![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 14 of 14. This is the beginning of the thread.
Posted by stjames on July 11, 2000, at 22:36:09
Want to talk about long term effects ? Left unchecked
depression is a progressive process that eats away on mood but there are somatic inplications. Take a look at http://www.sigmaxi.org/amsci/articles/00articles/Jacobs.html"Citing evidence that stress reduces neurogenesis (the production of new nerve cells)and that the most effective antidepressive medications increase it, the authors suggest that the waning and waxing of neurogenesis in the hippocampus might trigger the precipitation of and recovery from episodes of clinical depression. "
Then get the latest news from American Psychiatric Association 153rd Annual Meeting "New Clinical Advances in Depression" Day 2 - May 15, 2000 at:
http://www.medscape.com/Medscape/CNO/2000/APA/Story.cfm?story_id=1175
You will need to subscribe to Medscape, it's free.
I got all this from McMan's Depression and Bipolar Weekly, to subscribe (and you should) email jmcmanamy@snet.net and put "subscribe" in the heading and your email address in the body.
Posted by SLS on July 11, 2000, at 23:11:01
In reply to New Clinical Advances in Depression, posted by stjames on July 11, 2000, at 22:36:09
Thanks.
> Want to talk about long term effects ? Left unchecked
> depression is a progressive process that eats away on mood but there are somatic inplications. Take a look at http://www.sigmaxi.org/amsci/articles/00articles/Jacobs.html
>
> "Citing evidence that stress reduces neurogenesis (the production of new nerve cells)and that the most effective antidepressive medications increase it, the authors suggest that the waning and waxing of neurogenesis in the hippocampus might trigger the precipitation of and recovery from episodes of clinical depression. "
>
> Then get the latest news from American Psychiatric Association 153rd Annual Meeting "New Clinical Advances in Depression" Day 2 - May 15, 2000 at:
>
> http://www.medscape.com/Medscape/CNO/2000/APA/Story.cfm?story_id=1175
>
> You will need to subscribe to Medscape, it's free.
>
> I got all this from McMan's Depression and Bipolar Weekly, to subscribe (and you should) email jmcmanamy@snet.net and put "subscribe" in the heading and your email address in the body.
Posted by dj on July 12, 2000, at 18:00:50
In reply to New Clinical Advances in Depression, posted by stjames on July 11, 2000, at 22:36:09
> "Citing evidence that stress reduces >neurogenesis (the production of new nerve cells)
Which again shows the need to deal with the underlying source of the stress and not just the symptoms of...
Thanks for the reference. The audio references I cited above are very good at looking at these issues from a wide-ranging perspective. As they clearly pointed out in today's very balanced discussion of ADs and their effectiveness, once you cut through the statistical smoke and mirrors they only have about a 40% effectiveness rating and deal with symptoms not causes. Hence they are only dealing with the manifestations of stress and not the root causes.
Sante!
dj
Posted by SLS on July 12, 2000, at 21:12:00
In reply to Stress, Depression role of ADs, posted by dj on July 12, 2000, at 18:00:50
Hi dj.
I would like to offer a few points of contention.
> > "Citing evidence that stress reduces >neurogenesis (the production of new nerve cells)
> Which again shows the need to deal with the underlying source of the stress and not just the symptoms of...
What is the underlying source of the stress that produces these symptoms? What are symptoms? Is depression a symptom or an illness? Is depressed mood an illness or a symptom?
> As they clearly pointed out in today's very balanced discussion of ADs and their effectiveness, once you cut through the statistical smoke and mirrors they only have about a 40% effectiveness rating and deal with symptoms not causes.
What are the causes?
Depression is but one word used to describe more than one human condition. Certainly, for people suffering a depressive episode of bipolar disorder, depression (the word used to label a phenomenological phase of this illness) is the cause of their depressive symptoms. In this case, the depressed state reflects the autonomous depressive neuronal activity that is independent of exogenous and psychogenic influence. The best demonstration of the autonomous nature of bipolar depression (and mania) is represented by individuals for whom their conscious state changes abruptly and dramatically (mania -> depression -> mania -> depression...) every 24 hours without fail. This presentation is known as ultra rapid-cyclicity. Another example of the autonomous nature of some depressive phenomena is the regularly periodic and episodic mood lability that occurs in many women that begins a few days prior menses.
