Go Back   Bloggingheads Community > Diavlog comments
FAQ Members List Calendar Search Today's Posts Mark Forums Read

Notices

Diavlog comments Post comments about particular diavlogs here.
(Users cannot create new threads.)

Reply
 
Thread Tools Display Modes
  #41  
Old 08-06-2011, 05:35 PM
Ocean Ocean is offline
 
Join Date: Jun 2008
Location: US Northeast
Posts: 6,784
Default Re: Science Saturday: The Mental Illness Epidemic (John Horgan & George Johnson)

Quote:
Originally Posted by ohreally View Post
Carlat call this "a myth." Marcia Angell (former NEJM editor-in-chief) writes: "because Thorazine was found to lower dopamine levels in the brain, it was postulated that psychoses like schizophrenia are caused by too much dopamine. ... That was a great leap in logic, as all three authors point out." By that same logic, she writes "one could argue that fevers are caused by too little aspirin."
No, that's flawed logic. And I'm confident you can see that. Aspirin is not a chemical naturally found in our bodies, so it isn't possible to have a deficiency of it. However, dopamine is a chemical normally found in the brain. Lack of dopamine in certain areas of the brain cause Parkison's disease, for example.

The problem isn't about whether there's an excess or a deficiency but where and why. Although we don't have enough evidence to prove that this is the exact pathophysiological mechanism behind schizophrenia, there's enough evidence that dopamine is involved.

The topic is taken from observations that we can all agree with, for example that the simple excess or deficit of a neurotransmitter is only small part of the story, to saying that psychiatrists or neuroscientists are claiming that's all there is to it.

I agree that the way pharmaceutical companies advertise their medications is misleading. The lay person can have a very wrong impression from hearing those stories which are made to entice people into their products.

I've said this quite a few times in the years that I've been commenting in this forum. The brain is the most complex organ in our body. Its product is the most nuanced and sophisticated conundrum that we have encountered so far. Any claim that we have a clear understanding of how it works in its higher functions is obviously inaccurate. But ignoring the body of knowledge that is being accumulated as we speak and going into a contrarian rampage isn't going to advance science either.

People need to make a living, not only psychiatrists. Journalists and writers also have conflicts of interest. In order to sell books they need to be provocative. And they need to include enough stuff to fill a certain number of pages. If they were going to keep really solid arguments they may have ended with a nice thesis or essay instead of a book.

I repeat, my opinion is based only on this discussion and the articles and reviews that I've read so far. But when I start to find a significant number of flaws and conspiracy theories, I can't avoid but question the whole endeavor.

Quote:
By the way, Marcia Angell makes Horgan's worries seem rather tame. And medicine is her field.
I read the article (Part I of a two part article). Marcia is not a psychiatrist or neuroscientist. Although I don't question her credentials, I do question whether she understands what she's talking about when it comes to brain function and the subtle interactions between environment-psychology-brain function. The article cited suggests that she doesn't understand it. Sorry to say.

Some of the criticisms that the article reproduces from the original book are issues that I have brought up informally as concerns. For example the changes in rating scales of one or two units are statistically significant but aren't clinically significant.

I've always been receptive to new findings and criticism of treatments that may be ineffective. But, I really think that we need to take this skepticism, if I may, skeptically. If we are going to question the practice of psychiatry, we need to be able to provide some solid evidence. Otherwise these people are making the same mistake that they seem so eager to criticize. Mixing good arguments with bad arguments is a disservice to their cause.

Clean up the book from all the misconceptions and misinterpretations and then we'll talk.
Reply With Quote
  #42  
Old 08-06-2011, 05:35 PM
sugarkang sugarkang is offline
 
Join Date: Oct 2008
Location: Cali, Small-Govt Liberal
Posts: 2,186
Default Re: Science Saturday: The Mental Illness Epidemic (John Horgan & George Johnson)

Quote:
Originally Posted by eeeeeeeli View Post
I worked for a number of years in San Francisco, mainly in the Tenderloin district, which was almost a modern day mental institution, considering the number of mentally ill people living there. (I specifically worked with those with "triple diagnosis", meaning: AIDS, Mental Illness, and Drug Addiction.)
Tenderloin... ain't nothin tender about that place. -- Dave Chappelle

I lived in the Mission / Potrero Hill area and had to pass by the Tenderloin every day on the way to/from work in downtown SF. It didn't seem all that bad from Market Street, but then again, I never went into the belly of the beast.
__________________
The mixing of populations lowers the cost of being unusual.
Reply With Quote
  #43  
Old 08-06-2011, 06:11 PM
ohreally ohreally is offline
 
Join Date: Jan 2010
Posts: 666
Default Re: Science Saturday: The Mental Illness Epidemic (John Horgan & George Johnson)

Quote:
Originally Posted by Ocean View Post
Although we don't have enough evidence to prove that this is the exact pathophysiological mechanism behind schizophrenia, there's enough evidence that dopamine is involved.
No one questions that. When Carlat (an expert) calls it a myth, he refers to the causal link. So dopamine is involved. But if that's only a side effect of something else that we don't understand, then to go after the dopamine might exactly the wrong thing to do. The key point is this: Both Kirsch and Carlat say there is no statistical evidence that either schizophrenia or depression is caused by chemical imbalances. In fact they challenge anyone to point to any study that shows statistically significant chemical imbalances prior to drug treatment. (The latter of course causes imbalances.) Either they're bullshitting in which case it should be easy to refute or they're correct. Which way is it?

