"Obamacare found Constitutional"

[goDel]

Great post.

 

One point though. There's a fundamental difference between diagnosing reuma and depression. Reuma can be physically/objectively measured. Depression not so much. Although much work is being put into the DSM-bible to create the impression that mental illnesses can be objectively measured (with a good success rate). Some can perhaps, but depression?

 

And from another perspective: misdiagnoses with respect to reuma seem to be rarer than misdiagnoses of depression. Although I wonder if it's even possible to measure those in the depression-department. And this is where things get really cynical. How can misdiagnoses of depressions be objectively measured? Can they? So it's hard to diagnose depression. And it's as hard to find out whether the original diagnosis was actually the right diagnosis. Especially when no other/bigger problems arise for the given patients.

 

And given these uncertainties, treatments are being researched and/or given. Yes, money is to be made, I guess.

 

I think my hypothesis still stands: 20% of the people currently taking anti-depressants are better off running 5 miles, 3 times a week. And if that's true, that says a lot about the health providers involved (the doctors and the pharmaceutical industry). (and 20% being a conservative estimate, imo)

[jhonny]

Yeah you're right about the diagnosis, and diagnostic problems with depression. It's both a clinical issue, and also a more general problem. You can have a depressing life, but not be 'depressed'. You can be depressed but everyone around you can be telling you to cheer up.

 

Complex stuff. Ben Goldacres new book should be v. interesting

[Guest disparaissant]

Yeah, depression is a really hard one, and psychiatric diagnoses are pretty fuckin subjective, I will grant you that.

But I don't think that not understanding WHAT the chemical change is equates to not thinking there IS a chemical change. That was the implication that it looked like you were making. Our brain is all chemicals, chemicals cause our moods to change on every level, you would think that when your mood is depressed for months on end there is a sustained chemical change of one sort or another, no? It's like physics - we can't observe something directly, but we can observe the effect it is having on things around it, therefore we can infer its existence. Like the higgs boson. And all these whacky brain chemical drugs can be used diagnostically as well. When a significant number of patients in a double blind have x% less manic episodes while on drug y - an anti-seizure calcium channel blocker - we learn that mania very likely has something to do with calcium channels, or at least causes brain changes that are similar to seizures in one way or another.

 

In any case, yeah, I have some personal stake in this, largely because my life has improved significantly thanks to a handful of drugs, some of which I have even talked shit about in this thread. And I do get a bit bothered when people take it so far in the cynical direction. I'm fairly cynical about big pharma's goals and intents, but I'm also aware that it's not ALL terrible.

 

Fully agree re: people running 5 miles a day.

[eugene]

chemicals cause our moods to change on every level

there are many things that makes our moods change, no new boc album in the last 7 years can be pretty depressing for some people.

 

let me ask you, at what stage did you decide that you need drugs rather than cycling or meditating for example ?

 

imo, there's this unholy mix of belief in the infallibility of bio-medicine and american capitalism (dtc ads) that makes the decision to

gobble drugs with their countless "side" effects much (dangerously) easier.

[goDel]

I'm glad these medicines helped you personally. And that your personal experiences might have been a positive, but the phrase "chemicals cause our moods to change on every level" is unfounded. At best, there is a correlation between certain mental conditions and levels of various chemicals in a brain. Causality is an entirely different beast.

 

Sorry to be nitpicking. But from my perspective, I see huge numbers of people (and a growing number at that) who seek refuge in drugs in order to make them feel better. While the diagnosis and prescription can be pretty lackluster (see the GSK case: give a present to the medical doctor and he's happy to prescribe medicine X). While the costs rise enormously. And while the overall effectiveness is still being debated, at best (although in some cases it's more a global warming kind of discussion, if you catch my drift).

 

And about the outcomes of research: it's not nearly as simple as you present. There are numerous factors which could falsify outcomes such as "a significant % of patients show a significant % of improvement over X time".

