Psycho-Babble Psychology Thread 297643

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Brain Responds Differently to Meds vs Talk therapy

Posted by jrbecker on January 7, 2004, at 12:04:29

Depressed Mind Responds Differently to Different Therapies
New study finds talking, drugs don't act on brain in same way

By Kathleen Doheny
HealthDay Reporter

http://www.healthday.com/view.cfm?id=516820

WEDNESDAY, Jan. 7 (HealthDayNews) -- Patients who engage in cognitive or "talk" therapy to recover from depression show brain changes that differ from what occurs with drug therapy, new research finds.

The study shows for the first time with imaging evidence that the depressed brain responds differently to different treatments -- and the results may help doctors understand why one treatment works for one patient but not another, says study author Dr. Helen Mayberg. Her report appears in the January issue of the Archives of General Psychiatry.

Mayberg, an associate scientist at the University of Toronto's Rotman Research Institute at Baycrest Centre for Geriatric Care, and her team looked at 14 adults with clinical depression who received 15 to 20 sessions of outpatient talk therapy without any drug treatments. They gave the patients brain scans before and after therapy using positron emission tomography (PET), which pinpoints the areas where the most changes in brain metabolism occur. They compared the results to typical changes that have been found with drug therapy.

They found both therapies affected many of the same regions in the brain, but in different ways.

"One [treatment] isn't better than the other," says Mayberg, who is also a professor of psychiatry and neurology at Emory University School of Medicine in Atlanta. "Different treatments work on the brain in different ways."

In drug therapy, the brain chemistry is altered in the bottom regions of the brain, such as the limbic region, areas that drive basic emotional behaviors, according to Mayberg. It's considered a "bottom-up" approach.

Talk therapy is termed a "top-down" approach because it focuses on changes in the cortical -- or top -- areas of the brain, regions associated with thinking functions, to change abnormal mood states.

With drug therapy, experts know that blood flow decreases in the bottom regions and increases in the top areas. But with talk therapy, blood flow increased in the bottom regions and decreased in the top regions.

Mayberg says the reverse pattern can be explained this way: As talk therapy patients learn to shut off the thinking patterns that lead them to dwell on negativity, activity in areas of the cortical or top regions decrease as well.

Dr. Aaron Beck, one of the originators of cognitive therapy and a professor of psychiatry at the University of Pennsylvania in Philadelphia, praises the new study. "It demonstrates that cognitive therapy does have a serious impact insofar as there are brain changes," he says.

"Clinically, we have documented the changes in depression [with talk therapy]," he says. Now, he adds, the study provides the subjective evidence that there are neurophysiological changes.

The findings, he adds, are consistent with the top-down theory of how cognitive therapy works. "You do get a kind of confluence between the two approaches in terms of the brain changes," he adds.

The findings may help doctors better decide how to treat depression, says Mayberg, using a combination of approaches. "The areas that cognitive therapy work in are areas that drugs don't touch," she says.

More information

For information on cognitive therapy, try the Beck Institute for Cognitive Therapy. Read about depression from the National Institute of Mental Health, and find a therapist at the American Psychological Association.

SOURCES: Helen Mayberg, M.D., associate scientist, Rotman Research Institute, Baycrest Centre for Geriatric Care, University of Toronto, and professor, psychiatry and neurology, Emory University School of Medicine, Atlanta; Aaron Beck, M.D., professor, psychiatry, University of Pennsylvania, Philadelphia, and president, Beck Institute for Cognitive Therapy; January 2004 Archives of General Psychiatry

Copyright © 2004 ScoutNews, LLC. All rights reserved.

http://www.healthday.com/view.cfm?id=516820

 

CBT is not really 'talk' therapy

Posted by badhaircut on January 7, 2004, at 14:58:59

In reply to Brain Responds Differently to Meds vs Talk therapy, posted by jrbecker on January 7, 2004, at 12:04:29

That's another good article about the Toronto study. (Thanks, jr.) The HealthDay editor is a little misleading, though, in calling CBT "talk" therapy. CBT is usually distinguished from the various dyad-based, catharsis-oriented, free-asociating, psychodynamic, "depth" psychotherapies -- which really do emphasize *talk*. CBT teaches step-by-step techniques, assigns homework exercises and doesn't linger on talking.

-bhc

 

Re: CBT is not really 'talk' therapy

Posted by ann72 on January 7, 2004, at 18:37:04

In reply to CBT is not really 'talk' therapy, posted by badhaircut on January 7, 2004, at 14:58:59

I have SAD and am on benzo's, just makes me cope, but I'm not getting better mentally. I want to join a CBT group, but there are none in my city. What can I do?

 

Re: CBT is not really 'talk' therapy

Posted by Joslynn on January 8, 2004, at 12:35:11

In reply to Re: CBT is not really 'talk' therapy, posted by ann72 on January 7, 2004, at 18:37:04

Well, it wouldn't be the same as a group, but you can get workbooks to do the assignments on your own.

