RE: mental issues and drugs

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cagliostro -> RE: mental issues and drugs (11/3/2009 10:40:14 PM)
OP: The treatment of mental disorders is a fuzzy science at best. Drugs like prozac affect processes in nerves that are supposed to help people with whatever the drug is prescribed for. But the fact is that science has only a vague understanding of how the brain works, and consequently how the drugs help. There is a category of drugs called SSRI's, or Selective Seretonin Reuptake Inhibitors. It's complicated, but they create an imbalance in favor of seretonin in nerves. Likewise there are SNRI's, which affect seretonin and norepinephrine. Basically they raise the level of those neurotransmitters in nerves, and consequently the brain. I don't know if anybody figured it out yet, but there are 3 neurotransmitters I know of that affect mood: seretonin, norepinephrine and dopamine. If a person's brain is deficient in any of those the drugs will help. But only if that is the problem. Hence the sort of voodoo nature of treating psychological disorder. I don't know of anyone finding "the cause" of these things.

wandersalone -> RE: mental issues and drugs (11/4/2009 12:01:06 AM)
Interesting thread and responses. I am yet another advocate for a combination of medication and therapy. However finding the right combination can be a minefield for people. There are so many medications and people often have to trial a number of different medications before they find the one that works for them. And then often start the process again a few years later if the medication loses it's efficacy. Coupled with finding the right medication is taking one where the side effects don't outweigh the benefits. Many of the anti-depressants cause weight gain and loss of libido for starters.... for a person with low mood and often loss of self esteem etc, these side effects magnify the symptoms of depression. Often people require the medication to stabilise their symptoms and enable them to then work with a good counsellor. As others have said there are so many types of therapy and techniques, it really is about finding both a counsellor that you feel comfortable with AND finding a paradigm/s that is a good fit. Talk therapy often isn't anything to do with curing people as many of these conditions will be life long, what they can do though is provide strategies for the person on how to live with the condition AND continue to live a life rich in meaning and value. It is even better when the doctor, psychiatrist and the psychologist work together with the person to ensure that they all are providing the support and treatment the person needs. quote: ORIGINAL: littlewonder Drugs are usually the easy way out. They don't have to deal with the real issues. Drugs are a panacea many times. Little Wonder I know you have used the words usually and many however I would even debate those terms. For many people medication is needed to stabilise their moods or at least minimise some of the most extreme symptoms. This doesn't make the issues go away nor mean they can then avoid them, what it does though is help them be in a place wehre they can start working on these issues. If someone is in the pits of their depression or their OCD habits and patterns are overwhelming they will often be unable to obtain any therapeutic benefit from therapy until these have been brought under control a little by medication.

Toppingfrmbottom -> RE: mental issues and drugs (11/4/2009 1:26:47 AM)
because for me intense therapy won't help the fact that I have chemical imbalances in my brain that make me pychotic. because I need meds to control the sheer amount of pychotic stuff that goes on outside of therapy. I need therapy AND meds both. quote: ORIGINAL: barelynangel I have a question i see so many people when it seems like a vast amount of people on the boards claim some type of mental issue and they take drugs for their mental issues and the advocating of same on here is like watching commercials on TV for same. I don't have any mental issues that i know of, so i am coming from a position of ignorance, but could someone explain to me why drugs seem to be many times the treatment of choice versus intense therapy? I realize doctors push drugs nowadays moreso than not, but could someone explain why you would rather take drugs than not and instead use intense therapy for mental issues many people seem to be suffering from? Was it you who initiated the idea of drugs or your doctor? angel

