Pharma companies would be sued nearly out of existence and the use of anti-depressants strictly regulated (some of them may be banned altogether), all to the detriment of those people who'd actually benefit from them.
Now, I'm an expert in medicine (not), but I do think this would be a good turn of events. Doctors over-prescribe this crap. People got on just fine in the old days without anti-depressants and Ritalin. Animals get along just fine. I think the vast majority of psychological problems are caused by lifestyle, and that is where the docs need to look for the fix, not to drugs which allow the unhealthy lifestyle to continue, deepening the condition all the while. Why do you think people go from unhappy to nutso so easily these days?
I think that there is a vast overuse of antidepressants and other mood-altering drugs, surely.
But I also think that bans, strict regulation and attacks on the pharma companies are not the best solution to the problem.
The solution would start with parents being willing and able to do real parenting, and teachers bein will and able to instill some discipline in kids. And many other suggestions already seen on this website.
He was off his medication but he had trouble when he was on his medication as well...from family members and friends.
Age is also a factor in these cases. People under 25 have a higher rate of violent thoughts and aggression when they take SSRIs then people over 25. Under 17 and the rate goes to 1 out of every 100 people on an SSRI wants to go buy a gun and shoot people. Whether or not they do it is a different story but they still get the urge.
Mental hospitals emptied from the 1950s onward due to these drugs. As more drugs have become available in the last 20 years or so, surprise surprise, school shootings have gone up.
ben is correct. Doctors over prescribe and this is the result.
My aunt is a textbook case in overmedication. Her doctors should be sent to jail. She takes drugs for everything, and then she takes drugs to counter the unwanted effects of the the first batch of drugs.
She lied about symptoms to get some drug nicknamed stupimax, because her daughter was on it for headache treatment and as a side effect it helped her loose weight. I was wondering what was wrong with my aunt the last time I saw her, I thought she was retarded or had had a brain injury or something.
I even had a doctor friend who noticed my seasonal allergy sneezing, said it might be related to asthma (!?) and told me he could write me a prescription for an asthma puffer. What the hell is wrong with doctors. They think their medications are magic pills, when in reality they have a very poor understanding of what the drugs are doing to the organism as a whole. Our drug culture is absolute madness.
My good wife adjusted my diet to balance my lab results and they have gone from pretty bad to right down the center with a just out of norm on one remaining (which we are working on now). The doc was getting ready to write prescriptions after the first set of lab results and was scratching his head after the second.
Now, about anti-depressants. I take one and have for years, not for depression, but for impulse control.
My good wife had already tried and failed to adjust my ADD induced short temper via dietary inputs.
The drug has significantly reduced my A.Q. (A-hole Quotient) AND saved my marriage.
Outright slams in either direction are not a great idea.
I think the vast majority of psychological problems are caused by lifestyle
Ben, that just proves you have no first hand experience with depression. No medical professional would tell you that drugs 'fix' depression. To this day I can't tell you how much of my own depression was mitigated by drugs versus therapy. But I can sure as hell tell you that "lifestyle", whatever you meant by that, was not the issue. You come off sounding just a bit like Tom Cruise there.
No, juris, Ben is right. He is speaking in terms of how depression is brought on by over-stimulation, i.e. over-enjoyment of something -- anything -- with the result being that the organism attempts to bring itself back into balance (homeostasis) by inducing negative feelings. It's called the law of relativity of human value reactions -- in other words, you can't have an up without a down. My family (Swedes) are very prone to depression and anxiety, but while our aforementioned aunt medicates herself into oblivion, I have learned to make the necessary adjustments to deal with the depression without any drugs whatsoever -- I accelerate the negative feelings by cutting out all stimulation (TV, music, tasty food, etc.) and do things I don't particularly like (drudgery kind of work), and before long I have restored balance and feel normal again.
There is a classic case in Germany during WWII where several mental patients in a hospital were abandoned by the staff during a siege or something, and ended up escaping. These patients were so far gone that they were considered beyond hope. After the war was over, an attempt was made to locate these patients to put them back into care. To their astonishment, the doctors discovered that a huge percent, something like 90% of them, were functioning normally in society. The terrors and oppression of the war had in effect restored balance for these people, and they became functional. This, more than anything, shows that the vast majority of mental health issues in our society are induced by lifestyle. I can dig up the reference for you if you're interested.
If you want to talk about people who don't understand depression, it's the medical community. Could any of them tell you why Ritalin -- a stimulant -- works to calm hyperactivity? No. Do they know why anti-depressants are correlated with over-the-top violent behavior and suicide? No. The law of relativity of human value reactions explains it very simply, but to the medical community it's all alchemy at this stage, and that's what makes them such a danger.
Ben, that just proves you have no first hand experience with depression.
You might think, but it's not true. I went through a pretty good bought of depression when I was a junior in high school. Sarah probably remembers this. My grandpa would see me coming down the block and turn the other way to avoid me, and I don't blame him.
And what preceded this depression? Something bad happening? A death in the family? A natural tendency to depression?
Nope.
This was late fall of my junior year in high school. The preceding summer I had gotten my first girlfriend. Along with said girlfriend came the intense emotional pleasure. Then for no reason I became an ass-crack and then super depressed. At the time I figured I was down because we were a little destitute at the time and everyone else I went to school with had it pretty good. I still remember walking through the school bleary eyed and feeling sorry for myself one day and the thought "I don't have any money" went though my head as the self-pity ramped further upwards.
About a half second after that I realized how stupid that was and snapped out of the whole thing. The depression reached its peak and then abruptly ended. Only years later did I connect it to the super-high that I had experienced with my new girlfriend, whom I nearly drove away with my stupid behavior and depression reaction.
Fortunately, I drove her away a year later just by being a selfish teenage dickhead.
Yes, I remember this. And it's worth pointing out that: (a) Since birth, Ben has always been extremely good-natured, so this episode was unusual; (b) my grandfather liked everybody, so for him to go out of his way to avoid Ben was also unusual.
Our mother was very prone to depression (which I inherited to a much larger degree than Ben) and she also had a few other medical issues that could have been mitigated through lifestyle -- or just acceptance of the realities of nature, like the fact that we all eventually age and die. We're pretty sure it was the chemical cocktail her doctor had her on that killed her at the age of 54 -- anti-depressants, cholesterol meds, hormone replacement therapy, blood pressure meds. She got a weird form of liver cancer, and it's the liver that processes all this junk. Doctors are great at surgical type stuff, but most of the time when it comes to drugs, they have no clue what they're doing.
Well, I guess the new theory explains some types of depression, but what abut the old post-traumatic depression? SSRIs appear to be effective in many such cases with no serious side-effects.
We know very little of that preposterously complex system that is brain, and that makes trating its dysfunctions very difficult. However, many other processes and organs are still complex but manageable, and appropriate drugs can be manufactured.
And in most cases these drugs do what they are designed for, and produce side effects in a known range.
He is speaking in terms of how depression is brought on by over-stimulation
I wouldn't even accept that as a majority of cases of depression let alone ALL mental illness.
I would agree that there are issues with over-medication, particularly of adolescents, and also with antibiotics - not just psychoactives.
I'm even open-minded toward Eastern medicine and other holistic health ideas.
So, whether you pop a pill, chew a root, hum a mantra or do some 'onerous' task - all of that is in response to a particular neurochemistry. I don't follow the notion of "lifestyle" as cause.
I've been on SSRI's and later, SDSRI's for years. With them on board, I'm me, as far as my personality goes. They keep the RCOB out of my eyes and, like Rob, they suppress my A.Q. Without them, my Viking/Scot heritage comes out pretty unpleasantly and I'm not a lot of fun to be around, unless you enjoy breaking stuff.
I don't get mad, I don't get upset over stuff that isn't really important, and I'm fully functional. Without them, there are a lot of days I wouldn't be getting out of bed.
I relate it to the timeless quote attributed to Mike Tyson- "If it wasn't for the Zoloft, I'd kill all you mf'ers in this room". That's what it does for me. It makes me human, and not a slave to my inner berzerker.
Fortunately, I drove her away a year later just by being a selfish teenage dickhead.
Actually, sounds like you were a pretty typical teenage boy the whole time. To the extent that someone wanted to pump you full of psychoactives, I would agree that they would have been horribly wrong. But adolescent experience is nothing to judge all of life by.
