advertisement


The Great Obesity Epidemic

You clearly have a problem. I'm sorry about that.

Being rude to other people however is unlikely to make you better.

You know nothing about me. Once again. Have you read the article and what makes you think psychiatry is a science?


Here's a scenario for you. If you go into your GP with a fever, he can carry out a number of accepted tests to ascertain the cause of that fever and to cure you.

If you go to a psychiatrist complaining of feeling suicidal they have no blood tests. No glucose tests. No thermometer. They have in short no real idea what might be the cause from a clinical POV. Now if they take the time to talk to you then they might get an idea of the cause but then they have no idea on what might rid you of the affliction.

What they will do is prescribe an expensive unproven drug in the hope that you will respond psychologically. If you don't they will try another. Then another and another. Maybe a little cocktail. All of which costs the NHS a fortune and none of it is proven to work better than a placebo in the eyes of many esteemed scientists around the world.

So where exactly is the science that tells us that one of us is feeling down or anxious because of a lack of norepinephrine in the presynaptic cleft?

I'd be happy to drop this by the way if you would stop posting offensive statements claiming those (including many in the science community) who disagree with you are "clueless and ignorant". Your call.
But where is your proof of this, have you experienced any of this for yourself or read it on google search, you should know there is a lot of rubbish written on google, I have experienced this & can assure you it is nothing like is being described in this thread, for some to suggest it isn't even real when I have gone through what I have for 30 years as have thousands of others is very insulting as you can imagine. I have seen friends jump to their deaths because of this illness & have lost some very special people close to me.

This thread has unfortunately turned into what a lot of threads do on here, the usual bashing of a subject, unfortunately this subject affects peoples lives unlike silly threads regarding hifi cables, some thought & respect should be put into posts when a delicate subject such as this is discussed I think, I would certainly show this if I were dealing with this. I don't want any sympathy for my illness just a little tact maybe as tony L suggested.

Surely you & others here could show some respect here, I imagine if others have read some of the posts here & are suffering from this horrible condition, they will feel as I do. It feels like users are treating this with the disrespect a lot of other threads receive, I wonder if this would be discussed this way if it were regarding a physical disability, I doubt it, I have experienced this kind of ignorance all my life, in our enlightened times I expected people to be a little more tolerant of this subject but so far it seems not, I am not being rude or disrespectful of peoples views but please do not suggest this condition is a fake illness, if all who claim this had suffered with it you would feel very differently.
 
Waited a little while before contributing. Seems like some people have very fixed and sincerely held attitudes here. My wife and I have had a troubling couple of years (at least) for various family and business reasons.

Last January she went to our GP and poured her heart out. Not a 'superficial' examination by any means. She was prescribed a course of drugs. In a few months she had noticeably improved and was able to function fantastically at work and home.

Meanwhile on the inside I've always been an unsure miserable git! I was lethargic, worried all the time, shaking, drinking too much even though I knew at heart we had a great family and prospects. Go to the doctor she said. And I did - and was the best thing I have done in the last 30 years. Prescribed drugs (generic not 'expensive' I assume). Last Christmas I was feeling very dark thoughts. This Christmas I have nothing but hope and optimism for myself and family.

We are all different. Have compassion. If you think depression does not really exist - fine. I don't care. I know I am getting better and looking forward to the rest of my life.
Thank god for a sensible post & I will certainly be taking your attitude towards a lot of the nonsense stating this illness doesn't exist. Thank you, Cannot take another second of reading such low insulting statements.
 
Surely you & others here could show some respect here, I imagine if others have read some of the posts here & are suffering from this horrible condition, they will feel as I do.

Maybe you could look at yourself and try to both show respect for the opinions of others and try to not prejudge people of whom you have absolutely no knowledge whatsoever.

Respect is a two way street I'm afraid, and just because there are those who express opinions you disagree with does not give you the right to tell them to be silent or to label them as clueless. It seems you feel the need to do this in a remarkable percentage of your PFM posts. Mods might take note?

As I say, looking into yourself is important. Is English your second language by chance?
 
I am training to be an Analytical Psychologist. It's a school which was started by Carl Jung after he stopped collaborating with Sigmund Freud in 1913.

Analytical Psychology is a talking therapy. I don't personally know any psychotherapist who says that depression is self-inflicted or that medication doesn't work in the short term, including SSRIs.

An Analytical Psychologist helps a client, via psychotherapy, to reestablish a healthy relationship with the unconscious. Depression is one of the neuroses that we deal with. This usually takes years to achieve and is relatively expensive. A person who successfully goes through this process doesn't need medication.

