Psycho-Babble Medication Thread 87644

Shown: posts 1 to 9 of 9. This is the beginning of the thread.

 

Disease vs. Disorder - Elizabeth/Cam/anyone?

Posted by Alan on December 21, 2001, at 23:10:03

Is it true that anything in the DSM IV is a disorder simply because it does not have a biologically proven underpinning, a definite pathology, and therefore is not observeable under the microscope? Can't see depression therefore it's a disorder - even though working backwards, depression and schizophrenia only treatable by medicinal intervention in many cases? Confusing to me.

I hear that this is a controversial issue in psychychiatry/psychology with the drug companies lined up on one side saying disease and the psychologists on the other side saying disorder.


depression - disease?
schizophrenia - disease?
panic - disorder?

What gives anyway?

What schools of thought are there on the subject? Does it matter where you're coming from as to how it's viewed differently? Is it a political and moralistic battle mixing free will issues with medicine?

For instance, I believe my chronic anxiety is a disease because it only responds to chemical intervention. Is it simply a matter of we haven't found the physiological roots of the disorders' cause YET so that it can be classified as disease?

Alan

 

Re: Disease vs. Disorder - Elizabeth/Cam/anyone?

Posted by spike4848 on December 21, 2001, at 23:40:37

In reply to Disease vs. Disorder - Elizabeth/Cam/anyone?, posted by Alan on December 21, 2001, at 23:10:03

Dear Alan,

This is just one humble doctor's opinion. The DSM IV is a matter of politics. In medicine, us doctors love a list of criteria to label a patient with a diagnosis. That was the reason behind the DSM IV, to give a list a criteria to precisely diagnosis a patient with a disease. Unforunately, people do not fit convinently into separate, narrow diagnosis. People can have features of depression and anxiety and schizophrenia. I have said this in the past, but diagnotic labels are for doctors ... not patients. Don't get bogged down in labels. The goal is to get better .... 100% better ... no symptoms. If it takes an a combination of medications, so be it.

Psychiatric illnesses are rooted in biological disturbances. Just like diabetes and hypertension, psychiatric illness is biologic as well. There are hundreds of studies to prove that patients with psychiatric illness have hormonal abnormalities and brain structure changes. Unforunately, our knowledge of the brain is limited .... we know of about 12 neurotranmiters in the brain when their is approximately 200 total. It is easy for some people to simply attribute mental illness as a character flaw or personality problem. People do this out of fear, because deep inside they know if mental illness is biologic they are susceptable to depression/anxiety/schizophrenia like everyone else.

Summary (1) psychiatry illness is biologic (2) don't get bogged down in labels, just find the medication that works for you (3) know every day we are getting closer to solving mental illness puzzle

Spike

 

Re: Disease vs. Disorder - Elizabeth/Cam/anyone?

Posted by spike4848 on December 21, 2001, at 23:45:34

In reply to Disease vs. Disorder - Elizabeth/Cam/anyone?, posted by Alan on December 21, 2001, at 23:10:03

by the way, the current thinking in the medical community is that depression/ anxiety/ schizophrenia will be treated in the future by neurologist ... not psychiatrist ... because of the biologic original of this disease.

Spike

 

Re: Disease vs. Disorder - Elizabeth/Cam/anyone?

Posted by Alan on December 22, 2001, at 11:09:23

In reply to Re: Disease vs. Disorder - Elizabeth/Cam/anyone?, posted by spike4848 on December 21, 2001, at 23:45:34

> by the way, the current thinking in the medical community is that depression/ anxiety/ schizophrenia will be treated in the future by neurologist ... not psychiatrist ... because of the biologic original of this disease.
>
> Spike
********************************************

So then how can some "diseases" be solved through CBT and psychotherapy if the symptoms are irradicated (as claimed) by non med intervention? Wouldn't that then argue that the biologic and environmental are in some proportion to each other depending on the nature and the severity of the illness?

Anyone????? Thanks.

By the way I agree with your analysis Spike....

Alan

 

Re: Disease vs. Disorder - Elizabeth/Cam/anyone?

