![[dr. bob]](/dr-bob-sm.gif)
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 SLS on May 22, 2008, at 6:48:38
Can we really choose drugs based on known mechanisms?
Are we really able to deduce our individual psychobiological abnormalities?
All comments welcome.
- Scott
Posted by bulldog2 on May 22, 2008, at 9:39:24
In reply to Can we really choose drugs based on mechanisms?, posted by SLS on May 22, 2008, at 6:48:38
> Can we really choose drugs based on known mechanisms?
>
> Are we really able to deduce our individual psychobiological abnormalities?
>
> All comments welcome.
>
>
> - ScottI caught the last hour of a show last night about depression and treatment options. The vagus deep stimulation sounds promising. But one p-doc felt he had as much chance of curing depression (and it is important to get the type of depression correct) as another doc might have with heart disease or diabetes.It is important to get a correct diagnosis and there are also mri imaging techniques.
So the anwer is yes with a skilled p-doc along with proper mri imaging.The docs on the panel felt the mris are proof of depression as a biological illness. Also depression causes the body to react with a host of phsyical abnormalities.There is a greater disposition to many other illnesses which is further proof.So a skilled p-doc will have a sense of what to prescribe or what combo to prescribe.
Posted by Phillipa on May 22, 2008, at 10:28:14
In reply to Re: Can we really choose drugs based on mechanisms?, posted by bulldog2 on May 22, 2008, at 9:39:24
You say proper MRI's so this means a regular MRI is worthless right? As I've had them and they show normal aging of the brain. Phillipa
Posted by bulldog2 on May 22, 2008, at 11:01:00
In reply to Re: Can we really choose drugs based on mechanisms? » bulldog2, posted by Phillipa on May 22, 2008, at 10:28:14
> You say proper MRI's so this means a regular MRI is worthless right? As I've had them and they show normal aging of the brain. Phillipa
These mris showed different colors in different parts of the brain. I'm assuming it's a special type of mri.
Posted by BGB on May 22, 2008, at 12:22:24
In reply to Re: Can we really choose drugs based on mechanisms?, posted by bulldog2 on May 22, 2008, at 11:01:00
I saw that show, too....it's too bad that nobody has access to those MRI's. I've never heard of a single person having one, and when I asked one of my p-doc's, he said that it's outrageously expensive and only available to people in special research studies.
Also, the special spoke about the experimental procedure targeting "Area 25" of the brain. While the pacemaker-type device is similar, the stimulus is occurring at a totally different place than vagus nerve stimulation procedures that are now FDA approved. This experimental treatment seems like it would be more successful, although the show only claimed a success rate of about 50%, which is similar to VNS.
Posted by seldomseen on May 22, 2008, at 13:34:24
In reply to Can we really choose drugs based on mechanisms?, posted by SLS on May 22, 2008, at 6:48:38
In my opinion, no we can not choose drugs based on mechanisms.
We may luck into something, but we simply do not know enough about the individual brain to say "you know, I think I need some more serotonin etc...".
Maybe one day, and really that's where all medicine is going - the right drug in the right person at the right time - but not yet.That just my answer to your question.
Seldom.
Posted by torachan on May 22, 2008, at 18:08:30
In reply to Re: Can we really choose drugs based on mechanisms? » SLS, posted by seldomseen on May 22, 2008, at 13:34:24
First off, the special MRI images are fMRI's which stands for "functional magnetic resonance imaging" and it works by indicating the areas of the brain with increased oxygen flow, thus increased brain activity in that area.
I'm thinking though, that the scans were actually PET scans which uses a radioactive dye injected into the brain, and this dye will build up more in overactive areas, and an image can be produced with different color coded areas indicating different levels of brain activity. I think red indicates the highest level.
And yes, I believe in about 10 or so years nearly all psychiatric disorders will be proven as actual biopsychological disorders with definitive abnormalities in certain areas of the brain. The interplay between the amygdala (the "emotional center of the brain"--actually the entire limbic system is crucial in emotion) and the frontal lobes or cortex will be likely shown to be the foundation of many mental illnesses, especially anxiety, depression, and bipolar disorder. Also, the hippocampus is a crucial area.
