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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by willyee on March 11, 2005, at 21:51:46
In reply to Posters on this board, posted by alexandra_k on March 9, 2005, at 2:40:35
> I'm sure different people feel differently but I would be interested in hearing peoples opinions on this.
>
> Are
> 1) you
> 2) posters on this board (in your opinion)
> Specifically wanting a MEDICATION or DRUG as an answer? I mean sometimes people post about a certain symptom or problem. I think I have been jumped on on a couple of occasions now for suggesting a psychological rather than medication way of dealing with that symptom.
>
> I guess I was wondering whether people are open to a variety of suggestions or if people have already made their mind up that some DRUG must be the answer (this is after all the medications board I suppose).
>
> Just thought I'd ask.
>
> Perhaps I'll redirect my response to the psychology board and it is up to you guys whether you want to follow the link...
>
> Fair enough?Well this is my view...we are presented with the notion by the industry,the docters and phar companys that emotional disorder,depression,anxiety,ocd, etc are bio-chemical imbalances,not a flaw in character.
OK,if this is what they are presenting,and if this is what we are to rely on,then would these disorders not be a pyhscial disorder,as a seizure is,or parkins,would a chemical problem not mean there are pyhsicals attributes in the brain,not working correctly,and that the medication helps adjust these chemicals to a somewhat normal state.
If this is the case,how would talk therapy be anything but harmful as an alternate option to a person clincialy distressed by one of these disorders.If its chemical then its not logical disease,it is a very real pyhsical disease,and having a person not take a pyshical medication but instead seek a logical treatment to treat a pyhscial disorder be malpractive,and endangering the patient?
I mean wouldent it be a very bad thing to try to treat a parkinson patient with talk therpay instead of meds.
I have heard rebuttals where talk therapy makes changes in brain pattterns,im sorry,i can not buy this at all,i can not see how talk therpay can alter a pyshical defect in a brain,if this was the case then talk therapy should be a option for any brain trauma.Of course its not.
Now i can see someone valueing therapy with a medication,simply because it helps them to have support,and thats great,any thing excersie a friend a therapy etc that can help a person deal with the disease better is great.
But once again if we are gonna present our main theory as these being clinical bio-chemical disorders,then i dont understand how we can offer talk therapy,a very non-pyhscial therapy approach as treatment,it just doesent provide logic.I for example can have a great therapy session,but when i leave that office i still have my illness.I just enjoyed talking to someone,but would not label it a treatment.
When i did not take meds,and instead used techniques from therapy,my life was a horrid mess.
Marriage problems,family problems,break down in communications,a troubled child misbehaving,a abused person,these are all things a good therapist can make great strides in as being a third party infulenace,and providing a altentate means of emotional relase.
However,for CLINICAL "BIO-CHEMICAL" disorders such as clinical anxiety,clincial depression,clinical insomnia,....well therapy as a effective TREATMENT makes about as much sense as using it to treat parkinson,seizure,diabetes,narcolepys,or any brain trauma.
>
Posted by Shortelise on March 12, 2005, at 0:10:21
In reply to Re: Posters on this board, posted by willyee on March 11, 2005, at 1:08:49
Do a little research on depression and neural pathways, on PTSD and memory, and you may find a little more info on how talk therapy can influence the brain.
ShortE
Posted by alexandra_k on March 12, 2005, at 1:11:42
In reply to Re: Posters on this board, posted by willyee on March 11, 2005, at 1:08:49
> Well this is my view...we are presented with the notion by the industry,the docters and phar companys that emotional disorder,depression,anxiety,ocd, etc are bio-chemical imbalances,not a flaw in character.
Sure. I don't think that it is a flaw in character. But therapy, and skills learned in therapy can affect neurophysiological changes.
> OK,if this is what they are presenting,and if this is what we are to rely on,then would these disorders not be a pyhscial disorder,as a seizure is,or parkins,would a chemical problem not mean there are pyhsicals attributes in the brain,not working correctly,and that the medication helps adjust these chemicals to a somewhat normal state.Yes. Though medication is not the only way to alter brain chemistry.
> If this is the case,how would talk therapy be anything but harmful as an alternate option to a person clincialy distressed by one of these disorders.I wasn't advocating that people throw away their medications and get themselves into therapy. I was suggesting that if people are having difficulty finding a suitable medication then it might be worth seeing whether anything aside from meds can give them some relief. Also when people are unable to access the medication they believe they need then maybe it is worth seeing whether anything aside from meds can give them some relief. Also that therapy may enable the meds to be more effective.
