Mental Illness, what is it?

  • Thread starter scott_sieger
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  • #1
Since the suicidal death of my brother due to his state of mental health (Schizophrenia etc)

I have been studying and researching this issue (now nearly 12 years)

I have no formal background, no qualification except the most important one (life).

I have interviewed and listened to many many schizpohrenic and bi polar sufferers.

I found that the medical proffession was in a lot of ways way off the track in their approach to these and other problems.

I wrote a simlpe but relatively complete understanding of what I knew to be clinical mental illness and If I may I would like to post it here. (it includes and example of patient responses)

If i could get some feedback here or by e-mail it would be terrific.

scottsau1@yahoo.com.au


Mental Illness
A new approach
By
Scott Sieger

Introduction

When considering the nature of mental illness it is important that we define what it is we are considering.

Mental illness is a mental condition that prevents the sufferer from participating in life in the way he or she would wish. It is a condition that places the sufferer in a state of dysfunction.

It is a condition that society wants to protect itself from for it deems the mental state of the sufferer to be precarious, unreal and relatively unpredictable.

Within the following example of mental aberration I will use the condition notoriously referred to as Schizophrenia.

Schizophrenia demonstrates the greatest variety and complexities of the aberrant mental state and I intend to suggest a way that will allow us to treat and cure this condition.



w w w w



Schizophrenia is about ability, not ordinary ability but extraordinary ability.

At some time in the patient’s life his brain has acquired an ability or abilities that the patient has little to no control over. The ability(s) are acquired intuitively and usually discounted as inconsequential by the patient himself and as delusion or hallucination by the medical profession when he or she is finally admitted to hospital or some form of professional therapy and care.

The abilities I refer to are of a sensory nature: intuitive sensory abilities of an extraordinary nature. The patient immediately becomes embattled with what he senses as ordinary sensory behaviour and that which he himself would consider extraordinary sensory ability.

Society is telling him that his ability is delusional and yet he knows that it isn’t. His imagination tries to accommodate society and his own experiences, putting himself in a state of self delusion because he is inclined to deny his ability as real because society is saying that this is the case.

So we have at least two abilities happening. The first is his ability to know what is extraordinary (Aberrant) sensing this and the actual intuitive ability that he has acquired which is also sensed.

A classic example would be paranoid schizophrenia where by the patient feels a strong sense of conspiracy, that the CIA or the police are watching him or his parents are threatening to kill him etc.

A normal person is quite capable of sensing conspiracy in fact we are all part of a conspiracy. We are all part of everyone else’s plans. The wife or girlfriend is planning a special dinner. The government is planning to introduce the GST. The guy down the pub is planning to punch him in the nose etc.

So the patient has developed an ability to sense conspiracy to a depth that would be considered extraordinary. His sense of reality is threatened and he becomes deluded trying to deal with his sensory ability and that which society would consider normal.

For instance he senses his girlfriend’s plans for dinner and feels threatened because of his fear of his ability to sense this. He behaves badly trying to cope with all the mixed signals that his brain is trying to interpret. He behaves badly and arrives in the hospital in an extreme state of anxiety.

The premise I am using here is that fear is always real. Not always understood for what it is but very real and valid. The ability to understand and learn from it is the ability that needs to be learned and it is only by achieving understanding and learning that the patient has any chance of recovery.

To deny the ability is to provoke delusion. To nurture the ability is to free the patient of delusion.

Funnily enough it is society’s state of delusion as to the nature of Schizophrenia that is actually perpetrating and enforcing a delusion upon the sufferer. Society having the delusion that extraordinary ability doesn’t exist. Which is of course not true as some of our most gifted people exhibit extraordinary ability all of which could be considered intuitive.

I am suggesting that the patient’s sensory abilities have somehow achieved a greater depth than would be considered normal and like a person studying martial arts the patient must learn sensory discipline and nurture his ability to the level that he is comfortable with.

I believe that our current approach to Schizophrenia is in fact quite deluded and as you would now understand the patient is also aware of this causing even more grief.

Medication rejection, hospitalisation rejection etc are all symptoms of our “insane” approach to schizophrenia: the patient being caught between two worlds and not knowing what to believe.

Sensory ability is essentially reflexive in that until controlled by other governing reflexes the ability continues to exist at all times in a way that is ungoverned and it is only when the ability is governed by learned reflexes that the ability is controlled and the patient’s anxiety and comfort levels return to “normal”

w w w w

Conclusion

What I propose is that the patient be treated as a person who has abilities yet to be governed and not denied.

That the treating staff attempt to identify what abilities are in play and structure a learning and therapy program that helps the patient in the achievement of comfort by allowing him to achieve the skills and disciplines needed.

Many programs can be developed that are able to help the patient with the above in mind.

Open mindedness to what the patient is describing as delusion and treating the description in the light of uncontrolled intuitive ability will achieve significant results.


A Response by M. C, California USA

WOW. I like this. Particularly from a sufferer’s point of view..

I can’t tell you how much comfort it gave me to hear from you that I wasn’t just stupid and/or crazy to be thinking the thoughts that I was thinking.
In our overactive minds, we create connections and find significance in insignificant, unconnected events. And this was (sometimes is) my reality. And I found it utterly frustrating to hear from people that I should just not believe what I already believed. It was liberating, and yet scary, to think that I might be right.

You’re right in recognizing the person’s ability to perceive as being real, because it is real, and then your next question to me was “Why?”. This caused me to look deeper into what I was experiencing. It gave me comfort and strengthened my belief in and view of God and helped me to give purpose and meaning to what I was experiencing.

The similarity to this approach is striking to a form of therapy that exists for Borderline Personality Disorder. Are you familiar with that? It’s also called emotional intensity disorder and it affects about 1-2 million Americans. It causes the person to experience each situation to a fully charged emotional level, and they frequently are very frightened people who act in harsh, angry ways. It’s hard to treat but the recommended treatment today is called Dialectical Behaviour Therapy (DBT). It consists of accepting the patient the way they are and also accepting the need to change (thus the term Dialectical, accepting two seemingly opposite themes).

Your idea seems revolutionary to the field of schizophrenia and also interestingly similar to this field’s approach. The thing that I like about your approach is the respect that it gives to the individual. You hit the nail on the head when you said society’s reality does not accept the other person’s. By recognizing the person’s reality as real, you’re recognizing the person as significant.

It was an extremely exciting proposition when you said that my perception was founded. I felt like for the first time someone was saying I wasn’t stupid, or self-absorbed, or just crazy. Because according to my perceptions, the delusions I was experiencing were real.

I think you should also recognize society’s reality as being real. You didn’t say it wasn’t, but I think to be fair you should say that both realities are real in a sense. I mean perception is relative anyway.

Regarding the final conclusion:

“Open mindedness to what the patient is describing as delusion and treating the description in the light of uncontrolled intuitive ability will achieve significant results.”

I think you should go on to explain more as to why this recognition will help the patient. I have tried to give you my perception as to why it helped me, but I’m sure you have some ideas of your own that I’d love to hear.

Matt.
 