What I am seeing both in the chronic overprescription of psychotropic medication and here is a profound confusion between being unhappy and being depressed. Unhappiness is a normal psychological state brought about by any number of things, some of them unexpected- like having chronically high expectations and yet still feeling unfulfilled because things aren't just perfect. Unhappiness can suck hard, and it can become depression, but they are not interchangeable concepts.
Mental illness runs in my family. Thankfully, it didn't hit me, but I've had the experience of living with someone in a major depression (as well as other mental states that had nothing to do with "lifestyle"), and believe you me, the problem was not "over-stimulation" or an over-abundance of good feelings leading to some kind of "backlash" of negative ones. A person who has shut down to the point where all they can bring themselves to do is sleep or stare at the wall is not over-stimulated because they don't talk, they don't eat, they don't do ANYTHING because they don't have the energy and don't see the point besides. There's a reason one of the diagnostic characteristics of clinical depression is anhedonia- the complete INABILITY to feel pleasure or much of anything else at all other than an overwhelming sense of hopelessness. Not self-pity- hopelessness. They don't pity themselves because they hate themselves and come to believe that they deserve to.
People in the "old days" did not get along "fine". Although it's more common (and likely vastly more over-diagnosed) now, mental illness traces a very recognizable path throughout history, from depression to OCD to schizophrenia. "Madness" is not a modern concept, and neither is intractable despair- or suicide. Not even animals are all "fine"- any wild animal that is mentally off is quickly killed, but domestic animals- particularly dogs, high in intelligence and social needs- can have a range of mental pathologies... some of which respond to treatment with drugs if all behavioral interventions fail.
There ARE strong behavioral and cognitive components in depression, and it's foolish to ignore them in favor of a quick fix in a pill, but especially as it snowballs, also biological ones. Eliminating all biological treatments would be a step that would probably be fatal for some of those prone to true clinical depression.
Ritalin - when it works (didn't for me) stimulates an inactive brain, which is self-stimulating with hyperactivity behaviors.
The ADD brain has areas of inactivity, not hyperactivity. The external hyperactivity (addiction to chatting in my case) is the way the brain makes up for it. Look up "stimming" as it relates to Autism. They are in the same spectrum.
Ritalin in a "normal" is just a stimulant and a powerful one. In an ADD person it calms them, because their brain can stop the behaviors used to self level externally.
ADD folk tend to self medicate if left alone. They also tend to engage in risky behaviors (because it is risky and therefore stimulating).
Ritalin IS over perscribed as is almost every drug. This said, I cannot focus well enough to harness a genius level IQ and that is frustrating!(IQ - 99th percentile, memory - 98th percentile, attention - submedian) I have tried about ten different drug therapies and only the anti-depressant has been a sustained sucess, and that only for impulse control.
I hate being a guinea pig (as my previous comment should have indicated), but some things are (for the time being at least) best adjusted with applicable drugs.
Ah, the coincidences again. I hope y'all will bear with me through another short story, but it's relevant and has a good ending.
A month ago, I threw my back out big time. I slipped my shoes on, stood up, lifted my left foot onto a stool, and bent over to tie my shoelaces (y'all be careful now, hear?), and BANG, it felt as if someone stuck an ice pick into the base of my spine. The pain was intense, such that I could barely function. Every slight move sent my back into spasms. Damn, but I hate getting older.
I already had an appointment scheduled two days later with my doctor for my yearly cholesterol and other routine blood tests, so I just suffered until then. My doctor recommended an injection of steroids, followed by an MRI scan to find out exactly what was wrong, meanwhile using ibuprofen to dull the pain. That translates into layman's terms as, "Golly, but I hope it goes away."
An MRI wouldn't fix anything. Indeed it would be of no value unless surgery was indicated, and surgery is never indicated in such cases unless and until some months have gone by without the problem going away on its own. So, I declined the recommendation, but I picked up a souvenir case of the flu on my way out.
Next day, I went to a local chiropractor, a brand-new graduate just six months into practice. I walked in, explained the problem, and we got busy. His X-rays showed my L2 and L3 vertebrae were rotated roughly five to ten degrees about a vertical axis. After four treatments (pushing, pulling, stretching, and the like) over six days (I was really tightened up), my back suddenly straightened up and the pain vanished. I am still pain free. And, turns out he's a deer, coyote, and hog hunter, same as I am, so I have a new friend.
The point is that doctors see problems in terms of the tools they have to work with, but different doctors have different tools. Every tool is good for something, and so the trick is to find the doctor who uses the proper tools for the presenting problem. In my case, the chiropractor had the right tools.
Sometimes, though, drugs are the right tool. I would have been dead two decades ago if it weren't for man-made insulin. Had I taken statins for my cholesterol, I wouldn't have needed bypass surgery. Now, I take them to prevent a recurrence, and my total cholesterol is 118. It's expensive, but it works.
My wife is a retired clinical psychologist who saw lots of depressed clients. A psychologist's tool kit does not include drugs, indeed they are not licensed to prescribe drugs. They do, however, understand the pharmacopeia, and often have to deal with the problems that drugs cause in addition to the problems the drugs are prescribed to treat. Their toolkit is listening, talking, and training to help a client uncover a root cause of a problem. Sometimes it works.
So, I sing the praises of the modern pharmaceutical industry, but I don't for a moment think that its products are the solutions to all problems.
Well, I guess the new theory explains some types of depression, but what abut the old post-traumatic depression?
that's the difference between chronic and acute disorders. The docs seem to have a handle on the acute stuff, but the chronic problems, well if the docs knew what they were doing, the problems wouldn't be chronic, now would they?
ADD is different from hyperactivity, no? I don't know anything about ADD. But doctors prescribe Ritalin for hyperactivity, and I wonder if they understand why a stimulant works to calm hyperactive people. Also, do doctors understand why shock therapy works?
And, if psychiatrists understand human behavior so well, why do they commit suicide at 4x the rate of the rest of the population?
juris,
"Our mother was very prone to depression (which I inherited to a much larger degree than Ben)"
Then what is this business about "lifestyle"?
I am also much more prone to being fat than some people, but that doesn't mean that lifestyle doesn't play a part: eating too much and not exercising does have something to do with my being overweight. It means I have to work harder at managing diet and exercise than someone who has a fast metabolism.
Likewise, someone who is prone to depression needs to lead a more disciplined lifestyle than someone who is on an even keel most of the time. I have to get up and go to bed at reasonable hours, limit TV and movies, not over-eat, and exercise daily (this works especially well for me). Managing depression is very simple. When I start to feel the depression coming on, I cut out all stimulation and live like a monk for a few days. Bingo, depression's gone.
But, you know, sometimes I just live with it. When our mom died, Ben and I went through some deep depression -- for me it lasted almost two years. Neither of us medicated, we just lived with it. Pain and discomfort are a natural part of life, but a lot of Americans have acquired this bizarre notion that it's abnormal to feel unhappy or anguished or just "blah," even for extended periods of time. Life is a series of peaks and troughs, but too many people just want to experience the peaks. If we don't get a grip on this, it's going to be our downfall.
A person who has shut down to the point where all they can bring themselves to do is sleep or stare at the wall is not over-stimulated because they don't talk, they don't eat, they don't do ANYTHING because they don't have the energy and don't see the point besides.
Yes, they are over-stimulated. This is exactly what Ben and I are talking about. I don't know what caused this depression, but barring some kind of trauma, it is extremely likely that this person simply exhausted his/her ability to experience pleasure. Human beings have a finite capacity to experience pleasure, and when that capacity has been exhausted, the person is incapable of enjoying anything. They shut down, exactly as you described. Depression is the organism readjusting itself and building up its capacity to be stimulated again. It's like saving up money in a bank account and spending it: you build up your pleasure reserves through work and modest lifestyle or some other kind of uncomfortable thing, and then you spend a bit of the reserve by doing something pleasurable. For a well-balanced person, the earning and spending cycles aren't very pronounced. But for people experiencing depression, it means they've emptied the bank account and have to earn back the reserves before they can feel good again.
This is why anti-depressants are counterproductive: they interfere with the body's natural tendency to adjust itself through depression, and instead allow a person to persist in doing whatever it was that overstimulated him in the first place. Anti-depressants are emotional credit cards where all you're doing is borrowing against your future capacity to feel good. But eventually you have to pay up. If this borrowing continues, then either you reach the point that no amount of medication will work or you precipitously go off the medication and experience a sudden emotional bankruptcy.
