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Roger&Me

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Dec 8, 2004
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Rog et al., I find the anti-psychiatry/anti-psych med viewpoint to be extremely problematic.

I just wanted to point out that I am most certainly not anti-psychiatry, in fact I'm a supporter (Clinical psychology I'm a bit more iffy about than psychiatry, although I admit I'm definitely no expert). But I think that many (most? I dunno) psychiatrists have flawed methods, and rely too heavily on prescribing instead of incorporating a more balanced approach. I also think that many disorders, such as ADHD, are applied excessively-- especially in children. As a child who was medicated with amphetamine due to ADHD, I think it had long-term negative effects on my personal development. And like you mentioned, SSRIs are probably the prime example of flawed prescribing methods in the industry-- although some people do find them helpful, they shouldn't be dished out like candy because some of them cause pretty tough dependency issues.

I really don't have that strong of a viewpoint on the issue, and I respect all the opinions about it that I've heard. In fact, I've revised my opinion a couple of times since the discussion began. :)

If anything, I think that mental functioning is something that we need to learn to better manage as a society. I think that the current state of the mental health industry could be upgraded to be more effective (although this is probably a pipe-dream, I admit). I'm speaking just as a private citizen who has had a few run-ins with the mental health industry, and found the care to be rather generic and ineffective. Like anything involving people, though, I'm sure it comes down to the individual patient-caregiver relationship and the specific dynamics involved.

Again, I want to point out that I'm not anti-psychiatry. If anything, I would like to see psychiatry become a more effective medical discipline. Unfortunately, pharmaceuticals seem to be such blunt tools-- I wonder if we'll ever devise more effective methods of treatment? Or indeed, if more effective methods of treatment are even possible?

Lately I've come to realize the extreme limitations of the "better living through chemistry" mindset. Many times it doesn't end well, because it essentially boils down to selectively disturbing the homeostasis of the body. In some instances, this selective disturbance can have positive effects (or even neutral effects that are simply different enough from normal consciousness to help the person change ingrained habits)-- however, the long-term effects of continually ingesting exogenous chemicals can be quite problematic. I mean, nowadays I'm pretty hesitant to really recommend ANY kind of drug to anyone, even piracetam and the like I think can have bad effects. I'm not saying I don't use drugs myself, because I still do-- although much less than at other times in my life-- but I don't see it as a beneficial activity anymore. So in that sense, I don't think I necessarily subscribe to the "better living through chemistry" mindset-- perhaps in a limited way, with specific caveats.

I still suffer from benzo cessation symptoms months after stopping them (took them as prescribed), and I know people who have been similarly harmed by SSRIs and antipsychotics. I just think that the seriousness of medication needs to be thoroughly considered, when in so many cases it simply is not-- some doctors act like they are handing out vitamins, with very little actual information being doled out. In many cases, the only information the doctors even have regarding these medications was given to them by the companies that manufacture them-- which is absurd..

The reality is that long-term use of many psychiatric medications can cause terrible withdrawal effects and cessation syndromes, that are improperly managed by doctors in so many cases (you would be appalled to learn what a large percentage of psychiatrists are ignorant or dismissive of the existence of benzo & SSRI withdrawal syndromes). Due to these conditions, many people are forced to continue using these medications indefinitely even if they stop helping them. That's an example of the type of behavior that needs to be banished from psychiatry, IMO-- ideally, I would like to see more informed and compassionate care as the industry standard. With the state of the industry today, trusting your psychiatrist's advise could potentially be a disastrous decision.

It's a complicated issue, no doubt. The human mind is extremely complex and amorphous, hard to define or pin down. Again, I'm not even really arguing a side here-- I'm more interested in discussing the matter in general. :)

]But people have real psychiatric needs and medications can be really helpful, and I do not think it is in the interests of harm reduction to encourage people not to do what can be helpful. It is in the interests of harm reduction however to encourage people to become well informed and consider the pro's and con's.

This is essentially all I'm saying as well. :) I think we're both coming to the issue from different perspectives, though, which should be noted. I know you see a lot of the people who REALLY NEED psychiatric treatment through your work-- I've never had that experience. My experience has been more on the "cosmetic psychiatry" end of the industry, which I have found to have many problems. These are basically two completely different animals, IMO, and in many ways incomparable.
 