Answers and Replies

  • #2
sandinmyears
18
0
Matt,

I have a neurological illness that 100 years ago would have been considered a mental illness. (Epilepsy). I also have in my family (both maternally and paternally) Bipolar Disorder, Autism and ADHD. I myself also have either Bipolar Disorder (Type II) or Bipolar tendencies. The medications that I take treats both seizures and mood swings (depression and hypomania). I also have had the good sense (with the prompting of a few friends) to seek therapy. Both (meds and therapy) are very helpful. They help keep me on track.

Does this make me crazy? Ofcourse not. A person with Schizophrenia is not crazy either. If I am not on any of my medications, I will experience auditory (sound) and olfactory (smell) hallucinations during a seizure. Before surgery (done 15 years ago), I would experience extreme fear (terror even) during a complex-partial seizure. If it progressed far enough, I would scream. Was this insanity? No, it's related to the Amygdala in the Hippocampus (located in both temporal lobes of the brain) which experience the emotions of fear and anger. 100 or 150 years ago (before anticonvulsants) I would have been locked up in an insane asylum. I would have been considered crazy...phobic at best.

The medical community is seeing Axis I disorders (such as schizophrenia, clinical depression, bipolar disorder, autism, and ADHD) with much more respect than it did a generation ago. I see society starting to follow suit-- and it's about time. There really isn't much difference between neurology and psychology. (Hence, neuropsychology). Axis II disorders are usually related to general personality (personality disorders or personality traits), and intelligence (mental retardation). Axis I disorders are usually innate and often genetic in origin. They are also often quite treatable. If you're interested in genetics, read up on chromosome bands: 10q24-26, 12q24, 15q11-14, 16p13/16p13.3, 22q11-13.

I'm sorry about your brother. I attend a "Grief Share" group at our church because of a recent loss in my family. (My daughter). One woman who attends has a grandson who committed suicide. She had a hard time at first (spiritually) because of teachings that she has heard about hell and suicide. She, like anyone experiencing suicide in their family, struggled with this. One thing that we emphasize at "Grief Share" is that you never know what state of mind a person is in when suicide occurs and it isn't our place to judge. I don't know if you are a spiritual person, but I thought that might help.

~Sandy
 
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  • #3
Nommos Prime (Dogon)
224
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A Personal View

I believe that current descriptions of any form of mental illness (as distinct from a disease such as brain cancer which can cause similar hallucinations, bizarre patterns of behaviour etc.) are woeful and lack any real insight into the phenomena.
Mental illnesses are merely descriptions of patterns of “antisocial” or “unexplainable” behaviour. Post Traumatic Stress Disorder is a good example of a recently “manufactured” condition, as is Anxiety Disorder. These conditions are simply normal human reactions to a threat on personal safety. One must remember that psychiatrists and pharmaceutical companies make countless billions of dollars peddling drugs each year to the public (state-sponsored drug trafficking). These companies therefore have a vested interest in what drugs people are prescribed. Psychiatrists get kickbacks from companies if their particular brand of drugs are prescribed.
Those who radiate human emotions when they feel them are not considered normal. Empathic abilities are frowned upon. I think the rise in “diagnosed” mental illness is more a reflection of the problems in our society as a whole than any personal demons. When we look at Western society with its wage-slavery, taxes to fuel the war-machine of government, mortgages, terrorism, electromagnetic pollution, media whitewashes, its surprising that all of us aren’t insane!
 
  • #4
Nommos Prime (Dogon)
224
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Mental Illness in Young Japanese

To illustrate my previous comments regarding society causing mental illness.
There is a relatively new phenomena occurring in Japan where young Japanese are refusing to come out of their rooms for years. It has a hesitant diagnosis attached to it. Thousands of young people in Japan are suffering from this uniquely Japanese phenomena. The parents don't admit it, the authorities and professionals are baffled by the condition, nobody knows what to do.
The "mental illness" did not exist before the eighties. The very severe form of agoraphobia is theorized to be a result of Japan's amazingly rigid and disciplined society, where if children do not succeed at their studies, they are considered failures.
I wonder how long until this reaches our shores?
 
  • #5
adrenaline
Science Advisor
103
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Originally posted by Nommos Prime (Dogon)
Psychiatrists get kickbacks from companies if their particular brand of drugs are prescribed.

I just want to set the record straight. Unless a doctor owns stock in a drug company (99% don't) the only kickbacks docs get for prescribing a drug these days are free pens and an occassional lunch.

Not much compensation for 90 hour work weeks.

The pharmaceutical reps reap all the benefits.(The average pharmaceutical rep makes makes more than the average physician in Georgia and they don't get out of bed at 2 in the morning most nights a week.) They get a "commission" for every drug the physician writes. Most doctors try to prescribe medicines based on evidence based clincal trials and tailor it to the individual.

Back to the issue at hand. I think bipolar disease is one of those diseases that can reap wonderful feats and accomplishments for the individual during their bouts of mania as well as a fuel for incredible creativity. Unfortunately, the natural history of untreated bipolarI (not necessarily bipolar II) disease is that 80 percent will go on to successfully commit suicide unless treated with a mood stabilizer. Many a great thinker and artists have been bipolars. I knew the chief resident at Yale University who was brilliant, dedicated and unstoppable...until he committed suicide at the tender age of 38. Of course, it was probably his mania that allowed him to thrive in an environment that already demands inhuman sleep deprivation but it eventually caused his early destruction. Some professions are naturally suited for bipolars. I know an artist who spends countless sleep deprived nights painting some of her most brilliant work and when she lapses into despondancy, has written some brilliant pieces. However, she has divorced three times, has one child in a foster home and has been kicked out of rental units due to unpaid rent. I have dragged my bipolar brother out of state hospitals many times in my life until he stayed on his medicines. (He is now a wallstreet consultant in New York City) but he has almost taken his life twice. It is a difficult problem since the disease itself can be both a blessing and a curse.
 
  • #6
Semper000
3
0


Originally posted by adrenaline


Unfortunately, the natural history of untreated bipolarI (not necessarily bipolar II) disease is that 80 percent will go on to successfully commit suicide unless treated with a mood stabilizer.


Where did you find this statistic?!? All the studies I've ever read put the rate of completed suicides for untreated bipolar patients (Types 1 and 2 combined) at 20%, or a 1 in 5 chance.

You need to be very accurate with your numbers. Bloating a statistic like this one can be dangerously negatively suggestive to people who suffer from the disorder. It is needlessly discouraging and weakening to the morale.
 
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  • #7
adrenaline
Science Advisor
103
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Originally posted by Semper000
Where did you find this statistic?!? All the studies I've ever read put the rate of completed suicides for untreated bipolar patients (Types 1 and 2 combined) at 20%, or a 1 in 5 chance.

You need to be very accurate with your numbers. Bloating a statistic like this one can be dangerously negatively suggestive to people who suffer from the disorder. It is needlessly discouraging and weakening to the morale.