What percentage of the cases that are diagnosed as major depression are sustained by autonomous biological abnormalities, regardless of induction, that are not acutely responsive to psychotherapies and behavioral changes? I don't know. My guess is the majority. What percentage of these biologically-driven cases evolve as the result of chronic psychosocial stress? I don't know. Possibly the majority. What percentage of these psychosocially-induced cases were born with or developed a biological template vulnerable to the precipitation of depressive biological abnormalities? I don't know. My guess is the majority.
As best as I can surmise, at worst, 40% might represent the rate at which any *one* antidepressant effectively alleviates 100% of the depression in any one individual. The rate at which any one individual properly diagnosed with endogenous unipolar depression fully responds to any one, or a combination of all the available antidepressants is probably more like 80%. If this figure is accurate, treating depression with antidepressant drugs is manifestly effective and often necessary. There is no smoke and mirrors when the details of these statistics are detailed and parsed accurately and meaningfully. In addition, combining somatic therapies and psychotherapies for an individual is sometimes more effective than somatic therapy alone.
> Hence they are only dealing with the manifestations of stress and not the root causes.
I passionately believe the following statements (not that this means anything), and consider their validity to be self-evident and supported by the proponderance of published and unpublished scientific evidence.
1. Stress can cause depression, although it is obviously not a causative factor in all cases.2. Depression causes stress. Stress can therefore be a manifestation of depression without depression being a manifestation of stress.
4. Biological and psychological contributions to the evolution of a depressed state are not mutually exclusive. However, either can be sufficient.
5. Biological depressions usually require biological intervention for rapid resolution. Biological intervention is sometimes necessary for any resolution.
6. Using the full armamentarium of antidepressant drugs to treat each properly diagnosed case of major unipolar depression, the rate of achieving a robust remission is at least 80%.
- Scott
Posted by dj on July 13, 2000, at 0:53:37
In reply to Re: Stress, Depression role of ADs, posted by SLS on July 12, 2000, at 21:12:00
Scott,
As always your comments are very thoughtful, reasoned, passionate and logical based on the information you've viewed and your interpretation of it.
Though I agree with much of what you've noted, there are some points where I respectfully do not concur with your conclusions, based on what I've read, heard, seen, experienced and my interpretations of those many diverse sources of input over the years.
And like yourself, I could be wrong, and am always open to that possibility. Generally I believe we differ in matters of degree of and impact of influences.
The sources I've cited in my postings here provide a more rounded and even picture than I do and if you haven't already read: "Undoing Depression" (http://www.undoingdepression.com) and/or "Why Zebras Don't Get Ulcers: An Updated Guide to Stress, Stress-Related Diseases, and Coping", I commend them to you, as they are both very scientific and broad ranging in examining and reviewing a variety of theories about the roots of dis-ease and depression from different scientific perspectives and how and where they may come together.
My comments and conclusions from these and other learned, thoughtful and detailed sources barely does them justice, which is why I occasionally post other's commentary, to allow their words to speak to the issues addressed as they intended them to. However I will touch on the assumptions you embraced at the end of your post, elegant and direct as it was and is your style.
> I passionately believe the following statements (not that this means anything), and consider their validity to be self-evident and supported by the proponderance of published and unpublished scientific evidence.
>
>
> 1. Stress can cause depression, although it is obviously not a causative factor in all cases.
>My impression is that it is the primary causative agent, in combination with genetic vunerability and that some are much more vunerable than others. However as Sapolsky carefully accentuates in Zebra: "...one of the critical lessons in behavioural genetics, and one that can't be emphasized enough - genes in this realm are rarely about inevitability, but instead about vunerability. And in the specific context of depression, what this means is that an environmental trigger is needed to turn that vunerability into an overt disease."
In the chapter devoted to the links between stress and depression he does differntiate the different shadings and expressions of depression(s) and that the word likely lumps together a range of dis-eases "that have different underlying biologies". He also notes that once depression has been triggered more than once it develops its own ryhtmnic patterns, seemingly independant of stressors but that severe stress (trauma - be that biological, pscyhological or some combo) seems to be the initial trigger.