angelikaJ -> RE: mental issues and drugs (11/4/2009 11:30:59 AM)
quote: ORIGINAL: cagliostro OP: The treatment of mental disorders is a fuzzy science at best. Drugs like prozac affect processes in nerves that are supposed to help people with whatever the drug is prescribed for. But the fact is that science has only a vague understanding of how the brain works, and consequently how the drugs help. There is a category of drugs called SSRI's, or Selective Seretonin Reuptake Inhibitors. It's complicated, but they create an imbalance in favor of seretonin in nerves. Likewise there are SNRI's, which affect seretonin and norepinephrine. Basically they raise the level of those neurotransmitters in nerves, and consequently the brain. I don't know if anybody figured it out yet, but there are 3 neurotransmitters I know of that affect mood: seretonin, norepinephrine and dopamine. If a person's brain is deficient in any of those the drugs will help. But only if that is the problem. Hence the sort of voodoo nature of treating psychological disorder. I don't know of anyone finding "the cause" of these things. It is a little bit more complicated than that. Often it is an issue of there being plenty neurotransmitter in the brain but the chemical doesn't connect with the correct neurons. Some of the causes *are* known: many illicit drugs flood the brain with so much of one transmitter that the balance is permanently skewed. There are some genetic pre-dispositions. Chronic stress changes the cortisol level in the brain. A low (or high) thyroid level can cause symptoms of depression. Some people have a genetic defect that limits their ability to convert folate into the L-methylfolate. Low levels of Vitamin D are associated with Seasonal Affective Disorder. it can also be the side effect of certain medications.

angelikaJ -> RE: mental issues and drugs (11/4/2009 11:51:35 AM)
quote: ORIGINAL: littlewonder Did you read where I said "usually" and "many"? Yes, and that is why I chose to respond. Had you used different quantifiers, I might not have. Btw: as much as it may seem like I am pushing medications to treat everyone, I'm not. A medication will not cure grief, nor trauma sustained through abusive situations although in both cases medication may ease symptoms and as mentioned there is a medication that may prevent PTSD. A pill won't fix living with an alcoholic husband/wife. What I am trying to get across is an understanding of what medications can and can't do. I believe in a holistic approach; seeing the whole person. For instance proper diet and excercise combined with good quality sleep can go a long way towards alleviating the symptoms of depression. But getting someone who is very depressed to do those things is another matter.

sirsholly -> RE: mental issues and drugs (11/4/2009 11:53:39 AM)
And to add to Angelika's post...medicine is always an inexact science, but especially so when it comes to the brain. I hate to say the medications are hit or miss, but in some cases they are. Some are of the opinion that psychiatric care is simply milking the patient and/or the patients insurance company by having the patient return to the Psychiatrist on a monthly basis in addition to the patient seeing a therapist, but the prescribing physician needs to monitor the effectiveness of the medications and the patients reaction to them.

angelikaJ -> RE: mental issues and drugs (11/4/2009 12:00:14 PM)
quote: ORIGINAL: sirsholly And to add to Angelika's post...medicine is always an inexact science, but especially so when it comes to the brain. I hate to say the medications are hit or miss, but in some cases they are. Some are of the opinion that psychiatric care is simply milking the patient and/or the patients insurance company by having the patient return to the Psychiatrist on a monthly basis in addition to the patient seeing a therapist, but the prescribing physician needs to monitor the effectiveness of the medications and the patients reaction to them. I think in the realm of neuropsychiatry, finding the right medication is more art than science sometimes. Medication management is another matter. Many appts for medication management are what I call cattle call medicine... appointments done in 5-10 minutes tops. .

sirsholly -> RE: mental issues and drugs (11/4/2009 12:25:27 PM)
quote: Many appts for medication management are what I call cattle call medicine... appointments done in 5-10 minutes tops. this has always pissed me off....

devilishpixie -> RE: mental issues and drugs (11/4/2009 1:22:33 PM)
quote: ORIGINAL: sirsholly quote: Many appts for medication management are what I call cattle call medicine... appointments done in 5-10 minutes tops. this has always pissed me off.... I love that my therapist and pshycologist work together and meet once a week to discuss between the two of them if my treatment is working and any issues that may be coming up. My appointents for medication, last 30 minutes each month.

