[Guest]

I just want to clarify something that Sojourner said (in fact, it's part of her signature now in her posts). While it MAY be true that if someone responds to anti-depressant medication, then that shows they were depressed, that is NOT always the case.

Very important because I'm concerned on two counts here:
(1) someone might try anti-depressants and get NO help, and then deduce (incorrectly) that therefore, it proves they are not really depressed to begin with; and/or
(2) someone with a variety of all kinds of mental anguish will BE helped from an anti-depressant and assume they DO/DID HAVE clinical depression. Not true either.

THe ssri's often work on "normal" people - doctors even write about this effect, calling it "making people feel BETTER than normal" - sometimes increases in serotonin will give someone a "high" feeling and that is indeed BETTER than normal...such a person might not have been depressed to begin with.

Also, people with intense underlying anxiety are often helped by anti-depressants - and NOT necessarily because they have some "chemical imbalance" but because for the first time, they are able to RELAX and feel emotionally safe with themselves. Nothing wrong with continuing to take the med - to use it to help them cope better. But responding well to an anti-depressant is NOT a diagnostic of Depression. No way.

Also, MANY many MANY very very depressed people fail to respond well to any anti-depressant med.

The mind is very complicated and there is no easy way to disentangle the psychological from the neurochemical.

Just don't let yourselves make sweeping assumptions about medication. Not only do different meds respond differently to each of us, but even the SAME PERSON might respond differently to a med if tried years later.

All the best,
Janine

 

[Dreamland]

Are you of the opinion that a chemical imbalance causes depression/anxiety, or is it possible that being depressed or constantly anxious will cause your chemical composition to change. The reason I'm asking this is because many chronically depressed people are often subjected to a whole laundry list of medications during the course of their illness. Nowandays they'll inititially prescribe SSRI's, if that doesn't work they'll switch to SMRI, followed by tricyclics or other heterocyclics, and finally MAOI's. Your body gets used to the medications but your soul is continuously eclipsed by a dark cloud.

 

[Guest]

I think it can be both. Mind and thoughts can alter brain chemisty and haywire brain chemistry can alter thoughts and feelings. Depends on the person, depends on the day.

But I think many more people are subject to psychological triggers than most people CURRENTLY realize, only because the money spent on advertising in the last decade has promoted the public opnion to believe first and foremost in "chemical imbalances" as if they are always a biological cause. So my particular bent is to try to point out the OTHER side - and it was also what ended up being true for me (the psychological source rather than biochemical)

 

[Sojourner]

Janine,

I am open to changing my signature if it is in error.

I am astonished to hear what you have said about normal people getting a high from antidepressants. My doctor has told me numerous times that normal people don't feel anything at all. I intend to ask him about this again.

Can you refer me to more information on "making people feel BETTER than normal"? I'll look for information myself, as well.

With regard to the two counts you were concerned about, I certainly didn't address those things, but my presumption was that anyone who does see a regular doctor first and then a psychiatrist, if one is recommended, would ask his or her doctor about any questions. I'm sure there are myriad other questions.

I appreciate your clarifying things that I say and correcting me if I am mistaken. I am really surprised to learn what I learned from you just now. I would regret causing anyone to have any misconceptions.

Sojourner

 

[Sojourner]

Some interesting links:

http://www.eurekalert.org/pub_releases/ ... 020503.php

The following seems to disagree with you, Janine, but I will continue to look for further information that explains what you said:

http://www.mental-health-matters.com/ar ... ?artID=120

 

[Sojourner]

Brian Knutson 1998 serotonin

Searching for the above on Google provides interesting links.

What I have learned is:

- Antidepressants do not produce euphoria in normal people
- Antidepressants can affect normal people by making them less reluctant to take risks and can alter some personality traits, such as a tendency to display hostility

More links:

http://www.eurekalert.org/pub_releases/ ... 020503.php
Brain images reveal effects of antidepressants

http://www.mental-health-matters.com/ar ... ?artID=120
"When I suggest to a new patient that they consider antidepressant medication, I get a picture of all the misconceptions people have about what these medications do. First of all, they are not happy pills; they don't artificially induce a feeling of bliss or unrealistic well-being. No medication can do that, except for alcohol and some illegal drugs, and their effects don't last. Nor do antidepressants insulate you from life, make you not care about important things, or insensitive to pain or loss. Tranquilizers can do that, for a while, but antidepressants can't. Also, antidepressants aren't addictive, nor does their effect diminish so that you will have to increase your dosage later on. What antidepressants do is somehow prevent us from sliding down the chute into the blackest depths of depression when something bad happens. We still can feel hurt, pain, worry, but we feel these like normal people do, without depression."

