Got the right genes?
December 18, 2004 1:04 PM Subscribe
Predicting who'll benefit from anti-depressants From the study's abstract: "There are well-replicated, independent lines of evidence supporting a role for corticotropin-releasing hormone (CRH) in the pathophysiology of depression." The NY Times has a bit more readable explanation (reg-free link) of a recent investigation of into whether there is a genetic explanation for why some people get more from their drugs than others.
Where are the behavioural studies and depression located?
posted by wah at 1:47 PM on December 18, 2004
posted by wah at 1:47 PM on December 18, 2004
I wish we could get the full text cuz I have some ? about this study.
First, anti-depressents occur in several classes:
1: Serotonin specific reuptake inhibitors: Prozac, Paxil, Zoloft, Celexa, Lexapro.
I find that a good part of my patients in my family practice respond, at least to some degree, to one of these medications, which are the most tried and true antidepressants. They also have a significant anxiolytic effect.
2: Effexor, which inhibits norepinephrine, serotonin, and dopamine reuptake
3: Wellbutrin, which inhibits uptake of the same chemicals as effexor and has some other mechanisms less clear. Unfortunately it also lowers seizure threshold.
If these specific agents weren't compared. It would be interesting to explore this in the future.
Also, do the tried and true pot, pron, and ETOH help these sorry saps ;-)
posted by dancingbaptist at 1:56 PM on December 18, 2004
First, anti-depressents occur in several classes:
1: Serotonin specific reuptake inhibitors: Prozac, Paxil, Zoloft, Celexa, Lexapro.
I find that a good part of my patients in my family practice respond, at least to some degree, to one of these medications, which are the most tried and true antidepressants. They also have a significant anxiolytic effect.
2: Effexor, which inhibits norepinephrine, serotonin, and dopamine reuptake
3: Wellbutrin, which inhibits uptake of the same chemicals as effexor and has some other mechanisms less clear. Unfortunately it also lowers seizure threshold.
If these specific agents weren't compared. It would be interesting to explore this in the future.
Also, do the tried and true pot, pron, and ETOH help these sorry saps ;-)
posted by dancingbaptist at 1:56 PM on December 18, 2004
The abstract specifies the antidepressants used: fluoxetine (aka Prozac) and desipramine (apparently aka Norpramin and Pertofrane).
posted by paul! at 2:23 PM on December 18, 2004
posted by paul! at 2:23 PM on December 18, 2004
OIC, was scanning it too fast. thanks
posted by dancingbaptist at 2:32 PM on December 18, 2004
posted by dancingbaptist at 2:32 PM on December 18, 2004
so they checked out SSRI's and tricyclics, but not the newer generation of happy pills yet.
still waiting for the effects of pot, beer, and pron
posted by dancingbaptist at 2:33 PM on December 18, 2004
still waiting for the effects of pot, beer, and pron
posted by dancingbaptist at 2:33 PM on December 18, 2004
The New York Times version is more readable, but it's also wrong.
The researchers found that after being treated with antidepressants, patients with the genetic variation were far less anxious and depressed than when they began the study, said the lead author, Dr. Julio Licinio...
No: patients with the genetic variation AND a high score on the anxiety scale were affected. They get this distinction right in the following paragraph, when they say that "anxious, depressed patients who did not have the variation got much less relief from the drugs..." Low anxiety depressed patients/Los Angeles Mexicans didn't get "relief" from the drugs whether or not they had the genetic variation.
So genetics can affect how the body responds to drugs that alter a brain chemistry that is not at all understood. Does that mean depression is a disease? No. [whispers from pharmaceutical industry rep, rustling of paper in the hands] I mean, yes.
so they checked out SSRI's and tricyclics, but not the newer generation of happy pills yet.
Well, they checked out one of each. Doesn't response vary pretty widely even within a given category, like SSRIs? As I understand it docs often try one after another until something "works."
posted by paul! at 2:40 PM on December 18, 2004
The researchers found that after being treated with antidepressants, patients with the genetic variation were far less anxious and depressed than when they began the study, said the lead author, Dr. Julio Licinio...
No: patients with the genetic variation AND a high score on the anxiety scale were affected. They get this distinction right in the following paragraph, when they say that "anxious, depressed patients who did not have the variation got much less relief from the drugs..." Low anxiety depressed patients/Los Angeles Mexicans didn't get "relief" from the drugs whether or not they had the genetic variation.
So genetics can affect how the body responds to drugs that alter a brain chemistry that is not at all understood. Does that mean depression is a disease? No. [whispers from pharmaceutical industry rep, rustling of paper in the hands] I mean, yes.
so they checked out SSRI's and tricyclics, but not the newer generation of happy pills yet.
Well, they checked out one of each. Doesn't response vary pretty widely even within a given category, like SSRIs? As I understand it docs often try one after another until something "works."
posted by paul! at 2:40 PM on December 18, 2004
Low anxiety depressed patients/Los Angeles Mexicans didn't get "relief" from the drugs whether or not they had the genetic variation.
Sorry, no: in this case, the genetic variation didn't make a difference to the response.
posted by paul! at 2:42 PM on December 18, 2004
Sorry, no: in this case, the genetic variation didn't make a difference to the response.
posted by paul! at 2:42 PM on December 18, 2004
ok, i didn't bother reading the article. it's glaringly obvious that different people would respond differently to any kind of drug for whatever reason (genetic/biological/chemical/yadayada). c'mon. we all experience some depression to varying degrees for any number of reasons. it's very much a normal aspect of human nature and biology. i guess what i'm trying to say is that we should all smoke a little pot every now and then. works for me!
posted by yedgar at 3:14 PM on December 18, 2004
posted by yedgar at 3:14 PM on December 18, 2004
Are you a physician, dancingbaptist? You refer to "my patients in my family practice", etc.
I'm just curious what kind of physician would refer to antidepressants as "happy pills" or make an offhand comment like "Also, do the tried and true pot, pron, and ETOH help these sorry saps?"
Depression is a serious and complicated illness -- not simply the absence of "happiness". And people who suffer from it are not "sorry saps".
posted by 327.ca at 3:16 PM on December 18, 2004
I'm just curious what kind of physician would refer to antidepressants as "happy pills" or make an offhand comment like "Also, do the tried and true pot, pron, and ETOH help these sorry saps?"
Depression is a serious and complicated illness -- not simply the absence of "happiness". And people who suffer from it are not "sorry saps".
posted by 327.ca at 3:16 PM on December 18, 2004
And here I was wondering what sort of family physician would use l33t without any hesitation.
posted by Hildegarde at 3:22 PM on December 18, 2004
posted by Hildegarde at 3:22 PM on December 18, 2004
yes,but i'm also a metafilter / fark reading nerd and have a life outside my practice.
in my practice, would I refer to anxiolytics / antidepressants as happy pills... no.
i hope i have your permission to let my hair down a little here, pretty please.
l33t? wtf is that?
yes, people may respond to some ssris better than others. In the elderly, for instance, paxil is often used more often then prozac because it has a shorter half-life. The newest generation ssri is perhaps Lexapro, which seems to be better tolerated without as many side effects.
Many psychiatrists recommend switching classes, rather than sticking with meds in the same class if someone does not respond, to say fluoxetine.
So if someone does not respond to prozac, I'm more inclined to try them on Effexor or buproprion rather than Paxil.
Anywhoo.... as far as the THC, pron, and ETOH.... i'm just being silly... see your doc is not a doc-bot.... this one is a doc-bot who has a 5 year old child who he treasures, a wife who he is infatuated with... and plays Half-Life 2 and watches Southpark occasionally in his other life.
Compartmentalization i think it is called. No I don't drink and smoke pot... which is why I suppose i act like a silly butthead on this thread for some form of catharsis.
when i say silly things here... i'm just being silly. I suppose I could have been totally dishonest and not revealed my occupation here, but alas it is still a part of me.
posted by dancingbaptist at 3:55 PM on December 18, 2004
in my practice, would I refer to anxiolytics / antidepressants as happy pills... no.
i hope i have your permission to let my hair down a little here, pretty please.
l33t? wtf is that?
yes, people may respond to some ssris better than others. In the elderly, for instance, paxil is often used more often then prozac because it has a shorter half-life. The newest generation ssri is perhaps Lexapro, which seems to be better tolerated without as many side effects.
Many psychiatrists recommend switching classes, rather than sticking with meds in the same class if someone does not respond, to say fluoxetine.
So if someone does not respond to prozac, I'm more inclined to try them on Effexor or buproprion rather than Paxil.
Anywhoo.... as far as the THC, pron, and ETOH.... i'm just being silly... see your doc is not a doc-bot.... this one is a doc-bot who has a 5 year old child who he treasures, a wife who he is infatuated with... and plays Half-Life 2 and watches Southpark occasionally in his other life.
Compartmentalization i think it is called. No I don't drink and smoke pot... which is why I suppose i act like a silly butthead on this thread for some form of catharsis.
when i say silly things here... i'm just being silly. I suppose I could have been totally dishonest and not revealed my occupation here, but alas it is still a part of me.
posted by dancingbaptist at 3:55 PM on December 18, 2004
antidepressants worry me. We're raising an entire generation of children on these pills, meaning that they will grow-up never having had to deal with their feelings or emotions.
It also angers me to read about so many parents medicating their kids for being, well, kids. I believe there should be a law requiring a doctor (If not two or three) to confirm that a child has a critically serious problem before pills can be given till them. Of course when they reach sixteen they should be free to do whatever they want, no matter how stupid.
posted by Vaska at 4:03 PM on December 18, 2004
It also angers me to read about so many parents medicating their kids for being, well, kids. I believe there should be a law requiring a doctor (If not two or three) to confirm that a child has a critically serious problem before pills can be given till them. Of course when they reach sixteen they should be free to do whatever they want, no matter how stupid.
posted by Vaska at 4:03 PM on December 18, 2004
We're raising an entire generation of children on these pills - I'd say that's a bit of an overstatement.
However, there continues to be conflicting reports as to the safety of prescribing some antidepressants to children and teenagers. Last week there were reports that focused on caution in prescribing SSRI's to youngters (relative to suicide risk), while other reports found otherwise.
posted by ericb at 4:18 PM on December 18, 2004
However, there continues to be conflicting reports as to the safety of prescribing some antidepressants to children and teenagers. Last week there were reports that focused on caution in prescribing SSRI's to youngters (relative to suicide risk), while other reports found otherwise.
posted by ericb at 4:18 PM on December 18, 2004
Vaska: antidepressants worry me. We're raising an entire generation of children on these pills, meaning that they will grow-up never having had to deal with their feelings or emotions.
I don't know how to put this nicely, so I'm not going to. To everyone like Vaska who knows better than the doctors, the families, and those who suffer from depression - fuck off.
Clinical Depression is not the normal "gee, I'm sad because Jill doesn't like me", or "damn, I'm depressed because we lost the basketball game."
When you've been stuck in your room terrified of any little noise, can't stand it when the phone rings, can't fall asleep for 3 or 4 hours after going to bed, can't sleep the whole night through, can't go down to the living room and watch tv with your roommates because you're afraid (and don't ask of what - you don't know), start crying from a sad moment on the Simpsons - when you've experienced some of that for months on end, then tell me your opinion.
It also angers me to read about so many parents...
It REALLY ANGERS me when some asshole from the sidelines thinks they know better than those involved.
Anti-depressants are not "happy pills". Those on anti-depressants do not float around in a cloud of bliss. Those on anti-depressants feel the normal ups and downs that others feel - they are just no longer constantly at rock bottom where they were before.
/end rant
posted by Bort at 4:43 PM on December 18, 2004
I don't know how to put this nicely, so I'm not going to. To everyone like Vaska who knows better than the doctors, the families, and those who suffer from depression - fuck off.
Clinical Depression is not the normal "gee, I'm sad because Jill doesn't like me", or "damn, I'm depressed because we lost the basketball game."
When you've been stuck in your room terrified of any little noise, can't stand it when the phone rings, can't fall asleep for 3 or 4 hours after going to bed, can't sleep the whole night through, can't go down to the living room and watch tv with your roommates because you're afraid (and don't ask of what - you don't know), start crying from a sad moment on the Simpsons - when you've experienced some of that for months on end, then tell me your opinion.
It also angers me to read about so many parents...
It REALLY ANGERS me when some asshole from the sidelines thinks they know better than those involved.
Anti-depressants are not "happy pills". Those on anti-depressants do not float around in a cloud of bliss. Those on anti-depressants feel the normal ups and downs that others feel - they are just no longer constantly at rock bottom where they were before.
/end rant
posted by Bort at 4:43 PM on December 18, 2004
As someone who finally broke down and went on one of these drugs, I have to say, the 'happy pills' comment isn't too far off. It does improve your mood, and the lows don't get as low.
What I found amazing, was how much of your mood, thoughts, and actions, are just chemical, and how changing the chemistry, changes who you are. Its something you can't fully understand unless you've experienced it for yourself.
I think these drugs should be taken with caution, but at the same time, everyone freaking out about the overmedication of our culture can scare people away from drugs that they might very well need, I almost ended up killing myself because I was scared to go on a prescription. Kind of funny really..
on preview, what bort said.
posted by Pink Fuzzy Bunny at 4:47 PM on December 18, 2004
What I found amazing, was how much of your mood, thoughts, and actions, are just chemical, and how changing the chemistry, changes who you are. Its something you can't fully understand unless you've experienced it for yourself.
I think these drugs should be taken with caution, but at the same time, everyone freaking out about the overmedication of our culture can scare people away from drugs that they might very well need, I almost ended up killing myself because I was scared to go on a prescription. Kind of funny really..
on preview, what bort said.
posted by Pink Fuzzy Bunny at 4:47 PM on December 18, 2004
There is no doubt that depression is a combination of situation and chemistry/phsysiology.
I have had a couple periods of depression and had to be on them too. While many of us behind the scenes refer to them as "happy pills" it's just a saying. Hell, we call Cialis, Viagra, and Levitra "boner pills". It takes a healthy balance of a sense of humor, compassion, and seriousness to survive in this health-care culture. My biggest pet peave about online forums is how damn sensative everyone is and how they are looking for excuses to be offended.... smile sheesh.
I've put kids and teenagers on them, begrudgingly (because of the controversy and FDA warnings). I only do this with close consultation with a psychiatrist/psychologist/therapist and very close follow up. Unfortunately, most of these kids are in shitty social situations, but then many of us are.
Antidepressants aren't magic but do serve their role. Like any medications, they are all double edge swords.
posted by dancingbaptist at 4:59 PM on December 18, 2004
I have had a couple periods of depression and had to be on them too. While many of us behind the scenes refer to them as "happy pills" it's just a saying. Hell, we call Cialis, Viagra, and Levitra "boner pills". It takes a healthy balance of a sense of humor, compassion, and seriousness to survive in this health-care culture. My biggest pet peave about online forums is how damn sensative everyone is and how they are looking for excuses to be offended.... smile sheesh.
I've put kids and teenagers on them, begrudgingly (because of the controversy and FDA warnings). I only do this with close consultation with a psychiatrist/psychologist/therapist and very close follow up. Unfortunately, most of these kids are in shitty social situations, but then many of us are.
Antidepressants aren't magic but do serve their role. Like any medications, they are all double edge swords.
posted by dancingbaptist at 4:59 PM on December 18, 2004
Bort, I think you're ignoring the fact that the prescriptions are (often, generally, mainly?) given in conjunction with talk therapy. Certainly that is what was required of me any time I was given them. So stop ranting without understanding, okay?
posted by billsaysthis at 5:08 PM on December 18, 2004
posted by billsaysthis at 5:08 PM on December 18, 2004
Yes, medications can do wonders. But I do worry when GPs and family docs do the majority of the presribing of these meds, often with no referral to a mental health professional for additional help.