Having said that, the Pharma industry is massive and doctors sometimes prescribe drugs for things that don't need medication, especially in America. They also appear to get dinners, trips and kickbacks from the Pharma companies, which calls into question their prescribing.

Far from being non-addictive, some people can have real problems getting off SSRIs, but that doesn't mean they shouldn't be prescribed. They are a lot less addictive than benzodiazepines.

There is no doubt that SSRIs and other drugs can help people with serious depression, some of whom will be considering suicide to escape their inner torment.

The big growth area in the NHS is in mindfulness meditation. This and CBT have taken off, while talking therapies have been shoved aside.

As a quick fix, medication can definitely help people with depression. I don't think a placebo would work in most cases.

Jack
 
Having said that, the Pharma industry is massive and doctors sometimes prescribe drugs for things that don't need medication, especially in America. They also appear to get dinners, trips and kickbacks from the Pharma companies, which calls into question their prescribing.

Those days are gone, very lucky to get a biro these days. But keep banging the old worn-out conspiracy drum, Jack. Obviously, analytical psychologists are all very saintly people.
 
Imosdad.

I'm delighted to hear you are feeling so much better.

I didn't mean to come across as saying that people cannot be depressed. My point was that there may well have been a collective marketing initiative amongst the pharmaceutical companies that has persuaded many people that the answer is found in a tablet that many scientists claim is little more than a placebo.

If it is a placebo, but by taking the placebo one is helped through difficult times then that's good. It's just for me the issue of the cost to the health authorities that potentially could be avoided - much the same as in the case of modern day obesity.

To be clear though, I am very happy indeed that things are a lot better for you this Christmas.

As am I.

I'm sure that 'Big Pharma' will continue to invest in, and push drugs for everything. Let's balance that though. There's emerging evidence of a vaccine for Ebola and the Flu jab plus the assorted stuff given to kids has saved zillions of lives. Smallpox is gone.. etc. It' not all bad.

I've never heard SSRIs etc., described as Placebos. They are powerful drugs which have a proven effect upon the levels of Serotonin. That said, I have no idea whether they really can lift mood in anything other than a superficial way. After a brush with them many years ago I can't say one way or the other, but I can say that I am very intolerant of the side effects. Others may cope better.

For those who aren't familiar, there are a range of Antidepressants about. They can have stimulant or sedative side effects and can therefore be chosen to suit either agitated or unresponsive patients.

ISTM that Antidepressants, and/or Tranquillizers, which are a very different animal indeed, can be used to start treatment, or to throw a lifeline to someone who is fragile and bewildered. But mostly the 'cure', or at least the control of the illness, comes through other therapies.

Years ago, I went down with a deep depression coupled with severe anxiety and full on panic attacks. (I had to take myself to A&E a couple of times because the panic was so intense.)

The main resolution came with time, but also with assorted therapies including CBT and a very good anxiety management course.

For many years the above plus the occasional resort to very low and intermittent doses of Diazepam saw me happy.

Then, for no reason I can properly pinpoint.. it all came back earlier this year.
I have refused antidepressants. I have also probably taken even less Diazepam than while I was 'well', because even that seems to no longer be my friend. We had a spate of 'unexpected' (As in.. not just elderly people passing in the proper order of things) bereavements last year, and my daughter also had a very rough time and I 'retired'. Possibly that lot.. who knows?

I have just spent several hours desperately trying to beat down panic because my youngest didn't confirm she had made it to the airport for a flight back from Barcelona. I tracked the flight all the way and then sat wondering how long it would take for her to text me to say she had landed.. but with a nagging fear that she hadn't even boarded the plane... Goes against all logic and evidence. but that's the nature of the beast.

Now she's finally in a Taxi on her way from Manc to here and I am just about holding off thoughts of RTAs etc.

This shit is indeed 'all in the mind', but no sane person would volunteer for it.

All I learned about positive thinking, relaxation etc., all those years ago seems lost. It's as if I'd suddenly forgotten to ride a bike and we all know that doesn't happen.

Currently awaiting first appointment with somebody who may be able to help me press the reset button.

Mull


My next mission is to look up Mindfulness. I have no idea what it means though I could guess.
 
Can you define 'Mindfulness' well enough that a study could be done into its effectiveness at combatting mental illness?

Because it looks like tosh to me.

