Heck, maybe I am depraved, drug addicted, and weak.
I don’t care. I don’t want to die.
And if one day it comes to drugs to keep me from suicide (which I suspect will one day be the case) then I’m gonna take the drugs. And it doesn’t matter one whit whether you “believe” in depression or not.
Um, lander, ever heard of molecular biology?
No, since they don’t have specific effects.
What seems to be the case to you is entirely irrelevant. As long as you don’t even know what a hormone is, don’t know what diabetes is, and don’t know what antidepressants do, all you are doing is ranting about issues you have no idea about.
There is several types of diabetes, and they are caused by a multitude of factors. Insulin is used because insulin is precisely the problem in diabetic people. For the same reason, antidepressants are used, because they address precisely the problem with neurotransmitters depressed people have.
(cf. eg. Life Sci 2003 May 23;73(1):1-17 ‘G protein signaling and the molecular basis of antidepressant action.’ by Donati RJ, Rasenick MM.) Do you even know how antidepressants work? Do you know what serotonin is? (Cf. also Tafet GE, Toister-Achituv M, Shinitzky M. ‘Enhancement of serotonin uptake by cortisol: a possible link between stress and depression.’ in
Cogn Affect Behav Neurosci. 2001 Mar;1(1):96-104. Sulser F. ‘The role of CREB and other transcription factors in the pharmacotherapy and etiology of depression.’ Ann Med. 2002;34(5):348-56, McLeod TM, Lopez-Figueroa AL, Lopez-Figueroa MO. ‘Nitric oxide, stress, and depression.’ Psychopharmacol Bull. 2001 Winter;35(1):24-41. or Muller M, Holsboer F, Keck ME. ‘Genetic modification of corticosteroid receptor signalling: novel insights into pathophysiology and treatment strategies of human affective disorders.’ Neuropeptides. 2002 Apr-Jun;36(2-3):117-31. and many, many others)
And yes, that major change in brain chemistry CAUSED their grief. Because it is that change in brain chemistry that evokes emotions. What is at issue is what caused that change in brain chemistry. In one case, it is a temporary experience that can be dealt with. In the other case, it is an underlying change in the neurological makeup of the brain.
They either “dealt with it”, or ended up in a mental institution, I imagine. Either way, their quality of life was diminished. I’m not sure what your point is, though. If I couldn’t walk, I would get around in a wheelchair, because that would be my only option. But I certainly wouldn’t choose to.
They don’t cure. The effects of antidepressants only last as long as the person is taking the drug.
SSRIs like Prozac do not make you “high”. If it allows a person who would otherwise have a debilitating condition to function, what’s wrong with that?
I don’t think you really understand what major depression is and how serious it can be.
What effect do they have on “normal” people?
You clearly do not understand the distinctions between the categories listed above. But I’m not sure you’re willing to listen to anything but your own ramblings.
No, it’s not. Herbal medicine - which is what you’re talking about, essentially - is notoriously inconsistent and the quality varies all over the place. That’s one reason for the rise of the pharmaceutical manufacturer - quality control and consistency, so that if you take something you know you’re taking a reaonably pure substance of a known quantity.
And you are correct that some people self-medicate… but the long term side effects can be very unpleasent.
Not exactly.
First of all, there is a distinction between “smack”, a street available, heavily “cut” - with God knows what - product of highly variable quality and purity and a drug like morphine or heroin. Morphine is administered for acute physical pain, such as arising from surgery or traumatic injury in a controlled setting where (ideally) the minimum amount required for the job at hand is used. “Smack” is typically self-administered for mental pain in an uncontrolled setting, using the maximum amount short of killing the person (if that can even be determined, given the uneven quality). Perhaps there is no difference to you - there is to a lot of the rest of us.
As a matter of fact, it can be when administered in sufficient doses.
Absolutely - I’ll die without it.
You do not understand.
Diabetes is several “physiological conditions”. It is NOT “spawned” by diets full of “processed junk food”. Diabetes was first described and named in ancient Greece, thousands of years ago, long before junk food was invented. In those days it was invariably fatal. If there weren’t a lot of diabetics around until the 20th Century it’s because they all died in a fairly short time after diagnosis. Or, if they had adult-onset they went blind or had their limbs rot off or their kidneys fail and never knew why.