As for the historical aspects of madness, I'll refer you back to the case I cited in Germany, which clearly indicates that the majority of mental illnesses are functional disorders.
Sarah, if you have a process that works for you, fine. But I think you should be very careful about spouting off that it is THE solution for everyone. It ends up sounding a bit like Tom Cruise and Scientology.
I also think you are confused. You mention genetic characteristics and then wander off into activities. Say that depressed people were all adrenaline junkies - even the 'lifestyle' of risk taking would be more of a symptom then a cause. The underlying neurochemical imbalance is the cause. Now, there may well be many different ways of mitigating that, including drugs. Someone who proclaims that ONLY drugs work - well, I would say that person is as misguided as you seem to be, even if meant with the best of intentions.
ADD, ADHD, Hyperactivity, MBD (minimal brain damage/dysfunction), all these are terms for the same problem.
Dr. Daniel Amen has characterized 6 differing forms which have different treatments. What works for one will not work for another.
Most treatment options involve diet, activity and drugs. What has not proven effective is talk therapy. New coping behaviors can be learned and used, but these are band-aids, not fixes. At present there are no fixes.
Hyperactivity is just the most obvious form of "stimming". My chattiness is my current form. When I was in grade school (and undiagnosed) I couldn't stay in my chair. I was classically hyperactive when I was kid. One teacher used a playground rope to tie me in (try that today and see how fast you find yourself in court).
Speaking of being a kid, you don't grow out of it. You may find coping behaviors (which themselves may be as bad as the behavior or benign), but I was formally diagnosed at age 45.
It doesn't fix a thing to be diagnosed in terms of the presenting problem, but how you feel about it (and yourself) does. It frustrates the !@#@#% out of me that I cannot operate at a far higher level than I do, but ADD is a road block and I have to operate in a different manner and take back roads to get places others take the freeway for.
Attention difficulties, hyperactivity and the like are all part of the same problem. They look different, because people are different and have learned (the hard way) different ways of dealing with it.
I, mostly, deal with my chattiness by staying away from people at work - I have no off switch, so I don't turn it on in the first place. This solution is crude but workable most of the time. For people I work with every day, I give them permission to shut me down when I go into chat mode. I tell them of my difficulty and that I will not be offended (or at least, not for long) when they invite me to move along.
All of this said, dragging myself back to the topic. As I often say to my also ADD son:
"Your boredom is no excuse for bad behavior."
Replace boredom with whatever you please. We have slid into a society which prides itself on not being responsible.
Everyone is responsible and must accept the consequences of their choices.
For those unable or unwilling to accept responsibility, and where that endagers the individual or those around him, we have various institutions.
Sarah, if you have a process that works for you, fine. But I think you should be very careful about spouting off that it is THE solution for everyone. It ends up sounding a bit like Tom Cruise and Scientology.
I wonder if you know why Tom Cruise is opposed to psychiatry. Well, unlike Scientologists, I don't believe psychiatrists are involved in conspiracies to start wars and take over the world. I don't have anything against psychiatry in principle. But I do have something against the current state of psychiatric practice, because, unlike the natural sciences, it is at a point in its development where it does not yet hold a coherent body of laws under which it operates. I don't think you or anyone else here could state one law of human behavior. Psychiatry as it is practiced now is alchemy. Try a bit of this, try a bit of that. Not much of it works, and when it does, few understand why.
Whether you believe in God or just nature, it seems bizarre to me that either would create an organism that is so faulty that nearly half need to be medicated in some way. The majority of these disorders must be functional, meaning that they are caused by something people are doing rather than genetic flaws or trauma. A convenient, all-encompassing way to refer to this is "lifestyle."
My dad's field of research is human behavior, and he has been working with disturbed children and young adults for nearly thirty years, so I am neither confused nor ignorant on the subject, though I admit that I'm probably not explaining myself very well.
To understand my concern about modern psychiatric practice, I'll quote from an undergraduate journal paper I co-authored with my dad:
[Psychologist] Hans Eysenck found that 67% of people who suffer from emotional disorders recover spontaneously while only 64% recover with psychotherapy and only 44% recover through psychoanalysis. In other words, the best efforts in [the social and behavioral] fields result in either no or negative results. These findings are confirmed in a morbid way by the fact that psychiatrists commit suicide four times as often as the general public. It is truly a case of "physician heal thyself" first.
That this is tolerable -- that people still believe psychiatrists know what they're doing in light of these statistics -- is unbelievable to me. If engineers designed bridges and buildings that collapsed more often than they stayed up, wouldn't you question their understanding of physics?
The principles underlying what I have been trying to explain are described by D. G. Garan in his books, including The Key to the Sciences of Man. An abridged version of this from my paper:
1. Start with the principle of homeostasis, the concept that all living things maintain a constant internal environment in which "all the vital mechanisms, varied as they are, have only one object: that of preserving constant the conditions of life... " (Claude Bernard). The human organism must simultaneously maintain unnumerable physical and chemical balances within fairly narrow biological limits.
2. Every experience results in changes to the body. For instance, when you look at something, light causes chemical changes in the rods and cones that make up the retina [n.b. -- this is an example of "stimulation"]. These chemical changes are transformed into electrical impulses that travel to the brain. This sort of thing happens every time a human experiences anything, even a thought or blinking an eye. There is no confusion or controversy to this point.
3. Things get more interesting when [Garan] derives his third principle in a syllogistic manner from the first two: if an organism must stay the same to survive but has to change in order to have experiences, then everything that happens to a human results in an equal but opposite reaction by the human organism. When light hits the retina, the chemicals in the rods and cones that are photosensitive exist in finite amounts that can be exhausted. For example, if you look at something blue the chemicals in the receiving cells are exhausted very quickly for that color, and that cell ceases to be able to perceive that color. That's why the human eye vibrates several times a second; if it didn't, your visual field would go gray. To restore the chemical balance in the cells of the retina, the cells must go through the opposite chemical process. That's why you see after-images. This third principle explains countless phenomenon such as the puzzling calming effects of Ritalin, the relief of chronic depression provided by electro-shock therapy, the reason for hangovers, the so-called side effects of medications, and countless others. [My dad wrote the bit about hyperactivity and Ritalin -- he works with hyperactive boys and has an understanding of the subject.]
4. Every experience has meaning only when compared to previous experience. This is the Sesame Street "things are large or small only in comparison to other things" principle that we all learn early in life. However simple, this principle can result in some elaborate complications and surprising effects. To understand it a little better, imagine holding one hand in a bucket of cold water and the other in a bucket of hot water for a minute, and then placing both hands under a tap running lukewarm water. The hand that was in cold water will register that the tap water is hot while the hand that was in hot water will register that the tap water is cold. The temperature of the water is experienced in two different and contradictory ways because of the previous state of the two hands. This principle of knowing by comparison applies to every experience people have. As Dantes observed at the end of The Count of Monte Cristo, "There is no such thing as happiness or unhappiness, only one state compared to another."
5. Garan's next law of human behavior takes this logic further by stating that an organism can become "exhausted" by any stimulation that is too strong and/or persists too long. Given that human beings must function within some fairly narrow organic limits, over stimulation causes an infinite number of what we can call functional disorders, both physical and emotional. On the flip side, we are invigorated and motivated by positive physical and emotional states. But, the only way these states can be produced in an entity that must remain the same is by prior restriction and deprivation. That's why puritans, as unappealing as their lifestyle is, are the most effective at building mental and physical health.
Now, in light of my statement that I am more prone to depression than the average person, what that means is that I become "exhausted" by stimulation very easily. This is because, like others in my kooky Swedish family, I am extremely sensitive. From the age of 9 months, before I could even walk, my mother would play Beethoven's "Fuer Elise" on her piano and I would weep. If something has the potential to stimulate me that much, then it doesn't take much to produce a depressive state.
It really is this simple. Of course, some disorders are genetic or caused by trauma and require medication and/or some kind of therapy. But the vast majority of people are not genetically deficient or victims of trauma, and would benefit greatly by the application of these principles. Some day, hopefully, psychiatry will reach that point.
By the way, in case it's not well known here, Swedes are notorious for being prone to emotional disorders, ranging from depression and anxiety to uncontrollable rage (berserker-state). Just mentioning that in case anyone is confused by my references to my Swedish heritage.
