A squared = B squared = my head falling off

Herb Says:

Dear Liz,

I don’t mean to be overstaying my welcome. I’m just not able to complete some other research and sharing of information due to server problems on my site so I’ve been hanging around and I just caught you’re newest posting.

I quickly read through the article you suggested and just as quickly I came up with a counter article. I’ve also come to learn when reading these various articles and studies to always look for what I consider the key words such “may” or “in our opinion” etc.

Cerebral Blood Flow Changes: An Explanation for ECT?
http://www.psychweekly.com/aspx/article/ArticleDetail.aspx?articleid=411

So it’s once again back to what you stated previously, “It’s not about being positive or negative — it’s about telling the truth.”

“ECT = decreases blood flow” — Liz Spikol
ECT = increases blood flow — read link above.

I’m only a layperson, so what is “the truth” in this matter.

Have a great week-end.

Warmly,
Herb
VNSdepression.com

Kent Says:

All those Greek letters – do they really mean anything? (I guess to somebody they must.) Apparently, serious physical activity can also reduce depression sometimes. So I’ve been told, anyway, and I think I may have even experienced that effect* occasionally myself. I guess I know more about what causes depression than what cures it.

Poverty can cause depression, I think – isolation, loneliness, not having enough to eat or a place to live. All those things can do the trick as far as causing an otherwise stable person to slide into depression, I believe. Maybe if a small fraction, say maybe about ten percent(?), of all the money spent on bio-chemo-electrical based research into curing depression was spent instead on providing basic housing, food, and other very basic things for the many people who don’t have them today – maybe that much smaller amount of money could actually go further towards preventing the overall prevalance of depression in the general population than all those more high-tech solutions.

‘e’ or ‘a’? – I don’t know – it seems too complicated to even bother worrying about.

Kristin Says:

I guess I’m truly nerdy, because the garbldy-gook math at the beginning makes sense to me! (Calculus I thank thee). I’m glad I never had to try ECT it seems so…the words extreme and barbaric come to mind.

SallyT Says:

Herb,

You really need to get a life.

Without paying to read the entire article you cited, it does state in the abstract (which you so very conveniently omit mention of):

“Results: Cerebral blood flow during ECT increased particularly in the basal ganglia, brain-stem, diencephalon, amygdala, vermis and the frontal, temporal and parietal cortices compared with that before ECT. The flow increased in the thalamus and decreased in the anterior cingulate and medial frontal cortex soon after ECT compared with that before ECT.

Conclusions: These results suggest a relationship between the centrencephalic system and seizure generalisation. Further, they suggest that some neural mechanisms of action of ECT are mediated via brain regions including the anterior cingulate and medial frontal cortex and thalamus.”

Note the last sentence in the “Results” portion states there is decreased blood flow after ECT in some areas. And I don’t have the time right now to research the significance of those areas mentioned. But I know that I, myself, am getting tired of your smarmmy smug allusions that Liz is one-sided.

PS. Please excuse any misspelling on my part. It’s one of the difficulties I have after having been damaged by ECT.

Sally Says:

While I oppose ECT, I think Herb gets one thing right, when any discussion of “mental illness” takes place look at the key words. In SallyT’s post, note the word “suggests.” That’s pretty weak as is the entire proposition that depression is caused by physical conditions unrelated to perception. The original article says lack of blood flow is associated with depression in some people. Confusing association (correlation) and causation is dangerous. Besides, shouldn’t one then look to what causes the lack of blood flow? Who, finding themselves hooked up to a machine that measures in the bloodflow in their brain will have a normally functing brain? How exactly was blood flow measured and on whom to get the results? To quote someone I read on the net, “to blame mental illness on the brain, is like blaming the bat for a homerun.” Liz is great, but to put in this piece “depression=decreased bloodflow” is to mislead and oversimplify in a way that stigmatizes people labeled as depressed by perpetuating the myth that there is some proof that depression is a physical disease.

Jon S. Says:

Sally,

I just want to make sure I’m reading your comment correctly:

Are you suggesting that “proof that depression is a physical disease” is stigmatizing? And if so, could you explain how?

