When thinking about the treatment options available for dealing with life's complications, there are an abundance of choices available. However, the use of each option can require a bit of assistance, in the beginning; so you don't "get in over your head", so to speak. You don't go swimming in the deep end of the pool without lessons first. The very same thing goes for self-help books. You don't want to get in "over your head" and drown, from all the information.
Think of the various treatment options as spokes on a wheel. Treatment options may, but not necessarily include: One on one psychotherapy, Small group therapy, Large group therapy, the use of medications to treat the condition.
There are also a plethora of "Self Help" books out there, to be used as another tool. I would never use a "self-help" book, without the recommendation of a professional. There are too many books out there, written by a great many people that do not have the credentials to be giving out advice. Just look at this blog. It is written by an untrained, uneducated simple-minded guy.
Yes, self-help books can be useful. I am not saying that they are not helpful. But, to use them without some "oversight" of some kind, is foolhardy. We all want to improve ourselves, yet, if we do not know HOW to improve ourselves, picking up a book might be the worst thing to do. Use some common sense before picking up a book to "cure" your ills.
Tuesday, January 7, 2014
Friday, November 29, 2013
Depression and the Damaged Brain: Seeking treatment
The choice of the type of therapist can be quite daunting. The choices I will focus on are MD/DO, Psychologists, Social Workers and Clergy. While there are other options, I don't know enough about those choices to either be pro or con, so I will stay away from that type of discussion. You can go the medical route; for instance; a psychiatrist. Psychiatrists can be either M.D.'s or D.O.'s (Medical Doctors or Doctor of Osteopathy) in the US.
In choosing an MD or a DO, you can avail yourself of the various medications that a licensed MD or DO are allowed to prescribe. In certain jurisdictions, only MD's and DO's are allowed to prescribe medications to deal with psychiatric issues, due to the need of blood needing to be taken to make sure the drug is in the therapeutic range for the patient.
Be aware that trying a new drug to treat a psychiatric condition can take up to 8 to 10 weeks to get the medication in the therapeutic range. Patience is required for the patient to stick with the medication. There is one caveat. That caveat is unanticipated drug interactions, allergic reactions or an unwanted change in behavior that is detrimental to the course of treatment the patient is wanting to pursue.
One other thing to be very aware of is that sometimes medication is NOT an option when dealing with depression and the damaged brain. Most of the medications on the market currently, are for brains that have not been damaged structurally. If you have had a shunt placed for hydrocephalus, have had a stroke or a tumor pressing on a part of your brain that affects behavior, medication for depression may not work at all. For example, you would need to treat the tumor first and then see if there is a need for anti-depressant medication. You have to treat the problem first, and then the resolution will come.
Take a list of your current medications (including dosage amounts) with you to your appointment to make sure that your psychiatrist does not prescribe something that may have an adverse reaction with your current medications. There are certain medications that do not work at all well with psychiatric medications. If you are on one of those, make sure you inform your psychiatrist.
Psychologists are another route to go, when seeking treatment for depression. While psychologists have their place in the healthcare field, they are not medical doctors and can not prescribe medications, at this time. There are discussions going on to see if they should be allowed to prescribe medications, on a limited basis. Yet, what has been done is to have a psychologist refer a patient to a psychiatrist they work with for medication distribution. Psychologists can either have a Masters or PhD. A Masters program can take as little as 2 yrs after the four years in college. Whereas a PhD program can be 4-8 yrs after graduation from college.
Social Workers (usually they have a LCSW after their name among other initials) can work very well for people that do not need medication, but may need a different type of support structure to deal with issues. Noted, LCSW's can refer their patients to an MD/DO if they find the patient is in need of treatment options outside the realm of their licensure.
Though last on the list, clergy can also be a very good source of support and counsel when dealing with depression. Granted, clergy are not allowed to prescribe medications, their counsel can be just what the individual needs to resolve a conflict they might be dealing with.
In choosing an MD or a DO, you can avail yourself of the various medications that a licensed MD or DO are allowed to prescribe. In certain jurisdictions, only MD's and DO's are allowed to prescribe medications to deal with psychiatric issues, due to the need of blood needing to be taken to make sure the drug is in the therapeutic range for the patient.