We have decades' worth of research that show for serious mental illness such as depression, medication in combination with psychotherapy is the most effective form of treatment. Docs who do one without referring for the other (in either direction) for depression do their patients a serious disservice.
posted by docjohn at 5:09 PM on December 18, 2004
We have decades' worth of research that show for serious mental illness such as depression, medication in combination with psychotherapy is the most effective form of treatment. Docs who do one without referring for the other (in either direction) for depression do their patients a serious disservice.
posted by docjohn at 5:09 PM on December 18, 2004
My biggest pet peave about online forums is how damn sensative everyone is and how they are looking for excuses to be offended.... smile sheesh.
Well listen up, doc, and cut the shit-eating routine. We here aren't all necessarily "behind the scenes" like you and your golf buddies. Those in-the-know references to drug brandnames and ETOH (alcohol, for us plebes) are very impressive, but while you "let [your] hair down a little here, pretty please" some of the people reading your deathless prose are actually among the afflicted.
Sure, let your hair down. But don't trade on your doc status at the same time.
posted by 327.ca at 5:19 PM on December 18, 2004
Well listen up, doc, and cut the shit-eating routine. We here aren't all necessarily "behind the scenes" like you and your golf buddies. Those in-the-know references to drug brandnames and ETOH (alcohol, for us plebes) are very impressive, but while you "let [your] hair down a little here, pretty please" some of the people reading your deathless prose are actually among the afflicted.
Sure, let your hair down. But don't trade on your doc status at the same time.
posted by 327.ca at 5:19 PM on December 18, 2004
What has happened to metafilter? Profanity in every reply, doctors speaking like teenagers in an attempt to "let their hair down", and personal attacks at every moment possible. All in a topic that could have easily led to some interesting discussion. (yes, flame me too, some more "fuck-you" utterances will really fix the atmosphere)
posted by Shusha at 5:36 PM on December 18, 2004
posted by Shusha at 5:36 PM on December 18, 2004
(Currently writing an Rx for Haldol and Prozac for 327.ca and Shusha, then stepping away from the computer and talk to real people with a sense of humor)
posted by dancingbaptist at 5:45 PM on December 18, 2004
posted by dancingbaptist at 5:45 PM on December 18, 2004
(Currently writing an Rx for Haldol and Prozac for 327.ca and Shusha, then stepping away from the computer and talk to real people with a sense of humor)
Well, wish I could write a prescription that would get rid of asshats like you, but then...I'm not a doc.
Cheers.
posted by 327.ca at 5:48 PM on December 18, 2004
Well, wish I could write a prescription that would get rid of asshats like you, but then...I'm not a doc.
Cheers.
posted by 327.ca at 5:48 PM on December 18, 2004
billsaysthis: Bort, I think you're ignoring the fact that the prescriptions are (often, generally, mainly?) given in conjunction with talk therapy.
????
What does talk therapy have to do with my rant? I'm not sure what you're talking about.
Certainly that is what was required of me any time I was given them. So stop ranting without understanding, okay?
Well, it wasn't required of me, but I did go through it. I tried that for a while before I tried the medication, and talk didn't do anything to help me.
I think battling depression for 15 odd years and being on Paxil for a decade gives me a little understanding. okay?
Did you mis-read my post?
dancingbaptist:
I was much more offended at your "Also, do the tried and true pot, pron, and ETOH help these sorry saps ;-)" line - being a sorry sap myself.
But then, what should I expect from a community college, head-up-his-ass, MD. :) <---- see, don't take offense, I used a smilee!
posted by Bort at 5:55 PM on December 18, 2004
????
What does talk therapy have to do with my rant? I'm not sure what you're talking about.
Certainly that is what was required of me any time I was given them. So stop ranting without understanding, okay?
Well, it wasn't required of me, but I did go through it. I tried that for a while before I tried the medication, and talk didn't do anything to help me.
I think battling depression for 15 odd years and being on Paxil for a decade gives me a little understanding. okay?
Did you mis-read my post?
dancingbaptist:
I was much more offended at your "Also, do the tried and true pot, pron, and ETOH help these sorry saps ;-)" line - being a sorry sap myself.
But then, what should I expect from a community college, head-up-his-ass, MD. :) <---- see, don't take offense, I used a smilee!
posted by Bort at 5:55 PM on December 18, 2004
Sure, let your hair down. But don't trade on your doc status at the same time.
Well done, 327.ca. In two brief sentences, you've pissed on the terpsichorian Protestant's hypocritical appeal to/flight from authority.
posted by vetiver at 5:56 PM on December 18, 2004
Well done, 327.ca. In two brief sentences, you've pissed on the terpsichorian Protestant's hypocritical appeal to/flight from authority.
posted by vetiver at 5:56 PM on December 18, 2004
Dear Bort: Fuck you too. Actually, I don't even mean that, but I'm taken aback at your needlessly vitriolic statement. If you read my comment I said I was concerned about how many parents medicate children who are merely rambunctious and they have no wish to deal with, and I can give several examples I know of this in real life. Far too many. However, I also said that there are people out their with serious problems that need this kind of medication to survive. One lady I know had her brother murdered in front of her violently and has basically been a walking wreck since then, she needs pills to function, to survive. I would never think of telling her to deal with that sort of trauma on her own. It would be telling someone with a massive headache to get by without aspirin because it's natural; it's moronic. But pills like Ritalin make my skin crawl.
posted by Vaska at 6:10 PM on December 18, 2004
posted by Vaska at 6:10 PM on December 18, 2004
I refer to my Zoloft as my "happy pills." I keep them in a candy dish, too.
And I was prescribed just by asking my gp for it.
I'm going to leave this angry little thread and go sing "kumbayaa" now.
posted by ruby.aftermath at 6:11 PM on December 18, 2004
And I was prescribed just by asking my gp for it.
I'm going to leave this angry little thread and go sing "kumbayaa" now.
posted by ruby.aftermath at 6:11 PM on December 18, 2004
I'm going to leave this angry little thread and go sing "kumbayaa" now.
Good. Glad you could obtain "happiness" so easily.
posted by 327.ca at 6:14 PM on December 18, 2004
Good. Glad you could obtain "happiness" so easily.
posted by 327.ca at 6:14 PM on December 18, 2004
Good. Glad you could obtain "happiness" so easily.
Sorry. I didn't mean that.
posted by 327.ca at 6:15 PM on December 18, 2004
Sorry. I didn't mean that.
posted by 327.ca at 6:15 PM on December 18, 2004
Well, as a patient who's been on a few cocktails for clinical depression over the years, I have some conflict. On the one hand, I find comments that dismiss anti-depressants as crutches or as "happy pills" frustrating. On the other hand, I do see a real trend these days towards throwing pills at a problem without really defining the problem carefully beforehand or insisting on the other behavioral changes necessary to supplement the chemical changes. A severe diabetic may benefit from insulin, but they still need to modfify their diet.
When I first went on meds, I went through talk therapy, and my doctor closely montored the effects and side effects of the drugs I was on and we worked as a team to fine-tune. These days I can't afford talk therapy, and I got my current scrip by telling my HMO's general practitioner that buprioxion had helped me in the past. Don't get me wrong, I think my current doc is competent and ethical (we did have a discussion about the meds and he trusted me about my medical history) but it's pretty clear that my corporate benefits package is streamlined towards the "magic pill" solution.
posted by Karmakaze at 6:18 PM on December 18, 2004
When I first went on meds, I went through talk therapy, and my doctor closely montored the effects and side effects of the drugs I was on and we worked as a team to fine-tune. These days I can't afford talk therapy, and I got my current scrip by telling my HMO's general practitioner that buprioxion had helped me in the past. Don't get me wrong, I think my current doc is competent and ethical (we did have a discussion about the meds and he trusted me about my medical history) but it's pretty clear that my corporate benefits package is streamlined towards the "magic pill" solution.
posted by Karmakaze at 6:18 PM on December 18, 2004
I find the degree to which we know nothing about the brain fascinating, particularly given its implications for clinical practice.
Researchers who spend their lives becoming experts in psychopharmacology can't explain with any kind of certainty why Paxil works like a charm for one person while nothing but Wellbutrin works for another. Particularly in the field of mental illness, docs and nurse practitioners (both of whom have prescriptive authority) are just as dependent on the newest research to guide their practice as patients are when choosing a specific therapy.
Studies like the one linked in this post are only beginning to explore the mystery of why some drugs work better than others. Until that research tells us anything more definitive (assuming it ever will), the only thing docs and NPs have to go by is their own assessment of the patient's signs (by that I mean a manifestation of illness that can be objectively seen and measured, like a decreased heart rate or low blood pressure, both of which are common in clinical depression, understanding that there are an enormous number of reasons why someone's signs could change) and whether or not the patient reports an improvement of symptoms (those feelings that can't be seen or measured and can only be reported). If anything, the latter is likely to be more accurate.
The process of finding the right drug at the right dose can take long, frustrating years and requires an enormous amount of patience on the part of the practitioner and fortitude on the part of the patient. We're in the Stone Age when it comes to treating mental illness in comparison to what we know about antihypertensives, chemotherapy for cancer, or antibiotics.
On preview: Despite what it may seem like at times, I'd like to add that the vast majority of medical professionals are doing the best they can with the limited tools at their disposal and with a great deal of respect for the struggle of those with a mental illness.
In case that last paragraph sounds defensive, in the interest of full disclosure: I'm in nursing school right now and intend to go on to advanced practice as a nurse practitioner; I only don't say "we" and "our" when referencing medical professionals because I'm not one--yet.
posted by jesourie at 6:23 PM on December 18, 2004
Researchers who spend their lives becoming experts in psychopharmacology can't explain with any kind of certainty why Paxil works like a charm for one person while nothing but Wellbutrin works for another. Particularly in the field of mental illness, docs and nurse practitioners (both of whom have prescriptive authority) are just as dependent on the newest research to guide their practice as patients are when choosing a specific therapy.
Studies like the one linked in this post are only beginning to explore the mystery of why some drugs work better than others. Until that research tells us anything more definitive (assuming it ever will), the only thing docs and NPs have to go by is their own assessment of the patient's signs (by that I mean a manifestation of illness that can be objectively seen and measured, like a decreased heart rate or low blood pressure, both of which are common in clinical depression, understanding that there are an enormous number of reasons why someone's signs could change) and whether or not the patient reports an improvement of symptoms (those feelings that can't be seen or measured and can only be reported). If anything, the latter is likely to be more accurate.
The process of finding the right drug at the right dose can take long, frustrating years and requires an enormous amount of patience on the part of the practitioner and fortitude on the part of the patient. We're in the Stone Age when it comes to treating mental illness in comparison to what we know about antihypertensives, chemotherapy for cancer, or antibiotics.
On preview: Despite what it may seem like at times, I'd like to add that the vast majority of medical professionals are doing the best they can with the limited tools at their disposal and with a great deal of respect for the struggle of those with a mental illness.
In case that last paragraph sounds defensive, in the interest of full disclosure: I'm in nursing school right now and intend to go on to advanced practice as a nurse practitioner; I only don't say "we" and "our" when referencing medical professionals because I'm not one--yet.
posted by jesourie at 6:23 PM on December 18, 2004
terpsichorian Protestant, I have no doubt you and all your cohorts in whatever medical complex you infest refer to anti-depressants as "happy pills." No doubt you all yuk it up about how everybody on "happy pills" would be better off ingesting lots of "THC, pron, and ETOH." You apparently think that sharing this with the world at large shows that you're just a normal guy, not a "doc-bot." Actually, it shows that you're an arrogant dickweed, one of the failures of our medical training system.
If I had to pick, a doc-bot would be a vast improvement over you. Fortunately, I don't have to pick. I pay for my own medical care so I'm able to -- and I have -- fired disrespectful and incompetent physicians. I hope to have the chance to fire you.
on preview: karmakaze, I understand. In my experience, medication meant only that all the talking-therapy stuff could actually take hold. Either without the other would have been worthless. I loathe the "Prozac:depression::penicillin:bacterial infection" meme that's taken hold.
posted by vetiver at 6:28 PM on December 18, 2004
If I had to pick, a doc-bot would be a vast improvement over you. Fortunately, I don't have to pick. I pay for my own medical care so I'm able to -- and I have -- fired disrespectful and incompetent physicians. I hope to have the chance to fire you.
on preview: karmakaze, I understand. In my experience, medication meant only that all the talking-therapy stuff could actually take hold. Either without the other would have been worthless. I loathe the "Prozac:depression::penicillin:bacterial infection" meme that's taken hold.
posted by vetiver at 6:28 PM on December 18, 2004
Jesourie, you sound like someone who could give me hope. Stick with it.
posted by 327.ca at 6:33 PM on December 18, 2004
posted by 327.ca at 6:33 PM on December 18, 2004
Vaska: Dear Bort: Fuck you too. Actually, I don't even mean that, but I'm taken aback at your needlessly vitriolic statement.
I apologize. I get too emotional about this topic and I let my emotions take over. I probably shouldn't have even opened this thread.
If you read my comment I said I was concerned about how many parents medicate children who are merely rambunctious and they have no wish to deal with, and I can give several examples I know of this in real life. Far too many .... But pills like Ritalin make my skin crawl.
Well, Ritalin is not an anti-depressant, so you probably should have specified Ritalin in your original post. I would probably still argue that the family and doctor are better equipped to make the determination, but I don't know much about Ritalin.
However, I also said that there are people out their with serious problems that need this kind of medication to survive.
I re-read your post, and I don't see anything like that. If you had written that, I probably wouldn't have lost it like I did. I still apologize though. I should not have told you to fuck-off. I should have raised my objections in a thoughtful manner. Its no excuse - but reading your post on top of the doctor's "happy pills" and "sorry saps ;) " made me lose it.
Again, I'm sorry Vaska.
posted by Bort at 6:40 PM on December 18, 2004
I apologize. I get too emotional about this topic and I let my emotions take over. I probably shouldn't have even opened this thread.
If you read my comment I said I was concerned about how many parents medicate children who are merely rambunctious and they have no wish to deal with, and I can give several examples I know of this in real life. Far too many .... But pills like Ritalin make my skin crawl.
Well, Ritalin is not an anti-depressant, so you probably should have specified Ritalin in your original post. I would probably still argue that the family and doctor are better equipped to make the determination, but I don't know much about Ritalin.
However, I also said that there are people out their with serious problems that need this kind of medication to survive.
I re-read your post, and I don't see anything like that. If you had written that, I probably wouldn't have lost it like I did. I still apologize though. I should not have told you to fuck-off. I should have raised my objections in a thoughtful manner. Its no excuse - but reading your post on top of the doctor's "happy pills" and "sorry saps ;) " made me lose it.
Again, I'm sorry Vaska.
posted by Bort at 6:40 PM on December 18, 2004
Thanks, 327.ca. I'm coming up on final exams and my stress is at a heretofore unknown level, so the compliment is greatly appreciated right now.
posted by jesourie at 6:52 PM on December 18, 2004
posted by jesourie at 6:52 PM on December 18, 2004
Bort : No worries. I'll have to be more comprehensive with my comments in the future, I just prefer keeping them brief for readabilty. I didn't know Ritalin was not an anti-depressant; I lump it and many others in the 'mood altering' category which I am wary of. Oh, and I agree the 'sorry saps' crack was in terribly bad taste, it makes me regret we cannot physically smack people around here on occasion (A form of therapy I can certainly can endorse). I should also like to note for the record that I actually take a mood altering drug, specifically Valium, though not for the stated purpose of the pill. I use it as a muscle relaxant because I often grind my teeth at night from stress which causes me terrific aches and pain. Taking Valium makes my body relax when a drink with dinner and a round with the punching bag fails.
posted by Vaska at 6:54 PM on December 18, 2004
posted by Vaska at 6:54 PM on December 18, 2004
I apologize for being flippant. Please don't be so mean on this forum.
posted by dancingbaptist at 6:54 PM on December 18, 2004
posted by dancingbaptist at 6:54 PM on December 18, 2004
What PinkFuzzyBunny said - before my doc put me on 10mg a day of Lexapro four and a half months ago, I thought being depressed, anxious, and suicidal (over things like a minor spousal argument, job, etc) was *normal*.