You are absolutely right! The statistics apply to the general population of diagnosed bipolars in the US. It also dependent on the nosological differences between bipolar II and I and how it is defined. (Then this can flucuate from 20-50%)

The 80 percent comes from a psychiatric epidimeologist here at the CDC (Centers for Disease Control.) who is a professor at Emory University. His statistics seem inflated because of the fact that a majority of biplors (especially bipolar IIs) are misdiagnosed with other mood disorders (in children they are diagnosed as attention deficit disorder...if you look at ADHD and Bipolar II questionaires, they are very similar), or in adults, major depressive illness, anxiety disorders or substance abuse diagnosis when many bipolars have comorbid substance abuse. He believes many of the substance abusers are comprised of a huge number of undiagnosed bipolars. Thus, his statisitcs was to incorporate undiagnosed bipolars by looking at people whose behavioral patterns coincide with bipolar I o r II but were not officially diagnosed (thus they never got the appropriate treatment.) I will try to get his work for you

What is interesting is that Lithium is still the best treatment for suicidal prevention in this population but it has gone out of favor due to side effects and the public stigmata about it. However, due to the trend in evidence based medicine, more are starting to return to its use. The more popular alternative is valproic acid and causes liver dysfuction and massive weight gain , the latter causes many to discontinue and become non compliant.
 
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  • #8
sandinmyears
18
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Originally posted by adrenaline
What is interesting is that Lithium is still the best treatment for suicidal prevention in this population but it has gone out of favor due to side effects and the public stigmata about it. However, due to the trend in evidence based medicine, more are starting to return to its use. The more popular alternative is valproic acid and causes liver dysfuction and massive weight gain , the latter causes many to discontinue and become non compliant.

Actually, there are many more mood stabilizers out there. Valproic Acid isn't the only AED (anticonvulsant) on the market that is also used for Bipolar Disorder. Some others that come to mind are: Tegretol (Carbamazepine), Lamictal, Topamax (Topiramate), Klonopin (Clonazepam), and Trileptal (Oxcarbazepine). Not all cause weight gain like Depakote (Valproic Acid) does and infact one of the newer ones, Topamax (Topiramate), actually brings about weight loss in most people.

I am on both Tegretol and Topamax. They treat both the seizures and the mood swings. :smile: (Lithium is not normally recommended for people who have seizures). BTW, I've lost 10 pounds since beginning Topamax this past summer. :smile:

There are many more meds out there for Bipolar Disorder, but because I also have Epilepsy, we have focussed on AED's (anti-epileptic drugs).
 
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  • #9
adrenaline
Science Advisor
103
3


Originally posted by sandinmyears
Actually, there are many more mood stabilizers out there. Valproic Acid isn't the only AED (anticonvulsant) on the market that is also used for Bipolar Disorder. Some others that come to mind are: Tegretol (Carbamazepine), Lamictal, Topamax (Topiramate), Klonopin (Clonazepam), and Trileptal (Oxcarbazepine). Not all cause weight gain like Depakote (Valproic Acid) does and infact one of the newer ones, Topamax (Topiramate), actually brings about weight loss in most people.

I am on both Tegretol and Topamax. They treat both the seizures and the mood swings. :smile: (Lithium is not normally recommended for people who have seizures). BTW, I've lost 10 pounds since beginning Topamax this past summer. :smile:

There are many more meds out there for Bipolar Disorder, but because I also have Epilepsy, we have focussed on AED's (anti-epileptic drugs).

Actually, klonipin is not a mood stabilizer. It is an excellent benzodiazepene sedative for the acute mania and its accompanying anxiety . There is also neurontin. Technically, all the medicines listed except for lamotrigine and lithium are off label use for long term relapse prevention. And only olanzapine, valproic acid and lithim are technically indicated for the acute treatment of mania. http://www.medscape.com/viewarticle/458706 In addition, none of them have been shown to have the superior suicide prevention efficacy that lithium has, although all are excellent for decreasing the frequency of the cycling in and out of mania . Some are better for rapid cyclers etc. The studies are on the way, but none have shown any superiority and some (valproic acid) inferior to lithium for suicide prevention rates. http://hdlighthouse.org/treatment-care/treatment/drugs/related/updates/0060lithium.phtml [Broken]

However, you are right, topomax has great side effects profile..it also helps bipolars with migraines. Topomax has such great weight loss potential a lot of docs are prescribing it off label for weight loss and it is now going up for FDA approval just for its use as a weight loss drug! The variety of medicines just show how each person has to be individually catered to.. unfortunately, due to the trend towards practicing evidence based medicines, the individual and personal touch that comes with prescribing any medicines is now in jeapordy. Some HMOS will not approve Topomax for bipolar disease until it becomes formally FDA approved for its treatment etc. How sad since so much of medicine involves using the medicines in a off label manner due to the rapidity of change in clinical medicine vs. waiting for a formal research and the bureaucratic inertia of the FDA for its approval.
 
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  • #10
sandinmyears
18
0
You're actually out of date about Neurontin. Sad to say, many doctors are also. This is just one of many sources about the Neurontin scam (there are many more):
http://www.msnbc.com/news/937302.asp?0dm=-22MV&cp1=1#BODY
(When you get there, click on "Complete Story").

It is still, however, an effective anticonvulsant. I infact, was on Neurontin, and after reading up on its ineffectiveness (long before "Dateline's" story this Fall-- this news has actually been out for over a year), I asked my doctor to switch me to Topamax. He hee hawed on it, but I came into his office with quite a few facts that I'd dug up. I'm sure it helps that I'm a little bit overweight and gained about 35 pounds in the 7½ years that I'd been on Neurontin. (I was not an overweight person before being on Neurontin, BTW).

He agreed, and it's (in conjunction with Tegretol) is working very well. I have also been dx'd with ADHD, but because meds like Ritalin can (and do with me) lower the seizure threshold, I'm currently unmedicated for it. We've tried the new ADHD med (Straterra), but it seemed to make my hypomanic. This was before we switched to Topamax, however. We may give it another try at some time as I am currently unemployed and the reason why is because of my problems with concentration and following (primarily auditory) instructions.

Keep reading. Keep learning. You sound like a person who cares about this sort of things. KUDOS for you!

~Sandy

PS As for Klonopin (and one of my sources for other mood stabilizers that I listed), check this link: http://www.mercer.edu/pharmacy/faculty/holbrook/Moodst1.html
 
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  • #11
adrenaline
Science Advisor
103
3
Originally posted by sandinmyears
You're actually out of date about Neurontin. Sad to say, many doctors are also. This is just one of many sources about the Neurontin scam (there are many more):
http://www.msnbc.com/news/937302.asp?0dm=-22MV&cp1=1#BODY
(When you get there, click on "Complete Story").

It is still, however, an effective anticonvulsant. I infact, was on Neurontin, and after reading up on its ineffectiveness (long before "Dateline's" story this Fall-- this news has actually been out for over a year), I asked my doctor to switch me to Topamax. He hee hawed on it, but I came into his office with quite a few facts that I'd dug up. I'm sure it helps that I'm a little bit overweight and gained about 35 pounds in the 7½ years that I'd been on Neurontin. (I was not an overweight person before being on Neurontin, BTW).

