antidepressants

[musclebrains]

buddy, it's generalized anxiety for me (or free-floating).
The negative messages you mention were begun about 34 years ago, by my physically and emotionally abusive mother.
I was in Cognitive therapy for a few years and it hlped, but not to where I can go off meds for any serious length of time.
I have also heard that serious stress over a very long period can condition the brain's usage of serotonin. That could explain why a few years of cognitive therapy have not undone over 30 years of negative conditioning.

I've had clients who came off them successfully after 5-10 years, though it is not unusual now to regard the drugs as a lifetime regimen. However, it's also common for a drug to stop being effective and then you have to find a new one. Oddly, people on Prozac frequently lose the full effect of the drug after a few years and, for some reason, they often respond again when you cut the dose in half.

By the way , there is a piece in this week's Sunday NY times magazine about the effects of these drugs on marriages.

Cognitive therapy is fairly effective for specific phobias and anxiety triggers. It is not as effective on generalized anxiety and certainly has virtually no benefit for people who want to undertake a deep examination of their lives.

Cognitive therapy is the pet of the NIMH right now and is getting a lot of overstated promo. The reason it's advocated is because it is fairly standardized and its effects can be more readily measured, compared to insight therapy. However, there have been few long-term studies. It's basically symptom management.

 

[smallmovesal]

musclebrains.. pm me if you have aim or icq

 

[buddy28]

"Cognitive therapy is fairly effective for specific phobias and anxiety triggers. It is not as effective on generalized anxiety and certainly has virtually no benefit for people who want to undertake a deep examination of their lives. " ---MuscleBrains

Not true at all. Comprehensive cognitive therapy for GAD has been proven to reduce the irrational cognitions that are partly responsible for triggering anxiety (Durham & Turvey 1987) and has been shown to reduce overall anxiety after treatment (Borkovec & Costello 1993) . GAD requires Comprehensive Cognitive Behavioural therapy for complete recovery. The cognitive therapy acts as a backbone for which the patient can learn to reinterpret events more rationally thus reducing triggered anxiety responses and allowing the patient to feel more in control of events. The behavoral component allows the patient to experience mastery over anxiety causing situations and further reinforces the cognitive matieral.


Few long term studies exist of the effectiviness of cognitive therapy?!?? For what disorder....there are tons.

Cogntive therapy is touted as the #1 therapy for depression and some anxiety disorders because it works, and its been shown to work. Meta anaylsis of 10,000 different clincal studies that employed 5 different types of conventional therapy for depression (cognitive, behavioral, meds alone, psychoanalytic, humanistic) revealed cognitive therapy to be significantly more effective then the others.

Of course, the best type of therapy depends on the disorder.

Im mad that you would recommend to Weapon that cognitive therapy has no use for people with GAD. Completly not true. cognitive - behavorial therapy specifically for GAD is the most effective treatment.

Personally, Ive seen what cognitive therapy has done in my life for social anxiety and depression. Its made a huge change. I wouldnt be so quick to discount it as a theraputic tool since its effectivness has been validated and replicated in thousands of studies, and has helped tons of people like me.


WeaponX --- check this link out

http://www.anxietynetwork.com/gahome.html

.....Dr Richards runs the anxiety network. He had social anxiety for 20 years + depression, overcame it, and now has his PhD running the Anxiety Network on the Net. He works with the major anxiety disorders (social anxiety, GAD, Panic, agorophobia). He's helped me alot and theres alot of good info specifically for GAD on that link. DOnt give up dude, and dont believe that meds are the only solution to overcoming ur problem . COmpletly untrue.

Ive done 45 minutes of cognitive therapy everyday for the past 2.5 years. Thats alot of time!!! Its the repitition and persistence that makes cognitive therapy work. I said it before and Ill say it again. We live in a culture that wants the quick fix. If I said to you, which do you want, a pill to solve all your problems, or 30 minutes everyday of cognitive therapy for 6 months.... what would you pick?? People want the pill.