More than once since then, I've said that the prescription is the best $40/month I've ever spent. I no longer spend days (or weeks) continually depressed and paranoid that OMG EVERYTHING IS GOING TO END; as the doctor said, "it turns the chatter in your head off, or at least turns down the volume a bit". I'm a little more mellow, and after I got on the meds, was able to step back, actively look at myself, and realize "wow, i was really fucked up."
posted by mrbill at 6:54 PM on December 18, 2004
More than once since then, I've said that the prescription is the best $40/month I've ever spent. I no longer spend days (or weeks) continually depressed and paranoid that OMG EVERYTHING IS GOING TO END; as the doctor said, "it turns the chatter in your head off, or at least turns down the volume a bit". I'm a little more mellow, and after I got on the meds, was able to step back, actively look at myself, and realize "wow, i was really fucked up."
posted by mrbill at 6:54 PM on December 18, 2004
I believe there should be a law requiring a doctor (If not two or three) to confirm that a child has a critically serious problem before pills can be given till them.
Isn't that general concept called "having a prescription"?
posted by clevershark at 6:58 PM on December 18, 2004
Isn't that general concept called "having a prescription"?
posted by clevershark at 6:58 PM on December 18, 2004
"Let's gang up on the doctor for not having a huge stick up his ass"-filter
posted by clevershark at 7:02 PM on December 18, 2004
posted by clevershark at 7:02 PM on December 18, 2004
vetiver, like I said, I don't really approve of how easily I got meds from a gp with no followup. But, well, I tried being off the meds, and on is better. I'd love to go back into therapy as a supplement, but can't afford it on my own and can't figure out how to get my benefits package to cover it. What I do now is obsessively cultivate a support system. I make a point of regular exercise. I have a friend whose job it is to IM me daily and make sure I've taken my meds, and other friends who've been primed with descriptions of my warning signs whose job it is to call me on them. The work I do when I'm stable is what keeps my minor episodes from turning into major ones, and includes realizing that I backslide faster off the meds than I do when I'm on them. As far as the prosac=penecillin thing, that's why I usually use diabetes/insulin as my analogy - the behavioral component there is more apparent.
on preview, vaska - Ritalin is a treatment for Attention Defecit/Hyperactivity, not depression. A number of people do have both, though.
posted by Karmakaze at 7:07 PM on December 18, 2004
on preview, vaska - Ritalin is a treatment for Attention Defecit/Hyperactivity, not depression. A number of people do have both, though.
posted by Karmakaze at 7:07 PM on December 18, 2004
dancingbabtist: having trained as a physician I'm at least nominally on the same team as you and I have to say I find your comments bizarre and inappropriate. "Happy Pills"?: shame on you for promulgating this mistaken stereotype. Would you tell the family of a cancer patient on morphine for intractable pain that you're giving her some 'joy juice'? "Sorry saps"? Wrong, wrong, wrong, dude.
As for the vitriol this topic has drawn out of the others, I, as a fellow sufferer, think that people with depression get tired of others thinking they are just weak or lazy and take the easy way (happy pills) out of situations that 'normal' people can deal with on their own. Depression is profoundly unpleasant and extremely debilitating. Hopelessness is part of the illness, and it's frustrating to have no control over something that takes over every single facet of your life as depression does. Those who have responded to antidepressant medication like SSRI's feel a profound debt of gratitude to these for rescuing them. To have these dismissed as happy pills, well, that's when I feel like seconding what bort said.
posted by Turtles all the way down at 7:10 PM on December 18, 2004
As for the vitriol this topic has drawn out of the others, I, as a fellow sufferer, think that people with depression get tired of others thinking they are just weak or lazy and take the easy way (happy pills) out of situations that 'normal' people can deal with on their own. Depression is profoundly unpleasant and extremely debilitating. Hopelessness is part of the illness, and it's frustrating to have no control over something that takes over every single facet of your life as depression does. Those who have responded to antidepressant medication like SSRI's feel a profound debt of gratitude to these for rescuing them. To have these dismissed as happy pills, well, that's when I feel like seconding what bort said.
posted by Turtles all the way down at 7:10 PM on December 18, 2004
db: Sorry, I posted before reading your apology. But on the other hand, this is mefi: if you don't want to run with the big dogs you can always stay on the porch.
posted by Turtles all the way down at 7:12 PM on December 18, 2004
posted by Turtles all the way down at 7:12 PM on December 18, 2004
Well vetiver and 327.ca have thrown me into a depression as the humourless and self-righteous often do. I dread to think what they'd think of military personnel refering to the F-104 as the Widowmaker.
These meds certainly helped myself out and some associates as well. They helped me tremendously in two key areas, regaining an appetite (food does wonders for the body) and regaining my ability to fall asleep. Didn't do much for the emotional state-of-being however. I, like everyone, had been down before, but this one was different and there didn't seem to be an end in sight. What's wrong with actively trying to remedy the situation? I referred to them as happy caps to my physician and he was kindly amused. Helpful and harmless.
My physician set me up with what is referred to in this thread as "talk-therapy" and was very thorough in speaking about what is known and not known about the meds, as well as the side effects. When I felt better I stopped taking them (my decision), and Effexor eventually put me into a perpetual sleep to boot. Others find they need them more or less permanently. I count myself fortunate not to be one of them.
Allergy medication and shots did wonders for my life as well and yet I consistently encountered a 'you'll get used to it' attitude. Sneezing blood for 20 minutes straight about 10 - 15 times a day is a little different than a couple of baby sneezes a day. Is Claritin destroying our children's ability to deal with annoying physical distractions?
posted by juiceCake at 7:14 PM on December 18, 2004
These meds certainly helped myself out and some associates as well. They helped me tremendously in two key areas, regaining an appetite (food does wonders for the body) and regaining my ability to fall asleep. Didn't do much for the emotional state-of-being however. I, like everyone, had been down before, but this one was different and there didn't seem to be an end in sight. What's wrong with actively trying to remedy the situation? I referred to them as happy caps to my physician and he was kindly amused. Helpful and harmless.
My physician set me up with what is referred to in this thread as "talk-therapy" and was very thorough in speaking about what is known and not known about the meds, as well as the side effects. When I felt better I stopped taking them (my decision), and Effexor eventually put me into a perpetual sleep to boot. Others find they need them more or less permanently. I count myself fortunate not to be one of them.
Allergy medication and shots did wonders for my life as well and yet I consistently encountered a 'you'll get used to it' attitude. Sneezing blood for 20 minutes straight about 10 - 15 times a day is a little different than a couple of baby sneezes a day. Is Claritin destroying our children's ability to deal with annoying physical distractions?
posted by juiceCake at 7:14 PM on December 18, 2004
I'm coming up on final exams and my stress is at a heretofore unknown level
You'll be fine.
Years ago, my violin teacher, Mr. Hoppy, said, "Your heart's in the right place." That was his preamble to why I should give up the violin. But that's not my point. ;-)
Now I understand that having one's "heart in the right place" is sometimes the best we can do, and it is all that truly matters.
Good luck on those finals, kiddo.
posted by 327.ca at 7:19 PM on December 18, 2004
You'll be fine.
Years ago, my violin teacher, Mr. Hoppy, said, "Your heart's in the right place." That was his preamble to why I should give up the violin. But that's not my point. ;-)
Now I understand that having one's "heart in the right place" is sometimes the best we can do, and it is all that truly matters.
Good luck on those finals, kiddo.
posted by 327.ca at 7:19 PM on December 18, 2004
Mr. Hoppy,
GODDAMIT YOU BASTARD, "MR HAPPY"? Don't you understand...oh, "Hoppy". never mind.
posted by Turtles all the way down at 7:21 PM on December 18, 2004
GODDAMIT YOU BASTARD, "MR HAPPY"? Don't you understand...oh, "Hoppy". never mind.
posted by Turtles all the way down at 7:21 PM on December 18, 2004
Having suffered with depression for 10 years, and being on antidepressents in the past for a total of about 3 of those 10, particularly during residency, I do not dismiss anyone as saps other than myself. I suppose my friends know me and about me and they don't take my weird, often self-deprecating humor as offensive, but know that I never joke about others unless I'm joking about myself.
So, yes, I'm a sorry sap who has taken his share of prescribed happy pills, that have assisted in keeping this sorry sap from being 6-feet under.
posted by dancingbaptist at 7:21 PM on December 18, 2004
So, yes, I'm a sorry sap who has taken his share of prescribed happy pills, that have assisted in keeping this sorry sap from being 6-feet under.
posted by dancingbaptist at 7:21 PM on December 18, 2004
Clevershark : I'm aware of prescriptions, but in the two recent whitebread communities I've resided in had doctors that didn't ask a single question when I asked for rather serious pain drugs. They simply listened to my tale, did no tests, and gave me what I had asked for. That worries me. Lazy parents are bad enough, combining it with lazy doctors is a recipe for something unpleasant. I could have been just unlucky mind you, but three doctors in a row certainly had me unnerved. It would be nice if there was a net in the system with over-sight, but I have to admit I have no idea what form it should take or be handled.
posted by Vaska at 7:23 PM on December 18, 2004
posted by Vaska at 7:23 PM on December 18, 2004
My original post that started this all was substantive with a joke at the end of the substance. I'm sorry for offending those who have active depression or with loved-ones with active depression who suffer. It was posted as someone who's been to the brink and perhaps may deal with it with (odd) humor.
posted by dancingbaptist at 7:24 PM on December 18, 2004
posted by dancingbaptist at 7:24 PM on December 18, 2004
dancingbaptist: fair enough as far as I'm concerned. Sorry again--it's clear your comment just didn't come across as it was intended.
posted by Turtles all the way down at 7:27 PM on December 18, 2004
posted by Turtles all the way down at 7:27 PM on December 18, 2004
And yet another example how in the absence of physical and other cues to put a remark in context, naked text on the web can so easily lead to misunderstandings, anger, and hurt feelings.
posted by Turtles all the way down at 7:29 PM on December 18, 2004
posted by Turtles all the way down at 7:29 PM on December 18, 2004
Not only some interesting content in the link and these comments, but wow, check out the excellent conflict resolution. Nice job, folks.
posted by clever sheep at 7:37 PM on December 18, 2004
posted by clever sheep at 7:37 PM on December 18, 2004
It was posted as someone who's been to the brink and perhaps may deal with it with (odd) humor.
No worries, dancingbaptist. Odd indeed, but I'm not one to judge. Thank you for hanging in on this thread. Please keep this conversation (and us) in the back of your mind when you're next called upon to help some fucked-up depresso.
Cheers.
posted by 327.ca at 7:38 PM on December 18, 2004
No worries, dancingbaptist. Odd indeed, but I'm not one to judge. Thank you for hanging in on this thread. Please keep this conversation (and us) in the back of your mind when you're next called upon to help some fucked-up depresso.
Cheers.
posted by 327.ca at 7:38 PM on December 18, 2004
juiceCake : If that's bad you might be amused to know the F-101 was called the Farmingdale Fireball. However, I find your 'Is Claritin destroying our children's ability to deal with annoying physical distractions?' comment to be a bit much. Someone taking pills for intestinal problems is far removed from someone who is angry all the time and hurts people. In theory the angry fellow can be given therapy or even change his own ways, meanwhile all the talk in the world isn't going to make your GI tract any better.
posted by Vaska at 7:40 PM on December 18, 2004
posted by Vaska at 7:40 PM on December 18, 2004
hee hee 327.ca LOL you hit my humor target
;-)
posted by dancingbaptist at 7:41 PM on December 18, 2004
;-)
posted by dancingbaptist at 7:41 PM on December 18, 2004
Lay off dancingbaptist. Sounds to me that folks are projecting a little hostility on him just cuz he's a doc.
As for me, I really miss zoloft. Before I was on it I literally did not know what it was like to feel good. But as an uninsured bipolar, right now I am getting by on talk therapy, and a kick-butt social support system. I will say that even when I did have insurance and was on all kinds of drugs, the drugs can only do so much for you. Most of the time they get you stable enough so you can actually work on your "stuff." Or in my case learn to cope. Drugs usually cannot fix you completely.
posted by konolia at 7:46 PM on December 18, 2004
As for me, I really miss zoloft. Before I was on it I literally did not know what it was like to feel good. But as an uninsured bipolar, right now I am getting by on talk therapy, and a kick-butt social support system. I will say that even when I did have insurance and was on all kinds of drugs, the drugs can only do so much for you. Most of the time they get you stable enough so you can actually work on your "stuff." Or in my case learn to cope. Drugs usually cannot fix you completely.
posted by konolia at 7:46 PM on December 18, 2004
hee hee 327.ca LOL you hit my humor target
;-)
That wasn't meant as humour. It was meant as sympathy.
If you are a doc, then I think you need to weigh a few things. What's more important to you -- a mefi ID that you can recycle, or the name "James Henderson" which, according your mefi profile, is who you are.
posted by 327.ca at 7:48 PM on December 18, 2004
;-)
That wasn't meant as humour. It was meant as sympathy.
If you are a doc, then I think you need to weigh a few things. What's more important to you -- a mefi ID that you can recycle, or the name "James Henderson" which, according your mefi profile, is who you are.
posted by 327.ca at 7:48 PM on December 18, 2004
Perhaps my flippancy is fueled by the Nyquil I'm taking while laying around watching Steven Seagal movies on TNT trying to recover from a cold.
Unfortunate occupation. Listening to some kid's chest the other day and he sneezed in my face. All the handwashing in the world sometimes does no good.
To seriously get back on topic though (Nyquil 10% ETOH content not withstanding... don't worry I'm not on call!) I think studies like this, if carried out among the many different classes of meds, could really help the future pharmacotherapy component of psychiatric treatment.
posted by dancingbaptist at 7:54 PM on December 18, 2004
Unfortunate occupation. Listening to some kid's chest the other day and he sneezed in my face. All the handwashing in the world sometimes does no good.
To seriously get back on topic though (Nyquil 10% ETOH content not withstanding... don't worry I'm not on call!) I think studies like this, if carried out among the many different classes of meds, could really help the future pharmacotherapy component of psychiatric treatment.
posted by dancingbaptist at 7:54 PM on December 18, 2004
327.ca I am a practicing physician, but entering a Ph.D. program in neuroscience next year and at that time will limit my practice to urgent care. Nothing against medicine... just a long term goal as my true interest lies in molecular biology and this is a plan I've been been working on for the last 3 years. Will be a financial blow (20k graduate stipend plus a few K per year moonlighting on weekends) but as everyone that knows me realizes, financial motives are not what drive me.
posted by dancingbaptist at 8:01 PM on December 18, 2004
posted by dancingbaptist at 8:01 PM on December 18, 2004
Look, terpsichorian Protestant, as 327.ca pointed out, you can't simultaneously declare your authority as a physician when snortling about all us "sorry saps" on "happy pills" and then pretend that you're just one of us chickens when you're called on it.
