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Seeing Beyond Depression


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https://www.psychologytoday.com/us/articles/201901/seeing-beyond-depression

Seeing Beyond Depression

There's new evidence that depression is not just a disorder of the mind—and blood tests for signs of inflammation promise treatment options precisely tailored to each patient's needs.

By Edward Bullmore M.D., published January 2, 2019 - last reviewed on January 3, 2019

There is talk about meds in this article ,I am not advocating this .powerback.

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I'm very dubious that "depression" is commonly caused by "inflammation" rather than situational factors, particularly one's family.

 

However, I do believe that a lot of people with physical ailments that may cause inflammation feel unwell; this is distressing to them, they may have additional worries -- such as how to work while ill or get effective medical treatment -- and this can be "depressing."

 

When a researcher is biased towards the medical model of mood disorders, it may see logical that "depression" has a physical cause since it's seen so often when people are found to be ill via medical tests. However, I believe this is yet another example of correlation being mistaken for causation, and indicative of psychiatry being more of a religion than a science.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

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On 1/17/2019 at 6:50 PM, Altostrata said:

However, I believe this is yet another example of correlation being mistaken for causation, and indicative of psychiatry being more of a religion than a science.

 

Many psychiatrists want their field to be a(n) (exact) science so bad, they equate mental "ilness" with physical brain"disease". That is why they are so happy to prescribe pills, thinkering with chemicals makes them feel 'sciency'. The other reason of course is the corrupting influence of the pharmaceutical industry and the fact it is easier to just prescribe a pill (only takes a minute).

 

I would however not throw the baby away with the bathwater, biological psychiatry imo has a role to play next to therapy, which should be the main focus. Some developments make me hopeful (like the discovery of the gut-brain-axis and the possibility of psychobiotics (beneficial probiotics that affect mental health), early days but promising. Another interesting field is the (non)invasive stimulation of the vagus nerve.

 

It is clear people who are struggling mentally (with depression, ptsd etc.) have distinct biological markers,. You are of course right to say correlation does not equal causation, but imo medicine has to stop the cartesian dualism,  both mind and body play a role (they are interconnected, how can they not be), a good doctor should be focussing on both. Never biological psychiatry can or should be the only therapy.

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Supplements: magnesium malate, fish oil, curcumin, multivitamin, iodine, probiotics, vitamine D along with eating healthy 80 percent of the time, I have no problem whatsoever taking supplements.

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3 minutes ago, Linus said:

It is clear people who are struggling mentally (with depression, ptsd etc.) have distinct biological markers,.

 

I strongly disagree with this statement. Whatever evidence there is for this is strongly contaminated by observer bias, a shaky diagnostic base, and the aforementioned logical error of mistaking correlation for causation.

 

The misdiagnosis of physical illness as a mood disorder, especially in women, is so common, it's tragic.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

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As I said, mind and body are interconnected, if you have the flu (body) you will also feel depressed (mind), if you have ptsd (mind) the body keeps the score, to borrow a phrase from Bessel Van der Kolk. Seems pretty straighforward to me.

 

 

7 minutes ago, Altostrata said:

The misdiagnosis of physical illness as a mood disorder, especially in women, is so common, it's tragic.

 

Well I can only agree but I did not say anything about this, so not sure why you bring this up.

Escitalopram 1.05 mg (max of 30 mg, taper from 10 mg to now started september 2016)

 

Klonopin 0.3 mg (one dosage reduction of 25 percent, from 0.4 to 0.3 mg september 2017)

 

Supplements: magnesium malate, fish oil, curcumin, multivitamin, iodine, probiotics, vitamine D along with eating healthy 80 percent of the time, I have no problem whatsoever taking supplements.

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Because among the population of people diagnosed with a mood disorder is a large subgroup who were misdiagnosed and had the physical illness all along. This contaminates the findings of any study that finds correlation between mood disorder and physical illness in a population diagnosed with mood disorder.

 

In populations that have physical illnesses, of course a large number have "mood disorders." They're unhappy they're sick, in pain, and have to deal with a difficult and largely clueless health care system. Correlations there are also questionable. Bad mood is normal when you're sick!

 

Plus, there's the issue of psychiatric diagnoses of mood disorders are nothing but semi-informed guesses. Few psychiatrists go to the trouble of differential diagnosis, it's so easy to simply hand out prescriptions for "mood disorder." A mood disorder can be diagnosed in a ham sandwich.

 

Unhappy you're sick, unhappy because of your marriage, unhappy because you're poor -- all of these can be diagnosed as "mood disorders." And a large number are also physically ill.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

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34 minutes ago, Altostrata said:

Because among the population of people diagnosed with a mood disorder is a large subgroup who were misdiagnosed and had the physical illness all along. This contaminates the findings of any study that finds correlation between mood disorder and physical illness in a population diagnosed with mood disorder.

 

Correct, but that is another issue (an important one for sure). But not everybody diagnosed with a mood disorder has a physical illness. I have ptsd (a mood disorder) , and of course this has an impact on my biology (hpa axis, amygdala, cortisol, most likely my microbiome etc.).

 

34 minutes ago, Altostrata said:

In populations that have physical illnesses, of course a large number have "mood disorders." They're unhappy they're sick, in pain, and have to deal with a difficult and largely clueless health care system. Correlations there are also questionable. Bad mood is normal when you're sick! 

