@Mackers: Well, yes and no, again, it depends Psychiatry is reasonably robust, not because of the psychiatrists but because mental illnesses are genuine conditions which have been quite effectively systematised in terms of their presentation. We account for all possibilities, various typical and atypical presentations etc. But people who are depressed, or have PTSD or bipolar or anxiety, or histrionic personality or whatever from the diagnostic spectrum, have remarkably uniform presentations (in terms of symptomatology). Or to put in a different way, a mentally ill person can't help but fulfil the right criteria. Not only do they not need to try hard, they can't stop the symptoms and behaviours even if they wanted to. Have a read on Google on "Mental State Examination" (MSE). It is a very complex type of assessment that takes med students years to master, but once we do, it's the same as assessing diabetes or rheumatism or whatever else physical. True, there is no blood test for depression (yet) but the patient's demeanour, speech, thought (including types of thoughts, their flow, form, content etc), presence of hallucinations, mood, affect (the way their facial expression follows or doesn't follow mood), reasoning, judgement, insight, they are all standardised and used as diagnostic tools. So, for example a person comes in and they say they are suicidal. What do they look like? Well-kempt? Bizarre clothing? Dishevelled? What are their body movements like? Are they fast or slowed down? Do they 'look' depressed or are they perplexed? How do they make you, the interviewer, feel? Are they 'responding' as if they can see or hear something we can't? Then the speech. Is it slow or fast?Is it pressured? Can the person be interrupted? Are they making sense? Are they capable of staying on topic or do they wander? If yes, do they come back to the topic at all? Do they even speak or are they mute? are they starting to speak but never actually say anything? Just the first couple of considerations in the MSE can reveal a wealth of information on the mental health of a person, and probing further into mood, thoughts, and the rest can confirm or refute the diagnosis. As someone who did this for a long time, once you know how to use this method of assessment, it is very elegant and holistic way of ascertaining what is happening in the inner life of a person. We all like to think human nature is mysterious and we are all unique, and we are to an extent, but the reality is, we are actually all quite similar, and we react similarly if put in similar situations (that goes for body chemistry also). I always wondered whether the biggest reason general public is suspicious toward psychiatry isn't 'One Flew Over the Cookoo's Nest' but rather, this reluctance to give up their sense of uniqueness and accept being 'catalogued or 'analysed' into a pattern (which is essentially what psych assessment aims to do). GPs these days are much better at psych assessments, and most surgeries have doctors who had some solid past experience working in psychiatry, but still, some GPs are more prescription-pad happy than others, and yes, a'hysterical female' is the most likely to get dismissed with a prescription for Prozac. On the other hand, GPs are quite aware of the phenomenon of personality disorders (which comes to mind based on your description), so a melodramatic complainer would trigger high alert anyway, and if the signs appear over time, that confirm the presence of the PD, they get passed onto the Mental Health Team who can decide to withdraw treatment on that basis because they are skilled enough to tell the difference, whilst the GP might feel uncomfortable to make such a decision. People with personality disorders, or even factitious disorders and malingering aren't giving mentally ill a bad name in the eyes of doctors. All these are psych diagnoses and we just work to ascertain everyone is properly diagnosed in order to give them appropriate treatment. Nobody can help what they get sick with, and every system has its abusers. However general public might feel differently, mainly due to lack of appreciation for the continuum of human psychology, as well as due to sensationalist reporting in the media.
I once read (can0t remember the exact source) that depression is responsible for volume change in the hippocampus. And that's basically what anti-D drugs act upon.
There are actually a few different kinds of antidepressants. Selective serotonin reuptake inhibitors (SSRIs) Serotonin-norepinephrine reuptake inhibitors (SNRIs ) Monoamine oxidase inhibitors (MAOIs) Tricyclic antidepressants http://depression.emedtv.com/antidepressants/types-of-antidepressants.html They each have a different function. Some times the synapses in the brain don't absorb serotonin the way it is supposed to. MAOI's work differently by keeping a protein from burning up the MAO's in the brain once they have transmitted to the brain. That's why giving the right medicine to a person is so difficult, it's nothing but a trial process because there is no way to actually diagnose the cause.
They need a bogeyman. A single point of failure to point to. People can't fathom the myriad of contributing factors, so they highlight one. Still, not all is bad. It may drum up charitable contributions for that cause, however, being introverted is not an illness to be treated.
You are conflating clinical depression with feeling a little sad. With clinical depression a persons nerve's don't transmit as well. The literally cannot feel emotions.
There are many theories, many different medications that can ultimately alleviate the symptoms of depression (or any other illness that originates in the central nervous system). The problem lies in the fact that central nervous system is the highest authority the body, and the relatively uniform structure (gray and white matter) and a few neurotransmitters give instruction to all the muscles and nerves, it produces hormones which initiate a cascade which affects different functions on many different levels, it's responsible for our perception, thoughts, experiences, and ultimately, it influences even our autonomic functions. Basically everything. It also works on the principle of a positive and negative feedback mechanisms. So you have various neurotransmitters and they'll have an inhibitory or excitatory effect on different areas of the CNS, thus leading to some other chemical to express itself or not. Then factor in brain anatomy, where different areas co-operate or antagonise or even control various and seemingly unrelated things. So, there might be many paths to Rome - different anatomy eventually producing same behaviour or same anatomy producing different behaviour. Add into it gene expression and RNA, which directly influences the production of chemicals throughout the body who in turn give various instructions to cells to make things happen (or not happen) and you end up with a lot of unknowns.