So is a lot of medicine, since it most often relies on the patient to describe how he feels. Remember, I stated that I'm open-minded to 'alternative' medicines. Obviously not for rational, scientific reasons, but because it 'works', i.e. the patient feels better (and is presumably not objectively worse off).
Whether you believe in God or just nature, it seems bizarre to me that either would create an organism that is so faulty...
Let's leave aside the God proposition. Our biology is slow to adapt to our evolving life. As I understand it many modern alergies may be a reaction to living in a cleaner environment (say in comparison to the last few hundred, let alone few thousand years). If something as simple (ha) as our immune system isn't keeping pace, why should we be that surprised that our pysches don't as well?
Now, if you mean that we, as creatures that evolved in more primitive circumstances have trouble maintaining ourselves (physically as well as psychically) in our rapidly changing world, ok, I'll accept that as "lifestyle". I wouldn't use that word myself, as it connotes different things in the usage I most commonly associate with it.
After I've had dinner and have a measurable blood glucose level again, I'm totally going on a jam-fest of the Greatest Hits of Nature's Hilarious Design Flaws.
Oh, and about berserkers. From a community perspective, having a few of those in your village/tribe/genepool in the midst of a hostile environment is NOT a bad thing. Berserker behavior becomes problematic when it doesn't have an outlet - which has been more and more the case in the last few hundred years. But for a couple of thousand years before it was a different story.
On berserkers- the Vikings had the most famous, but berserk individuals and cults are found all throughout history and across many cultures. The Greek Maenads, Turkish whirling dervishes, Arab Isawiyya, the Malaysians who "ran amok", and others all share a lot of markers with the berserk practices of the Vikings. It seems to be something latent in humanity in general- a sort of voluntary activation of the fight-or-flight response, with training to make it focus on "fight".
Anyway.
Whether you believe in God or just nature, it seems bizarre to me that either would create an organism that is so faulty that nearly half need to be medicated in some way.
"Nearly half" is almost certainly an artifact of over-diagnosis and over-prescription, but a wide variety and degree of mental illnesses, especially in humans, isn't just agreeable with evolution, it's predicted by any logical application.
A key concept in evolutionary theory- the one that explains why the evolutionarily-driven "design" can get so jury-rigged and bizarre- is historical constraints. For the most part, there are very few novel structures- just new extensions and permutations of what was already there. A bat's wings are planned like any vertebrate's hands, only what would have been fingers on a primate have been grossly elongated into the "spines" underlying the structure of a bat's wings. It's an inferior design to a bird's wing in many ways, but it's what was available from the starting point the bat's distant ancestors began from- much easier to evolve a scale into something like a primary flight feather than a hair.
The human brain is not a structure that was specifically designed to suit a civilized primate. It started from the most basic structures of a primitive fish and was slowly built upon, new features added and old ones withering away- or remaining as atavisms, or old parts doing new jobs- over many millions of years... and also went through a period of extremely rapid expansion, when the cranial capacity of hominids ballooned from about 400 cc (A. africanus) to about 1200 (modern humans) over a time period of about three million years. Humans made a lot of physical tradeoffs for this massive explosion of the most biologically expensive tissue in the body; it's why babies must be born so incredibly undeveloped and helpless compared to the babies of other species: if they developed any further, their heads would never fit through the pelvic opening. Even then we're cutting it close, which is why childbirth is so much more dangerous for a human than for a dog. There's a second tradeoff of developmental delay in the form of childhood- the only biological reason a hominid must stay so relatively undeveloped for so long, even compared to much larger animals, is that brain development is so much slower, more complex, and costlier a process than that of muscle and bone: if the skull sutures closed earlier with earlier maturity, along with other growth plates, the brain would have to stay much smaller and less developed. This is why a horse can be physically full-grown at four years but it takes a human child as many as eighteen.
With that period of rapid development, the degree of pressure, and the historical constraints in place, we should ABSOLUTELY expect the brain and the psyche to be as problem-prone if not more so than the rest of our bodies. There are hundreds of genetic diseases, both those that only show from interaction with the environment and those that are present from birth, and thousands of ways to break from injury or disease... and no reason whatsoever this should not apply as much to our minds as to our metabolisms, skeletons, muscles, and nerves.
And, some of them should be like modern chronic diseases of lifestyle, like Type II diabetes, heart disease, and widespread cancers: diseases of the interaction between a biological design meant for the Neolithic with modern civilization... but not all of them by any means.
Check out some of the essays in The Trouble With Testosterone and the sections on depression and psychology in Why Zebras Don't Get Ulcers; neurobiologist Robert Sapolsky has some very interesting stuff on evolution, psychology, and neurobiology.
I wound up eating at the in-laws' tonight and having much less time than I thought, so I'll probably have to do my Celebration of Hilarious Design tomorrow rather than tonight, since it's a big subject. I definitely plan to include the species that has managed to evolve to a point where violent homosexual rape is a major feature of its reproductive strategy. :)
Hmmm... All this talk of homeostatis and normality...
What is an acceptable level of deviation?
I have to deal with my ADD, because of society. There is nothing deadly about my attention deficit (perhaps focus deficit would be a better term, but I digress).
I medicate because I have to get along with people.
In Attention Deficit Disorder, a different perception - Thom Hartmann, offers the idea that ADD folks are actually a normal variation. He likens normal folks to farmers and ADD folks to hunters. The skills needed for these are different. The focus/attention is different. Ask a Hunter/ADDer to watch over a field as a farmer does and he will likely "loose it." A farmer will focus on the seeds and weeds to the point where he doesn't notice the mountain lion which is stalking him. The hunter cannot stand the mere thought of farming, but he will notice the mountain lion and "take care of the problem" before the farmer comes to harm - possibly without the farmer even noticing.
Problem - we don't need many hunters anymore.
Problem - there is higher concentration of ADD folks in the US and Australia. The theory is that it is the impatient, risk taking folks settled the two countries with a genetic pre-disposition towards ADD.
So, people, my medication is your fault, because I have to deal with all of you farmers (normal people).
It makes even less sense than the joke, DJ. Why put the urethra- a thin, compressible tube- so damn close to the prostate, which is a bit of tissue with a strong tendency to inflammation and swelling?
Well, the urethra goes through the prostate, and the two cooperatively interact during use of the playground. So far, so good, as it were. But, given that my PSA is at 4.4 and rising, I do seriously question the wisdom of the overall design. I'll probably have a more unfavorable opinion once I have a diagnosis.
Through, right. Bleh, shouldn't shoot my mouth before lunch, I'm stupid when my blood sugar is low.
Still, moving the problematic tissue a few millimeters away and employing one more tube wouldn't have been a problem for a designer working from scratch.
Yup, and any designer of such things with even a tiny bit of sense would have them wear out at the same rate. Gazillions of guys my age and older can't take a piss because of a swollen prostate and lots of them will die when it turns cancerous, but who ever heard of someone dying of a failed urethra?
Always look on the bright side of life...
If life seems jolly rotten,
There's something you've forgotten!
And that's to laugh and smile and dance and sing,
When you're feeling in the dumps,
Don't be silly chumps,
Just purse your lips and whistle -- that's the thing!
And... always look on the bright side of life...
Come on!
For life is quite absurd,
And death's the final word.
You must always face the curtain with a bow!
Forget about your sin -- give the audience a grin,
Enjoy it -- it's the last chance anyhow!
So always look on the bright side of death!
Just before you draw your terminal breath.
Life's a piece of shit,
When you look at it.
Life's a laugh and death's a joke, it's true,
You'll see it's all a show,
Keep 'em laughing as you go.
Just remember that the last laugh is on you!
And always look on the bright side of life
Always look on the bright side of life
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Pharma companies would be sued nearly out of existence and the use of anti-depressants strictly regulated (some of them may be banned altogether), all to the detriment of those people who'd actually benefit from them.
Now, I'm an expert in medicine (not), but I do think this would be a good turn of events. Doctors over-prescribe this crap. People got on just fine in the old days without anti-depressants and Ritalin. Animals get along just fine. I think the vast majority of psychological problems are caused by lifestyle, and that is where the docs need to look for the fix, not to drugs which allow the unhealthy lifestyle to continue, deepening the condition all the while. Why do you think people go from unhappy to nutso so easily these days?