Posted by spike4848 on December 22, 2001, at 11:55:58

In reply to Re: Disease vs. Disorder - Elizabeth/Cam/anyone?, posted by Alan on December 22, 2001, at 11:09:23

> So then how can some "diseases" be solved through CBT and psychotherapy if the symptoms are irradicated (as claimed) by non med intervention?

I think "symptoms" of some diseases can be controled through CBT and psychotherapy, but I do not think the disease is solved. The biochemical imbalance in the brain still exists.

Mild depression and anxiety disorder are ammenable to therapy, people can retrain their brain to deal with stressful situations and irrational thoughts. But I do not know of any studies demonstrating efficacy of psychotherarpy in severe depression or schizophrenia.

On the other hand, we still do not have any medications that solve these diseases either. All current medications also relieve symptoms only. I think attacking the disease with both psychotherapy and medication provides the best results. That is until we find the cause and cure of depression-anxiety-schizophrenia.

Happy Holidays!

Spike


Wouldn't that then argue that the biologic and environmental are in some proportion to each other depending on the nature and the severity of the illness?
>
> Anyone????? Thanks.
>
> By the way I agree with your analysis Spike....
>
> Alan

 

Re: Disease vs. Disorder - Elizabeth/Cam/anyone? spike4848

Posted by Dinah on December 22, 2001, at 19:26:36

In reply to Re: Disease vs. Disorder - Elizabeth/Cam/anyone?, posted by spike4848 on December 21, 2001, at 23:40:37

> Dear Alan,
>
> This is just one humble doctor's opinion. The DSM IV is a matter of politics. In medicine, us doctors love a list of criteria to label a patient with a diagnosis. That was the reason behind the DSM IV, to give a list a criteria to precisely diagnosis a patient with a disease. Unforunately, people do not fit convinently into separate, narrow diagnosis. People can have features of depression and anxiety and schizophrenia. I have said this in the past, but diagnotic labels are for doctors ... not patients. Don't get bogged down in labels. The goal is to get better .... 100% better ... no symptoms. If it takes an a combination of medications, so be it.
>
> Psychiatric illnesses are rooted in biological disturbances. Just like diabetes and hypertension, psychiatric illness is biologic as well. There are hundreds of studies to prove that patients with psychiatric illness have hormonal abnormalities and brain structure changes. Unforunately, our knowledge of the brain is limited .... we know of about 12 neurotranmiters in the brain when their is approximately 200 total. It is easy for some people to simply attribute mental illness as a character flaw or personality problem. People do this out of fear, because deep inside they know if mental illness is biologic they are susceptable to depression/anxiety/schizophrenia like everyone else.
>
> Summary (1) psychiatry illness is biologic (2) don't get bogged down in labels, just find the medication that works for you (3) know every day we are getting closer to solving mental illness puzzle
>
> Spike

I am beginning to come to full agreement with this thought. It seems like I am betwixt and between several DSM diagnoses. I don't fit any completely and I fit several to a large degree. Also, there is so much overlap of criteria that if you are, for example, an extreme introvert you are halfway to several personality disorder diagnoses and each doctor has a different thought on what is what. Or how do you tell the difference between social phobia and avoidant personality disorder?
I'm pretty sure that one day they'll figure out the biological underpinnings of the "personality disorders". And they'll find out that any given DSM IV diagnosis can have a dozen biological causes. Maybe then we'll get somewhere.

 

Re: Disease vs. Disorder - Elizabeth/Cam/anyone?

Posted by cisco on December 23, 2001, at 23:20:48

In reply to Disease vs. Disorder - Elizabeth/Cam/anyone?, posted by Alan on December 21, 2001, at 23:10:03

My Two Cents on the Subject:

Our understanding of the Human Brain, and the effects of PsychoPharmacological substances, is still in its infancy, to say the least. Reading the literature about any of our currently prescribed AD's Confirms it: "Although the precise mechanism is unknown, it is is BELIEVED, or ASSUMED, or APPEARS that Drug 'X' works by...." Talk about a crap shoot. Did the researchers just trip over these compounds by accident? Hey, if Fluoxetine, or Riboxetine or whatever kinda works, lets just run all similar molecules, maybe we'll get lucky...

I would hope that the future holds a promise, where an imbalanced brain can be precisely targeted and corrected.

