6 ms·

For those suffering from depression, anxiety, stress please consider meeting with a psychiatrist and psychologist. Some brains are neurologically misconfigured

by weej 6y ago

For those suffering from depression, anxiety, stress please consider meeting with a psychiatrist and psychologist. Some brains are neurologically misconfigured and prone to chemical depletion or lack receptors for it (ex: serotonin or dopamine). All the pushing through and search for answers, triggers, or source of problems won't solve this. Secondly, cognitive behavioral therapy (CBT) can work well for analyzing the 'why' you feel and/or behave the way you do. It provides perspective, insight, and tools for helping cope with problems (control/mitigate or potentially eliminate). Both of these are tools that can dramatically improve your life. I've been there and still am. Seek the support you deserve. Tomorrow will bring a better future.

stronglikedan 6y ago
IME, it's best to start with the psychologist. They can determine whether talk therapy will be enough to correct the chemical imbalance without drugs. If necessary, they can refer you to the psychiatrist, who can give you the medication, but doesn't want to talk.
- tachyonbeam 6y ago
  They can also work in tandem. You might be more receptive to therapy and analyzing your feelings when you don't feel like the world is ending. IMO, there's a threshold where antidepressants are necessary. When I lose interest in everything I care about, I don't feel like cooking, everything seems boring, and I have no energy (anhedonia), that's my threshold.
deleted 6y ago
[deleted]
smacktoward 6y ago
This. I had great results from working with a cognitive-behavioral psychologist. She helped me see patterns in my life that I had never even suspected were there before. I'm skeptical that I could have gotten the same results by reading a couple books on CBT on my own. The exercises were valuable, but so was the outside perspective, and I don't think either would have worked as well without the other.
slothtrop 6y ago
> Some brains are neurologically misconfigured This is almost always symptomatic. There's a fair amount of research on dopamine depletion. Addiction, including but not limited to drug use (e.g. high-fat-high-sugar food, pornography) can show deceases in receptors. Vitamin D3 deficiency can pose a problem. Sedentary behavior. etc. I'd recommend CBT principles to anyone, research shows they're as effective as prozac. The point is many changes can be implemented before resigning to perpetual medication.
- zxexz 6y ago
  I'd be cautious of the claim that CBT is 'as effective as Prozac', or another chemical solution, in general. A cursory glance at the Wikipedia Criticisms section for CBT points out at least several concerns with the existing research[0]. Anecdotally, a family member of mine went through a complete round of CBT, for a mental health disorder, and they said that it seemed mostly just like standard therapy, and perhaps increases mindfulness a bit, but definitely felt it could not hold a candle to standard treatment. I should point out that they followed the protocol quite rigidly, and embraced the therapy with an open mind. No doubt CBT has varying effectiveness between individuals. Somewhat tangentially, I find this[1] article cited in the Wikipedia page[0] to be an interesting read; a meta-analysis of ~70 studies, showing a seeming decrease in effectiveness of CBT over 30 years. [0] https://en.wikipedia.org/wiki/Cognitive_behavioral_therapy#Criticisms https://en.wikipedia.org/wiki/Cognitive_behavioral_therapy#C... [1] https://www.semanticscholar.org/paper/The-effects-of-cognitive-behavioral-therapy-as-an-A-Johnsen-Friborg/ba5fa04b5f4556cc6ccdc3e4004fe0ec28f6a188 https://www.semanticscholar.org/paper/The-effects-of-cogniti...
  - slothtrop 6y ago
    A single study is listed as being challenged. Have others: From 2010 - "In this 36-week study, partial and nonresponders to placebo, and responders and partial responders to Prozac, CBT, and combination treatments in the 12-week trial were openly treated (TADS Team, 2007). As in Phase 1, Prozac and combination groups received additional encouragement and contact (medication management). Despite this, all treatment conditions converged by 30 weeks and remained so by Week 36, with significantly more suicidal ideation in the Prozac-alone group. The percentage of suicidal events for those on Prozac, whether in combined or alone groups, was nearly 12%, double the 6% in the CBT group. Despite the convergence of efficacy and continued risks, TADS is often cited as evidence that combining psychotherapy and medication produce superior results (e.g., NIMH, n.d.)." -- https://www.researchgate.net/profile/Dickson_Adom/post/What_are_the_overall_benefits_of_psychotropic_drugs/attachment/5abc04c44cde26965866175a/AS%3A609264682942464%401522271428237/download/CohenPsychiatricDrugsCommonFactorsRiskandBenefits.pdf https://www.researchgate.net/profile/Dickson_Adom/post/What_... "Collectively, the findings detailed inA.C. Butler et al. / Clinical Psychology Review 26 (2006) 17–3127 this review suggest that CT is highly effective for adult unipolar depression, adolescent unipolar depression,generalized anxiety disorder, panic disorder with or without agoraphobia, social phobia, PTSD, and childhooddepressive and anxiety disorders. The comparison-weighted grand mean effect size for these disorders when compared to no-treatment, wait list, or placebo controls is 0.95 (SD=0.08). CBT is associated with large improvements in symptoms for bulimia nervosa, and the associated effect sizes (M=1.27, SD=0.11) are significantly larger than those that have been found for pharmacotherapy. CBT also has shown promising results as adjunct to pharmacotherapy in the treatment of schizophrenia." -- https://www.get.gg/docs/Empirical-Status-of-CBT.pdf https://www.get.gg/docs/Empirical-Status-of-CBT.pdf Prozac yields a risk of side effects, and ceasing use brings a strong risk of relapse. Comparatively CBT offers a lasting solution.
mitjak 6y ago
just to throw my hat in, I've found CBT difficult to put into practice. a vicious cycle formed as I increasingly blamed myself for not working hard enough to help myself and buckled under the pressure of completing exercises. psychodynamic approaches and group therapy had much more palpable impact, as the missing piece I think was seeing and relating to others. not being alone and talking through issues made a world of difference compared to applying what felt like mechanical exercises of CBT.