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^Great post. :)

Flarestar said:
If it's not the norm, then it IS a disorder. Kind of by definition...

By that logic, people over 6'4" and those with an IQ>132 (2 standard deviations from the mean) have a "disorder." And redheads (<2% ) too! ;)

I've always thought that in order to be a disorder it must have a substantially negative impact on daily functioning.

The author argues that the "irrationality" of excessive happiness can have a negative impact on the individual.

"Happy people have also been shown to exhibit various biases of judgement that prevent them from acquiring a realistic understanding of their physical and social environment. Thus, there is consistent evidence that happy people overestimate their control over environmental events (often to the point of perceiving completely random events as subject to their will), give unrealistically positive evaluations of their own achievements, believe that others share their unrealistic opinions about themselves, and show a general lack of evenhandedness when comparing themselves to others."

But then he goes on to argue that value judgments have no place in the classification of psychiatric disorders. It's an interesting argument, but I think fails in the same way that the categorical classification most psychiatric diagnoses fails: it lack validity as discrete entity...I'll explain below. Also, I'd say that value judgments are critical in establishing who we treat. To clarify, I am not at all anti-psychiatry. In fact, I'll be entering the field in the near future.

Roger&Me said:
I just think that people ought to avoid labeling themselves as disordered without strong reason. I also think that people ought to avoid medicating themselves with psychiatric drugs unless they are in significant distress, because I have seen people be severely harmed by those drugs and believe they should be used sparingly and with caution.

I'm not saying that there aren't any disorders, or anything like that. I'm just saying that psychiatric labels are powerful things and should only be applied to people in extreme circumstances. I also take issue with the lack of appropriate diagnostic testing for the presence of these disorders, there is no type of assay that can be done to establish their existence-- therefore the system is essentially reliant on the opinion of one particular medical professional.

I agree. The word has clear negative connotations. There's no reason to go applying it haphazardly to as many people as possible. Some other thoughts on definitions...

The problem with the term "disorder" is that, like "disease," it has no commonly accepted, unambiguous definition.

The “disease realism” model has predominated in psychiatry, which states that a disease is “an objectively demonstrable departure from adaptive biological functioning.” Therefore, clinical signs and symptoms do not constitute disease. It is not until the causal mechanisms are clearly identified that we are unequivocally speaking of a disease. Much to the chagrin of psychiatrists, no consistent underlying pathology has been identified for the majority of psychiatric disorders, and that leaves big questions regarding how we define mental illness. To clarify, I'm not implying that mental illness does not exist. I'm simply saying that the definition is not as clear as many believe it to be. Delineating borders between pathology and normality are ultimately somewhat arbitrary.

It’s likely that many psychiatric disorders merge into others with no natural boundary in between...the proposed category of pathological happiness being one example. If we are giving an accurate description of nature, there should be "zones of rarity.” Attempts to demonstrate natural boundaries between major depressive disorder and normality have consistently failed. Instead, studies have found that these zones of rarity may not exist where we expected them. For example, it was demonstrated that the genetic basis of anxiety and depression are very similar, if not indistinguishable. What exists is a spectrum. The same goes for schizophrenia, psychotic affective illness, and a spectrum of other disorders, including szhizotypal/paranoid personality disorder. Again, I should clarify that this muddiness does not mean that the profession should withhold effective treatments from patients with significantly impaired functioning..."effective" being the key word there, since psychiatry has a track record of premature and overenthusiastic endorsements of new treatments, accompanied by a minimization of potential harms. If we don’t acknowledge the lack of real boundaries, we could end up pathologizing nearly all of human behavior.
 
Roger&Me said:
... I also think that many disorders, such as ADHD, are applied excessively-- especially in children. As a child who was medicated with amphetamine due to ADHD, I think it had long-term negative effects on my personal development ...

ADHD is a prime example of a culturally-dependent psychiatric diagnosis. Would it be meaningful to describe it as a disorder in an agrarian or hunter-gatherer society?

The arbitrariness is exemplified by widely varying prevalence rates (0.5% to 26%!) depending on the epidemiological study. As far as I am aware, attention (along with other measures in psychometrics) essentially follows a normal (Gaussian) distribution, and we as a society, designate a cutoff at the tail end of this distribution and define it as pathology. Since those at the tail end do struggle in a society in which quiet classroom attentiveness for 8 hours a day is considered "normal," drug treatment would be all fine and good if we could really help those that we were treating. Unfortunately, there is no data that stimulant medications result in any long term benefits in emotional adjustment, delinquency, or academic performance, and there is serious concern that these drugs have detrimental effects on development.