 

As the GSK case shows:

- researches showing contradicting results can be held back

- data from various researches can be cherry picked to create favorable outcomes

- the significance of an outcome is hard to measure (how would you objectively measure the outcome of an anti-depressant?)

- how biased/blind was the research? and how do medicines perform with respect to just the passing of time?

 

The book I mentioned is full of examples and goes into great detail in subjects like these. There's enough reasons for being skeptical when some research shows proof of some medicine being effective. In general it's already very complex. In the context of mental illnesses even more.

[SR4]

chemicals cause our moods to change on every level

there are many things that makes our moods change, no new boc album in the last 7 years can be pretty depressing for some people.

 

let me ask you, at what stage did you decide that you need drugs rather than cycling or meditating for example ?

 

imo, there's this unholy mix of belief in the infallibility of bio-medicine and american capitalism (dtc ads) that makes the decision to

gobble drugs with their countless "side" effects much (dangerously) easier.

 

because sometimes medicines actually do work.

 

mine have completely changed my life around, coupled with exercise, and a healthy diet, I can't even believe I was the person I was a few years ago.

 

The problem with the system is the belief thats force-pushed that one medicine will have the exact same helpful effects on every and anyone that uses it.

[eugene]

of course they work, people are generally quite pragmatic after all.

im just interested in this decision process, like, what are the variables that lead to the final decision to go with drugs.

 

there's an interesting article about that whole topic: http://www.palgrave-journals.com/biosoc/journal/v1/n3/pdf/biosoc200626a.pdf

[SR4]

of course they work, people are generally quite pragmatic after all.

im just interested in this decision process, like, what are the variables that lead to the final decision to go with drugs.

 

there's an interesting article about that whole topic: http://www.palgrave-...osoc200626a.pdf

 

i can only speak for my personal experience by saying that i tried several different medicines accompanied by several different types of exercise, sleep programming, breathing exercises, etc.

 

in comparison to the other variables I realized that my quality of life had benefited immensely overall with this specific set of lifestyle and medication as opposed to all the other various methods I had tried thus far.

 

I think it makes sense for it to be a very very slow decision making process.

[goDel]

Smetty, as a sceptic I can fully support the use of medicines to create (or rather: support) some sort of break through. The most important thing is that you're currently happy and not dependent on medicines to sustain your current level of well-being. So my respect for having achieved that.

[eugene]

of course they work, people are generally quite pragmatic after all.

im just interested in this decision process, like, what are the variables that lead to the final decision to go with drugs.

 

there's an interesting article about that whole topic: http://www.palgrave-...osoc200626a.pdf

 

i can only speak for my personal experience by saying that i tried several different medicines accompanied by several different types of exercise, sleep programming, breathing exercises, etc.

 

in comparison to the other variables I realized that my quality of life had benefited immensely overall with this specific set of lifestyle and medication as opposed to all the other various methods I had tried thus far.

 

I think it makes sense for it to be a very very slow decision making process.

alright, but would you say that in usa there are powers that are working to make it a very quick process that'll lead you to taking drugs over alternatives ?

[SR4]

oh absolutely. I was a victim of it myself, admittedly. Some of my doctors acted as if the prescription mattered more than my personal feelings and reactions towards it. Now, to a degree I can understand their concern (some prescriptions take a few months to start working, some have adverse reactions in the beginning, etc.). But I eventually realized that there should only be one standard on which to judge anti-depressants, and that is a personal evaluation of whether you have had improved quality of life. Easier said than done, and I had jumped the gun too quickly (the medication I take now, I had stopped taking it years ago because I thought I was being forced to take it, etc. etc.)....only years after when other methods had failed had I realized that the medication actually did help augment my mental self-improvement for the better....