kccuckoldmist -> RE: mental issues and drugs (11/4/2009 2:25:26 PM)
quote: ORIGINAL: sirsholly quote: Many appts for medication management are what I call cattle call medicine... appointments done in 5-10 minutes tops. this has always pissed me off.... It is unfortunate but the people who do best with dealing with the psychiatrists that prescribe the medicine and the psychologists that handle the mental therapy part are usually people that actively engage these doctors and people fortunate enough to be able to see people they can choose and not just what is the least cost. Way too many people either just go along for the ride as they are put through the medical ringer and for many that will unfortunately include dealing with less talented or caring doctors. Medicine field can be sometimes described as part science and part art mainly because part of treating any patient requires the patient to be truthful and care enough to do what is needed. Personally I like to describe the medical field by dividing it up by people that care enough to stay modern and always on the look out for doing something a better way and people just mailing it in only learning what they are forced to learn or treat something once there one or two common ways does not work. But the biggest problem with mental health field is just the fact you have to treat people that for whatever reasons their brains are not functioning properly. Just getting them to take charge of their situation, stay on a treatment course (especially keep taking their medicine) and look for ways to change their life to help cope the best way to have the least problems and medicine in them is extremely daunting. The fact is even a totally healthy person be forced to confront having to change their lifestyle in drastic ways or take medicine that comes often with their own lousy symptoms would be a major undertaking. Outside of the “are we over medicating children in today’s society” debate which I think is a very needed and healthy debate the fact is the argument of pills being the easy way out simply is an unenlightened viewpoint. People who have to take pills are rarely happy or embrace taking them. In many ways people with mental diseases that become revealed in adulthood can mirror in ways an addict. Often fighting what they have, denial, self destructive self medicating and until they reach a certain bottom where they accept what they have and will always have and find their best way to deal. As I wrote in my previous post, there are no style points for our personal health. Anyway that works that can be kept to on a ongoing basis that can give a person the least limited and impacted life should be embraced. Only for a small percentage the popping of a pill is all that is needed and not everyone is realistically has it in them to drastically change their lifestyle and have the mental strength to wage a war on their disease in a way that no medication can work.

DesFIP -> RE: mental issues and drugs (11/4/2009 6:28:32 PM)
quote: ORIGINAL: littlewonder Drugs are usually the easy way out. They don't have to deal with the real issues. Drugs are a panacea many times. B.S. My daughter is Bipolar Type II, Adolescent Onset, Mixed States, Ultra High Cycling. She was diagnosed after six weeks in a very well respected adolescent psychiatric unit. At which time I was told she would be a pregnant, drug addicted runaway by age 16, and dead by age 20. Because no one with this diagnosis had ever survived past that. As far as we know she is one of the first sufferer, if not the very first to graduate high school. She'll probably be the first to graduate college. She will certainly be the first to gain a PhD. She is one of the top 200 national competitors in her sport, this for a kid who was told couldn't handle the stress of Special Olympics. All because a year after her diagnosis, a new epilepsy drug came on the market which not only controls seizures, but bipolar II. She will be on this medication for life in the exact same way a diabetic will be on insulin for life. Her 'issues' are having a miswired brain.

DesFIP -> RE: mental issues and drugs (11/5/2009 11:22:00 AM)
The major problem here is that people think there is no relationship between the mind and the emotions on one hand and the brain on the other. These are not 'mental' illnesses, these are brain illnesses. CAT scans of the brains of suicides show abnormalities.