Once a better understanding of the psychobiological underpinnings of mental illness is achieved, better treatment options will emerge. The current treatment for these disorders focusing on neurotransmitters like serotonin will be expanded, or go beyond these typical ones to ones like glutamate perhaps. Also, better targeting of specific receptors say for instance in the amygdala will lead to better treatment.
Posted by chiron on May 22, 2008, at 19:07:17
In reply to Re: Can we really choose drugs based on mechanisms, posted by torachan on May 22, 2008, at 18:08:30
All I can say is I wish. I would love to get an fMRI to see what is going on. I would love to have genetic testing. I have such paradoxical effects to meds & it has been going on so long I don't know if I can wait 10+ years.
Example - I found out I have one gene for Wilson's (you need two) because of family history & my high copper urine output. Copper is suppose to be good for you? Not if your body can't get rid of it & it collects in the brain & liver. What other things are my genes doing?
ECT initially had wonderous mood effects on me. So if putting a stimulation device in my brain would work, I'm all for it.
Posted by bulldog2 on May 23, 2008, at 15:00:27
In reply to Re: Can we really choose drugs based on mechanisms, posted by chiron on May 22, 2008, at 19:07:17
The one thing that stuck in my head is that if parents suffer from depression you have a much greater chance of suffering from depression.I strongly believe there is a genetic component.
Posted by Racer on May 26, 2008, at 10:13:25
In reply to Can we really choose drugs based on mechanisms?, posted by SLS on May 22, 2008, at 6:48:38
> Can we really choose drugs based on known mechanisms?
>
> Are we really able to deduce our individual psychobiological abnormalities?
>I don't think there's enough information yet known for drugs to be chosen by mechanism. Just the fact that the SSRIs have such different effects, despite their related mechanisms, suggests that there's more to it than simply boosting one single neurotransmitter.
On the other hand, I do believe that past experience with medications can help suggest directions to explore. For example, I have done best on medications which target norepinephrine, and had problems with serotinergic medications. I'm much more willing to try the noradrenergic/dopaminergic medications than anything serotinergic, based on my own experiences. I don't think that's the same thing as being able to deduce my own biochemical eccentricities, though.
In the course of my readings, I've found some interesting articles that make me much more skeptical about any putative one-to-one relationship between medications and neurochemicals. For instance, did you know that Ritalin reduces the ADHD-like symptoms in dopamine knock-out mice? These are mice without active dopamine receptors -- and yet, we discuss Ritalin as a dopaminergic medication. That seems to suggest -- strongly -- to me that boosting the action of dopamine is probably not the solution to ADHD-like symptoms, it's probably not how Ritalin actually works. Or, at least, it's not the whole story.
After years of reading that glial cells are the neurological equivalent of styrofoam packing peanuts, suddenly we know that they're actually active in the brain. Dopamine was thought for decades to be nothing more than a precursor to norepinephrine. Overactivity at certain serotonin receptors in the Central Nervous System is associated with anxiety, and yet SSRIs are effective for anxiety for many people. I don't believe there is enough information yet known to say for certain that any particular mechanism is The Cause of anyone's symptoms.
What's more, I don't believe that there is one disorder called Depression. I believe that there are clusters of symptoms which we group together for convenience sake, and call Depression. It may be that your depression is related to one neurochemical, and mine another. It may even be that none of the catecholamines are involved in some cases of depression -- perhaps it's an abnormality of the calcium channels on your neurons, and a calcium channel modulator would be your best bet. Perhaps glutamate is the culprit for some cases of depression. Maybe the problem isn't at the synapse at all, but somewhere downstream in the synthesis process -- maybe I can't create serotonin from tryptophan? Neuroscience just does not yet know enough to say with any degree of certainty.
And yet -- I do believe that prior experience with medications of various mechanisms can suggest directions to explore.
How's that? "No, but..."