He agreed, and it's (in conjunction with Tegretol) is working very well. I have also been dx'd with ADHD, but because meds like Ritalin can (and do with me) lower the seizure threshold, I'm currently unmedicated for it. We've tried the new ADHD med (Straterra), but it seemed to make my hypomanic. This was before we switched to Topamax, however. We may give it another try at some time as I am currently unemployed and the reason why is because of my problems with concentration and following (primarily auditory) instructions.

Keep reading. Keep learning. You sound like a person who cares about this sort of things. KUDOS for you!

~Sandy

PS As for Klonopin (and one of my sources for other mood stabilizers that I listed), check this link: http://www.mercer.edu/pharmacy/faculty/holbrook/Moodst1.html

Thank you.

I mentioned neurontin because some are still using it in an off label manner. Here is where those strict advocates of evidence based medicines want only medicines used in in large clinical trial to be used by all physicians. As for the list, it is not a reliable source labelling klonipin as a mood stabilizer. I have found that 20 percent of all "medical facts" on the internet are wrong. No psychiatrist would use it as a mood stabilizer...once again, only lithium and lamotrigine have consistent data on long term mood stabilization. It may listed as a mood stabilizer because of its acute anxiolytic effect during the acute manic phase but does not prevent cycling.

here is a quote
CLONAZEPAM ORAL
Pharmacology & Chemistry
Pharmacology from AHFS DI™
The pharmacologic actions of clonazepam are qualitatively similar to those of other benzodiazepine derivatives.In animal studies, clonazepam has been shown to protect against seizures induced by pentylenetetrazol and, to a lesser extent, electrical stimulation.Clonazepam also appears to antagonize seizures produced by photic stimulation in animals.In humans, clonazepam can suppress the spike and wave discharge in absence seizures (petit mal) and can decrease the frequency, amplitude, duration, and spread of discharge in minor motor seizures.Clonazepam also has been shown to produce a taming effect, muscle weakness, and hypnosis in animals.The exact mechanism(s) by which clonazepam exerts its anticonvulsant, sedative, and antipanic effects is unknown.However, it is believed to be related at least in part to the drug’s ability to enhance the activity of ã aminobutyric acid (GABA), the principal...

And a link to its usage. I like the medscape site due to its more reliable data vs. webmd that is still very commercial and has given some wrong info in the past. The link goes into all the different main uses of clonezapam. http://www.medscape.com/druginfo/Dr...=1&MenuID=USEDOS&ClassID=N&GeneralStatement=N
also
Return to Medscape coverage of: XXIIIrd Congress of the Collegium Internationale Neuro-Psychopharmacologicum (CINP) | Bipolar and Schizophrenia



Emerging Treatment Strategies for Bipolar Disease
Disclosures

Martin L. Korn, MD Rachel A. Pollock, PhD


It is important to distinguish between the treatment of the acute episode and long-term maintenance therapy. Acute treatments may not necessarily be effective for prolonged mood stabilization and may, at times, even worsen the course of illness if they are continued past the required period. The older typical neuroleptics may contribute to recurrent major depressive episodes or rapid cycling. Antidepressants may also contribute to rapid cycling or switches into mania. bezodiazepines may be useful to control acute agitation, but may not be advisable for long-term treatment due to issues of dependence and abuse. The ideal pharmacologic agent should prove to be effective both acutely during manic and depressive episodes as well as prophylactically in preventing recurrences. This ideal agent is not available, however, and polypharmacy is often the rule.

Mood stabilizers may also be classified as those that stabilize mood from above and below a baseline state.[12] States that are above baseline include states of mania, mixed states, hypomania, and subsyndromal mood elevation. States that are below baseline include periods of depression and subsyndromal depression. Mood stabilizers acting from above the baseline include lithium,carbamazepine, divalproex, atypical antipsychotics (eg, olanzapine, risperidone, ziprasidone), and ECT. Mood stabilizers acting below the baseline include lithium, lamotrigine, olanzapine, and ECT.
http://www.medscape.com/viewarticle/438505
A psychiatrist would be negligent if he used klonipin as a mood stabilizer.
 
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  • #12
adrenaline
Science Advisor
103
3
As for the neurontin. After reading the Dateline article more closely, it became clear that the whistleblower in this case is not an unbiased figure. Because of national legislation regarding whistleblowers, he stands to get 30% of fines that are levied against the company if the lawsuit is successful. His allegations are substantiated with strong evidence...evidence of the company's wrong-doing.

As to the question of Neurontin's efficacy, the water is still very muddy.

There's apparently evidence that treatment is not an overwhelming success story... two studies showed no measurable effect. But it may be good for some people.

Here is where psychiatry differs from most of clinical medicine.

All double blinded, randomized placebo controlled trials tell us is whether treatment X works for the general populatin studied. It does not predict an individual's response, especially somewhere as gray as psychiatry (vs. cholesterol lowering drugs where numbers can be assessed.) There are many psychiatrists who have tried the whole gamit of antipsychotics and neuroleptics and have seen an obvious improvement in their bipolars who were finally tried on neurontin.

The religion of double blinded placebo controlled trials as the ultimate truth of the efficacy of a drug or treatment is currently being challenged by many clinicians.


What may not work for 51% of the study group does not mean it will not work for Joe Smith whose clinician can carefully follow his disease and monitor him well. The jury is still out and the clinical studies are ongoing.


Remember, topomax has still yet to have large, randomized, double blinded placebo controlled trials that show its efficacy as well although many of the open labelled trials look promising.

Psychiatrists and other clincians aren't going to wait since individual successes such as yours are enough for now. http://www.ncbi.nlm.nih.gov/entrez/...ve&db=PubMed&list_uids=11912568&dopt=Abstract


Your obvious intelligence and capacity for research makes you a great ally along with your clincian. He/she is lucky :smile:
 
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  • #13
sandinmyears
18
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Originally posted by sandinmyears
Keep reading. Keep learning. You sound like a person who cares about this sort of things. KUDOS for you!

~Sandy

Duh. I just read your profile and read that you are a physician. I feel about this tall [picture my finger and my thumb about an inch apart] trying teach you about neurology, psychology and medicine.


~Sandy
 
  • #14
adrenaline
Science Advisor
103
3
Originally posted by sandinmyears
Duh. I just read your profile and read that you are a physician. I feel about this tall [picture my finger and my thumb about an inch apart] trying teach you about neurology, psychology and medicine.


~Sandy

you shouldn't, more people should be as well versed and active in researching things to help their docs. We can't and will never know everything. It helps to have patients who are so intelligent and inquisitive as it directs the docs appropriatly. (remember it was a bunch of concerned, intelligent mothers who helped the physicians in lyme connecticut realize they were misdiagnosing a rash of juvenile rheumatoid arthritis instead of lyme's disease.)
 
  • #15
Raven
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Bump!
 
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  • #16
Raven
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Ignore. Error. [b(]
 
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  • #17
sandinmyears
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Originally posted by adrenaline
you shouldn't, more people should be as well versed and active in researching things to help their docs. We can't and will never know everything. It helps to have patients who are so intelligent and inquisitive as it directs the docs appropriatly.