Be aware that trying a new drug to treat a psychiatric condition can take up to 8 to 10 weeks to get the medication in the therapeutic range. Patience is required for the patient to stick with the medication. There is one caveat. That caveat is unanticipated drug interactions, allergic reactions or an unwanted change in behavior that is detrimental to the course of treatment the patient is wanting to pursue.
One other thing to be very aware of is that sometimes medication is NOT an option when dealing with depression and the damaged brain. Most of the medications on the market currently, are for brains that have not been damaged structurally. If you have had a shunt placed for hydrocephalus, have had a stroke or a tumor pressing on a part of your brain that affects behavior, medication for depression may not work at all. For example, you would need to treat the tumor first and then see if there is a need for anti-depressant medication. You have to treat the problem first, and then the resolution will come.
Take a list of your current medications (including dosage amounts) with you to your appointment to make sure that your psychiatrist does not prescribe something that may have an adverse reaction with your current medications. There are certain medications that do not work at all well with psychiatric medications. If you are on one of those, make sure you inform your psychiatrist.
Psychologists are another route to go, when seeking treatment for depression. While psychologists have their place in the healthcare field, they are not medical doctors and can not prescribe medications, at this time. There are discussions going on to see if they should be allowed to prescribe medications, on a limited basis. Yet, what has been done is to have a psychologist refer a patient to a psychiatrist they work with for medication distribution. Psychologists can either have a Masters or PhD. A Masters program can take as little as 2 yrs after the four years in college. Whereas a PhD program can be 4-8 yrs after graduation from college.
Social Workers (usually they have a LCSW after their name among other initials) can work very well for people that do not need medication, but may need a different type of support structure to deal with issues. Noted, LCSW's can refer their patients to an MD/DO if they find the patient is in need of treatment options outside the realm of their licensure.
Though last on the list, clergy can also be a very good source of support and counsel when dealing with depression. Granted, clergy are not allowed to prescribe medications, their counsel can be just what the individual needs to resolve a conflict they might be dealing with.
Wednesday, October 19, 2011
Death Discussion
Death, it is one of those inevitable things that happens. Not just to men, women, boys and girls; but everything. Plants die, animals die, fish die. So, why is everyone so hung up about discussing the topic of death???
Death can happen prior to birth, a few seconds after birth... or, if you are really lucky, after 100+ years.
The only thing I can think of is that the *talk* of death seems to; in the minds of some; bring it *closer* than they would prefer. People are *suppose to* live. They are suppose to have goals, ambitions.
Talking about death is for *old* people. We shouldn't be "bothered" by such talk... especially when we are young and vibrant. Ahhh youth. But wait, there are young people that struggle every day, just to survive! Don't you remember seeing pictures of young kids with pot bellies. They didn't get that from *overeating*. NO. They got that from malnutrition. They want to eat healthy foods, yet, there is not much around for them to eat. Not everyone has a fully stocked fridge and cupboard full of food. Their spindly arms and legs are a *dead* give away (no pun intended), that something is wrong. They could die at any moment. Yet, no one cares.
Let's bring the "death discussion" in to focus, shall we. One of the components of Affordability Care Act, is that an individual; on Medicare; can have a once a year discussion about "available options" for care. In-home care, nursing home care, hospice care, palliative care.
People freaked out thinking that those on Medicare were going to be "put on a bus", so to speak, and removed from society. That's not it at all. What the Affordable Care Act does, is allow Medicare to pay for that very important discussion. Something that *previously* was not allowed. That is a *GOOD* thing. now those on Medicare can have a discussion with their doctor and find out new options when it comes to "end of life" discussions.
I *think* about death all the time. I have since I was a young kid. The first death that impacted me was that of a classmate. For the longest time, I thought he was just sick. It wasn't until his and members of his family, who were in a car accident funeral; that I understood he was *not* coming to class the next day.. I was very sad. I tried to understand more about death, but, I was a kid and had nothing to base the concept of death on, until that incident.
