not to
> look too closely at our own faults.
>
> g. We get guilt feelings when we stand up for ourselves instead of giving in to others.
>
> h. We become addicted to excitement.
>
> i. We confuse love with pity and tend to "love" people who we can "pity" and "rescue".
>
> j. We have stuffed our feelings from our traumatic childhoods and have lost
> the ability to feel or express our feelings because it hurts so much (denial).
>
> k. We judge ourselves harshly and have a very low sense of self-esteem.
>
> l. We are dependent personalities who are terrified of abandonment and will do anything to hold on to a relationship in order not to experience painful abandonment feelings which we received from living with sick people who were
> never there emotionally for us.
>
> m. Alcoholism is a family disease and we became para-alcoholics and took on the characteristics of the disease even though we did not pick up the drink.
>
> n. Para-alcoholics are reactors rather than actors.
>
> (Adapted version) Tony A., 1977
>
> Reprinted from WSO Newcomer, Page 2, with permission from Adult Children of
> Alcoholics, World Service Organization,
> P. O. Box 3216, Torrance, CA 90510
> 310/ 534-1815.
> _________________________________
>
> For further information about Adult Children of Alcoholics, go to the following URL:
>
> www.adultchildren.org
>
> > Pennie Lane,
> > What you have to say here about people thinking their depression has been caused solely by some neurotransmitter imbalance is interesting to me. I always thought my depression was purely biological, inherited from my looney tunes grandmother (I'm allowed; I too am "looney tunes :-)). My brother suicided, due to undiagnosed depression and that added to my theory about myself. Basically, I didn't feel that I had the stressors that typically contribute to a "situational depression". So went to g.p. and started Prozac, which luckily worked for me. This too reinforced the physiological depression theory. However, after 18 months in psychotherapy (after a bout of major depression), I'm beginning to wonder just how much of this illness really is bio-chemical. I also have abuse problems with alcohol and prescription meds. I've come to think my depression may be a combination of things, with a genetic predisposition to mental illness. Part of the problem is, I don't want to think my past was anything but normal. We weren't the Brady Bunch, but was it really that bad? Hard for me to say; that was my reality and I had nothing else to compare it to.
> > Anyway, I was curious if this is what you meant when you said "how the norms they excepted effected their development, and what alternatives might have produced different results."
> > I was also curious as to your background. Are you a psychologist or psychiatrist? Thanks for your thoughts.
> >
> > Marie
> >
> > Underneath the blue suburban skies, I sit and meanwhile back at Pennie Lane....
Posted by Rosa on August 27, 2001, at 8:07:23
In reply to 12 steppers and alike, posted by gilbert on August 26, 2001, at 23:27:24
Valium has been referred to as "dry alcohol" because it has the same effect as alcohol. Valium was prescribed because I had difficulty with life on life's terms. I suppose it could have been described as a "spiritual" issue.
Whenever we have problems that we don't want to face, it is usually a spiritual issue as well as an emotional issue. There are written policies concerning the use of medication for 12-steppers to use as a guide.
What do you think comprises the misuse of drugs?
Rosa
________________________________________________
Well the same old story about how taking meds violates the integrity of working your 12 step program. I have been sober 15 years from cocaine and vodka. I have been on xanax for the last 3 years...it has literally saved my life. After 10 years sober and suffering from severe panic and agoraphobia I was suicidal. I got help and meds and my life is wonderfull. The big book allows for medical use of medication which most people in AA and NA seem to read past or miss. The founder of the 12 steps Bill W. suffered from such severe depressions that he experimented with LSD after he had been sober many years so even the founder knew that those of us who are dual diagnosed I.E. addicts and panic or depressives would need medical attention. I have been put through hell trying to take "program acceptable drugs" to feel like I fell inbetween the lines and suffered needlessly. I do not get high off my xanax, I do not get thrown in jail, I do not run from bar to bar looking for quick sex....although I am older now so it would be more like slow sex, I feel normal for the first time in my life. I just came back from vacation and was able to drive across the Mackinaw bridge panic free for the first time in years. Thank God for modern science. When Rosa has been sober for a few more years she may realize that alcohol and valium was only a symptom of her illness and hopefully she will be able to get by without meds.....but I see tons of people at AA meetings who are suffering needlessly due the stigma of taking these drugs. Panic disorder and depression kill just like alcoholism the only difference is mental illness hasn't hit the chic status that addiction has. We just don't get the parade of movie stars on Larry King saying how they are fighting mental illness but boy if they get clean they run for those cameras.
>
> Gil
Posted by Phil on August 27, 2001, at 9:17:37
In reply to Re: 12 steppers and alike » gilbert, posted by Rosa on August 27, 2001, at 8:07:23
Gil, I'm with you on this because of the enormous amount of suffering I have seen in Al Anon, AA, etc.
I said earlier that I was okay with my Mom not wanting to do psychiatric drugs after years of recovery but I think they may have headed off the ECT that had to be done STAT.
I've seen folks do amazing things by just working the program also.