Thanks. I figure someone needs to keep my doctors on their toes.
 
  • #18
zoobyshoe
6,551
1,287
Adrenaline,

Is your training in this area psychiatric or neurological?

-zoob
 
  • #19
adrenaline
Science Advisor
103
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Originally posted by zoobyshoe
Adrenaline,

Is your training in this area psychiatric or neurological?

-zoob

Internal medicine, specifically managing intensive care, critically ill patients in a large suburban hospital. However, I also hold office hours in a rural clinic (which is why my hours are insane) and see a lot of everything including psychiatry. Isometimes don't come home for a couple of days, thank goodness my husband is stay at home dad. There is only one neurologist for a population over 50,000 (counting adjoining counties) so internists are expected to manage as many neurological emergencies as well as outpatient problems. There is a huge stigma about seeing psychiatrists, especially in rural Georgia where everyone knows your business! Actually, many family practitioners, general practioners and internal medicine specialists diagnose and manage many psychiatric patients due to the stigma of seeing psychiatrists and the great role these psychiatric diseases play in regular physical illnesses. For example, after salvaging an intentional drug overdose for a suicidal patient in the ICU you screen quickly for bipolar disease, knowing the probability is great for finding one under these circumstances. An insulin dependant diabetic may be bouncing in and out of the hospital for diabetic ketoacidosis because they are paranoid schizophrenics (many are surprisingly functional at times) and just forget or have delusions about giving themselves insulin injections. The list goes on. Not to mention the personality disorders that result in just frequent office visits and contacts etc. However, if they become too difficult to manage, they are encouraged to see a psychiatrist, but it takes an act of congress to get many to accept they need specialized help! AARGH!
 
  • #20
zoobyshoe
6,551
1,287
I became interested in Neurology after reading some of Oliver Sack's books and have done quite a bit of follow up research, particularly on seizures.

It is not well known to many doctors that Complex Partial and Simple Partial seizures frequently present in such a way that they are mistaken for psychosis.

Here is a link to an introductory article on the matter:

Psychiatric Times
Address:http://www.psychiatrictimes.com/p950927.html [Broken]

-zoob
 
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  • #21
adrenaline
Science Advisor
103
3
Originally posted by zoobyshoe
I became interested in Neurology after reading some of Oliver Sack's books and have done quite a bit of follow up research, particularly on seizures.

It is not well known to many doctors that Complex Partial and Simple Partial seizures frequently present in such a way that they are mistaken for psychosis.

Here is a link to an introductory article on the matter:

Psychiatric Times
Address:http://www.psychiatrictimes.com/p950927.html [Broken]

-zoob

Thank you. I was also one of the "unawares" until my brother was diagnosed with bipolar I disorder! He had frank hallucinations and the neuropsychiatrist at the hospital in California did a spinal tap and an EEG (sleep deprived) to rule out some other mimics. It is probably why many neuroleptics work on most bipolars. I think the general rule is if they don't become well controlled with lithium and antipsychotics (which are not neuroleptics) then that is a consideration.

I love, love Oliver Sacks. His most hilarous book was the Man who Mistook His Wife for a Hat. I'm sure you read that one!
 
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  • #22
sandinmyears
18
0
Originally posted by zoobyshoe
I became interested in Neurology after reading some of Oliver Sack's books and have done quite a bit of follow up research, particularly on seizures.

It is not well known to many doctors that Complex Partial and Simple Partial seizures frequently present in such a way that they are mistaken for psychosis.

Here is a link to an introductory article on the matter:

Psychiatric Times
Address:http://www.psychiatrictimes.com/p950927.html [Broken]

-zoob
Zoob,

The "TLE Personality" referred to in this article that you left (in your link) is also known as Geschwind Syndrome. There is a book called "Seized" (by Eve LePlante) about this phenomenon. I don't believe it is currently in the bookstores, but I was able to get it through an inter-library loan this past summer. [NOTE: It is controversial as to whether or not the syndrome/personality disorder actually even exists].
A book review of "Seized"
http://nasw.org/finn/brnstrm.html [Broken]

PubMed Abstract on the Geschwind Syndrome
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=2003418&dopt=Abstract

There is also a phenomenon known as Interictal Dysphoric Disorder. Dietrich Blumer, MD, currently a professor at the University of Tennessee, has done much research on IDD. He was kind enough to speak to me on the phone (and answer some questions) a few months ago.
PSYCHIATRIC DISORDERS IN EPILEPSY: An Interview With Dietrich Blumer, MD
http://neuropsychiatryreviews.com/dec00/npr_dec00_epilepsy.html [Broken]

~S.I.M.E.
 
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  • #23
zoobyshoe
6,551
1,287
Sandinmyears,

I bought a copy of Seized back when it first came out. I have read many parts of it many times. It is packed full of information, case histories, and history. A extremely interesting book.
 
  • #24
zoobyshoe
6,551
1,287
Originally posted by adrenaline I love, love Oliver Sacks. His most hilarous book was the Man who Mistook His Wife for a Hat. I'm sure you read that one!
Hilarious? This book is about people with severe nurological disorders, some of them in extreme distress.
 
  • #25
adrenaline
Science Advisor
103
3
Originally posted by zoobyshoe
Hilarious? This book is about people with severe nurological disorders, some of them in extreme distress.

True, but I did read it over ten years ago and the cases that stuck in my mind were the parietal lobe infarcts where they have hemineglect (patients come in only grooming one side of their body with either lipstick, coming one side of their head...and of course, the man who had lost his visual spatial capabilities and grabbed his wife's head thinking she was a hat.) In medicine, most docs have developed a twisted sense of irony and humor or else you get bludgeoned to death with everyone's pain and agony. The TV series M*A*S*H was probably a good representation of the daily dark humor physcians use to cope. The TV show ER was a little too over dramatized. If you lose the ability to see the humor, you eventually lose the ability to empathiSe. Many collegues who have left the clinical field and have seguayed into the more business end or less clinical aspects of medicine were,in the past, the most sensitive and eventually burned completely out and became very embittered. Sometimes this black humor is all you have at 4 in the morning after being up since 5 yesterday morning and you have a full day in the office ahead of you. Come to think of it, I think I read it during my neurosurgical rotation (talk about sleep deprivation) since the senior resident reccomended it. I think a lot of surgeons utilize this coping mechanism; some of the best jokes I have heard are during surgeries where aneurysms are dissecting in front of you or a lung collpses etc., I think it was the only way the surgeons turned off the natural instinct to run screaming from the operating room and dealt with the situation at hand without even breaking out in a sweat.
 
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  • #26
mikelus
91
0
I feel mental disorders are started from some sort of confusion between your ego which circles with fear of the past and your stable self. I believe that disorders get confused between these two type of realities. the real and the unreal. The real is your self with no douts or fears. The unreal is based upon fear and beliefs. Your ego is the plan laid out to cope with your douts and fears.
 
  • #27
sandinmyears
18
0
Originally posted by mikelus
I feel mental disorders are started from some sort of confusion between your ego which circles with fear of the past and your stable self. I believe that disorders get confused between these two type of realities. the real and the unreal. The real is your self with no douts or fears. The unreal is based upon fear and beliefs. Your ego is the plan laid out to cope with your douts and fears.