Effectiveness is a red herring. No one disputes that. The only issues discussed are: (i) are they placebos? (ii) do they cause mental illness? Carlat dismisses (ii) but the authors under review seem to agree that no evidence is there to refute (i). (Which of course doesn't mean that (i) is true.)
Reply With Quote
  #44  
Old 08-06-2011, 06:36 PM
cragger cragger is offline
 
Join Date: Aug 2007
Posts: 632
Default Re: Science Saturday: The Mental Illness Epidemic (John Horgan & George Johnson)

Quote:
Originally Posted by Ocean View Post
Lack of dopamine in certain areas of the brain cause Parkison's disease, for example.
There's been some interesting stuff about dopamine acting in the reward centers and addiction out lately, particularly to gambling games centered on exceptional rewards. Seems like people getting dopamine for Parkinson's treatment should maybe be careful. Just a tangent.
Reply With Quote
  #45  
Old 08-06-2011, 06:42 PM
Wonderment Wonderment is offline
 
Join Date: Jul 2007
Location: Southern California
Posts: 5,694
Default Re: Science Saturday: The Mental Illness Epidemic (John Horgan & George Johnson)

Quote:
Several of the medications are cheap generics, paroxetine, fluoxetine and citalopram are available for $4 for 30 days or $10 for 90 days at WalMart, Kmart, Target and other major retailers. So much for the 'Big Pharma" conspiracy.
Well, yeah, because the patents have now expired. The propaganda comes as each new elixir is marketed. Abilify (Aripiprazole) is a good example of a drug developed for schizophrenia that they finally got approved for dual diagnosis (schizo + severe depression) and that now is being sold like candy on television, targeting people for whom other anti-depressants are still not solving all their life problems. "If you're still (fill in the blank) Abilify may be right for you. Ask your doctor."

The scam is that Big Pharma works the consumer who in turn works the PCP. Patients doctor-shop, and the doctor who is a little more compliant with the prescription pad will keep the business.

Anyway, I am certainly not defending John's paranoia, but -- as Ocean and you have pointed out elsewhere -- the advertising for many of these medications is deeply misleading and disgusting.


Quote:
Maybe John will work out his aversion to medications and his prejudice against Psychiatrists
He's a skeptic, doc.
__________________
Seek Peace and Pursue it
בקש שלום ורדפהו
Busca la paz y síguela
--Psalm 34:15
Reply With Quote
  #46  
Old 08-06-2011, 06:57 PM
Ocean Ocean is offline
 
Join Date: Jun 2008
Location: US Northeast
Posts: 6,784
Default Re: Science Saturday: The Mental Illness Epidemic (John Horgan & George Johnson)

Quote:
Originally Posted by ohreally View Post
No one questions that. When Carlat (an expert) calls it a myth, he refers to the causal link. So dopamine is involved. But if that's only a side effect of something else that we don't understand, then to go after the dopamine might exactly the wrong thing to do. The key point is this: Both Kirsch and Carlat say there is no statistical evidence that either schizophrenia or depression is caused by chemical imbalances. In fact they challenge anyone to point to any study that shows statistically significant chemical imbalances prior to drug treatment. (The latter of course causes imbalances.) Either they're bullshitting in which case it should be easy to refute or they're correct. Which way is it?

Effectiveness is a red herring. No one disputes that. The only issues discussed are: (i) are they placebos? (ii) do they cause mental illness? Carlat dismisses (ii) but the authors under review seem to agree that no evidence is there to refute (i). (Which of course doesn't mean that (i) is true.)
Carlat says:

Quote:
My overall take is that Whitaker has his basic facts right, and that he communicates them in a compelling style that I envy. But I disagree with his interpretation of the facts.
And:

Quote:
Next time I'll get into some of the studies he cites in support of the idea that psychiatric drugs can worsen mental illness. I believe he is on shaky ground here as well.
In another post Carlat says:

Quote:
Before beginning, as anybody who has followed my blog knows, I readily acknowledge that psychiatrists over-rely on drug treatment of mental illness and should be doing more therapy. In order to maximize profits, drug companies consistently downplay the side effects of their medications. It's not that I believe drug treatment worsens conditions--rather, that our obsession with psychopharmacology has deprived many patients of integrative treatment, which combines the judicious use of medications (when needed) with the right kind psychotherapy (also, when needed). Thus, while both Whitaker and I end up with a similar conclusion--that psych meds are inappropriately used in the U.S--we arrive at that conclusion in very different ways and we mean different things by "inappropriate use."
I agree with the above. I've been presenting this argument for years.

More Carlat:

Quote:
The point is that most of the long term outcome data Whitaker cites is based on unreliable and very broad conceptions of schizophrenia. While he accurately describes studies showing that schizophrenic patients who were not on medications often did very well, I'll bet you a dime to a dollar that many of these high functioning schizophrenics never had schizophrenia in the first place, at least not according to current DSM-IV criteria. They did perfectly well off antipsychotics for the same reason somebody without diabetes would do well off insulin--they didn't actually have the disease.
And:

Quote:
Most of the studies Whitaker cites are observational studies--which are suggestive, but not definitive.
Now, I would never take away merit from a professional who reviews the literature and puts together critical thinking educational material. Dr. Carlat seems to do that through his published reports. I commend him and his work. I happen to agree with pretty much everything that he wrote regarding Whitaker's book. But I'm not sure I would call him an expert in the sense of a specialized form of scholarship. If we were to get into a discussion of the fine grain of neuroscience, I would probably want to have the opinion of a different kind of expert. I suspect that Dr. Carlat would agree.
Reply With Quote
  #47  
Old 08-06-2011, 07:03 PM
Ocean Ocean is offline
 
Join Date: Jun 2008
Location: US Northeast
Posts: 6,784
Default Re: Science Saturday: The Mental Illness Epidemic (John Horgan & George Johnson)

Quote:
Originally Posted by cragger View Post
There's been some interesting stuff about dopamine acting in the reward centers and addiction out lately, particularly to gambling games centered on exceptional rewards. Seems like people getting dopamine for Parkinson's treatment should maybe be careful. Just a tangent.
It's a good tangent because those studies are very interesting. NIDA (National Institute on Drug Abuse) has been following studies of dopamine as the reward/pleasure mediator in the brain. Brain imaging studies show how the brain lights up during drug use and withdrawal, and in this case during gambling is similar fashion. Behavioral addictions are going to be included in the new version of the diagnostic manual (to the dismay of many psychiatry detractors).