To answer an earlier question - in the old days, folks who couldn’t find a way to cope with their mental illness either wound up dead, in jail, or in a madhouse. A substantial number were not able to “deal with it” and yes, some did “crumble into perpetual anxiety attacks and depressive states”
Speaking as someone who works in the Evil Insurance Empire: What will and will not be treated varies from one insurance plan to another, at least here in the US. Some will only treat on strict, DSM diagnosis. Others allow more leniency. A clear case of “your mileage may vary”
Yes Yes YES!!!
I can’t tell you how many people have told me that my ailments would go away if I’d just “grin and bear it,” or “chin up!”. Or if I just accept JAYSUZ!!! into my heart.
Or they tell me that medication is just a crutch. Yes, it is. So fucking WHAT? I wonder if they go up to the man with one leg and yank his crutch away and scream, “Walk on your own!”
:mad:
blowero:
Very well put.
Hey, lander2k2, since this thread is similar to this previous thread, do you think that you could give us some type of cite for a statement that you made?
Normally I wouldn’t do this, but your arguments in this thread are essentially the same, and I was curious about your answer.
Do you know the difference between addiction and physical dependence? I ask because you seem to be using them the same way in this statement.
spectrum
There is also a social myth, a hateful, destructive social myth in our society, that venerates and praises the wonders of the pharmaceutical industry and the efficacy of the psychiatric profession. Says mental illness is a biological condition of the brain, a physiological brain malfunction, and that the pills the pharmaceutical companies manufacture and the psychiatrists prescribe are magic bullets that go right in there and fix the nasty old chemical imbalances and make everything right as rain. And when some of us find these little mind modifiers to be not to our liking, we are said to lack insight into our condition, for which reason we should be stripped of our right to make our own treatment decisions. And when people like Lander point out that arguments supporting psychiatric drugging here in this thread could be applied in support of (recreational) drug pushers and junkies and their relationship with each other, people get offended.
Hey, if medication helps you face the day, more power to you.
But it is true that the arsenal of psychiatric medicines is composed mainly of clumsy systemic neurological impediments – broadly effective chemicals that mess around with synapsing either by directly impacting neurotransmitters or indirectly by impacting uptake mechanisms that would otherwise soak up certain naturally occurring neurotransmitters or neurotransmitter catalysts.
The ones that have been around long enough to have been studied tend to show signs of being dangerous. Every decade brings its new shiny “atypicals” or “new generation” antipsychotics and antidepressants which don’t have such side effects, and then time goes on and it turns out they do, too.
And it remains as true as ever that depression, like all the other psychiatric diagnoses, consists of its symptoms. There is no underlying physiological condition that has ever been substituted in the definition such that if you have the symptoms but don’t have the physiological condition you don’t have the mental illness. Furthermore, the symptoms which constitute the disease are spelled out in such a way that there are no formal explicit criteria which must be met before the diagnoses can be confirmed, nor any which, if present, rules it out, so its existence in any given case remains a matter of opinion.
Kindly keep in mind that while the psychiatric profession and its pills may have saved your life, many others have not experienced them so benignly, and we are tired of hearing their positions reflected in the general social opinion as if they were neither dangerous nor controversial.
AHunter3, I agree with 90% of what you wrote, and what you say is worthy of a Great Debate. However, it is off topic from the OP. I would welcome a thread that focuses on the flaws versus strengths of psychiatry with respect to depression, as well as a thread on the state of current knowledge about depression as a physical illness.
To bring your comments back to the OP, what situation, if any, constitutes an appropriate use of these chemicals in your view?
General social opinion? I don’t think so. The general social opinion about psychiatry is that it’s creepy, and the drugs are too expensive or don’t work very well.
The only people with the opinion that they are neither dangerous nor controversial are the pharmaceutical companies and the psychiatrists, IMHO. I don’t know anyone who doesn’t think psychiatrists are out of touch or a bit nutty.
It’s not utterly off-topic: the belief that various psychological disorders have physiological causes is usually cited in defense of our current standards of treatment.
Heck, maybe we should start up another GD thread about psychiatry…
You might wish to browse through these old ones first, although it would be my recommendation that you not POST to them.
Dear Sister, please take your lithium
The Role of Culture in Mental Illness
What does it feel like to have schizophrenia?
ECT - Living Better Electrically
If schizophrenia is a virus then…
How can you be committed against your will?
Do the mentally ill have voting rights?
If you Know Anything About Manic Depression Please Read This
Uuuh…
[shudders]
I really don’t need to read any more about ECT, thank you very much.
Hunter, how are SSRIs dangerous?