You could search under the authors David Burns, Aaron T. Beck. And I think there is one by Chirstine Padesky?? (Just off the top of my head) Or you can go to the psych section of a bookstore, look for books by those authors.

David Burns is in most bookstores. I know that some people on here think he is simplistic. For me, the exercises work as more of a maintenance thing. When I am deeply depressed, I just can't even focus on opening a workbook.

 

Re: Re: Our Ancesters were willing to bootstrap

Posted by Kalamatianos on January 8, 2004, at 13:59:20

In reply to Re: CBT is not really 'talk' therapy, posted by Joslynn on January 8, 2004, at 12:35:11

Sometime about 200 to 400 years ago we got lost. Reading contemporaneous historical literature, our Ancestors did what was necessary and within their means. Today, we get out of sorts and we hire a (metaphorical) mechanic to fix us.

In a previous post in this thread, the illusion of "helplessness" was stated, paraphrased as I get so far gone I "CAN'T" pick up a workbook.

Within all our means is to be curious as to who we might know that would meet regularly to "PICK UP THAT WORKBOOK". I'm not suggesting something grandiose like starting a movement or a religion.

I'm suggesting starting a new (good) habit of outreach to others to replace the (bad) habit of faulty thinking to the point of avalanching into depression. REPLACEMENT of bad habits is within everyone's means.

Dr. Phil McGraw has two wonderful workbooks that I found better for me than reading the books they were supporting. The first is "Life Strategies", and the next one is "Life Matters".

I am starting locally "The Puzzlemasters" for like minded folks with bad (avoidance) habits that want to improve small items in their lives by solving some of life's puzzles. I will encourage all who are interested to use Amazon or go to the Mall and buy, "Life Strategies Workbook", by Dr Phil.

The simple goal is to share our mutual capacities for help to encourage each and all to replace the particular bad habit of "putting things off that can be done today", with the good habit of "suiting up and showing up".

It's like the LOTTO: if you don't do it, you can't win! Corollary: if you promise to do it and don't, you promise to lose.

 

Re: CBT is not really 'talk' therapy » badhaircut

Posted by Kalamatianos on January 8, 2004, at 14:05:12

In reply to CBT is not really 'talk' therapy, posted by badhaircut on January 7, 2004, at 14:58:59

Hmmmmmmmm....
...not what I hear from insurance companies.

Could you restate your position without "qualifing conditions"?

Adding enough qualifiers, the Government made a hammer become a chicken.

 

Re: Re: Our Ancesters were willing to bootstrap » Kalamatianos

Posted by Joslynn on January 8, 2004, at 14:18:15

In reply to Re: Re: Our Ancesters were willing to bootstrap, posted by Kalamatianos on January 8, 2004, at 13:59:20

You said: "In a previous post in this thread, the illusion of "helplessness" was stated, paraphrased as I get so far gone I "CAN'T" pick up a workbook."

I believe you were referring to me. I did not literally mean that when I was depressed I refused to even lift the cover of a workbook. In fact, I believe I tried, though is a bit of a blur now. But since I had been going weeks without eating or sleeping, and was feeling nauseous and crying with no provocation, the words swam in front of my eyes and I couldn't process the information. By the way, the illusion of helplessness is a classic symptom of depression. It is the disease talking, not a weakness in the person.

My point was that the physical aspects of depression can make it very difficult to do homework exercises and that first a person should try to stabilize themselves. Did I pull myself up by my bootstraps? YES, I have been depression-free for two and a half years and I had to do some very hard things to get to this place and maintain it.

I believe you are the poster previously known as Mind's Eye, or of a similar camp. I ask that you please do not reference my posts again, for the same reasons that I explained in my previous posts to Mind's Eye.

Thank you.

 

You encouragement as chastisement (nm) » Joslynn

Posted by Kalamatianos on January 8, 2004, at 14:41:12

In reply to Re: Re: Our Ancesters were willing to bootstrap » Kalamatianos, posted by Joslynn on January 8, 2004, at 14:18:15

 

...took my... (nm) » Joslynn

Posted by Kalamatianos on January 8, 2004, at 14:43:22

In reply to Re: Re: Our Ancesters were willing to bootstrap » Kalamatianos, posted by Joslynn on January 8, 2004, at 14:18:15

 

wrong name

Posted by Joslynn on January 8, 2004, at 15:03:03

In reply to ...took my... (nm) » Joslynn, posted by Kalamatianos on January 8, 2004, at 14:43:22

I don't understand what the msgs above are about, but I just realized, I had the name wrong. Sorry if there is another person really called Mind's Eye. The previous poster I am thinking of used the term "Dr." in their name, and I think he or she labeled a post with the title of Mind's Eye, so I got confused.

I still think the posts are the same person, but I don't think I am remembering the names correctly.

It doesn't really matter, except if there is a poster named Mind's Eye who does not have a similar style and quote Dr. Phil, then I apologize, I wasn't referring to that individual.