>If its chemical then its not logical disease,it is a very real pyhsical disease,and having a person not take a pyshical medication but instead seek a logical treatment to treat a pyhscial disorder be malpractive,and endangering the patient?
There is two way interaction between 'mind' and 'body'. So, for example if you are talking about something you are very frightened of then you may find your heart starts to beat faster, you start perspiring, your pupils dialate or whatever. Talking and thinking about what you are afraid of can result in adrenalin being released into your body, for example. That is just a simple example to show you that talking can affect physiological changes. People have been taught (via biofeedback devices) to slow down their heart rate by 'thinking about it' or by 'learning how to will it to be so'. This is helpful with respect to people who are at risk of heart attack preventing themselves from having a heart attack. You might think that heart attack is a physical problem and people just need to take their medication but a combination of biofeedback training and medication is more effective then either one alone.
> I mean wouldent it be a very bad thing to try to treat a parkinson patient with talk therpay instead of meds.I don't know enough about parkinsons. I am not advocating that people have to pick one or the other. Meds or therapy. Evidence has shown that a combination of both is more effective than either strategy alone for a number of conditions. If meds are helping people then I am most certainly not advocating that people stop them.
> I have heard rebuttals where talk therapy makes changes in brain pattterns,im sorry,i can not buy this at all,i can not see how talk therpay can alter a pyshical defect in a brain,if this was the case then talk therapy should be a option for any brain trauma.Of course its not.Stroke victims spring to mind... People can have a lesion where part of their brain has died. That is a physical defect in the brain. Sometimes they can't do certain tasks because that part of their brain has been damaged. But the brain can adapt. New parts can take over old function. We might think that people with mental illness will never really get any better. All that can be hoped for is that they can be maintained on medications. But maybe the brain can learn new tricks. Talk can help. Talk is what helps peoples brains learn how to speak again, for instance.
> Now i can see someone valueing therapy with a medication,simply because it helps them to have support,and thats great,any thing excersie a friend a therapy etc that can help a person deal with the disease better is great.Yeah. Some people try therapy and find it just isn't that helpful for them. That is fine. I just think that there are techniques etc that people typically learn in therapy that can help. Can help with stuff like sleep, anxiety, pain management especially. But you don't have to go to therapy to learn about those techniques.
> But once again if we are gonna present our main theory as these being clinical bio-chemical disorders,then i dont understand how we can offer talk therapy,a very non-pyhscial therapy approach as treatment,it just doesent provide logic.Talk is physical. To put it crudely talk is sound waves which travel through the air then into your ear to be 'transduced' (translated) into neural signals. Thinking about different things, doing different things does result in a change in your brain processes. It is just a matter of whether those ones that are distressing to you / others can be stopped. There really is still so very much we don't know. All I mean to say is that talk can alter behaviour. It can alter how we feel (start talking about sad things and after a while you will feel sad). That isn't a problem for the idea that mental illness is a legitimate phenomena. Maybe thats what you are worried about.
> When i did not take meds,and instead used techniques from therapy,my life was a horrid mess.Don't stop taking meds if they help you.
I never meant to advocate that.
> However,for CLINICAL "BIO-CHEMICAL" disorders such as clinical anxiety,clincial depression,clinical insomnia,....well therapy as a effective TREATMENT makes about as much sense as using it to treat parkinson,seizure,diabetes,narcolepys,or any brain trauma.But that doesn't account for its proven effectiveness for clinical depression, insomnia, anxiety, and also pain management / relief.
Posted by cubic_me on March 12, 2005, at 6:40:05
In reply to Re: Posters on this board » willyee, posted by alexandra_k on March 12, 2005, at 1:11:42
Many people on the meds board have tried many types of therapy, and are still experiencing distress or they have had success on meds before but they have 'pooped out' or given them side effects, that is why they are asking for advice on meds. I agree that psychological treatments can be very helpful, but medications can also be, especially if a person is too depressed to have the motivation use therapy properly, or if they are too anxious.
Posted by Dinah on March 12, 2005, at 7:58:57
In reply to Re: Posters on this board, posted by willyee on March 11, 2005, at 1:08:49
The trouble with science is that sometimes they measure and measure things and don't think about cause. For example, they might measure the brains of lots of people with depression and find that serotonin is low, so voila add serotonin and things will be fine.