IMO, this might be true with personality disorders (Axis II), but with many/most Axis I disorders, there is an innate/genetic predisposition. A few that come to mind are:
Schizophrenia
Bipolar Disorder
(Clinical) Depression-- (I believe this term/title is changing)
Autism, Pervasive Developmental Disorder & Asperger Syndrome
ADHD

There are many other interesting arguments out there. There's an interesting correlation between Autism, ADHD, Alzheimer Disease, and Metal Toxicity. Talk to some parents with children who have "acquired autism" about immunizations and mercury toxicity. (The MMR/Measles, Mumps & Rubella shot in particular). I find it frightening to see how enthusiastically we all stand in line to get vaccinated for flu shots w/o paying much mind to any of the warnings. Autism has skyrocketed in the past 25 years since the introduction of the MMR shot in the early 1980s. This may partially be a matter of awareness, but I find this alone to be an inadequate explanation. The statistics are too overwhelming.

There is also an interesting connection between the brain and the "gut." (The effect that an overabundance of candida yeast in the system can have on one's behavior). It's also amazing how much a change in one's diet can have on one's health and behavior. Talk to a parent with a hyperactive child who's taken processed sugars and artificial dyes out of their diet. Talk to a parent with an autistic child who has taken gluten and casein out of their diet.

BTW, Gluten is found primarily in the grains WHEAT, OATS, BARLEY, and RYE, but is also found in many other processed foods such as LICORICE and some CORN CHIPS-- though it is not found in CORN. Casein, a protein found in milk, is in all dairy products, but again can be found in many processed foods. For example, most all margarines (even oil based) have casein in them.

I'm reading also of many (with neurological and psychological disorders) who are having success with supplements such as Vitamin Bcomplex as well as Omega 3 and Omega 6 Fatty Acids.

OK, well, I went off on a tangent. I did it, however, to make a point which is just this: mental health is much more complicated than it appears. The brain is an organ in our system-- but a complicated one. People forget that it interacts with other parts of our body; it's not an island. (One part of our body effects another).
 
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  • #28
adrenaline
Science Advisor
103
3
Originally posted by sandinmyears

There's an interesting correlation between Autism, ADHD, Alzheimer Disease, and Metal Toxicity. Talk to some parents with children who have "acquired autism" about immunizations and mercury toxicity. (The MMR/Measles, Mumps & Rubella shot in particular). I find it frightening to see how enthusiastically we all stand in line to get vaccinated for flu shots w/o paying much mind to any of the warnings. Autism has skyrocketed in the past 25 years since the introduction of the MMR shot in the early 1980s. This may partially be a matter of awareness, but I find this alone to be an inadequate explanation. The statistics are too overwhelming.

With regards to autism. The initial hysteria was based on a case study of twelve children. Here is the full article and some reviews. The jury is still out on the others.


Pediatric Bulletin
MMR and Autism: Suspect or Superstition?


from Infections in Medicine ®
Benjamin Estrada, MD



Concerns about a possible relationship between autism and measles/mumps/rubella (MMR) vaccine administration were triggered in 1998 by a report that suggested a possible association between the two (Wakefield AJ et al. Lancet. 1998;28:637-641). This report was based on a case series of 12 children who presented with developmental regression associated with diarrhea, abdominal pain, and ileal-lymphoid nodular hyperplasia. These events were temporally related to administration of the MMR vaccine, and it was hypothesized that this product could trigger an intestinal inflammatory response that could be associated with developmental regression in previously normal children. This hypothesis has not been proved, and a causal association between the administration of this vaccine and the development of autism has not been found in recent studies.
Taylor and collaborators in the United Kingdom reported one of the first epidemiologic studies on this subject in 1999. These investigators included children born since 1979. Although there was an increase in the number of cases of autism, the authors did not find any difference in age at diagnosis between the vaccinated and unvaccinated subjects. From the data collected in this study, there was no evidence to support a significant temporal association between the administration of MMR vaccine and the development of this disorder. In addition, no evidence of a change in the trend of cases of autism was found after the introduction of MMR into the United Kingdom immunization program in 1988.The lack of association between autism and MMR vaccine administration has also been demonstrated in other studies performed in Finland and Sweden (Taylor B et al. Lancet. 1999;353:2026-2029).

Dales and collaborators recently reported a study to evaluate an association between development of autism and MMR administration in the United States (Dales L et al. JAMA. 2001;285:1183-1185). This was a retrospective study designed to evaluate the presence of a correlation between the trends of MMR immunization coverage and the occurrence of autism. This analysis included children born between 1980 and 1994 in California. The investigators included 600 to 1900 children in each year's cohort and determined their yearly immunization coverage. Data obtained from this study show that the rates of MMR immunization have remained relatively stable since 1998 and that they do not correlate with the increase in the number of cases of autism observed since 1985 in California.

In another study, Kaye and collaborators performed a data analysis from the United Kingdom general practice research database to evaluate the relationship between autism and MMR vaccine administration (Kaye JA et al. BMJ. 2001;322:460-463). Although they also found an increase in the incidence of autism between 1988 and 1999, no evidence to support a correlation between the prevalence of MMR immunization and the increase in the number of cases of autism was found.

It is very difficult to diagnose autism in the first year of life. Since MMR is usually administered to children after their first birthday, the diagnosis of this condition may occur temporally close to the vaccine administration, but there is no evidence to support a causal association between them. In addition, current data suggest a lack of correlation between the rates of MMR vaccine administration and the increase in the number of cases of autism observed during the last 20 years. Although the cause for the increase in the incidence of this disorder is not known (the apparent increase might simply be the result of increased awareness), mounting evidence suggests that immunization with MMR vaccine should eventually be excluded from the list of "usual suspects."


other links http://bmj.bmjjournals.com/cgi/content/full/324/7334/393

http://www.medscape.com/viewarticle/463573 [Broken]


quote from latter link
Data showed that autism incidence remained stable until 1990. In 1991, the incidence began to rise, but the greatest increases occurred after the discontinuation of thimero sal. The rate of incidence peaked in 1999; children between the ages of 2 and 6 who were diagnosed with autism that year had been born after the introduction of thimerosal-free vaccines.

The spike in the incidence of autism after 1990 may be attributable to increased attention to the disorder, as well as to a change in the diagnostic criteria that occurred in 1994, the authors suggest.


As for alzheimer's and aluminum toxicity, here is a nice link summarizing some of the controversies. Conclusion: no data to absolve or implicate aluminum yet. http://www.sciam.com/askexpert_question.cfm?articleID=0000FCD2-AA88-1C71-9EB7809EC588F2D7




There is also an interesting connection between the brain and the "gut." (The effect that an overabundance of candida yeast in the system can have on one's behavior). It's also amazing how much a change in one's diet can have on one's health and behavior. Talk to a parent with a hyperactive child who's taken processed sugars and artificial dyes out of their diet. Talk to a parent with an autistic child who has taken gluten and casein out of their diet.