VivaciousSub -> RE: mental issues and drugs (11/5/2009 4:04:41 PM)
quote: ORIGINAL: DesFIP The major problem here is that people think there is no relationship between the mind and the emotions on one hand and the brain on the other. These are not 'mental' illnesses, these are brain illnesses. CAT scans of the brains of suicides show abnormalities. Yeah, but no one really knows what those abnormalities mean yet. Correlation doesn't imply causation, yada yada basic stats. The brain is a mysterious and wonderful thing - I'm sure the answer is in there somewhere, but really if you ask psychiatrists to describe the exact mode of action of psychotropic drugs, they can't tell you - if you listen carefully, for instance, to the SSRI TV ads, they use waffle words like "it is thought that....". But, since the drugs work over placebo to a statistically significant degree, we know that something in the brain is up. Thus, it seems to prove this is physical. Also, I find that I do agree with the poster who stated that drugs are a panacea many times and a cheap shortcut. I know tons of people who do so many things to contribute to their crappy moods/depression/etc, and throw pills at it, and still struggle, but can't figure out that "genius, you're doing this to yourself to some degree". I know tons of people who take the meds, and don't do anything to improve their odds of getting off the meds, and don't struggle, but that means they're okay with taking powerful psychotropic drugs which feature unknown modes of action instead of doing the soul-searching and moral inventory that change requires. I have been there, taking the meds and full-on skipping doing any serious effort to change so long as the drugs worked. And then, I used my disease as a crutch and an excuse, because the thought of that much additional effort to change scared me. Then, the day I surprised myself and everyone else by waking up after a very nearly successful suicide attempt, and I realized that "terrified to change" was no reason to die. I also know many people who take the meds, have done/are doing the work, changed a lot about themselves and no longer need anywhere near as many pills and at are now on the lowest effective dose. Some eventually come off the meds altogether, if that's a possibility for them. Finally, it's clear reading these responses that everyone who has weighed in feels very strongly about the subject be ye for, against, or whatever. The most serious source of friction that I can identify relating to mental illnesses is that we are a society that strongly believes we ought to be able to control our behavior at all times. Mental illnesses are for the most part physical diseases that express themselves through psychological symptoms/behaviors that are often horrible, frustrating, hurtful and cruel to ourselves and to others. We are no fun to be around, dealing with us is exhausting and frightening - my first manic episode, I had a psychotic break and chased my (unsurprisingly) ex-fiance with a butcher knife. It finally took 3 ppl the size of linebackers to subdue me. Was the manic behavior my fault? No....but it didn't change the fact that mentally ill or not, I scared the ever living shit out of my ex. And boy, was he angry with me. Why? Cause I lost control. We don't like it when others, or ourselves, lose control. We feel contempt towards that, when perhaps compassion is more called for. Think of the weddings we've attended where someone got a little too enthused with the open bar and made an ass of themselves. Instead of thinking "hey, maybe they need help, I'm worried" - we come down like a ton of bricks. How DARE Aunt Susie/Uncle Fester ruin her big day! Can't they control themselves? Sheesh. And so on. Not helpful, really, and alienates our best sources of help and support. Not surprisingly then, it's easy - really easy - to feel contemptuous towards those who take meds to help control their behavior.

whiteslavebitch -> RE: mental issues and drugs (11/5/2009 5:48:07 PM)
A lot of mental disorders are chemical imbalances, and require medication to regulate them. Therapy alone is not often enough. I had suffered with depression recurrently for many years, my doctor would prescribe anti-depressants and suggest therapy. I didn't accept that I needed therapy in addition to the meds. I finally went into therapy after my marriage ended, not because I felt that I needed it, but at the request of my now ex-husband. (I think he hoped that the therapist would talk me into staying in the marriage.) It was one of the best things I ever did. My therapist helped me immensly. But it won't help anyone if they aren't honest about the issues.

Firebirdseeking -> RE: mental issues and drugs (11/5/2009 6:07:12 PM)
My two cents as a mental health professional, who has also taken some psychotropic meds: 1. the research shows that mild to moderate depression is best treated with BOTH therapy and medication. If one only takes drugs, then if and when the drugs are stopped, the issues return because they have not been addressed. 2. Since mental health is treated differently by this the "best health care system in the world", drugs ARE often the easy way out, and many people dont want to take the time to do therapy, they want the pill to cure their ills. 3. Some conditions, like panic disorder, or bi polar disorder, or major depression cannot effectively be addressed by therapy alone, as there have been changes in the brain that result in a chemical imbalance. Just like a diabetic needs insulin, sometimes drugs are needed for psychological reasons.