Dopamine for Parkinson's can cause hallucinations and psychosis. It's one of the well known side effects. Just saying.
Reply With Quote
  #48  
Old 08-06-2011, 07:24 PM
willmybasilgrow willmybasilgrow is offline
 
Join Date: May 2008
Posts: 142
Default Re: Science Saturday: The Mental Illness Epidemic (John Horgan & George Johnson)

Quote:
Originally Posted by Ocean View Post
If anyone has a link to the Finland studies that John mentions, I would like to take a look.

People with schizophrenia were treated with psychotherapy only in quite a number of facilities in the US and it was a total disaster. I grant that the treatment approach is key to success or failure of treatment, so I'd love to see those studies.

One of the main theories of how schizophrenia symptoms occur is that there is a deficit of dopamine to certain areas of the brain. That causes social isolation and decreased motivation. The brain in an attempt to compensate increases the availability of dopamine. Unfortunately that availability increases everywhere, not just in the areas that were lacking. So an increase of dopamine to the temporal lobes, for example, will cause auditory hallucinations, in others paranoia or violent reactions out of fear. Some Scandinavian countries had started an early intervention program by which teenagers showing the early signs of schizophrenia would be started on medications to prevent progression to the worst forms. Those patients had a better outcome than those who were not treated with antipsychotics. Here: easy reading.
You are very very wedded to the biomedical model. The Soteria method in the US was not a failure. Don't know where you're getting you're information, probably the NIMH. Google Daniel Mackler. He made a film about the work being done in Finland. You're no doubt dubious of him, so google him anyway, go to his homepage if he has one (I don't know) and see what's under his resources page. And Whitaker probably references them too. There's lots out there. I don't think you've really looked.
Reply With Quote
  #49  
Old 08-06-2011, 07:43 PM
Ocean Ocean is offline
 
Join Date: Jun 2008
Location: US Northeast
Posts: 6,784
Default Re: Science Saturday: The Mental Illness Epidemic (John Horgan & George Johnson)

Quote:
Originally Posted by willmybasilgrow View Post
You are very very wedded to the biomedical model. The Soteria method in the US was not a failure. Don't know where you're getting you're information, probably the NIMH. Google Daniel Mackler. He made a film about the work being done in Finland. You're no doubt dubious of him, so google him anyway, go to his homepage if he has one (I don't know) and see what's under his resources page. And Whitaker probably references them too. There's lots out there. I don't think you've really looked.
This Daniel Mackler?

Quote:
My name is Daniel Mackler and I am filmmaker, writer, and musician based in New York City. I also worked for ten years as a psychotherapist in New York, though I ended my formal therapy practice in early 2010. My writings focus on the causes, consequences, and radical significance of childhood trauma. I see childhood trauma as ranging from the extreme, which is common, to the mild, which is so much MORE common that few even notice it at all, much less call it by its proper name. I view the norm in our culture as being highly traumatized, and I view the average, and even above-average, childhood as being extremely traumatic – and the average parent as lacking both awareness of this and deep empathy for the child.

I see our world growing more pathological, confused, polluted, overpopulated, and disturbed by the day – and I feel that to stand by and say nothing while we destroy our planet is irresponsible and even criminal. Yet I write with great hope – both for individual healing and for the collective healing of our world. I seek to offer a new perspective – on relationships, on enlightenment, on the potential value of celibacy, on the pathology of the family system, and on the future of our species.
I'm not wedded to anything, but for what I've seen of Mr. Mackler, I'm more inclined to trust what comes out of the top researchers in mental health in this country through the National Institute of Mental Health.

I haven't read Mr. Mackler, he may have some good points. I don't know. It's just that I don't read everything that's posted on the internet.

Soteria.

I'd love to see therapeutic communities applying the best evidence-based forms of treatment, with minimal use of medication, and maximal emphasis in recovery and rehabilitation.

Most of the time those programs lack funding in this country. There may be better models in countries with socialized medicine which have a different emphasis. Here some people think that taxpayers shouldn't be paying for someone else's mental illness. It's sad.
Reply With Quote
  #50  
Old 08-06-2011, 08:00 PM
ohreally ohreally is offline
 
Join Date: Jan 2010
Posts: 666
Default Re: Science Saturday: The Mental Illness Epidemic (John Horgan & George Johnson)

I think we agree about Carlat. I was mostly curious about the claim that there is no chemical imbalance in depressed or psychotic patients prior to treatment. If that claim is true I wonder what it says about the scientific status of psychiatry. Is it the case that psychiatrists have tons of useful tools at their disposal and tons of practical knowledge about what works and what does not (all of which matters more than anything) but no science to speak of in the sense of causal models that allow us to explain what causes X and why X causes Y?
Reply With Quote
  #51  
Old 08-06-2011, 08:32 PM
Ocean Ocean is offline
 
Join Date: Jun 2008
Location: US Northeast
Posts: 6,784
Default Re: Science Saturday: The Mental Illness Epidemic (John Horgan & George Johnson)

Quote:
Originally Posted by ohreally View Post
I think we agree about Carlat. I was mostly curious about the claim that there is no chemical imbalance in depressed or psychotic patients prior to treatment. If that claim is true I wonder what it says about the scientific status of psychiatry. Is it the case that psychiatrists have tons of useful tools at their disposal and tons of practical knowledge about what works and what does not (all of which matters more than anything) but no science to speak of in the sense of causal models that allow us to explain what causes X and why X causes Y?
Just as the rest of medicine, the field developed historical from trying to help people with various ailments with whatever was available and seemed to help. The science behind it developed much later, in recent centuries, very slowly, and mostly in the last century and decades. Some of the most important drugs used in psychiatry were discovered by accident. Others have been developed as the understanding about how the brain works grows. There's been, and there is a lot of trial and error.