I'm assuming that you actually graduated from some kind of medical school somewhere and passed the boards for some sort of practice, which means you have specialized knowledge. You could have read and commented on the study cited in the original post, explicating it for the rest of us who aren't as conversant in the clinical language. That would have been immensely valuable, especially since the NYT article is damn sketchy.
Instead, you indulged in the dumbest jokes residents swap among themselves, and when you were called on it, you whimpered about people being "mean in this forum." This is, happily, the only forum in which I encounter you. Where else should I call you on your jackassery?
posted by vetiver at 8:08 PM on December 18, 2004
I'm assuming that you actually graduated from some kind of medical school somewhere and passed the boards for some sort of practice, which means you have specialized knowledge. You could have read and commented on the study cited in the original post, explicating it for the rest of us who aren't as conversant in the clinical language. That would have been immensely valuable, especially since the NYT article is damn sketchy.
Instead, you indulged in the dumbest jokes residents swap among themselves, and when you were called on it, you whimpered about people being "mean in this forum." This is, happily, the only forum in which I encounter you. Where else should I call you on your jackassery?
posted by vetiver at 8:08 PM on December 18, 2004
not going to engage, smile a bit please
posted by dancingbaptist at 8:12 PM on December 18, 2004
posted by dancingbaptist at 8:12 PM on December 18, 2004
Perhaps my flippancy is fueled by the Nyquil I'm taking while...
[Self-serving references to (cough, cough...) the common cold as a warmup to why we should sympathize with the cost of medical eduaction...]
Yeah, dancingbaptist, perhaps my flippancy is fueled by the Paxil I've taken, lo, these many years and years and years. Actually, it's not. Paxil is the one thing that's brought me back to something resembling normal (pathetic "sap" that I am).
Will be a financial blow (20k graduate stipend plus a few K per year moonlighting on weekends) but as everyone that knows me realizes, financial motives are not what drive me.
Fine. I didn't bring up the cost of learning, y'know.
posted by 327.ca at 8:13 PM on December 18, 2004
[Self-serving references to (cough, cough...) the common cold as a warmup to why we should sympathize with the cost of medical eduaction...]
Yeah, dancingbaptist, perhaps my flippancy is fueled by the Paxil I've taken, lo, these many years and years and years. Actually, it's not. Paxil is the one thing that's brought me back to something resembling normal (pathetic "sap" that I am).
Will be a financial blow (20k graduate stipend plus a few K per year moonlighting on weekends) but as everyone that knows me realizes, financial motives are not what drive me.
Fine. I didn't bring up the cost of learning, y'know.
posted by 327.ca at 8:13 PM on December 18, 2004
Sorry, meant to add:
jesourie, good luck, and I'm sure you'll do fine. Your original post could've been written by a good friend who graduated from Johns Hopkins a few years ago. She was just as stressed about finishing and she did great -- incredibly busy and incredibly happy now.
posted by vetiver at 8:14 PM on December 18, 2004
jesourie, good luck, and I'm sure you'll do fine. Your original post could've been written by a good friend who graduated from Johns Hopkins a few years ago. She was just as stressed about finishing and she did great -- incredibly busy and incredibly happy now.
posted by vetiver at 8:14 PM on December 18, 2004
best to you all, good night
posted by dancingbaptist at 8:16 PM on December 18, 2004
posted by dancingbaptist at 8:16 PM on December 18, 2004
I don't really approve of how easily I got meds from a gp with no followup.
Speaking of the process of getting meds from a general practitioner....
Since moving 'bout 3 years ago, I've had a new doctor through an HMO. I don't usually go to the doctor for a cold/flu unless it's pretty bad. About a year ago I went to him with a chest cold. He says maybe 20 words to me - "Hi, how are you doing? What's wrong?" kind of stuff. Checks me over for 3 minutes. Says "I'll be right back." Comes back 5 minutes later, hands me a prescription and says "this should help you." And that's it. Not a word about what he thinks I have, not a word about what he just prescribed me.
Anyone else experience anything like that?
On a side note - I think pot certainly helped me with my depression, but I doubt it would've pulled me out of it by itself. And I don't mean helped just while I was high. The day after getting stoned (if I didn't get REAL stoned) I would usually feel mentally clearer.
Unfortunately, I wasn't smoking it for the next day clarity, but for the high. So each day I'd need to smoke a little more to overcome the tolerance and get the high, and that lead to a constant cloudiness. What I'm curious about is what it would've done if I just smoked a little bit everyday - not even enough to get the high. I suspect that it may have helped, but until the government allows actual research to be done on the medicinal effects of pot, we can't objectively know.
posted by Bort at 8:27 PM on December 18, 2004
Speaking of the process of getting meds from a general practitioner....
Since moving 'bout 3 years ago, I've had a new doctor through an HMO. I don't usually go to the doctor for a cold/flu unless it's pretty bad. About a year ago I went to him with a chest cold. He says maybe 20 words to me - "Hi, how are you doing? What's wrong?" kind of stuff. Checks me over for 3 minutes. Says "I'll be right back." Comes back 5 minutes later, hands me a prescription and says "this should help you." And that's it. Not a word about what he thinks I have, not a word about what he just prescribed me.
Anyone else experience anything like that?
On a side note - I think pot certainly helped me with my depression, but I doubt it would've pulled me out of it by itself. And I don't mean helped just while I was high. The day after getting stoned (if I didn't get REAL stoned) I would usually feel mentally clearer.
Unfortunately, I wasn't smoking it for the next day clarity, but for the high. So each day I'd need to smoke a little more to overcome the tolerance and get the high, and that lead to a constant cloudiness. What I'm curious about is what it would've done if I just smoked a little bit everyday - not even enough to get the high. I suspect that it may have helped, but until the government allows actual research to be done on the medicinal effects of pot, we can't objectively know.
posted by Bort at 8:27 PM on December 18, 2004
wow, check out the excellent conflict resolution. Nice job, folks.
I guess *that* was, unfortunately, a little premature.
posted by Turtles all the way down at 8:29 PM on December 18, 2004
I guess *that* was, unfortunately, a little premature.
posted by Turtles all the way down at 8:29 PM on December 18, 2004
Doctors are, in fact, regular people. (I know this firsthand.) What exactly is the supposed justification for holding an (off-duty) doctor to a higher standard of discourse here than anyone else? He's not your doctor and you're not his patient. Why expect him to maintain a Professional Bedside Manner™ 24 hours a day? Let him come down off that pedestal you've made for him once in a while. Sheesh.
posted by kindall at 8:30 PM on December 18, 2004
posted by kindall at 8:30 PM on December 18, 2004
What exactly is the supposed justification for holding an (off-duty) doctor to a higher standard of discourse here than anyone else?
Oh, fuck off. Because he posted as a doctor.
posted by 327.ca at 8:37 PM on December 18, 2004
Oh, fuck off. Because he posted as a doctor.
posted by 327.ca at 8:37 PM on December 18, 2004
Doctors are, in fact, regular people. (I know this firsthand.) What exactly is the supposed justification for holding an (off-duty) doctor to a higher standard of discourse here than anyone else?
Of course doctors are permitted to have private lives, and engage in "non-doctorly" activities, whatever those may be. The objection is to dancingbaptist's public attitude towards his own profession. Let him say whatever he wishes, in private and among other medical professionals, but when he comes to MetaFilter and starts slinging around jargon like "happy pills" and "sad sacks," I, as a theoretical patient, conclude that he would not take my condition seriously. And did you notice how he started in with the insults from the beginning, and only when he was called on it identified himself as a doctor? When that didn't work, he tried to pull, "Wait, I'm also a sufferer of depression myself!" If he'd given the full disclosure first, he might have gotten away with it. As it is, he's just covering his ass, and not doing a very good job of it.
(Speaking of full disclosure, I'll add that I am not a medical professional, and am on medication for depression.)
posted by Faint of Butt at 8:43 PM on December 18, 2004
Of course doctors are permitted to have private lives, and engage in "non-doctorly" activities, whatever those may be. The objection is to dancingbaptist's public attitude towards his own profession. Let him say whatever he wishes, in private and among other medical professionals, but when he comes to MetaFilter and starts slinging around jargon like "happy pills" and "sad sacks," I, as a theoretical patient, conclude that he would not take my condition seriously. And did you notice how he started in with the insults from the beginning, and only when he was called on it identified himself as a doctor? When that didn't work, he tried to pull, "Wait, I'm also a sufferer of depression myself!" If he'd given the full disclosure first, he might have gotten away with it. As it is, he's just covering his ass, and not doing a very good job of it.
(Speaking of full disclosure, I'll add that I am not a medical professional, and am on medication for depression.)
posted by Faint of Butt at 8:43 PM on December 18, 2004
OHMYGOD I'M DEPRESSED AND YOU DISSED MY MEDS!!! What the hell is up with you people?
Doctors are just like you and me -- with a shitload of training under their belts. Wouldn't you develop some strange humor around different types of shellac if you trained for 8 years as a cabinet maker?
Get some perspective. Get outside. Leave dancingbaptist alone, he sounds like a good guy to me (and I've been on a shitload of antidepressants in my life, and only wish they'd been "happy pills" in my case).
posted by _sirmissalot_ at 9:07 PM on December 18, 2004
Doctors are just like you and me -- with a shitload of training under their belts. Wouldn't you develop some strange humor around different types of shellac if you trained for 8 years as a cabinet maker?
Get some perspective. Get outside. Leave dancingbaptist alone, he sounds like a good guy to me (and I've been on a shitload of antidepressants in my life, and only wish they'd been "happy pills" in my case).
posted by _sirmissalot_ at 9:07 PM on December 18, 2004
Get some perspective. Get outside. Leave dancingbaptist alone, he sounds like a good guy to me (and I've been on a shitload of antidepressants in my life, and only wish they'd been "happy pills" in my case).
Yeah. Ok. So what? What's your point exactly? Dancingbatist wants to impress us with doctorly wisdom. Well, whoopde-do.
posted by 327.ca at 9:19 PM on December 18, 2004
Yeah. Ok. So what? What's your point exactly? Dancingbatist wants to impress us with doctorly wisdom. Well, whoopde-do.
posted by 327.ca at 9:19 PM on December 18, 2004
good point, q.
posted by _sirmissalot_ at 9:27 PM on December 18, 2004
posted by _sirmissalot_ at 9:27 PM on December 18, 2004
when he comes to MetaFilter and starts slinging around jargon like "happy pills" and "sad sacks," I, as a theoretical patient, conclude that he would not take my condition seriously.
Huh? That's quite the non-sequitur. Why would you conclude that?
posted by kindall at 9:29 PM on December 18, 2004
Huh? That's quite the non-sequitur. Why would you conclude that?
posted by kindall at 9:29 PM on December 18, 2004
Huh? That's quite the non-sequitur. Why would you conclude that?
If I see someone behaving unprofessionally outside of his work, I lose the expectation that he will behave professionally when working. Now, I'm no killjoy-- I have a pretty strict definition of unprofessional behavior, and it doesn't include most things you could name, but insulting one's customer base or clientele qualifies.
posted by Faint of Butt at 9:41 PM on December 18, 2004
If I see someone behaving unprofessionally outside of his work, I lose the expectation that he will behave professionally when working. Now, I'm no killjoy-- I have a pretty strict definition of unprofessional behavior, and it doesn't include most things you could name, but insulting one's customer base or clientele qualifies.
posted by Faint of Butt at 9:41 PM on December 18, 2004
In the interest of creating discussion again...
Jesourie, nice post and good luck on your final!
My question involves the recent hubbub over adolescents and anti-depressants. My impression from the research was that the increased risk of suicide and other problems noted was simply a result of lifting some of the depression symptoms so they actually have enough energy to get on with doing the things they've wanted to for awhile. As a severely depressed gradeschooler, and much better now with prozac, this makes sense to me. I really hope they don't stop prescribing anti-depressants for adolescents. If I had to wait until I as an adult to not suffer from depression, I don't think I would have made it alive until I was an adult. This just drives home the point that drugs should only be prescribed as part of a support plan, which I had plenty of. Do doctors actually hand out prozac these days? At every place I've gotten it, I had to enroll in a counseling program to even get access to it, which is actually fairly silly now. My counseling is basically one meeting a semester to get a referral, because I'm totally happy with my drug setup. Of course, I'm a fairly open guy and generally talk to my parents and close friends about the stuff I used to save for my counselor in grade school.
Basically, vaska, I totally disagree with you. There's no way I would have been diagnosed with a serious life-ending depression when I was in grade school, because I was good at hiding it. But, there was enough of a problem that I couldn't hide all of it. Getting the drugs then was the Right Thing to do. However, what is important is to try going off drugs every once in awhile. I wasn't sure if the drugs were doing anything until I spent 6 months off prozac as a freshman. My conclusion from that experience is that me on drugs is exactly the same as me off drugs, +10% happiness. There wasn't a numbing out, there was just a general improvement. Possibly relevant to the discussion: I'm on a low dosage of prozac, so many of the side effects and other negatives really don't effect me. It turns out I just needed a chemical boost in adolescence to start getting my brain straightened out.
Random other question, how do you think that pot helps with depression? I can see how it would reduce anxiety levels, and in many people like me anxiety and depression is closely related. Is there something else at work there that should be investigated?
posted by JZig at 9:41 PM on December 18, 2004
Jesourie, nice post and good luck on your final!
My question involves the recent hubbub over adolescents and anti-depressants. My impression from the research was that the increased risk of suicide and other problems noted was simply a result of lifting some of the depression symptoms so they actually have enough energy to get on with doing the things they've wanted to for awhile. As a severely depressed gradeschooler, and much better now with prozac, this makes sense to me. I really hope they don't stop prescribing anti-depressants for adolescents. If I had to wait until I as an adult to not suffer from depression, I don't think I would have made it alive until I was an adult. This just drives home the point that drugs should only be prescribed as part of a support plan, which I had plenty of. Do doctors actually hand out prozac these days? At every place I've gotten it, I had to enroll in a counseling program to even get access to it, which is actually fairly silly now. My counseling is basically one meeting a semester to get a referral, because I'm totally happy with my drug setup. Of course, I'm a fairly open guy and generally talk to my parents and close friends about the stuff I used to save for my counselor in grade school.
Basically, vaska, I totally disagree with you. There's no way I would have been diagnosed with a serious life-ending depression when I was in grade school, because I was good at hiding it. But, there was enough of a problem that I couldn't hide all of it. Getting the drugs then was the Right Thing to do. However, what is important is to try going off drugs every once in awhile. I wasn't sure if the drugs were doing anything until I spent 6 months off prozac as a freshman. My conclusion from that experience is that me on drugs is exactly the same as me off drugs, +10% happiness. There wasn't a numbing out, there was just a general improvement. Possibly relevant to the discussion: I'm on a low dosage of prozac, so many of the side effects and other negatives really don't effect me. It turns out I just needed a chemical boost in adolescence to start getting my brain straightened out.
Random other question, how do you think that pot helps with depression? I can see how it would reduce anxiety levels, and in many people like me anxiety and depression is closely related. Is there something else at work there that should be investigated?
posted by JZig at 9:41 PM on December 18, 2004
I've been on antidepressants for 7 years now and none of them have done much for me. The side effects (major anxiety) I get from all of them keep me from being able to get up to a theraputic dose. Switching meds wreaks havoc on my emotions and body, but I've had to deal with it over and over trying to find something that helps. I'm on Lexapro now, which is as bad as anything else, but I can't deal with switching and I can't deal with being on nothing.
I've got a lot of humor about the drugs and the depression, but it's really just a way of talking about stuff that's just too damn awful to go into fully. This stuff hurts, it really hurts. All the time. It's hard to breathe. It's hard to think. It's hard to fall asleep and it's hard to stay awake...all at the same time.