Paul
 
I've never heard SSRIs etc., described as Placebos. They are powerful drugs which have a proven effect upon the levels of Serotonin. That said, I have no idea whether they really can lift mood in anything other than a superficial way. After a brush with them many years ago I can't say one way or the other, but I can say that I am very intolerant of the side effects. Others may cope better.

Mull,

Sorry to hear about your troubles and hope you find a way to progress without recourse to medications. I always think that Diazepam still leaves people feeling down and depressed, they just don't give a **** that they are :)

I think a lot of people really need someone rather than something to help them through difficult times and to put them on the road to recovery. Hoping your appointment provides that.

As the article I linked to is long and many probably haven't read it, I'll quote from it if I may to give you and others an idea of what some professionals are saying about anti depressants.

Irving Kirsch is an American psychologist who now works in the United Kingdom. Fifteen years ago, he began conducting meta-analyses of antidepressant drug trials. A meta-analysis is a statistical abstract of many individual drug trials, and the method is controversial. Drug trials are designed for different reasons—some are done to secure government approval for a new drug, and some are done to compare treatments—and they have different processes for everything from selecting participants to measuring outcomes. Adjusting for these differences is complicated, and Kirsch’s early work was roundly criticized on methodological grounds by Donald Klein, of Columbia University, who was one of the key figures in the transformation of psychiatry to a biologically based practice. But, as Kirsch points out, meta-analyses have since become more commonly used and accepted.

Kirsch’s conclusion is that antidepressants are just fancy placebos. Obviously, this is not what the individual tests showed. If they had, then none of the drugs tested would have received approval. Drug trials normally test medications against placebos—sugar pills—which are given to a control group. What a successful test typically shows is a small but statistically significant superiority (that is, greater than could be due to chance) of the drug to the placebo. So how can Kirsch claim that the drugs have zero medicinal value?

His answer is that the statistical edge, when it turns up, is a placebo effect. Drug trials are double-blind: neither the patients (paid volunteers) nor the doctors (also paid) are told which group is getting the drug and which is getting the placebo. But antidepressants have side effects, and sugar pills don’t. Commonly, side effects of antidepressants are tolerable things like nausea, restlessness, dry mouth, and so on. (Uncommonly, there is, for example, hepatitis; but patients who develop hepatitis don’t complete the trial.) This means that a patient who experiences minor side effects can conclude that he is taking the drug, and start to feel better, and a patient who doesn’t experience side effects can conclude that she’s taking the placebo, and feel worse. On Kirsch’s calculation, the placebo effect—you believe that you are taking a pill that will make you feel better; therefore, you feel better—wipes out the statistical difference.

One objection to Kirsch’s argument is that response to antidepressants is extremely variable. It can take several different prescriptions to find a medication that works. Measuring a single antidepressant against a placebo is not a test of the effectiveness of antidepressants as a category. And there is a well-known study, called the Sequenced Treatment Alternatives to Relieve Depression, or STAR*D trial, in which patients were given a series of different antidepressants. Though only thirty-seven per cent recovered on the first drug, another nineteen per cent recovered on the second drug, six per cent on the third, and five per cent after the fourth—a sixty-seven-per-cent effectiveness rate for antidepressant medication, far better than the rate achieved by a placebo.

Kirsch suggests that the result in STAR*D may be one big placebo effect. He cites a 1957 study at the University of Oklahoma in which subjects were given a drug that induced nausea and vomiting, and then another drug, which they were told prevents nausea and vomiting. After the first anti-nausea drug, the subjects were switched to a different anti-nausea drug, then a third, and so on. By the sixth switch, a hundred per cent of the subjects reported that they no longer felt nauseous—even though every one of the anti-nausea drugs was a placebo.

Kirsch concludes that since antidepressants have no more effectiveness than sugar pills, the brain-chemistry theory of depression is “a myth.” But, if this is so, how should we treat depression? Kirsch has an answer: C.B.T. He says it really works.

It's interesting in my view and important. We all too readily accept the diagnosis of supposed mental health professionals when the evidence to support their proposed treatments is sketchy at best. There is little doubt that a large number of people are unhappy in modern society. The question for me is whether this is a symptom of illness or of society.
 