 

Correct, that is exactly what I said.

 

The point I am trying to make is that body and mind work upon each other, if you have the flu, you will feel depressed, because the body influences the mind, goes in the other direction as well, if you have ptsd (a mood disorder), your body will suffer the consequences (your sympathetic nervous system (biology)takes a big hit), so your mind influences your body. For me this pretty straightforward stuff.

 

I firmly reject the biomedical model of psychiatry (as clearly stated in my first comment), but still see a role for biological psychiatry, well let us say I hope there will be a role for it, in the form of psychobiotics for example. See for instance http://yadda.icm.edu.pl/yadda/element/bwmeta1.element.psjd-0ad309a0-661b-4021-9d34-15c0b61d5e06

 

From the article: " Until recently, it seemed unlikely to combine fecal microflora with mood disorders. The growing amount of animal research shows that one of the etiological factors of mood disorders may be irregularities in this area. "

 

Will we ever have psychobiotics, I don't know, I hope so, so that in combination with the right therapy, people stand a better chance of recovering from what life throws at them.

 

34 minutes ago, Altostrata said:

Plus, there's the issue of psychiatric diagnoses of mood disorders are nothing but semi-informed guesses

 

I have first hand experience with this (misdiagnosed on several occasions), so I agree wholeheartedly.

 

EDIT:  well actually I don't fully agree, would you also say a diagnosis of ptsd is a "semi-informed" guess, I am not married to my diagnosis, but clearly I have ptsd, on the other hand a person who just broke up with his girlfriend, goes to the doctor for being down, does not need a diagnosis of depression and a prescription for antidepressants, so I see what you mean.

Escitalopram 1.05 mg (max of 30 mg, taper from 10 mg to now started september 2016)

 

Klonopin 0.3 mg (one dosage reduction of 25 percent, from 0.4 to 0.3 mg september 2017)

 

Supplements: magnesium malate, fish oil, curcumin, multivitamin, iodine, probiotics, vitamine D along with eating healthy 80 percent of the time, I have no problem whatsoever taking supplements.

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Yes, a diagnosis of PTSD is a semi-informed guess.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

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I don't agree.

Escitalopram 1.05 mg (max of 30 mg, taper from 10 mg to now started september 2016)

 

Klonopin 0.3 mg (one dosage reduction of 25 percent, from 0.4 to 0.3 mg september 2017)

 

Supplements: magnesium malate, fish oil, curcumin, multivitamin, iodine, probiotics, vitamine D along with eating healthy 80 percent of the time, I have no problem whatsoever taking supplements.

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You may believe whatever you wish. Much of psychiatry is belief-based, rather than evidence-based. It resembles a religion in that regard.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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@Altostrata

 

There’s evidence that stress causes inflammation and so too does infection. In which case it’s not so hard to believe that inflammation and ‘mood disorders’ go hand in hand, as all of the variables you mentioned i.e. family, sickness, pain, may indeed correlate with inflammatory markers in the body. 

 

Just posting some examples below:

 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5476783/

 

https://www.pnas.org/content/110/41/16574

 

Adverse life events can impact on multiple bodily systems, such as the HPA axis, immune system, epigenetics, microbiome.

 

There’s a lot of things that are ‘not good for us’ or that ‘make us feel bad’, and inflammation could be one way to measure the impact of these things. 

 

What I don’t necessarily agree with is the idea of making an inflammation model similar to the current bogus serotonin model, where eventually we’re all prescribed powerful anti inflammatory drugs to cure our family issues etc.

PLEASE NOTE:  I am not a medical professional.  I can only provide information and make suggestions.

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1 hour ago, Altostrata said:

Much of psychiatry is belief-based, rather than evidence-based. It resembles a religion in that regard.

 

Indeed, I agree.

 

And thanks for the permission to think for myself I guess, you may also believe whatever you wish.

Escitalopram 1.05 mg (max of 30 mg, taper from 10 mg to now started september 2016)

 

Klonopin 0.3 mg (one dosage reduction of 25 percent, from 0.4 to 0.3 mg september 2017)

 

Supplements: magnesium malate, fish oil, curcumin, multivitamin, iodine, probiotics, vitamine D along with eating healthy 80 percent of the time, I have no problem whatsoever taking supplements.

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2 minutes ago, eymen23 said:

Adverse life events can impact on multiple bodily systems, such as the HPA axis, immune system, epigenetics, microbiome.

 

There’s a lot of things that are ‘not good for us’ or that ‘make us feel bad’, and inflammation could be one way to measure the impact of these things. 

 

What I don’t necessarily agree with is the idea of making an inflammation model similar to the current bogus serotonin model, where eventually we’re all prescribed powerful anti inflammatory drugs to cure our family issues etc.

 

Yup, that nicely sums up how I think about the issue.

 

And indeed anti-inflammatory drugs are no good: From the first day of use, all NSAIDs increase the risk of gastrointestinal (GI) bleeding, myocardial infarction, and stroke.

Escitalopram 1.05 mg (max of 30 mg, taper from 10 mg to now started september 2016)

 

Klonopin 0.3 mg (one dosage reduction of 25 percent, from 0.4 to 0.3 mg september 2017)

 

Supplements: magnesium malate, fish oil, curcumin, multivitamin, iodine, probiotics, vitamine D along with eating healthy 80 percent of the time, I have no problem whatsoever taking supplements.

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