> 2. Depression causes stress. Stress can therefore be a manifestation of depression without depression being a manifestation of stress.
>If you check out my Sleep and then Achey-Wakey Fatigue, unless... post above, I quote S. on the stressful nature of depression. However, his and my point is that we both believe stressors to be the initial source of onset of depression.
> 4. Biological and psychological contributions to the evolution of a depressed state are not mutually exclusive. However, either can be sufficient.
>I concur that they are not exclusive of each other. I believe they work in unison. And both can be complimentary sources of stress leading to a depression which may eventually develop its own pattern seemingly independant of stressors, if not dealt with promptly and sufficiently initially.
> 5. Biological depressions usually require biological intervention for rapid resolution. Biological intervention is sometimes necessary for any resolution.
>If you are referring to ADs as biological they are not. They are chemical and pharmaceutical and at best are a pale imitation of biology. They are very clumsy instruments, which is one of my core points, not clean and precise in their impact and effects as the marketers would have the general public believe.
However, ADs can help stabilize one so one can deal with whatever are the intial conscious or unconscious sources of stress, if one so chooses.
> 6. Using the full armamentarium of antidepressant drugs to treat each properly diagnosed case of major unipolar depression, the rate of achieving a robust remission is at least 80%.
>Perhaps, at the early intervention stages. Perhaps not. I have no way to check the statistics but have read enough, from trusted and reliable sources about how the pharmaceutical companies distort statistics and know enough about marketing and public relations to not trust any numbers from those sources, or those funded by them.
I've only scanned "Prozac Backlash" but enough to pick up on some pretty telling and credible critiques which reflect what I've read from other trusted sources, including postings here and my own experiences.
I remain actively skeptical but open...to various possibilities.
Sante!
dj
Posted by stjames on July 13, 2000, at 1:12:00
In reply to Re: Stress, Depression role of ADs, posted by dj on July 13, 2000, at 0:53:37
> Scott,
>
> As always your comments are very thoughtful, reasoned, passionate and logical based on the information you've viewed and your interpretation of it.
>James here....
The points Scott made (1, 2, 3, ect) are not just his "opinion" or "interpretation" but facts and educated observations held by many in the psyco field. If stress was the only causative factor in depression everyone would be very depressed !
Scott did a top job in pulling all of this together with such clairity.
james
james
Posted by dj on July 13, 2000, at 10:50:30
In reply to Re: Stress, Depression role of ADs, posted by stjames on July 13, 2000, at 1:12:00
> James here....
>
> The points Scott made (1, 2, 3, ect) are not just his "opinion" or "interpretation" but facts and educated observations held by many in the psyco field. If stress was the only causative factor in depression everyone would be very depressed !
>James you have missed the nuances of my argument and might do well to go back and carefully reread it, a couple of times perhaps. I did NOT say that stress is the ONLY causative factor. However, I and many who are more learned and thoughtful on these issues and have looked at the theorie(s) on them have concluded that stress is a PRIMARY causative factor, which plays a role in tandem with genetics.
See my next two posts on this as well and consider them and all of the above a much more carefully, puhleezee...
Sante!
dj
Posted by dj on July 13, 2000, at 10:55:22
In reply to Re: Stress, Depression role of ADs, posted by stjames on July 13, 2000, at 1:12:00
Here's a well written piece on the interplay of enviroment and genetics from today's Boston Herald.
Environment causes more cancers than genes
by Michael LasalandraThursday, July 13, 2000
The environment, not genetics, plays the major role in causing most cancers, says a Swedish study some say sheds doubt on the role that mapping the human genome may have in wiping out the disease.
Genes account for only about one-third of all cancers, concludes the study in today's New England Journal of Medicine.
``Inherited genetic factors make a minor contribution,'' it says.
Cancer researchers say the findings are significant.
``I hope this will be a wake-up call for anybody who cares about cancer,'' said Julia Brody, executive director of the Silent Spring Institute in Newton, which has been studying environmental causes of breast cancer.