I think that there is a vast overuse of antidepressants and other mood-altering drugs, surely.
But I also think that bans, strict regulation and attacks on the pharma companies are not the best solution to the problem.
The solution would start with parents being willing and able to do real parenting, and teachers bein will and able to instill some discipline in kids. And many other suggestions already seen on this website.
Seems he had stopped taking his medication. Color me surprised.
He was off his medication but he had trouble when he was on his medication as well...from family members and friends.
Age is also a factor in these cases. People under 25 have a higher rate of violent thoughts and aggression when they take SSRIs then people over 25. Under 17 and the rate goes to 1 out of every 100 people on an SSRI wants to go buy a gun and shoot people. Whether or not they do it is a different story but they still get the urge.
Mental hospitals emptied from the 1950s onward due to these drugs. As more drugs have become available in the last 20 years or so, surprise surprise, school shootings have gone up.
ben is correct. Doctors over prescribe and this is the result.
My aunt is a textbook case in overmedication. Her doctors should be sent to jail. She takes drugs for everything, and then she takes drugs to counter the unwanted effects of the the first batch of drugs.
She lied about symptoms to get some drug nicknamed stupimax, because her daughter was on it for headache treatment and as a side effect it helped her loose weight. I was wondering what was wrong with my aunt the last time I saw her, I thought she was retarded or had had a brain injury or something.
I even had a doctor friend who noticed my seasonal allergy sneezing, said it might be related to asthma (!?) and told me he could write me a prescription for an asthma puffer. What the hell is wrong with doctors. They think their medications are magic pills, when in reality they have a very poor understanding of what the drugs are doing to the organism as a whole. Our drug culture is absolute madness.
My good wife adjusted my diet to balance my lab results and they have gone from pretty bad to right down the center with a just out of norm on one remaining (which we are working on now). The doc was getting ready to write prescriptions after the first set of lab results and was scratching his head after the second.
Now, about anti-depressants. I take one and have for years, not for depression, but for impulse control.
My good wife had already tried and failed to adjust my ADD induced short temper via dietary inputs.
The drug has significantly reduced my A.Q. (A-hole Quotient) AND saved my marriage.
Outright slams in either direction are not a great idea.
Now, if it turns out that the shooter went bonkers because he stopped taking his medication, the situation will be very different.
I think the vast majority of psychological problems are caused by lifestyle
Ben, that just proves you have no first hand experience with depression. No medical professional would tell you that drugs 'fix' depression. To this day I can't tell you how much of my own depression was mitigated by drugs versus therapy. But I can sure as hell tell you that "lifestyle", whatever you meant by that, was not the issue. You come off sounding just a bit like Tom Cruise there.
No, juris, Ben is right. He is speaking in terms of how depression is brought on by over-stimulation, i.e. over-enjoyment of something -- anything -- with the result being that the organism attempts to bring itself back into balance (homeostasis) by inducing negative feelings. It's called the law of relativity of human value reactions -- in other words, you can't have an up without a down. My family (Swedes) are very prone to depression and anxiety, but while our aforementioned aunt medicates herself into oblivion, I have learned to make the necessary adjustments to deal with the depression without any drugs whatsoever -- I accelerate the negative feelings by cutting out all stimulation (TV, music, tasty food, etc.) and do things I don't particularly like (drudgery kind of work), and before long I have restored balance and feel normal again.
There is a classic case in Germany during WWII where several mental patients in a hospital were abandoned by the staff during a siege or something, and ended up escaping. These patients were so far gone that they were considered beyond hope. After the war was over, an attempt was made to locate these patients to put them back into care. To their astonishment, the doctors discovered that a huge percent, something like 90% of them, were functioning normally in society. The terrors and oppression of the war had in effect restored balance for these people, and they became functional. This, more than anything, shows that the vast majority of mental health issues in our society are induced by lifestyle. I can dig up the reference for you if you're interested.
If you want to talk about people who don't understand depression, it's the medical community. Could any of them tell you why Ritalin -- a stimulant -- works to calm hyperactivity? No. Do they know why anti-depressants are correlated with over-the-top violent behavior and suicide? No. The law of relativity of human value reactions explains it very simply, but to the medical community it's all alchemy at this stage, and that's what makes them such a danger.
Ben, that just proves you have no first hand experience with depression.
You might think, but it's not true. I went through a pretty good bought of depression when I was a junior in high school. Sarah probably remembers this. My grandpa would see me coming down the block and turn the other way to avoid me, and I don't blame him.
And what preceded this depression? Something bad happening? A death in the family? A natural tendency to depression?
Nope.
This was late fall of my junior year in high school. The preceding summer I had gotten my first girlfriend. Along with said girlfriend came the intense emotional pleasure. Then for no reason I became an ass-crack and then super depressed. At the time I figured I was down because we were a little destitute at the time and everyone else I went to school with had it pretty good. I still remember walking through the school bleary eyed and feeling sorry for myself one day and the thought "I don't have any money" went though my head as the self-pity ramped further upwards.
About a half second after that I realized how stupid that was and snapped out of the whole thing. The depression reached its peak and then abruptly ended. Only years later did I connect it to the super-high that I had experienced with my new girlfriend, whom I nearly drove away with my stupid behavior and depression reaction.
Fortunately, I drove her away a year later just by being a selfish teenage dickhead.
Sarah probably remembers this.
Yes, I remember this. And it's worth pointing out that: (a) Since birth, Ben has always been extremely good-natured, so this episode was unusual; (b) my grandfather liked everybody, so for him to go out of his way to avoid Ben was also unusual.
Our mother was very prone to depression (which I inherited to a much larger degree than Ben) and she also had a few other medical issues that could have been mitigated through lifestyle -- or just acceptance of the realities of nature, like the fact that we all eventually age and die. We're pretty sure it was the chemical cocktail her doctor had her on that killed her at the age of 54 -- anti-depressants, cholesterol meds, hormone replacement therapy, blood pressure meds. She got a weird form of liver cancer, and it's the liver that processes all this junk. Doctors are great at surgical type stuff, but most of the time when it comes to drugs, they have no clue what they're doing.
Well, I guess the new theory explains some types of depression, but what abut the old post-traumatic depression? SSRIs appear to be effective in many such cases with no serious side-effects.
We know very little of that preposterously complex system that is brain, and that makes trating its dysfunctions very difficult. However, many other processes and organs are still complex but manageable, and appropriate drugs can be manufactured.
And in most cases these drugs do what they are designed for, and produce side effects in a known range.
He is speaking in terms of how depression is brought on by over-stimulation
I wouldn't even accept that as a majority of cases of depression let alone ALL mental illness.
I would agree that there are issues with over-medication, particularly of adolescents, and also with antibiotics - not just psychoactives.
I'm even open-minded toward Eastern medicine and other holistic health ideas.
So, whether you pop a pill, chew a root, hum a mantra or do some 'onerous' task - all of that is in response to a particular neurochemistry. I don't follow the notion of "lifestyle" as cause.
I've been on SSRI's and later, SDSRI's for years. With them on board, I'm me, as far as my personality goes. They keep the RCOB out of my eyes and, like Rob, they suppress my A.Q. Without them, my Viking/Scot heritage comes out pretty unpleasantly and I'm not a lot of fun to be around, unless you enjoy breaking stuff.
I don't get mad, I don't get upset over stuff that isn't really important, and I'm fully functional. Without them, there are a lot of days I wouldn't be getting out of bed.
I relate it to the timeless quote attributed to Mike Tyson- "If it wasn't for the Zoloft, I'd kill all you mf'ers in this room". That's what it does for me. It makes me human, and not a slave to my inner berzerker.
Regards,
Rabbit.
Fortunately, I drove her away a year later just by being a selfish teenage dickhead.
Actually, sounds like you were a pretty typical teenage boy the whole time. To the extent that someone wanted to pump you full of psychoactives, I would agree that they would have been horribly wrong. But adolescent experience is nothing to judge all of life by.
Our mother was very prone to depression (which I inherited to a much larger degree than Ben)
Then what is this business about "lifestyle"?
What I am seeing both in the chronic overprescription of psychotropic medication and here is a profound confusion between being unhappy and being depressed. Unhappiness is a normal psychological state brought about by any number of things, some of them unexpected- like having chronically high expectations and yet still feeling unfulfilled because things aren't just perfect. Unhappiness can suck hard, and it can become depression, but they are not interchangeable concepts.