Why is it more difficult to treat depression than it is to treat hypertension? Well, the mechanisms of hypertension are relatively well known. If you think about it, they're limited to the understanding of how a system of expandable pipes handles the fluid that circulates through them. The amount of fluid, the elasticity of the pipes and the pressure placed on the fluid by the pump that moves it vary. In a very simplistic way, that's all there is to it.

Now if you think about the brain in all its complexity, you would understand why there are so many questions. In spite of that neuroscience is advancing pretty fast and it's promising.

In terms of whether there's chemical imbalance in depression and psychosis previous to treatment, some of the imbalances that we talk about would be difficult to demonstrate. Other imbalances are detected before treatment, such as the dexamethasone suppression test for depression.

There are studies with patients with untreated schizophrenia, like this one.

Quote:
They compared brains in 13 healthy people with five people with untreated schizophrenia and another 16 who were on medication for the condition.
There may be other more recent studies. I don't follow this part of neuroscience so closely and I don't think that I can get more information online.
Reply With Quote
  #52  
Old 08-06-2011, 09:28 PM
Hal Morris Hal Morris is offline
 
Join Date: Jun 2011
Posts: 85
Default Re: Sleep and Depression

Quote:
Originally Posted by Ocean View Post
The quick answer is that it is impractical.
Well, Ocean that's got the virtue of brevity alright, but I'd like to know more. Will put in my 2 cents that, I've been on antidepressants (primarily prozac and welbutrin) for around 20 years, which has been very beneficial, but it might be said that I was self-medicating with sleep deprivation before that time.

I'm not sure I should call it self-medicating or sleep-deprivation
, but I would have terrible days if I got 8 hours of sleep, and could generally operate very well on 5-6 hours sleep (with a run or some other aerobic exercise as soon as I got up).

I have a funny story about how I first decided to go the Prozac route (here I have to say that a certain amount of publicity was useful in causing me to seek out a psychiatrist who I knew was likely to prescribe it to me). The funny thing is, at the time, Michael Moore was known only as the guy who did "Roger and Me", but then for a while he had a TV show examining with some humor and/or ridicule whatever he thought were disfunctions in American life, and he happened to have a piece called "Prozac for pets". Prozac was almost obscenely expensive at that time, which was probably part of the appeal for MM -- kind of like diamond necklaces for dogs might have been the angle he was going for. But the nice old couple were telling how much good it had done for their dog, who used to spend all his time "worrying the same old bone", and how he was now much more cheerful and doggy. My wife and I saw this and it kind of clicked "worrying the same old bone" seemed somewhat like my experience.

I took one break from it, and used the same low-sleep and exercise discipline I'd used in the past which worked well until a very difficult experience came along and I went into classic depression for the first time in my life, complete with sharp weight loss (previously the diagnosis was "anhedonia" and I ate a bit too much if anything). After a few months in which long walks in the woods kept me from totally going off the rails, I went back on it and have been since then. Some time I'd like to try going off it again, but not with my current stressful life.

Frankly, I haven't yet listened to the diavlog at all, but will, and probably will say some more about free will, as I am not called the ontological comedian for nothing (well, only by myself).
Reply With Quote
  #53  
Old 08-06-2011, 09:41 PM
willmybasilgrow willmybasilgrow is offline
 
Join Date: May 2008
Posts: 142
Default Re: Science Saturday: The Mental Illness Epidemic (John Horgan & George Johnson)

George,

May I recommend a book for you -- The youngest science : notes of a medicine-watcher / by: Thomas, Lewis
Reply With Quote
  #54  
Old 08-06-2011, 09:49 PM
Ocean Ocean is offline
 
Join Date: Jun 2008
Location: US Northeast
Posts: 6,784
Default Re: Sleep and Depression

Quote:
Originally Posted by Hal Morris View Post
Well, Ocean that's got the virtue of brevity alright, but I'd like to know more. Will put in my 2 cents that, I've been on antidepressants (primarily prozac and welbutrin) for around 20 years, which has been very beneficial, but it might be said that I was self-medicating with sleep deprivation before that time.

I'm not sure I should call it self-medicating or sleep-deprivation
, but I would have terrible days if I got 8 hours of sleep, and could generally operate very well on 5-6 hours sleep (with a run or some other aerobic exercise as soon as I got up).

I have a funny story about how I first decided to go the Prozac route (here I have to say that a certain amount of publicity was useful in causing me to seek out a psychiatrist who I knew was likely to prescribe it to me). The funny thing is, at the time, Michael Moore was known only as the guy who did "Roger and Me", but then for a while he had a TV show examining with some humor and/or ridicule whatever he thought were disfunctions in American life, and he happened to have a piece called "Prozac for pets". Prozac was almost obscenely expensive at that time, which was probably part of the appeal for MM -- kind of like diamond necklaces for dogs might have been the angle he was going for. But the nice old couple were telling how much good it had done for their dog, who used to spend all his time "worrying the same old bone", and how he was now much more cheerful and doggy. My wife and I saw this and it kind of clicked "worrying the same old bone" seemed somewhat like my experience.

I took one break from it, and used the same low-sleep and exercise discipline I'd used in the past which worked well until a very difficult experience came along and I went into classic depression for the first time in my life, complete with sharp weight loss (previously the diagnosis was "anhedonia" and I ate a bit too much if anything). After a few months in which long walks in the woods kept me from totally going off the rails, I went back on it and have been since then. Some time I'd like to try going off it again, but not with my current stressful life.

Frankly, I haven't yet listened to the diavlog at all, but will, and probably will say some more about free will, as I am not called the ontological comedian for nothing (well, only by myself).
Interesting story, Hal.

