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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 21 of 21. This is the beginning of the thread.
Posted by Bradley on March 22, 2001, at 22:33:06
Maybe if miracles were to happen an understanding of AD's is comeing. Did you read that they made a breakthough in the understanding of how aspirin works.
Why do people feel AD's mode of action is known, it is'nt. It might be something totally different than alltering serotonin,dopamine,norepinepherin or any other nuerotransmitters. Maybe it is'nt brain chemistry. In my case, I am certain its endocrine. Do others feel this way about their own condition. The chaos of mental health treatment is so so frustrating.
Posted by pat123 on March 24, 2001, at 18:47:27
In reply to Wow! Aspirin is allmost understood, posted by Bradley on March 22, 2001, at 22:33:06
The chaos of mental health treatment is so so frustrating.
I have never seen chaos. I do carefully pick my docs, but in their well qualified hands the meds
do work. People I know or have refered get better, too. There is always going to be trials of meds that don't work, but I quickly found what worked. Do keep in mind that many do get good results and your bad experiences are your own and not indicative of others.Asprin works through prostoglandins, we have known that for some time.
Pat
Posted by Bradley on March 24, 2001, at 21:18:10
In reply to Re: Wow! Aspirin is allmost understood, posted by pat123 on March 24, 2001, at 18:47:27
It said to the effect ealier theories on Aspirin don't appear to be correct. That's theories for you.
> The chaos of mental health treatment is so so frustrating.
>
> I have never seen chaos. I do carefully pick my docs, but in their well qualified hands the meds
> do work. People I know or have refered get better, too. There is always going to be trials of meds that don't work, but I quickly found what worked. Do keep in mind that many do get good results and your bad experiences are your own and not indicative of others.
>
> Asprin works through prostoglandins, we have known that for some time.
> Pat
Posted by Bradley on March 24, 2001, at 21:55:44
In reply to Re: Wow! Aspirin is allmost understood, posted by pat123 on March 24, 2001, at 18:47:27
Of course you don't see the chaos of mental health treatment, you are one of the few lucky ones that find something that helps. There are millions of us that are'nt succefully treated. You don't hear to much from us because we don't have the energy to do much. We usually just die.
It would take courage for you to consider that things are not so hunky dory in mental health treatment. It is possible that the emperor has no clothes.
> The chaos of mental health treatment is so so frustrating.
>
> I have never seen chaos. I do carefully pick my docs, but in their well qualified hands the meds
> do work. People I know or have refered get better, too. There is always going to be trials of meds that don't work, but I quickly found what worked. Do keep in mind that many do get good results and your bad experiences are your own and not indicative of others.
>
> Asprin works through prostoglandins, we have known that for some time.
> Pat
Posted by stjames on March 25, 2001, at 13:32:05
In reply to I envy your succesfull treatment » pat123, posted by Bradley on March 24, 2001, at 21:55:44
> Of course you don't see the chaos of mental health treatment, you are one of the few lucky ones that find something that helps. There are millions of us that are'nt succefully treated. You don't hear to much from us because we don't have the energy to do much. We usually just die.
No I am not the few, I would say all my close friends are mentally ill and have sucess with their treaatments. Support groups I have attended indicate 50-60 % of people get better on the first or second meds they try (depression). What I see is that those who say "I'm sick, help me" and then wait remain sick. Those who have a negative view of mental helth providers do poorly.