 

but I am in no way suggesting that all medications be evaluated the same way, and I obviously value the expertise of trained professionals....but eventually I was in such a mental and physical mess that I had to reconsider the fact that what the med professes to do must be weighed against your self-perception of whether quality of life has improved. its not a perfect solution, but I can only personally speak for myself that with a combination of this med, philosophy/reading/discussion, and now a strenuous exercise routine, i feel healthier than I have been in a long long time....maybe the healthiest Ive ever felt.

 

and as goDel said earlier, the USA is not the only guilty nation when it comes to pharma....but we certainly are the biggest target for good reason.

[SR4]

So i think a lot of people railing against pharm have a really good point that I agree with to a point....we as members of a hi-technological and highly integrated world society are experiencing an incredibly different variation on depression's causalities...which also mean we should be training the mind to adapt and use new techniques to combat it.

 

Im sorta just spouting this, but ill keep thinking further on it. Training of the mind is far far more important than taking a pill. But, with the right pill, it might just be able to stabilize an unhealthy wreck to allow them the time and ability to transition into a better mental lifestyle.

[SR4]

oh and back on the obamacare topic,

 

 

I think I have been using middle-class incorrectly in this discussion. I think I would (incorrectly) consider myself middle-class because my upbringing was from lower-class to middle-class over my childhood, so I was lucky to experience that transition...and I guess in some weird way I believe that my mother and father are some of the very few examples of the "American Dream"....but now entering society expecting that the same amount of hard work yields similar results is naive and stupid. This is a far different age than twenty to thirty years ago.

 

So to revise my earlier statements, this plan has the potential to cripple lower-class income earners fresh out of college/grad school, etc. trying to transition into a higher income bracket. Knowing that the minute I go over a certain line in income can potentially fuck my financial means more than if I stayed in poverty.

[sergeantk]

So to revise my earlier statements, this plan has the potential to cripple lower-class income earners fresh out of college/grad school, etc. trying to transition into a higher income bracket. Knowing that the minute I go over a certain line in income can potentially fuck my financial means more than if I stayed in poverty.

 

Hasn't this been the case for a long time now? What with the way tax brackets are set up and all. This is just adding fuel to the fire from that perspective. Not to mention that college degrees are becoming increasingly less useful (except for specialized fields of course)

[SR4]

So to revise my earlier statements, this plan has the potential to cripple lower-class income earners fresh out of college/grad school, etc. trying to transition into a higher income bracket. Knowing that the minute I go over a certain line in income can potentially fuck my financial means more than if I stayed in poverty.

 

Hasn't this been the case for a long time now? What with the way tax brackets are set up and all. This is just adding fuel to the fire from that perspective. Not to mention that college degrees are becoming increasingly less useful (except for specialized fields of course)

 

yeah, exactly. it only serves to exacerbate the problem.

[Guest disparaissant]

eugene -

tbh i used to be totally sceptical of psychiatric medicine in general (for reasons xxx got into, what with adolescents being medicated instead of asked what's wrong, as well as everything else discussed in the last few pages here), and was off meds for 10 years. i completely fucked my life up a whole bunch and every time i did that i would try to change my diet or exercise or something or this or that and it never worked because the shit i've got going on (i'll just throw it out there, bipolar disorder) just isn't something that can be easily dealt with without meds of some kind. and i have it bad enough that i don't honestly think i can cope at all without SOME medication. i'm trying to stay undermedicated so i don't turn into a fat zombie, and that's working out for me (well, halfway anyway). i'm a lot more stable than i have been since i was 13 or so. i can actually focus and even when i'm having an episode, i can function as a human being (got a 4.0 last semester despite a mixed episode that lasted a month and a half what WHAT) and that is something i don't honestly think i could have done with just diet and exercise and therapy. so i guess my decision making process was along the lines of "fuck this shit DIET fuck this shit EXERCISE fuck these people THERAPY fuck big pharma OKAY FINE MY LIFE IS SHIT GIVE ME PILLS I WILL TRY THEM oh this isn't so bad."