Now I'm at a kompewter, for Paul (or anyone else interested):
Suggested intro reading:

http://en.wikipedia.org/wiki/Mindfulness

http://en.wikipedia.org/wiki/Mindfulness-based_cognitive_therapy

http://oxfordmindfulness.org/

http://www.umassmed.edu/cfm/

http://en.wikipedia.org/wiki/Jon_Kabat-Zinn

Prof. Mark Williams on Mindfulness
http://www.youtube.com/watch?v=wAy_3Ssyqqg

An example study:
"Antidepressant Monotherapy versus Sequential Pharmacotherapy and Mindfulness-Based Cognitive Therapy, or Placebo, for Relapse Prophylaxis in Recurrent Depression"

Abstract

Context

Mindfulness Based Cognitive Therapy (MBCT) is a group-based psychosocial intervention designed to enhance self-management of prodromal symptoms associated with depressive relapse.

Objective

To compare rates of relapse in remitted depressed patients receiving MBCT against maintenance antidepressant pharmacotherapy, the current standard of care

Design

Patients who met remission criteria following 8 months of algorithm informed antidepressant treatment were randomized to either: Maintenance Antidepressant Medication (M-ADM), MBCT or placebo (PLA) and were followed for 18 months.

Setting

Outpatient clinics at the Centre for Addiction and Mental Health, Toronto and St. Joseph’s Healthcare, Hamilton.

Participants

One hundred sixty patients aged 18 to 65 meeting DSM-IV for major depressive disorder with a minimum of 2 past episodes. Of these, 84 achieved remission (52.5%) and were assigned to one of the 3 study conditions.

Interventions

Remitted patients either discontinued their antidepressants and attended eight weekly group sessions of MBCT, continued on their therapeutic dose of antidepressant medication or discontinued active medication onto placebo.

Main Outcome Measure

Relapse was defined as a return, for at least 2 weeks, of symptoms sufficient to meet the criteria for major depression on Module A of the SCID.

Results

Intention to treat analyses revealed a significant interaction between the quality of acute phase remission and subsequent prevention of relapse in randomized patients (p = .03). Among unstable remitters (defined as 1 or more HRSD >7 during remission) patients in both MBCT and M-ADM showed a 73% decrease in hazard compared to PLA (p = .03), whereas for stable remitters (all HRSD ≤ 7 during remission) there were no group differences in survival. Findings remained significant after accounting for the effects of past depressive episodes on relapse.

Conclusion

For depressed patients who are unwilling or unable to tolerate long term maintenance antidepressant treatment, MBCT offers equivalent protection from relapse."

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3311113/
 
It's interesting in my view and important. We all too readily accept the diagnosis of supposed mental health professionals when the evidence to support their proposed treatments is sketchy at best. There is little doubt that a large number of people are unhappy in modern society. The question for me is whether this is a symptom of illness or of society.

I am struggling to appreciate what your point is .

Diagnosis and treatment efficacy are not the same thing . Mental illness is defined in accordance with agreed criteria evaluated in interview and observation .

The name given to the collective manifestation of the symptoms is largely irrelevant .Are you suggesting the symptoms are not real .

It may be true that what mental symptoms the state chooses to make its concern is a matter of power, politics and money but that does not make the symptoms any less real .

Just because there is an element of social construction in the definition and diagnosis of mental illness does not make it any less real than say cancer . The effects and consequences are what they are .

You seem to repeatedly want to collapse mental illness in to a state of unhappiness , this is not correct or helpful .

And this sentence “The question for me is whether this is a symptom of illness or of society.”

Does not make sense . It obvious that a persons mental illness will in some way be causally connected to the society they live in .
 
Wonder what the total cost of mental illness is to the State when prescriptions, staff wages, loss of taxes from those suffering and unable for the moment to contribute to the State and all other costs are considered? May make a juicy target for those that see it a low hanging fruit that can be plucked and cut from the budget but then what will be the next category of illness to face a cut in funding?
 
Kirsch’s conclusion is that antidepressants are just fancy placebos.


Placebos work with a range of physical conditions as well as depression. Placebos cannot be looked at in relation to mental illness alone.
 
IIRC a whole industry has been built upon homeopathy and some may well feel that it is just one big placebo.
 
Wonder what the total cost of mental illness is to the State when prescriptions, staff wages, loss of taxes from those suffering and unable for the moment to contribute to the State and all other costs are considered? May make a juicy target for those that see it a low hanging fruit that can be plucked and cut from the budget but then what will be the next category of illness to face a cut in funding?

The point is , that it supposedly an investment to save money and assist societal functioning .
 
Placebos work with a range of physical conditions as well as depression. Placebos cannot be looked at in relation to mental illness alone.

I agree wholeheartedly Gassor. The power of the subconscious is remarkable indeed. It's just a shame that we currently potentially have expensive placebos rather than investing in creating an inexpensive one IMHO.
 


advertisement


Back
Top