If you're a doctor that can help, I don't care how you talk about depression or medication. I haven't met one of those yet.
posted by spaghetti at 9:55 PM on December 18, 2004
I've got a lot of humor about the drugs and the depression, but it's really just a way of talking about stuff that's just too damn awful to go into fully. This stuff hurts, it really hurts. All the time. It's hard to breathe. It's hard to think. It's hard to fall asleep and it's hard to stay awake...all at the same time.
If you're a doctor that can help, I don't care how you talk about depression or medication. I haven't met one of those yet.
posted by spaghetti at 9:55 PM on December 18, 2004
JZig,
You are referring to the "rollback" phenomenon, if I recall. The notion that people are too enervated to kill themselves when deeply depressed, but do, often, attempt and succeed in the early stages of treated depression. From what I can tell, some of the adolescent suicides were hard to explain by this alone. Common sense dictates that these are individuals that are by nature more impulsive. But in an even more prosaic sense, I find myself made very uncomfortable by the mere fact that adolescents are often left alone for hours during the day, and as you said, they are experts at hiding their real intent from people around them.
I practice in a fairly large community. I could get someone seen by a specialist for a seizure, a breast reduction, pulmonary disease, or cancer - you name it - in a few days, but god help you if you are under eighteen and need an inpatient bed for suicidal behavior. There is no state spending for it (or enough). It's fucking horrifying. On any given day when this comes up, my assistant will spend no less than 1-2 hours trying to get a bed. I sometimes tell parents to go to the ER and refuse to leave until a social worker comes in to assist.
This entire thread is quite impressive to read and illustrates a lot of what I love about MeFi. But frankly, db's comments strike me as either immature, insensitive, or insecure. Flippancy about medical issues from a health professional, when talking to non-physicians, is just fucking stupid. The only time I ever saw it as forgiveable was when I saw first year med students trying out their new-found cojones in a bar with a co-ed as they talked too loudly about their cadaver in gross anatomy. After that, it's just embarrassing.
posted by docpops at 10:05 PM on December 18, 2004
You are referring to the "rollback" phenomenon, if I recall. The notion that people are too enervated to kill themselves when deeply depressed, but do, often, attempt and succeed in the early stages of treated depression. From what I can tell, some of the adolescent suicides were hard to explain by this alone. Common sense dictates that these are individuals that are by nature more impulsive. But in an even more prosaic sense, I find myself made very uncomfortable by the mere fact that adolescents are often left alone for hours during the day, and as you said, they are experts at hiding their real intent from people around them.
I practice in a fairly large community. I could get someone seen by a specialist for a seizure, a breast reduction, pulmonary disease, or cancer - you name it - in a few days, but god help you if you are under eighteen and need an inpatient bed for suicidal behavior. There is no state spending for it (or enough). It's fucking horrifying. On any given day when this comes up, my assistant will spend no less than 1-2 hours trying to get a bed. I sometimes tell parents to go to the ER and refuse to leave until a social worker comes in to assist.
This entire thread is quite impressive to read and illustrates a lot of what I love about MeFi. But frankly, db's comments strike me as either immature, insensitive, or insecure. Flippancy about medical issues from a health professional, when talking to non-physicians, is just fucking stupid. The only time I ever saw it as forgiveable was when I saw first year med students trying out their new-found cojones in a bar with a co-ed as they talked too loudly about their cadaver in gross anatomy. After that, it's just embarrassing.
posted by docpops at 10:05 PM on December 18, 2004
Thanks, docpops. See, everyone? That's what a doctor's comment on a medical thread is supposed to look like.
posted by Faint of Butt at 10:23 PM on December 18, 2004
posted by Faint of Butt at 10:23 PM on December 18, 2004
I apologize for being flippant. Please don't be so mean on this forum.
They can't help it, they ran out of happy pills.
posted by jonmc at 10:36 PM on December 18, 2004
They can't help it, they ran out of happy pills.
posted by jonmc at 10:36 PM on December 18, 2004
JZig: Random other question, how do you think that pot helps with depression? I can see how it would reduce anxiety levels, and in many people like me anxiety and depression is closely related. Is there something else at work there that should be investigated?
I've suspected that it releases extra serotonin like extasy, only not to the extend that extasy does (but I'm probably wrong). I did a quick google search and found some interesting links:
This one claims a link between pot and neurotransmitters:
The cannabinoid system also appears to exert wide influence, modulating the release of dopamine, serotonin and other neurotransmitters.
And this one:
Marijuana also works by prolonging the time the serotonin stays in the gaps between nerve cells
seems to directly conflict (or maybe just counter-act the effects of ) this one:
Migraines are caused by the release of the neurotransmitter serotonin and smoking marijuana or the THC inhibited the release of serotonin.
I think much more research is needed. But I don't think it will happen in the US anytime soon.
posted by Bort at 10:45 PM on December 18, 2004
I've suspected that it releases extra serotonin like extasy, only not to the extend that extasy does (but I'm probably wrong). I did a quick google search and found some interesting links:
This one claims a link between pot and neurotransmitters:
The cannabinoid system also appears to exert wide influence, modulating the release of dopamine, serotonin and other neurotransmitters.
And this one:
Marijuana also works by prolonging the time the serotonin stays in the gaps between nerve cells
seems to directly conflict (or maybe just counter-act the effects of ) this one:
Migraines are caused by the release of the neurotransmitter serotonin and smoking marijuana or the THC inhibited the release of serotonin.
I think much more research is needed. But I don't think it will happen in the US anytime soon.
posted by Bort at 10:45 PM on December 18, 2004
Thanks docpops for that comment.
I was very fortunate to have a loving, experienced family (well, ignoring the fact that they probably gave it to me in the first place...) and free counseling and medical care (yey for military health plan). Without those, I really don't know if I'd be here now.
Education and the treatment of mental health problems are in my opinion two of the biggest problems today, and I'm going to do whatever I can to help out in both. I want everyone who has a chance to be as happy as I am now to BE that happy, it's our moral obligation. For now, drugs are a good bet, and they can't go away. For the future, advances in neuroscience and medicine in general will help open up the way we work to science.
posted by JZig at 10:47 PM on December 18, 2004
I was very fortunate to have a loving, experienced family (well, ignoring the fact that they probably gave it to me in the first place...) and free counseling and medical care (yey for military health plan). Without those, I really don't know if I'd be here now.
Education and the treatment of mental health problems are in my opinion two of the biggest problems today, and I'm going to do whatever I can to help out in both. I want everyone who has a chance to be as happy as I am now to BE that happy, it's our moral obligation. For now, drugs are a good bet, and they can't go away. For the future, advances in neuroscience and medicine in general will help open up the way we work to science.
posted by JZig at 10:47 PM on December 18, 2004
Leave dancingbaptist alone, he sounds like a good guy to me
Not until he stops typing without a shift key, and starts refraining from saying things like 'LOL' and using emoticons.
Although I hate doctors on principle, I'd be willing to let the substance of his comments slide, but the breathless-14-year-old-girl form of them is, well, it's plain inexcusable.
posted by stavrosthewonderchicken at 11:21 PM on December 18, 2004
Not until he stops typing without a shift key, and starts refraining from saying things like 'LOL' and using emoticons.
Although I hate doctors on principle, I'd be willing to let the substance of his comments slide, but the breathless-14-year-old-girl form of them is, well, it's plain inexcusable.
posted by stavrosthewonderchicken at 11:21 PM on December 18, 2004
JZig : You totally disagree with me on which part exactly? If you mean that by having a backup net to prevent unwanted and unnecessary medication you would have been missed, there is nothing I can say to that. People fall through the cracks of every system. I know that sounds cruel and possibly quite flippant but it is unfortunately true. I am simply of the impression, from talking to my neighbors and friends, that for every 1 kid that needs urgent medication 2 that don't are getting it. The question is how to turn it around without screwing that one poor kid.
posted by Vaska at 11:23 PM on December 18, 2004
posted by Vaska at 11:23 PM on December 18, 2004
the breathless-14-year-old-girl form of them is, well, it's plain inexcusable
*blushes*
posted by quonsar at 11:34 PM on December 18, 2004
*blushes*
posted by quonsar at 11:34 PM on December 18, 2004
Now that this thread has pretty much run its course as per a real discussion, can we all just call out 327.ca on what a fucking ass he is.
Jeezes fucking christ, db apologized, and contributed, and you just keeping on being a snarky fucking asshole.
When the stick up your ass gives you a bowel obstruction, I hope you find a doctor as human as dancingbaptist to perform the extraction.
posted by PissOnYourParade at 12:18 AM on December 19, 2004
Jeezes fucking christ, db apologized, and contributed, and you just keeping on being a snarky fucking asshole.
When the stick up your ass gives you a bowel obstruction, I hope you find a doctor as human as dancingbaptist to perform the extraction.
posted by PissOnYourParade at 12:18 AM on December 19, 2004
I disagree with the "don't drug kids" angle as well. From another perspective and this goes for psychiatric care in general *some* people are over medicated and not treated as they should be but that can be said of all medical specialities. I know a woman who was treated by Dr Ewan Cameron - he's the doc that was hired by the CIA to do brain washing experiments in order to find a way to make people "Manchurian Candidates"). I know some other people who were given insulin shock treatment to "cure" their depression. I know of many people who have been mistreated and misdiagnosed but I know of thousands more who have gotten the treatment they needed and are better for it. From my POV there have been some crazy things done in the name of medicine but I really don't think the proverbial "baby" needs to be thrown out with the bath water because a few people have had a rough go with the medical profession.
I do agree that if you are going to diagnose and treat anyone they should be under the care of a doctor trained specifically to deal with mental illness but I don't agree, at all, that doctors should stop medicating all kids because a few are mistreated/misdiagnosed/over medicated. Actually in some ways I hope they aren't cared for by a psychiatrist in a lot of cases a GP does a better job of caring for their patients than psychiatrists do. But I do think second opinions should be mandatory. (probably contradicted myself but ... oh well)
posted by squeak at 12:27 AM on December 19, 2004
I do agree that if you are going to diagnose and treat anyone they should be under the care of a doctor trained specifically to deal with mental illness but I don't agree, at all, that doctors should stop medicating all kids because a few are mistreated/misdiagnosed/over medicated. Actually in some ways I hope they aren't cared for by a psychiatrist in a lot of cases a GP does a better job of caring for their patients than psychiatrists do. But I do think second opinions should be mandatory. (probably contradicted myself but ... oh well)
posted by squeak at 12:27 AM on December 19, 2004
've suspected that it releases extra serotonin like extasy,
I'm pretty sure that it doesn't, this from Erowid says that Cannabis suppresses serotonin, if I'm reading it right.
I'm going to go along with some of the others and say that I found dancingbaptist's comments to be inappropriate. This is a public forum and he must have guessed that many depressives would read this thread. The last thing we need is someone downplaying the seriousness of the illness, or perpetuating myths that SSRIs are happy pills. But I'm sure it was an honest mistake and he certainly didn't intend anything by it.
posted by Infinite Jest at 12:51 AM on December 19, 2004
I'm pretty sure that it doesn't, this from Erowid says that Cannabis suppresses serotonin, if I'm reading it right.
I'm going to go along with some of the others and say that I found dancingbaptist's comments to be inappropriate. This is a public forum and he must have guessed that many depressives would read this thread. The last thing we need is someone downplaying the seriousness of the illness, or perpetuating myths that SSRIs are happy pills. But I'm sure it was an honest mistake and he certainly didn't intend anything by it.
posted by Infinite Jest at 12:51 AM on December 19, 2004
Oh, good night nurse. Lay off the dancing baptist, willya? Or hold docpops to the same standard, as Christians have to go to the doctor too.
Sometimes I think people get on this site just looking for someone to fight with. Stop it.
posted by konolia at 4:27 AM on December 19, 2004
Sometimes I think people get on this site just looking for someone to fight with. Stop it.
posted by konolia at 4:27 AM on December 19, 2004
I was going to tip my hat to _sirmissalot_ said, but then docpops made me change my mind a bit.
I was diagnosed (finally, after ignoring it for too long) with depression in 2000 and resisted going on medication until the summer of 2003, when a doctor started me on Lexapro. That didn't do much for me and the side effects sucked, so I gave up on it. I didn't really want to be on medication anyway because I believed that therapy alone was enough. But this year a new therapist convinced me to give medication a try again, and a different doctor prescribed Wellbutrin. I take one of those a day and continue to see a therapist about once a week, and I'm actually kind of impressed with the results. The factors contributing to my depression haven't changed a whole lot, but I haven't felt this good in a long time.
This doctor, who I only see for the prescription and nothing else, seemed only vaguely interested in what I was telling him as he wrote on his notepad. After 10 minutes or so of asking me yes/no questions, he sent me home with a month's worth of free Wellbutrin. Followup visits since then have taken even less time. The medication helps me as I'm sure it helps many, many other people, but prescriptions for antidepressants are far too easy to come by and I think many doctors are a little too eager to prescribe them.
posted by emelenjr at 7:13 AM on December 19, 2004
I was diagnosed (finally, after ignoring it for too long) with depression in 2000 and resisted going on medication until the summer of 2003, when a doctor started me on Lexapro. That didn't do much for me and the side effects sucked, so I gave up on it. I didn't really want to be on medication anyway because I believed that therapy alone was enough. But this year a new therapist convinced me to give medication a try again, and a different doctor prescribed Wellbutrin. I take one of those a day and continue to see a therapist about once a week, and I'm actually kind of impressed with the results. The factors contributing to my depression haven't changed a whole lot, but I haven't felt this good in a long time.
This doctor, who I only see for the prescription and nothing else, seemed only vaguely interested in what I was telling him as he wrote on his notepad. After 10 minutes or so of asking me yes/no questions, he sent me home with a month's worth of free Wellbutrin. Followup visits since then have taken even less time. The medication helps me as I'm sure it helps many, many other people, but prescriptions for antidepressants are far too easy to come by and I think many doctors are a little too eager to prescribe them.
posted by emelenjr at 7:13 AM on December 19, 2004
holy, lots of bullshit on metafilter (threads, links and, of course, all these petty, waste-of-time-and-space, comments). can we have real discussions about issues, instead of personal mudsling-fests. this thread should be called "why dancing baptist is a disgrace to his profession and all of humanity at large". gimme a break. let's move on, folks.
posted by yedgar at 8:10 AM on December 19, 2004
posted by yedgar at 8:10 AM on December 19, 2004
However, I find your 'Is Claritin destroying our children's ability to deal with annoying physical distractions?' comment to be a bit much.
Good. It was supposed to be as flippant as the post it mirrors. Mission accomplished. But I am guilty of being easily derailed. I am matchstick.
The last thing we need is someone downplaying the seriousness of the illness, or perpetuating myths that SSRIs are happy pills. But I'm sure it was an honest mistake and he certainly didn't intend anything by it.
I respectfully disagree, or hold a different opinion. There was absolutely no downplaying of the serious of the illness whatsoever nor perpetuating a myth that SSRIs are happy pills. It's simply lighthearted humour and lingo, in my humble opinion, or is that IMHO?
The F-104 example I cited earlier was a plane that often crashed and became known as the Widowmaker. Those who referred to it as such did not have a careless disregard for those who'd perished and those who suffered loss.
Sense of humour differs of course as you clearly state as well, but using such terminology or slang for items related to one's profession is common and the medical profession shouldn't be an exception.
Now that this thread has pretty much run its course as per a real discussion, can we all just call out 327.ca on what a fucking ass he is.
Agreed.