 

[dakotajo]

This is only my opinion. I believe severe anxiety and depression have an organic cause. I believe that our mind is at the mercy of our brain chemistry and not the other way around. The only way I can see any type of talk therapy even a little bit helpful is to aid in stress reduction. As of right now, anti depressants are the closest thing to a cure.

 

[Dreamland]

There have been some interesting experiments conducted by healthy people who began taking Paxil to see if it would alter their mood in any way shape or form. It apparently does change for some. A couple of these subjects changed so drastically that they had second thought about participating in this study. Healthy people feel the effects of benzodiazepines since they affect gamma aminobutrtic receptors in the brain equally. The same goes for other mood altering medications. Did you know that MAOI's were discovered by accident as far as treating depression? They were initially intended for treating tuberculosis but some patients began feeling better, as a side effect; these were people who were not depressed! I wonder about the chemical imblance theory; for a few, yes. For most people, probably not. But I could be wrong.

 

[Guest]

I don't know of any sources offhand. In time, I'm sure I'll come across some and will gladly post.

I'm also not trying to be disagreeable - it's only that MANY people react in wildly varied ways to different psych meds. There are no absolutes where psych meds are concerned.

Often someone with a latent mood swing proclivity (touches of Bi-Polar Disorder) will develop a kind of manic high if they use SSRI's (which is fine, except IF they are indeed Bi-Polar, there will be a devastating crash into depression soon to follow). Many psychiatrists hand out SSRI's without making any effort to see if the person's history or personality in interview indicates a possibility of Manic Depression.

NOrmal people (if there is such a thing, lol...by "normal" I mean someone who has no complaints about disturbing symptoms) may feel VERY good once an anti-depressant kicks in. That can be true for a variety of anti-d's. It's the same argument the A.D.D. people use about the use of Ritalin - they say that ONLY a person with Attention Deficit Disorder would function better on Ritalin, which is simply UNtrue. Ritalin is speed, and a normal person often feels more focused on it - just as they do after drinking two cups of coffee.

Again, I AM NOT ANTI-MED. I took meds for most of my life - I needed some extra help to keep me calm and at least relatively able to function. I was crippled without my medication. (crippled WITH it, too, lol). But I did not have any kind of "chemical imbalance" - my anxiety states and dp and obsessiveness were lifelong conditioned states of mind that I had fallen prey to for psychological reasons.

My point is that meds can really be helpful WHETHER OR NOT there is anything biochemically wrong with a person. And sometimes a person can have something biochemically wrong and be unable to find medication that touches it.

I think we as a country have gone WAY TOO FAR into the "I have a chemical imbalance" rationalization. Some people might have one. But there are also many people who are mental wrecks for a complicated set of psychological causes - and I've actually seen more people make major changes in themselves from therapy than from medication. Again, if someone needs a med, TAKE IT. But don't assume that "needing" it means there is something biochemically wrong with you.

Peace,
Janine

 

[Sojourner]

Janine,

You said, "Again, I AM NOT ANTI-MED. I took meds for most of my life - I needed some extra help to keep me calm and at least relatively able to function. I was crippled without my medication. (crippled WITH it, too, lol). But I did not have any kind of "chemical imbalance" - my anxiety states and dp and obsessiveness were lifelong conditioned states of mind that I had fallen prey to for psychological reasons."

As far as I am aware, there is no existing way that you or anyone can correctly determine whether mental illness is caused initially by a chemical imbalance or strictly psychological reasons. All mental states are a result of brain chemistry; whether psychotherapy changes your brain chemistry or medicine -- the end result is STILL normalization of your brain chemistry.