Great topic, Scott -- and now will you share your answer with us?
Posted by undopaminergic on May 26, 2008, at 15:05:18
In reply to GREAT topic -- my answer is 'No, but...' » SLS, posted by Racer on May 26, 2008, at 10:13:25
>
> In the course of my readings, I've found some interesting articles that make me much more skeptical about any putative one-to-one relationship between medications and neurochemicals.
>It's wise to keep an open mind about the potential for undiscovered properties of drugs. Most compounds have not even been tested for their possible binding affinity to most of the known receptors, enzymes and other targets, not to mention the targets that remain unknown to science.
> For instance, did you know that Ritalin reduces the ADHD-like symptoms in dopamine knock-out mice? These are mice without active dopamine receptors -- and yet, we discuss Ritalin as a dopaminergic medication. That seems to suggest -- strongly -- to me that boosting the action of dopamine is probably not the solution to ADHD-like symptoms, it's probably not how Ritalin actually works. Or, at least, it's not the whole story.
>You are probably thinking of dopamine transporter knockout (DAT-KO) mice, because mice lacking dopamine receptors would presumably suffer from extreme parkinsonism, and quite possibly worse. You may also be confusing cocaine with methylphenidate - although these drugs are similar in many ways, methylphenidate lacks the serotonin reuptake inhibition that seems to account for the major effects of cocaine in DAT-KO mice. The case of the DAT-KO mice also illustrates the dangers of making generalisations based on results from experiments with genetically modified organisms: the lack of the dopamine transporter influences the development of the mice physiologically and behaviourally - for example, their weight is lower, their wakefulness and activity level enhanced (and sleep reduced), and they are hypersensitive to the stimulant effects of caffeine but have reduced sensitivity to cocaine, amphetamine, and modafinil.
It's true that dopamine is not the whole story in the case of ADD/ADHD, but it does seem to play the major role; noradrenaline also seems to be high significance, whereas serotonin appears to be a factor of little importance - probably less than glutamate.
> What's more, I don't believe that there is one disorder called Depression. I believe that there are clusters of symptoms which we group together for convenience sake, and call Depression.
>That's a very accurate conclusion. Some concepts of different subtypes of depression - such as melancholic and atypical - have already long been used, especially in research, but these subtypes are based on clusters of symptoms that can be observed. I think more focus on the etiology of these conditions and the underlying neurobiological substrates would be more useful, not only from a theoretical standpoint but even more so from the practical point of view of psychopharmacological treatment.
Posted by torachan on May 26, 2008, at 20:00:03
In reply to GREAT topic -- my answer is 'No, but...' » SLS, posted by Racer on May 26, 2008, at 10:13:25
'Overactivity at certain serotonin receptors in the Central Nervous System is associated with anxiety, and yet SSRIs are effective for anxiety for many people.'
Great knowledge displayed, Racer, of the field of neuroscience. However, I must say the above comment may be a bit misleading if not entirely incorrect. SSRI's have not proven to be effective for many people with anxiety. Not based on the studies I've read and on my own personal experience. Increasing serotonin activity is the antithesis to relieving anxiety.
As I said in my post, the key to curing anxiety lies largely in the amygdala, and all signs point to an over reactivity or sensitivity in this region, and increasing the action of any neurotransmitter in this region is not the key. Reducing the activity is.
Posted by undopaminergic on May 28, 2008, at 5:12:54
In reply to Re: GREAT topic -- my answer is 'No, but...' » Racer, posted by torachan on May 26, 2008, at 20:00:03
>
> Great knowledge displayed, Racer, of the field of neuroscience. However, I must say the above comment may be a bit misleading if not entirely incorrect. SSRI's have not proven to be effective for many people with anxiety. Not based on the studies I've read and on my own personal experience. Increasing serotonin activity is the antithesis to relieving anxiety.
>For reasons that are not fully understood, drastically increasing serotonin with MDMA (methylenedioxymethamphetamine, Ecstasy) appears to drastically reduce - even abolish - anxiety. SSRIs may not be powerful enough to achieve the necessary elevation of serotonin.
