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Tags depression , psychiatry

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Old 7th June 2016, 01:59 PM   #1
The Atheist
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The Ongoing Failure of Pyschiatry

When I was a kid I watched The Snake Pit, featuring Olivia de Havilland as a raving loony who gets locked in a padded cell during the 1920s.

We've come such a long way since then.

A case has come to light of an autistic man who has not been convicted of crimes, but who has been held in a small cell in solitary confinement for 5 years because psychiatric medicine can't calm the bloke down enough to handle.

This is rightly causing national outrage, especially since an unknown number of other people are held in similar circumstances, and that over 7000 people were held in solitary confinement due to mental illness in NZ last year.

To me, this is an indictment on an industry that has failed to make progress in the past century. They're still using ECT, they're still locking people up in solitary whose only crime is to be sick, and they're still prescribing drugs that are worse than the "cure".

Physician, heal thyself!
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Old 7th June 2016, 08:27 PM   #2
Reality Check
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Originally Posted by The Atheist View Post
A case has come to light of an autistic man who has not been convicted of crimes, but who has been held in a small cell in solitary confinement for 5 years because psychiatric medicine can't calm the bloke down enough to handle....
You cannot demand that an area of medicine magically cure people, The Atheist !

Strictly speaking the patient, Ashley, has been not in solitary confinement for 5 years. That would mean no leaving his room or contact with people for 5 years!
Ashley has been in seclusion for 5 years. That means a mental health unit which he can only leave for 90 minutes a day. He does spend more than half the time locked in his room which is totally inadequate for that purpose.
That is a failure of the health system, not psychiatry.
The reviewers in his last review pinpointed a lack of staff.
Quote:
They described how Ashley was commonly denied requests due to a lack of staff, such as watching a DVD, having a cup of tea or going for a walk. Instead he takes frequent baths, or cleans his room, spending hours wiping the walls.
Long periods of time go by marked down as, simply, "unengaged".
Personally I agree that Ashley's situation falls under the UN definition of torture since it has had adverse effects on his mental and physical health.

Locked in isolation: Lack of clarity around patient seclusion
Quote:
Over the past five years, inspectors have noted about five long-term seclusion cases in mental health facilities. But they say a "substantial number" of areas are not monitored, including community-based homes for the disabled, aged-care units and other compulsory care facilities.
...
Director of Mental Health Dr John Crawshaw said there was individual funding available for such cases. He said seclusion rates had dropped by 32 per cent, with 7091 people spending time in seclusion last year.
Ashley is one of the few reported cases of long term seclusion . The article suggests 5 or 6 reported cases in the last 5 years with the caveat that some faculties are not monitored so cases may be unreported.

Psychiatry still uses electroconvulsive therapy because it works (generally used as a last resort) despite its reputation and past history. An analogy: Doctors do not refuse to use morphine because its association with addicts or any past misuse !
Psychiatrists lock people up in seclusion because they cannot cure them and the legal system demands that potentially violent people be locked up safely.
Overuse of benzodiazepines: still an issue? is about the overuse by all doctors. The consultant for the article is Dr Jeremy McMinn, Consultant Psychiatrist and Addiction Specialist, Wellington. One of the references about adverse effects was published in J. Psychiatry (the other J. Psychiatry reference was about withdrawing patients from long-term use).

Last edited by Reality Check; 7th June 2016 at 08:47 PM.
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Old 7th June 2016, 11:56 PM   #3
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Originally Posted by Reality Check View Post
You cannot demand that an area of medicine magically cure people, The Atheist !
I'm not, but I am demanding some improvement in the "medicine".

Psychiatry is still using the equivalent of cupping.

Originally Posted by Reality Check View Post
Strictly speaking the patient, Ashley, has been not in solitary confinement for 5 years. That would mean no leaving his room or contact with people for 5 years!
Ashley has been in seclusion for 5 years. That means a mental health unit which he can only leave for 90 minutes a day.
Potato, potahto.