Death does not scare me. It is just one of those "facts of life" things that people have to come to grips with on their on terms.
Death can happen prior to birth, a few seconds after birth... or, if you are really lucky, after 100+ years.
The only thing I can think of is that the *talk* of death seems to; in the minds of some; bring it *closer* than they would prefer. People are *suppose to* live. They are suppose to have goals, ambitions.
Talking about death is for *old* people. We shouldn't be "bothered" by such talk... especially when we are young and vibrant. Ahhh youth. But wait, there are young people that struggle every day, just to survive! Don't you remember seeing pictures of young kids with pot bellies. They didn't get that from *overeating*. NO. They got that from malnutrition. They want to eat healthy foods, yet, there is not much around for them to eat. Not everyone has a fully stocked fridge and cupboard full of food. Their spindly arms and legs are a *dead* give away (no pun intended), that something is wrong. They could die at any moment. Yet, no one cares.
Let's bring the "death discussion" in to focus, shall we. One of the components of Affordability Care Act, is that an individual; on Medicare; can have a once a year discussion about "available options" for care. In-home care, nursing home care, hospice care, palliative care.
People freaked out thinking that those on Medicare were going to be "put on a bus", so to speak, and removed from society. That's not it at all. What the Affordable Care Act does, is allow Medicare to pay for that very important discussion. Something that *previously* was not allowed. That is a *GOOD* thing. now those on Medicare can have a discussion with their doctor and find out new options when it comes to "end of life" discussions.
I *think* about death all the time. I have since I was a young kid. The first death that impacted me was that of a classmate. For the longest time, I thought he was just sick. It wasn't until his and members of his family, who were in a car accident funeral; that I understood he was *not* coming to class the next day.. I was very sad. I tried to understand more about death, but, I was a kid and had nothing to base the concept of death on, until that incident.
Death does not scare me. It is just one of those "facts of life" things that people have to come to grips with on their on terms.
Tuesday, September 27, 2011
Structural damage
If you get into a car accident, external damage can be seen. Crumpled bumpers, broken glass, mangled metal is a visual image that you just can't get out of your head. You can get stressed out due to the high cost of repairing the vehicle. Vehicles can be repaired, to *next to new*. Yet, if you dig into the car's history, you will know that the car was in an accident.
Now, let's equate that to the human brain. Sometimes during birth, "accidents happen"; and I'm not talking about forgetting to wear a condom and finding out 9 months later, you have a new bundle of joy. No, what I am referring to are congenital issues that cause damage prior to, or at birth.Cerebral palsy and hydrocephalus are just two examples of the many health issues that are structural in nature.
There has been new reports that may have narrowed down the how congenital hydrocephalus occurs. Apparently, a "fat cell" may be the culprit. To read more about this interesting topic, feel free to click: http://news.sciencemag.org/sciencenow/2011/09/homing-in-on-hydrocephalus.html
The one problem with "structural" damage within the brain, you can't really go to the local body shop and have them "bang out the dents". Currently, the only way to "deal with" hydrocephalus is to have an internal "shunt" or tube going from one of the ventricles in the brain and drain it off into either the heart or abdomen.
One of the side effects of having "structural damage" in the brain is that the brain does not "act normal". Information is not processed properly. Think of the brain as one humongous roadway. Freeways with on ramps and off ramps that can be "under construction", due to knew information, or damage to an area. Getting new roads, well, that's always a good thing. Yet, learning how to "get around" during the "under construction" phase, can prove frustrating. Under normal circumstances, you know how to get from point A to point B. Enter the damaged brain and re-routes may frustrate, agitate and overwhelm the that very brain. This is where depression comes into play.
Depression is not a fun thing to deal with. Yet, there are different types of depression. For instance, you have Manic Depression (sometimes referred to as Bi-polar depression), SAD or Seasonal Affective Disorder; which has a component of depression in the affliction. You might have heard about MDD or Major Depressive Disorder. Chronic Depression (also called "dysthymia"), Psychotic Depression and rounding out the "fun times" is Postpartum depression.