THis is what makes me mad. Theres a huge misconception with some people in the mental healh feild (some psychatrists, and family physcians ) that meds are the end all be all for every mood disorder. Its complete tripe. Y is this happening??.....I think a big reason is the educational paradigm physcians and psychatrists taught: biology. If your brain is biological then meds will cure you for sure since they work on ur neurochemistry!!!

Tell me this: How do people overcome depression and anxiety disorders using no medication, just cognitive therapy?

The physcians and psychatrists should know . Our brains exhibit plasticity. Meaning they can change and adapt with given enviromental stimuli. Our enviroment can therefore change our thinking and neurochemical balance. Therefore, the cognitive therapy you put in *changes* the chemical composition of the brain and probably alot more. Thats why cognitive therapy works the best for the majority of mood disorders.......

Sorry for the rant, but that really pisses me off. I know what its like to suffffer and getting fed with incorrect sources of info can just prolong that suffering.


Musclebrains --- id be interested in what ur occupation is

 

[musclebrains]

WHOA. I did not say cognitive therapy is totally ineffective in teh treatment of GAD. I said it is less effective there than in more specific instances, like phobias.

I am unconvinced by the data on generalized anxiety, as are many other clinicians. The number of people who get miracle cures in cognitive therapy -- they last a few months often -- and then show up in offices of psychodynamic therapists is contantly discussed when psychologists get together. Symptom management may be adequate for some people. It is not adequate for many people. I'm glad it's worked for you, Buddy, and I note that you are not of the miracle-minded group.

The endorsement last year or the year before by the head of the APA of cognitive therapy produced a firestorm of criticism. It is the perfect therapy, of course, in a consumer economy whose psychological services are mediated by managed care and its lobbies. Not that I think insurance companies should pay for long-term insight therapy, but one can't help noticing how perfect cognitive therapy fits the economy and the preoccupation with symptom.

ON THE OTHER HAND, Buddy, I give you credit for your devotion to the exercises. Many people do not do that. So I would say you may be more motivated than a lot of people. I'm frankly not sure 2.5 years of daily therapeutic activity is more effective than weekly insight therapy for the same period. But it's very cool that you've taken responsibility for your own treatment.

I did not say there haven't been many studies. I said there have not been many long-term studies. I also said that cognitive therapy is easier to study because it is standardized, whereas psychodynamic practices are not. The fact that the latter works very differently and cannot be measured effectively does not mean it isn't effective... Where is that meta-analysis, by the way? Who published it and what was the standard of effectiveness?

I refer people all the time, especially those suffering phobias, to cognitive therapists. I have also seen some mediocre to good results in the treatment of panic anxiety disorder.

There are over 200 forms of psychotherapy now. All of them claim to be successful. I certainly do not recommend taking drugs if cognitive therapy, humanistic therapy, tai bo or fucking works better. Far too many lives have been saved by the antidepressants to reflexively dissmiss them. Nevertheless, I certainly agree they are WAY over-prescribed.

 

[buddy28]

Muscle Brains

Sorry for snapping. Ill get u some info on the meta anaylsis.

"The endorsement last year or the year before by the head of the APA of cognitive therapy produced a firestorm of criticism. It is the perfect therapy, of course, in a consumer economy whose psychological services are mediated by managed care and its lobbies. Not that I think insurance companies should pay for long-term insight therapy, but one can't help noticing how perfect cognitive therapy fits the economy and the preoccupation with symptom. "


I totally agree with that.