90 minutes a day and you're disputing solitary confinement? Each to their own, I guess, but you're also avoiding an unknown number of days where he did not get his 90 minutes, as noted in the original article.

I'm amused by the fact that actual criminals have been financially compensated for spending as little as two weeks in solitary, while Ashley just gets locked away in a shed.

Originally Posted by Reality Check View Post
He does spend more than half the time locked in his room which is totally inadequate for that purpose.
That is a failure of the health system, not psychiatry.
Completely incorrect.

The health system is charged with handling the meat; the psychiatric industry is charged with developing treatments, and there are none.

If you're going to blame those who get left the dregs of the psychiatric industry to look after, you may as well blame Ashley or his parents.

Originally Posted by Reality Check View Post
Personally I agree that Ashley's situation falls under the UN definition of torture since it has had adverse effects on his mental and physical health.
Then we're on the same wavelength.

Originally Posted by Reality Check View Post
Ashley is one of the few reported cases of long term seclusion . The article suggests 5 or 6 reported cases in the last 5 years with the caveat that some faculties are not monitored so cases may be unreported.
Precisely.

It is known that some Alzheimer's patients are restrained, but christ knows how many.

One is too many.

Originally Posted by Reality Check View Post
Psychiatry still uses electroconvulsive therapy because it works (generally used as a last resort) despite its reputation and past history. An analogy: Doctors do not refuse to use morphine because its association with addicts or any past misuse !
I have a much better analogy - you can still make fire by rubbing two sticks, but that technology has advanced a little.

Yes, it works for short-term help in acute cases - in other words, it delays the inevitable onset of the next episode.

It isn't a cure; it's a stop-gap for an industry incapable of real progress.

Originally Posted by Reality Check View Post
Psychiatrists lock people up in seclusion because they cannot cure them and the legal system demands that potentially violent people be locked up safely.
That is the problem as I've noted. We found a cure for AIDS in the space of a couple of decades; we can now keep people alive beyond the wildest dreams of the 1980s - Doug Myers, for example - and we produced a vaccine to the novel H1N1 virus in the space of a few months.

That psychiatry cannot even mitigate the effects of the illness is an indictment on their lack of progress.
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Old 8th June 2016, 01:14 AM   #4
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AIDS was an international crisis, and massive amounts of money were poured into drug research.

H1N1 was an international time bomb, and massive amounts of money were poured into development of the already existing flu drugs.

By contrast there's very little money in psychiatric drug research, largely because not enough people give a crap. It's not like psychiatric illness is contagious or anything, you can't catch madness from an infected person! There's no imminent crisis, no need for international cooperation, and the vast majority of seriously ill mental patients are pretty much invisible. Hence no research money.

So here's a suggestion, instead of spouting off to an Internet forum where nobody has any power or ability to make any difference, why don't you petition your parliament and help to get the psychiatrists the funding to run proper drug trials, and develop effective treatment?


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Old 8th June 2016, 10:34 AM   #5
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Originally Posted by The Atheist View Post
I'm not, but I am demanding some improvement in the "medicine".

Psychiatry is still using the equivalent of cupping.
Hyperbole.



Originally Posted by The Atheist View Post
Potato, potahto.

90 minutes a day and you're disputing solitary confinement? Each to their own, I guess, but you're also avoiding an unknown number of days where he did not get his 90 minutes, as noted in the original article.
Reality Check was not quibbling... I think you misunderstand the definitions. The 90 minutes is not time outside a locked room, but time outside the unit entirely. Going to a cafe, for example. I expect he doesn't always get a pass every day, no. Being in a unit and being able to interact with other patients is not 'solitary'. However, there are periods where he is in full seclusion and unable to interact with the other patients for several hours a day.


Originally Posted by The Atheist View Post
I'm amused by the fact that actual criminals have been financially compensated for spending as little as two weeks in solitary, while Ashley just gets locked away in a shed.
Crap analogy, and further hyperbole regarding 'shed'. The key difference being whether it's justified. Prisoners were compensated because their solitary was not justified. Heck: there are convicts who receive compensation for being in prison at all (eg: false convictions). Their compensation doesn't prove that imprisonment is wrong.