Sleep deprivation works for many, not all. It works while you're doing it and the effect goes away as soon as you go back to a more normal sleep pattern. Most people that I know aren't willing to be sleep deprived. It has also long term problems, including possible decreased concentration which can interfere with driving or operating heavy machinery. Most people aren't willing to go for long walks in the morning either.

I recommend my patients who get depressed during the winter months to consider light therapy, or try to be outdoors daily for at least 30- 45 minutes, bundled up if needed. Noon is a great time because of the intensity of light then.

It's interesting that you distinguish periods of anhedonia from a period of clinical depression. I agree that they are different. Perhaps one indicates a predisposition to the other, but certainly not the same.

If at some point you and your treating physician decide that it's a good time to go off medications, the recommendation is to do it gradually, tapering off to avoid discontinuation syndrome or relapses. Once you're off it, you can use other strategies to reduce stress, manage anxiety or negative thinking, and physiologically boost your mood with exercise, light, and perhaps mild sleep deprivation. I would be careful with the latter, and would advise to be under medical supervision at least for a while to make sure you don't end up experiencing other mood problems (irritability or hypomania).

How do you like that? As you can imagine it wouldn't be appropriate for me to get into any more detail or individualized advice. These are general recommendations. You would have to consult your doctor for more detail.
Reply With Quote
  #55  
Old 08-06-2011, 09:53 PM
willmybasilgrow willmybasilgrow is offline
 
Join Date: May 2008
Posts: 142
Default Re: Science Saturday: The Mental Illness Epidemic (John Horgan & George Johnson)

George and his lack of depth: if he went home and killed himself that would obviously be worse than any ECT treatment. As if 1) he won't kill himself after ECT. etc etc...

Can we PUH LEASE dig a little bit deeper here? Or is there nothing left to drain out of the pool?

Conflict of interest/ transparency is "totally" happening. No it's not George. I have stories. Fundraising by psychiatrists to their PATIENTS. George, dear Lord, PLEASE stop talking in humongous generalities.
Reply With Quote
  #56  
Old 08-06-2011, 09:58 PM
Parallax Parallax is offline
 
Join Date: May 2011
Posts: 219
Default Re: Science Saturday: The Mental Illness Epidemic (John Horgan & George Johnson)

I started watching this against my better judgement. Some points:

1. These days nobody believes in the chemical imbalance theory of depression. Research indicates that depression is basically a reversible neurodegenerative disease. That is why both Selective Serotonin Reuptake Inhibitors and Selective Serotonin Reuptake Enhancers are used to treat depression.

2. Both John and George bring up these studies that show except in severe depression antidepressants are indistinguishable from placebo. To me the most interesting part is that in severely depressed they do differ from placebo by a wide margin (this btw is consistent with the new theory of depression explained above).

3. John mentions that back in the day mental illnesses used to be self limiting. I propose that a local mental hospital sends him a paranoid schizophrenic to hang out with for 6 months and then report back. On a more serious note being self limiting is not an excuse for avoiding treatment. Lets assume depression is self limiting (certain variety of it are) but some people might kill themselves before the 6 months is up.

Was there a discussion in commenter court about giving money to BHTV not to see someone ever again?
Reply With Quote
  #57  
Old 08-06-2011, 10:11 PM
Parallax Parallax is offline
 
Join Date: May 2011
Posts: 219
Default Re: Science Saturday: The Mental Illness Epidemic (John Horgan & George Johnson)

Quote:
Originally Posted by SkepticDoc View Post
Maybe John will work out his aversion to medications and his prejudice against Psychiatrists
I hear a big pharma conglomerate (Pfizer, Merck, Norvatis and Roche) are developing a new drug called Coniuratio for precisely that condition! The problem was finding a failsafe delivery mechanism which has been solved by developing another drug, Impero, which compels the loved ones of the afflicted to give them Coniuratio without their knowledge.
Reply With Quote
  #58  
Old 08-06-2011, 10:11 PM
sugarkang sugarkang is offline
 
Join Date: Oct 2008
Location: Cali, Small-Govt Liberal
Posts: 2,186
Default Re: Science Saturday: The Mental Illness Epidemic (John Horgan & George Johnson)

Quote:
Originally Posted by Parallax View Post
Was there a discussion in commenter court about giving money to BHTV not to see someone ever again?
Okay, I don't have a background in the hard sciences. So, who won the debate: Brooke Shields or Tom Cruise?
__________________
The mixing of populations lowers the cost of being unusual.
Reply With Quote
  #59  
Old 08-06-2011, 10:23 PM
willmybasilgrow willmybasilgrow is offline
 
Join Date: May 2008
Posts: 142
Default Re: Science Saturday: The Mental Illness Epidemic (John Horgan & George Johnson)

Quote:
Originally Posted by sugarkang View Post
Okay, I don't have a background in the hard sciences. So, who won the debate: Brooke Shields or Tom Cruise?
Excellent short cut! Hard to say. Both sides were too superficial in their argumentation and assumptions. Unsatisfactory is my grade for both.
Reply With Quote
  #60  
Old 08-06-2011, 11:59 PM
whburgess whburgess is offline
 
Join Date: Jun 2010
Posts: 1,202
Default Re: Science Saturday: The Mental Illness Epidemic (John Horgan & George Johnson)

Quote:
Originally Posted by Parallax View Post
I hear a big pharma conglomerate (Pfizer, Merck, Norvatis and Roche) are developing a new drug called Coniuratio for precisely that condition! The problem was finding a failsafe delivery mechanism which has been solved by developing another drug, Impero, which compels the loved ones of the afflicted to give them Coniuratio without their knowledge.
That's funny right there
Reply With Quote
  #61  
Old 08-07-2011, 09:06 AM
Hal Morris Hal Morris is offline
 
Join Date: Jun 2011
Posts: 85
Default Re: Sleep and Depression

Quote:
Originally Posted by Ocean View Post
Interesting story, Hal.

