Panic/Anxiety Disorders

[JustAnotherGuy]

One point I would like to make is.

Different treatments work for different people. Some people respond well to meds, and some people don't respond at all to meds.

But, why do people insist on thinking only their way works? Or use an example of a family member as the basis of their opinion?

Yes, read and read and educate yourself and then decide what is best for you. Then when you get people telling you that you are wrong. (which will happen) tell them to bugger off.

[Flames Draft Watcher]

Originally Posted by joe_mullen

sounds like a fairly biased course. "electro-shock therapy" (aka ECT) is actually an extremely effective treatment for treatment resistant/difficult to treat depression. it has been given a bad name in the media but is actually a great form of treatment. as for medications, why the stigma against them. would your opinion be the same if it was medication for diabetes or hypertension? mental illness is a medical illness just like those others. some can be treated with non-pharmacological measures, some require prescription medications.

Depends how you define extremely effective. Depends on if you value memory. ECT has helped some people no doubt. But don't minimize the experiences of those who've had it who think the only effects its had on their life was negative. What percentage of people would it have to help to be considered extremely effective by you? What percentage of people would it have to harm to make you wonder about how effective it is?

Call me biased but blasting people's brains with electricity to make them forget isn't a "extremely effective" way to deal with depression. Some people are depressed because they have bad life coping skills, how's it going to help that?

The role of community, family and counselling is often minimized in order to get the quick fix of some pills or ECT or what have you. Damage has been done to lots of people who might have had normal lives.


One of the more damning statistics I've found was in a study the World Health Organization did which said that good outcomes for schizophrenics in First World countries was around 1/3. Good outcomes for schizophrenics in Third World countries was 2/3 or twice as good if I remember correctly. Tends to indicate the drugs we feed schizophrenics are doing little to cure them, and only changing symptomology while putting them on drugs they have to stay on indefinitely. In Third World countries schizophrenics are actually being cured after an episode, probably with the help of community and family.

[peter12]

Originally Posted by Flames Draft Watcher

Depends how you define extremely effective. Depends on if you value memory. ECT has helped some people no doubt. But don't minimize the experiences of those who've had it who think the only effects its had on their life was negative. What percentage of people would it have to help to be considered extremely effective by you? What percentage of people would it have to harm to make you wonder about how effective it is?

Call me biased but blasting people's brains with electricity to make them forget isn't a "extremely effective" way to deal with depression. Some people are depressed because they have bad life coping skills, how's it going to help that?

The role of community, family and counselling is often minimized in order to get the quick fix of some pills or ECT or what have you. Damage has been done to lots of people who might have had normal lives.


One of the more damning statistics I've found was in a study the World Health Organization did which said that good outcomes for schizophrenics in First World countries was around 1/3. Good outcomes for schizophrenics in Third World countries was 2/3 or twice as good if I remember correctly. Tends to indicate the drugs we feed schizophrenics are doing little to cure them, and only changing symptomology while putting them on drugs they have to stay on indefinitely. In Third World countries schizophrenics are actually being cured after an episode, probably with the help of community and family.

This I am in absolute agreement with. The love and care of family and friends is essential to your recovery.

[peter12]

Originally Posted by JustAnotherGuy

One point I would like to make is.

Different treatments work for different people. Some people respond well to meds, and some people don't respond at all to meds.

But, why do people insist on thinking only their way works? Or use an example of a family member as the basis of their opinion?

Yes, read and read and educate yourself and then decide what is best for you. Then when you get people telling you that you are wrong. (which will happen) tell them to bugger off.

I agree. From personal experience, I've found the drugs give you some clarity or serenity of mind that allows you to find perspective on your problems, but I would never say they are the only way to find a way out of your mental state.

[Flames Draft Watcher]

Originally Posted by Iowa_Flames_Fan

Do they no everything? No--but they aren't some sinister cabal out to sell drugs and harm people with experimental therapies. They're doctors--their secret agenda is to treat illness.

I don't doubt that doctors are trying to help people. I'm doubting whether they know everything that will happen long term with some of the drugs they are prescribing. Money is not an irrelevant factor when looking at how studies are done, which studies are promoted, which drugs are marketed to the doctors to use, etc.

If there's any agenda to be found its with Big Pharmaceutical companies. I'm not sure everyone realizes how many billions are at stake with some of these drugs given the prevalence of prescribing today. That's big money. No secret agenda, a quite open one. They want to sell drugs. In order to do that bad side-effects may be talked down. It isn't really that long ago in the grand scheme of things that Tobacco companies were still producing "studies" and research that showed tobacco wasn't as bad as some though. That's an excellent case study to use to see how big money can corrupt public safety.

Perhaps some attention should be given to the idea of making the drug business a public one, gov't run to reduce the conflict between proft and public safety.

Like I said, read some books on these drugs and on mental illness.