Originally Posted by The Atheist View Post
Completely incorrect.

The health system is charged with handling the meat; the psychiatric industry is charged with developing treatments, and there are none.
Sort of... the profession is also charged with publishing guidelines for care. Since this institution violated the professional guidelines for care, I agree that blame for this example should be placed on the institution, not the profession.


Originally Posted by The Atheist View Post
If you're going to blame those who get left the dregs of the psychiatric industry to look after, you may as well blame Ashley or his parents.
It depends on what they knew.



Originally Posted by The Atheist View Post
Then we're on the same wavelength.



Precisely.

It is known that some Alzheimer's patients are restrained, but christ knows how many.

One is too many.
I disagree, sometimes you gotta restrain. The alternative is sedation, and that's a higher risk of unintended/undesireable side effects. The important question is whether the incidents in question are aligned with professional guidelines or not. If yes, then we can direct criticism to the profession, but if not, then the facility is accountable, or perhaps specific individuals if they were acting contrary to the facility's directive.



Originally Posted by The Atheist View Post
I have a much better analogy - you can still make fire by rubbing two sticks, but that technology has advanced a little.

Yes, it works for short-term help in acute cases - in other words, it delays the inevitable onset of the next episode.

It isn't a cure; it's a stop-gap for an industry incapable of real progress.
Industry? Do you mean pharmaceuticals? I'm confused, because in the OP I thought you were talking about psychiatry, which is a medical specialty.

Psychiatry has made a lot of progress in the approximately 50 years since the introduction of the first pharmaceuticals. It's one of the newest specialties within medicine, and arguably the most complex subject matter. Vaccines, by comparison, are the medical low hanging fruit.

Having done HIV research (MSc) and psychology research (BA), I can say that HIV research is an order of magnitude less difficult - the subject matter isn't trying to trick you, for one thing. (caveat - I worked in study design, so yeah, sometimes trials volunteers are trying to trick us, but HIV itself isn't)



Originally Posted by The Atheist View Post
That is the problem as I've noted. We found a cure for AIDS in the space of a couple of decades; we can now keep people alive beyond the wildest dreams of the 1980s - Doug Myers, for example - and we produced a vaccine to the novel H1N1 virus in the space of a few months.
Meh. And we've been kicking the tires on cancer and cardiovascular disease with little progress for ten generations.

I think progress against a particular category of illness can also mean it's a bugger to cure, not necessarily a lack of competence or interest.



Originally Posted by The Atheist View Post
That psychiatry cannot even mitigate the effects of the illness is an indictment on their lack of progress.
Psychiatry can, and does. This is an edge case. Millions of kids on the lower functioning end of spectrum disorder are living astronomically better lives than they would have 50 years ago when we threw them into prisons or stacked them into mental institutions like cordwood. My best friend's kid is medium functioning autistic, and his life is much better than his grand-uncle's (my friend's dad's brother) who had about the same impact, but had the misfortune of being born in the 1930s.


Scientology has a pretty well funded 'rage machine' that cranks out these edge cases in the guise of journalism, and tries to paint the entire psychiatric landscape with them, because that's their idee fixe these days.

There's another example they've been championing here in Canada. It's a guy who cut up his wife's face and his lawyers successfully obtained a defense of mentally ill and unable to understand his actions. So, he's been in an institution in Ontario for almost ten years... if he had been found criminally responsible for his actions, he'd be out of prison by now.
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Old 8th June 2016, 10:41 AM   #6
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Crank nonsense of the most ignorant and arrogant kind. Another genius that knows better than the scientific community. Little regard for objective argument or research, due diligence has not been done on claims.
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Old 8th June 2016, 12:34 PM   #7
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Autism is NEUROLOGICAL disorder with multiple manifestations and functional differences.
It can NOT be treated by psychiatry. Some manifestations can be reduced in a pallative fashion.

