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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 4 to 28 of 39. Go back in thread:
Posted by Squiggles on June 23, 2007, at 15:37:23
In reply to Re: I've wondered about that » Squiggles, posted by Zyprexa on June 23, 2007, at 14:52:15
depression
Posted by Phillipa on June 23, 2007, at 15:39:12
In reply to Re: I've wondered about that » Squiggles, posted by Zyprexa on June 23, 2007, at 14:52:15
I just posted a thread above this on docs and depression Squiggles is answering that. Love Phillipa
Posted by med_empowered on June 23, 2007, at 15:42:00
In reply to What Happens to Docs if they get TX Resistant Depr, posted by Phillipa on June 23, 2007, at 14:12:09
I had a doc with depression. Its a small town, so lots of people knew--he responded well to antidepressants, so he tended to offer them up more than I imagine most other general practice docs. Similarly, I've heard that docs with more pronounced stress/anxiety tend to rx tranquilizers more (this may have been more the case in the pre-prozac era).
Posted by Cecilia on June 23, 2007, at 17:30:38
In reply to What Happens to Docs if they get TX Resistant Depr, posted by Phillipa on June 23, 2007, at 14:12:09
Often, kill themselves. Doctors have one of the highest suicide rates of any profession. Cecilia
Posted by Squiggles on June 23, 2007, at 20:54:24
In reply to Re: What Happens to Docs if they get TX Resistant Depr, posted by Cecilia on June 23, 2007, at 17:30:38
> Often, kill themselves. Doctors have one of the highest suicide rates of any profession. Cecilia
Is that so? Why, if so... stress, depression,
availability of suicidal drugs?Squiggles
Posted by Phillipa on June 23, 2007, at 21:56:34
In reply to Re: What Happens to Docs if they get TX Resistant Depr, posted by Cecilia on June 23, 2007, at 17:30:38
Cecelia it's true and I worked with one who did with carbon monoxide. The other pdocs he worked with didn't have a clue. I knew something was wrong he was so disorganized. Another reason for wondering if meds work he wanted me to up my xanax at the time and I refused. He was a great person . Love Phillipa
Posted by med_empowered on June 23, 2007, at 22:25:20
In reply to Re: What Happens to Docs if they get TX Resistant Depr » Cecilia, posted by Phillipa on June 23, 2007, at 21:56:34
yeah...docs are white and upper-middle/upper-class (both of which are risk factors for suicide, along with higher-than-average education), and they're still mostly male (again, risk factor for suicie). Add in expertise and availability of methods...lethal combo.
Posted by Phillipa on June 23, 2007, at 22:31:52
In reply to Re: What Happens to Docs if they get TX Resistant Depr, posted by med_empowered on June 23, 2007, at 22:25:20
If they know they are depressed why don't they do what they tell us to do and take an antidepressant or are they saying they don't work? Love Phillipa
Posted by Cecilia on June 24, 2007, at 4:42:13
In reply to Re: What Happens to Docs if they get TX Resistant Depr » med_empowered, posted by Phillipa on June 23, 2007, at 22:31:52
By definition, if they've got treatment resistant depression, like so many of us, the drugs don't work. Yes, I know someone will write in and say they tried 45 different combinations and miraculously the 46th one worked, and sure, it could happen, let's just say the odds are against it. Cecilia
Posted by linkadge on June 24, 2007, at 6:57:05
In reply to Re: What Happens to Docs if they get TX Resistant Depr, posted by Cecilia on June 24, 2007, at 4:42:13
Docs probably commit suicide not just because they're depressed, but because they have the inside scoop on the efficacy (or lack therof) of these medications.
Linkadge
Posted by Squiggles on June 24, 2007, at 7:37:51
In reply to Re: What Happens to Docs if they get TX Resistant Depr, posted by linkadge on June 24, 2007, at 6:57:05
I wish Dr. Bob would intercept these
conversations about the lack of anti-depressant
efficacy. I'd love to hear *his* views, being
a psychiatrist, but I think he can't as
moderator.Squiggles
Posted by ttee on June 24, 2007, at 10:21:33
In reply to Re: What Happens to Docs if they get TX Resistant » linkadge, posted by Squiggles on June 24, 2007, at 7:37:51
One of the biggest problems with docs when they have depression (mental illness), is they can't let anyone know and seek treatment, because they couldn't practice medicine with a mental illness. Let's say your PCP has depression and he misses diagnosing cancer in you during your annual physical. When you sue him for malpractice, he will lose if you find out he was suffering from mental illness or was taking psychiatric drugs and practicing medicine. It ends their career.