I just don't think anyone should rule out possibilities where deep suffering is concerned. Sometimes suffering leads to enlightenment. Usually, it leads to more suffering and it can be helped.
I've had to search my soul over the years on which way to go with all of these issues. Last week, when my med combo started really working after about 3 years of incredible frustration, there is no doubt in my mind about the power of meds to save lives.
I must say, I have had more fun this week than I have had in years.
We've all gotta respect others decisions and to interfere too much is not a healthy caring.
Healthy caring just says,"Hey, if ya wanna talk about it..."
This has been a good discussion. Don't y'all think?Thanks for letting me ramble,
Pj
Posted by JahL on August 27, 2001, at 9:19:04
In reply to Re: 12 steppers and alike » gilbert, posted by Rosa on August 27, 2001, at 8:07:23
> Whenever we have problems that we don't want to face, it is usually a spiritual issueDon't think so...
Nice post Gilbert.
Posted by Mitch on August 27, 2001, at 15:33:06
In reply to Re: Abuse of Prescription Medication, posted by Marie1 on August 27, 2001, at 7:40:15
> I have also wondered just why so many people (it seems) have developed depression during the 20th century. I know it was around before then, but these days it seems to be epidemic. I think this may be in part due to: 1. the relatively sedentary life style of people in this computer and labor-saving machinery age. We all know that consistent exercise contributes to healthy brains, but it's difficult to get exercise while going about the business of living, unless it's a scheduled activity; and 2. (and I even hesitate to post this) spirituality. Many of us, disturbed by the hypocrisy and self serving of many organized religions, have abandoned spirituality all together.
> Marie
>Marie, I agree with you about the exercise thing. I used to have a very physical job (construction work and demolition) while I was going to school
and I felt a LOT better before I got a "cubicle job". In fact since I got that job (there is a lot of interpersonal stress and a borderline boss, too), I can trace a deterioriation in social skills, sense of humour, interest in doing things, uh, like most of the symptoms of a clinical depression. I also agree about the spirituality issue. I would like to join a church that is more into the "spirit" of the religion not the history and the rules. It doesn't seem very easy.Mitch
>
Posted by Rosa on August 27, 2001, at 20:24:16
In reply to Re: Abuse of Prescription Medication » Marie1, posted by Mitch on August 27, 2001, at 15:33:06
How do you distinguish between depression and burnout or chronic fatigue syndrome?
Rosa
> > I have also wondered just why so many people (it seems) have developed depression during the 20th century. I know it was around before then, but these days it seems to be epidemic. I think this may be in part due to: 1. the relatively sedentary life style of people in this computer and labor-saving machinery age. We all know that consistent exercise contributes to healthy brains, but it's difficult to get exercise while going about the business of living, unless it's a scheduled activity; and 2. (and I even hesitate to post this) spirituality. Many of us, disturbed by the hypocrisy and self serving of many organized religions, have abandoned spirituality all together.
> > Marie
> >
>
> Marie, I agree with you about the exercise thing. I used to have a very physical job (construction work and demolition) while I was going to school
> and I felt a LOT better before I got a "cubicle job". In fact since I got that job (there is a lot of interpersonal stress and a borderline boss, too), I can trace a deterioriation in social skills, sense of humour, interest in doing things, uh, like most of the symptoms of a clinical depression. I also agree about the spirituality issue. I would like to join a church that is more into the "spirit" of the religion not the history and the rules. It doesn't seem very easy.
>
> Mitch
> >
Posted by gilbert on August 27, 2001, at 20:42:04
In reply to Re: Abuse of Prescription Medication » Marie1, posted by Mitch on August 27, 2001, at 15:33:06
Rosa,
Alcoholism and addiction is a three fold disease, mental, spiritual and physical,.....I tried every spirtual cure known to God and man to cure my panic and agoraphobia, I have been prayed for I have prayed too I have done for others I have meditated, I have been in pyschotherapy I have counseled with priests I have done eveything possible........xanax works better and more effectively than any of the above....not to mention how angry you get at God for not curing your affliction......my enlightment occurred when realizing that my closed mindedness had not allowed me a full recovery from my underlying illness (panic disorder). I do not think valium or xanax use is something most addicts would want to try unless it is prescribed for panic and they are able to take it as prescribed.....which by the way most do. There are studies that show that panic patients do not abuse their benzos even if they happen to be recovering alkies like me. My sponsor has 28 years sober he is on prozac, effexor and xanax for sleep. He does not abuse his meds either. If everything is in a sense spiritual than I would hope one could look at the invention of life saving drugs as a spiritual tool as well, or maybe one could look at all the good that is accomplished on this board and all the giving and again feel that Dr Bob and many board members are spiritual beings who are not any less God-connected than people working the 12 steps and fortunate enough not to need meds for other illnesses. I love your enthusiasm for the fellowship and the spiritual feelings you get are wonderfull....but and this is only a caution, we need to talk again after you have been sober for 10 years and hopefully I pray to God you will not be in need of any of the medications you feel inappropriate for your own sobriety. Most alcoholics are not just addicts. I have been deeply involved with AA since the seventies. Most addicts after staying sober for a time realize that they were medicating an underlying illness like depression with the booze and then are in need of pyschiatric intervention to really get well.....and maybe the answer to the prayer is those doctors and the drugs they prescribe so they can finally live a life as full as God would want for them rather than a tortured secluded existence......Rosa trust me on this one...the steps are not a cure all for everything....not even close.....but they are certainly a great start.
best regards.