What seems to me, AHunter, is that you lack a fundamental understanding of molecular medicine. Yes, antidepressives modulate the effect or production of naturally occuring neurotransmitters. Rather than being ‘clumsy systemic neurological impediments’, it means they are designed to the specific task they are needed for. If there is a high activity of a given signalling pathway in the brain, you need to tone it down to abolish its effect. That might be treating symptoms, rather than causes, but it is all we can do until we understand more, and is a practice that is common in similar situations (such as HIV) when there is no treatment for the cause, or the cause is unknown. Doing so is not any more clumsy as modern anticancer drugs targeting specific growth signalling pathways is. Gleevec, a modern drug to treat certain kinds of leukemia, for example, specifically inhibits a certain type of enzymes one of which is excessively active in that type of leukemia.
What you are doing is no more and no less than calling someone ‘clumsy’ for using a screwdriver to turn a screw.
That has NOTHING to do with recreational drugs, which are applied by people without any knowledge of their actual effect, without control of their composition, and their side effects.
It is funny that you spew venom at psychiatrists and corporations when in fact, the people you should complain about is the neurologists at public research institutions which provided the basic research about neurological systems that the psychiatrists and companies merely apply. You can continue to believe all of them are morons, but please accept when you are considered one in return.
No, they’re not. Oh, they’re better than what we used to have, but that doesn’t mean they paragons of precision.
A comparison would be saying how much better a job we’re doing now that we’re driving screws into a 2x4 with a hammer instead of a rock. Uh, yeah, the screw is, actually, in the 2x4 and it’s somewhat prettier than when we were using a rock to bash, but it ain’t a screwdriver yet.
Back to the diabetes comparison – insulin doesn’t cure diabetes, it keeps the symptoms and damage under control IF used properly. Likewise, mental illness can be treated but we don’t have a definitive cure.
Again, better than our old “poison everything and hope the person survives” approach to chemo, but still not a picture of elegance. Gleevac et. al are better than what we had before but nowhere near perfect.
I’d say it’s knowledge of their effects that prompts people to take them. Do I think there’s a difference between recreational and therapeutic drugs? Yes. But not as much as some folks would like us to believe.
MY main objection to what is being discussed here is “cookie-cutter” medicine. The idea that if you are showing a particular collection of symptoms you have Label A and should take drug X at Y dosage to achieve effect Q.
People are all different, and so are their mental landscapes. Just taking depression - yes, some people are depressed due to innate chemical imbalances (apparently), but chronic unrelenting pain can also trigger depression (maybe in most people), as can a sufficiently traumatic event (at least in some people). Similar symptoms, three different causes. If it’s innate, you may need treatment/support for the rest of your life. If it’s chronic pain, then when you can eliminate the cause of the pain the depression may well lift on it’s own - but meanwhile, so long as the pain lasts it lasts, and if you can’t get rid of the pain then you, too, may be in the “treatment for life” category. And for those affected by trauma - treatment may bring them back to normal after enough time. Does anyone seriously think all three categories should be shoe-horned into one treatment plan? Well, yes, actually some people do. And I think they’re wrong.
I really hate the push towards simply handing out drugs as “treatment”. It’s not. It’s woefully incomplete. After years of neglect other modalities - talk therapy, behavioral therapy, even job training - are needed to truly restore a person to functional life.
I also am very nervous about the idea that there IS a norm. How “normal” do you need to be? When does “eccentric” become “mad”? Some very creative people in our past, if they were alive today, would be heavily medicated - and perhaps not as creative. How do you determine the dose of a drug? What about side effects, which will vary enormously from person to person, and over time?
I am not a person who makes “mainstream” choices in my life - but I most days I’m happy with that. That doesn’t stop people from trying to change me and make me fit it with the herd. Likewise, who determines what “normal” and “healthy” is for the mentally ill? Certainly, if someone is catatonic or wildly hallucinating, a danger to himself or others, we can all agree there is a problem - but what about a person who is “moody”? Should he be drugged into being a compliant corporate drone, or, so long as he is able to fend for himself in the world, allow him his “moodiness” if he wants it?