If you look at the history of psychiatry and mental illness the 20th century unfortunately looks a lot more like the 19th century than you'd think. A lot of reports of miracle cures, great success rates. Then a procedure or drug becomes widely used and the effectiveness comes into question and side-effects are found out to be more debilitating than first thought.

Doctors raved about anti-psychotics early on. Then they ackowledged the side-effects were horrible. Now we've got the wondrous atypical anti-psychotics. These have replaced some horrible side-effects with other horrible side-effects.

This is still going on today. New studies can reveal side effects that weren't previously known. Drug companies have been sued for deaths and side effects. Drug interactions cannot be fully tested with 100% certainty.

It may be less of a concern for certain types of medication than others. As I've said, I'd be particularly wary about anti-psychotics.

[joe_mullen]

with regards to poor coping skills, you are confusing axis I psychiatric disorders with axis II. there is a big difference in how they are managed. major depressive disorder, generalized anxiety disorder and panic disorder are axis I disorders that can be complicated but are not due to "poor coping skills". poor coping skills are suggestive of a axis II condition such as borderline personality disorder. these are treated differently, whether w/ medications or non-pharmacological means.

also, when it comes to medications/ECT, no one is suggesting that they are devoid of possible side effects (it needs to be stated that the majority of people do not encounter debilitating side effects), but studies suggest that statistically outcomes are more positive than the alternative. absolutely, ECT can cause short term memory loss, but I would argue that in a majority of cases this is a better outcome than suicide or other sequelae of untreated major depression.

Originally Posted by Flames Draft Watcher

Depends how you define extremely effective. Depends on if you value memory. ECT has helped some people no doubt. But don't minimize the experiences of those who've had it who think the only effects its had on their life was negative. What percentage of people would it have to help to be considered extremely effective by you? What percentage of people would it have to harm to make you wonder about how effective it is?

Call me biased but blasting people's brains with electricity to make them forget isn't a "extremely effective" way to deal with depression. Some people are depressed because they have bad life coping skills, how's it going to help that?

The role of community, family and counselling is often minimized in order to get the quick fix of some pills or ECT or what have you. Damage has been done to lots of people who might have had normal lives.


One of the more damning statistics I've found was in a study the World Health Organization did which said that good outcomes for schizophrenics in First World countries was around 1/3. Good outcomes for schizophrenics in Third World countries was 2/3 or twice as good if I remember correctly. Tends to indicate the drugs we feed schizophrenics are doing little to cure them, and only changing symptomology while putting them on drugs they have to stay on indefinitely. In Third World countries schizophrenics are actually being cured after an episode, probably with the help of community and family.

[Flames Draft Watcher]

The DSM and its changing definitions is another topic. Like I said, the classification of mental illness is always in flux, always changing.

When was homosexuality finally removed from the DSM as a mental illness? The 60's or 70's?

[Iowa_Flames_Fan]

Originally Posted by Flames Draft Watcher

The DSM and its changing definitions is another topic. Like I said, the classification of mental illness is always in flux, always changing.

When was homosexuality finally removed from the DSM as a mental illness? The 60's or 70's?

There's no doubt that psychiatry has a spotty history--as does Western Medicine more generally. But the fact is, you can't treat bipolar disorder or schizophrenia, or major depression with cognitive therapy, or better coping skills. The treatments we have are the best available with what we now know--and there are people who need treatment right now, who without treatment could suffer serious adverse consequences or even death.

You would advocate that we withhold that treatment until we know more? Fine. I wouldn't. I think the best thing is to treat the illnesses we know using the treatments that work, and hope that in the future we will understand these illnesses better and develop even better treatments. In the meantime, you use the tools that you have to address the pressing problems of today.

[Methanolic]

I think one of the biggest weapons a person can have against Panic/Anxiety Attacks is Recognizing that you DO have a propensity for these attacks and also recognizing what it is you are going through at that moment.

For example: When you have the really bad attacks, you feel like you are going to pass out or you are having a heart attack. the reason this is happening is because your brain has told your body to react in a parasympathectic manor because it goes into survival mode. It's not a heart attack, you are not going to die, you are having a panic attack.

Although, for what ever reason your brain decided to set this in motion, It will not be pleasant, but one can reduce the effects simply by recognizing it for what it truly is.

I've had 2 of these in my life. The first was about 8 years ago, the last one was about 6 months ago (1 week after being laid off) and it was brutal for about 1 full minute. The deep, controlled breaths (in through the nose, out through the mouth) help tremendously.

I also don't beleive that a person can be "cured" of this horrible ailment. I DO, However, beleive it can be controlled and greatly minimized.

I am a beleiver in the positive thinking aspect and I guarantee diet and physical health have a great deal to do with minimizing the effects.