- Gibbon1 6y ago
  > vicious cycle formed as I increasingly blamed myself for not working hard enough to help Something that took me way too long to understand. Beating yourself up for feeling bad makes it twice as bad. A counter argument is negative emotional stress is motivational. My argument is negative emotional stress is one of the crummier types of motivation.
  - mitjak 6y ago
    > My argument is negative emotional stress is one of the crummier types of motivation i agree. i am jealous of people who find empowerment in struggle this way but insistence on CBT just made me feel more alone. now that I do not feel so hopeless about being able to affect change, i am more able to reach for self-help tools, but i'd argue that it could be dangerous to have it be suggested as the first line of help for someone that's already holed up in self-destructive tools, especially if they lack self awareness.
- Trasmatta 6y ago
  CBT definitely won't work for everyone, but this seems like something a good therapist could help someone work through. Self blaming like that is one of the cognitive distortions that CBT should be able to help root out. I realize that it very likely just wasn't the type of therapy that works for you, just throwing out the alternative perspective for anyone reading this and considering CBT.
  - mitjak 6y ago
rjkennedy98 6y ago
> Some brains are neurologically misconfigured and prone to chemical depletion or lack receptors for it. Bullshit pure bullshit. This has never been shown and its disgusting that its re-iterated by people purported to be well-meaning.
harimau777 6y ago
I've been leery of CBT because it seems like it's too focused on how the patient thinks about their situation and not on actually creating a situation that's worth living. It seems like for many people the issue isn't so much that they are sad or in pain so much as it is that their life lacks any sort of meaning or direction. The problem isn't so much the presence of something bad as it is the lack of something good. In your experience does CBT engage with those sorts of issues?
mnm1 6y ago
> Some brains are neurologically misconfigured and prone to chemical depletion or lack receptors for it (ex: serotonin or dopamine). All the pushing through and search for answers, triggers, or source of problems won't solve this. Do you have proof of any of this or are you just regurgitating the bullshit you've been fed? I've been searching for years and all I can find is that this hypothesis is bullshit without any evidence behind it whatsoever. Even psychiatrists and neurologists know it's bullshit. It doesn't help anyone to pretend like this is true and it can be harmful. Encouraging people to take drugs based on what is essentially a fantasy is likely a huge part of the problem. If I'm wrong, I'd like to see the proof I've been trying to find now for over a decade.
- diehunde 6y ago
  What proof specifically would you like to see?
  - mnm1 6y ago
    Proof that "Some brains are neurologically misconfigured and prone to chemical depletion or lack receptors for it (ex: serotonin or dopamine)" and that this is the cause of depression.
    - diehunde 6y ago
      No I read that, I meant, what type of experiment that proves that statement would you like to see. Because I feel like if I point out some research you would find something weird about them just to dismiss them, so I'm asking beforehand what kind of setup or study would like to see.
      - mnm1 6y ago
        One that demonstrates that serotonin/dopamine is actually the cause of depression and that taking drugs affects those neurotransmitters and relieves depression. If we're going to say to someone that you are depressed because of a chemical imbalance, you must first prove that is actually the cause. Then you must prove that the medicine affects that neurotransmitter and relieves the disease. This hand wavy "chemical imbalance" idea is barely a hypothesis. Prove it. Measure serotonin in a live brain and demonstrate the causation with depression. Demonstrate that the level is truly imbalanced compared to a non depressed person. Show that changing the level relieves depression. Instead, we don't even know how depression drugs work and last I checked, measuring neurotransmitter levels in a live brain was impossible. That would be ok as science doesn't know everything, but then we need to stop with the idiotic "chemical imbalance" lie.
banads 6y ago
>Some brains are neurologically misconfigured and prone to chemical depletion or lack receptors for it (ex: serotonin or dopamine). Readers: please be aware at best the science on this statement is hypothetical, at worst it's a marketing slogan designed to sell someone drugs for the rest of their life.
masonic 6y ago
A problem with the emphasis on CBT over the past couple of decades is that it cannot work for a fair percentage of chronically depressed people because it emphasizes challenging negative thoughts on the assumption that they are untrue. The problem is, what if you have depressing thoughts that are totally rooted in reality? CBT doesn't have a very good answer for that. There are other strategies and models. IPT. Psycho-dynamic. ACT (which does address the gap I refer to above). So, a patient may well have to shop different practitioners, clinics, and models to find one that addresses your needs. After all, the response to a bad haircut is to find a different stylist, not to give up on haircuts forever. Out of pocket costs can get excessive. If price is a major factor, consider university teaching clinics, which can often provide talk therapy (generally with student therapists, and quality/interest can vary a lot) on a sliding scale based on ability to pay. In SV, for example, there is the Gronowski clinic staffed from Palo Alto University).
- metabagel 6y ago
  “ The problem is, what if you have depressing thoughts that are totally rooted in reality?” I thought the point of CBT was to avoid making negative assumptions or falling into thinking traps. For example, “I’m on the street and hungry. I’ll probably be like this for the rest of my life.” This is a thinking trap - thinking that bad situations will last indefinitely. Instead, we can think, “I’m on the street and hungry, but I’m alive, and I can probably turn things around.”