You may FEEL that the cause was psychological only, but you really cannot know that -- not even the experts can determine that. If you believe I'm in error, please explain why and tell me how you can know what is currently beyond the best medical understanding to date.

Brain imaging work has been done, but as far as I know, causation is impossible to determine.

Looking forward to your reply.

I agree with everything else you said. ; )

 

[Guest]

Well, sure. TECHNICALLY, no one can know these things.

But here's the deal: I was a mental wreck for over 15 years (teenage years through my 20's into early 30's). Had therapy and medications. nothing worked. I also didn't DO much in therapy except talk about how terrified I was.

When I was 32, I found a therapist I really liked - it took over a year for me to decide I could MAYBE trust him, but somehow we clicked and I started to really tell him things. I looked at thoughts and feelings I had never told anyone - explored turf I had refused to look at.

I even remember the day I thought "I have to do this...I have to. I am losing my damn mind...I have to ONCE find some ONE human being to trust...and truly try this..." And he was kind to me and caring, but not at all patronizing. He also PUSHED me and challenged me and did NOT tell me just stuff I wanted to hear.

Could it be coincidence that my brain dysfunction suddenly cleared up at the precise time I got deeply into this psychological work? well.....anything is possible, I suppose.

People who have had real success stories with therapy will tell you they could FEEL the shift once they got deep into the work. Same for me.
My anxiety and dp were based in psychological mechanisms - because the symtpoms VANISHED (over the years of the work). My "Fear" responses to ordinary fearful situations (I was in NY during 9/11 for dramatic example) are now ORDINARY fear levels. It never takes me into "dp land" or the mental state of bizarre and obsessive anxiety.

Before, when i had symptoms, I would have SWORN that my general Fear Meter was just set higher than normal. But it wasn't so.
There is almost a different intrinsic FEEL to the types of annihilation anxiety and terror that encompass mental stuff - I can "feel" the difference now. Can't explain beyond that, sorry.

And everyone is different. I'm not saying you do NOT have a chemical imbalance. You might very well have one. I just didn't want the generalization to be made for others. I am not trying to tell you what you have, please don't think that.

Peace,
Janine

 

[Dreamer]

Before, when i had symptoms, I would have SWORN that my general Fear Meter was just set higher than normal. But it wasn't so.
There is almost a different intrinsic FEEL to the types of annihilation anxiety and terror that encompass mental stuff - I can "feel" the difference now. Can't explain beyond that, sorry.

Janine, you already know I'm more on Sojourner's wavelength here. I recall reading about "normal" people "feeling better" after Prozac in I believe that book by what's his name, Kramer. "Prozac Nation" ... what is the name of that. He was very critical of the drug when it was introduced.

Also, I believe all of us have unique experiences. One person's DP/DR can stem from panic attacks and will occur only during a panic attack, others have it with depression, or OCD. In many of these cases when the "primary" illness is treated, then can't remember what DP even felt like. I know several such people personally.

I know my general fight or flight meter was off since I popped out of the womb. I'm certain of it ... but as my signature says, "Confucious say ... certainty is ridiculous." And that is true to a degree. I say that to myself when I catastrophize and am certain the worst possible outcome will happen.

But here is yet another unique example. H from here on the board. When she was a young woman, still in high school, out of the blue she had a psychotic depression,heard voices, had DP/DR (hope I've got the story straight). She was AWARE the voices were wrong to be hearing. She asked her parents for help.

They had private insurance, not just the NHS, which made the change for her. 6 months in the hospital, drugged up with antipsychotics!!!! YIPES. :shock: (The diagnosis was schizophrenia, but that was incorrect .. it was a severe depression with psychotic features.)

Well, she said, one morning, she woke up, and was feeling better. The voices had stopped, her energy returned, the darkness lifted. She was left with some DP symptoms. Her hands not looking like hers, etc.

She visited us in L.A. and had a wonderful time with my husband as I didn't have 1/100th her energy. She also noted to him that I had sky high anxiety that she didn't have.

She has moved on with her life. Has not had any extensive psycotherapy. Last I heard she has a Ph.D. in Neuroscience and enjoying life.

Her story would indicate that 6 months in a hospital bed on Stellazine (or Thorazine), "HEY STELLAAAAAAAA!!" 8) "cures" psychotic depression.