A great many doctors want to have the patient take pills to deal with the "symptoms" of the depression. The problem is a "chemical imbalance" is one thing. A depression caused by structural damage can not be fixed by a pill.
Doctors mean well, but sometimes they don't know what else to do to treat the patient and their last resort are pills. It is not only frustrating for the doctor but the patient goes through all sorts of emotions trying out different drugs. A few things about drugs that has to be discussed: Side effects and contraindications.
Side effects and contraindications need to be talked about by the physician and patient, so that the patient is well aware of what could happen when taking the pills.
Ahhhh, but what about those individuals that can not take medication for depression. Well, for those who can not take medication there are a few options: 1) Psychotherapy, 2) Art therapy, 3) Writing therapy, ECT or Electro-convulsive Therapy, also known as "Electric shock therapy" and 5) "Self-help".
All the above types of treatment have their merits, yet, they also have their downfalls. The patient and the treating physician should look at *all* options. Discuss the benefits and the possible problems with each type of treatment. Don't rush into any kind of treatment.
In future blogs, we can discuss the various types of depression as well as go into further detail regarding drug interactions and contraindications.
Now, let's equate that to the human brain. Sometimes during birth, "accidents happen"; and I'm not talking about forgetting to wear a condom and finding out 9 months later, you have a new bundle of joy. No, what I am referring to are congenital issues that cause damage prior to, or at birth.Cerebral palsy and hydrocephalus are just two examples of the many health issues that are structural in nature.
There has been new reports that may have narrowed down the how congenital hydrocephalus occurs. Apparently, a "fat cell" may be the culprit. To read more about this interesting topic, feel free to click: http://news.sciencemag.org/sciencenow/2011/09/homing-in-on-hydrocephalus.html
The one problem with "structural" damage within the brain, you can't really go to the local body shop and have them "bang out the dents". Currently, the only way to "deal with" hydrocephalus is to have an internal "shunt" or tube going from one of the ventricles in the brain and drain it off into either the heart or abdomen.
One of the side effects of having "structural damage" in the brain is that the brain does not "act normal". Information is not processed properly. Think of the brain as one humongous roadway. Freeways with on ramps and off ramps that can be "under construction", due to knew information, or damage to an area. Getting new roads, well, that's always a good thing. Yet, learning how to "get around" during the "under construction" phase, can prove frustrating. Under normal circumstances, you know how to get from point A to point B. Enter the damaged brain and re-routes may frustrate, agitate and overwhelm the that very brain. This is where depression comes into play.
Depression is not a fun thing to deal with. Yet, there are different types of depression. For instance, you have Manic Depression (sometimes referred to as Bi-polar depression), SAD or Seasonal Affective Disorder; which has a component of depression in the affliction. You might have heard about MDD or Major Depressive Disorder. Chronic Depression (also called "dysthymia"), Psychotic Depression and rounding out the "fun times" is Postpartum depression.
A great many doctors want to have the patient take pills to deal with the "symptoms" of the depression. The problem is a "chemical imbalance" is one thing. A depression caused by structural damage can not be fixed by a pill.
Doctors mean well, but sometimes they don't know what else to do to treat the patient and their last resort are pills. It is not only frustrating for the doctor but the patient goes through all sorts of emotions trying out different drugs. A few things about drugs that has to be discussed: Side effects and contraindications.
Side effects and contraindications need to be talked about by the physician and patient, so that the patient is well aware of what could happen when taking the pills.
Ahhhh, but what about those individuals that can not take medication for depression. Well, for those who can not take medication there are a few options: 1) Psychotherapy, 2) Art therapy, 3) Writing therapy, ECT or Electro-convulsive Therapy, also known as "Electric shock therapy" and 5) "Self-help".
All the above types of treatment have their merits, yet, they also have their downfalls. The patient and the treating physician should look at *all* options. Discuss the benefits and the possible problems with each type of treatment. Don't rush into any kind of treatment.
In future blogs, we can discuss the various types of depression as well as go into further detail regarding drug interactions and contraindications.
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