Mental illness runs in my family. Thankfully, it didn't hit me, but I've had the experience of living with someone in a major depression (as well as other mental states that had nothing to do with "lifestyle"), and believe you me, the problem was not "over-stimulation" or an over-abundance of good feelings leading to some kind of "backlash" of negative ones. A person who has shut down to the point where all they can bring themselves to do is sleep or stare at the wall is not over-stimulated because they don't talk, they don't eat, they don't do ANYTHING because they don't have the energy and don't see the point besides. There's a reason one of the diagnostic characteristics of clinical depression is anhedonia- the complete INABILITY to feel pleasure or much of anything else at all other than an overwhelming sense of hopelessness. Not self-pity- hopelessness. They don't pity themselves because they hate themselves and come to believe that they deserve to.
People in the "old days" did not get along "fine". Although it's more common (and likely vastly more over-diagnosed) now, mental illness traces a very recognizable path throughout history, from depression to OCD to schizophrenia. "Madness" is not a modern concept, and neither is intractable despair- or suicide. Not even animals are all "fine"- any wild animal that is mentally off is quickly killed, but domestic animals- particularly dogs, high in intelligence and social needs- can have a range of mental pathologies... some of which respond to treatment with drugs if all behavioral interventions fail.
There ARE strong behavioral and cognitive components in depression, and it's foolish to ignore them in favor of a quick fix in a pill, but especially as it snowballs, also biological ones. Eliminating all biological treatments would be a step that would probably be fatal for some of those prone to true clinical depression.
Ack. pyschotropics - that was the word I meant.
Well said LabRat.
Ignorance is a wonderful thing.
Ritalin - when it works (didn't for me) stimulates an inactive brain, which is self-stimulating with hyperactivity behaviors.
The ADD brain has areas of inactivity, not hyperactivity. The external hyperactivity (addiction to chatting in my case) is the way the brain makes up for it. Look up "stimming" as it relates to Autism. They are in the same spectrum.
Ritalin in a "normal" is just a stimulant and a powerful one. In an ADD person it calms them, because their brain can stop the behaviors used to self level externally.
ADD folk tend to self medicate if left alone. They also tend to engage in risky behaviors (because it is risky and therefore stimulating).
Ritalin IS over perscribed as is almost every drug. This said, I cannot focus well enough to harness a genius level IQ and that is frustrating!(IQ - 99th percentile, memory - 98th percentile, attention - submedian) I have tried about ten different drug therapies and only the anti-depressant has been a sustained sucess, and that only for impulse control.
I hate being a guinea pig (as my previous comment should have indicated), but some things are (for the time being at least) best adjusted with applicable drugs.
Ah, the coincidences again. I hope y'all will bear with me through another short story, but it's relevant and has a good ending.
A month ago, I threw my back out big time. I slipped my shoes on, stood up, lifted my left foot onto a stool, and bent over to tie my shoelaces (y'all be careful now, hear?), and BANG, it felt as if someone stuck an ice pick into the base of my spine. The pain was intense, such that I could barely function. Every slight move sent my back into spasms. Damn, but I hate getting older.
I already had an appointment scheduled two days later with my doctor for my yearly cholesterol and other routine blood tests, so I just suffered until then. My doctor recommended an injection of steroids, followed by an MRI scan to find out exactly what was wrong, meanwhile using ibuprofen to dull the pain. That translates into layman's terms as, "Golly, but I hope it goes away."
An MRI wouldn't fix anything. Indeed it would be of no value unless surgery was indicated, and surgery is never indicated in such cases unless and until some months have gone by without the problem going away on its own. So, I declined the recommendation, but I picked up a souvenir case of the flu on my way out.
Next day, I went to a local chiropractor, a brand-new graduate just six months into practice. I walked in, explained the problem, and we got busy. His X-rays showed my L2 and L3 vertebrae were rotated roughly five to ten degrees about a vertical axis. After four treatments (pushing, pulling, stretching, and the like) over six days (I was really tightened up), my back suddenly straightened up and the pain vanished. I am still pain free. And, turns out he's a deer, coyote, and hog hunter, same as I am, so I have a new friend.
The point is that doctors see problems in terms of the tools they have to work with, but different doctors have different tools. Every tool is good for something, and so the trick is to find the doctor who uses the proper tools for the presenting problem. In my case, the chiropractor had the right tools.
Sometimes, though, drugs are the right tool. I would have been dead two decades ago if it weren't for man-made insulin. Had I taken statins for my cholesterol, I wouldn't have needed bypass surgery. Now, I take them to prevent a recurrence, and my total cholesterol is 118. It's expensive, but it works.
My wife is a retired clinical psychologist who saw lots of depressed clients. A psychologist's tool kit does not include drugs, indeed they are not licensed to prescribe drugs. They do, however, understand the pharmacopeia, and often have to deal with the problems that drugs cause in addition to the problems the drugs are prescribed to treat. Their toolkit is listening, talking, and training to help a client uncover a root cause of a problem. Sometimes it works.
So, I sing the praises of the modern pharmaceutical industry, but I don't for a moment think that its products are the solutions to all problems.
Well, I guess the new theory explains some types of depression, but what abut the old post-traumatic depression?
that's the difference between chronic and acute disorders. The docs seem to have a handle on the acute stuff, but the chronic problems, well if the docs knew what they were doing, the problems wouldn't be chronic, now would they?
So ben, would you mind elaborating on what you meant by lifestyle - I'm still curious.
Rob,
ADD is different from hyperactivity, no? I don't know anything about ADD. But doctors prescribe Ritalin for hyperactivity, and I wonder if they understand why a stimulant works to calm hyperactive people. Also, do doctors understand why shock therapy works?
And, if psychiatrists understand human behavior so well, why do they commit suicide at 4x the rate of the rest of the population?
juris,
"Our mother was very prone to depression (which I inherited to a much larger degree than Ben)"
Then what is this business about "lifestyle"?
I am also much more prone to being fat than some people, but that doesn't mean that lifestyle doesn't play a part: eating too much and not exercising does have something to do with my being overweight. It means I have to work harder at managing diet and exercise than someone who has a fast metabolism.
Likewise, someone who is prone to depression needs to lead a more disciplined lifestyle than someone who is on an even keel most of the time. I have to get up and go to bed at reasonable hours, limit TV and movies, not over-eat, and exercise daily (this works especially well for me). Managing depression is very simple. When I start to feel the depression coming on, I cut out all stimulation and live like a monk for a few days. Bingo, depression's gone.
But, you know, sometimes I just live with it. When our mom died, Ben and I went through some deep depression -- for me it lasted almost two years. Neither of us medicated, we just lived with it. Pain and discomfort are a natural part of life, but a lot of Americans have acquired this bizarre notion that it's abnormal to feel unhappy or anguished or just "blah," even for extended periods of time. Life is a series of peaks and troughs, but too many people just want to experience the peaks. If we don't get a grip on this, it's going to be our downfall.
LabRat,
A person who has shut down to the point where all they can bring themselves to do is sleep or stare at the wall is not over-stimulated because they don't talk, they don't eat, they don't do ANYTHING because they don't have the energy and don't see the point besides.
Yes, they are over-stimulated. This is exactly what Ben and I are talking about. I don't know what caused this depression, but barring some kind of trauma, it is extremely likely that this person simply exhausted his/her ability to experience pleasure. Human beings have a finite capacity to experience pleasure, and when that capacity has been exhausted, the person is incapable of enjoying anything. They shut down, exactly as you described. Depression is the organism readjusting itself and building up its capacity to be stimulated again. It's like saving up money in a bank account and spending it: you build up your pleasure reserves through work and modest lifestyle or some other kind of uncomfortable thing, and then you spend a bit of the reserve by doing something pleasurable. For a well-balanced person, the earning and spending cycles aren't very pronounced. But for people experiencing depression, it means they've emptied the bank account and have to earn back the reserves before they can feel good again.
This is why anti-depressants are counterproductive: they interfere with the body's natural tendency to adjust itself through depression, and instead allow a person to persist in doing whatever it was that overstimulated him in the first place. Anti-depressants are emotional credit cards where all you're doing is borrowing against your future capacity to feel good. But eventually you have to pay up. If this borrowing continues, then either you reach the point that no amount of medication will work or you precipitously go off the medication and experience a sudden emotional bankruptcy.
