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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 24 of 24. This is the beginning of the thread.
Posted by river1924 on November 5, 2006, at 13:04:18
http://www.sciencedaily.com/releases/2006/11/061101151355.htm
Hi Everyone!
Two passges stand out for me:1.
"This study emphasizes the importance of long-term management of this disease," Dr. Rush said. "The short-term matters, but the long-term matters even more."
2.
"There's good news and not-so-good news," said Dr. A. John Rush, vice chairman of clinical sciences and professor of psychiatry at UT Southwestern. "The good news is that two-thirds of people can be relieved of their depression if they can hang in there for up to four treatment steps. That's pretty significant for a tough illness.
"The not-so-good news is that when more steps are needed to get to remission or meaningful improvement, the higher the risk is for having a return of the depressive episode -- or a relapse," said Dr. Rush, the study's principal investigator."
What da ya think?
RiverJulian Fish
Posted by notfred on November 5, 2006, at 13:15:43
In reply to Article about depression, STAR*D, posted by river1924 on November 5, 2006, at 13:04:18
As for the one-third of individuals who didn't reach remission, possible explanations include:
* There may be some depressions for which medications don't work.
* Individual biological and genetic differences, as well as life circumstances and other medical conditions, may render some medication treatments ineffective.
* People suffering from long bouts of depression might have been helped earlier in the course of the disease, but may not achieve remission after lengthy chronic depression.
Posted by river1924 on November 5, 2006, at 14:16:24
In reply to Re: Article about depression, STAR*D, posted by notfred on November 5, 2006, at 13:15:43
* People suffering from long bouts of depression might have been helped earlier in the course of the disease, but may not achieve remission after lengthy chronic depression.
That is depressing. :)
That suggests irreversible brain "damage" or changes. That suggests a process like kindling in seizures or manic depression. I've never read anything about that?
Has anyone read anything so... so depressing?
RiverJulian.
Posted by notfred on November 5, 2006, at 14:48:15
In reply to Re: Article about depression, STAR*D » notfred, posted by river1924 on November 5, 2006, at 14:16:24
> That suggests irreversible brain "damage" or changes. That suggests a process like kindling in seizures or manic depression. I've never read anything about that?
>All MI is progressive if not treated.
> Has anyone read anything so... so depressing?
>
Behaviors such as denying the degree/existance of MI one has or delaying starting at least some kind of treatment have consequences.
Posted by Jost on November 5, 2006, at 15:34:46
In reply to Re: Article about depression, STAR*D » notfred, posted by river1924 on November 5, 2006, at 14:16:24
It doesn't suggest that at all.
The conclusion isn't warranted by the premise.
I can think of many other explanations, for example, they haven't come up with medications that treat certain types of depression, or certain intensities of depression, or that experiences, fears, bad feelings become more deeply woven into one's mind, after experiencing them for many years.
Bad experiences are not the same as brain damage.
Jost
Posted by linkadge on November 5, 2006, at 15:51:36
In reply to Re: Article about depression, STAR*D, posted by Jost on November 5, 2006, at 15:34:46
Sorry, I'm not familiar with that term.
??
Linkadge
Posted by river1924 on November 5, 2006, at 16:16:02
In reply to Re: Article about depression, STAR*D, posted by Jost on November 5, 2006, at 15:34:46
"bad feelings become more deeply woven into one's mind, after experiencing them for many years."
Brain changes/damages/weaving are similar concepts to me.
For many, the darkest aspect of one's personality are tolerable and minor part of one's life. I'd like to believe I can get there or at least grow enough (change/damage/weave) myself and my brain to live with my depression rather than feel stomped on by it.
I'd like to believe the subtle changes in the brain due to long time depression can be short circuited by drugs, a better enviroment, therapy, or time. I want to believe the brain is fluid enough to change for the better.
I don't like the idea (perhaps I am in denial) that I will needs 6 meds and therapy to feel okay for the next ten years just because that has been true for the last ten years.
Posted by river1924 on November 5, 2006, at 16:18:13
In reply to What does MI stand for?, posted by linkadge on November 5, 2006, at 15:51:36
I thought he meant mental illness. I could be wrong. (Where I work, it means heart attack but I doubt that is what he meant by MI.)
Posted by notfred on November 5, 2006, at 18:23:15
In reply to Re: Article about depression, STAR*D » Jost, posted by river1924 on November 5, 2006, at 16:16:02
I don't like the idea (perhaps I am in denial) that I will needs 6 meds and therapy to feel okay for the next ten years just because that has been true for the last ten years.
10 yrs of feeling OK ? Many here should be so lucky.
Posted by Jost on November 5, 2006, at 19:26:05
In reply to Re: Article about depression, STAR*D, posted by notfred on November 5, 2006, at 18:23:15
>>10 yrs of feeling OK ? Many here should be so lucky.
I had the same thought.
Still don't think it's brain damage, though.
Jost
Posted by Phillipa on November 5, 2006, at 19:59:19
In reply to Re: Article about depression, STAR*D, posted by Jost on November 5, 2006, at 19:26:05
Me too haven't felt okay in l0 years and I'm not young. I'd like to have l0years total at this point. Love Phillipa ps Fred did you borrow my cane?
