Posted by Elroy on July 8, 2005, at 14:40:42
In reply to Lou's acceptance of Dr. Hsiung's offer-chmimbal? » Dr. Bob, posted by Lou Pilder on July 8, 2005, at 10:35:04
An exception that I see that immediately speaks out as an exception occurs with people who develop Cushing's of one form or the other (Cushing's Disease, Cushing's Syndrome, or even Pseudo Cushing's). They have NO mood disorder problems prior to the onset of Cushings and then develop anything from mild to moderate to even very severe depression and / or anxiety due to the excessive levels of cortisol in their bodies. Once the cortisol problem is corrected the depression / anxiety is also cleared up. That correction may be in the form of surgery (i.e., removal of a pituitary tumor or removal of an adrenal gland tumor) OR it may be in the form of medications (as an exciting example, recent studies using the drug RU486 for a very SHORT-TERM application have had amazing results in Pseudo Cushing's type cases).
Clearly an example of a BIOLOGICAL cause of a mood disorder... and that was corrected by (in some cases) pharmaceutical intervention.
Another example, somewhat rare, that comes to mind is that with "Pheo tumors" (pheochromocytoma tumor) of the adrenal gland. A pheo tumor (generally located inside the cortex area of the adrenal gland) causes the generation of excess adrenaline hormones (epinehprine, norepinehprine, etc.) and cause many symptoms... physical ones such as very high blood pressure but also generate extremely severe anxiety. When the pheo tumor is removed and the adrenaline hormones - which are also, BTW, neurotransmitters - brought back into balance, the anxiety disappears.
Clearly an example of a BIOLOGICAL cause of a mood disorder...
Another very obvious example lies in the realm of menopause / andropause situations. Being a male I will focus on the example of andropause. A male has NO mood disorder problems of any type when his testosterone production begins falling. As it continues its downward trend, the male becomes more and more depressed... and as his testosterone decline continues it is accelerated by an aromatase proces that begins escalating and converting more and more testosterone to more and more estradiol (E2, one of the estrogens) leading to an "estrogen dominance" situation in this male. Now his depression may get severe - or he may instead continue to have moderate depression, but now also have severe anxiety and/or panic attacks. The male gets his hormone levels checked and finds that he has abnormally low testosterone and highly elevated estradiol (E2). He then goes into an HRT (hormone replacement therapy) program and gets intermuscular testosterone shots weekly and Arimidex to control his E2 levels - and within a few weeks is feeling great again, with no more depression and/or anxiety!
Clearly an example of a BIOLOGICAL cause of a mood disorder... and that was corrected by pharmaceutical intervention!
In fact, in the latter example, the HRT the male is receiving is very probably prolonging his life and definitely providing for a very high quality of life. HRT (done properly with the use of bioidentical or near bioidentical hormones - and NOT any processed horse urine! - will strengthen his cardivascular system, improve his cholosterol picture, and stop the occurrence on bone loss).
There are clearly biological causes of mood disorders. In addition, when a trauma situation occurs (whether long-term, chronic stress that leads to severe anxiety or an acute trauma situation that leads to depression), it only stands to reason that the stress to the HPA Axis is going to effect the production of various hormones and neurotransmitters. In fact, the dysfunction of the HPA Axis is the primary concept behind several of the Pseudo Cushing's variations. The functions of the brain itself become overloaded and/or otherwise dysfunctional when anxiety or depression settles in for the long haul. Serotonin levels become depleted or dopamine levels become excessive, or cortisol levels become elevated, or whatever cmbination thereof...
Sure, brain brain chemistry is difficult to measure directly, but brain electrical activity, which results from chemical reactions, is now easy to assess with Quantitative Electroencephalography (QEEG), also called brain mapping... just as an EKG measures electrical activity in the heart. (There's also some other brain scanning techniques that are showing very promising results as possible methods of observing brain chemstry and brain chemistry activity)
Dr. Eric Braverman uses a computer with special interfaces and software to record and interpret the four key electrical measures of brain health, those being voltage (or energy), latency (or speed), rhythm (or balance), and synchrony (or symmetry).
According to Dr. Braverman, " ...these measurements reveal everything we need to know about dopamine, acetylcholine, GABA, and serotonin levels, respectively. Brain chemical imbalances are uncovered by lobe-specific brainwave abnormalities."
Maybe, a bit of a "stretch" (i.e., "reveal 'everything' we need to know... ").... but still very promising and more advanced technology.
I also note with interest that Dr. Braverman takes a quite "holistic" approach to his practice:
"Selective serotonin reuptake inhibitors (SSRIs) correct the neurotransmitter deficiency responsible for causing depression. Xanax and Klonopin do likewise for GABA-deficient anxiety, Aricept addresses acetylcholine-deficient memory loss, and Dexedrine bolsters the brain's dopamine when chronic fatigue presents. But drugs, as effective as they might be, should be the last-not first-resort. With "The Edge Effect", they can be.Amino acids that are the raw material precursors to the neurotransmitters. Tyrosine and phenylalanine are transformed into dopamine; acetylcholine comes from phosphatidyl serine and n-acetyl carnitine; glutamine supports GABA; and tryptophan is the raw ingredient for serotonin."
NOW......
That said, I do agree that there is too much "art" and not enough "science" in the psychiatric field. When SSRI medications came on the field, it was as if psychiatrist (generally) only had a hammer so every problem became a nail.