As for the historical aspects of madness, I'll refer you back to the case I cited in Germany, which clearly indicates that the majority of mental illnesses are functional disorders.
Sarah, if you have a process that works for you, fine. But I think you should be very careful about spouting off that it is THE solution for everyone. It ends up sounding a bit like Tom Cruise and Scientology.
I also think you are confused. You mention genetic characteristics and then wander off into activities. Say that depressed people were all adrenaline junkies - even the 'lifestyle' of risk taking would be more of a symptom then a cause. The underlying neurochemical imbalance is the cause. Now, there may well be many different ways of mitigating that, including drugs. Someone who proclaims that ONLY drugs work - well, I would say that person is as misguided as you seem to be, even if meant with the best of intentions.
Sarah,
ADD, ADHD, Hyperactivity, MBD (minimal brain damage/dysfunction), all these are terms for the same problem.
Dr. Daniel Amen has characterized 6 differing forms which have different treatments. What works for one will not work for another.
Most treatment options involve diet, activity and drugs. What has not proven effective is talk therapy. New coping behaviors can be learned and used, but these are band-aids, not fixes. At present there are no fixes.
Hyperactivity is just the most obvious form of "stimming". My chattiness is my current form. When I was in grade school (and undiagnosed) I couldn't stay in my chair. I was classically hyperactive when I was kid. One teacher used a playground rope to tie me in (try that today and see how fast you find yourself in court).
Speaking of being a kid, you don't grow out of it. You may find coping behaviors (which themselves may be as bad as the behavior or benign), but I was formally diagnosed at age 45.
It doesn't fix a thing to be diagnosed in terms of the presenting problem, but how you feel about it (and yourself) does. It frustrates the !@#@#% out of me that I cannot operate at a far higher level than I do, but ADD is a road block and I have to operate in a different manner and take back roads to get places others take the freeway for.
Attention difficulties, hyperactivity and the like are all part of the same problem. They look different, because people are different and have learned (the hard way) different ways of dealing with it.
I, mostly, deal with my chattiness by staying away from people at work - I have no off switch, so I don't turn it on in the first place. This solution is crude but workable most of the time. For people I work with every day, I give them permission to shut me down when I go into chat mode. I tell them of my difficulty and that I will not be offended (or at least, not for long) when they invite me to move along.
All of this said, dragging myself back to the topic. As I often say to my also ADD son:
"Your boredom is no excuse for bad behavior."
Replace boredom with whatever you please. We have slid into a society which prides itself on not being responsible.
Everyone is responsible and must accept the consequences of their choices.
For those unable or unwilling to accept responsibility, and where that endagers the individual or those around him, we have various institutions.
Sarah, if you have a process that works for you, fine. But I think you should be very careful about spouting off that it is THE solution for everyone. It ends up sounding a bit like Tom Cruise and Scientology.
I wonder if you know why Tom Cruise is opposed to psychiatry. Well, unlike Scientologists, I don't believe psychiatrists are involved in conspiracies to start wars and take over the world. I don't have anything against psychiatry in principle. But I do have something against the current state of psychiatric practice, because, unlike the natural sciences, it is at a point in its development where it does not yet hold a coherent body of laws under which it operates. I don't think you or anyone else here could state one law of human behavior. Psychiatry as it is practiced now is alchemy. Try a bit of this, try a bit of that. Not much of it works, and when it does, few understand why.
Whether you believe in God or just nature, it seems bizarre to me that either would create an organism that is so faulty that nearly half need to be medicated in some way. The majority of these disorders must be functional, meaning that they are caused by something people are doing rather than genetic flaws or trauma. A convenient, all-encompassing way to refer to this is "lifestyle."
My dad's field of research is human behavior, and he has been working with disturbed children and young adults for nearly thirty years, so I am neither confused nor ignorant on the subject, though I admit that I'm probably not explaining myself very well.
To understand my concern about modern psychiatric practice, I'll quote from an undergraduate journal paper I co-authored with my dad:
[Psychologist] Hans Eysenck found that 67% of people who suffer from emotional disorders recover spontaneously while only 64% recover with psychotherapy and only 44% recover through psychoanalysis. In other words, the best efforts in [the social and behavioral] fields result in either no or negative results. These findings are confirmed in a morbid way by the fact that psychiatrists commit suicide four times as often as the general public. It is truly a case of "physician heal thyself" first.
That this is tolerable -- that people still believe psychiatrists know what they're doing in light of these statistics -- is unbelievable to me. If engineers designed bridges and buildings that collapsed more often than they stayed up, wouldn't you question their understanding of physics?
The principles underlying what I have been trying to explain are described by D. G. Garan in his books, including The Key to the Sciences of Man. An abridged version of this from my paper:
1. Start with the principle of homeostasis, the concept that all living things maintain a constant internal environment in which "all the vital mechanisms, varied as they are, have only one object: that of preserving constant the conditions of life... " (Claude Bernard). The human organism must simultaneously maintain unnumerable physical and chemical balances within fairly narrow biological limits.
2. Every experience results in changes to the body. For instance, when you look at something, light causes chemical changes in the rods and cones that make up the retina [n.b. -- this is an example of "stimulation"]. These chemical changes are transformed into electrical impulses that travel to the brain. This sort of thing happens every time a human experiences anything, even a thought or blinking an eye. There is no confusion or controversy to this point.
3. Things get more interesting when [Garan] derives his third principle in a syllogistic manner from the first two: if an organism must stay the same to survive but has to change in order to have experiences, then everything that happens to a human results in an equal but opposite reaction by the human organism. When light hits the retina, the chemicals in the rods and cones that are photosensitive exist in finite amounts that can be exhausted. For example, if you look at something blue the chemicals in the receiving cells are exhausted very quickly for that color, and that cell ceases to be able to perceive that color. That's why the human eye vibrates several times a second; if it didn't, your visual field would go gray. To restore the chemical balance in the cells of the retina, the cells must go through the opposite chemical process. That's why you see after-images. This third principle explains countless phenomenon such as the puzzling calming effects of Ritalin, the relief of chronic depression provided by electro-shock therapy, the reason for hangovers, the so-called side effects of medications, and countless others. [My dad wrote the bit about hyperactivity and Ritalin -- he works with hyperactive boys and has an understanding of the subject.]
4. Every experience has meaning only when compared to previous experience. This is the Sesame Street "things are large or small only in comparison to other things" principle that we all learn early in life. However simple, this principle can result in some elaborate complications and surprising effects. To understand it a little better, imagine holding one hand in a bucket of cold water and the other in a bucket of hot water for a minute, and then placing both hands under a tap running lukewarm water. The hand that was in cold water will register that the tap water is hot while the hand that was in hot water will register that the tap water is cold. The temperature of the water is experienced in two different and contradictory ways because of the previous state of the two hands. This principle of knowing by comparison applies to every experience people have. As Dantes observed at the end of The Count of Monte Cristo, "There is no such thing as happiness or unhappiness, only one state compared to another."
5. Garan's next law of human behavior takes this logic further by stating that an organism can become "exhausted" by any stimulation that is too strong and/or persists too long. Given that human beings must function within some fairly narrow organic limits, over stimulation causes an infinite number of what we can call functional disorders, both physical and emotional. On the flip side, we are invigorated and motivated by positive physical and emotional states. But, the only way these states can be produced in an entity that must remain the same is by prior restriction and deprivation. That's why puritans, as unappealing as their lifestyle is, are the most effective at building mental and physical health.
Now, in light of my statement that I am more prone to depression than the average person, what that means is that I become "exhausted" by stimulation very easily. This is because, like others in my kooky Swedish family, I am extremely sensitive. From the age of 9 months, before I could even walk, my mother would play Beethoven's "Fuer Elise" on her piano and I would weep. If something has the potential to stimulate me that much, then it doesn't take much to produce a depressive state.
It really is this simple. Of course, some disorders are genetic or caused by trauma and require medication and/or some kind of therapy. But the vast majority of people are not genetically deficient or victims of trauma, and would benefit greatly by the application of these principles. Some day, hopefully, psychiatry will reach that point.
By the way, in case it's not well known here, Swedes are notorious for being prone to emotional disorders, ranging from depression and anxiety to uncontrollable rage (berserker-state). Just mentioning that in case anyone is confused by my references to my Swedish heritage.