``To prevent cancer, we have to study the environment,'' she said.
Some cancers are more gene-based than others, the study says.
Genes account for about 42 percent of all prostate cancers, for example, while genetic factors cause about 27 percent of breast cancer cases, the study says.
The findings surpass earlier estimates that genes account for 10 percent to 20 percent of all cancers, said Paul Lichtenstein, an epidemiologist who led the study at the Karolinska Institute.
Still, the finding flies in the face of the idea that scientists ``will find solutions or cures to all diseases in the genes,'' he said. ``That won't be the case.''
Lichtenstein looked at 44,788 sets of twins in Sweden, Denmark and Finland. They studied both identical twins, who have the same genes, and fraternal twins, who are no more closely related than any other brothers and sisters, to analyze the importance of genetics in each type of cancer.
He stressed that the figures do not mean that someone whose identical twin has prostate cancer has a 42 percent risk of developing it, too.
The identical twin of someone with breast, colorectal or prostate cancer had an 11 percent to 18 percent risk of developing the same cancer before age 75, the researchers said.
The risk was only 3 percent to 9 percent for fraternal twins.
Those figures should go a long way toward dismissing the widespread belief ``that if your sister has cancer, you're doomed,'' said Dr. Robert N. Hoover of the National Cancer Institute.
Eric Lander, director of the Whitehead Institute's Center for Genomic Research, said the findings don't discount the potential of the genome mapping project.
``The fact that most cancers may depend on the environment doesn't mean that understanding the minority of genetic cases wouldn't teach us about the environmentally-caused cases,'' he said.
``If a quarter of cancer cases have genetic causes, that's more than enough to use to find the mechanism that may tell us what the environmental triggers are and how to prevent them.''
Posted by dj on July 13, 2000, at 10:58:24
In reply to Re: Stress, Depression role of ADs, posted by stjames on July 13, 2000, at 1:12:00
From Today's Boston Globe:
Study says genes account for more than one-quarter of cancer cases
By Janet Mcconnaughey, Associated Press, 7/13/2000 00:42
Genes cause more than one-quarter of three major types of cancer more than previously thought, but not enough to sustain hopes that the cracking of the human genetic code could eliminate the disease, researchers say.
Scandinavian researchers concluded that genes account for 42 percent of the risk for prostate cancer, 35 percent for colorectal cancer, and 27 percent for breast cancer.
The rest of the cases are caused by what people do, such as smoking and diet, or what happens to them, such as on-the-job hazards, random genetic mutations or viral infections, the researchers said.
The finding, published in Thursday's New England Journal of Medicine, exceeds earlier estimates that genes account for 10 percent to 20 percent of all cancer, said Paul Lichtenstein, an epidemiologist who led the study at the Karolinska Institute in Stockholm.
Still, the conclusion runs contrary to the widespread belief that scientists ''will find solutions or cures to all diseases in the genes,'' Lichtenstein said. ''That won't be the case.''
The study is the largest of its kind yet, said Heather Spencer Feigelson, senior epidemiologist for the American Cancer Society.
Lichtenstein and colleagues studied 44,788 sets of twins in Sweden, Denmark and Finland. They looked at both identical twins, who have the same genes, and fraternal twins, who are no more closely related than any other brothers and sisters, to analyze the importance of genetics in each type of cancer.
Overall, genes probably account for 30 percent of various cancers, Lichtenstein estimated in an interview.
He emphasized that the figures do not mean that someone whose identical twin has prostate cancer has a 42 percent risk of developing it, too. The identical twin of someone with breast, colorectal or prostate cancer had an 11 percent to 18 percent risk of developing the same cancer before age 75, the researchers said.
The risk was only 3 percent to 9 percent for fraternal twins.
Those figures should go a long way toward dismissing the widespread belief ''that if your sister has cancer, you're doomed,'' said Dr. Robert N. Hoover, a director at the National Cancer Institute.
''Someone with the identical set of genes has a much greater chance of not developing cancer than of developing it,'' he said. ''I think that's a useful piece of information.''
In the Scandinavian study, only breast, prostate and colorectal cancer were common enough for full analysis. Lichtenstein said he expects enough information over the next 10 to 20 years to analyze 10 more types of cancer.