It's interesting that you distinguish periods of anhedonia from a period of clinical depression. I agree that they are different. Perhaps one indicates a predisposition to the other, but certainly not the same.

If at some point you and your treating physician decide that it's a good time to go off medications, the recommendation is to do it gradually, ...
A bit too much advice though I don't want to be too hard on your doctor-ly impulses. I was just trying to contribute something in the manner of dinner conversation.

Do you know in certain philosophical discourses, "patient" and "agent" are treated as opposite poles of something-or-other?

I could go riffing on about Thomaz Szatz (who I think has not done much good for the world), and modern libertarians, and maybe Michel Foucault as an alternate way of demonizing therapy. So many thoughts so little time.

Best Regards,
Reply With Quote
  #62  
Old 08-07-2011, 09:38 AM
willmybasilgrow willmybasilgrow is offline
 
Join Date: May 2008
Posts: 142
Default Re: John has gone off the deep end

Quote:
Originally Posted by thprop View Post
I have little respect for John anymore. His critique of string theory was taken apart in his diavlog with George Musser. He insists that we have free will because it is good to have. Jerry Coyne dismiised those arguments.

Now he is into conspiracy theory. Here are a few counters to Whitaker:
Carlat

A debate on the subject

A mental health professional who says to take his research seriously

John lets his own feelings override science.
Yes, regarding Carlat. I also urge other commenters here to go to Carlat. There are some excellent comments there.

Such as:
"The Harvard psychiatrists refuting Bob [Whitaker] were truly laughable. They seem to think that all it takes for them to be convincing is to say “I don’t agree” and issue a few ad hominem attacks. There was not one substantive argument that the way they practice medicine is actually doing good. And then for Dr. Rosenbloom to take pride in the fact that their department was actually one of the first to acknowledge “discontinuation” and "rebound" twenty or more years after the drugs were introduced just added insult to injury as far as I was concerned. This is what is so frightening about psychiatry – there is some gross disconnect between the doctors and their patients. What the doctors “see” and the patients describe is completely at odds. Until that comes into alignment we are in for some serious trouble and the trends Whitaker describes will only get worse. "
Reply With Quote
  #63  
Old 08-07-2011, 09:47 AM
Ocean Ocean is offline
 
Join Date: Jun 2008
Location: US Northeast
Posts: 6,784
Default Re: Sleep and Depression

Quote:
Originally Posted by Hal Morris View Post
A bit too much advice though I don't want to be too hard on your doctor-ly impulses. I was just trying to contribute something in the manner of dinner conversation.
Yes, I know. Sorry if I went overboard. I try to stay away from giving that kind of advice. That's why I made all the disclaimers.

Quote:
Do you know in certain philosophical discourses, "patient" and "agent" are treated as opposite poles of something-or-other?
The issue about calling patients "patient" has been around for quite a while. I think that there are a couple of reasons why I keep using this term. One is everybody else around me uses it, and I use it out of habit, without any specific implication. Second, I have never come across a term (that I can remember) that is a good substitute for it. I find very negative connotations attached to terms like "client", "customer" or "consumer" so I never got used to them.

I think most people can reach a certain level of maturity to be able to overcome their dislike of the use of certain terms.

Do you have serious objections to the term?

Quote:
I could go riffing on about Thomaz Szatz (who I think has not done much good for the world), and modern libertarians, and maybe Michel Foucault as an alternate way of demonizing therapy. So many thoughts so little time.

Best Regards,
Oh, yes. There's that too. Definitely, people whose sensibilities are hurt by going to physicians who will tell them what they need to do to address their medical problems, shouldn't feel obliged to.

The rest of society should just ask them to stay away if they are contagious, stay controlled if they have violent impulses and stay at home in their final days of suffering.

There's always a different perspective.
Reply With Quote
  #64  
Old 08-07-2011, 09:50 AM
badhatharry badhatharry is offline
 
Join Date: Jul 2009
Location: eastern sierra
Posts: 5,413
Default Re: John has gone off the deep end

Quote:
Originally Posted by willmybasilgrow View Post
There are some excellent comments there.

Such as:
"They seem to think that all it takes for them to be convincing is to say “I don’t agree” and issue a few ad hominem attacks. "
sounds like the comments section at BHtv.

PS. has your basil grown?
__________________
"By pursuing his own interest he frequently promotes that of the society more effectually than when he really intends to promote it." Adam Smith
Reply With Quote
  #65  
Old 08-07-2011, 10:01 AM
Ocean Ocean is offline
 
Join Date: Jun 2008
Location: US Northeast
Posts: 6,784
Default Re: John has gone off the deep end

Quote:
Originally Posted by willmybasilgrow View Post
Yes, regarding Carlat. I also urge other commenters here to go to Carlat. There are some excellent comments there.

Such as:
"The Harvard psychiatrists refuting Bob [Whitaker] were truly laughable. They seem to think that all it takes for them to be convincing is to say “I don’t agree” and issue a few ad hominem attacks. There was not one substantive argument that the way they practice medicine is actually doing good. And then for Dr. Rosenbloom to take pride in the fact that their department was actually one of the first to acknowledge “discontinuation” and "rebound" twenty or more years after the drugs were introduced just added insult to injury as far as I was concerned. This is what is so frightening about psychiatry – there is some gross disconnect between the doctors and their patients. What the doctors “see” and the patients describe is completely at odds. Until that comes into alignment we are in for some serious trouble and the trends Whitaker describes will only get worse. "
You picked on among many comments. I read many comments that were not favorable to Whitaker at all.