But her UNIQUE experience doesn't speak for the experience of anyone else really. It's rather unusual.

I feel my anxiety was exacerbated by verbal abuse and my mother's borderline tendencies, the lack of love at home, but I was born anxious. I am conditioned, like a tortured dog, to overreact to the smallest bit of stress.

I see I have psychological issues, and phsyical symptoms. They interact, but I believe the biological is the primary problem, though had I had early intervention by a loving parent, I may not have chronic DP/DR.

What has helped me? Meds, some sane psychotherapy wherein I learned I was the sane one in the family, and recently group (and I stress GROUP) DBT/CBT where I learned I was far from alone thinking and feeling certain ways, and I had control to recondition myself, though this will be a life long battle. Hard work.

And for all I know ... a miracle could occur, and I could go into remission.

I just think it's important to acknowledge that we are all different. And WHATEVER works ... gotta go for it.

D,
The Hairball and Ramachandrian :shock:

Quid Pro Quo, Clarice????? 8)

 

[Dreamer]

PS, man there is ALWAYS a PS...

I recall my mother the shrink did a bit of an experiment on herself, and this was something other colleagus had done, and is documented.

If a healthy person takes a high dose of antipsyhotic, they're bound to end up laying on the floor in a stupor. If a schizoprhenic takes a high dose, they STILL may rip the doors off of the bathroom stall in the psych ward -- known to happen frequently. It takes MUCH more medication sometimes to "bring them down" whereas a healthy person feels like Hell, sometimes on a small dose.

OK, end of lecture.
In the spirit of healthy debate. 8)

 

[Guest]

Between "STELLLLAAAA!" and "quid pro quo, Clarice..." I am in hysterics that The Hairball Returneth.

Agreed. And I am not trying to be overly certain here. But..for ME, for my own experience and those of many people I know personally, there is a "trigger" of some symptoms that is eventually perceived after long and successful therapy. A few years into it, I could bring ON massive dp and anxiety if I "went into" certain topics, or if I tried to ignore certain things....as horrible and unpredictable as my symptoms had always seemed to me all my life, suddenly there was an ON switch and soon an OFF switch too. I would not have believed all this myself, had I not seen myself repeatedly spiral into hyper-DP hysteria from NOTHING but a single and highly predictable series of thoughts.

I even remember, in my delightfully sarcastic way, saying to him "Well, lovely. NOw we know how to bring it ON. Is that all I get for my money and time?" lol

But everyone be unique.

each of us.
the quids

and

the pros



Welcome Back, Ball du Hair

 

[Guest]

COMPLETELY true re: the anti-psychotics! yes!

And in the 60's the E.R.'s DID often use them as diagnostics - if they did not know if a patient was schizophrenic or having a manic anxiety state, they'd give them high doses of thorazine. If it helped, probably schizophrenia. If they knocked the person unconscious for days, probably not.

 

[Sojourner]

Janine,

If you were not on antidepressants at the time, I would tend to agree with you. But if you were, how do you know that they didn't dispose you to open up at last?

I have been open since day 1 with my therapist, but she insists I have a delusion about how I look. They say I have BDD.

 

[Guest]

They MAY have disposed me to open up - but my wearing a facade and keeping all my thoughts secret and leading a kind of double life was not the result of a chemical imbalance. And the talking didn't "Cure" me per se, it's not the saying of words cured me - but those actions laid the groundwork for ME to finally look at parts of me I was lying to myself about - and then to TRULY take the reins of my own life instead of fooling myself into thinking I had them.

Also, I was on anti-depressants and tranquilzers since i was 18. I also took antipsychotics for awhile - for my own delusions.

Meds help reduce the overwhelm. But if there is psychological stuff that a person has not dealt with, the psyche is held together in a VERY fragile way (defenses that are massive keep the person teetering constantly on the edge of TOO much reality versus Not Enough)

The valium calmed me. Anti-depressants gave me the PUSH to at least not end up in a hospital. But the recovery from my symptoms came from the changes that happend to me psychologically over a period of years. (and still are happening, it's ongoing, I'm sure for life).