Posted by dj on July 13, 2000, at 11:05:14
In reply to Re: Stress, Depression role of ADs, posted by dj on July 13, 2000, at 10:50:30
Doctor warns of 'hype' in genome decoding
By Richard Saltus, Globe Staff, 7/13/2000
Promises of a medical revolution in which common diseases will be predicted - and even prevented - through gene tests are largely ''geno-hype,'' contends a Johns Hopkins University expert, arguing that scientists have oversold the likely health value of decoding the human genome.
As for biotech companies investing millions in search of genetic differences linked to major diseases, ''I think they are barking up the wrong tree,'' said Dr. Neil A. Holtzman, a pediatrician and medical policy specialist, in an interview.
Holtzman, lead author of an opinion piece in today's issue of the New England Journal of Medicine, said he was reacting to grandiose claims made by scientists and officials involved in sequencing, or identifying, the human genetic code.
A publicly funded US project and Celera Genomics Inc. last month announced they had identified and cataloged most of the set of human genes. In addition to learning how genes work in the body, many scientists said the genome decoding would bring about a ''revolution in medicine.''
''The new genetics will not revolutionize the way in which common diseases are identified or prevented,'' said Holtzman in the article, co-authored by Theresa M. Marteau, a psychologist at King's College in London. Holtzman chaired a task force on genetic testing for the Department of Health and Human Services.
But other scientists were quick to say they thought Holtzman missed the major point.
''If Holtzman means there are many overly simplistic notions about how genetics will be implemented in medicine, he's right,'' said Eric Lander, director of the MIT-Whitehead Institute genome sequencing center in Cambridge. ''But if he thinks that understanding the genetic basis of disease won't revolutionize medicine, he's simply wrong.''
The authors of today's article directed most of their criticism not at what would be learned from the human genome, but at the idea that predictive testing will be feasible and widely used. They said scientists have spent years looking for genes that strongly influence whether or not a person would get such illnesses as schizophrenia, manic depression, and asthma, but with little success.
''Most people will have little interest in learning their genotype [individual pattern of genetic variations],'' especially if the gene tests don't have great predictive power and there aren't effective methods of preventing the diseases, said the authors.
While it may be possible to find variations between people's DNA that match their susceptibility to diseases, Holtzman says the links generally won't be strong enough to be useful in predicting diseases caused by many genetic and environmental factors. Or, if there is a strong effect - like the BRCA1 and 2 genes causing a markedly increased risk of breast cancer - such genes are likely to be found only in a small percentage of individuals with the disease. Only one-quarter of one percent of women carry those genes, said Holtzman.
Holtzman said another hoped-for outcome of the genome project - finding genetic variations that predict whether individuals will react well or badly to certain drugs - is potentially achievable.
But he termed ''not very realistic'' often-cited scenarios in which infants could have their entire set of genes tested to determine what diseases they would be susceptible to - and even at what age they would die.
Yet prominent scientists, as well as start-up biotech company officials, have conjured such visions in the euphoria over the near-completion of decoding the human genome, said Holtzman and Marteau.
''We had the head of the Wellcome Trust [a London health philanthropy] saying this was the greatest thing since the invention of the wheel,'' said Marteau in a telephone interview.
In the United States, Dr. Francis Collins, head of the publicly funded genome project, has said that reading out all the genetic scripts in our cells will ''change the way medicine is practiced'' and ''could bring new treatments for every single disease.''
Gene scientists and biotech firm officials agreed that the genome project has been hyped - and they blamed the media as well as scientists and government officials - but they said Holtzman's arguments were flawed.
Jonathan Rothberg, chairman and CEO of CuraGen Corp. of New Haven, said that even if genome information doesn't lead to powerful predictive tests, it is already making it possible to develop better drugs.
For example, he said, discovering the underlying genetic problem in children with a rare form of high cholesterol has led to cholesterol-lowering drugs like Lipitor that are helpful to millions of people with more-common (but less severe) cholesterol problems.