by weej 6y ago

stronglikedan 6y ago

IME, it's best to start with the psychologist. They can determine whether talk therapy will be enough to correct the chemical imbalance without drugs. If necessary, they can refer you to the psychiatrist, who can give you the medication, but doesn't want to talk.

tachyonbeam 6y ago
They can also work in tandem. You might be more receptive to therapy and analyzing your feelings when you don't feel like the world is ending. IMO, there's a threshold where antidepressants are necessary. When I lose interest in everything I care about, I don't feel like cooking, everything seems boring, and I have no energy (anhedonia), that's my threshold.

deleted 6y ago

[deleted]

smacktoward 6y ago

This. I had great results from working with a cognitive-behavioral psychologist. She helped me see patterns in my life that I had never even suspected were there before. I'm skeptical that I could have gotten the same results by reading a couple books on CBT on my own. The exercises were valuable, but so was the outside perspective, and I don't think either would have worked as well without the other.

slothtrop 6y ago

> Some brains are neurologically misconfigured This is almost always symptomatic. There's a fair amount of research on dopamine depletion. Addiction, including but not limited to drug use (e.g. high-fat-high-sugar food, pornography) can show deceases in receptors. Vitamin D3 deficiency can pose a problem. Sedentary behavior. etc. I'd recommend CBT principles to anyone, research shows they're as effective as prozac. The point is many changes can be implemented before resigning to perpetual medication.