If your care is in a state of choas, change it. Seek out others who do well and find out what they do and what docs they see. Don't envy me, nothing magic happened, I just worked hard at getting well. You have to educate and advocate for yourself. I have walked out of several docs offices on a first meeting because they were weong for me. If you are staying with bad docs or docs that are no helping you then it is your fault
fore waisting your time.Pat
Posted by Bradley on March 25, 2001, at 16:19:58
In reply to Re: I envy your succesfull treatment, posted by stjames on March 25, 2001, at 13:32:05
I don't mean to be confrontational. Sure the more treatments a person tries the odds of finding help increase. But what many of us have had to go through is way beyond extreme. I have really lost count of how many treatments and docs I have gone through. My frustration is where we are with mental health treatment. I think it is far behind where it ought to be. The reasons for this are many. Limited amount of funds addressing this area is a big factor. Little focus on the endocrine system does'nt help. Where do you think the future of treatments is headed? It was'nt that long ago that your upbringing was blamed for a persons mental health problems. At least we have progressed beyond that. Current nuero transmitter theories do not explain a large percentage of mental health disorders. Although now my particular disorder is diagnosed as atypical refractory depression, one day it will not be. It will be found to be an endocrine disorder and treated properly. Current research( HPA axis function, cortisol imbalances, androgen role in mood, nuerosteroid fuction,etc.)is addressing different causes of mood disorders, but it is slow slow slow. Yes I envy people that are'nt stuck in this nightmare. I think I can see your perspective, try on my shoes and millions of others and you will find them uncomfortable.
> > Of course you don't see the chaos of mental health treatment, you are one of the few lucky ones that find something that helps. There are millions of us that are'nt succefully treated. You don't hear to much from us because we don't have the energy to do much. We usually just die.
>
> No I am not the few, I would say all my close friends are mentally ill and have sucess with their treaatments. Support groups I have attended indicate 50-60 % of people get better on the first or second meds they try (depression). What I see is that those who say "I'm sick, help me" and then wait remain sick. Those who have a negative view of mental helth providers do poorly.
> If your care is in a state of choas, change it. Seek out others who do well and find out what they do and what docs they see. Don't envy me, nothing magic happened, I just worked hard at getting well. You have to educate and advocate for yourself. I have walked out of several docs offices on a first meeting because they were weong for me. If you are staying with bad docs or docs that are no helping you then it is your fault
> fore waisting your time.
>
> Pat
Posted by Dubya on March 25, 2001, at 16:36:54
In reply to I would bet I have worked harder than you, posted by Bradley on March 25, 2001, at 16:19:58
St. James, very good encouragement here but, is it really our fault for getting a bad doc or one which isn't helping? We often put too much trust in such individuals and then, blame ourselves if we fail to feel well. When you say Endocrinology, are you referring to hormones and chemical changes in the body or ???
Posted by Lorraine on March 25, 2001, at 16:39:28
In reply to I would bet I have worked harder than you, posted by Bradley on March 25, 2001, at 16:19:58
I happen to agree with you about where we are now in diagnosing mental illness. The DSM categories are not rooted in physiology. We are in the "black box" era of treatment, where we try one pill and assess whether it works. We don't usually understand the mechanism by which the drugs work. (Sure we have some knowledge, but it is pretty limited.) If I find the right combination for you and I believe that it impacts dopamine receptors, perhaps I'll say that you have a dopamine deficiency. Nobody really knows. And the combination of drugs you can use is pretty staggering even if you approach their selection "intelligently". How long is a valid trial of a med? Some books want 6 weeks even for non-SSRIs. If I went at that pace, we would finally lock onto the right combo for me in about 20 years. I don't have that amount of time to waste. So I understand your frustration. I'm frustrating too. But moving forward one step at a time the best way I know how. Doing research, challanging my pdoc, changing pdocs when it's clear that I've exhausted this one's expertise, but never giving up.
Posted by ShelliR on March 25, 2001, at 20:56:39
In reply to Re: I envy your succesfull treatment, posted by stjames on March 25, 2001, at 13:32:05
> No I am not the few, I would say all my close friends are mentally ill and have sucess with their treaatments. Support groups I have attended indicate 50-60 % of people get better on the first or second meds they try (depression). What I see is that those who say "I'm sick, help me" and then wait remain sick. Those who have a negative view of mental helth providers do poorly.