When I earlier ( a couple of years ago) had mild to moderate anxiety, I was able to handle it with "talk therapy" and some sleep aid assistance (ambien). Why did my p-doc keep trying to put me on SSRI medications? With anxiety it was highly unlikely that I had a serotonin problem! If anything, very low dose Xanax XR might have been a more effective option but as it turned out then I didn't need it. An even better option - with mild to moderate anxiety - would have been to put me on a regimen of certain amino acids (taurine, glutamate) and vitamins (a little extra B6) to build up my likely depleted GABA levels.
But pharmaceutical medications unfortunately DO have their place.
When the bottom fell out (for me) in June of 2004, I tried "toughening it out" for about 3 months, only for the anxiety to continue to get worse and worse. Talk therapy was like trying to pit into a hurricane (accomplishing nothing). I was first put on Ativan and then upped to Xanax XR... and quite honestly believe that I would not be here today had not the Xanax XR been able to "quench the fire" of the raging anxiety that was going on at that time.
As testing would later show (the very next month) I had very high levels of cortisol and was initially thought to have Cushing's. I was also found to now be hypogonadal (again courtesy of highly elevated cortisol). Numerous advanced testings later revealed that I did not have "regular" Cushing's, but an adrenal gland tumor (benign, thanfully) was found and it was suspected to be a Pheo tumor due to the severity of the anxiety.
That turned out to be a negative (several more tests later) and I was finally diagnosed with Pseudo Cushings due to a dysfunctional HPA Axis caused by several years of chronic stress and milder anxiety. I am currently taking the AD "Remeron", not for its AD effects (as I really have fairly mild depression and that comes and goes... and is just from being so pissed off that nothing has "cured" my condition to this point, though many thing, individually, have helped). No, I'm taking the Remeron because a number of clinical trials (remember that phrase) have shown that it has strong effects in lowering cortisol. My GP doc has hopes that we can get the cortisol lowered and keep it down for a sufficient period of time for the HPA Axis to "re-set" itself and bring cortisol production back to normal ranges.
So, it's pretty far-fetched to make generalized claims that there's no such thing as biological causes for mood disorders and psychological problems... even when the cause is one of traumatic issue, it still effects the hormones, the neurotransmitters, the HPA Axis (and as I found in becoming hypogonadal, the HPAT Axis), etc.
And, yes, I have read your links.
Some of it I agreed with....
QUOTE:
In the Florida study, psychiatrists missed diagnosing physical illness in 80% of the cases. Gold said he was "embarrassed" at how bad psychiatrists were at "doctoring" and that one third of psychiatrists admit feeling incompetent to give a patient a complete physical examination. [Mark Gold, The Good News About Depression, 1986, p.22-24]
END QUOTEJust as I stated before, this is a field where often there's too much "art" and not enough "science", too much of a "guessing game" (and often with no logic behind it... why give someone with anxiety a serotonin boosting drug? why give someone with anxiety a norepinehrine boosting drug - which will just make their anxiety worse?)
But I often noted that studies that were cited were older (like the above one, 1986, almost 20 years ago) and / or very minor studies.
But mostly it was simply citing ancedotal cases. This individual was found to have really had this problem, and this other individual was actually found not to have depression but had this brain tumor, etc., etc. There are ALWAYS exceptions, and exception do NOT make the rules, but are exceptions to those rules.
Otherwise, most of what I noted was simply the opinions of various medical individuals. Those opinions can be countered by opposing opinion of other medical authorities back and forth ad nauseum...
And what sources are referred to?
Medicine on Trial
CCHR publication, Psychiatry: Committing Fraud
The Good News About Depression
No More Ritalin, Treating ADHD Without Drugs
The Hyperactivity Hoax
Prescription for Disaster
Etc., etc., etc.Pretty "one-sided" view, no?
Again, views that can be countered by numerous other medical books by other medical authorities that say otherwise.
That said, I will state in my personal opinion that I think that we - as a country and society - ARE overmedicated, that doctors ARE too likely to look for a pharmaceutical response (jeez, with all those sales reps, I wonder why?) and that doctors should take more holistic approaches to both treating symptoms AND finding root causes for full treatment, and that pharmaceuticals should be last-ditch responses when severity simply insists that it must be done (I, for example, would not want to go to the ER with a badly infected arm wound and be given a regimen of vitramins and amino acids to take when clearly some strong antibiotics would be called for to keep from losing the limb - or even worse!).
As to the pharmaceutical companies themselves, I (again my own personal opinion) believe them to simply be necessary evils. They are too profit oriented, often - IMHO - conduct questionable studies, and simply by their mode of operation put too much pressure on doctors to use them as a first resort rather than a last resort.
Elroy
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X> Dr. Hsiung and all members of this mental-health community.
> I am delighted to accept the offer here by Dr. Hsiung to show reserch that could indicate that the taking of psychotropic could harm your health amd that the statement by Dr. Hsiung that the poster in question's statement has the potential to be accurate and is not overgeneralizing or exaggerating.
> What I will post here is to show where the psychotropic drugs came from, what the chmicals do to those that take them, how pesticides and poisons act and how nerve agents that kill are related to the development of psychotropic drugs. I also will show the relationship with the Nazi regime and psychiatry along with IG Farben and Nazi Germany, Bayer and Hoechst.
> But first I would like for those that are going to post to this thread to take in consideration what is written in the following link concerning the "chemical imbalance" theory of psychiatry.
> Lou Pilder
> http://www.deep-trance.com/treatment/chemical-imbalance.html
poster:Elroy
thread:13781
URL: http://www.dr-bob.org/babble/20050708/msgs/524998.html