With regards to gluten, it also may be related to the fact that 1/250 people have celiac disease.



I'm reading also of many (with neurological and psychological disorders) who are having success with supplements such as Vitamin Bcomplex as well as Omega 3 and Omega 6 Fatty Acids.

I really like this guy Stoll at Harvard doing these studies but, this is one of the only double blinded, randomized controlled studies but it was done in conjuction with taking other antipsychotics or neuroleptics but they did show benefit..however, the sample sizes were still very small.

see link http://www.ncbi.nlm.nih.gov/entrez/...ve&db=PubMed&list_uids=10232294&dopt=Abstract

Note: patients were given 9.6 grams of fish oil or olive oil and their regular maintenance bipolar drugs. It was in 30 people and carried out over 4 months. May not be valid in those who cycle over a longer period and it shows is is a good adjuvant but not replacement therapy yet.

The other studies out there deal mostly with unipolar depression.
http://www.psycheducation.org/depression/meds/Omega-3.htm [Broken]

Which probably has far better data from folic acid. We now use the latter as adjuvant therapy in both preventing heart disease (hyperhomocystinemia) and for depression along with serotonin reuptake inhibitior resistance (especially in women)

quick link http://www.findarticles.com/cf_dls/m0BJI/5_31/72882026/p1/article.jhtml

lot more where that came from, but I think all this points to what you were alluding to which is we should not discount how important environmental exposure, good nutrition and natural food intake play a role in so much of our health, both mental and physical.

OK, well, I went off on a tangent. I did it, however, to make a point which is just this: mental health is much more complicated than it appears. The brain is an organ in our system-- but a complicated one. People forget that it interacts with other parts of our body; it's not an island. (One part of our body effects another). ]

You are 100 percent right about this one!
 
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  • #29
sandinmyears
18
0
Data showed that autism incidence remained stable until 1990. In 1991, the incidence began to rise, but the greatest increases occurred after the discontinuation of thimero sal.
This is a portion of a post I just read today on an autism board I frequent:
"...I am stewing about this flu season. My state hasn't been hit hard yet, but it's coming. The media is full of urgent warnings saying kids need to be immunized because this flu is a killer. But they also admit that the precise flu strain that is wreaking havoc is not in this year's vaccine. They also admit that the shots do contain thimerosal..."

It appears that Thimerosal is still out there.

Originally posted by adrenaline
With regards to gluten, it also may be related to the fact that 1/250 people have celiac disease.

There are actually many diseases/disorders associated with gluten intolerance (celiac disease). Here are just a few:
Anxiety and Depression
Attention Deficit Disorder / ADHD
Autism
Brain White-Matter Lesions
Cerebellar Atrophy
Chronic Fatigue Syndrome (myalgic encephalomyelitis or ME, PVS, post
Epilepsy (with or without cerebral calcification)
Migraine Headaches
Schizophrenia

SOURCE: http://www.celiac.com/cgi-bin/webc.cgi/st_prod.html?p_prodid=84&p_catid=&sid=91hH9H0me58T010-11103290248.7a [Broken]

Also, there is a difference between Gluten Intolerance (Celiac Disease) and Gluten Sensitivity. I myself, am on a Gluten Free diet. I am very faithful to it. I read all the labels (of the foods I eat). I also read-up and occasionally call 800 numbers as well to help avoid (food) cross-contamination. I do not have Celiac Disease and yet this diet is able to raise my seizure threshold. (I am sensitive to gluten but not intolerant).

Originally posted by adrenaline
The other studies out there deal mostly with unipolar depression.
http://www.psycheducation.org/depression/meds/Omega-3.htm [Broken]

Which probably has far better data from folic acid. We now use the latter as adjuvant therapy in both preventing heart disease (hyperhomocystinemia) and for depression along with serotonin reuptake inhibitior resistance (especially in women).

I too am reading about the importance of Folic Acid. I've been reading about it's importance during pregnancy especially. Two teratogenic diseases/disorders that come to mind (that can be either prevented-- or atleast lessened-- with the intervention of Folic Acid) are Spina Bifida and Fetal Hydantoin Syndrome (AKA Fetal Anticonvulsant Syndrome).

BTW, I read that Dilantin robs the body of Folic Acid-- and vice versa (That is, Folic Acid, robs the body of Dilantin). I'm not sure about other anticonvulsants/ AED's. It seems to be a tricky sort of thing when epilepsy is involved. If this is true with other AED's, (Depakote and Tegretol are coming to mind), my guess is that it may be a tricky thing with Bipolar Disorder as well.
 
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  • #30
adrenaline
Science Advisor
103
3
Originally posted by sandinmyears
This is a portion of a post I just read today on an autism board I frequent:
"...I am stewing about this flu season. My state hasn't been hit hard yet, but it's coming. The media is full of urgent warnings saying kids need to be immunized because this flu is a killer. But they also admit that the precise flu strain that is wreaking havoc is not in this year's vaccine. They also admit that the shots do contain thimerosal..."

It appears that Thimerosal is still out there.


The flu shot is almost never the precise strain, always a close approximation but it will still provide some cross protection (may get the flu but less likely to die)

Remember, thimerosal and its mercury content still has not been implicated in autism. the pediatric flu shot is a much lower thimerosal content as well. I really think the class action lawyers have just found themselves a cash cow... the only beneficiaries of this whole debacle. I don't think those parents of those kids who died of the flu would have cared about the thimerosal. Because the CDC recommends flushots in those kids 2 and under,I anticipate lawsuits against the pediatricians of the children below 2 yrs of age who have died for not enforcing the flu shots. It's damned if you do and damned if you don't!

Besides, there is the nasal spray flumist, but it is only for kids who are 5 yrs of age or more.



There are actually many diseases/disorders associated with gluten intolerance (celiac disease). Here are just a few:[/b]
Anxiety and Depression
Attention Deficit Disorder / ADHD
Autism
Brain White-Matter Lesions
Cerebellar Atrophy
Chronic Fatigue Syndrome (myalgic encephalomyelitis or ME, PVS, post
Epilepsy (with or without cerebral calcification)
Migraine Headaches
Schizophrenia[


Associated, not proven as causal.

For example, the association between smoking and protection from Parkinson's disease is making clinical headlines...but I am not about to advise my patients to smoke! The association may not be a direct causal protection from smoking!

This brings up the issue that most clinicians have noticed with medicine.

The field of analytic epidemiology has gone beyond [ib]description [/i]and into the arena of causal inferences.

Unfortunately, it is relatively easy for chance observations and unfounded conclusions based on inappropriate study designs to become widely regarded as causal associations. Inferences drawn from descriptive studies may ignore or miss some important information necessary to infer a causal association between an exposure and disease.

This was actually an excercise in medical school. Imagine a hypothetical scenario in which state health officials tabulated the number of cases of disease Y that occurred in each of ten counties where I live . They also are able to relate those cases to the census of each county (the denominator). Separate information shows that pollen counts in the ambient air differed across the same counties. Cursory examination of these data reveals that counties with the highest proportion of disease Y cases per population also has the highest pollen counts in the air. Therefore, pollen must be causing disease X . Without measuring pollen exposures of individual subjects before the onset of disease, the official (moi) is drawing the type of conclusion referred to as an ecologic fallacy...By the way, I proved strokes were related to pollen count...barely...my p value was barely significant.