Alan Gutmacher, senior clinical adviser to Collins, the genome project director, agreed with Holtzman about ''geno-hype,'' but added, ''it's a very tough thing to try to remove the hyperbole while still including the real wonder and the awesome power'' of sequencing the genome.
This story ran on page A9 of the Boston Globe on 7/13/2000.
© Copyright 2000 Globe Newspaper Company.
Posted by ksvt on July 14, 2000, at 21:24:24
In reply to Re: Stress, Depression role of ADs, posted by SLS on July 12, 2000, at 21:12:00
> Hi dj.
>
> I would like to offer a few points of contention.
>
> > > "Citing evidence that stress reduces >neurogenesis (the production of new nerve cells)
>
> > Which again shows the need to deal with the underlying source of the stress and not just the symptoms of...
>
> What is the underlying source of the stress that produces these symptoms? What are symptoms? Is depression a symptom or an illness? Is depressed mood an illness or a symptom?
>
> > As they clearly pointed out in today's very balanced discussion of ADs and their effectiveness, once you cut through the statistical smoke and mirrors they only have about a 40% effectiveness rating and deal with symptoms not causes.
>
> What are the causes?
>
> Depression is but one word used to describe more than one human condition. Certainly, for people suffering a depressive episode of bipolar disorder, depression (the word used to label a phenomenological phase of this illness) is the cause of their depressive symptoms. In this case, the depressed state reflects the autonomous depressive neuronal activity that is independent of exogenous and psychogenic influence. The best demonstration of the autonomous nature of bipolar depression (and mania) is represented by individuals for whom their conscious state changes abruptly and dramatically (mania -> depression -> mania -> depression...) every 24 hours without fail. This presentation is known as ultra rapid-cyclicity. Another example of the autonomous nature of some depressive phenomena is the regularly periodic and episodic mood lability that occurs in many women that begins a few days prior menses.
>
> What percentage of the cases that are diagnosed as major depression are sustained by autonomous biological abnormalities, regardless of induction, that are not acutely responsive to psychotherapies and behavioral changes? I don't know. My guess is the majority. What percentage of these biologically-driven cases evolve as the result of chronic psychosocial stress? I don't know. Possibly the majority. What percentage of these psychosocially-induced cases were born with or developed a biological template vulnerable to the precipitation of depressive biological abnormalities? I don't know. My guess is the majority.
>
> As best as I can surmise, at worst, 40% might represent the rate at which any *one* antidepressant effectively alleviates 100% of the depression in any one individual. The rate at which any one individual properly diagnosed with endogenous unipolar depression fully responds to any one, or a combination of all the available antidepressants is probably more like 80%. If this figure is accurate, treating depression with antidepressant drugs is manifestly effective and often necessary. There is no smoke and mirrors when the details of these statistics are detailed and parsed accurately and meaningfully. In addition, combining somatic therapies and psychotherapies for an individual is sometimes more effective than somatic therapy alone.
>
> > Hence they are only dealing with the manifestations of stress and not the root causes.
>
> I passionately believe the following statements (not that this means anything), and consider their validity to be self-evident and supported by the proponderance of published and unpublished scientific evidence.
>
>
> 1. Stress can cause depression, although it is obviously not a causative factor in all cases.
>
> 2. Depression causes stress. Stress can therefore be a manifestation of depression without depression being a manifestation of stress.
>
> 4. Biological and psychological contributions to the evolution of a depressed state are not mutually exclusive. However, either can be sufficient.
>
> 5. Biological depressions usually require biological intervention for rapid resolution. Biological intervention is sometimes necessary for any resolution.
>
> 6. Using the full armamentarium of antidepressant drugs to treat each properly diagnosed case of major unipolar depression, the rate of achieving a robust remission is at least 80%.
>
>
> - Scott
Scott - I agree with alot you say altho I clearly don't have the scientific expertise of you and dj. However, I question the 80% robust remission statistic. Particularly given the great difficulty people seem to have coming up with the right drug or combinations of drugs. What do you think it means that these remissions are only temporary even when you're on maintenance medication?