I think we will look back on the overmedication of children with stimulants and antipsychotics in a similar way to how we now look back on the lobotomy, as primitive and unethical.
 
Adderall made me excel in school, but in the long run it's done nothing for me. In fact after I took myself off of it I felt that my "symptoms" were at least twice as bad.

What really scared me about adderall, was how its the only drug I've ever taken that literally changed my whole personality while I was on it and made me into a different person with totally different values. A staunchly reductionist, productivity-oriented jackass basically.

I'm actually way more productive now without the adderall anyways. When I think about things, I can ponder and meander around the concepts-- not power through them like a bulldozer. On adderall, all the subtlety of life is missed. You have no time for it, you're too spun-- you hyper-focus on the surface level. I would sit down and truck through problems for 8 hours without a break, and at the end of the day I would have a whole bunch of scribblings on paper to show for it but no deep comprehension of the material.

I've learned that nothing will ever make academic work easy, its just hard. And you have to REALLY suck it up and work hard, and it just feels unpleasant a lot of the time. But there's no short-cut that takes you to the same destination as just plain hard work with a clear, sober mind.
 
Lame I'm out of weed. I would get more but it's not a good idea since I have to clean my system out. My doctor hasn't drug tested me again lately but she just may my next apointment since she increased my hydrocodone dosage again. If I fail another drug test from her I will get droped as a patient.


I need some mushrooms right now.
 
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I believe you are right, but karmatic just sounds cooler. Nothing wrong with creating new words :D

PD Social: The tears of Traveling entities
PD Social: The ketamanic experience
PD Social: Hyperspace Hive, where one can truly bee
PD Social: All aboard the karma express



Just so people on this page can see some suggestions

and

Jon Hopkins - Circle
http://www.youtube.com/watch?v=lL0PGjdMfIw

Jon Hopkins - Reprise
http://www.youtube.com/watch?v=8FYOgTy0u8Y

Straight up ballin` downtempo (what can I say I'm Durham NC, can't help but speak from my roots)
 
I believe it used to be just a handful of years ago.

In the recent years the rates of violent crime haven't been as high. I saw some statistic report that showed Greensboro to have one of the highest rates in the southeast and the highest in NC. The stats are located here http://www.wral.com/news/local/story/3179442/ . This article just says basically Durham is middle of the road in terms of crime http://www.thedurhamnews.com/2009/08/01/198731/citys-crime-rate-average.html . This is probably one of the better articles using 2008-2009 data basically saying the same thing. http://www.bullcityrising.com/2010/...continued-strong-showing-among-nc-metros.html . Worth a read.

I remember hearing back in early 2000s I believe that Durham used to have one of highest Murder rates or violent crime rates percentage wise (though honestly it could have been just one highest for its size) for the united states. The data for the recent year definitely doesn't show anything like that, but like I said, it could have been the early 2000s or late 1990s. In comparison to the surrounding cities it does have a lot higher rate of crime, but we are talking about places like Cary, Raleigh, and Chapel Hill especially. All these places have such different a socioeconomic situation than the city of Durham.

I'm glad I was raised there. I was glad to actually experience a wider range of experiences that often were negative due to the poverty of a lot of the students and because of race relations. I grew up having a great sense of street smart and dealt with racism first hand as the receiver of the bigotry which helped open my eyes to the truth about the reality of the world at a young age.

Ah, I miss that place. I meet some cool kids and had some life experiences


edit: http://www.epodunk.com/cgi-bin/genInfo.php?locIndex=19253 This link apperently has 2003 violent crime numbers for Durham In comparison to the ~800 in 2009 for the city of durham, there was 1633 violent crimes.
 
PD Social: Can I have a side of ketamine with that Beef brisket?
 
"xbox make me a sandwich!" =D

Seems to mistake everything I say as 'microsoft debit my account' =D

(btw 'xbox make me a sandwhich' somehow started zune and tried to queue up a load of tunes, maybe xbox thought 'naw you don't need a sandwhich listen to this instead)
 
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