I think with a bit of effort and concentration, the afflicted can discontinue any prescribed medication. Drugs may be a good thing for the short term, but after that you should be able to cope. Support from others is tremendously beneficial as well, whether they suffer from an anxiety disorder or not.

I wish you all the best.

[Dion]

Originally Posted by peter12

I strongly disagree with this post. Today's drugs have to undergo rigourous testing and scrutiny before being approved for medical use. An SSRI, like Lexapro, or an SNRI, like Cymbalta, can give you that extra safeguard to prevent stress or stop an anxiety attack in its tracks. All they do is increase the amounts of chemicals, like seritonin, which are depleted through anxiety attacks.

If drugs have to undergo rigourous testing and scrutiny before being approved for medical use why do we keep seeing drugs pulled from the market?

Serzone was pulled from Canadian and other world markets in 2004. It was also a drug that I had used for 6 months. It's quite a shock to find out a drug you were using wasn't that safe.

Bristol-Myers Squibb announced today that it is pulling its antidepressant Serzone (nefazodone) from the U.S. market. The controversial antidepressant has already been banned from sale in many countries because of links to cases of liver failure and injury, and at least 20 deaths.

http://mentalhealth.about.com/od/psy...serzone504.htm

Then you have the FDA stepping in due to concerns of suicide events happening while taking antidepressents.

FDA officials expressed great frustration that drug companies had been slow in supplying data from their unpublished antidepressant trials.

GlaxoSmithKline was singled out for mislabelling suicide related events that were possibly associated with paroxetine under the heading “emotional lability.”

During a 10 hour hearing, experts weighed the official presentations of uncertain scientific data against powerful emotional testimony from dozens of families whose children have killed themselves or others after taking a selective serotonin reuptake inhibitor—a class including fluoxetine (Prozac), sertraline (Zoloft), and paroxetine (Paxil, Seroxat).

In a surprise move on 2 February, a panel of scientific advisers of the US Food and Drug Administration urged the agency to warn that new anti-depressants may increase the risk of suicidal thinking or behaviour among children and teenagers.

http://www.pubmedcentral.nih.gov/art...i?artid=338125

After a two-day hearing, two U.S. Food and Drug Administration advisory committees have recommended that packages of antidepressants carry a "black box" warning - which is the highest FDA warning level -- indicating that the drugs can increase suicidal tendencies in children and adolescents.

http://www.suicide.org/fda-black-box-warning.html

Truth is there are long term studies done by the drug companies before they hit the market. It's left in the hands of doctors and psychiatrists to report the adverse side effects to the FDA and other health agencies. We as patients become guinea pigs for these newer medications.

[Flames Draft Watcher]

Originally Posted by Iowa_Flames_Fan

You would advocate that we withhold that treatment until we know more? Fine. I wouldn't.

No I'm not saying that. I just think think that people are a little too trusting in our knowledge of mental illness. I think that people think there is certainty, that there are "cures". All I mean to do is cast a bit of doubt on this. If you go in to talk to a psychiatrist thinking that they would never prescribe a drug that might cause you harm in some way, I think thats naive.

Originally Posted by Iowa_Flames_Fan

I think the best thing is to treat the illnesses we know using the treatments that work, and hope that in the future we will understand these illnesses better and develop even better treatments. In the meantime, you use the tools that you have to address the pressing problems of today.

I agree. But as I said, I think its important patients realize that they are basically part of an ongoing experiment in drug cocktails. Even some established drugs I'd consider as "experimental treatments". They should be told the "side-effects" of the drugs are on, and Doctors should be responsible for informing their patients when new studies come out highlighting new "side-effects" of any drug they are on (I've heard of times when this hasn't happened.) And no doubt there are some better psychiatrists than others, and in choosing one, someone may be experimenting with their treatment. You can and probably should in some cases get a second or third opinion.

My own experience with my half-brother has shown how radically different some diagnoses can be. Especially when my brother admittedly tries to manipulate the psychiatrists and say what they want to hear. His diagnosis has shifted from bi-polar, to personality disorder and alcoholic.

I think people should consider counselling or talk therapy for more milder mental illnesses and not be so quick to demand a quick-fix like a pill. I am especially questioning the use of medication to treat mild depression.

Anxiety disorders I don't know as much about. I am not advocating that all prescription drugs are bad. I am simply highlighting some issues, concerns, doubts about some of them and encouraging people to research stuff for themselves. Mental illness just isn't as cut and dried as people believe. The definitions, classifications and treatments are always in flux. New information is coming out all the time about potential dangers of certain drugs, new drugs are even coming out all the time.

I am not saying don't seek treatment. I'm not saying rule out all drugs. I'm just saying don't be a naive believer that psychiatrists have miracle cures for everything in the form of a pill.

[mikey_the_redneck]

I assume psychiatrists are expensive, but I remember there was a poster on here who was an NLP trainer.........you could try that. It is all about managing your thoughts, emotions and beliefs and it could be a cheaper, short term alternative.
Also, maybe meditation would help..............even though it is kind of hippy-ish.