Posted by Squiggles on June 24, 2007, at 10:29:56
In reply to docs and depression, posted by ttee on June 24, 2007, at 10:21:33
> One of the biggest problems with docs when they have depression (mental illness), is they can't let anyone know and seek treatment, because they couldn't practice medicine with a mental illness. Let's say your PCP has depression and he misses diagnosing cancer in you during your annual physical. When you sue him for malpractice, he will lose if you find out he was suffering from mental illness or was taking psychiatric drugs and practicing medicine. It ends their career.
Well, Dr. Kay Jamison has written books about her
bipolar disorder and with meds she *is* one of the top doctors in her field.Perhaps it depends on your personal moral code or needs, but if i were a depressed dr. i would either seek treatment or stop practicing and get another job. Surely, there are people who may suffer from hiding this illness, including the dr. Money isn't everything.
Squiggles
Posted by linkadge on June 24, 2007, at 12:25:16
In reply to Re: What Happens to Docs if they get TX Resistant » linkadge, posted by Squiggles on June 24, 2007, at 7:37:51
What do you mean by intercept? There is very little proof of antidepressants being more effective than placebos.
Linkadge
Posted by linkadge on June 24, 2007, at 12:27:21
In reply to Re: docs and depression » ttee, posted by Squiggles on June 24, 2007, at 10:29:56
I would think that a doctor could still practice even if they have a mental illness. Malpractice is malpractice. I don't know how sucessfull somebody would be on directly linking malpractice to a doctor's illness.
Linkadge
Posted by Squiggles on June 24, 2007, at 12:29:51
In reply to Re: docs and depression, posted by linkadge on June 24, 2007, at 12:27:21
> I would think that a doctor could still practice even if they have a mental illness. Malpractice is malpractice. I don't know how sucessfull somebody would be on directly linking malpractice to a doctor's illness.
>
> LinkadgeYou may be right. To be frank, i have not
actually studied the issue at depth nor
searched for statistics. And the malpractice
-mental illness link is a legal issue.Squiggles
Posted by BabyBunny on June 24, 2007, at 12:58:54
In reply to Re: What Happens to Docs if they get TX Resistant Depr, posted by linkadge on June 24, 2007, at 6:57:05
I think Link is onto something here...
> Docs probably commit suicide not just because they're depressed, but because they have the inside scoop on the efficacy (or lack therof) of these medications.
>
> Linkadge
Posted by Squiggles on June 24, 2007, at 13:04:43
In reply to Re: What Happens to Docs if they get TX Resistant Depr » linkadge, posted by BabyBunny on June 24, 2007, at 12:58:54
Yup.. i think he's onto something too.
Squiggles
Posted by ttee on June 24, 2007, at 13:40:32
In reply to Re: docs and depression » ttee, posted by Squiggles on June 24, 2007, at 10:29:56
BTW, Dr. Kay Jamison is a renowned expert on bipolar as suffers from the illness. But she is NOT a practicing psychiatrist and has a Ph.D in Psychology. Most all state medical boards have rules of conduct for physicians and one of them is not to practice if you have mental illness. Just like if you are a pilot, you can not take ANY psychiatric meds (even Prozac) and still fly. This is an automatic FAA grounding. A doctor would need to stop practicing if he needed to take psychoactive drugs, or take them and not tell anyone. They don't want surgeons operating on people while on mind alterning drugs. If they went for psychiatric help in their local community, the risk is too great. Doctors don't get treatment for depression and this leads to an increased percentage of suicides.