Autism is not a mental illness
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Old 8th June 2016, 12:45 PM   #8
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Originally Posted by wollery View Post
AIDS was an international crisis, and massive amounts of money were poured into drug research.

H1N1 was an international time bomb, and massive amounts of money were poured into development of the already existing flu drugs.
Lemme see...

HIV has killed an estimated 650,000 Americans.

The first HIV death in USA was around 1980.

Since 1980, at least 1,500,000 Americans have died as a result of mental illness.

The number of HIV deaths is decreasing very quickly; the number of deaths from mental illness is not.

1.2M Americans live with HIV; almost 10,000,000 Americans live with serious mental illness.

Do you really want to argue maths on this?

Originally Posted by wollery View Post
By contrast there's very little money in psychiatric drug research, largely because not enough people give a crap. It's not like psychiatric illness is contagious or anything, you can't catch madness from an infected person! There's no imminent crisis, no need for international cooperation, and the vast majority of seriously ill mental patients are pretty much invisible. Hence no research money.
That's one of the silliest comments I've ever seen.

The number one prescription in USA is for an anti-psychotic tablet, and many psychiatric drugs make up the top 100 prescribed.

The industry is immense, and since people are much likely to be on psychiatric drugs for much longer than antibiotics or cancer treatment, the idea that the industry lacks money is laughable.

The nobody cares part is correct.

Originally Posted by wollery View Post
So here's a suggestion, instead of spouting off to an Internet forum where nobody has any power or ability to make any difference, why don't you petition your parliament and help to get the psychiatrists the funding to run proper drug trials, and develop effective treatment?
What an inane comment.

Anyone reading that out of context would need to be unaware of what discussion forums actually are.

Originally Posted by blutoski View Post
Hyperbole.
Good spot.

Originally Posted by blutoski View Post
Reality Check was not quibbling... I think you misunderstand the definitions. The 90 minutes is not time outside a locked room, but time outside the unit entirely. Going to a cafe, for example. I expect he doesn't always get a pass every day, no. Being in a unit and being able to interact with other patients is not 'solitary'. However, there are periods where he is in full seclusion and unable to interact with the other patients for several hours a day.
More absurdity married to ignorance. Did you read the whole articles?

He does not get to go to cafes and almost all of his times out of his shed are on his own, barring his two guards. He almost never interacts with other humans and has spent over half of his five years in a single cell.

That's close enough to solitary for me. I'm surprised you didn't spot the slight analogy after having been so brilliant at spotting hyperbole.

Originally Posted by blutoski View Post
Crap analogy, and further hyperbole regarding 'shed'.
The shed is no hyperbole. My shed is far nicer than his cell.

Originally Posted by blutoski View Post
The key difference being whether it's justified.
I'm not arguing the justification - there's no doubt he's a danger to everyone. A big, strong raving loony who could rip your head off in a heartbeat, and who might do at the least provocation.

I think the health board could do a bit more in terms of comfort and life, but the issue is with the shrinks who can't even begin to control the disability.

Originally Posted by blutoski View Post
Industry? Do you mean pharmaceuticals? I'm confused, because in the OP I thought you were talking about psychiatry, which is a medical specialty.
Psychiatry is an industry, and psychiatric drugs are a part of the industry.

Originally Posted by blutoski View Post
Psychiatry has made a lot of progress in the approximately 50 years since the introduction of the first pharmaceuticals.
Wow, I hope you had your fingers crossed when you typed that.

They're still prescribing the exact same drugs all this time later. In time frames, penicillin only pre-dates psychiatric drugs by a decade or so, so the time argument falls flat on its face there. Antibiotics have almost come full circle while doctors are still prescribing Valium.

Anti-psychotic drugs have extremely high incidence rates of adverse side effects (up to 50%); as shown recently, are so much more likely to lead to suicidal thoughts that drug companies lied about their research, and also carry increased risk of cardiac arrest and sudden death.