Posted by blueboy on May 28, 2008, at 8:43:21
In reply to Re: GREAT topic -- my answer is 'No, but...', posted by undopaminergic on May 28, 2008, at 5:12:54
> >
> > Great knowledge displayed, Racer, of the field of neuroscience. However, I must say the above comment may be a bit misleading if not entirely incorrect. SSRI's have not proven to be effective for many people with anxiety. Not based on the studies I've read and on my own personal experience. Increasing serotonin activity is the antithesis to relieving anxiety.
> >
>
> For reasons that are not fully understood, drastically increasing serotonin with MDMA (methylenedioxymethamphetamine, Ecstasy) appears to drastically reduce - even abolish - anxiety. SSRIs may not be powerful enough to achieve the necessary elevation of serotonin.Very interesting topic. I do have a comment about Ecstasy. In at least one case of an addictive serotonin-increasing drug (heroin), a study showed that exposure to the drug causes gross physical change in receptor neurons -- which is why addicts need more and more drug to achieve the desired effect. Then, when the drug is discontinued, the terrible withdrawal occurs (at least in part) because the number and sensitivity of the receptors is insufficient for normal response.
IIRC, the same is true of alcoholics; they can actually see the degradation in serotonin receptor neurons.
I don't know much about this. I'm just recounting my memory of a past issue of Scientific American Mind. My memory of the article is that they were fairly confident of the conclusion.
Posted by SLS on May 28, 2008, at 20:52:41
In reply to GREAT topic -- my answer is 'No, but...' » SLS, posted by Racer on May 26, 2008, at 10:13:25
> Can we really choose drugs based on known mechanisms?
>
> Are we really able to deduce our individual psychobiological abnormalities?> Great topic, Scott -- and now will you share your answer with us?
I really have nothing profound to say. I really wanted to hear from others.
> How's that? "No, but..."
I guess I can't do much better than that. Sort of yes, sort of no...
For now, our ambitions are thwarted by our ignorance. I like to think that physicians come upon their clinical practices by observing what they see and hear in the field. I think a good doctor can characterize symptom clusters as being more amenable to some treatments and not others.
- Scott
Posted by okydoky on May 30, 2008, at 10:14:34
In reply to Can we really choose drugs based on mechanisms?, posted by SLS on May 22, 2008, at 6:48:38
> Can we really choose drugs based on known mechanisms?
>
> Are we really able to deduce our individual psychobiological abnormalities?
>
> All comments welcome.
>
>
> - ScottWhat do you think?
oky
Posted by SLS on May 30, 2008, at 10:26:52
In reply to Re: Can we really choose drugs based on mechanisms? » SLS, posted by okydoky on May 30, 2008, at 10:14:34
> > Can we really choose drugs based on known mechanisms?
> >
> > Are we really able to deduce our individual psychobiological abnormalities?
> >
> > All comments welcome.
> >
> >
> > - Scott
>
> What do you think?
To some degree, yes. I've seen it done.Probably the best person here at doing so is Linkadge.
Unfortunately, my memory is so badly impaired, I can't remember detail. I don't have a database in my head of drug mechanisms and receptors. Earlier in my life, details thrilled me. Now they overwhelm me. Although my depression is in large degree improved, reading, learning, and remembering are still badly impaired, presumably from years of excessive cortisol exposure and atrophy.
- Scott
Posted by okydoky on May 30, 2008, at 12:25:19
In reply to Re: Can we really choose drugs based on mechanisms » okydoky, posted by SLS on May 30, 2008, at 10:26:52
> > > Can we really choose drugs based on known mechanisms?
> > >
> > > Are we really able to deduce our individual psychobiological abnormalities?
> > >
> > > All comments welcome.
> > >
> > >
> > > - Scott
> >
> > What do you think?
>
>
> To some degree, yes. I've seen it done.
>
> Probably the best person here at doing so is Linkadge.