Again, I am NOT saying you're like I was.

But if you also have Body Dysmorphia, there may be more at work in the psyche than "only" a chemical imbalance.

And I am NOT judging anyone who has a chemical imbalance. I WOULD RATHER have had one, lol....at least it would have made me feel like "SEE? this is what is wrong with me!" instead for me, it was a question of seriously re-examining the entire way I was put together.

I was always very rickety, lol..I was a house with a foundation waiting to fall. And I always knew it was just a matter of time.

Some people are NOT so vulnerable. IF someone has a strong ego foundation, but has mood problems and fears, then meds may certainly be enough to handle their symptoms. Absolutely agree.

And you and I agree on the idea that YES, brain chemisty goes awry in all of us with mental symptoms - even if the thoughts and personality structure are CAUSING the distortions inside the brain chemicals. Meds can help stabilize such chemicals - but if the CAUSE was the PERSON's psychological structure in the first place, a shift in neurochemistry through medication is only a temporary fix. New symptoms will just crop up elsewhere.

And we can agree to disagree here, lol.....room for ALL our opinions. I am really only speaking from my own experience and the experiences of those reported directly to me.

Peace,
Janine

 

[Dreamer]

I agree with Sojourner that we can't measure anecdotal reports the way we can control group research. Main thing being, again our UNIQUENESS -- I can't stop saying that enough. And it's true, at some point, there are so many varaibles to getting well ... well, 'nuf said.

Below is an amazon review of Peter Kramer's book, Listening to Prozac -- I must have gotten Prozac Nation from Janet Jackson's "Rhythm Nation" LOLOLOL. Unfortunately, the Jackson name is on my mind these days. Hey and I read this book nearly 15 years ago, forgive me. 8)

He noted that MILDLY depressed patients seemed to respond in a way that disturbed him. Their personalities changed, and hence what was the REAL personality -- did Prozac create a "new person" -- who was the real person?

At any rate these people had come in with help-seeking behavior, not looking to feel super duper. It was an observation he made when Prozac was a new fangled "in" med.

Hence this initial conclusion entered popular culture, the media, etc., that antidepressants are "happy pills". They really aren't to the best of my understanding. A "regular healthy person" may get no effect, or side effects only. I guess if they want to get "happy" there are plenty of rec drugs out there that would do a much better job.

I still agree that a med does not a diagnosis make, however. But if a psychiatrist makes a good diagnosis, it can be further confirmed by the appropriate med and the patient's positive response to it.

Best,
D

From: an amazon review
Amazon.com
Psychiatrist Peter Kramer's book Listening to Prozac created a sensation when it was released in 1993, and it remains the most fascinating look at the new generation of antidepressants.

Kramer found that the changes in brain chemistry brought about by Prozac had a wide variety of effects, often giving users greater feelings of self-worth and confidence, less sensitivity to social rejection, and even a greater willingness to take risks. He cites cases of mildly depressed patients who took the drug and not only felt better but underwent remarkable personality transformations--which he (along with many of the book's readers) found disconcerting, leading him to question whether the medicated or unmedicated version was the person's "real" self.

Kramer has been criticized for seeming to advocate Prozac over psychotherapy or as a way of achieving personality changes not directly related to the disease of depression, such as improving one's social confidence or job performance.

In fact, he makes no such recommendations; he was simply the first popular writer to suggest that these changes might occur. (He answers those critics in the afterword to this 1997 edition.) For anyone considering taking antidepressants or wanting a better understanding of the effects these drugs are having on our society, Listening to Prozac is a very important book.

 

[Guest]

My last comment on this thread, but want to point out that Official Scientific Research on the brain is based primarily on anecdotal information, whether you are looking at it that way or not.

They conduct trials, run studies, perform measurements and do fancy scans. Then at the end, they ASK the participants "how do you feel now? Good? Better? Worse?"

The evidence is anecdotal. Assessments of mental symptoms and recovery and remissions are nearly always based on how the patient SAYS she feels (or in extremely debilitating cases, how the patient BEHAVES)
But no mental research is based on scientific observation in a lab where the doctors say "oh, look....there at that scan....see, the person's symptoms are reducing."