Originally Posted by blutoski View Post
Meh. And we've been kicking the tires on cancer and cardiovascular disease with little progress for ten generations.
Ten generations being around 250 years, yet you accuse me of hyperbole?

In 250 years, life expectancy has almost doubled.

The progress made in cancer & cardiac treatment is immense. You don't even need me to point that out, but if you wish, I'm quite happy to back up the case with plenty of examples.

Originally Posted by blutoski View Post
Psychiatry can, and does. This is an edge case. Millions of kids on the lower functioning end of spectrum disorder are living astronomically better lives than they would have 50 years ago when we threw them into prisons or stacked them into mental institutions like cordwood. My best friend's kid is medium functioning autistic, and his life is much better than his grand-uncle's (my friend's dad's brother) who had about the same impact, but had the misfortune of being born in the 1930s.
And is that more down to societal change or psychiatry's?

I'm picking the former, since we [generally] don't insist loonies be locked up and kids with autism have a much greater emphasis on normalisation, achieved by attending normal schools and getting lots of help that did not previously exist.
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Old 8th June 2016, 12:48 PM   #9
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Originally Posted by Dancing David View Post
Autism is NEUROLOGICAL disorder with multiple manifestations and functional differences.
It can NOT be treated by psychiatry. Some manifestations can be reduced in a pallative fashion.

Autism is not a mental illness
Yes, mea maxima culpa.

However, treatment of it still rests within the psychiatric industry, so it's another difference that makes no difference.

Saying " It can NOT be treated by psychiatry" is patently incorrect. What branch of medicine do you think it should attach to? Obstetrics? Gynaecology? Proctology?
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Old 8th June 2016, 01:01 PM   #10
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"psychiatric industry"

Crank language, weasel words. Psychiatry is a medical science, the application of which requires money. When the regulations are as thick as the earth's crust, calling it an industry is just hilarious. Watch, I'm gonna google "Psychiatric industry" and the top 3 sites will be crank sites.

HAHAHAHAHAHA

I am right about my prediction. Your thread sucks really bad.
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Old 8th June 2016, 01:27 PM   #11
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Any company that could create a low-side-effect drug that, taken daily, effectively treated depression, with little potential for abuse, would be worth billions. Occam's razor suggests that companies are desperately trying but haven't been able to succeed, rather than that this (and similar needs) need pointed out to them as something important to work on.
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Old 8th June 2016, 02:24 PM   #12
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Originally Posted by The Atheist View Post
Yes, mea maxima culpa.

However, treatment of it still rests within the psychiatric industry, so it's another difference that makes no difference.

Saying " It can NOT be treated by psychiatry" is patently incorrect. What branch of medicine do you think it should attach to? Obstetrics? Gynaecology? Proctology?
Psychiatry may be able to alleviate some of the effects of autism in some people and is apparently doing so. Some extreme cases do not react to this treatement. This would be a treatment but not a cure.

As to your comments on medical specialties involving the pelvic area (freudian?), perhaps neurology is the word you were searching for? Neurological research is probably the specialty most likely to reach an understanding of, and more effective treatment for autism.
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Old 8th June 2016, 02:25 PM   #13
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Originally Posted by The Atheist View Post
I'm not, but I am demanding some improvement in the "medicine".
No you are not, The Atheist - you are demanding a specific improvement in the medicine - the ability to completely control patients who have psychotic episodes.
Insulting an area of medicine do not impress me nor I suspect other posters.

Some dictionary English for you, The Atheist: Solitary confinement
Quote:
Solitary confinement is a form of imprisonment in which an inmate is isolated from any human contact, often with the exception of members of prison staff. It is sometimes employed as a form of punishment beyond incarceration for a prisoner and has been cited as an additional measure of protection for the inmate. It is also given for violations of prison regulations or as a form of protective custody and, in the case of possible suicide, to prevent access to items that could disrupt the prisoner's health.
Long term seclusion used in mental institutions is not strictly solitary confinement because the patients have limited human contact including in this case time outside of the facility: 90 minutes a day currently with a past period when it was 30 minutes a day.