Herb Says:

Dear Sally T,

“You really need to get a life.” — Sally T

Why in this discussion is there a need to exhibit hostility? It seems several others utilize this same phrase and I would guess it is not a greeting or intended sign of friendship or camaraderie. Unlike you I do hope you are having a wonderful life and I harbor no hostility or ill will toward anyone, even those who may disagree with my opinions. And yes, I do have a life and a reasonably good one, thank you!

“But I know that I, myself, am getting tired of your smarmmy smug allusions that Liz is one-sided.” — Sally T

Whether you can rationalize or comprehend, the fact is, I treat most individuals respectfully and as adults. I think Ms. Spikol is more than qualified and mature to defend or take a position on any subject matter although I do feel on certain subjects she may exhibit certain leanings, in her opinions, which I can respect but not necessarily agree with. And as an adult I would presume that you’re capable of also ignoring or bypassing particular authors that which you don’t agree or feel comfortable with.

I didn’t “which you so very conveniently omit mention of” anything. That is the reason I try to almost always site a link so that folks can read for themselves the original document and make their own determination(s). And when you have the time to read through carefully please come back and share your understanding of which areas have increased or decreased blood flow and most importantly the significant and “definitive” effects upon mood state if any.

And as Sally so rightfully states in her posting, we have another of the many keywords which she cited, “suggests.” Many articles and studies contain these keywords and yet I personally find no “definitive” statements or conclusions in order to help me make mental health medical decisions. Which also raises a question in my mind as to Sally’s other statement?

“While I oppose ECT” — Sally

Sally was that an opposition for your own treatment purposes or for forced treatment on others or for those who make an informed and un-coerced medical decision for one self?

Thanks for the thoughts and opinions without any personal affront.

Warmly,
Herb
VNSdepression.com

Sally Says:

Jon, just a quick response, yes, I am suggesting that proof that depression is a physical disease would be stigmatizing if there were any such proof. There’s just not. To tell someone who is stricken with emotional unhappiness that is physically and emotionally paralyzing that the problem is not whatever it is that they “think” is making them unhappy, i.e. homelessness, social isolation, but is instead all in their head which is producing a chemical which makes their thoughts wrong, is demeaning and inaccurate. Sure emotional pain can make you sick and physical problems can cause emotional pain, but the idea that proving that people who are depressed really don’t have anything to be unhappy about but instead have defective brains (a depressing proposition itself) is horribly stigmatizing. Thanks for asking.

Sally Says:

Herb, I think that if someone makes an informed and uncoerced decision to have ECT, they have a right to try the procedure. So, not to stir up trouble, but what how about you? How do you feel about forced treatment? (note to Liz: if this conversation is getting too heavy, how about another basset hound cute fix?) – Sally

Joe Says:

Having offered myself up twice for ECT, I’d like to know what a hug does to regional cerebral blood flow. At both times, I was desperately depressed and a hug, an encouraging word, or situational assistance were simply not on the therapeutic menu. [Ultimately, I was turned down for ECT, "We don't do ECT on persons with OCD with comorbid depression" and "There is nothing in your life to take advantage of the opportunity afforded by ECT."]

But in the big picture, how is it that anything considered supportive for a person without the chronically depressed label is no longer appropriate? Sure you can get more SSRIs, a MAO inhibitor, try an old fashioned tricyclic, get ECT, give TMS or VNS a whack, venture into polypharmacy land, or go to the hospital for “meds, beds and milieu” but as for a hug or an encouraging word, well, that’s no longer considered of value. Are we being viewed and treated as merely bodies with broken brains rather than people? And if so, are we now considered inured to simple human compassion or do those who treat us too often lack it?

UTgrad Says:

Joe, if only there was some way to get mental health care professionals to hear what you are saying. Why is that compassion is often completely absent from these “therapeutic milieus?”

I suppose they can’t bill for a kind word. So, instead they will focus on things they can bill for like having patients glue together doilies to tape on their doors. God, I’m glad to be away from all of that goofiness.