DesFIP -> RE: mental issues and drugs (11/6/2009 5:50:52 AM)
Vivacious, and if you just wait, you'll need lower levels of the medication anyway. Mood disorders are definitely linked to your hormones. SSRIs will put an end to hot flashes and other symptoms of menopause. Mood disorders manifest during adolescence and middle age, the two times your hormones change. Once the hormones settle down, you need less of the medication because there's less fueling the problem. There's also a huge genetic component. If you have depression, start looking into the family tree. The great aunt who no one ever talks about or visits? Probably an undiagnosed and untreated mood disorder which drove everyone else away. These are physiological issues, biochemical disorders.

VivaciousSub -> RE: mental issues and drugs (11/6/2009 6:18:58 PM)
quote: ORIGINAL: DesFIP Vivacious, and if you just wait, you'll need lower levels of the medication anyway. Mood disorders are definitely linked to your hormones. SSRIs will put an end to hot flashes and other symptoms of menopause. Mood disorders manifest during adolescence and middle age, the two times your hormones change. Once the hormones settle down, you need less of the medication because there's less fueling the problem. I'm off meds now, and I would love to stay off them forever - I've gotten this far, right? However, I am reconciled to the fact that I will almost certainly need to be on meds again at some point in my future. My mood episodes, looking back over my experience with manic-depression thus far, tend to be triggered by situations more so than strictly a biochemical shift. My best bet (but not sure bet) to avoid future episodes is to do what I did, i.e. intensive therapy, to address what specific thought processes accompanied the situation leading to the mood episode which led to needing medication. I can't control everything though, and if/when my hormones go on sabbatical and everything is turned upside again - I'll be okay with utilizing the meds in conjunction with therapy, and then go back off them when things have settled down. quote: There's also a huge genetic component. If you have depression, start looking into the family tree. The great aunt who no one ever talks about or visits? Probably an undiagnosed and untreated mood disorder which drove everyone else away. These are physiological issues, biochemical disorders. If you took a genealogy chart of my family, and colored the circles and squares "solid black" for known mental illness, and "black stripes" for unknown but likely mental illness, it'd look like Jackson Pollock took a can of black paint and just launched it onto the paper. Going back 3 generations on both sides, we have - this isn't everyone and everything by far, but to give you an idea: Mom's Side: Great-grandfather -- alcoholic, likely depressed Great-uncle - alcoholic, likely depressed Grandfather - severely alcoholic starting later in life (mid-40s), severe depression Mother - depression Aunt 1 - depression Aunt 2 - panic disorder 1st cousin #1 - BP 1 1st cousin #2 - BP 1 1st cousin, #3 - alcoholic 1st cousin, #4 - PTSD Dad's Side: Grandmother - post-partum depression (institutionalized for 4 months in the early 1960s after my dad's youngest sister was born), BP Father - cyclothymia, probably OCD Uncle - OCD Aunt - PMDD, BP 1 We all well versed in the mental-hilarity! I'd love the researches to come test our genes for this stuff.