zxexz 6y ago
I'd be cautious of the claim that CBT is 'as effective as Prozac', or another chemical solution, in general. A cursory glance at the Wikipedia Criticisms section for CBT points out at least several concerns with the existing research[0]. Anecdotally, a family member of mine went through a complete round of CBT, for a mental health disorder, and they said that it seemed mostly just like standard therapy, and perhaps increases mindfulness a bit, but definitely felt it could not hold a candle to standard treatment. I should point out that they followed the protocol quite rigidly, and embraced the therapy with an open mind. No doubt CBT has varying effectiveness between individuals. Somewhat tangentially, I find this[1] article cited in the Wikipedia page[0] to be an interesting read; a meta-analysis of ~70 studies, showing a seeming decrease in effectiveness of CBT over 30 years. [0] https://en.wikipedia.org/wiki/Cognitive_behavioral_therapy#Criticisms https://en.wikipedia.org/wiki/Cognitive_behavioral_therapy#C... [1] https://www.semanticscholar.org/paper/The-effects-of-cognitive-behavioral-therapy-as-an-A-Johnsen-Friborg/ba5fa04b5f4556cc6ccdc3e4004fe0ec28f6a188 https://www.semanticscholar.org/paper/The-effects-of-cogniti...
- slothtrop 6y ago
  A single study is listed as being challenged. Have others: From 2010 - "In this 36-week study, partial and nonresponders to placebo, and responders and partial responders to Prozac, CBT, and combination treatments in the 12-week trial were openly treated (TADS Team, 2007). As in Phase 1, Prozac and combination groups received additional encouragement and contact (medication management). Despite this, all treatment conditions converged by 30 weeks and remained so by Week 36, with significantly more suicidal ideation in the Prozac-alone group. The percentage of suicidal events for those on Prozac, whether in combined or alone groups, was nearly 12%, double the 6% in the CBT group. Despite the convergence of efficacy and continued risks, TADS is often cited as evidence that combining psychotherapy and medication produce superior results (e.g., NIMH, n.d.)." -- https://www.researchgate.net/profile/Dickson_Adom/post/What_are_the_overall_benefits_of_psychotropic_drugs/attachment/5abc04c44cde26965866175a/AS%3A609264682942464%401522271428237/download/CohenPsychiatricDrugsCommonFactorsRiskandBenefits.pdf https://www.researchgate.net/profile/Dickson_Adom/post/What_... "Collectively, the findings detailed inA.C. Butler et al. / Clinical Psychology Review 26 (2006) 17–3127 this review suggest that CT is highly effective for adult unipolar depression, adolescent unipolar depression,generalized anxiety disorder, panic disorder with or without agoraphobia, social phobia, PTSD, and childhooddepressive and anxiety disorders. The comparison-weighted grand mean effect size for these disorders when compared to no-treatment, wait list, or placebo controls is 0.95 (SD=0.08). CBT is associated with large improvements in symptoms for bulimia nervosa, and the associated effect sizes (M=1.27, SD=0.11) are significantly larger than those that have been found for pharmacotherapy. CBT also has shown promising results as adjunct to pharmacotherapy in the treatment of schizophrenia." -- https://www.get.gg/docs/Empirical-Status-of-CBT.pdf https://www.get.gg/docs/Empirical-Status-of-CBT.pdf Prozac yields a risk of side effects, and ceasing use brings a strong risk of relapse. Comparatively CBT offers a lasting solution.

mitjak 6y ago

just to throw my hat in, I've found CBT difficult to put into practice. a vicious cycle formed as I increasingly blamed myself for not working hard enough to help myself and buckled under the pressure of completing exercises. psychodynamic approaches and group therapy had much more palpable impact, as the missing piece I think was seeing and relating to others. not being alone and talking through issues made a world of difference compared to applying what felt like mechanical exercises of CBT.

Gibbon1 6y ago
> vicious cycle formed as I increasingly blamed myself for not working hard enough to help Something that took me way too long to understand. Beating yourself up for feeling bad makes it twice as bad. A counter argument is negative emotional stress is motivational. My argument is negative emotional stress is one of the crummier types of motivation.
- mitjak 6y ago
  > My argument is negative emotional stress is one of the crummier types of motivation i agree. i am jealous of people who find empowerment in struggle this way but insistence on CBT just made me feel more alone. now that I do not feel so hopeless about being able to affect change, i am more able to reach for self-help tools, but i'd argue that it could be dangerous to have it be suggested as the first line of help for someone that's already holed up in self-destructive tools, especially if they lack self awareness.
Trasmatta 6y ago
CBT definitely won't work for everyone, but this seems like something a good therapist could help someone work through. Self blaming like that is one of the cognitive distortions that CBT should be able to help root out. I realize that it very likely just wasn't the type of therapy that works for you, just throwing out the alternative perspective for anyone reading this and considering CBT.
- mitjak 6y ago

rjkennedy98 6y ago

> Some brains are neurologically misconfigured and prone to chemical depletion or lack receptors for it. Bullshit pure bullshit. This has never been shown and its disgusting that its re-iterated by people purported to be well-meaning.