How about the “social anxiety” thing the drug companies are pushing? Who defines that? Is it a problem if someone prefers their own company? Do you have to have a lot of friends and social a lot to be OK, or do we still allow for the person who has just a few close friends, doesn’t get out much, and is happy with that? Folks who are UNhappy with their situation are a different matter, but in some cases that could be cured with better personal hygiene and perhaps some classes in manners and which fork to use at dinner rather than a beter SSRI
Sorry, but that is not a valid comparison, for the reasons I specified. The symptoms are consequential of improper signaling through neurotransmitters. Which is precisely what the drugs address. Serotonin levels DO affect our mood, and as such, modulating serotonin levels DOES modulate our mood.
What would be your idea of a ‘perfect’ treatment? I seriously doubt that something you would consider perfect will ever exist, for the simple fact that a given cancer more often than not is not one single disease, but a bunch of different and distinct cells going haywire.
The cells grow out of control and don’t die when they should. If you manage to prevent them from growing and get them to die, you have addressed the problem.
Yes, Gleevec has its shortcomings. But they are in a whole different ballpark. It does what it is supposed to do admirably well, with the big problem being that it doesn’t cross the blood/brain barrier, and as such, leukemia cells that have already reached the CNS can survive.
I’d say it is kidding themselves into knowing the effects that prompts people to take them. It is ridiculous to claim they would know of the effects say, extasy has on the brain.
And I think that you probably have very limited knowledge of what it takes to get a drug on the market. Clinical trials aren’t child’s play, and most stories you find on the web are plain and simply scare stories by people who don’t grasp that the FDA is not the authority for worldwide approval of drugs, but merely for the US, and that most big pharmaceutical companies are global players.
What you fail to understand is that you’re talking about yesterday’s therapies, not today’s (though still widely used today, since most of today’s doctors got their education yesterday), and not tomorrow’s.
What you fail to understand is that you’re not talking about three different causes. The chemical imbalance is involved in all cases. It is the level of neurotransmitters that makes us feel a certain emotion. The difference between the cases you describe is not that an imbalance is involved in one case, and not in the others, but rather that the imbalance is permanent or semi-permanent in one case, and not in others. Addressing the chemical imbalance will help in all cases, but in some, it is unnecessary, in others, it can easily be stopped after a time, and in others, it will be necessary for a lifetime.
There are feedback mechanisms in our physiological system that can reinforce, or mediate, signals. When these get a serious kick, they can sometimes go haywire. In some cases, they will find back after a while. In others, they won’t. Genetic predisposition can make it particularly hard for a given individual’s system to come back to a balanced level. As can the subjective severity of the triggering experience. It is a pendulum that strikes out in one direction. Normally, it swings back pretty quickly. Sometimes, it takes a bit longer. Sometimes, it looks like it is stuck.
In the case of depression, in a lesser event, the mood might persist for hours, for days, and in the case of serious grief sometimes weeks. But when the return time goes into years and approaches a lifetime, then you have a serious problem that needs to be taken care of.
And I am not sure where you see that push. If anywhere, that push is in the public, which wants to pop a pill for everything and get on with their life. Therapy is an integral part of practically all psychotherapy, but and that is the important thing to keep in mind it is not always enough. There are cases where this kind of therapy doesn’t cut it, and where drugs are needed.
See above. I suggest you inform yourself on what is done during clinical trials, since it is precisely all of these points that are being addressed.
Last time I checked, drugging someone is a severe violation of his privacy that needs a very good and convincing rationale to be legal.
I am not sure what you understand under ‘pushing’, but being in the biomedical field, I see little but the usual hype a company lets out at every release of a new drug on the market. What you should keep in mind is that the US is but one market, and not even the largest in the world, and that for those companies that count, the world is what matters. A product that takes decades to develop but gets only accepted by some fundamentalists in the US is going to be pulled quicker than you can say ‘Oops’.
But the signally is considered improper only because we don’t like the symptoms. All you’ve demonstrated is that drugs can affect our states of mind.
For starters, it would deal with the underlying problem instead of altering symptoms. We don’t know what the underlying problem is with mental illnesses, or even whether all people considered to have a given disorder have the same underlying problems.
** And the pharmaceutical companies are the ones who do the testing and choose what results to report to the FDA.
** First of all, there’s about a twenty to thirty year gap between medical research and medical practice. Secondly, therapies aren’t magically wonderful just because they’re new.
There isn’t a known “chemical imbalance”. That last sentence is also a gross oversimplification.
No, you’re merely generating this statement from your assumption that a “chemical imbalance” is responsible for depressive states.
Incorrect. You don’t know anything about the treatment of depression, do you?
And here’s no way of determining who’s who without trying them…
** What “balanced level”? What characterizes a “neurotransmitter balance”?