Posted by notfred on November 5, 2006, at 20:25:19
In reply to Re: Article about depression, STAR*D, posted by Jost on November 5, 2006, at 19:26:05
> Still don't think it's brain damage, though
In most chronic diseases treatments and even cures exist for early stages but options dry up in later stages. To me this seems more a biochemical opportunity which exists for a time.
Chronic diseases tend to be progressive if not treated. There is no reason to expect MI (mental illness) to be any different. No need to attach a loaded word like "brain damage" to what is a normal disease process.
Posted by Jost on November 5, 2006, at 20:51:14
In reply to Re: Article about depression, STAR*D, posted by notfred on November 5, 2006, at 20:25:19
I guess we all have our own degree of optimism about the future.
Diseases may tend to do all sorts of things, and there's plenty of reason in my mind not to assume the worst. But that's my mind.
Jost
Posted by Phillipa on November 5, 2006, at 21:45:58
In reply to Re: Article about depression, STAR*D » notfred, posted by Jost on November 5, 2006, at 20:51:14
Jost and you're so young. So many years for improvements in treatment. Love Phillipa
Posted by River1924 on November 6, 2006, at 1:25:15
In reply to Re: Article about depression, STAR*D » Jost, posted by Phillipa on November 5, 2006, at 21:45:58
Well, there people far worse than me, I agree.
If I take psychological tests, I come up as severely depressed. To me okay is not suicidal and not so irritable that I can't work.
Perhaps, I'm greedy but I've had glimpses of peace, tranquil happiness, times when my mind worked and my memory functioned. Times when I was outgoing and spontaneous and funny.
To me okay is apathy, indecisiveness, guilt ectetera and so on.
Didn't want you to think I was happy. ;) RiverJulian.
Posted by notfred on November 6, 2006, at 10:48:44
In reply to Re: Article about depression, STAR*D » notfred, posted by Jost on November 5, 2006, at 20:51:14
> I guess we all have our own degree of optimism about the future.
>
> Diseases may tend to do all sorts of things, and there's plenty of reason in my mind not to assume the worst. But that's my mind.
>
>
> Jost
So are go saying dont treat MI an you will not progress ?Take a look at catatonic states, once meds were common place catatonic states are quite rare.
Same with "waxy flexability".
Posted by linkadge on November 6, 2006, at 11:55:16
In reply to Re: Article about depression, STAR*D, posted by notfred on November 6, 2006, at 10:48:44
What meds work best for catatonic states?
Linkadge
Posted by ed_uk on November 6, 2006, at 13:27:29
In reply to Re: Article about depression, STAR*D, posted by linkadge on November 6, 2006, at 11:55:16
Hi Link
Catatonia is often treated with a benzo, lorazepam seems to be a popular choice.
Ed
Posted by linkadge on November 6, 2006, at 15:22:12
In reply to Re: Article about depression, STAR*D » linkadge, posted by ed_uk on November 6, 2006, at 13:27:29
Whats the rationale benhind that. Isn't catatonia where you don't move at all. How does a tranqulizer reverse that?
Linkadge
Posted by ed_uk on November 6, 2006, at 15:33:00
In reply to Re: Article about depression, STAR*D » ed_uk, posted by linkadge on November 6, 2006, at 15:22:12
>How does a tranqulizer reverse that?
I don't know but it does. Perhaps it's because high doses produce disinhibition?
Ed
Posted by linkadge on November 6, 2006, at 16:19:29
In reply to Re: Article about depression, STAR*D » linkadge, posted by ed_uk on November 6, 2006, at 15:33:00
Interesting.
Thx
Linkadge
Posted by Jost on November 6, 2006, at 16:59:37
In reply to Re: Article about depression, STAR*D, posted by notfred on November 6, 2006, at 10:48:44
The argument is that catatonia, among other types of schizophrenia, have become much less common since the 1940's or 1950's, not because of treatment, but because of some change in the causative factors of schizophrenia, esp. more disabling forms of schizophrenia.
There's a lot of debate about what those causes are, or whether they could have changed, or whether the rate of schizophrenia is stable from society to society or in different historical periods.
I've also heard it claimed that catatonia exists, but is less recognized, or talked about.
Plus I never suggested in any way that any form of depression, psychosis, or other mental disorders shouldn't be treated.
Jost
Posted by notfred on November 6, 2006, at 17:30:59
In reply to Re: Article about depression, STAR*D » notfred, posted by Jost on November 6, 2006, at 16:59:37
> The argument is that catatonia, among other types of schizophrenia, have become much less common since the 1940's or 1950's, not because of treatment, but because of some change in the causative factors of schizophrenia, esp. more disabling forms of schizophrenia.
>I would say Thorazine was the major factor here. Kinda hard to discount the fact there was no effective treatment prior to the 50's and catatonia rates dropped after Thorazine. I have not heard of a modern account (post 1950's) of waxy flexability, either.
Posted by zazenducky on November 7, 2006, at 17:20:44
In reply to Re: Article about depression, STAR*D, posted by notfred on November 6, 2006, at 17:30:59
You don't see hysterical paralysis either but I don't think it's because of medication. I think social conditions can cause some illnesses.
And I also think there is a chance of spontaneous recovery.
In schizophrenia a lot of the damage is done by the "medication". It's hard to tell which is which particularly in the case of negative symptoms.
This is the end of the thread.
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