> If your care is in a state of choas, change it. Seek out others who do well and find out what they do and what docs they see. Don't envy me, nothing magic happened, I just worked hard at getting well. You have to educate and advocate for yourself. I have walked out of several docs offices on a first meeting because they were weong for me. If you are staying with bad docs or docs that are no helping you then it is your fault
> fore waisting your time.
>
> PatI hope those who think that resistent treatment depression is the patient's fault, might be a little less judgemental. I hit it on my second antidepressant. But for some anti-depressants seem to poop out after a while (very well documented) and that is what happened to me--luckily after many years of success.
So yes, count your blessings. It is not just all about your hard work. It involves a lot of luck. Would it take your antidepressant to stop working for you to perhaps see the larger picture and open yourself up to see that many people try really hard and have not found the right medication. Why do you think there exists the term, "treatment resistent depression."
Pat, envy you? No way. I would never envy anyone who sees and expresses things in such a narrow-minded way that compassion is left out of the equation.
Also wondering why most of your friends are mentally ill, James.
Shelli
Posted by stjames on March 25, 2001, at 21:08:36
In reply to Very True ST.JAMES but, you did offend ppl a bit., posted by Dubya on March 25, 2001, at 16:36:54
> St. James, very good encouragement here but, is it really our fault for getting a bad doc or one which isn't helping? We often put too much trust in such individuals and then, blame ourselves if we fail to feel well. When you say Endocrinology, are you referring to hormones and chemical changes in the body or ???
It is not your fault that the doc is bad or not helping. You do make a choice to stay with someone who is not right for you. I have never just consulted with whoever, I did research. Picking pdocs at random is not advovating for yourself. Not having money for treatment is no excuse, the meds are free if you cannot afford them. The best psycopharacologist charged me $90 for an hour consult, $45 for a four week check up.
From there we did the rest by phone, for free. i saw her every 6 months after that at $45, and she let me run a tab. All I did is state that I had little money, she offered to do more by phone for free and run a tab on the 6 month check ups. Gave me free samples so I did not have to pay to try meds and in a pinch would give me samples if I could not refill my meds on time.We can all find reasons why we cannot get help but this kind of thinking is not going to get us well.
james
Posted by Bill L on March 25, 2001, at 21:18:52
In reply to I would bet I have worked harder than you, posted by Bradley on March 25, 2001, at 16:19:58
I agree with you that we are behind where we should be. But it's changing. In recent years drug companies have been working very hard on treatments for depression and related conditions. It's turning out that there is a large overlap in treatments for ADD, depression, anxiety, OCD, fibromyalsia, etc.
These drugs are basically just trial and error. Aspirin was trial and error also. I think that although there is LOTS of room for improvement, that a really good doc can help pick out the right drug combo (eventually) from today's drugs to treat depressive symptoms and help with the AD's side effects with practically any patient.
You mentioned that you have tried a lot of AD's. I hope you don't give up. Call a teaching (University) hospital and make an appointment. It might be expensive but you might only need a couple of visits to come up with the best drug combo.
You might be right that the endocrine system turns out to be the main culprit. Estrogen replacement often helps the mood of para and post menopausal women. Thyroid replacement (especially T3) makes some people feel better even if they had "normal" TSH levels to begin with.
So docs have looked at hormones but there very well be important stuff about hormone treatment for depression that has not been discovered. I'll bet you that even when the drug companies finally do come up with revolutionary new treatments, that they still won't really know why they work.
I personally went through lots of stuff. I am currently having very good results from a combo of SAM-e and Celexa. Once again, please do not give up.