 

Re: wrong name

Posted by Joslynn on January 8, 2004, at 15:23:18

In reply to wrong name, posted by Joslynn on January 8, 2004, at 15:03:03

Oh, I just strung together the words of the two msg headings.

For me and other people who have struggled with depression, we have heard such things as "snap out of it," "pull yourself up by your bootstraps," "get a life" etc. all too many times. It does not sound encouraging, it sounds judgmental. For me,I spoke to myself like that for a long time too, and it delayed me from getting much needed help.

 

Re:thanks for explaining » Joslynn

Posted by Kalamatianos on January 8, 2004, at 16:34:36

In reply to Re: wrong name, posted by Joslynn on January 8, 2004, at 15:23:18

May I offer encouragement?

Take the next 10 years to re-friend yourself.

Only a guess: you are told to, "pull yourself together by your bootstraps", etc. by those who want something from you and forget to balance the ledger. Am I close? I have "controlling" people around me like that. I now keep them at arms length, and my arms keep getting longer and longer, where they are concerned.

Pick some new friends because these aren't working out. Since I can't tell the future, I bet you can't either. You have no idea who else that would be a better match as a friend until you look for some. That's how I am, toooo.

If you have limits in place for the new friends, you'll do nicely. There are bunches of folks out there who would appreciate you much better than you have been by those around you, from what you say.

Focus on people that ARE good, not just those who act good or look good. I'm not implying anything. I am encouraging focus. Develop habits that include seeking beautiful outcomes and successes. You will be amazed how effective it becomes to ignore the "what ifs" and go for the beautiful. "What ifs" come from obligatory thinking. Just say, "make mine beautiful!"

10 years can be lots of time to devote to this update. And, BTW, 10 years from now you'll really only be 10 years older, but with 10 years of people that tend to encourage you instead of control and diminish you.

I hope you find my words encouraging.

 

Redirect: requests not to reference posts

Posted by Dr. Bob on January 8, 2004, at 18:31:17

In reply to Re: Re: Our Ancesters were willing to bootstrap » Kalamatianos, posted by Joslynn on January 8, 2004, at 14:18:15

> I believe you are the poster previously known as Mind's Eye, or of a similar camp. I ask that you please do not reference my posts again, for the same reasons that I explained in my previous posts to Mind's Eye.

FYI, I replied, but over at PBA:

http://www.dr-bob.org/babble/admin/20031120/msgs/298286.html

Bob

 

Re:thanks for explaining » Kalamatianos

Posted by Joslynn on January 8, 2004, at 21:18:20

In reply to Re:thanks for explaining » Joslynn, posted by Kalamatianos on January 8, 2004, at 16:34:36

FYI, I have made lots of great new friends since recovering from depression. The people with the senseless comments were usually acquaintainces or family members who are in denial about their own mental health issues.

You made the "pull yourself up by the bootstraps" comment yourself in a previous post. Yet now you are saying not to befriend people who say things like that. So, using your own logic, I should not communicate with you.

Your response to my post just shows me you truly do not get where I am coming from, and that's ok. We can both peacefully coexist not referencing each other's posts (I know I did that in the first paragraph, but won't do it again).

In the future, I'll just use the scroll feature. Sorry for taking up the board with this.

 

Please, Joslynn, please, I beg you » Joslynn

Posted by Kalamatianos on January 8, 2004, at 23:26:58

In reply to Re:thanks for explaining » Kalamatianos, posted by Joslynn on January 8, 2004, at 21:18:20

I have read and re-read our posts and I can't follow how you conclude that I am like your relatives and acquaitances telling you to "pull yourself up by your bootstaraps".

The title of my piece was intended for a leadin to the first paragraph. And, I absolutely didn't know about YOUR relatives and acquaintances for sure.

I innocently was telling a story about how us earthlings seem to have gotten lost 200 to 400 years ago. You took a much more personal meaning to the comment than I ever could have mustered.

Let's say I made a big mistake. I take full responsibility if I did. If I didn't.....

In the final analysis, what I said didn't evoke nearly any interest I expected concerning my perceived need for all of us earthlings to look seriously about how we are conducting our daily lives, since we are truly acting sorta like we are lost alot of the time; us earthlings. I got this idea several years ago, and I am interested to connect with anyone else who sees what I see. I broached the idea poorly. I should have started a new thread.

 

Re: Please, Joslynn, please, I beg you

Posted by Joslynn on January 9, 2004, at 8:46:22

In reply to Please, Joslynn, please, I beg you » Joslynn, posted by Kalamatianos on January 8, 2004, at 23:26:58

I think what upset me is that the you referenced the example from my own personal life right after your bootstrap analogy. So I read it as you using a painful moment from my life to illustrate the theory of "learned helplessness."

It was the placement of the paraphrase from my post that upset me. I felt insulted to see an example from my life used as an example to support the theory of learned helplessness.

In the future, perhaps you could consider using examples from your own life.

Anyway, I am over it now, just explaining my viewpoint. I will stop now, since this is off topic and I don't have anything else to say on this.


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