This problem makes it difficult to determine a cause and effect relationship and the controversy goes on...


It is this one excercise that has made most clinicians respect but wary of epidimiological data, especially something as difficult as the human body. However, sometimes, epidimiology is all we have!


My theory with Alzheimers is that humans are living long enough in higher numbers to be diagnosed with Alzheimers (thus third world, starving countries with the lowest life spans will have the least cases, which they do). The industrialized nations as a whole have the longest life spans and the highest prevalence of Alzheimers. These societies are exposed to more aluminum containing products due to our natural state of living... pots, pans, deoderant, indoor plumbing, etc. But thats' just my theory.




BTW, I read that Dilantin robs the body of Folic Acid-- and vice versa (That is, Folic Acid, robs the body of Dilantin). I'm not sure about other anticonvulsants/ AED's. It seems to be a tricky sort of thing when epilepsy is involved. If this is true with other AED's, (Depakote and Tegretol are coming to mind), my guess is that it may be a tricky thing with Bipolar Disorder as well. [/B]

The neurologists in this institution have been recomending folic acid supplementation as well as vitamin d supplementation with dilantin (to prevent anticonvulsant osteomalacia) for a long time.

I think in general, as you already know, that good nutrition and perhaps a multivitamin supplementation would not be a bad idea no matter what you are taking.
 
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  • #31
sandinmyears
18
0
Originally posted by adrenaline
The neurologists in this institution have been recomending folic acid supplementation as well as vitamin d supplementation with dilantin (to prevent anticonvulsant osteomalacia) for a long time.

I think in general, as you already know, that good nutrition and perhaps a multivitamin supplementation would not be a bad idea no matter what you are taking.


I agree that there are many benefits to folic acid (Vitamin B9). One of my daughters has "Fetal Anticonvulsant Sydrome." (She is my daughter who is autistic (low functioning/non-verbal). She is also diagnosed as being severely/profoundly mentally retarded). Perhaps, had I been taking folic acid supplements prior to my pregnancy, this might have been prevented or atleast lessened.

When AEDs are taken however, it's a tricky situation because folic acid and anticonvulsant don't always interact well. Here's a link to a report on a double blind study: "Effect of Folic Acid Pretreatment on Convulsions in Mice."

http://www.ijp-online.com/archives/1984/016/02/r0107-0108ra.pdf [Broken]

One of the findings is that folic acid reduced the activity of the anticonvulsants in the mice. [b(] (Sad). I hope there's an answer out there to this dilemma, because I agree; folic acid does seem to be a God send.

Until one is found (I had a doctor who used to say this)
Eat right.
Sleep right.
Exercise.
Think positive.

And I would also add to adopt into one's daily regiment
Granny's Cod Liver Oil. /i.e. Omega 3 (and also Omega 6 fatty acids).
Vitamin Bcomplex
Music/Learn an instrument (Had to stick that one in...I play music) :smile:
 
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  • #32
mikelus
91
0
I feel mental disorders are started from some sort of confusion between your ego which circles with fear of the past and your stable self. I believe that disorders get confused between these two type of realities. the real and the unreal. The real is your self with no douts or fears. The unreal is based upon fear and beliefs. Your ego is the plan laid out to cope with your douts and fears. [/B][/QUOTE]
Originally posted by sandinmyears
IMO, this might be true with personality disorders (Axis II), but with many/most Axis I disorders, there is an innate/genetic predisposition. A few that come to mind are:
Schizophrenia
Bipolar Disorder
(Clinical) Depression-- (I believe this term/title is changing)
Autism, Pervasive Developmental Disorder & Asperger Syndrome
ADHD
why could this theory not be passed through genes?
 
  • #33
sandinmyears
18
0
Originally posted by mikelus
I feel mental disorders are started from some sort of confusion between your ego which circles with fear of the past and your stable self. I believe that disorders get confused between these two type of realities. the real and the unreal. The real is your self with no douts or fears. The unreal is based upon fear and beliefs. Your ego is the plan laid out to cope with your douts and fears.
Originally posted by sandinmyears
IMO, this might be true with personality disorders (Axis II), but with many/most Axis I disorders, there is an innate/genetic predisposition. A few that come to mind are:
Schizophrenia
Bipolar Disorder
(Clinical) Depression-- (I believe this term/title is changing)
Autism, Pervasive Developmental Disorder & Asperger Syndrome
ADHD
why could this theory not be passed through genes?

As I understand it, most Axis I (psychiatric) disorders carry with them an innate genetic predisposition. That's not to say "you don't stand a chance if they run in your family," but you are certainly more prone to them.

A child with ADHD or Autism isn't that way because they were abused or neglected. (This type of reasoning is over 30 years old and has sent many parents on unnecessary guilt trips). The same can be true with Bipolar disorder and Schizophrenia. I would agree, however that social environment and upbringing does play an important part in your personality. But if we're referring to "personality", is this Axis I or Axis II? (Axis II includes "Personality Disorders" and "Mental Retardation").

Many physical disorders (such as epilepsy, which has been mentioned in this thread a number of times) can bring with them psychiatric problems-- e.g. Interictal (between seizure) Dysphoric Disorder, Postictal, Preictal and Interictal Depression. (BTW, When a psychiatric problem is the result of physical disorder, it is listed as Axis III in a psychiatric evaluation).

I believe that in a psychiatric evaluation, "Axis IV" might touch on those "doubts and fears" that you are referring to in your post. "Environment or social environment," that is. It takes into account things such as: Deaths/grieving issues, Divorce, Income Situation, Unemployment/Underemployment, Occupational Problems, Family Support, Physical Health Problems/Burdens, Miscellaneous Stress Factors, etc.

I will add this, from a personal point of view:
I was adopted at the age of 5 weeks. When I was 19 years old, I "found" my biological "family." (Just out of sheer curiosity). I (myself) have: (Temporal Lobe) Epilepsy, Bipolar Disorder and ADHD. I have a daughter with (Low Functioning) Autism and another daughter who was diagnosed with ADHD and who probably had Childhood-onset Bipolar Disorder. She was also suspected of having Asperger Syndrome. (A disorder on the "Autism Spectrum"). She died last year in an accident, however, so this remains unclear. In addition, I have another daughter ADHD.

In my extended "biological family" (biological father, aunt, cousins, half brother, niece, nephew), a family that I did not grow up in, exists: Bipolar Disorder (3 cases), ADHD (many cases), 2 cases of Autism, 1 case of PDD-NOS (also on the "Autism Spectrum"), and 2 cases Epilepsy/Seizures.

It goes back to the argument "Is it nature or nurture?" I'd say it's a little bit of both.
 
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  • #34
S = k log w
66
0
Some of the genetic links may be polymorphisms.
 
  • #35
sandinmyears
18
0
Originally posted by S = k log w
Some of the genetic links may be polymorphisms.

Could you expand on this?
 
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