Lessons I learned from my cat December 3, 2013Posted by indigomind in Nature, Philosophy.
Tags: Basic needs, Behavior, Mental health
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Some things my cat has taught me.
1. Get enough sleep and rest when tired. Many studies show that getting enough sleep is very important. A most recent study found a link between insomnia and depression.
2. Focus on your basic needs first which consist of shelter, food and companionship. If these basic needs aren’t met it is difficult to focus on the higher ones such as actualizing one’s potential.
3. Give others feedback. Cats compared to other animals will not put up with mistreatment and will often return kindness with kindness.
4. Pick your battles wisely. My latest cat while not putting up with mistreatment will avoid fighting with other cats if she can.
5. Take time to play. Play helps my cat to relax and sharpen her hunting skills. It not a waste of time.
6. Be patient and persistent. My cat usually get what she wants by waiting long enough whether it is food from me or a mouse.
7. Go outside and exercise. My cat makes every attempt to be outside during the day.
8. Demand and expect the best. My cat makes every effort to be as comfortable as possible. She never sits on the bare floor in order to wash herself when there is an oriental carpet to sit on.
9. Avoid stress if possible. If something bothers my cat such as the noise from a vacuum she makes every effort to get away from it.
10. Maintain your boundaries. Cats are fairly territorial and while this might seem primitive they are making sure their basic needs are being met.
11. Only eat when hungry and what appeals to your senses. Humans do this when younger too but as we grow up we force ourselves to eat at certain times and often don’t eat according to our senses.
12. Embrace your curiosity. Cats are known for their curiosity and it ensures that they aren’t bored and are constantly learning.
How to measure mood stabilizer efficacy? November 27, 2013Posted by indigomind in Pharmacology, Sleep, Uncategorized.
Tags: Antidepressant, Insomnia, Lamotrigine, Major depressive disorder, New York Times
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It’s been a month now since I have been on Lamotrigine and I am having a hard time telling whether it is improving my mood or not. Tomorrow I have an appointment with my pdoc and I am not sure what to say about the drug. Since I have gone to this person I have taken the Beck Depression Inventory as a way to somewhat objectively measure any improvements. In the beginning I tested as moderately depressed and now I still test as moderately depressed however I have improved within the range of moderate.
There are other ways of gauging my progress and that is by looking at my energy level, my sleep, appetite, and motivation/interest level. I have staying asleep ok however since I read that article in the NYT about insomnia and depression I have been having more insomnia. An article that was about insomnia made me start worrying about insomnia. Slightly amusing. The rest of the indicators haven’t improved much except it is easier to stay awake during the day.
This study mentioned in the NYT is interesting and shows promise however there is a considerable percentage of depressed people who over sleep rather than suffer from insomnia. In my case I have experienced a combination of the two– insomnia at night and oversleeping during the day. Additionally, I noticed that if I went to bed earlier than usual I would be more likely to have insomnia. This latest theory doesn’t explain this.
“The new report, from a team at Ryerson University in Toronto, found that 87 percent of patients who resolved their insomnia in four biweekly talk therapy sessions also saw their depression symptoms dissolve after eight weeks of treatment, either with an antidepressant drug or a placebo pill — almost twice the rate of those who could not shake their insomnia. Those numbers are in line with a previous pilot study of insomnia treatment at Stanford.”
Other problems with the study were that it was on the small side and the tools for measuring depression are questionable. They didn’t appear to use a test that was specific for depression but one that was specific to rumination and insomnia. Why not use the same test as other depression studies?
The efficacy of Lamotrigine with depression November 16, 2013Posted by indigomind in Pharmacology.
Tags: antidepressants, bipolar spectrum, Lamotrigine, Major depressive disorder
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After giving lithium a try my pdoc decided to add on Lamotrigine to my antidepressant and antipsychotic. I didn’t notice a significant improvement in either my mood or energy with lithium so I’m not too hopeful about the Lamictal. So far all I notice is that I feel unusually calm and there are no noticeable side effects.
When I initially googled Lamotrigine I had the impression that it should work well for depression that has any degree of bipolarity however upon further investigation it appears that it is questionable if it works at all on either mania or depression. It is even more debatable if it works on unipolar depression according to the Psychiatric Times. According to one source GlaxsoSmithKline did about nine studies on the drug and they were as follows: two came out favorably, two were negative with positive secondary outcomes while the rest were not favorable and were not published. This is somewhat similar to what has happened with antidepressants, positive studies were published while many negative ones weren’t.
Determining whether a given drug has antidepressant effects is somewhat challenging . In order to measure I use the Beck Depression Inventory and a personal assessment of my energy level. I usually have a leaden feeling with severe fatigue in my legs/arms when depressed. When my mood improves so does the heavy feeling. It is one assessment that feels fairly objective to me.
Hopefully Lamotrigine will work since I seem to be coming to the end of the line as far as pharmaceuticals are concerned.
Joanna Moncrieff and anti-psychiatry October 28, 2013Posted by indigomind in Diagnosis, Medicine.
Tags: anti-psychiatry, Joanne Moncrieff
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Recently I visited the Mad in America website and commented on an article and video by Joanna Moncrieff. Moncrieff is a psychiatrist in the UK who has written a number of books against the use of drugs and the idea of a bipolar spectrum. Since we both appeared to have the same opinion regarding the efficacy of antidepressants I thought some exchange might be interesting. In a comment I wrote that I wish I had taken antipsychotics sooner than I had and that anti-psychiatrists appear to be in a hurry to normalize mental disorders despite the lack of evidence for many of them one way or the other. In response a man replied that I hadn’t paid attention to the previous discussion and how disastrous all psychiatric drugs/labels are.