When you talk about a disconnect between what doctors and patients describe, you must be talking about ex-patients. Current patients come to see their psychiatrists because they are to some degree or the other satisfied with the results. Otherwise they wouldn't come.

I find interesting how many people use internet sites to pour their grievances about all kinds of things. One of the popular topics is, of course, psychiatry. Unless they present a form of mental illness that would merit mandatory treatment, most people are free to choose whether to see a psychiatrist or not. If someone thinks that their problem would be better addressed without medication, in therapy or some other way, no one will stop them when they seek that kind of help. What's the problem then?
Reply With Quote
  #66  
Old 08-07-2011, 10:01 AM
badhatharry badhatharry is offline
 
Join Date: Jul 2009
Location: eastern sierra
Posts: 5,413
Default Re: John has gone off the deep end

Quote:
Originally Posted by willmybasilgrow View Post
Such as:
"The Harvard psychiatrists refuting Bob [Whitaker] were truly laughable. They seem to think that all it takes for them to be convincing is to say “I don’t agree” and issue a few ad hominem attacks. There was not one substantive argument that the way they practice medicine is actually doing good. And then for Dr. Rosenbloom to take pride in the fact that their department was actually one of the first to acknowledge “discontinuation” and "rebound" twenty or more years after the drugs were introduced just added insult to injury as far as I was concerned. This is what is so frightening about psychiatry – there is some gross disconnect between the doctors and their patients. What the doctors “see” and the patients describe is completely at odds. Until that comes into alignment we are in for some serious trouble and the trends Whitaker describes will only get worse. "
PS. This reminds me of the reason Popper's concept of falsifiability came into being.

Quote:
That is to say, he saw that what is apparently the chief source of strength of psychoanalysis, and the principal basis on which its claim to scientific status is grounded, viz. its capability to accommodate, and explain, every possible form of human behaviour, is in fact a critical weakness, for it entails that it is not, and could not be, genuinely predictive. Psychoanalytic theories by their nature are insufficiently precise to have negative implications, and so are immunised from experiential falsification.
__________________
"By pursuing his own interest he frequently promotes that of the society more effectually than when he really intends to promote it." Adam Smith
Reply With Quote
  #67  
Old 08-07-2011, 10:07 AM
badhatharry badhatharry is offline
 
Join Date: Jul 2009
Location: eastern sierra
Posts: 5,413
Default Re: John has gone off the deep end

Quote:
Originally Posted by Ocean View Post
When you talk about a disconnect between what doctors and patients describe, you must be talking about ex-patients. Current patients come to see their psychiatrists because they are to some degree or the other satisfied with the results. Otherwise they wouldn't come.
This is defintely not true. While people may think that the time spent on the couch is a waste of time and that it's not helping, there is a strange psychology that tells them that their dissatisfaction may be (and probably is) resistance to therapy and that they should stick with it. It's a win-win for the practitioner.
__________________
"By pursuing his own interest he frequently promotes that of the society more effectually than when he really intends to promote it." Adam Smith
Reply With Quote
  #68  
Old 08-07-2011, 10:12 AM
willmybasilgrow willmybasilgrow is offline
 
Join Date: May 2008
Posts: 142
Default Re: John has gone off the deep end

Quote:
Originally Posted by badhatharry View Post
sounds like the comments section at BHtv.

PS. has your basil grown?
Finally yes. That was the name I chose for myself originally on BhTV because I was creating a log in, and glancing around the room for objects. I saw my little basil plant on the window sill. I was a novice gardener then. Four, five or however many years later, I've found that full sun, lots of water, and benign neglect are great ingredients that go into letting my basil grow (and grow and grow).

Thanks.
Reply With Quote
  #69  
Old 08-07-2011, 10:22 AM
Ocean Ocean is offline
 
Join Date: Jun 2008
Location: US Northeast
Posts: 6,784
Default Re: John has gone off the deep end

Quote:
Originally Posted by badhatharry View Post
This is defintely not true. While people may think that the time spent on the couch is a waste of time and that it's not helping, there is a strange psychology that tells them that their dissatisfaction may be (and probably is) resistance to therapy and that they should stick with it. It's a win-win for the practitioner.
Badhat, you're confusing the practice of psychiatry with psychoanalysis.
Reply With Quote
  #70  
Old 08-07-2011, 10:33 AM
ledocs ledocs is offline
 
Join Date: Sep 2007
Location: France, Earth
Posts: 1,165
Default Re: Oral Sex and Squamous-cell carcinoma

Thanks for this update!
__________________
ledocs
Reply With Quote
  #71  
Old 08-07-2011, 11:53 AM
badhatharry badhatharry is offline
 
Join Date: Jul 2009
Location: eastern sierra
Posts: 5,413
Default Re: John has gone off the deep end

Quote:
Originally Posted by Ocean View Post
Badhat, you're confusing the practice of psychiatry with psychoanalysis.
may I remind you that you are ignoring me. But I'm sure that what I said would be applicable to psychiatry as well as to psycoanalysis. Besides those two are not mutually exclusive.
__________________
"By pursuing his own interest he frequently promotes that of the society more effectually than when he really intends to promote it." Adam Smith
Reply With Quote
  #72  
Old 08-07-2011, 11:55 AM
badhatharry badhatharry is offline
 
Join Date: Jul 2009
Location: eastern sierra
Posts: 5,413
Default Re: John has gone off the deep end

Quote:
Originally Posted by willmybasilgrow View Post
Finally yes. That was the name I chose for myself originally on BhTV because I was creating a log in, and glancing around the room for objects. I saw my little basil plant on the window sill. I was a novice gardener then. Four, five or however many years later, I've found that full sun, lots of water, and benign neglect are great ingredients that go into letting my basil grow (and grow and grow).