 

and my "chemicals cause changes of mood" thing was not saying that external chemicals do, it was saying that every mood we have is the result of neurons firing and causing different chemicals to be released. which. i mean are you going to argue with that?

[Guest theSun]

So i think a lot of people railing against pharm have a really good point that I agree with to a point....we as members of a hi-technological and highly integrated world society are experiencing an incredibly different variation on depression's causalities...which also mean we should be training the mind to adapt and use new techniques to combat it.

 

Im sorta just spouting this, but ill keep thinking further on it. Training of the mind is far far more important than taking a pill. But, with the right pill, it might just be able to stabilize an unhealthy wreck to allow them the time and ability to transition into a better mental lifestyle.

 

good post, the changing dynamic of technology in our lives has a very real effect on us that isn't really discussed often or seriously enough.

 

of course they work, people are generally quite pragmatic after all.

im just interested in this decision process, like, what are the variables that lead to the final decision to go with drugs.

 

there's an interesting article about that whole topic: http://www.palgrave-...osoc200626a.pdf

 

i can only speak for my personal experience by saying that i tried several different medicines accompanied by several different types of exercise, sleep programming, breathing exercises, etc.

 

in comparison to the other variables I realized that my quality of life had benefited immensely overall with this specific set of lifestyle and medication as opposed to all the other various methods I had tried thus far.

 

I think it makes sense for it to be a very very slow decision making process.

alright, but would you say that in usa there are powers that are working to make it a very quick process that'll lead you to taking drugs over alternatives ?

 

this is exactly what is happening. the other alternative could be another drug that another company makes, an over the counter alternative, a backwoods hippie shit alternative or nothing at all is the alternative. in every case pharma would rather sell you their drug. the effect it has on you doesn't matter at all to their bottom line as long as you keep buying it and the side effects are disclosed.

[Hoodie]

of course they work, people are generally quite pragmatic after all.

im just interested in this decision process, like, what are the variables that lead to the final decision to go with drugs.

 

there's an interesting article about that whole topic: http://www.palgrave-...osoc200626a.pdf

 

i can only speak for my personal experience by saying that i tried several different medicines accompanied by several different types of exercise, sleep programming, breathing exercises, etc.

 

in comparison to the other variables I realized that my quality of life had benefited immensely overall with this specific set of lifestyle and medication as opposed to all the other various methods I had tried thus far.

 

I think it makes sense for it to be a very very slow decision making process.

alright, but would you say that in usa there are powers that are working to make it a very quick process that'll lead you to taking drugs over alternatives ?

 

i feel like you'd be interested in this documentary: http://www.pbs.org/wgbh/pages/frontline/medicatedchild/view/

 

it's about doctors going medicatin' crazy and prescribing anti-psychotics to children for their "mood swings."

[eugene]

of course they work, people are generally quite pragmatic after all.

im just interested in this decision process, like, what are the variables that lead to the final decision to go with drugs.

 

there's an interesting article about that whole topic: http://www.palgrave-...osoc200626a.pdf

 

i can only speak for my personal experience by saying that i tried several different medicines accompanied by several different types of exercise, sleep programming, breathing exercises, etc.

 

in comparison to the other variables I realized that my quality of life had benefited immensely overall with this specific set of lifestyle and medication as opposed to all the other various methods I had tried thus far.

 

I think it makes sense for it to be a very very slow decision making process.

alright, but would you say that in usa there are powers that are working to make it a very quick process that'll lead you to taking drugs over alternatives ?

 

i feel like you'd be interested in this documentary: http://www.pbs.org/w...atedchild/view/

 

it's about doctors going medicatin' crazy and prescribing anti-psychotics to children for their "mood swings."

 

yeah this is THE issue, not cases like disp's and sr4..

the film's on youtube for the non-americans of us:

http://www.youtube.com/watch?v=d5lE8BAbnyQ

[Guest disparaissant]

there's a louis theroux doc about the same thing, highly recommended.

but yeah like i said i was basically one of those kids? i mean i was 13 but they put me on all sorts of stuff trying to "fix" me or whatever without actually addressing my shitty home life or anything.

i guess i just don't really like reactions that go all the way in the other direction because this idea that most mental illnesses are faked* adds a lot of stigma to people who have legitimate mental illnesses.