It is irrelevant that some NZ criminals in 2005 were compensated for actual and illegal solitary confinement

Denying what you cited is bad, The Atheist: Autistic man locked in isolation for five years
Quote:
The three expert reviewers decided much of Ashley's impulsive and unpredictable aggression was due to the mismatch between the care he needs, and the service he was getting at Tawhirimatea.

They described how Ashley was commonly denied requests due to a lack of staff, such as watching a DVD, having a cup of tea or going for a walk. Instead he takes frequent baths, or cleans his room, spending hours wiping the walls.

Long periods of time go by marked down as, simply, "unengaged".
You still need to learn about electroconvulsive therapy
Quote:
A round of ECT is effective for about 50% of people with treatment-resistant major depressive disorder, whether it is unipolar or bipolar.[6] Follow-up treatment is still poorly studied, but about half of people who respond relapse within 12 months.[7]
(leaving 25% of treated people still cured after 12 months for an unknown time)

Pipedreams about what psychiatry should be able to do, does not reflect the real world.
There is no cure for AIDS
Quote:
There is no cure or vaccine; however, antiretroviral treatment can slow the course of the disease and may lead to a near-normal life expectancy.[9][12] Treatment is recommended as soon as the diagnosis is made.[13] Without treatment, the average survival time after infection is 11 years.[14]
The disease that Ashely suffers from is called autism. Psychiatry can mitigate its effects, e.g. tranquilizers exist !

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Old 8th June 2016, 02:28 PM   #14
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I am heartily pleased that people with the OP views have little to no influence over the care I or my loved ones receive. Certainly, I have the 'Psychiatry Industry' to thank for the continued health and well being of a couple of family members and for assisting me in understanding their needs.

I've learned that trying to reason with people having the OP view is like trying to reason with a delusional person (and I have tried to reason with a delusional person).
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Old 8th June 2016, 02:31 PM   #15
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Originally Posted by The Atheist View Post
More absurdity married to ignorance. Did you read the whole articles?
Yes, and I also worked in a hospital for over a decade and my wife is a psychiatrist.
I actually understand the subject matter. I'm hoping to educate you about the definitions, you seem either to not understand them, or to not care. eg: solitary vs seclusion, for example.


Originally Posted by The Atheist View Post
He does not get to go to cafes and almost all of his times out of his shed are on his own, barring his two guards. He almost never interacts with other humans and has spent over half of his five years in a single cell.

That's close enough to solitary for me. I'm surprised you didn't spot the slight analogy after having been so brilliant at spotting hyperbole.
I don't think the article gives us enough detail to say what the actual conditions are, but I think my main point is that it sounds like it's contrary to psychiatric recommendations, so therefore not a good criticism of psychiatry, without exploring that comparison.

Personally, I think he has a case against the facility, based on the information available. A failure of capitalism, IMO.



Originally Posted by The Atheist View Post
The shed is no hyperbole. My shed is far nicer than his cell.
He has a cell? Not a room? (ergo: the hyperbole accusation)



Originally Posted by The Atheist View Post
I'm not arguing the justification - there's no doubt he's a danger to everyone. A big, strong raving loony who could rip your head off in a heartbeat, and who might do at the least provocation.

I think the health board could do a bit more in terms of comfort and life, but the issue is with the shrinks who can't even begin to control the disability.
OK, so I'm getting the picture that you think the lack of solution is "somebody's fault" - ?

That's why I'm curious about your opinion about medicine in general, which has failed to make much more than a dent in cancer rates.

This has come up on the list before... cancer is a family of conditions (similar to mental illness), some of which are easier to treat than others and have seen incredible progress (similar to mental illness), while others are stubbornly resistant to any treatment to the point of despair and global statistics for incidence are getting even worse (similar to mental illness).



Originally Posted by The Atheist View Post
Psychiatry is an industry, and psychiatric drugs are a part of the industry.
OK, sure... but then I guess medicine is an industry, do you think they're all quacks because no cure for cancer?