Posted by SLS on July 15, 2000, at 11:03:23
In reply to Re: Stress, Depression role of ADs, posted by ksvt on July 14, 2000, at 21:24:24
> Scott - I agree with alot you say altho I clearly don't have the scientific expertise of you and dj. However, I question the 80% robust remission statistic. Particularly given the great difficulty people seem to have coming up with the right drug or combinations of drugs.
80% does sound high. It seems reasonable to me, though. Perhaps it is just wishful thinking on the part of those who offer it. Two things to keep in mind:
1. This 80% is a statistic representing the remission rate for an individual whose doctors employ every drug at their disposal.
2. The population of posters on Psycho-Babble is probably skewed towards cases that have been relatively treatment-resistant or have experienced a recent loss of antidepressant response. Perhaps the remaining 20% makes up 100% of Psycho-Babble. I'm sure that this depiction is an exaggeration, but it helps to demonstrate what may be the constituency of the posting community.
> What do you think it means that these remissions are only temporary even when you're on maintenance medication?
There is more than one reason why an individual might relapse. Certain antidepressant drugs, given their mechanisms of action, may produce their therapeutic effects in a way that allows the brains of some individuals to develop a compensatory response over time, or perhaps foster a depletion of resources. Some people experience medication break-through (not a good thing) as the result of an increase of what I like to call "depressive pressure" or stress. They may be subject to a greater degree of the type of stress that precipitated their depression in the first place. This is why I feel that adjunctive psychotherapy and emotional support are sometimes so important. An alternate perspective appropriate for some people is that medication is an adjunct to psychotherapy.
Hormonal changes, environmental toxins, changes due to aging, infections, development of other diseases, injury, changes in diet, intense exercise, other medications, changes in geographical location, etc. Who knows what else?
I wish I knew why MY brain is so quick to fight mental health. I will often respond to a medication for three days (consistent pattern) before something occurs to reverse the effect. Are four letter words appropriate in the forum?
- Scott
Posted by shar on July 15, 2000, at 21:50:49
In reply to More on overemphasis on genetics..., posted by dj on July 13, 2000, at 11:05:14
If you are interested in the future of our DNA it's worth looking at www.bltc.com as they talk about people should not have genes that make them unhappy, but ones that make them happy. (That is bacon-lettuce-tomato-cheese for the url.)
The article I read talked about meds also. Good drugs and bad drugs.
Interesting.
Shar
Posted by dj on July 16, 2000, at 11:04:06
In reply to Making our DNA and Selfish Genes Blissful, posted by shar on July 15, 2000, at 21:50:49
> The article I read talked about meds also. Good drugs and bad drugs.
>
> Interesting.It is an interesting and utopian perspective: better living via technological tweaks - part of a long-standing historical, theological, ethical, philosophical, conscious and unconscious dialogue and source of tension in our society.
Take, for instance, this quote from BLT's intro. page:
"Life on earth can be animated by gradients of ecstatic well-being beyond the bounds of normal human experience.
In the end, the greatest obstacles to superhealth may prove ideological, not technical. BLTC RESEARCH campaign to promote paradise-engineering as a rigorous academic discipline and a mature applied science."
and contrast it with the following quote from the book: "An Unquiet Mind: A Memoir of Moods and Madness" by Kay Redfield Jamieson who, (according to Book News Inc. as quoted at amazon.com)is:
A psychiatry professor, author, and recipient of numerous national and international scientific awards describes her own struggle since adolescence with manic-depressive illness and recounts how it has shaped her life."I have often asked myself, whether given the choice I would have anything to do with manic-depressive illness? If lithium were not available to me, the answer would be a simple no - and it would be an answer laced with terror. But lithium does work for me, and therefore I suppose I can afford to ask the question. Strangely enough I think I would choose to have it. It's complicated. Depression is awful beyond sounds or word or images; I would not go through an extended one again....There is nothing good to say for it except that it gives you the experience of how it might be to be old, to be old and sick, to be dying; to be slow of mind; to be lacking in grace, polish, and coordination...
So why would I want anything to do with this illness? Because I honestly believe that as a result of it I have felt more things, more deeply; had more experiences, more intensely; loved more, and been more loved; laughed more often for having cried more often; appreciated more the springs, for all the winters; worn death "as close as dunagrees," appreciated it - and life - more...