 

*not the right word, but like. could be solved in therapy or whatever. i dunno. you get me.

[goDel]

When a pharmacy sells the heartburn drug Zantac, each pill costs about 35 cents. But doctors dispensing it to patients in their offices have charged nearly 10 times that price, or $3.25 a pill.

 

The same goes for a popular muscle relaxant known as Soma, insurers say. From a pharmacy, the per-pill price is 60 cents. Sold by a doctor, it can cost more than five times that, or $3.33.

 

At a time of soaring health care bills, doctors, experts say that middlemen and drug distributors are adding hundreds of millions of dollars annually to the costs borne by insurance companies, employers and taxpayers through the practice of physician dispensing.

 

http://www.nytimes.com/2012/07/12/business/some-physicians-making-millions-selling-drugs.html?partner=rss&emc=rss

 

Although I mustn't be too positive, but there might be some positive signs that the healthcare market will improve significantly. Because the insurers are going to cary bigger financial risks, they might actually be going after the margins in the healthcare system in a far more effective way. I expect more examples like this in the coming months and perhaps years.

[Guest A/D]

i mean i was 13 but they put me on all sorts of stuff trying to "fix" me or whatever without actually addressing my shitty home life or anything.

i guess i just don't really like reactions that go all the way in the other direction because this idea that most mental illnesses are faked* adds a lot of stigma to people who have legitimate mental illnesses.

 

*not the right word, but like. could be solved in therapy or whatever. i dunno. you get me.

I go back and forth on this. Sounds like you might too? After all, your home life (however bad, and I'm sorry that it was bad) is an external circumstance, not an internal one like brain chemistry. You probably learned bad problem-solving skills from people who reacted to situations with anger, or self-hatred, or any number of things. I think that emotions do have visible effects in the brain and the body, but it's not clear whether an imbalance causes the emotions, or vice versa.

 

I have a lot of shitty tendencies when I'm not in control of myself. I think we we all do. And I think a good [therapist, friend, drug, meditation practice, life-changing situation] can teach you how to reach beyond all the mental bullshit into who you really are. I also think we are all, at our core, peaceful people who are taught shitty problem solving skills by a world that's possessed by its own mental problems.

 

I cut out a lot of this because I hate rambling about my theories on mental health, so I'm sorry if my thoughts are unclear.

[lumpenprol]

I credit antidepressants for keeping me from killing myself at one point in my life. They also made me terminally fat. So...

[HoA]

Zoloft

 

"Check with your doctor if any of these most COMMON side effects persist or become bothersome when using Zoloft:

Anxiety; constipation; decreased sexual desire or ability; diarrhea; dizziness; drowsiness; dry mouth; increased sweating; loss of appetite; nausea; nervousness; stomach upset; tiredness; trouble sleeping; vomiting; weight loss.

Seek medical attention right away if any of these SEVERE side effects occur when using Zoloft:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); bizarre behavior; black or bloody stools; chest pain; confusion; decreased bladder control; decreased concentration; decreased coordination; exaggerated reflexes; fainting; fast or irregular heartbeat; fever; hallucinations; memory loss; new or worsening agitation, panic attacks, aggressiveness, impulsiveness, irritability, hostility, exaggerated feeling of well-being, restlessness, or inability to sit still; persistent or severe ringing in the ears; persistent, painful erection; red, swollen, blistered, or peeling skin; seizures; severe or persistent anxiety or trouble sleeping; severe or persistent headache; stomach pain; suicidal thoughts or attempts; tremor; unusual bruising or bleeding; unusual or severe mental or mood changes; unusual weakness; vision changes; worsening of depression."