But low serotonin is potentially the result of many things. Have you read the studies on dominant and submissive male monkeys? If I remember correctly, if a sumbissive male monkey was placed in a dominant position, his serotonin levels rose. His life circumstances changed, and that changed his biochemistry. No one gave him any drugs.
They've also identified major changes in brain chemicals by changing the environment in which young primates grow up.
So it's a big jump between identifying biochemicals that are associated with depression, anxiety, etc. and identifying the cause underlying the biochemical differences.
And if negative life circumstances affect our biochemical profiles, why shouldn't positive life experiences? The effect of stress on a gazillion illnesses has been identified. Why should mental illness be any different? If learning to reduce stress or change our response to stress in therapy can help diabetes, why not depression?
There is absolutely no doubt in my mind that some of us have biochemical systems that differ from the norm. Medication can change that, so can altering life circumstances, or our responses to life circumstances. A combination of the two has consistently proven most productive.
Good therapy is more than a chat. More than support even (unless support is the desired goal).
I have had disastrous medication results. For me, therapy has far fewer side effects than Wellbutrin or Effexor or Luvox or nortryptiline or Remeron. Moreover, I'm convinced that the bipolar tendencies that emerged with those medications forever sensitized my biochemical system and changed my illness forever. I wish to God I had never started them. I'm ok with my mood stabilizers, Klonopin, and anything that calms rather than stimulates my system.
Medications have an effect on everyone, some positive and some negative. Therapy helps some people but doesn't help other people at all. There are numerous possible reasons for that, but rather than speculating on them, I'd just say that therapy is useful for those who benefit from it, medications are useful for those who benefit from it, and whatever is useful for anyone is great, as long as it doesn't have a negative impact on other areas of their lives.
Maximize positive effects while minimizing negative effects from whatever treatment you choose, and I will certainly never judge your decisions whatever they may be.
Posted by Dinah on March 12, 2005, at 8:09:21
In reply to Re: Posters on this board » willyee, posted by Dinah on March 12, 2005, at 7:58:57
I wouldn't include schizophrenia, autism, or bipolar I as things that could be helped with therapy without medication AT ALL. There are probably some forms of depression that would also fit into this category, but I'm not sure medical science can identify the causes all that well yet. And even for illnesses that are as clearly biological as schizophrenia or autism, therapy could be a helpful adjunct for living with a chronic illness.
Posted by alexandra_k on March 12, 2005, at 17:56:25
In reply to Re: Posters on this board, posted by cubic_me on March 12, 2005, at 6:40:05
> Many people on the meds board have tried many types of therapy, and are still experiencing distress or they have had success on meds before but they have 'pooped out' or given them side effects, that is why they are asking for advice on meds. I agree that psychological treatments can be very helpful, but medications can also be, especially if a person is too depressed to have the motivation use therapy properly, or if they are too anxious.
Sure. I agree 100%. I guess I just thought people were asking for help with their symptoms... But to get a variety of suggestions from a variety of different treatment modalities it seems that one must either post the question to a few different boards or post it over on social.How about a symptoms board Dr Bob?
A board for people wanting help with their symptoms despite treatment modality?
One thing that worries me about the current board divisions is that people may be led to think that one treatment modality precludes others. That was my bug with 'alternative' medicine rather than 'complimentry'.Oh well. It doesn't worry me particularly.
Posted by alexandra_k on March 12, 2005, at 17:59:20
In reply to Addendum, posted by Dinah on March 12, 2005, at 8:09:21
Never say never...
Who knows what theraputic techniques have yet to be developed...> I wouldn't include schizophrenia, autism, or bipolar I as things that could be helped with therapy without medication AT ALL.
I would say it still depends a great deal on the particular individual with the disorder...
>There are probably some forms of depression that would also fit into this category, but I'm not sure medical science can identify the causes all that well yet. And even for illnesses that are as clearly biological as schizophrenia or autism, therapy could be a helpful adjunct for living with a chronic illness.
All illnesses are clearly biological.
I am a materialist.
There isn't any immaterial 'mind stuff' so of course mental illness is a form of physical illness.
Thoughts arise from neural signals.
And you are absolutely correct with respect to environment (and talk is part of that) affecting neural changes
This is the end of the thread.
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