>
>
> I don't mean to be confrontational. Sure the more treatments a person tries the odds of finding help increase. But what many of us have had to go through is way beyond extreme. I have really lost count of how many treatments and docs I have gone through. My frustration is where we are with mental health treatment. I think it is far behind where it ought to be. The reasons for this are many. Limited amount of funds addressing this area is a big factor. Little focus on the endocrine system does'nt help. Where do you think the future of treatments is headed? It was'nt that long ago that your upbringing was blamed for a persons mental health problems. At least we have progressed beyond that. Current nuero transmitter theories do not explain a large percentage of mental health disorders. Although now my particular disorder is diagnosed as atypical refractory depression, one day it will not be. It will be found to be an endocrine disorder and treated properly. Current research( HPA axis function, cortisol imbalances, androgen role in mood, nuerosteroid fuction,etc.)is addressing different causes of mood disorders, but it is slow slow slow. Yes I envy people that are'nt stuck in this nightmare. I think I can see your perspective, try on my shoes and millions of others and you will find them uncomfortable.
>
>
>
>
>
>
> > > Of course you don't see the chaos of mental health treatment, you are one of the few lucky ones that find something that helps. There are millions of us that are'nt succefully treated. You don't hear to much from us because we don't have the energy to do much. We usually just die.
> >
> > No I am not the few, I would say all my close friends are mentally ill and have sucess with their treaatments. Support groups I have attended indicate 50-60 % of people get better on the first or second meds they try (depression). What I see is that those who say "I'm sick, help me" and then wait remain sick. Those who have a negative view of mental helth providers do poorly.
> > If your care is in a state of choas, change it. Seek out others who do well and find out what they do and what docs they see. Don't envy me, nothing magic happened, I just worked hard at getting well. You have to educate and advocate for yourself. I have walked out of several docs offices on a first meeting because they were weong for me. If you are staying with bad docs or docs that are no helping you then it is your fault
> > fore waisting your time.
> >
> > Pat
Posted by stjames on March 26, 2001, at 0:28:51
In reply to Re: I envy your succesfull treatment-james, pat, posted by ShelliR on March 25, 2001, at 20:56:39
> Also wondering why most of your friends are mentally ill, James.
>
> Shelli
What is wrong with having friends that are mentally ill ?James
Posted by ShelliR on March 26, 2001, at 8:25:42
In reply to Re: I envy your succesfull treatment-james, pat, posted by stjames on March 26, 2001, at 0:28:51
> > Also wondering why most of your friends are mentally ill, James.
> >
> > Shelli
>
>
> What is wrong with having friends that are mentally ill ?
>
> JamesNothing is wrong with having mentally ill friends, but I think it is unusual to say "all" my friends are mentally ill. And I wondered if that affected your perspective, since at times you can be very harsh and judgmental. Maybe having a mixture of friends, some who are not mentally ill might give you a broader perspective. Perhaps friends who are not mentally ill would be more apt to confront you when your empathy (meaning here ability to see others' views) is blocked.
For what it's worth, it has seemed to me on the board that you will continue to cling to your point of view, even when facts have disproved it.
If you weren't such a bright guy with so much to offer, I probably wouldn't even have noticed.
Anyway, it's just my point of view. ShelliR
Posted by pat123 on March 26, 2001, at 12:25:13
In reply to Re: I envy your succesfull treatment » stjames, posted by ShelliR on March 26, 2001, at 8:25:42
> Nothing is wrong with having mentally ill friends, but I think it is unusual to say "all" my friends are mentally ill. And I wondered if that affected your perspective, since at times you can be very harsh and judgmental.
While not all my friends are mentally ill amoung those that are, treatment is very sucessful. This
supports my view that everyone can get better, at least to some point. I also do work with disabled persons who have significant physical problems. I have not found that negativity and and an attitude that the system does not work ever helps
one get better. I agree that the system could be better but it does work.james
Posted by Dr. Bob on March 27, 2001, at 2:01:11
In reply to Re: I envy your succesfull treatment » stjames, posted by ShelliR on March 26, 2001, at 8:25:42
> I would never envy anyone who sees and expresses things in such a narrow-minded way that compassion is left out of the equation.
>
> Also wondering why most of your friends are mentally ill> at times you can be very harsh and judgmental...
>
> it has seemed to me on the board that you will continue to cling to your point of view, even when facts have disproved it.Please be civil. Remember, the goals here are support and education...