Perhaps in the decades following the deciphering of the Human Genome, we will come to an understanding of the Brain, where a single pill, taken ONE TIME, will induce a lifetime of happiness, Euphoria and Joy.

That's not too much to hope for, is it?

-Cisco

 

Yeah Cisco, It's Reverse Logic

Posted by spike4848 on December 24, 2001, at 9:22:24

In reply to Re: Disease vs. Disorder - Elizabeth/Cam/anyone?, posted by cisco on December 23, 2001, at 23:20:48

> My Two Cents on the Subject:
>
> Our understanding of the Human Brain, and the effects of PsychoPharmacological substances, is still in its infancy, to say the least. Reading the literature about any of our currently prescribed AD's Confirms it: "Although the precise mechanism is unknown, it is is BELIEVED, or ASSUMED, or APPEARS that Drug 'X' works by...." Talk about a crap shoot. Did the researchers just trip over these compounds by accident? Hey, if Fluoxetine, or Riboxetine or whatever kinda works, lets just run all similar molecules, maybe we'll get lucky...

It is reverse logic. So we don't know what causes depression ... that's a fact. We know in a test tube .... granted a test tube .... that prozac blocks the reuptake of serotonin. And these is done on rat neurons, e.g. synapisomes. Then we take this huge leap of faith and say serotonin is involved in depression. It may have nothing to do with depression.

The last time this happened Dr. Benjamin Rush discovered "capillaries." He then assumed all disease was cause by "overactive capillaries" and the cure to disease was blood letting. That why doctors use to take pints and pints of blood from patients. Actually, it turns out that is how one of our Presidents died. Good old George Washington had like 6 pints of blood taken from him when he had the flu ... and died a couple of days latter.

Spike

 

Re: Disease vs. Disorder - Elizabeth/Cam/anyone?

Posted by OldSchool on December 30, 2001, at 12:36:57

In reply to Re: Disease vs. Disorder - Elizabeth/Cam/anyone?, posted by Alan on December 22, 2001, at 11:09:23

> > by the way, the current thinking in the medical community is that depression/ anxiety/ schizophrenia will be treated in the future by neurologist ... not psychiatrist ... because of the biologic original of this disease.
> >
> > Spike
> ********************************************
>
> So then how can some "diseases" be solved through CBT and psychotherapy if the symptoms are irradicated (as claimed) by non med intervention? Wouldn't that then argue that the biologic and environmental are in some proportion to each other depending on the nature and the severity of the illness?
>
> Anyone????? Thanks.
>
> By the way I agree with your analysis Spike....
>
> Alan


All severe forms of mental illness are brain based, physical illnesses. In fact, there is no such thing as a "mental illness." What we call "mental illness" is in fact a physical illness of the brain...in short a neurological disorder.

Severe mental illness equals > > > >physical illness.

Much of the better quality psychiatry research being done currently is being done by psychiatrists with dual backgrounds in neurology. Example: Mark George of MUSC. Many of the experimental therapies for resistant depression basically amounts to nothing more than tools originally designed to treat neurological conditions, applied to psychiaty (VNS, rTMS, DBS, etc).

Both ECT and VNS work by raising the seizure threshholds. Thats what both of these treatments do in depressives...when the seizure threshhold is raised from ECT or VNS, mood seems to improve.

The experimental functional neuroimaging is a neurology tool. Neurologists are ALREADY using SPECT/PET for diagnosing parkinsons, Alzheimers and dementia at the clinical levels. Why are psychiatrists not already using SPECT/PET for psychiatric diagnosis at the clinical level? Answer? Much of it is cultural, institutionalized resistance to the idea that mental illness is really a physical disease.

The bottom line is that many people, including some psychiatrists and psychologists, just cannot mentally accept the fact that severe mental illness basically equals screwed up brain function and not some bizarre or deep seated "psychological" problem.

I do very much hope that in the future Psychiatry is formally merged with Neurology. Its long overdue and should have already occurred. If I could find a Neurologist who would treat my depression as a physical disease and look at it in the same way a Neurologist views epilepsy or parkinsons, Id switch right now and never go back to a psychiatrist ever again.

Old School


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