When someone pulls out a hard figure, I require proof. Care to link to where you're getting this number?
Well I'll tell you guys I'm going through a manic episode that is peaking today. I'm a little stressed so I'm kind of irritated which contradicts what I said earlier, but I definitely don't feel like going out and hurting anyone. I am however being irritated by the work that has been going on in the apartment next door, but I think most of the irritations comes from the elevated hearing sensitivity and the lack of any sleep. This is the second or second and a half day so hopefully in the next 8-12 hours I'll crash and go back to normal.
Ok, I apologize. I forgot this was about a specific group. For some reason, my mind locked on society as a whole. However, I appreciate you providing a source for your claim. That is important in my eyes so people don't get into a habit of pulling numbers out of their a**.
I think bipolar disorder is used because it's something people know. It's really shocking how many different disorders there are: borderline, dissociative, or histrionic, just to name a few.
Well, bipolar is a mood disorder while borderline is a personality disorder. Personality disorders are a lot harder to treat because the etiologies are much harder to pin down. Bipolar at least has some biological markers so you can target it with medication.
That bothered me as well. Bipolar Affective Disorder is a mood disorder. It does not cause disorganized thinking, delusions, or hallucinations. Dude is an asshole, period.
@Cogito: Bipolar illness, especially type I with manic episodes can definitely have psychotic features. Not saying always, but sometimes. The expansive mood component and likely grandiosity distinguishes it from schizophrenic-type psychosis, but all other components can be there, including disorganised thinking, delusions and hallucinations. This is however different from schizoaffective disorder, but it would take a bit of explaining so won't go into it now. In cases of mania with psychotic features, you have to treat both the disorders of perception and mood. Newer drugs such as olanzepine are indicated for both schizophrenia and bipolar, because it's effective in the acute relief of both.
I have BP II, but like lot of other people it runs co-morbid with Borderline Personality Disorder, so as a consequence, my symptoms are a bit messed up having mood and personality aspects. That made finding the right medical cocktail really difficult. When I was originally diagnosed I thought I may have had some form of PTSD, or schizophrenia, my anxiety issues and psychosis were so bad. I get annoyed by media portrayal. I have a reasonably healthy grip on the illness, though I do get the ups and downs. The most immediate danger I've always felt myself to be is to to myself, not others. And yes, @jazzabel, the treatment you describe was very much how I was treated. Couldn't treat one without the other.
@Cogito: No they are not, as per my previous comment. Mania sometimes takes a turn into psychosis, in which case they aren't separate phenomena, they are on a continuum. Psychosis can be the outcome of severe depression, in which case you'll have Major Depression with psychotic features, where the psychosis has more of a nihilistic flavour. Not dual diagnosis of mood disorder and psychosis or mood disorder and schizophrenia (granted, this usually gets converted into schizoaffective disorder because pronounced mood symptoms co-exist with chronic psychotic illness, but like I said here it gets complicated from here). And as I said, the manic psychosis has a 'manic' flavour but all other hallmark symptoms that you mentioned are there. This is 101 psychiatry so no point arguing with me over it
Again, tthe psychotic or schizophrenic element is diagnosed and treated separately from the bipolar disorder. Certainly there is a synergy between the manic phase and any other disorder, but calling someone bipolar has nothing to do with explaining a bonehead, attention-seeking stunt.
@Cogito: Scrapped the comment because I don't want to argue about this. I told you how things are in the real world, given you a professional opinion. Do what you want with it, it's none of my concern
No it absolutely is not. Treatment for BpD is usually an anti-psychotic coupled with a mood stabilizer. The anti-psychotic controls the manic phase but your psychiatrist will up it to control any psychotic symptoms. There's no way to treat that "separately" from the BpD.
Sorry, but that is not true. BAD is often treated with lithium carbonate, especially if certain genetic markers are present. LiCO3 treats the chemical imbalance that alters the neuron firing potentials and causes the mood swings. Anti-psychotics are only used if there are psychotic symptoms presented. Again, however, that is NOT the point. The point is widespread ignorance regarding the disorder, and the public tendency to consider ANY emotional disturbance as insanity.
@Cogito: The only reason why I'm replying is for the sake of authentic information. Olanzepine, a new generation antipsychotic, is indicated and indeed frequently used in bipolar I disorder, regardless of whether there are any psychotic features present (we even have wafers that dissolve under the tongue to avoid the complication of having to inject a patient in an emergency). It calms the patient down, allows them to sleep and rest and considering mood stabilising drugs can take months to take effect, Olanzepine is instrumental in inpatient treatment. Also, it seemingly potentiates the effects of lithium and other mood stabilisers which makes it an useful adjunct in preventing relapses. This together with a specific clinical picture, testifies to the continuum of mania and psychosis, which occurs in certain patients. Genetics of it all is extremely poorly understood, still. You appear to be thinking concretely about this, categorising these terms into separate compartments separated by a wall. This isn't how the mind works, things are connected to each other, and they overlap. Nobody knows exactly how lithium works but there are several theories (latest research here,) and it doesn't work for every bipolar patient by far. Do you really think we do genetic testing for everyone we start on Lithium? I am all for educating the general public about mental illness. However, you yourself have demonstrated why it is exceedingly difficult. I am a psychiatrist with 15 years experience, and look how you are reacting to factual information I'm giving you. ps. Edited to add a couple of links, for those who accept nothing other than.
