[Neuroscience] Re: Depression, behavior, and Neurobiology

John H. j_hasenkam at yahoo.com.au
Sun May 28 21:59:05 EST 2006


Dr. Wayne Simon wrote:
> "John H." <j_hasenkam at yahoo.com.au> wrote in message
> news:1148529304.803506.85760 at u72g2000cwu.googlegroups.com...
> > No-one, except the scientologists, is denying the value of drugs. I
> > explicitly stated that the drugs are important as a treatment but that
> > the problem is the over riding emphasis on drugs; though this too is
> > now changing. As to my stated concerns regarding the use of
> > antidepressants in children, I do think that psychiatry has a case to
> > answer here. I am not suggesting children should be denied access to
> > the same but much greater prudence and a more creative approach to
> > treating depression children is required. Indeed, given the research on
> > the potential long term problems I am surprised that at the frequency
> > of treating childhood depression with antidepressants. As you stated
> > many years ago Doc: benefits and costs: there is a long term risk but
> > the short term risk is also substantial. The trouble with that though
> > is the simple fact that the vast majority of clinicians have little
> > awareness of the long term problems that may arise. Methinks they
> > prefer not to dwell upon the same.
> >
> > As  to causative matters, it would do the mental health profession the
> > world of public image good if it refrained from grasping at straws that
> > will eventually be used to light bonfires upon which to roast
> > psychiatry. This is one reason why the scientologists are attracting
> > attention. Don't worry Doc, here in Australia at least we dismiss those
> > sorts, though I'm not sure of the situation in the USA.
> >
> >
> > John
>
> I respectfully have to disagree.  I think more people are attracted to the
> pseudo-science of folks like el ron hubbard, because they are not fully
> educated in the sciences and are easily swayed by arguments that appear to
> be scientific and logical but are truly loaded with flaws.  The
> attractiveness and simplicity of some of these alternatives seem to be
> implicit if one believes that the well represented illogical trains of
> thought.  The fact that it takes weeks for the serotonin reuptake inhibitors
> to effect depression is not inconsistent with its mechanism.  For most
> patients the clinical syndrome called depression is best treated with
> medications at this point in time, other treatment modalities including
> pyschotherapy and life coping mechanisms can be very helpful as well as
> alternative therapeutic approaches.  Almost all alternatives work better
> with the medications on board for most patients.  Good luck with your
> alternative treatments and theories.

"truly loaded with flaws"

Hey come on, understanding human behavior and neurobiology is like
walking through a conceptual minefield that will blow your legs off and
leave you completely incapable of making any further progress in
understanding. Only just two weeks ago I read one psychiatrist who
claimed that our current understanding of depression is "hopelessly
simplistic". The diagnosis of schizophrenia can be extremely
problematic(Szasz and Rosenbaum!). It is often to think of a continuum
of symptoms rather than some threshold point where all hell breaks
loose. The same can be said for ADHD. I have heard far too many stories
of false diagnoses for this condition. Where's the science? How can we
have a scientific understanding of human behavior until we have
developed a much better understanding of the interactions between
behavior, neurobiology, and the environment? There is still much to be
done and in the interim we should be prepared to sound more prudent, be
more cautious, and most certainly be far more explorative in our
attempts to understand human behavior. Instead what has happened is
opting for the simplistic accounts because, to the general public at
least, it sounds so scientific to talk about ligands and receptors.

People are naturally attracted to the simple explanation. In this
regard everyone should take heed of Mencken's wonderful quip: for every
human problem there is a simple solution: simple, stupid, and wrong.
The "chemical imbalance" notion is a case in point. So is the "dopamine
hypothesis". The literature certainly proffers differing perspectives
on depression but these seem to be largely ignored. For example, the
impact on early childhood trauma on serotonin or nore levels in
adulthood. The relevance of cytokines in relation to depresssion,
particularly given the high rate of failure for depressives on the Dex
suppression test and that some cytokines will elevate IDO, which can
divert serotonin production towards K. acid. Think about sickness
behavior, particularly as chronically elevated cytokine levels can
induce glucocorticoid resistance; the same may be true for insulin
resistance. (Interestingly, obese people tend to have elevated Th 1
cytokines and in one fascinating study on obese women brain aging was
remarkably accelerated.)

We acknowledge the value of drugs in combination with other treatments.
That is exactly the point of my original post. It is worth remembering
that a great deal of experience has been gained in using drugs to treat
depression, it is just a pity a similiar level of experience is not
gained with other treatment modalities. I know alternative treatments
can work but I acknowledge that often drugs are required. What I
strongly object too is merely accepting unproven hypotheses and
throwing these out to the general public as "scientific explanations".

No, I have no real interest in alternative treatment regimes. I'm not a
clinician, I'm not a scientist, I'm just someone who is trying to
understand rather than sounding like I understand.

FWIW, I think anyone who wants to treat psychiatric disorders must be
insane! The greatest of challenges. Good luck to you.  



John H.



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