harimau777 6y ago

I've been leery of CBT because it seems like it's too focused on how the patient thinks about their situation and not on actually creating a situation that's worth living. It seems like for many people the issue isn't so much that they are sad or in pain so much as it is that their life lacks any sort of meaning or direction. The problem isn't so much the presence of something bad as it is the lack of something good. In your experience does CBT engage with those sorts of issues?

mnm1 6y ago

> Some brains are neurologically misconfigured and prone to chemical depletion or lack receptors for it (ex: serotonin or dopamine). All the pushing through and search for answers, triggers, or source of problems won't solve this. Do you have proof of any of this or are you just regurgitating the bullshit you've been fed? I've been searching for years and all I can find is that this hypothesis is bullshit without any evidence behind it whatsoever. Even psychiatrists and neurologists know it's bullshit. It doesn't help anyone to pretend like this is true and it can be harmful. Encouraging people to take drugs based on what is essentially a fantasy is likely a huge part of the problem. If I'm wrong, I'd like to see the proof I've been trying to find now for over a decade.

diehunde 6y ago
What proof specifically would you like to see?
- mnm1 6y ago
  Proof that "Some brains are neurologically misconfigured and prone to chemical depletion or lack receptors for it (ex: serotonin or dopamine)" and that this is the cause of depression.
  - diehunde 6y ago
    No I read that, I meant, what type of experiment that proves that statement would you like to see. Because I feel like if I point out some research you would find something weird about them just to dismiss them, so I'm asking beforehand what kind of setup or study would like to see.
    - mnm1 6y ago
      One that demonstrates that serotonin/dopamine is actually the cause of depression and that taking drugs affects those neurotransmitters and relieves depression. If we're going to say to someone that you are depressed because of a chemical imbalance, you must first prove that is actually the cause. Then you must prove that the medicine affects that neurotransmitter and relieves the disease. This hand wavy "chemical imbalance" idea is barely a hypothesis. Prove it. Measure serotonin in a live brain and demonstrate the causation with depression. Demonstrate that the level is truly imbalanced compared to a non depressed person. Show that changing the level relieves depression. Instead, we don't even know how depression drugs work and last I checked, measuring neurotransmitter levels in a live brain was impossible. That would be ok as science doesn't know everything, but then we need to stop with the idiotic "chemical imbalance" lie.

banads 6y ago

>Some brains are neurologically misconfigured and prone to chemical depletion or lack receptors for it (ex: serotonin or dopamine). Readers: please be aware at best the science on this statement is hypothetical, at worst it's a marketing slogan designed to sell someone drugs for the rest of their life.

masonic 6y ago

A problem with the emphasis on CBT over the past couple of decades is that it cannot work for a fair percentage of chronically depressed people because it emphasizes challenging negative thoughts on the assumption that they are untrue. The problem is, what if you have depressing thoughts that are totally rooted in reality? CBT doesn't have a very good answer for that. There are other strategies and models. IPT. Psycho-dynamic. ACT (which does address the gap I refer to above). So, a patient may well have to shop different practitioners, clinics, and models to find one that addresses your needs. After all, the response to a bad haircut is to find a different stylist, not to give up on haircuts forever. Out of pocket costs can get excessive. If price is a major factor, consider university teaching clinics, which can often provide talk therapy (generally with student therapists, and quality/interest can vary a lot) on a sliding scale based on ability to pay. In SV, for example, there is the Gronowski clinic staffed from Palo Alto University).

metabagel 6y ago
“ The problem is, what if you have depressing thoughts that are totally rooted in reality?” I thought the point of CBT was to avoid making negative assumptions or falling into thinking traps. For example, “I’m on the street and hungry. I’ll probably be like this for the rest of my life.” This is a thinking trap - thinking that bad situations will last indefinitely. Instead, we can think, “I’m on the street and hungry, but I’m alive, and I can probably turn things around.”