Thanks.
fresh basil is very, very good.
__________________
"By pursuing his own interest he frequently promotes that of the society more effectually than when he really intends to promote it." Adam Smith
Reply With Quote
  #73  
Old 08-07-2011, 11:58 AM
Ocean Ocean is offline
 
Join Date: Jun 2008
Location: US Northeast
Posts: 6,784
Default Re: John has gone off the deep end

Quote:
Originally Posted by badhatharry View Post
may I remind you that you are ignoring me. But I'm sure that what I said would be applicable to psychiatry as well as to psycoanalysis. Besides those two are not mutually exclusive.
Your response certainly reminds me of why I'm ignoring you.
Reply With Quote
  #74  
Old 08-07-2011, 12:02 PM
AemJeff AemJeff is offline
 
Join Date: Feb 2007
Posts: 7,750
Default Re: John has gone off the deep end

Quote:
Originally Posted by badhatharry View Post
may I remind you that you are ignoring me. But I'm sure that what I said would be applicable to psychiatry as well as to psycoanalysis. Besides those two are not mutually exclusive.
They're pretty much are mutually exclusive. One requires an MD and the other doesn't. A psychiatrist can prescribe medication, a psychoanalyst can't. Psychoanalysts engage in talk therapy ("the couch") and group therapy, and other behavioral modalities. Psychiatrists engage in the practice of a medical specialty (just like cardiologists, rheumatologists neurologists, and every other medical specialty.) There's really very little in common between them.
__________________
-A. E. M. Jeff (Eponym)
Magnets - We know how they work!
Reply With Quote
  #75  
Old 08-07-2011, 12:03 PM
badhatharry badhatharry is offline
 
Join Date: Jul 2009
Location: eastern sierra
Posts: 5,413
Default Re: John has gone off the deep end

Quote:
Originally Posted by Ocean View Post
Your response certainly reminds me of why I'm ignoring you.
It makes no difference to me. If you can't see the coercive, assymetrical quality of the profession that's too bad. This is not to say that there is no benefit. It's just a recognition of the way the system operates.
__________________
"By pursuing his own interest he frequently promotes that of the society more effectually than when he really intends to promote it." Adam Smith
Reply With Quote
  #76  
Old 08-07-2011, 12:05 PM
badhatharry badhatharry is offline
 
Join Date: Jul 2009
Location: eastern sierra
Posts: 5,413
Default Re: John has gone off the deep end

Quote:
Originally Posted by AemJeff View Post
They're pretty much are mutually exclusive. One requires an MD and the other doesn't. A psychiatrist can prescribe medication, a psychoanalyst can't. Psychoanalysts engage in talk therapy ("the couch") and group therapy, and other behavioral modalities. Psychiatrists engage in the practice of a medical specialty (just like cardiologists, rheumatologists neurologists, and every other medical specialty.) There's really very little in common between them.
Oh really? so when did psychiatrists stop practicing psychoanalysis? They just push pills now?
__________________
"By pursuing his own interest he frequently promotes that of the society more effectually than when he really intends to promote it." Adam Smith
Reply With Quote
  #77  
Old 08-07-2011, 12:38 PM
Florian Florian is offline
 
Join Date: Mar 2009
Posts: 2,118
Default Re: Sleep and Depression

Quote:
Originally Posted by Hal Morris View Post
I could go riffing on about Thomaz Szatz (who I think has not done much good for the world), and modern libertarians, and maybe Michel Foucault as an alternate way of demonizing therapy. So many thoughts so little time.
I was unaware that Foucaul demonized therapy, although I am sure he would have been suspicious of drug therapy as an all-purpose remedy for depression and other forms of "le mal de vivre" (difficult to translate: maybe "life sucks" in vulgar americanese)

What Foucault attacked was the belief that there is an absolute separation between the sane and the insane. That may be wrong---I am in no position to say---but it is not insane.

Last edited by Florian; 08-07-2011 at 12:41 PM..
Reply With Quote
  #78  
Old 08-07-2011, 12:42 PM
Ocean Ocean is offline
 
Join Date: Jun 2008
Location: US Northeast
Posts: 6,784
Default Re: Sleep and Depression

Quote:
Originally Posted by Florian View Post
What Foucault attacked was the belief that there is an absolute separation between the sane and the insane. That may be wrong---I am in no position to say---but it is not insane.
I don't know much about Foucault, but if that's what he said, I agree. There's a continuum for most psychiatric disorders from the normal average person to someone who experiences symptoms that interfere with their lives.

Perhaps the most extreme forms of psychiatric disorders, psychosis/schizophrenia are a bit more clearly demarcated from the rest, but still in many ways there is a continuum.
Reply With Quote
  #79  
Old 08-07-2011, 12:57 PM
badhatharry badhatharry is offline
 
Join Date: Jul 2009
Location: eastern sierra
Posts: 5,413
Default Re: John has gone off the deep end

Quote:
Originally Posted by sugarkang View Post
What is the standard tool for psychiatrists?
So you want to play Jeff's shell game, eh? Have fun.
__________________
"By pursuing his own interest he frequently promotes that of the society more effectually than when he really intends to promote it." Adam Smith
Reply With Quote
  #80  
Old 08-07-2011, 12:58 PM
AemJeff AemJeff is offline
 
Join Date: Feb 2007
Posts: 7,750
Default Re: John has gone off the deep end

Quote:
Originally Posted by badhatharry View Post
So you want to play Jeff's shell game, eh? Have fun.
harry, it's called "parsing the English language." Many people engage in it with great success!
__________________
-A. E. M. Jeff (Eponym)
Magnets - We know how they work!
Reply With Quote
 


Currently Active Users Viewing This Thread: 1 (0 members and 1 guests)
 
Thread Tools
Display Modes

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is On
HTML code is Off

Forum Jump


All times are GMT -4. The time now is 01:47 PM.


Powered by vBulletin® Version 3.8.7 Beta 1
Copyright ©2000 - 2020, vBulletin Solutions, Inc.