Reduction or increase in symptom is DEFINED by the patient.

Sorry to get so adamant, but I feel like I'm always being discounted (as is psychoanalysis) because we lack SCIENTIFIC proof. The "proof" you think your neuroscients have is basically the same things I'm talking about except they are wearing white coats when they disclose it.

 

[Dreamer]

Again, we all need to meet for coffee -- no for me make that orange juice :? -- as we've got a million points to discuss, but last comment here... 8)

But no mental research is based on scientific observation in a lab
where the doctors say "oh, look....there at that scan....see, the
person's symptoms are reducing."

Hmmm, OK, what I meant was, in your story and in H's story there
are various variables. As Sojourner said, could it have
been medications in conjunction with therapy in your case for instance. In H's case was it the safety of the hospital, not the antipsychotics that
suddenly caused her psychotic depression to lift. 6 months in a drugged horrendous state led to a sudden remission of symptoms in her case -- how? We can never really know. There are two unique experiences -- both equally valid, but not controlled studies.

In studies such as the below, variables need to be eliminated as much
as possible to get the most informative outcome. There is a coordination of the patient's experience and controlled study.

Yes of course, we HAVE to depend
on what a patient says when examining mental illness, but in a
sense we also depend on what the patient says AND the patient's
behavior in terms of say: patient presents unable to walk,
screaming "I feel a stabbing pain in my chest" -- (Dx, oh, it's not
a heart attack it's that axe there, LOL).

In my case there are a billion variables from abuse to inherited predisposition as to cause, and improvement due to meds, therapy, time, perspective even. I have theories but no certainty I guess. Though I do have my more biological POV.

The importance is, in trying to figure this mess out, it is
important to eliminate as many variables as possible.

It's also important to use healthy controls in a study vs. the non healthy controls, etc.

And here's one abstract we've all seen many times that I find
fascinating. And of course, those cases where there are lesions,
and during surgery a patient can describe what they feel during a
procedure.

ACH, I'm tired, perhaps I didn't explain this correctly.

In the spirit of healthy debate as always,
L'Hairballe of Miserable Uncertainty
Nature, Nurture, Nature, Nurture, OY :shock:

-----------------------------------------------------

http://www.neurotransmitter.net/depersonalization.html

Simeon D, Guralnik O, Hazlett EA, Spiegel-Cohen J, Hollander E,
Buchsbaum MS

Feeling unreal: a PET study of depersonalization disorder.
Am J Psychiatry. 2000 Nov;157(11):1782-8.

OBJECTIVE:
The goal of this study was to assess brain glucose metabolism and
its relationship to dissociation measures and clinical symptoms in
DSM-IV depersonalization disorder.

METHOD:
Positron emission tomography scans coregistered with magnetic
resonance images of eight subjects with depersonalization disorder
were compared to those of 24 healthy comparison subjects.

The two groups did not differ in age, sex, education, performance on a
baseline neuropsychological battery, or performance on a verbal
learning task administered during [(17)F]fluorodeoxyglucose uptake.

A cortical analysis by individual Brodmann's areas was performed.
RESULTS: Compared to the healthy subjects, subjects with
depersonalization disorder showed significantly lower metabolic
activity in right Brodmann's areas 22 and 21 of the superior and
middle temporal gyri and had significantly higher metabolism in
parietal Brodmann's areas 7B and 39 and left occipital Brodmann's
area 19.

Dissociation and depersonalization scores among the subjects with
depersonalization disorder were significantly positively correlated
with metabolic activity in area 7B.

CONCLUSIONS:
Depersonalization appears to be associated with functional
abnormalities along sequential hierarchical areas, secondary and
cross-modal, of the sensory cortex (visual, auditory, and
somatosensory), as well as areas responsible for an integrated body
schema.

These findings are in good agreement with the phenomenological
conceptualization of depersonalization as a dissociation of
perceptions as well as with the subjective symptoms of
depersonalization disorder. [Abstract]

-----------------------------------------------------------

These may lead researchers nowhere, but it is indeed intriguing and does show the ability to "see" SOMETHING re: DP on a scan while a patient is experiencing it.

There are many better examples, but this I always pull out of mothballs.