"ON THE OTHER HAND, Buddy, I give you credit for your devotion to the exercises. Many people do not do that. So I would say you may be more motivated than a lot of people. I'm frankly not sure 2.5 years of daily therapeutic activity is more effective than weekly insight therapy for the same period. But it's very cool that you've taken responsibility for your own treatment. "

It really comes down to the disorder someone has. I had social anxiety which caused major depression. I saw a psychologist for around 3 years, once a week. Most of my therapy consisted of psychodyaminic/humanistic/cathartic relating. It comprised elements of cognitive therapy in the sense I would bounce ideas off my Dr, and he would help me see situations or myself in a more rational light. However, social anxiety requires more structured cognitive exercises that need to be learned through repitition.....most people with depression require the same. ........people with SA need to learn to re-think how they view themselves, which ulitmately translates into feeling better about themselves (assuming a behavoral component has been completetd) . For me, seeeing a psychologist once a week and discussing my problems did little to alleviate my automatic negative thoughts that resulted in my social anxiety and depression.......

U reffered to symptom managment. Its funny, my therapy for social anxiety emphasises avoiding dwelling on anger, regret, past negative events, ect. My parents played a big role in creating this disorder. and in a sense the therapy ecourages me to avoid dwelling on these events. But this is good. .....because for me, "dealing with the root of the problem" , as opposed to
managing symptoms, would have exacerrabated the problem. I agree that dealing with the root of problem is great....but what happens if the root is tied to other people who dont want to admit any wrong doing and who will make u feel bad for even bringing it up? And even if they did tell me they were wrong for doing alot of things, I seriously doubt my brain would change......y? because its been conditioned to think negativily for soo long. Once the brain gets in the habit of thinking a certain way, one word , or apology wont miracally change it, at least i feel thats true for me.

The real trick is , is to specialize therapy for each disorder. Social anxiety therapy has to address 3 different facets:
1) cognitive material that stops automatic negative thoughts
2) cogntive material that helps one think more positivily about urself
3) behavoral therapy that helps u relax, and gradually exposes u to anxiety causing situations.
4) psychodynamic therapy ----- to an extent.

 

[HelenSL]

The real trick is , is to specialize therapy for each disorder. Social anxiety therapy has to address 3 different facets:
1) cognitive material that stops automatic negative thoughts
2) cogntive material that helps one think more positivily about urself
3) behavoral therapy that helps u relax, and gradually exposes u to anxiety causing situations.
4) psychodynamic therapy ----- to an extent.

Or...no offense...just go have some fun?

Sometimes I wonder if for all our 'expertise' we haven't just backtracked... -- after all emotional disorders seem to be more prevalent than ever...

Ah but I had better not say that because some people's livelihoods depend on their professional services being needed don't they?

love
Helen

 

[MommaKin]

Smalls, why exactly did your doc put you on anti-d's anyhow?
What were your symptoms?

 

[musclebrains]

Muscle Brains



It really comes down to the disorder someone has. I had social anxiety which caused major depression. I saw a psychologist for around 3 years, once a week. Most of my therapy consisted of psychodyaminic/humanistic/cathartic relating. It comprised elements of cognitive therapy in the sense I would bounce ideas off my Dr, and he would help me see situations or myself in a more rational light. However, social anxiety requires more structured cognitive exercises that need to be learned through repitition.....most people with depression require the same. ........people with SA need to learn to re-think how they view themselves, which ulitmately translates into feeling better about themselves (assuming a behavoral component has been completetd) . For me, seeeing a psychologist once a week and discussing my problems did little to alleviate my automatic negative thoughts that resulted in my social anxiety and depression.......

U reffered to symptom managment. Its funny, my therapy for social anxiety emphasises avoiding dwelling on anger, regret, past negative events, ect. My parents played a big role in creating this disorder. and in a sense the therapy ecourages me to avoid dwelling on these events. But this is good. .....because for me, "dealing with the root of the problem" , as opposed to
managing symptoms, would have exacerrabated the problem. I agree that dealing with the root of problem is great....but what happens if the root is tied to other people who dont want to admit any wrong doing and who will make u feel bad for even bringing it up? And even if they did tell me they were wrong for doing alot of things, I seriously doubt my brain would change......y? because its been conditioned to think negativily for soo long. Once the brain gets in the habit of thinking a certain way, one word , or apology wont miracally change it, at least i feel thats true for me.