>
> Unfortunately, my memory is so badly impaired, I can't remember detail. I don't have a database in my head of drug mechanisms and receptors. Earlier in my life, details thrilled me. Now they overwhelm me. Although my depression is in large degree improved, reading, learning, and remembering are still badly impaired, presumably from years of excessive cortisol exposure and atrophy.
>
>
> - ScottI am astounded by your description of how you are feeling. It is as if you were talking about me. Except I never comprehended the amount you seemed to have but then I never tried to learn it at an earlier time when I probably could have focused, learned and most importantly remembered as I learned so I could build upon what I already new. I learn something today and go back to it tomorrow and cannot remember it yet not build upon it. Undopameric's description of taking a shower was revealing for me. Except first I have to motivate to even take the shower.
I just thought with all the knowledge you have accumulated that this was your belief system. I guess not enough people have tried it to report enough if it actually pans out. I thought that when you make recommendation that you sometimes refer to it. I dont even understand it enough to remark intelligently.
oky
Posted by okydoky on May 31, 2008, at 12:39:40
In reply to Can we really choose drugs based on mechanisms?, posted by SLS on May 22, 2008, at 6:48:38
Actually Scott my old pdoc specifically prescribed Parnte because of the help I had from using cocaine. He was right too. If it had not pooped out I would still be functioning. I still do not understand how the maoi's work like with dopamine etc.. I thought it would help me decide what to try if I understood that better.
oky
Posted by bulldog2 on May 31, 2008, at 18:34:46
In reply to GREAT topic -- my answer is 'No, but...' » SLS, posted by Racer on May 26, 2008, at 10:13:25
> > Can we really choose drugs based on known mechanisms?
> >
> > Are we really able to deduce our individual psychobiological abnormalities?
> >
>
> I don't think there's enough information yet known for drugs to be chosen by mechanism. Just the fact that the SSRIs have such different effects, despite their related mechanisms, suggests that there's more to it than simply boosting one single neurotransmitter.
>
> On the other hand, I do believe that past experience with medications can help suggest directions to explore. For example, I have done best on medications which target norepinephrine, and had problems with serotinergic medications. I'm much more willing to try the noradrenergic/dopaminergic medications than anything serotinergic, based on my own experiences. I don't think that's the same thing as being able to deduce my own biochemical eccentricities, though.
>
> In the course of my readings, I've found some interesting articles that make me much more skeptical about any putative one-to-one relationship between medications and neurochemicals. For instance, did you know that Ritalin reduces the ADHD-like symptoms in dopamine knock-out mice? These are mice without active dopamine receptors -- and yet, we discuss Ritalin as a dopaminergic medication. That seems to suggest -- strongly -- to me that boosting the action of dopamine is probably not the solution to ADHD-like symptoms, it's probably not how Ritalin actually works. Or, at least, it's not the whole story.
>
> After years of reading that glial cells are the neurological equivalent of styrofoam packing peanuts, suddenly we know that they're actually active in the brain. Dopamine was thought for decades to be nothing more than a precursor to norepinephrine. Overactivity at certain serotonin receptors in the Central Nervous System is associated with anxiety, and yet SSRIs are effective for anxiety for many people. I don't believe there is enough information yet known to say for certain that any particular mechanism is The Cause of anyone's symptoms.
>
> What's more, I don't believe that there is one disorder called Depression. I believe that there are clusters of symptoms which we group together for convenience sake, and call Depression. It may be that your depression is related to one neurochemical, and mine another. It may even be that none of the catecholamines are involved in some cases of depression -- perhaps it's an abnormality of the calcium channels on your neurons, and a calcium channel modulator would be your best bet. Perhaps glutamate is the culprit for some cases of depression. Maybe the problem isn't at the synapse at all, but somewhere downstream in the synthesis process -- maybe I can't create serotonin from tryptophan? Neuroscience just does not yet know enough to say with any degree of certainty.
>
> And yet -- I do believe that prior experience with medications of various mechanisms can suggest directions to explore.
>
> How's that? "No, but..."