Psychiatry as it is practiced now is alchemy.
So is a lot of medicine, since it most often relies on the patient to describe how he feels. Remember, I stated that I'm open-minded to 'alternative' medicines. Obviously not for rational, scientific reasons, but because it 'works', i.e. the patient feels better (and is presumably not objectively worse off).
Whether you believe in God or just nature, it seems bizarre to me that either would create an organism that is so faulty...
Let's leave aside the God proposition. Our biology is slow to adapt to our evolving life. As I understand it many modern alergies may be a reaction to living in a cleaner environment (say in comparison to the last few hundred, let alone few thousand years). If something as simple (ha) as our immune system isn't keeping pace, why should we be that surprised that our pysches don't as well?
Now, if you mean that we, as creatures that evolved in more primitive circumstances have trouble maintaining ourselves (physically as well as psychically) in our rapidly changing world, ok, I'll accept that as "lifestyle". I wouldn't use that word myself, as it connotes different things in the usage I most commonly associate with it.
After I've had dinner and have a measurable blood glucose level again, I'm totally going on a jam-fest of the Greatest Hits of Nature's Hilarious Design Flaws.
Oooh! Definitely drop us a link!
Oh, and about berserkers. From a community perspective, having a few of those in your village/tribe/genepool in the midst of a hostile environment is NOT a bad thing. Berserker behavior becomes problematic when it doesn't have an outlet - which has been more and more the case in the last few hundred years. But for a couple of thousand years before it was a different story.
On berserkers- the Vikings had the most famous, but berserk individuals and cults are found all throughout history and across many cultures. The Greek Maenads, Turkish whirling dervishes, Arab Isawiyya, the Malaysians who "ran amok", and others all share a lot of markers with the berserk practices of the Vikings. It seems to be something latent in humanity in general- a sort of voluntary activation of the fight-or-flight response, with training to make it focus on "fight".
Anyway.
Whether you believe in God or just nature, it seems bizarre to me that either would create an organism that is so faulty that nearly half need to be medicated in some way.
"Nearly half" is almost certainly an artifact of over-diagnosis and over-prescription, but a wide variety and degree of mental illnesses, especially in humans, isn't just agreeable with evolution, it's predicted by any logical application.
A key concept in evolutionary theory- the one that explains why the evolutionarily-driven "design" can get so jury-rigged and bizarre- is historical constraints. For the most part, there are very few novel structures- just new extensions and permutations of what was already there. A bat's wings are planned like any vertebrate's hands, only what would have been fingers on a primate have been grossly elongated into the "spines" underlying the structure of a bat's wings. It's an inferior design to a bird's wing in many ways, but it's what was available from the starting point the bat's distant ancestors began from- much easier to evolve a scale into something like a primary flight feather than a hair.
The human brain is not a structure that was specifically designed to suit a civilized primate. It started from the most basic structures of a primitive fish and was slowly built upon, new features added and old ones withering away- or remaining as atavisms, or old parts doing new jobs- over many millions of years... and also went through a period of extremely rapid expansion, when the cranial capacity of hominids ballooned from about 400 cc (A. africanus) to about 1200 (modern humans) over a time period of about three million years. Humans made a lot of physical tradeoffs for this massive explosion of the most biologically expensive tissue in the body; it's why babies must be born so incredibly undeveloped and helpless compared to the babies of other species: if they developed any further, their heads would never fit through the pelvic opening. Even then we're cutting it close, which is why childbirth is so much more dangerous for a human than for a dog. There's a second tradeoff of developmental delay in the form of childhood- the only biological reason a hominid must stay so relatively undeveloped for so long, even compared to much larger animals, is that brain development is so much slower, more complex, and costlier a process than that of muscle and bone: if the skull sutures closed earlier with earlier maturity, along with other growth plates, the brain would have to stay much smaller and less developed. This is why a horse can be physically full-grown at four years but it takes a human child as many as eighteen.
With that period of rapid development, the degree of pressure, and the historical constraints in place, we should ABSOLUTELY expect the brain and the psyche to be as problem-prone if not more so than the rest of our bodies. There are hundreds of genetic diseases, both those that only show from interaction with the environment and those that are present from birth, and thousands of ways to break from injury or disease... and no reason whatsoever this should not apply as much to our minds as to our metabolisms, skeletons, muscles, and nerves.
And, some of them should be like modern chronic diseases of lifestyle, like Type II diabetes, heart disease, and widespread cancers: diseases of the interaction between a biological design meant for the Neolithic with modern civilization... but not all of them by any means.
Check out some of the essays in The Trouble With Testosterone and the sections on depression and psychology in Why Zebras Don't Get Ulcers; neurobiologist Robert Sapolsky has some very interesting stuff on evolution, psychology, and neurobiology.
I wound up eating at the in-laws' tonight and having much less time than I thought, so I'll probably have to do my Celebration of Hilarious Design tomorrow rather than tonight, since it's a big subject. I definitely plan to include the species that has managed to evolve to a point where violent homosexual rape is a major feature of its reproductive strategy. :)
Hmmm... All this talk of homeostatis and normality...
What is an acceptable level of deviation?
I have to deal with my ADD, because of society. There is nothing deadly about my attention deficit (perhaps focus deficit would be a better term, but I digress).
I medicate because I have to get along with people.
In Attention Deficit Disorder, a different perception - Thom Hartmann, offers the idea that ADD folks are actually a normal variation. He likens normal folks to farmers and ADD folks to hunters. The skills needed for these are different. The focus/attention is different. Ask a Hunter/ADDer to watch over a field as a farmer does and he will likely "loose it." A farmer will focus on the seeds and weeds to the point where he doesn't notice the mountain lion which is stalking him. The hunter cannot stand the mere thought of farming, but he will notice the mountain lion and "take care of the problem" before the farmer comes to harm - possibly without the farmer even noticing.
Problem - we don't need many hunters anymore.
Problem - there is higher concentration of ADD folks in the US and Australia. The theory is that it is the impatient, risk taking folks settled the two countries with a genetic pre-disposition towards ADD.
So, people, my medication is your fault, because I have to deal with all of you farmers (normal people).
B-)
snicker..
Hey Kevin- odd "design".
I wouldn't read it at work. My inner thirteen-year-old took over while I was choosing examples.
I've wondered: why would an intelligent designer put a sewage treatment plant right in the middle of a playground?
It makes even less sense than the joke, DJ. Why put the urethra- a thin, compressible tube- so damn close to the prostate, which is a bit of tissue with a strong tendency to inflammation and swelling?
Well, the urethra goes through the prostate, and the two cooperatively interact during use of the playground. So far, so good, as it were. But, given that my PSA is at 4.4 and rising, I do seriously question the wisdom of the overall design. I'll probably have a more unfavorable opinion once I have a diagnosis.
Through, right. Bleh, shouldn't shoot my mouth before lunch, I'm stupid when my blood sugar is low.
Still, moving the problematic tissue a few millimeters away and employing one more tube wouldn't have been a problem for a designer working from scratch.
Yup, and any designer of such things with even a tiny bit of sense would have them wear out at the same rate. Gazillions of guys my age and older can't take a piss because of a swollen prostate and lots of them will die when it turns cancerous, but who ever heard of someone dying of a failed urethra?
why would an intelligent designer put a sewage treatment plant right in the middle of a playground?
Now, language like that and you'll prove me right about why the word "lifestyle" was used in the first place! ;-)
Sooner or later someone is going to break out in a chorus of "Every Sperm is Sacred".
...always look on the bright side of life!
Always look on the bright side of life...
If life seems jolly rotten,
There's something you've forgotten!
And that's to laugh and smile and dance and sing,
When you're feeling in the dumps,
Don't be silly chumps,
Just purse your lips and whistle -- that's the thing!
And... always look on the bright side of life...
Come on!
For life is quite absurd,
And death's the final word.
You must always face the curtain with a bow!
Forget about your sin -- give the audience a grin,
Enjoy it -- it's the last chance anyhow!
So always look on the bright side of death!
Just before you draw your terminal breath.
Life's a piece of shit,
When you look at it.
Life's a laugh and death's a joke, it's true,
You'll see it's all a show,
Keep 'em laughing as you go.
Just remember that the last laugh is on you!
And always look on the bright side of life
Always look on the bright side of life
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