If I were you, I would not get dependant on the prescriptions either....

[FlamesAddiction]

Well, thanks for all the responses. I am definitely reading them even if I'm not responding. It's been really informative and was pretty much what I was looking for when I posted this. I never go to doctors and in fact yesterday, I had no idea if I was supposed to present ID or fill out paper work... so for me to go yesterday, it was obviously because things were getting out of control a little bit.

I'm always impressed with all the knowledge that is available on this board.

[Dion]

Originally Posted by mikey_the_redneck

I assume psychiatrists are expensive,

Nope. Health care covers the full costs.

[Methanolic]

Originally Posted by FlamesAddiction

I never go to doctors and in fact yesterday, I had no idea if I was supposed to present ID or fill out paper work... so for me to go yesterday, it was obviously because things were getting out of control a little bit.

.

Likewise,

[Igottago]

www.anxietycentre.com is a great resource. There is a fee for the members section, but its not expensive.

Read through it, there is a wealth of great information, about the disoder, what causes it, various sympstoms, coping with it, and the options you have to deal with it. This website helped me out quite a bit.

[Dion]

Antidepressant drug trials turn away most of the depressed population. A reason why drug trials are flawed.

Studies establishing the effectiveness of antidepressants are based on highly selective samples of depressed patients. New research by Brown University psychiatrists found as many as 85 percent of depressed patients treated in an outpatient setting would be excluded from the typical study to determine whether an antidepressant works.

Trials to determine the effectiveness of antidepressants have historically evaluated only a small subset of depressed individuals with a very specific clinical profile. People diagnosed with other psychiatric problems and people with mild depression are among those excluded, says the study, which appears in the March 2002 American Journal of Psychiatry.

“When you take any medicine you assume it’s been found to be effective for your condition,” said Mark Zimmerman, associate professor of psychiatry and human behavior, director of outpatient psychiatry at Rhode Island Hospital, and the study’s lead researcher. “No one knows for sure whether antidepressants are effective for most of the patients we treat.”

“Drug companies are concerned that individuals with mild depression will respond just as well to a placebo as they will to antidepressant medication,” said Zimmerman. “However, this represents a sizable number of individuals who are prescribed these medicines, especially by primary care physicians.”

“Drug companies have been correct in assuming that if they show their medicine works for a highly select group of depressed patients, physicians will use it for all patients,” said Zimmerman.

http://www.brown.edu/Administration/...02/01-091.html

[habernac]

my poor Great Uncle is schizophrenic. He's resistant to drugs and therapy out of fear. Had some horrible experiences in the 50's and 60's. He told my uncle once "If anyone ever says they're going to do electroshock therapy on you, run." And that's pretty much what he's been doing for the last 20 years. When his mother died, he stopped his meds. As far as I know, he's been homeless and on the run ever since.

[Flames Draft Watcher]

Great links and quotes Dion. Most people don't realize how questionable a lot of these studies are, or the history of drugs being taken off the market after being found to be deadly, marketing certain drugs as miracle cure all kinds of drugs only to find out later they are terrible for kids/elderly, etc.

I would have tried to find some of these myself at some point, thanks for the info. I might still try and find some more drug links later on. People just aren't informed enough about this given the high level of prescriptions.

[I wanna be like Miikka]

Originally Posted by Dion

Antidepressant drug trials turn away most of the depressed population. A reason why drug trials are flawed.

That is pretty much how all drug trials are conducted. They include a very detailed inclusion and exclusion criteria. It is a problem in clinical trials regarding cancer treatment because companies often reject later stage patients because they have a higher likelihood of dying and as such would make their results look worse.

Similarly, they have to restrict the type of depressed patients on the trial. Mild or Moderately depressed patients have a higher chance of responding due to the placebo effect which would make the drug look worse. After investing 200 million developing it the company tries to do their best to get it approved.

Unfortunately that is the way it is, the FDA is supposed to regulate these trials and monitor them to try and limit these sorts of things. At the end of the day though developing drugs is a business and you see things like this.

Edit: I should also add, even though some trials are skewed like this, there are several medicines that are critical for treating mental illness. It doesn't mean they are guaranteed to work on you but they have shown great promise in current patients and in past clinical trials.

With regards to avoiding medications completely, well some modern medicines have a lot of question marks but some have been absolutely outstanding. To repeat what others have said, it all depends on you as a person. Some people will react beautifully to one drug but then react terribly to a more common drug. Medicines are out there for a reason, they definitely have their drawbacks but to full out ignore them in treating Mental Illness is a very bad idea. Everything is about balance, if you rely and trust modern medicine completely you will get burned, if you ignore it completely you will also get burned. You try to take a calculated risk with each illness that you come upon and then just hope for the best!