>
> Great topic, Scott -- and now will you share your answer with us?yes i agree with you that depression is actually a symptom that is a sign of some physical disorder. Similar to cancer which in my mind is actually many diseases with certain similarities.
That's why there will never be a silver bullet that cures depression or cancer.Maybe in the end we will just have to manage it with many approaches and there will never be a cure.
Posted by B2chica on June 5, 2008, at 8:11:34
In reply to Re: Can we really choose drugs based on mechanisms? » SLS, posted by okydoky on May 30, 2008, at 10:14:34
i think yes (to a degree). my knowledge is small but i have an idea of what works and what absolutely doesn't. so i know a handful of meds to stay away from and a few that i thought worth a try. it's helped that i've been on a slu of them already so i can base by my reaction to those and cross reference their make up, and go from there.
so far so good.
i seem to be on target with the Geodon. it seems to be working well so far. quite well infact.
b2c.
> > Can we really choose drugs based on known mechanisms?
> >
> > Are we really able to deduce our individual psychobiological abnormalities?
> >
> > All comments welcome.
> >
> >
> > - Scott
>
> What do you think?
>
> oky
>
>
Posted by Zyprexa on June 7, 2008, at 19:58:18
In reply to Re: Can we really choose drugs based on mechanisms » okydoky, posted by B2chica on June 5, 2008, at 8:11:34
I think I can!
I read the descriptions of meds. Side effects, mechanisim of action, and anything I can find.
This seems to work for me. I've self (suggesting) prescribed several meds that work, most of the time I dead on. Metformin, perphenazine to mention a few. Worked better first try than any of the others doctors wanted to try on me, much better!
Posted by yxibow on June 8, 2008, at 6:07:45
In reply to Re: GREAT topic -- my answer is 'No, but...', posted by bulldog2 on May 31, 2008, at 18:34:46
> > > Can we really choose drugs based on known mechanisms?
> > >
> > > Are we really able to deduce our individual psychobiological abnormalities?
> > >
> >
> > I don't think there's enough information yet known for drugs to be chosen by mechanism. Just the fact that the SSRIs have such different effects, despite their related mechanisms, suggests that there's more to it than simply boosting one single neurotransmitter.Exactly
> > On the other hand, I do believe that past experience with medications can help suggest directions to explore. For example, I have done best on medications which target norepinephrine, and had problems with serotinergic medications. I'm much more willing to try the noradrenergic/dopaminergic medications than anything serotinergic, based on my own experiences. I don't think that's the same thing as being able to deduce my own biochemical eccentricities, though.But this, like everyone else's condition is individual, genetic, and a moving target over time.
>I don't believe there is enough information yet >known to say for certain that any particular >mechanism is The Cause of anyone's symptoms.
As my doctor has said, we're sort of in the middle ages of psychiatry. There is a lot we do not know about what certain psychoactive substances will do for one person or another. And psychiatry, though of course a medical field with scientific background, is yet more "of an art than a science."
That's one reason why importing prescriptions from secret no-question pharmacies over the internet is such a bad idea, not per se because of the quality, which is unknown sometimes, but because a doctor is not seeing you face to face, evaluating you, examining everything from body language to how you communicate.
> > And yet -- I do believe that prior experience with medications of various mechanisms can suggest directions to explore.
> >
> > How's that? "No, but..."That part I would agree with -- in the sense of how sensitive one is to side effects. But as said before since biochemical disorders change over a lifetime and some are known to become better with age such as some types of schizophrenia, and some we just don't know about.
There's an somewhat still new, expensive but given the green light scientifically for testing for certain P450 cytochrome deficiencies and metabolism, specifically 2D6 and 2C19, from Roche, called the Amplichip.
> yes i agree with you that depression is actually a symptom that is a sign of some physical disorder.Yes, it is only a symptom, just like dozens of anxiety symptoms are only symptoms, they don't actually say how many million cells need to be targeted, if that was even possible, which it isn't.
Similar to cancer which in my mind is actually many diseases with certain similarities.