Professional interests drove the transformation of antipsychotics from special sorts of tranquilisers into so-called ‘magic bullets’ back in the 1960s. It was this idea that antipsychotics constituted a sophisticated and targeted treatment, rather than a chemical suppressant, that obscured their unpleasant, mind-altering effects, thus enabling the pharmaceutical industry to expand their use over recent years.
Now I can see pluses and minuses to psychiatry however the people on this site are quite black and white. I am willing to bet for every story of someone harmed by psychiatry there is at least one who feels like he/she was saved by it. It is true that many people are being treated with drugs they don’t need and perhaps mislabeled but there certainly are people who desparately need drugs and some name to describe their problem. For some reason we expect psychiatry to perform on par with other medical specialties even though we still know very little about the brain.
Depression or nervous breakdown? October 16, 2013Posted by indigomind in Biology.
Tags: Anxiety, Atypical depression, Dysthymia, Major depressive disorder, Mental breakdown, psychotic depression
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After reading this article I’m not sure whether I’ve experienced true depression, other wise know as “melancholia”. I’ve been diagnosed with atypical depression, dysthymia and most recently, psychotic depression. Atypical depression according to most descriptions is nonmelancholic, as is dysthymia. Both atypical depression and dysthymia are not severe depressions, don’t involve an inability to feel pleasure and don’t involve motor slowing. Psychotic depression on the other hand does involve motor slowing and is unlikely to spontaneously improve without treatment. Additionally, I have felt sad off and on with my depressions. One criteria for melancholia is sadness. So, in the end, I’m still somewhat confused.
‘Depression is normally associated with loss or unhappiness,’ he says, adding that many cases of breakdowns are in fact caused by severe anxiety, as opposed to sadness.
Apparently according to the article the distinction between depression and nervous breakdown revolves around whether one has primarily depression or primarily anxiety. I hadn’t made this distinction before but given my diagnostic history it made me wonder if my primary problem has just been anxiety all these years.
When one looks at the various types of depression is becomes evident that the diagnosticians are mainly making the melancholic distinction as a way to quietly separate the “neurotics” from the true depressives and it is also evident that there is an element of subjectivity in typing people. How can a diagnostician be certain that one person’s “depression” is more biological than another’s? Additionally, motor slowing, another criteria, has to be noticed by others. What if no one else cares how slow you are?
If you put people with non-melancholic depression on Prozac, they get all the side-effects and none of the benefits.’
The article also mentions that melancholics are more likely to benefit from antidepressants while nonmelancholics are more likely to just notice the side effects. Personally, I have found antidepressants more helpful with anxiety which is what nonmelanchlics are supposed to primarily have. Puzzling.
In the end what upsets me about this is regardless whether I have biological depression or not I truly feel like my “depression” has been debilitating and it has been quite resistant to psychotherapy and medication. The DSM needs to create another category for me.
Anti-psychiatry is simple minded September 16, 2013Posted by indigomind in Biology.
Tags: mental illness, Pathology, Psychiatry
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According to this man in the video no known pathology exists in the mentally ill and consequently mental illness doesn’t exist. What annoys me is that anti-psychiatrists believe that pathology or abnormality can only exist as either a lesion or something measured in the blood. I submit that they have an overly narrow view of pathology. Given the complexity of the human body numerous things could function abnormally. Migraine, for example, is a well accepted neurological disorder however neurologists aren’t sure why migraines, much like mental illness, occur.
Another specific example of abnormality/pathology is the lack of circadian phase alignment between the sleep wake cycle and the melatonin cycle that exists in many depressed individuals. In SAD individuals the melatonin cycle is often delayed relative to the sleep wake cycle. This can be corrected by the use of bright light or melatonin supplements. One particular study even found a connection between the degree of depression and the lack of alignment between the two cycles.
Antidepressant augmentation with lithium again September 1, 2013Posted by indigomind in Medicine.
Tags: augmentation, Lithium, treatment resistant depression, Venlafaxine
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I was quite honest about my response to Venlafaxine and as a result my pdoc added lithium to help “potentiate” it. This has been tried before without much success so I’m not sure if I need to go through this again. For some reason he added such a small amount that my lithium plasma level was only .1 mmol/L and according to one Pubmed study the level should be closer to .33 mmol/L in order to be effective. Since I haven’t noticed a significant change in mood/energy perhaps he might increase it?
Our results show that treatment augmentation with low lithium dosage may be as effective as augmentation with higher dosage, is well tolerated and does not necessitate monitoring of plasma level.
Years ago another pdoc added lithium to a SSRI and not much changed. Then I was on lithium (.5 mmol/L)for about six months by itself and noticed some positive changes like an improvement in sleep and level of aggression. After six months I stopped it due to the questionable influence it had on my mood and to the side effects which included weight gain. This time however i have noticed that it has made me more alert during the day and has disrupted my sleep somewhat. Another interesting result is that it seemed to change my personality somewhat. For many years I was on a quest to figure out a cure for depression and become a research scientist however lately I don’t feel the compulsion to do this. The idea of me doing research seems kind of unrealistic. Of course this might not be due to the lithium but for some reason I just noticed this.