Personally more research, more development is, I believe, great. Yes there is the trend drugs factor but this does not negate the legitimate use of meds.
posted by juiceCake at 8:27 AM on December 19, 2004
Good. It was supposed to be as flippant as the post it mirrors. Mission accomplished. But I am guilty of being easily derailed. I am matchstick.
The last thing we need is someone downplaying the seriousness of the illness, or perpetuating myths that SSRIs are happy pills. But I'm sure it was an honest mistake and he certainly didn't intend anything by it.
I respectfully disagree, or hold a different opinion. There was absolutely no downplaying of the serious of the illness whatsoever nor perpetuating a myth that SSRIs are happy pills. It's simply lighthearted humour and lingo, in my humble opinion, or is that IMHO?
The F-104 example I cited earlier was a plane that often crashed and became known as the Widowmaker. Those who referred to it as such did not have a careless disregard for those who'd perished and those who suffered loss.
Sense of humour differs of course as you clearly state as well, but using such terminology or slang for items related to one's profession is common and the medical profession shouldn't be an exception.
Now that this thread has pretty much run its course as per a real discussion, can we all just call out 327.ca on what a fucking ass he is.
Agreed.
Personally more research, more development is, I believe, great. Yes there is the trend drugs factor but this does not negate the legitimate use of meds.
posted by juiceCake at 8:27 AM on December 19, 2004
I took several different meds for my bipolar disorder before I found what works for me. I am part of a bipolar support group, and most of the people in that group have been searching for the right med combo for years. Meds just work differently for different people. What works for me may not work for others.
It bothers me as well when people say things like "Everyone gets depressed!" because while that is certainly true, not everyone gets *severely* depressed. Most people have situational depression. It's hard for them to understand severe, debilitating depression that occurs for no reason. Medication is necessary for this type of depression, and using talk therapy in conjunction is also useful. As someone who had severe depression in adolescence and was not medicated, I can say that it disturbs me that people want to take medical assistance away from teens and kids. I think people need to be smart about it and closely observe their child, but I think it is a good tool to have available, and may save the life of your child.
In someone with bipolar who is not taking a mood stabilizer, an anti-depressant can cause them to swing into mania. Just another thing to watch out for: people should be instructed to watch for signs of mania when giving their kid an anti-depressant, especially if bipolar or depression runs in the family.
posted by veronitron at 10:10 AM on December 19, 2004
It bothers me as well when people say things like "Everyone gets depressed!" because while that is certainly true, not everyone gets *severely* depressed. Most people have situational depression. It's hard for them to understand severe, debilitating depression that occurs for no reason. Medication is necessary for this type of depression, and using talk therapy in conjunction is also useful. As someone who had severe depression in adolescence and was not medicated, I can say that it disturbs me that people want to take medical assistance away from teens and kids. I think people need to be smart about it and closely observe their child, but I think it is a good tool to have available, and may save the life of your child.
In someone with bipolar who is not taking a mood stabilizer, an anti-depressant can cause them to swing into mania. Just another thing to watch out for: people should be instructed to watch for signs of mania when giving their kid an anti-depressant, especially if bipolar or depression runs in the family.
posted by veronitron at 10:10 AM on December 19, 2004
Sorry, but the ETOH is just poking me in the eye and it's really annoying. It really should be EtOH (or CH3OH).
Konalia - you said you didn't know what happy was until you went on your meds... but you say that you're bipolar. Doesn't the mania feel 'good?'
posted by PurplePorpoise at 11:13 AM on December 19, 2004
Konalia - you said you didn't know what happy was until you went on your meds... but you say that you're bipolar. Doesn't the mania feel 'good?'
posted by PurplePorpoise at 11:13 AM on December 19, 2004
docpops didn't say he hated Christians, konolia, he said he hated Evangelicals. Stop trying to make the two things synonymous.
(However, docpops, don't hate the Evangelicals. They need help as much as--if not more than--the rest of us Christians, and all the other believers and non-believers as well.)
And, though I think that 327.ca got a wild hair about all of this, dancingbaptist does tend to adopt a confrontational posting style from time to time, and the "I'm just a regular person EXCEPT I'M A DOCTOR WHO KNOWS MORE THAN YOU but I'm just a regular person" tone he began with in this thread rubbed me the wrong way, too.
I also think that the "if you think I'm being an asshole, you just don't get my sense of humor" card has been played so often that it needs to be retired from the deck.
I also think that only psychiatrists should prescribe psychoactive medications. The sort of overprescription that vaska describes is, in my opinion, the result of overworked general practitioners without the diagnostic experience they need writing the presciptions their patients ask for, whether they're appropriate or not, because the patients have seen ads or read stories about drugs that they think they might need and the GP doesn't have the time or patience to do a thorough evaluation.
posted by Sidhedevil at 11:14 AM on December 19, 2004
(However, docpops, don't hate the Evangelicals. They need help as much as--if not more than--the rest of us Christians, and all the other believers and non-believers as well.)
And, though I think that 327.ca got a wild hair about all of this, dancingbaptist does tend to adopt a confrontational posting style from time to time, and the "I'm just a regular person EXCEPT I'M A DOCTOR WHO KNOWS MORE THAN YOU but I'm just a regular person" tone he began with in this thread rubbed me the wrong way, too.
I also think that the "if you think I'm being an asshole, you just don't get my sense of humor" card has been played so often that it needs to be retired from the deck.
I also think that only psychiatrists should prescribe psychoactive medications. The sort of overprescription that vaska describes is, in my opinion, the result of overworked general practitioners without the diagnostic experience they need writing the presciptions their patients ask for, whether they're appropriate or not, because the patients have seen ads or read stories about drugs that they think they might need and the GP doesn't have the time or patience to do a thorough evaluation.
posted by Sidhedevil at 11:14 AM on December 19, 2004
The factors contributing to my depression haven't changed a whole lot, but I haven't felt this good in a long time.
This is where it sticks, I think, for people who are wary of the current omnipresence of antidepressants. There is something unseemly in handing out pills without adressing the underlying problems. In some cases, yes, there is severe depression that needs medication to be treated—whose only underlying problem is chemical. On the other hand, the way our society is set up these days can be very, very inhuman (cube farms anyone?), and I think some people who are more anti-pill than average would rather we address those things, rather than making people structurally depressed and then giving them pills to fix that.
I would never presume to tell a specific person not to take drugs, and there is obvioulsy something problematic to saying, "I know you feel bad now, but lets work on structural changes that may never happen." However, it does make me sad to see the pill option so revered and questions of structural depression so unasked.
posted by dame at 11:18 AM on December 19, 2004
This is where it sticks, I think, for people who are wary of the current omnipresence of antidepressants. There is something unseemly in handing out pills without adressing the underlying problems. In some cases, yes, there is severe depression that needs medication to be treated—whose only underlying problem is chemical. On the other hand, the way our society is set up these days can be very, very inhuman (cube farms anyone?), and I think some people who are more anti-pill than average would rather we address those things, rather than making people structurally depressed and then giving them pills to fix that.
I would never presume to tell a specific person not to take drugs, and there is obvioulsy something problematic to saying, "I know you feel bad now, but lets work on structural changes that may never happen." However, it does make me sad to see the pill option so revered and questions of structural depression so unasked.
posted by dame at 11:18 AM on December 19, 2004
Konalia - you said you didn't know what happy was until you went on your meds... but you say that you're bipolar. Doesn't the mania feel 'good?'
I have the type two variety. My main symptom is depression. When the mood swings, unfortunately many times it swings into irritable hypomania (Hypomania being a "minor mania" which is what differentiates what I have from the classic type 1 bipolar disorder.) Any "happy" hypos are usually shortlived, and I am no different from the average overtalkative extrovert when that happens.
What I am talking about is being able to feel good and calm for long periods of time. For that to happen for me requires meds. Right now I compensate with exercise. It doesnt work that well, but better than nothing.
posted by konolia at 11:44 AM on December 19, 2004
I have the type two variety. My main symptom is depression. When the mood swings, unfortunately many times it swings into irritable hypomania (Hypomania being a "minor mania" which is what differentiates what I have from the classic type 1 bipolar disorder.) Any "happy" hypos are usually shortlived, and I am no different from the average overtalkative extrovert when that happens.
What I am talking about is being able to feel good and calm for long periods of time. For that to happen for me requires meds. Right now I compensate with exercise. It doesnt work that well, but better than nothing.
posted by konolia at 11:44 AM on December 19, 2004
konolia - would it be ok for me to pm you?
posted by PurplePorpoise at 11:47 AM on December 19, 2004
posted by PurplePorpoise at 11:47 AM on December 19, 2004
Bipolar mania does not mean that you are just very happy. I have the type one variety of bipolar, which means that I experience true mania (manic and mixed episodes - meaning you are both manic and depressed at the same time - are what I get most often). Mania usually means I'm doing something destructive. I am terrified of becoming manic.
Depression (and bipolar) are heritable illnesses. Meaning, they can be genetically passed down. My father has bipolar, and I got it from him. They are finding that with these illness, a person has a genetic predisposition to them, and that they are brought out by an environmental cause. It could be a good or a bad thing that brings it out. If there are "structural" causes to depression, it's more likely that these issues brought out the depression that the individual was genetically predisposed to getting anyway.
posted by veronitron at 12:54 PM on December 19, 2004
Depression (and bipolar) are heritable illnesses. Meaning, they can be genetically passed down. My father has bipolar, and I got it from him. They are finding that with these illness, a person has a genetic predisposition to them, and that they are brought out by an environmental cause. It could be a good or a bad thing that brings it out. If there are "structural" causes to depression, it's more likely that these issues brought out the depression that the individual was genetically predisposed to getting anyway.
posted by veronitron at 12:54 PM on December 19, 2004
I think there are many people who can't begin to address the things that make them sad before medication helps make their depression bearable enough so that they can get out of bed, take a shower, and stop thinking constantly about killing themselves.
I know I have been, in my life, one of those people.
It's like saying "People with diabetes can experience great improvements in their physical health when they change their diet and exercise habits" and not mentioning that there are some people who are slipping in and out of diabetic coma and need insulin RIGHT AWAY, and then they can start thinking about changing their diet and exercise.
posted by Sidhedevil at 12:57 PM on December 19, 2004
I know I have been, in my life, one of those people.
It's like saying "People with diabetes can experience great improvements in their physical health when they change their diet and exercise habits" and not mentioning that there are some people who are slipping in and out of diabetic coma and need insulin RIGHT AWAY, and then they can start thinking about changing their diet and exercise.
posted by Sidhedevil at 12:57 PM on December 19, 2004
Doesn't the mania feel 'good?'
Yes, but it is also more fatal than depression.
I also think that only psychiatrists should prescribe psychoactive medications.
If this were true there would be a lot more people suffering. Many will absolutely not see a psychiatrist, because of a percieved stigma, especially in the Midwest.
docpops didn't say he hated Christians, konolia, he said he hated Evangelicals. Stop trying to make the two things synonymous.
Oh, then that's morally OK.
Looking at this thread in retrospect, with people criticising non-use of a shift key, use of emoticons, and the chemical abbreviation of alcohol.... just fuck off, just go fuck yourselves and get a life.
posted by dancingbaptist at 1:20 PM on December 19, 2004
Yes, but it is also more fatal than depression.
I also think that only psychiatrists should prescribe psychoactive medications.
If this were true there would be a lot more people suffering. Many will absolutely not see a psychiatrist, because of a percieved stigma, especially in the Midwest.
docpops didn't say he hated Christians, konolia, he said he hated Evangelicals. Stop trying to make the two things synonymous.
Oh, then that's morally OK.
Looking at this thread in retrospect, with people criticising non-use of a shift key, use of emoticons, and the chemical abbreviation of alcohol.... just fuck off, just go fuck yourselves and get a life.
posted by dancingbaptist at 1:20 PM on December 19, 2004
dame, I wonder if I wasn't clear enough. The truth is that I'm feeling better thanks to both therapy and the medication. The underlying problems are being addressed, but mostly in the sense of learning how to cope with them rather than trying to get rid of them all completely. The latter just isn't a realistic option for me.
On preview, maybe you weren't taking issue with something I said after all.
posted by emelenjr at 1:24 PM on December 19, 2004
On preview, maybe you weren't taking issue with something I said after all.
posted by emelenjr at 1:24 PM on December 19, 2004
Jeez, dancingbaptist, have you considered happy pills?
posted by jonmc at 1:51 PM on December 19, 2004
posted by jonmc at 1:51 PM on December 19, 2004
Maybe I wasn't clear. It's the overfocus on the medical—to the detriment of considering the structural—that I take issue with. That depression is partially medical is, I think, obvious.
posted by dame at 1:52 PM on December 19, 2004
posted by dame at 1:52 PM on December 19, 2004
The advent of primary care physicians (BTW I don't believe there are any "GP"s in the US anymore, and might take that as an insult had I had a larger stick up my rectum as some seem to wish) providing mental health care has been part of a paradigm shift of the perception and treatment of mental illness over the last several decades. While some (and unfortunately some conservative talk-show hosts that I otherwise respect) still blame it totally on up-bringing and behavioral aspects, health-care providers now pretty much universally regard it as a combinaiton of genetic/chemistry/physiology and behavioral/situational aspects.
While I disagree with some fundementalist Christian pastors who state "I don't need Prozac, I have Jesus!" I do not hate them. My practice ranges from atheistic, liberal, conservative, and christian (and evangelical) Christian faith. I approach them all initially the same way, then adapt my style as I get to know them. Some very simple-thinking people without the benefit of higher education are depressed and feel that they lack the faith to pull them out of it. Now if I hated them as evangelical Christians I'd be in a pinch. I work with them, often convincing them that taking fluoxetine or something like it is not a lack of faith, but I do work with them and respect their faith. I often have to adapt terminology to work with them.
I agree with the previous poster that current psychiatric understanding is in its infancy if not toddler stage. I disagree with the person who stated PCPs are not trained in psychiatry. We have extensive training in psychiatry and it takes up a good portion of our board exams. I would estimate 1/5 of my practice is psychiatry related and 1/3 is at least indirectly. The hardest patient is the old guy with chronic pain and insomnia, who's spouse past away last year, who refuses to mention the word depression or counseling. If primary care providers (docs/PAs/ARNPs) weren't there for that guy, he'd probably blow his head off with one of the 1o shotguns in his gunrack. So I take offense to that statement, but it does not anger me and just reflects a lack of undertanding.
Finally, thanks to those of you who contributed to the substance of this issue without getting into the fray (even if you didn't like my humor) and to those who called the curmudgeons for what they are). My only regret is I through out a blanket apology. My apology is to those who are sincere, not to those who have ramose ojects so far up their sigmoid colons that they elevated to such a moraly superior pedestal that their shit don't stink. (me and bush say don't instead of doesn't)
And yes, I do have a confrontational style when I'm posting politics. Mainly because of the liberal-bent of Metafilter and my somewhat conservative nature. My initial posts on this topic were not confrontational at all, except to the curmudgeons... and the only kind thing I can say to them is....ummm..... ummm.... go do something fun today, with your family, your friends, your pet, and if I see you on the street I'll probably say "hi."
(Yes jonmc, and I wish they (uh, the trilateral commission or something) would put them (happy pills) in the water.)
posted by dancingbaptist at 2:10 PM on December 19, 2004
While I disagree with some fundementalist Christian pastors who state "I don't need Prozac, I have Jesus!" I do not hate them. My practice ranges from atheistic, liberal, conservative, and christian (and evangelical) Christian faith. I approach them all initially the same way, then adapt my style as I get to know them. Some very simple-thinking people without the benefit of higher education are depressed and feel that they lack the faith to pull them out of it. Now if I hated them as evangelical Christians I'd be in a pinch. I work with them, often convincing them that taking fluoxetine or something like it is not a lack of faith, but I do work with them and respect their faith. I often have to adapt terminology to work with them.