.

First of all, I am not a conventional psychologist. My background is in depth psychology -- the psychology of the unconscious -- and I work primarily with artistic people. I lecture pretty broadly about the failures of conventional psychological practice -- I'm not even sure I "believe" in therapy any more -- so please don't box me in.

You are pointing to some valid criticisms. The humanistic project, in particular, has assumed that catharsis is inherently therapeutic. I think that's true (in the Aristotelian, aestheic sense) but, as you say, there is also reason to believe that the repeated recollection of traumatic events RE-traumatizes the client. The most ludicrous example of this is Janov's primal therapy, with which I have a good bit of experience. These people continually reprocess and cathart and seem not to get very far except to feel good after screaming an hour. (I get the same effect in the gym and, like them, I keep going back for more!)

The point of psychodynamic therapy in unraveling the past is to derepress unconscious material. This was Freud's notion -- that the repressed returns as a symptom until it is brought into consciousness. In Freud's time, when psychotherapy was in its infancy, this worked quite well. Now, however, the general population is much more sophisticated -- you can't even work with "transference" without the client noticing now -- and, as you're suggesting -- once the past is known, we've found that it doesn't necessarily profoundly change behavior.

Part of this is the evolution of psychology. (Cognitive therapy represents standardization of some very effective techniques.) But part of it too is the difference in expectations between Freud's time and ours. We expect to be happy. We expect to be normal. We think its our birthright to be happy, joyous and free. Freud and his heirs -- and I include myself -- do not buy that. We believe that, as Freud said, the goal of analysis is reach an "uneasy peace" with the naturally conflicted psyche. So Freud wasn't trying to give people peak experiences. He was trying to help them adapt. In reality, the Standard Edition of Freud's works is a political translation and his adoption in America is of a Freud quite different from the European one.

We live in a culture that is attempting to standardize behavior. We pathologize eveyrthing now. Shyness becomes social anxiety. Distraction becomes ADD. Sadness becomes depression. A pill or the right therapy is supposed to turn everyone into Forrest Gump. I was lucky to have lunch with the Dalai Lama a few years ago -- I'm also a writer -- and I asked him about "low self esteem" in Tibet. He literally did not understand the phrase, no matter how it was explained to him. Low self esteem is only an issue when you think your birthright is special.

Summarily, what I'm saying is that I believe in "character." I think some people are naturally melancholic, others naturally more positive. The fact is that when you look at actual families, you can't, except in cases of profound abuse, predict how a person is going to respond, whether he's going to be affected as an adult. What we know deeply affects people is the meaning they make of their experience. That's part of the reason for telling your story in therapy, to make meaning of it. That is why I work with artists. They make meaning out of their experience by the production of images. Like story telling, image making, is an inherent need of the psyche....enough

 

[booger]

Anti-Depressants and Anti_Anxiety medication are BS stuff that disable certain areas of the brain. My take on it is that if depression is the problem then get something that will take you back to a manic state. Ritalin works good. Mix it with some Ephedrine and Caffiene on a couple of day on, couple of day off, and you'll be OK. Adjust dosage and timing as necessary so that you don't burn up your receptors.

The product information sheet on Ritalin even states that in some cases it is used to treat depression. But if you go to a regular doctor feign narcolepsy. That way he won't give you a referal to a shrink. Shrinks generally don't seem to want to prescribe Ritalin unless you're a kid.

When you're high as a kite you don't seem to worry about things. Pain killers are another good alternative but only on a limited basis. Percodan and Dilaudid will really mellow you out.
Don't be trying to do anything functional on them like driving a car.

 

[smallmovesal]

Smalls, why exactly did your doc put you on anti-d's anyhow?
What were your symptoms?

waking up several times a night... usually at about 4-5 in the morning... crying all the time... wanting to be alone... stuff like that.