Posted by Squiggles on June 24, 2007, at 13:53:00
In reply to Re: docs and depression, posted by ttee on June 24, 2007, at 13:40:32
OK - thanks for clarifying that. She certainly
writes well and has contributed greatly to the field with her research and collaboration with other psychiatrists.There are some depressions, which if mild would
probably not interfere with medical work; but there are others, which may actually lead to crime-- for example Dr. Shipfield in the UK? [i think that was his name]. Also, mental illness is insidious-- you can go on for years being eccentric and then at some time in your life do really things out of control; and there are also waves of madness during a lifetime. So, yeah, it would be risky.As Dr. Torrey said, much of the problem of people who do things they would not otherwise do, and are under the influence of biological brain disturbance, is that they are not always aware.
Squiggles
Posted by BabyBunny on June 24, 2007, at 13:54:48
In reply to Re: docs and depression, posted by ttee on June 24, 2007, at 13:40:32
That's sad. They're people too. But it just makes me doubt psychiatric drugs even more.
Why are they giving out this stuff like candy if it's so terrible? Makes one wonder...
> BTW, Dr. Kay Jamison is a renowned expert on bipolar as suffers from the illness. But she is NOT a practicing psychiatrist and has a Ph.D in Psychology. Most all state medical boards have rules of conduct for physicians and one of them is not to practice if you have mental illness. Just like if you are a pilot, you can not take ANY psychiatric meds (even Prozac) and still fly. This is an automatic FAA grounding. A doctor would need to stop practicing if he needed to take psychoactive drugs, or take them and not tell anyone. They don't want surgeons operating on people while on mind alterning drugs. If they went for psychiatric help in their local community, the risk is too great. Doctors don't get treatment for depression and this leads to an increased percentage of suicides.
Posted by Klavot on June 24, 2007, at 15:19:29
In reply to Re: What Happens to Docs if they get TX Resistant Depr, posted by linkadge on June 24, 2007, at 6:57:05
> Docs probably commit suicide not just because they're depressed, but because they have the inside scoop on the efficacy (or lack therof) of these medications.
>
> LinkadgeIn what way would having the "inside scoop" on antidepressant efficacy lead one to suicide?
Klavot
Posted by Klavot on June 24, 2007, at 15:26:37
In reply to Re: What Happens to Docs if they get TX Resistant, posted by linkadge on June 24, 2007, at 12:25:16
> What do you mean by intercept? There is very little proof of antidepressants being more effective than placebos.
>
> LinkadgeSome time back I was rebuked over at the alternative board for mentioning that there is nil evidence that homeopathy works. I don't have a problem with people questioning AD efficacy; I just wish there could be universal standards on different boards for asking awkward questions.
Klavot
Posted by Cecilia on June 24, 2007, at 15:42:52
In reply to Re: What Happens to Docs if they get TX Resistant » linkadge, posted by Squiggles on June 24, 2007, at 7:37:51
> I wish Dr. Bob would intercept these
> conversations about the lack of anti-depressant
> efficacy. I'd love to hear *his* views, being
> a psychiatrist, but I think he can't as
> moderator.
>
> SquigglesThe original question was not about the efficacy of AD's in general, obviously they do work for some people, but about docs with treatnment resistant depression, which by defintion is non-responsive to multiple meds. I don't think doctors are like pilots, they aren't required to have a yearly physical, I'm sure there are many many doctors on AD's and if they work for them, fine, no one need ever know. And even if they don't, plenty of depressed doctors, like depressed other people, work and contribute to the general betterment of society even though they are miserable their entire lives. Not that every depressed person can, but many do, the world is full of people who go to work every day and when people say "how are you" they answer "fine" when inside they're thinking "suicidal". Cecilia
Posted by linkadge on June 24, 2007, at 17:18:25
In reply to Re: What Happens to Docs if they get TX Resistant Depr, posted by Klavot on June 24, 2007, at 15:19:29
Well, I had a doctor (at the psychiatric unit in a Hospital in Waterloo Ontario Canada) say that the majority of the effect of these drugs is the placebo effect. Actually, she didn't volenteer the information, but we got to discussing them and she admitted I was right.
Anyhow, the point being, is that I am sure there are a number of doctors who think the drug effect is mainly placebo. They probably don't care though as long as they feel they can help the patient in some way.
So I am saying that I think the doctors probably know more about the treatments than we do. Just like how one of my best friend's fathers (a doctor who administered ECT) refused to allow his son to have ECT !!!
Linkadge
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