I agree with the previous poster that current psychiatric understanding is in its infancy if not toddler stage. I disagree with the person who stated PCPs are not trained in psychiatry. We have extensive training in psychiatry and it takes up a good portion of our board exams. I would estimate 1/5 of my practice is psychiatry related and 1/3 is at least indirectly. The hardest patient is the old guy with chronic pain and insomnia, who's spouse past away last year, who refuses to mention the word depression or counseling. If primary care providers (docs/PAs/ARNPs) weren't there for that guy, he'd probably blow his head off with one of the 1o shotguns in his gunrack. So I take offense to that statement, but it does not anger me and just reflects a lack of undertanding.
Finally, thanks to those of you who contributed to the substance of this issue without getting into the fray (even if you didn't like my humor) and to those who called the curmudgeons for what they are). My only regret is I through out a blanket apology. My apology is to those who are sincere, not to those who have ramose ojects so far up their sigmoid colons that they elevated to such a moraly superior pedestal that their shit don't stink. (me and bush say don't instead of doesn't)
And yes, I do have a confrontational style when I'm posting politics. Mainly because of the liberal-bent of Metafilter and my somewhat conservative nature. My initial posts on this topic were not confrontational at all, except to the curmudgeons... and the only kind thing I can say to them is....ummm..... ummm.... go do something fun today, with your family, your friends, your pet, and if I see you on the street I'll probably say "hi."
(Yes jonmc, and I wish they (uh, the trilateral commission or something) would put them (happy pills) in the water.)
posted by dancingbaptist at 2:10 PM on December 19, 2004
uh, passed and threw, didn't preview it enough first.
posted by dancingbaptist at 2:13 PM on December 19, 2004
posted by dancingbaptist at 2:13 PM on December 19, 2004
Re adolescents and depression: I understand from the literature that the main question has been about an increase in suicidal ideation in adolescents taking SSRIs, although the evidence shows increased risk of suicidality, including suicidal ideation, suicide attempts and actual self-harm events. The strongest association was with paroxetine and venlafaxine, but sertraline, citalopram and fluoxetine (Prozac) have also been implicated, with fluoxetine possibly having the smallest risk. Prozac is currently the only FDA approved SSRI for adolescents, which doesn't necessarily mean a hell of a lot, since so many meds are used sans approval. The FDA currently requires a "black box warning" on all SSRIs for adolescents. As with all meds, the risks, benefits, side effects, and alternatives have to be laid out on the table. The patient and the patient's family get to make the final, fully informed decision. 'Course, even whether SSRIs have shown efficacy in adolescents isn't well established at this point, given the rather sparse, conflicting studies.
There are a couple of other general points worth mentioning.
We are trying to model and treat, using simple receptor-neurotransmitter constructs, the most complex object in the known universe. We are unlikely to find simple explanations for diseases like depression by relying solely on paradigms like "serotonin/norepinephrine/corticotropin/whatever" models. These are people.
We are just as unlikely to make progress by looking at mental illnesses as utterly different from other systems diseases. We don't (hopefully) tell people with bone fractures to "just snap out of it", or "you just have no will power", or "Trust Jesus", or "just change your life and you'll be happy."
In addition to medication, either cognitive or some kind of "talk therapy" is absolutely crucial. The nervous/emotional/cognitive organ is experientially rewirable - probably pretty damned infinitely malleable.
Finally, no physician I know has ever referred to any of the medications mentioned as "happy pills" nor those with depression as "sorry saps" regardless of the irrelevancy of what illnesses they themselves may have had. You really think "sorry saps" is "humor"?
So you've had depression, doctor? You caught a cold from a peds patient, doctor? Had any deaths in your family, doctor? So fucking what? You mock those with mood disorders as "sorry saps" or imply they just need to get "happy", or you call any URI/RSV suffering pediatric patients "snot nosed brats", or you dare call the dying "gomers" anytime around me, and I'll jam your unprincipled "humor" and backtracking, lukewarm "apology"...along with an obviously needed pimp session on ethics and compassion and professionalism...so superior your sigmoid colon that you'll be wailing the Hippocratic oath for me...soprano.
posted by fold_and_mutilate at 3:13 PM on December 19, 2004
There are a couple of other general points worth mentioning.
We are trying to model and treat, using simple receptor-neurotransmitter constructs, the most complex object in the known universe. We are unlikely to find simple explanations for diseases like depression by relying solely on paradigms like "serotonin/norepinephrine/corticotropin/whatever" models. These are people.
We are just as unlikely to make progress by looking at mental illnesses as utterly different from other systems diseases. We don't (hopefully) tell people with bone fractures to "just snap out of it", or "you just have no will power", or "Trust Jesus", or "just change your life and you'll be happy."
In addition to medication, either cognitive or some kind of "talk therapy" is absolutely crucial. The nervous/emotional/cognitive organ is experientially rewirable - probably pretty damned infinitely malleable.
Finally, no physician I know has ever referred to any of the medications mentioned as "happy pills" nor those with depression as "sorry saps" regardless of the irrelevancy of what illnesses they themselves may have had. You really think "sorry saps" is "humor"?
So you've had depression, doctor? You caught a cold from a peds patient, doctor? Had any deaths in your family, doctor? So fucking what? You mock those with mood disorders as "sorry saps" or imply they just need to get "happy", or you call any URI/RSV suffering pediatric patients "snot nosed brats", or you dare call the dying "gomers" anytime around me, and I'll jam your unprincipled "humor" and backtracking, lukewarm "apology"...along with an obviously needed pimp session on ethics and compassion and professionalism...so superior your sigmoid colon that you'll be wailing the Hippocratic oath for me...soprano.
posted by fold_and_mutilate at 3:13 PM on December 19, 2004
fuck you
posted by dancingbaptist at 3:21 PM on December 19, 2004
posted by dancingbaptist at 3:21 PM on December 19, 2004
Well, perhaps I'm a cry-baby but there are so many god-damn fucking assholes on this forum I cannot take it any more.
Bye you liberal communist son-of-a-bitches, have a fucking party.
posted by dancingbaptist at 3:40 PM on December 19, 2004
Bye you liberal communist son-of-a-bitches, have a fucking party.
posted by dancingbaptist at 3:40 PM on December 19, 2004
fuck you
Is that a prescription, doctor? Cos I want a second opinion.
posted by jonmc at 3:40 PM on December 19, 2004
Is that a prescription, doctor? Cos I want a second opinion.
posted by jonmc at 3:40 PM on December 19, 2004
fold:
Could you come with me to court if I ever need you?
posted by docpops at 4:08 PM on December 19, 2004
Could you come with me to court if I ever need you?
posted by docpops at 4:08 PM on December 19, 2004
Well, perhaps I'm a cry-baby but there are so many god-damn fucking assholes on this forum I cannot take it any more.
And you only managed to last a month and 80-odd comments with us.
Wuss.
posted by jonmc at 4:20 PM on December 19, 2004
And you only managed to last a month and 80-odd comments with us.
Wuss.
posted by jonmc at 4:20 PM on December 19, 2004
Again. (And 327.ca, this doesn't excuse you.)
posted by Turtles all the way down at 4:33 PM on December 19, 2004
posted by Turtles all the way down at 4:33 PM on December 19, 2004
(And 327.ca, this doesn't excuse you.)
Yeah, I'm not thrilled with my own contributions to this thread. I definitely overreacted and I regret that.
posted by 327.ca at 4:39 PM on December 19, 2004
Yeah, I'm not thrilled with my own contributions to this thread. I definitely overreacted and I regret that.
posted by 327.ca at 4:39 PM on December 19, 2004
Looks like dancingbaptist couldn't handle a taste of his own medicine!
*rimshot*
posted by Faint of Butt at 5:52 PM on December 19, 2004
*rimshot*
posted by Faint of Butt at 5:52 PM on December 19, 2004
Sweet zombie jesus, people, I think the dancingbaptist got the fucking message already. He apologized and I can't imagine he'll casually mix his doctor-mode with his jackass-mode again.
Everyone, toke now. It'll do you good.
posted by five fresh fish at 6:55 PM on December 19, 2004
Everyone, toke now. It'll do you good.
posted by five fresh fish at 6:55 PM on December 19, 2004
Yeah, I'm not thrilled with my own contributions to this thread. I definitely overreacted and I regret that.
Good. My son, confess your sins and they will be absolved.
posted by Turtles all the way down at 7:49 PM on December 19, 2004
Good. My son, confess your sins and they will be absolved.
posted by Turtles all the way down at 7:49 PM on December 19, 2004
konolia - would it be ok for me to pm you?
But of course!
posted by konolia at 8:31 PM on December 19, 2004
But of course!
posted by konolia at 8:31 PM on December 19, 2004
Everyone, toke now. It'll do you good.
wish I could but gives me anxiety *sigh*
Beer, anyone?
posted by squeak at 8:34 PM on December 19, 2004
wish I could but gives me anxiety *sigh*
Beer, anyone?
posted by squeak at 8:34 PM on December 19, 2004
Well DB is a preachy know-it-all sumbiatch, but his first statement didn't really bother me that much. I'm Bipolar, type II. I call my meds "happy pills", albeit with as much deadpan monotone sarcasm as I can muster. Simply referring to a medication in a flippant way does not bother me nearly as much as people who tell me that I wouldn't need to take "that stuff" if I only found Jesus, joined Alanon, went to the gym every day, took multivitamins, etc.. I've known a few people in the medical profession with extremely inappropriate senses of humor about their job - and these are definitely the people I'd want around if I were in a car wreck. Inappropriate humor is a way to deal with what is often a very stressful and frustrating job.
That being said, DB didn't handle himself too well, despite a seeming reprieve in the middle of the tread. Dude, you need to lay off the, "if only you lightened up and opened your mind, you too could find the shining path to a red state happy ever after, as I, with my Promise Keeper (tm) brand of superior wisdom, have discovered so very long ago ". Acting like an insufferable dick is not the best way to get your point across. Mind you, he's not the only one on this thread, but I give my fellow unipolar/bipolar mefis a break seeing as many of them have probably gotten the same "You wouldn't need to take that poison if only you..." speech from far too many people - it tends to make one a bit testy when the subject comes up.
posted by echolalia67 at 8:35 PM on December 19, 2004
That being said, DB didn't handle himself too well, despite a seeming reprieve in the middle of the tread. Dude, you need to lay off the, "if only you lightened up and opened your mind, you too could find the shining path to a red state happy ever after, as I, with my Promise Keeper (tm) brand of superior wisdom, have discovered so very long ago ". Acting like an insufferable dick is not the best way to get your point across. Mind you, he's not the only one on this thread, but I give my fellow unipolar/bipolar mefis a break seeing as many of them have probably gotten the same "You wouldn't need to take that poison if only you..." speech from far too many people - it tends to make one a bit testy when the subject comes up.
posted by echolalia67 at 8:35 PM on December 19, 2004
Well, I HAVE found Jesus, I DO go to the gym, and occasionally remember to take my vitamin b complex and fish oil. Still have bipolar. Heh.
posted by konolia at 9:04 PM on December 19, 2004
posted by konolia at 9:04 PM on December 19, 2004
Maybe you need an exorcism! I hear the RC's have a special on that this week. :-)
posted by five fresh fish at 9:51 PM on December 19, 2004
posted by five fresh fish at 9:51 PM on December 19, 2004
Maybe you need an exorcism! I hear the RC's have a special on that this week. :-)
Already checked off that box, too, but thanks for asking. ;-)
posted by konolia at 11:22 PM on December 19, 2004
Already checked off that box, too, but thanks for asking. ;-)
posted by konolia at 11:22 PM on December 19, 2004
some more of my two cents: i've known several people who suffered from varying degrees of depression (including a family member), ranging from mild to severe, some medicated, others not, including one who had bi-polar disorder. one common gripe among the sufferers was that they resented those non-sufferers (myself included) who would misunderstandingly and insensitively say that they just had to "snap out of it". for all these people, there was an uncontrollable, inexplicable mechanism at work that brought on feelings of despair, low self-esteem arising from self-criticism, lethargy, and thoughts of suicide. some also suffered from anxiety. one girl said that the medication helped bring her out of the vicious cycle of despair and self-loathing so that she could start learning some coping mechanisms, because when you're in it, perspective is very much skewed against you. now i suspect with some of these people there were also personal past issues that also contributed to their depression. but it really is a matter of brain chemistry as well as thought patterns (coping mechanisms), and those who don't suffer from it, cannot truly understand the sufferers. it can be very debilitating and just plain awful.
as for what the meds do, one guy said it just made him feel neutral. he wasn't euphoric or "happy" per se, he just didn't feel like shit anymore which was good enough for him.
as for indiscrimate prescribing of drugs, one girl said she went to her doctor, described how she was feeling (she would suddenly feel severely shitty for no good reason and had suicidal thoughts) and she got the prescription on the spot. the meds worked for her, but she didn't have to do or say much to get them.
everyone take a pill.
posted by yedgar at 8:41 AM on December 20, 2004
as for what the meds do, one guy said it just made him feel neutral. he wasn't euphoric or "happy" per se, he just didn't feel like shit anymore which was good enough for him.
as for indiscrimate prescribing of drugs, one girl said she went to her doctor, described how she was feeling (she would suddenly feel severely shitty for no good reason and had suicidal thoughts) and she got the prescription on the spot. the meds worked for her, but she didn't have to do or say much to get them.
everyone take a pill.
posted by yedgar at 8:41 AM on December 20, 2004
and those who don't suffer from it, cannot truly understand the sufferers.
And vice versa. One of the most debilitating aspects of depression is that the sufferer gets so overwhelmed by their own pain that they lose vital contact with people around them, and they can't sustain the effort needed to communicate and empathize with "normal" people.
posted by 327.ca at 9:39 AM on December 20, 2004
And vice versa. One of the most debilitating aspects of depression is that the sufferer gets so overwhelmed by their own pain that they lose vital contact with people around them, and they can't sustain the effort needed to communicate and empathize with "normal" people.
posted by 327.ca at 9:39 AM on December 20, 2004
I think that GPs (what my doctor, a professor at a very fancy medical school, calls himself), PCPs, internists, et al., should not be in the position of having to prescribe psychoactive medication.
I understand that HMOs and other insurers probably discourage referrals to psychiatrists, but I think that that is an unfortunate problem in the US (and perhaps other countries' as well) health-care system.
I do not fault individual GPs/PCPs/internists who are doing their best to provide well-informed prescriptions for psychoactive medications, but I think that, ideally, psychoactive medication would a) only be prescribed by a psychiatrist, and b) only be prescribed in conjunction with some form of "talk therapy" (including cognitive and behavioral approaches, as well as Rogersian, Adlerian, and other post-Freudian "life history" approaches).
posted by Sidhedevil at 1:24 PM on December 20, 2004
I understand that HMOs and other insurers probably discourage referrals to psychiatrists, but I think that that is an unfortunate problem in the US (and perhaps other countries' as well) health-care system.
I do not fault individual GPs/PCPs/internists who are doing their best to provide well-informed prescriptions for psychoactive medications, but I think that, ideally, psychoactive medication would a) only be prescribed by a psychiatrist, and b) only be prescribed in conjunction with some form of "talk therapy" (including cognitive and behavioral approaches, as well as Rogersian, Adlerian, and other post-Freudian "life history" approaches).
posted by Sidhedevil at 1:24 PM on December 20, 2004
I understand that HMOs and other insurers probably discourage referrals to psychiatrists, but I think that that is an unfortunate problem in the US (and perhaps other countries' as well) health-care system.