Even when I have been most psychotic...I have been aware of finding new corners in my mind and heart. Some of these corners were incredible and beautiful...Some of them were grotesque and ugly...But always, there were those new corners and - when feeling my normal self, beholden for that self to medicine and love - I cannot imagine becoming jaded to life, becauase I know of those limitless corners with their limitless views."
Myself, I choose the latter. Given the myriad of ways our species has messed up the world we share with technological excesses (based on short-sighted utopian thinking and often driven and distorted by greed as much as and probably more than idealism), which I believe is the source of our increased and increasing rates of depression in our 'modern' societies.
David Suzuki is a brilliant Canadian ecologist, broadcaster, change agent, etc. who started his career as a genetics researcher/professor studying the lowly fruit fly. And as I've seen him eloquently note on occasion, when discussing man-made threats to our planet, species and other species (http://www.davidsuzuki.org) after years of study we know so very little about the lowly fruit fly, never mind the more complicated species such as ourselves and how we influence each other on a global basis.
Recently he noted that our species has for the first time exceeded the popluations of other species and he eloquently discusses the impacts of these trends in books such as his recent:
"From Naked Ape to Super Species : A Personal Perspective on Humanity and the Global Ecocrisis".Connecting that back to this thread, Utopianism and P.B. I believe that the rising rates of dis-eases (cancer, depression, etc.)are reflections of the many sources of stress we are and have been placing on ourselves by the societal models and mindsets we've chosen. And we can choose again...
Technology, indluding ADs, can, does and will play a role in re-creating the balance if we are conscious, compassionate, careful, thoughtful and purposeful in its applications both at individual and societal levels. However it has the ability to be as much of a curse as a blessing and could as easily destroy our species and planet (as it has other species and other culutures at other times eg. Romans, Mayans, etc.) if we do not deal with core issues promptly (if it is not already too late), passionately, compassionately and systematicaly.
That's what I believe and some of what I consider the best minds of our times and previous times do as well.
For instance here is a quote form American author (and marine biologist) John Steinbeck's Nobel Prize acceptance speech in 1940:
"Having taken God-like power we must seek in ourselves for the responsibility and the wisdom we once prayed some deity might have. Man himself has become our greatest hazard and our only hope."Times haven't changed, the peril has just become more imminent and our conscious roles as potential agents of conscience and change that much more important.
Wrapping up here's an applicable quote from amazon.com referring to "The Grapes of Wrath" for which Steinbach won the Nobel Prize:
When The Grapes of Wrath was published in 1939, America, still recovering from the Great Depression, came face to face with itself in a startling, lyrical way. John Steinbeck gathered the country's recent shames and devastations--the Hoovervilles, the desperate, dirty children, the dissolution of kin, the oppressive labor conditions--in the Joad family... For this marvel of observation and perception, he won the Pulitzer in 1940.
The prize must have come, at least in part, because alongside the poverty and dispossession, Steinbeck chronicled the Joads' refusal, even inability, to let go of their faltering but unmistakable hold on human dignity. Witnessing their degeneration from Oklahoma farmers to a diminished band of migrant workers is nothing short of crushing. The Joads lose family members to death and cowardice as they go, and are challenged by everything from weather to the authorities to the California locals themselves. As Tom Joad puts it: "They're a-workin' away at our spirits... They're workin' on our decency."
The point, though, is that decency remains intact, if somewhat battle-scarred, and this, as much as the depression and the plight of the "Okies," is a part of American history. When the California of their dreams proves to be less than edenic, Ma tells Tom: "You got to have patience. Why, Tom--us people will go on livin' when all them people is gone. Why, Tom, we're the people that live. They ain't gonna wipe us out. Why, we're the people--we go on." ...
They continue, now as much as ever, to illuminate and humanize an era for generations of readers who, thankfully, have no experiential point of reference for understanding the depression. The book's final, haunting image of Rose of Sharon--... forcing the milk intended for her stillborn baby onto a starving stranger, is a lesson on the grandest scale. "'You got to,'" she says, simply. And so do we all. --Melanie Rehak
Namaste!
dj
This is the end of the thread.
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