Bob
PS: Follow-ups, if any, regarding this should be redirected to Psycho-Babble Administration, thanks.
Posted by Cam W. on March 27, 2001, at 7:24:51
In reply to Re: I envy your succesfull treatment » stjames, posted by ShelliR on March 26, 2001, at 8:25:42
Shelli - Many of my friends have, or have had, a mental illness at some point in their lives. Many of my coworkers also have had mental problems that have required professional help. Since epidemiological studies show that 1 in 4 people will, at some point in their life, have a mental illness that will require professional treatment, I don't feel so alone and definitely am not ashamed by my illness. This fact of 1 in 4 people having a mental illness at some point in their life has been proven in several large epidemiological studies and seems to be ubiquitous (with some slight variations, due to cultural factors).
I think that the reason that myself, James and our friends can say that we have a mental illness, is because we have overcome our fear and inanity of being stigmatized by our illnesses; that not so many years ago, we may have hidden in our closets with the other skeletons accrued throughout our lives. We have illnesses and we are working hard (in many cases) to learn to live within the boundaries that the illness has set.
Sincerely - Cam
Posted by ShelliR on March 27, 2001, at 9:13:44
In reply to Re: I envy your succesfull treatment » ShelliR, posted by Cam W. on March 27, 2001, at 7:24:51
Sorry Cam, I didn't mean to imply that one should have shame about having a mental illness. I don't--it's not my fault.
I was just questioning why someone would have "all" friends with mental illness--I was curious. And I did perceive the post as blaming people who could not find the right meds for their illness.
Anyway, sorry I offended you; could explain more, but don't want to get in any deeper after my warning. Shelli
Posted by stjames on March 27, 2001, at 11:27:49
In reply to Re: I envy your succesfull treatment » ShelliR, posted by Cam W. on March 27, 2001, at 7:24:51
> Shelli - Many of my friends have, or have had, a mental illness at some point in their lives. Many of my coworkers also have had mental problems that have required professional help. Since epidemiological studies show that 1 in 4 people will, at some point in their life, have a mental illness that will require professional treatment, I don't feel so alone and definitely am not ashamed by my illness.
James here.....
I just saw a study that indicates 1 in 3 meet the critera for a mental illness condition. I think that because I am open about myself more are willing to mention their problems. Also LD's and comorbid disorders run in my family.
James who was pat123
Posted by Cam W. on March 27, 2001, at 11:40:56
In reply to Re: I envy your succesfull treatment » Cam W., posted by ShelliR on March 27, 2001, at 9:13:44
Shelli - I should be the one who should apologize to you. Stigma is a sore spot for me and I guess I overreacted. I am sure James has at least one friend who isn't mentally ill :)
I am very active in trying to dispel stigma towards the mentally ill and am currently writing lectures to give to pharmacists on the topic. I gave lectures to 2 third year classes of pharmacy students and I don't really think that they cared what I had to say. So, with this seeming failure to change their opinion of "crazy people" has left me a little sensitive.
Again, I apologize for using you as a scapegoat for my anger. I hope that you will forgive me.
Sincerely, Cam
Posted by ShelliR on March 27, 2001, at 13:51:29
In reply to Apology to Shelli, posted by Cam W. on March 27, 2001, at 11:40:56
>
Posted by Marie1 on March 28, 2001, at 7:54:23
In reply to Apology to Shelli, posted by Cam W. on March 27, 2001, at 11:40:56
Cam - I sincerely and wholeheartedly wish you the best in your anti-stigma campaign. To re-state the obvious, fighting our mental illnesses is challenging enough without having to stay in the closet for fear of ignorance. The 3rd anniversary of my 32 yr. old brother's death by suicide is coming up on April 1. I believe with all my heart that if the attitudes of society in general and my own family in particular had been more enlightened in this regard, my brother would still be alive.
This is the end of the thread.
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