> That's why there will never be a silver bullet that cures depression or cancer.Maybe in the end we will just have to manage it with many approaches and there will never be a cure.I wouldn't say never -- one can always dream, but I wouldn't say something any of us would see.
But yes, there is no magic bullet, I know from experience that has targeted a 7 year unwanted vacation with a disorder that mystifies trained neurologists -- and is a moving target.
There were points that "everything felt working to an extent" and I felt "on par" with society, but its different now and frustrating because it makes me feel alone to have the only disorder on the planet..
....the depression I can identify with others, but I never dreamed of taking antipsychotics in my life -- I only had a history of bad OCD that dissipated and some dysthymia.
And then a perplexing somatiform disorder came along that amplifies my vision and hearing 24/7 in ways that some could understand (natural phenomenon that are held longer and ignored like a gate or passed away in microseconds by others) and a few ways that are now coming out that are even more baffling like faster motion across my visual field in certain situations and staticky overlays when reading, e.g. (yes, MRIs fine and they wouldn't detect any disorder anyhow)
But anyhow that's just my story, I'm digressing.
I believe more that there will be cures or at least near lifetime remission rates for certain types of cancer in the lifetimes of some in this century.
Childhood leukemia has nearly a 90% success rate overall for people who meet certain criteria.
Some types of breast cancer caught early with regular mammograms and prostate cancer especially caught early with regular colonoscopies have better success rates (50% of most older males have BPH, or benign prostate hyperplasia which is not cancer).
There will be better vaccines, HIV treatment and possibly cures although it is a difficult moving target.
The real possibilities are stem cells for a number of conditions and there have been proof of concept for things including retinal regrowth in mice. This still remains a public controversy but private funding continues on.
If I were to say there were anything that there was a complete to limited cure now for are early caught strep throat and other non-complex antibiotic fought diseases. The trouble is the overuse of antibiotics and the ever increasingly sought fight for novel ones because for example 90% of things like pharyngitis are virally caused. The average person gets 1-5 infectious diseases a year and may not even be aware of all of them.
But then there are things like preventable conditions -- yes, quitting tobacco is very difficult and there are tons of arguments I can't list here but it equals the number of deaths by heart disease in the US for example, per year. Preventable flu deaths by vaccine may equal automobile incidents. At any rate, this is rather morbid, but regular physicals also have increased one's lifespan and reduced the load on hospital visits. Unfortunately there isn't universal coverage in the US and people without end up using the hospital as doctor visits (its illegal to turn away any patient with an emergency/illness at a hospital in the US)
Basically, there are no guarantees in anything in life but that doesn't mean the loss of hope or only looking or creating the most bleak scenarios (which I admit I do at times, I don't know where the future will bring me). Hope comes from within.But I want to emphasize also, that it isn't entirely the right polypharmacy that is the key to fighting a biochemical imbalance -- its also education about it and the fact that it takes someone with mental illness to have to work harder to succeed -- something that should empower people to seek therapy as well or self-help groups and keep as active as possible to fight off depression.
I'm not being Pollyanna --- there are serious disorders such as paranoid schizophrenia that may require a lot of medical intervention before someone has the hope of reintegrating with society in some capacity.
There is such a stigma still attached to mental illness and I rarely hear anything about such organizations as NAMI on here.
-- best wishes for a future worldJay
Posted by okydoky on June 8, 2008, at 9:40:35
In reply to Maybe at some indefinite future, posted by yxibow on June 8, 2008, at 6:07:45
I don't have much to add. It is all very interesting.
I thought this little story might be interest.
When I was doing social work no one knew I had depression. I worked along side a woman who had a distinct limp, I think one leg was longer, not sure. Anyway I at lunch with one of the "clients" because she asked me to. This woman that limped said one day, after that, that she did not understand why "these people" would want to socialise with people who were not depressed. (They were high functioning, in my opinion being held back They probably functioned as well as I did.) I just looked at her rather astounded. I dearly wanted to ask her why whe felt the need to work, socialise, marry... people who did not have a profound limp! Of ourse I did not do it.
oky
This is the end of the thread.
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