This goes beyond discouraging referrals and straight to making them nearly unavailable. The last plan I was on before now made it so difficult to get more than two visits approved that most people I knew about wouldn't bother as long as they could get prescirptions from their PCP; I just went to my own choice and used the Section 125 money to pay for it, which I could fortunately afford. Even now, on a better plan with the very recent improvements in coverage (I think mandated at least in California), there is a limit of 20 visits a year and the co-pay is more than double what it is for all other doctors. Why this type of illness, in 2004, is still treated so differently is a crime.
posted by billsaysthis at 4:15 PM on December 20, 2004
This goes beyond discouraging referrals and straight to making them nearly unavailable. The last plan I was on before now made it so difficult to get more than two visits approved that most people I knew about wouldn't bother as long as they could get prescirptions from their PCP; I just went to my own choice and used the Section 125 money to pay for it, which I could fortunately afford. Even now, on a better plan with the very recent improvements in coverage (I think mandated at least in California), there is a limit of 20 visits a year and the co-pay is more than double what it is for all other doctors. Why this type of illness, in 2004, is still treated so differently is a crime.
posted by billsaysthis at 4:15 PM on December 20, 2004
as for the therapeutic effects of pot: look, i do not suffer from depression, but i know that pot makes most people feel good. it's a great relaxant. it's a good painkiller. the paranoia some people experience is most likely just a result of heightened awareness. and it makes you feel all warm and fuzzy and giddy. there's a reason pot is so popular. heroin is awesome but you'd never get anything done, shrooms make you freak out, ecstasy is, well, ecstatic, but it's a chemical nightmare and can also freak you out, and cocaine is just plain stupid. but pot seems so natural, so meant for our self-edification and enlightenment. forget bill and ted, i'm talking about the 60s and 70s. yeah, i'm a bit of a dreamer. pot's good for that too. i'm serious, i think a little weed every now and then, in moderation, would do everyone some good.
"i'd like to teach the world to sing in perfect harmony..."
posted by yedgar at 5:30 PM on December 20, 2004
"i'd like to teach the world to sing in perfect harmony..."
posted by yedgar at 5:30 PM on December 20, 2004
..."wow. just wow."...
"What I'm curious about is what it would've done if I just smoked a little bit everyday - not even enough to get the high. I suspect that it may have helped, but until the government allows actual research to be done on the medicinal effects of pot, we can't objectively know."
posted by Bort at 10:27 PM CST on December 18
Believe it or not I actually did this for a few years. You'd be amazed at how little it takes. Seriously, sometime just take 1 hit and wait it out...even as a regular, >3 year user, I'm still usually surprised by how much it affects me. There's definately diminishing returns with dose increases. When I was in highschool, I was severely depressed (something I didn't really realize until I started feeling better). I couldn't sleep because of all the thoughts racing through my head, but I'd be really tired all day. I had panic attacks relatively frequently (didn't know what these were until about a year ago). I think the worst part was not understanding why these things were happening. I got along normally sometimes, so why couldn't I just "buck up" (you have no idea how infuriating that phrase is when you're really depressed)? Think about that the next time you want to judge someone's mental health, as much as you might be trying to cheer them up, sometimes it only makes things worse.
Every night I would take 1 large hit, occasionally two, about half an hour before bed. It was enough to calm down my mind enough to help me sleep, along with providing a relaxed sense of well-being. I didn't have to adjust the dose and all I really needed to keep me from going over the top was the assurance that after an extremely stressful and intense day, I could get at least half an hour of feeling better. Plus, since I went to sleep before I came down, I didn't have to worry about smoking more or feeling worse. I didn't have any good friends that smoked and I didn't really get out during the week. I used more on weekends, but due to my living situation, I kept it curtailed.
Once I found some similarly-minded friends and left home, however, I didn't use responsibly. After I realized this, and after quite a bit of up-and-down with use I've pretty much stabilized back to where I used to be. My cigarette consumption has followed a pretty similar pattern, as well, from 3/day to 10/day and back to 5/day. Of course, I'm also back to living a pretty hermetic life and don't really get out during the week. I'm a lot less depressed, but less "intense", too (which has it's +'s and -'s). I really wonder how much it plays into (vs situationl/developmental changes) that and I don't think I'll ever really know. I've been thinking about cutting back more to see if it would give me more energy, but it's hard to judge dosage. It's just too bad it has no medicinal value, otherwise maybe a doctor could help me figure it out.
posted by nTeleKy at 2:55 PM on December 21, 2004
"What I'm curious about is what it would've done if I just smoked a little bit everyday - not even enough to get the high. I suspect that it may have helped, but until the government allows actual research to be done on the medicinal effects of pot, we can't objectively know."
posted by Bort at 10:27 PM CST on December 18
Believe it or not I actually did this for a few years. You'd be amazed at how little it takes. Seriously, sometime just take 1 hit and wait it out...even as a regular, >3 year user, I'm still usually surprised by how much it affects me. There's definately diminishing returns with dose increases. When I was in highschool, I was severely depressed (something I didn't really realize until I started feeling better). I couldn't sleep because of all the thoughts racing through my head, but I'd be really tired all day. I had panic attacks relatively frequently (didn't know what these were until about a year ago). I think the worst part was not understanding why these things were happening. I got along normally sometimes, so why couldn't I just "buck up" (you have no idea how infuriating that phrase is when you're really depressed)? Think about that the next time you want to judge someone's mental health, as much as you might be trying to cheer them up, sometimes it only makes things worse.
Every night I would take 1 large hit, occasionally two, about half an hour before bed. It was enough to calm down my mind enough to help me sleep, along with providing a relaxed sense of well-being. I didn't have to adjust the dose and all I really needed to keep me from going over the top was the assurance that after an extremely stressful and intense day, I could get at least half an hour of feeling better. Plus, since I went to sleep before I came down, I didn't have to worry about smoking more or feeling worse. I didn't have any good friends that smoked and I didn't really get out during the week. I used more on weekends, but due to my living situation, I kept it curtailed.
Once I found some similarly-minded friends and left home, however, I didn't use responsibly. After I realized this, and after quite a bit of up-and-down with use I've pretty much stabilized back to where I used to be. My cigarette consumption has followed a pretty similar pattern, as well, from 3/day to 10/day and back to 5/day. Of course, I'm also back to living a pretty hermetic life and don't really get out during the week. I'm a lot less depressed, but less "intense", too (which has it's +'s and -'s). I really wonder how much it plays into (vs situationl/developmental changes) that and I don't think I'll ever really know. I've been thinking about cutting back more to see if it would give me more energy, but it's hard to judge dosage. It's just too bad it has no medicinal value, otherwise maybe a doctor could help me figure it out.
posted by nTeleKy at 2:55 PM on December 21, 2004
Once again, I tout Overgrow Forums as the place for informed knowledge of marijuana application.
Of particular note, it is possible to extract near-pure THC, activate the cannaboids, and encapsulate them in controlled-dosage gelatin capsules. This may allow you to ingest just enough active chemical to achieve the a physically-calming effect without the mental impairment of a higher dose.
I recommend using the search engine; there's tons of information if you're willing to mine for it.
posted by five fresh fish at 3:30 PM on December 21, 2004
Of particular note, it is possible to extract near-pure THC, activate the cannaboids, and encapsulate them in controlled-dosage gelatin capsules. This may allow you to ingest just enough active chemical to achieve the a physically-calming effect without the mental impairment of a higher dose.
I recommend using the search engine; there's tons of information if you're willing to mine for it.
posted by five fresh fish at 3:30 PM on December 21, 2004
/me gasses the entire thread with vapourized Soma.
Are you all wonderfully pneumatic yet? Delightfully so?
As a lifelong sufferer of some sort of rather severe and debilitating depression, I often ponder how directly related our urban/capitalist disposable lifestyle is to the crushing tidal wave of depression that seems to be sweeping the post-industrial world.
All I know is that all of my symptoms seem to vanish if I can just get the screaming farqwads out of the city out into some real God's Country style nature for more than a few hours or days. Seems like after two weeks to a month of some real quiet, open space, and gorgeous horizons it all goes away and all I'm left with is a fairly perpetual smile and an overwhelming sense of peace and well being.
Could we be having an epidemic of depression because our lifestyle sucks, our diet is generally riddled with hormones and additives with unknown neurological consequences and dubious nutritional value, and there's often very little real beauty or real value left for the common post-industrial human being, spiritual or otherwise?
Y'know what I really, truly like to do? What I like to do more than most anything, even more than reading a fine book, perhaps even more than making love?
I like to find quiet little sitting places, smoke a little pot, and just look at plants, letting my thoughts wander and sort themselves out. Trees are especially nice to look at. A nice leafy glade with a little leaf, reefer or flower and a sunny day just a'specklin down through the green, a calm breeze whispering sweet nothings to nobody at all, just whispering.
In the absence of this sort of ideal, idyllic glade almost any quiet corner with a little greenery will do, even the sad little hedges and daisies behind some godforsaken strip-mall, but it's just not the same.
There's something quite profoundly reassuring to me about that. Something about the fractal nature of nature itself, and the fractal nature of thought, and how the two illuminate, synergize and coalesce and tickle my head all together in just the right way.
But would that be too simple to accuse our modern life of being the problem itself? I really don't think that it is, and it just feels right to me. Perhaps we aren't actually broken. Perhaps the way we're expected to live, and what is expected to be normal and functional is what is actually broken, and in turn is breaking us.
How are we to expect to achieve any sort of personal, meaningful balance in a world so out of balance?
And even more important, how can we hope to balance the world around us while personally unbalanced?
posted by loquacious at 7:24 AM on December 23, 2004 [1 favorite]
Are you all wonderfully pneumatic yet? Delightfully so?
As a lifelong sufferer of some sort of rather severe and debilitating depression, I often ponder how directly related our urban/capitalist disposable lifestyle is to the crushing tidal wave of depression that seems to be sweeping the post-industrial world.
All I know is that all of my symptoms seem to vanish if I can just get the screaming farqwads out of the city out into some real God's Country style nature for more than a few hours or days. Seems like after two weeks to a month of some real quiet, open space, and gorgeous horizons it all goes away and all I'm left with is a fairly perpetual smile and an overwhelming sense of peace and well being.
Could we be having an epidemic of depression because our lifestyle sucks, our diet is generally riddled with hormones and additives with unknown neurological consequences and dubious nutritional value, and there's often very little real beauty or real value left for the common post-industrial human being, spiritual or otherwise?
Y'know what I really, truly like to do? What I like to do more than most anything, even more than reading a fine book, perhaps even more than making love?
I like to find quiet little sitting places, smoke a little pot, and just look at plants, letting my thoughts wander and sort themselves out. Trees are especially nice to look at. A nice leafy glade with a little leaf, reefer or flower and a sunny day just a'specklin down through the green, a calm breeze whispering sweet nothings to nobody at all, just whispering.
In the absence of this sort of ideal, idyllic glade almost any quiet corner with a little greenery will do, even the sad little hedges and daisies behind some godforsaken strip-mall, but it's just not the same.
There's something quite profoundly reassuring to me about that. Something about the fractal nature of nature itself, and the fractal nature of thought, and how the two illuminate, synergize and coalesce and tickle my head all together in just the right way.
But would that be too simple to accuse our modern life of being the problem itself? I really don't think that it is, and it just feels right to me. Perhaps we aren't actually broken. Perhaps the way we're expected to live, and what is expected to be normal and functional is what is actually broken, and in turn is breaking us.
How are we to expect to achieve any sort of personal, meaningful balance in a world so out of balance?
And even more important, how can we hope to balance the world around us while personally unbalanced?
posted by loquacious at 7:24 AM on December 23, 2004 [1 favorite]
Loquacious, thanks, I think I agree with you even though I don't smoke pot.
After millions of years of evolution I just can't believe that X% of humanity is supposed to be on SSRIs. I think society should be on SSRIs.
posted by inksyndicate at 10:44 PM on December 23, 2004
After millions of years of evolution I just can't believe that X% of humanity is supposed to be on SSRIs. I think society should be on SSRIs.
posted by inksyndicate at 10:44 PM on December 23, 2004
loquacious - I agree, wonder also, whether the fact that the prime motivational factor in the West is fear has something to do with it, so not being in the country per se, but being away from the things that we are afraid of - afraid of losing our jobs, afraid of crime, afraid of terrorism, afraid (in the United States at least*) of illness. To counter that, we distract ourselves with baubles and medicate ourselves with alcohol and other drugs, but the fear still carries on underneath: the distraction doesn't actually make anything go away. A lot of fear, not quite enough distraction, very little actual aspiration.
This isn't to demean the suffering of people who are the victims of bad chemistry, but that bad chemistry is going on against a background of collossal cognitive dissonance, terror that something out there is going to get us.
*To judge by comments I've read here and elsewhere, medical costs seem to be a large fear factor in the US, in a way they're not in other places. That's all. Of course, I'm not saying that illness is fun outside the US.
posted by Grangousier at 1:18 AM on December 24, 2004
This isn't to demean the suffering of people who are the victims of bad chemistry, but that bad chemistry is going on against a background of collossal cognitive dissonance, terror that something out there is going to get us.
*To judge by comments I've read here and elsewhere, medical costs seem to be a large fear factor in the US, in a way they're not in other places. That's all. Of course, I'm not saying that illness is fun outside the US.
posted by Grangousier at 1:18 AM on December 24, 2004
I think society should be on SSRIs.
Nicely put, inksyndicate. Millions of people "need" SSRI's to cope with life in modern society. It's rare to see anyone point out that it's at least theoretically possible to change society to meet people's needs better, instead of reaching for medication.
But until that's a realistic possibility (maybe never), SSRI's and other anti-depressants are the crutch some of us must use just to survive. I am glad we have at least *something*.
posted by beth at 9:57 AM on December 24, 2004
Nicely put, inksyndicate. Millions of people "need" SSRI's to cope with life in modern society. It's rare to see anyone point out that it's at least theoretically possible to change society to meet people's needs better, instead of reaching for medication.
But until that's a realistic possibility (maybe never), SSRI's and other anti-depressants are the crutch some of us must use just to survive. I am glad we have at least *something*.
posted by beth at 9:57 AM on December 24, 2004
Agreed, Beth. I'm not attacking the use or existence of chemical assistance or tools, but I am questioning them and the possible root cause of why they're needed/popular.
And nicely put, inksyndicate.
Grangousier: I think unmitigated fear has a whole lot to do with almost all of our social problems at this point. So much of Western/American human history seems to come from such a fearful mindset. The Cold War, the war on drugs, the war on terror and so much more.
posted by loquacious at 10:43 AM on December 24, 2004
And nicely put, inksyndicate.
Grangousier: I think unmitigated fear has a whole lot to do with almost all of our social problems at this point. So much of Western/American human history seems to come from such a fearful mindset. The Cold War, the war on drugs, the war on terror and so much more.
posted by loquacious at 10:43 AM on December 24, 2004
Three wise men followed the path of a star and found themselves in the presence of mathowie. He grew up to be the saviour of the metafollowers and turned the water of skanky forums into the wine of MeFi.
And this is what we do with it.
Jesus.
posted by apocalypse miaow at 6:58 AM on December 25, 2004
And this is what we do with it.
Jesus.
posted by apocalypse miaow at 6:58 AM on December 25, 2004
« Older Rub | It's insane, this post's taint! Newer »
This thread has been archived and is closed to new comments
Sincerely,
The Pharmaceutical Industry
posted by idontlikewords at 1:09 PM on December 18, 2004