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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by Dinah on August 9, 2011, at 8:46:30
Even my therapist doesn't understand what I'm talking about when I point out all the various health problems, including mental health problems, that would fit my hypothesis of a subset of patients whose mental health problems are due to problems in the HPA axis or autonomic nervous system. I'm not an academician or a practitioner.
Yet I strongly feel that this would be something that should be studied, not on an individual symptom basis, but on the basis of considering it a syndrome. If it could be validated, it would be helpful not only as a descriptor or cause of certain symptoms, but as an indicator of when to use those treatments that currently exist. With a simple questionnaire, or maybe a saliva test, even general practitioners could have a working basis on which to decide if, say, medications that raise NE levels might be a bad idea, or where atypical antipsychotics might be helpful if they are tolerated.
They want to remake psychiatry into a medical model, and surely a knowledge of which brain chemicals fit which symptoms of umbrella diagnoses like "depression" would be the quickest way to bring psychiatry into this model.
I wish I were in a position to do studies or suggest ideas. But I'm just a psych patient, and even my own doctors probably would pat me on the head and say it's an interesting idea.
Posted by ron1953 on August 9, 2011, at 10:41:31
In reply to I wish there was a way..., posted by Dinah on August 9, 2011, at 8:46:30
Except for one little problem: These so-called experts have proven time after time that they don't know very much. And I'm not surprised, because the human body and the human condition is complicated beyond the comprehension of their puny human brains, and ours, too. I have felt this way for a very long time, but finally someone has done the research and eruditely written about it. Worthwhile reading if one desires a balanced opinion, as it is becoming more and more apparent that mental health professions quite often do a great disservice to their clients.
Posted by Phillipa on August 9, 2011, at 11:42:10
In reply to Re: I wish there was a way..., posted by ron1953 on August 9, 2011, at 10:41:31
Oh I would love to don't work for me anymore as they can't cure a problem in life. They just happen. Phillipa
Posted by Dinah on August 9, 2011, at 13:06:19
In reply to Re: I wish there was a way..., posted by ron1953 on August 9, 2011, at 10:41:31
I'm not a huge fan of the state of the field, myself.
Posted by floatingbridge on August 9, 2011, at 17:38:31
In reply to I wish there was a way..., posted by Dinah on August 9, 2011, at 8:46:30
I certainly wish there were ways to bring research findings closer to practical medicine. I find it crazy making. If one has physical symptoms it's because of, as you say, the depression umbrella. If one has depression, often I find the tacit implication is that it's psychogenic. Which means to me, very often, gee, sorry lady. Next.... Sigh.
When I saw *my* endocrinologist, and inquired about HPA axis problems, he looked completely nonplussed.
I don't know Dinah. From your reading lately, you could be working on a thesis :-) How frustrating I imagine it is to begin to get a real inkling of the interconnectivity of these systems, only to be stymied in treatment.
I get frustrated when people still debate weight gain and AP's as if (at least most) do not effect the endocrine system.
:-/
Posted by floatingbridge on August 9, 2011, at 18:12:24
In reply to I wish there was a way..., posted by Dinah on August 9, 2011, at 8:46:30
The same short alle (5HTTLPR) in this study on borderline disorder had also been targeted as a predictor to poor or non-response to the majority of ssri therapies.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3089993/?tool=pubmed
Slightly off point here but part of a larger discussion.....
It was suggested I be tested for this. But where?
Posted by Dinah on August 10, 2011, at 9:35:13
In reply to Re: I wish there was a way...One genetic test.... » Dinah, posted by floatingbridge on August 9, 2011, at 18:12:24
Not off target at all! I think it sounds very promising. Maybe there is hope after all.
I'd like to be tested for it as well. If you find out who is doing the test, let me know. I thought about the saliva tests, but all that would show is that I have abnormally high levels of cortisol. I know that already, and I'm not sure if there's any therapeutic use in having it in writing.
I'm particularly liking the trend towards breaking bpd up into its different components. Wish they'd do that in the DSM.
Posted by Dinah on August 10, 2011, at 9:40:33
In reply to Re: I wish there was a way... » Dinah, posted by floatingbridge on August 9, 2011, at 17:38:31
I wish I could work on a thesis about it!
It's so frustrating to me that there are many studies linking the various problems to the same cause, yet I haven't seen any studies on looking at it as a whole, or using it for therapeutic purposes.
All my doctors have me pegged at first glance, not just the psych ones. And each doctor sees that the various indispositions I have within their specialty are not somatization or all in my head or caused by a need for attention or whatever. It's so strange that they aren't discussing it in terms of a root cause for various ailments. I can't tell you how relieved I was to speak to a neurologist about the very real physiological causes of migraines, when I always had the sense before then that my doctors just thought I was neurotic. Well, maybe I was, but maybe neurotic didn't mean what they thought it meant.
Posted by floatingbridge on August 10, 2011, at 10:49:59
In reply to Re: I wish there was a way... » floatingbridge, posted by Dinah on August 10, 2011, at 9:40:33
> when I always had the sense before then that my doctors just thought I was neurotic. Well, maybe I was, but maybe neurotic didn't mean what they thought it meant.
:-)
I make a crummy patient, now, I don't know. I just blurt out that I am neurotic just to clear the agenda and see if forward movement is possible given the advent of neurosis.
Not that there has been much forward movement unless one counts firings of old providers.
How is this for 'insane': you have chronic PTSD which shows borderline features and studies, never mind that they are old,
recycled, and have been overturned, show your conditions are most ammendable to therapy; therefore we are withdrawing pharmaceutical supports until some unspecified time in the future. Besides your profile, since we now have you profiled, it's here on this sheet, says your type, because you are now under a type heading will use medication not
only irresponsibly but in lieu of treatment (real treatment). So go out there and breath and do yoga. Oh. And somehow we will overlook your current recurrence of major depression as part of the above symptomology.They had not, I imagine read the NEJM article from May which my new primary doctor was kind enough to give me a hard copy of:
http://www.nejm.org/doi/full/10.1056/NEJMcp1007358#t=article
Posted by floatingbridge on August 10, 2011, at 11:55:05
In reply to Re: I wish there was a way... » floatingbridge, posted by Dinah on August 10, 2011, at 9:40:33
> I wish I could work on a thesis about it!
>If you want to, the community would surely benefit. Public Health?
Then, there are a few good blogs, but that seems so labor intensive.
Freelance writing. In the right venue. If you'd want to. I
highly regard your abilities..... Not in any perfectionistic way, though.I see a new therapist in a few hours. Meet and greet I call it. One of her specialities is helping 'complicated' patients navigate the health care system. I'm just going for therapy at this point. But I had not encountered that specialization before. She is social worker with other degrees, no doctorate I believe. A senior therapist I was told (by the person who referred me) meaningna kind of ranking? Her husband works in social service advocacy as well.
Anyways, somebody writes the information they read....
Posted by Christ_empowered on August 10, 2011, at 13:35:21
In reply to Re: I wish there was a way... » Dinah, posted by floatingbridge on August 10, 2011, at 11:55:05
I think psychiatry, since its inception, has been more about control and maintaining the status quo than about actual science. I think its also worth noting that as religion and family, the two institutions that helped socialize people, restrain their behavior, explain their lives, and give them meaning have weakened, psychiatry and psychology have become ever more popular.
This is the end of the thread.
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