Herb Says:

Dear Sally,

In response to your question, “How do you feel about forced treatment?” my position has remained the same over these many years. I advocate for patient and support person education, informed and un-coerced medical consent which therefore would mean I do oppose forced medical treatment with one possible exception and that being due process of law. I am for testing and reporting of equipment and detailed patient record keeping and periodic patient follow up evaluation and reporting etc. I also support the initiation of more comprehensive studies relating to this therapy.

I would take exception and oppose your statement “I am suggesting that proof that depression is a physical disease would be stigmatizing if there were any such proof. There’s just not.”

In my opinion, depression and other serious mood disorders have been stigmatized and discriminated against for centuries and long before there were any thoughts of these illnesses being of a “physical disease.” To the contrary, I feel strongly more and more evidence is demonstrating that many of these illnesses are neuro-bio-chemical in nature causing malfunctions in the brain and with this evidence and education there may finally be less discrimination and stigmatization as we shall be able to quantify, observe and finally qualify the exact nature of these illnesses instead of diagnosing subjective symptoms and labeling illnesses as is illustrated by the very non-scientific DSM IV.

Nor do I personally think that Alzheimer’s disease which is a chemical malfunctioning in the brain is any more demeaning and inaccurate which does affect ones thoughts as are processes taking place with depression. The more I research and read I personally believe in many cases of a genetic predisposition in families to mood disorders. I also believe that many of these disorders may well be situationally triggered through dysfunctional child rearing, abuse, environmental issues and stressful maturation.

“But the idea that proving that people who are depressed really don’t have anything to be unhappy about but instead have defective brains (a depressing proposition itself) is horribly stigmatizing.” — Sally

No different, than having diabetes, heart disease, MS, PD and any number of illnesses. It certainly can be depressing but doesn’t have to be stigmatizing. Stigmatization is derived from ignorance. Also no different than what transpired with HIV. Knowledge helps to dispel stigmatization as well as discrimination.

While being intimately knowledgeable of my spouse’s case history and being a former facilitator I have listened to many case histories where individuals cannot point to any issues or stressors causing them depression other than the fact the depression exists, is severe, and is debilitating to the point of suicidal ideations. Other than their severe depressions these individuals along with my spouse would have reasonably comfortable lives.

Everyone who suffers MDD does not necessarily have some situational issues to point at in order to overcome and in my opinion as it relates to my spouse, it is the aborting of the depression that eliminates her negativity, denigration of herself and many of the other negative symptoms she might exhibit. I can think of Parkinson disease as one of many physical illnesses that can easily cause unusual negative mood states and behaviors so why would one be as cavalier as to dismiss brain malfunctioning also causing mood state symptoms? My readings and research point more and more in that direction as it relates MDD.

As an analogy which I often use is that of astronomy. With the advent of newer, better and finer equipment scientists are finding objects that were thought non-existent while at the same time gaining a better understanding of the nature of the universe. I feel strongly with time the same will hold true for the understanding, workings and malfunctioning of the brain and the various detrimental mood state symptoms it exhibits.

Dear Joe,

I don’t know what a hug may do for blood flow but as I mentioned previously I was a former facilitator of several DBSA support groups. I can share with you that at many meetings there were tears shed and just as many warm and heartfelt hug amongst members. The hugs, listening and sharing was for many members a reminder that we’re all human, we’re social animals and we all count and have a need for the warmth and caring of others.

I do know for many participants coming to these meetings it was a difficult effort but it was an hour or so uplifting of their spirits and an opportunity to be hugged.

Warmly,
Herb
VNSdepression.com

Kent Says:

Just because not everyone who feels depressed can point to some life experience as the cause of their depression doesn’t show that it doesn’t have such a cause. We are affected by many things that we aren’t consciously aware of, both in terms of environment and experience. Many people who feel depressed CAN point to things in their environment that are causing them to feel that way, and it’s kind of unfair to dismiss their experiences as having no effect at all and tell them that it’s just a physical disease. I think many non-depressed people would feel depressed if they had to trade places and experience the kinds of things that many depressed people do. So I think Sally’s right that it is stigmatizing to deny the validity of people’s experiences and tell them their unhappiness is all because of some internal defect inside their own mind.