ranja -> RE: mental issues and drugs (11/11/2009 5:52:15 AM)
The amount of bored housewives on Valium prescribed by doctors was astronomical for quite a few years i have an in-law who has been in therapy for most of her life and also on meds... nothing is working 'cos she is just wallowing in the attention, depression is a lifestyle for her. my dear grand ma suffered dementia... there is no medication or therapy that i know of that can cure or even lessen it. When i have a headache i take paracetamol and when i feel down i take myself for a long vigorous walk, and i have to say that i am pretty sure that that would work for my depressed in-law as well if she could be bothered to get off her fat arse. my Husband suffered panic attacks a few times... initially He took some drugs to alleviate the panic, but eventually He managed to control His problem Himself... He would not go and talk to a shrink... that kind of therapy would just humiliate and totally disgust Him. My mother was in therapy for god knows how many years... i do not think it made the slightest bit of difference and she might as well have gone to a knitting group. My niece was in therapy and within a few sessions she improved I think depression is used like back-ache as an excuse to be lazy by many people and i think they should stop moaning and get on with it like the rest of us. And i think that for the genuinly ill people it is a total struggle to get and remain on top and i wish them all the best.

Missokyst -> RE: mental issues and drugs (11/11/2009 9:06:08 AM)
I have been quite shocked to see how many times I see people with mental disorders on the various bdsm boards I read. It is practically normal now to see bi-polar here, whereas in my doll groups I don't see a lot of that. I have issues myself but have found ways to manage around them or use them to my advantage, however those issues are more psychological rather than physical. I don't do drugs in general. That said... having known more than a few people who are bi-polar, or have other more serious issues I say, give them drugs! It makes them more content. It helps them manage and that helps them see the signs more clearly. Anything that can help someone find a way to cope is a good thing in my view. I do wonder though are some illnesses over diagnosed? My nephews wife is bi-polar, but I only see her act in the extreme when she is drunk. She is an alcoholic and if she can find any liquor around that is when the madness ensues. quote: ORIGINAL: barelynangel I have a question i see so many people when it seems like a vast amount of people on the boards claim some type of mental issue and they take drugs for their mental issues and the advocating of same on here is like watching commercials on TV for same. I don't have any mental issues that i know of, so i am coming from a position of ignorance, but could someone explain to me why drugs seem to be many times the treatment of choice versus intense therapy? I realize doctors push drugs nowadays moreso than not, but could someone explain why you would rather take drugs than not and instead use intense therapy for mental issues many people seem to be suffering from? Was it you who initiated the idea of drugs or your doctor? angel

Rastimmipitwax -> RE: mental issues and drugs (11/11/2009 9:25:57 AM)
Psychiatry and Psychology are a branch of science/medicine that is in its infancy, practitioners are beginning to have an idea what they are doing, but only just. I know many who have no doubt that there is a lot to learn, and that all possible therapies have to be investigated for merit. This includes drugs, therapy, diet and exercise (it is amazing what healthy eating and regular exercise can do), even such crazy-sounding things as biofeedback and meditation (but there is also a lot [understatement] of BS and hucksterism in these areas). For that matter, "modern medicine" itself is in its infancy compared to traditional practices, which go back thousands of years. quote: ORIGINAL: angelikaJ Which counseling method will help SAD (seasonal affective disorder). (There are studies now that show Wellbutrin can actually prevent it.) While I agree with you in general that therapy is not capable of curing serious brain disorders, I can say without the slightest doubt that Wellbutrin does very little to help victims of SAD. Wellbutrin works great for general or monopolar depression, but only very mild cases of SAD respond to it at all. There are some research studies that seemed to point to it as useful, but more that indicate the opposite. On the other hand, an SLT lamp (SAD Light Therapy) has proven almost universally effective, and I can vouch for it personally having used both Wellbutrin and an SLT lamp and tested them both individually and together. The lamp has no effect on my monopolar depression and the drug has no effect on my SAD. The biggest problem is that neither are a cure; once you stop taking/using them, your are soon right back where you started. This is fine with me, I can continue using them indefinitely. Now if I could just find a cure for procrastination I'd be set for life [8D] quote: ORIGINAL: Missokyst in my doll groups I don't see a lot of that. Is that "living doll" or "making/collecting dolls"? Most certainly there is as much going on with the living doll community as with the BDSM community, and well...let's just not go there on the subject of other sorts of dolls, especially combined with the ... inspiration ... to collect

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