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Entries by tag: depression

Democracy is based on the belief that people are more good than bad, that we are more curious than controlling, more playful than violent, and more kind than selfish.  I am not so sure anymore.  If the ways of a democratic society are based on the common denominator, and humans at base are horny, greedy and cruel, then society will be the same.  

I have come to suspect that we have not evolved to the point that our cognitive processes consistently overrule our animal instincts.  The idea that we can base our choices on verifiable information appears damned.  Civility is superficial and short-lived.  Democracy fails in the face of the self-righteous greed of our kind.  The solution of course would be a benevolent dictator, but the problem with those is that they are human too and the majority are not benevolent.

Please, America, prove me wrong.
I just saw something advertised under that title, and I clicked the link and was disappointed that the page did not come up.  I could use some help regaining mine.  I'm glad that there's been a shake up, hopefully it will get people talking across some lines again.  I'm aggravated by the ascendancy of self righteous ignorance.  What do you call it when you don't even know how much you don't know?  Unconscious Imcompetence.  Like the guy who told an MD/PhD infectious disease researcher "you should study microbes" because antibiotic resistance is no big deal.  I'll take conscious incompetence any time, or even better conscious competence.

I've come to a bit of am impasse with my medical practice, writings, even studies.  I'm losing interest.  It seems so fruitless.  I learn all this stuff and then nobody cares what I have to teach them.  If they want it they think it should be free like what they get from wikipedia.  Dr Google will be the death of me.

The more I read and study I am affronted by the tendency of humans to believe.  We want to believe.  We look for excuses to believe.  It saves us a whole lot of trouble just to believe in something, that way we can ignore all evidence to the contrary and enshrine every tidbit that supports our belief, and voila, the world is meaningful and live is worth living.  Just because we were believers.

Atheists and agnostics really have a hard row to how.  How do you create meaning in life, how do you form a community or tribe, without a belief-based grouping?  Can there be such a thing?  I have seen skepticism elevated to dogma.  Anything can be dogma.  If you think you are not dogmatic, look again.  Everyone is a hypocrite.

Rumi: Guest House

This being human is a guest house.
Every morning a new arrival.
A joy, a depression, a meanness,
some momentary awareness comes
as an unexpected visitor.
Welcome and entertain them all!

Even if they are a crowd of sorrows,
who violently sweep your house
empty of its furniture,
still, treat each guest honorably.
He may be clearing you out
for some new delight.

The dark thought, the shame, the malice
meet them at the door laughing and invite them in.

Be grateful for whatever comes
because each has been sent
as a guide from beyond.

~ Rumi

QotD: Seeking Happiness

“Everything is interconnected. Gratitude improves sleep. Sleep reduces pain. Reduced pain improves your mood. Improved mood reduces anxiety, which improves focus and planning. Focus and planning help with decision making. Decision making further reduces anxiety and improves enjoyment. Enjoyment gives you more to be grateful for, which keeps that loop of the upward spiral going. Enjoyment also makes it more likely you'll exercise and be social, which, in turn, will make you happier.”
--UCLA Neuroscience researcher Alex Korb



Four Rituals that Make You Happy:

(in summary, and as suggested by science to date)
1. Be grateful.
2. Name negative emotions.

3. Make good enough decisions.

4. Touch people.

SOURCE: http://theweek.com/articles/601157/neuroscience-reveals-4-rituals-that-make-happy

A Sad But Beautiful Song



I think the title is "Sweet Carolina" but in my mind the title ought to be "Pockets full of Dust" or something like it. This song is about how a lost soul can end up in a lonely place.
The DSM, of course, is the list of diagnoses written by and for psychiatrists who are dispensing pharmaceuticals which are covered by insurance. The DSM does not consider the possible causes of the disorders listed, nor allow for the possibility that simple lifestyle changes might be adequate to "cure" a disorder. The book is used to authorize the mental health professional to dispense psychoactive medications. No conflicts of interest there (ahem).

The National Institute of Mental Health (NIMH instead of just NIH) has decided that the basis of the DSM is not scientific enough, and it is not using those diagnoses as a foundation for ongoing research. The new Research Domain Criteria (RDoC) project to is intended to transform diagnosis by incorporating genetics, imaging, cognitive science, and more to create a new classification system. The new system of knowledge will be based on biology as well as symptoms, and will consider specific brain circuits, genetics, and experiences without regard for DSM categories. In fact the NIH is looking to support research projects that look across or subdivide current categories.

This is superb and hopeful to every person who has even been stuck with a diagnosis that didn't fit, or medicated when a simpler solution wasn't even entertained. My congratulations to the NIH for being independent enough to seek the truth.