Gil
Posted by Rosa on August 27, 2001, at 21:29:24
In reply to JUST FOR TODAY, posted by Rosa on August 21, 2001, at 7:06:06
Spirituality -- Isn't that a social issue?
For many of us, a spiritual awakening came gradually. We improve our concious contact through prayer and meditation on a daily basis.
We trust in a Higher Power for guidance, without whom life would be empty and meaningless. Sometimes it is necessary for us to go to the hospital or lose everything that is important to us before we become willing to surrender to a Power greater than ourselves.Rosa
If you think you may have a problem with prescribed medications, the Just For Today Meditation may be for you.
>
> Rosa
>
> You can read the JFT online at http://www.jft.ca/jftmeditation
Posted by Mitch on August 27, 2001, at 21:56:52
In reply to Depression? » Mitch, posted by Rosa on August 27, 2001, at 20:24:16
> How do you distinguish between depression and burnout or chronic fatigue syndrome?
>
> RosaRosa,
I don't see a lot of difference between any of them. I believe that the lack of *spontaneous* perceptual experiences is the main culprit. If you are running your own farm to feed your own family you are going to get lots of *spontaneous stuff* on a daily basis. This is opposed to the situations most workers are commonly exposed to in today's workplace environment. Most people nowadays are exposed to the same old crap over and over in a detaily inhuman fashion which I believe is fundamentally unhealthy. That is WHY depression is so common nowadays. It is the programming and repetitiousness (that is of course-most *efficient*) that smothers the human soul. The urban/rural "breakpoint" occured during the 1930's where more people lived in cities than in rural areas for the first time in history. Interestingly, this is where most of our modern psychopathology sprang from. Perhaps there is a "need" to be connected to the natural world outside of ourselves, and when that need gets thrwarted we see the pathological results.
Mitch
Posted by Zo on August 27, 2001, at 22:07:39
In reply to Re: Depression? » Rosa, posted by Mitch on August 27, 2001, at 21:56:52
Isn't this starting to belong on Social?
Best.
Zo
Posted by Rosa on August 27, 2001, at 22:09:59
In reply to Re: Depression? » Rosa, posted by Mitch on August 27, 2001, at 21:56:52
Interesting that this was during the Depression (1930's)-- when so many people were out of work, no wonder the depression. They must have moved to the cities to find work.
Rosa
> > How do you distinguish between depression and burnout or chronic fatigue syndrome?
> >
> > Rosa
>
> Rosa,
>
> I don't see a lot of difference between any of them. I believe that the lack of *spontaneous* perceptual experiences is the main culprit. If you are running your own farm to feed your own family you are going to get lots of *spontaneous stuff* on a daily basis. This is opposed to the situations most workers are commonly exposed to in today's workplace environment. Most people nowadays are exposed to the same old crap over and over in a detaily inhuman fashion which I believe is fundamentally unhealthy. That is WHY depression is so common nowadays. It is the programming and repetitiousness (that is of course-most *efficient*) that smothers the human soul. The urban/rural "breakpoint" occured during the 1930's where more people lived in cities than in rural areas for the first time in history. Interestingly, this is where most of our modern psychopathology sprang from. Perhaps there is a "need" to be connected to the natural world outside of ourselves, and when that need gets thrwarted we see the pathological results.
>
> Mitch
Posted by jojo on August 28, 2001, at 0:14:31
In reply to Re: JUST FOR TODAY, posted by Rosa on August 22, 2001, at 6:47:00
> The 'Just For Today' post was meant to be helpful to those who have a problem with addiction to prescription medicines.
>
> Do you think that it is possible to be addicted to prescription medicine?
>
> Do you think drug abuse is a physical (chemical) or an emotional (social) problem?I haven't followed this thread closely. The reaction to whatever Rosa said, apparently speaking in favor of treatments other than pharmaceutical, seems quite strong. Just a few inches down the PB Site page from this message is a posting by Adam, http://www.dr-bob.org/babble/20010822/msgs/76146.html concerning ECT. Although there often are very strong reactions against the use of ECT, it is more generally by those who favor pharmacotherapy, while those who generally favor psychotherapy might lean more toward ECT in sever cases.
Switch "drugs" for "ECT". Would Rosa, or people with similar attitudes, object to ECT? Why not? Their arguments appear similar when presented as logical abstractions. If I'm correct about the above, there might be a lesson here about the "true" nature of this interchange.jojo
This is the end of the thread.
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