SOURCE
http://www.nimh.nih.gov/about/director/2013/transforming-diagnosis.shtml
In this morning's medical news, Pfizer has issued a nationwide recall of Effexor/venlafaxine (a SSRI or SNRI), because a drug used for heart arrhythmias has shown up in somebody's bottle. The two drugs are packaged on the same line, suggesting to me that the pills are of a similar size and shape, and perhaps a pill or two could get stuck inside the machines and rattle out into the next batch being bottled.

But the hazards of taking drugs for depression are much broader than that. The pills themselves could have ingredients that aren't desirable. The drugs could have side effects that we don't understand yet. The drug companies could know about possible side effects but keep that information hidden to protect sales. They're recalling these three batches because accidental ingestion of the heart drug could kill someone. If it just make you a little sick, or did something that wasn't traceable to them, do you think they'd recall product? Or that doctors would stop prescribing them?

One glance at the list of adverse effects given on the wikipedia page for Venlafaxine will boggle your brain. There are a lot. These occur in over 10% of people taking the drug: headache esp when you start taking the drug, or increase the dose, nauseam insomnia, weakness, dizziness, trouble climaxing, sleepiness, drymouth and sweating. And these are a little less common: constipation, nervousness, abnormal vision, anorgasmia, hypertension, impotence, paresthesia, tremor, vasodilation, vomiting, suicide attempts, bruxism, so many more. The list is too long to reproduce here.

SOURCES
http://www.medscape.com/viewarticle/821631
http://en.wikipedia.org/wiki/Venlafaxine

RECALLED
Lot #V130142 and V130140, both expire 10/2015
Greenstone lot #V130014, exp 8/2015.

WORRY IF YOU TAKE VENLAFAXINE AND
you feel faint, get dizzy, pass out, or have a very fast heartbeat
Three lots of venlaxafine have just been recalled because one bottle contained one pill of a heart drug that could kill a person who didn't need it. The heart drug was an anti-arrhythmic called dofetilide/Tikosyn that could cause your heart to go wonky. The irony strikes me because there is always such noise about Quality Assurance for supplements and herbal medicines. Do people really believe that anything manufactured and packaged by Big Pharm is assuredly Safe? Another thing that strikes me as insane is the fact that brand names of pharmaceuticals are Capitalized. Who decided on That??

Recalled products:
30-count Effexor XR (venlafaxine HCI) 150 mg extended-release capsules
90-count Effexor XR (venlafaxine HCl) 150 mg extended-release capsules
Effexor lot numbers V130142 and V130140, exp October 2015
90-count Greenstone LLC-branded venlafaxine HCl 150 mg extended-release capsules
Greenstone lot number V130014, exp August 2015.

Potentially faulty product should be returned to Stericycle Inc, 1-888-345-0481.
Questions go to Pfizer Medical Information at 1-800-438-1985
Adverse reactions should be reported to www.fda.gov/medwatch/report.htm.

SOURCE
Medscape at http://www.medscape.com/viewarticle/821631

Walmart Wages

Today on MoveOn they're soliciting for signatures on a petition to make Walmart pay its workers better. Moveon says it's an outrage that Wallyworld employees have to use public services for healthcare because can't afford better. What isn't mentioned is that they spent what they had on vehicles and fuel, guns, alcohol and cigarettes, mobile phones and flatscreens. And a roof over their head.

Minimum wage is law. No company can hire you over the table for anything less. Walmart can pay minimum wage and if people apply for and accept that job, they have made a deal with that company. If they don't like it, they can quit, get another job. If there isn't another job, they can start their own business, or be useful to a family business or take care of an aging elder. They can run for office, start a protest, try and change the minimum wage. There is no shame in doing these things. The shame is in doing nothing. I just don't know how far from nothing this petition is. Having a grievance is not the same as having a solution.

When the economy contracts, families get closer. The resources that we do have get shared with those we care about. The death rate went down in the Great Depression, perhaps for this reason.

I can't get on board with political efforts to increase "jobs" because what "jobs" means is working for large corporations which will strike the best deal they can get for everything including manpower. It's the game, and winning for the 1% means never having to worry about a job. The worker never wins. The worker is a cog in a machine that cares nothing about him and will replace him the moment he begins to crack. The safety net may ease his passage a bit, but it is easy to get caught in.

To be trapped in the safety net is to lose your self respect, to become depressed, to want to die. This may be why so many white American men commit suicide. Middle-aged white guys commit suicide more than anybody else. Perhaps the veterans are driving that statistic.

DSM 5 (not V) Notes

These notes from the Oct 15, 2013 Grand Rounds at OHSU in the Psychiatry department. Watching it online, it's about "what you need to know about the new DSM".
notesCollapse )

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