Originally Posted by The Atheist View Post
Wow, I hope you had your fingers crossed when you typed that.

They're still prescribing the exact same drugs all this time later. In time frames, penicillin only pre-dates psychiatric drugs by a decade or so, so the time argument falls flat on its face there. Antibiotics have almost come full circle while doctors are still prescribing Valium.
Not sure what you mean by that. Valium is still prescribed, because it still works. There are better drugs now as well, for patients who need those.

My wife is prescribing what are called 3rd generation antipsychotics that are less than a decade old, they're now the first line in BC.



Originally Posted by The Atheist View Post
Anti-psychotic drugs have extremely high incidence rates of adverse side effects (up to 50%); as shown recently, are so much more likely to lead to suicidal thoughts that drug companies lied about their research, and also carry increased risk of cardiac arrest and sudden death.
Absolutely. So do chemotherapy drugs, surgery, and radiation therapy.
Is this evidence of an 'ongoing failure' in cancer treatment?



Originally Posted by The Atheist View Post
Ten generations being around 250 years, yet you accuse me of hyperbole?

In 250 years, life expectancy has almost doubled.

The progress made in cancer & cardiac treatment is immense. You don't even need me to point that out, but if you wish, I'm quite happy to back up the case with plenty of examples.
Hm, no I'm not sure what you would be presenting. Cancer is all cured now? I don't think I understand your thesis. My impression is that you think progress in psychiatry doesn't exist, whereas obviously it does. There has been progress in all fields of medicine, psychiatry included. I would say that psychiatry has had very rapid progress, and that is due to its very recent emergence as a field of study.



Originally Posted by The Atheist View Post
And is that more down to societal change or psychiatry's?
Well... both obviously. Psychiatry discovers new things and society responds to the facts. Same with any medical field. Is reduced typhoid incidence due to medicine or society? Both, right? Medicine identified the root cause of these epidemics, and society adapted to the information.



Originally Posted by The Atheist View Post
I'm picking the former, since we [generally] don't insist loonies be locked up and kids with autism have a much greater emphasis on normalisation, achieved by attending normal schools and getting lots of help that did not previously exist.
The main reason we've been able to deinstitutionalize the mentally ill is that we have better management options. Psychiatry has a combination of better talk therapy and more effective and tolerable medications, for when talk therapy is not effective enough to achieve the therapeutic goals.
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Old 8th June 2016, 02:50 PM   #16
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Originally Posted by Dancing David View Post
Autism is NEUROLOGICAL disorder with multiple manifestations and functional differences.
Correct, Dancing David.
However autism has historically been a psychiatric disorder (Leo Kanner who named it was a psychiatrist). The treatment is considered as part of psychiatry when it really should be a branch of neurology (autism spectrum sometimes appears as a neurological disorder).
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Old 8th June 2016, 03:00 PM   #17
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Originally Posted by Steve View Post
Psychiatry may be able to alleviate some of the effects of autism in some people and is apparently doing so. Some extreme cases do not react to this treatement. This would be a treatment but not a cure.

As to your comments on medical specialties involving the pelvic area (freudian?), perhaps neurology is the word you were searching for? Neurological research is probably the specialty most likely to reach an understanding of, and more effective treatment for autism.
The Atheist misses the boat again,

The most effective treatment fro autism is early identification and intervention not psychiatry
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Old 8th June 2016, 03:03 PM   #18
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Originally Posted by Reality Check View Post
Correct, Dancing David.
However autism has historically been a psychiatric disorder (Leo Kanner who named it was a psychiatrist). The treatment is considered as part of psychiatry when it really should be a branch of neurology (autism spectrum sometimes appears as a neurological disorder).
I think any one in the MH and development field and especially people who live with and intervene with autism will tell you it is not a mental illness.

It is developmental and neurological.


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Old 8th June 2016, 03:49 PM   #19
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Originally Posted by The Greater Fool View Post
I am heartily pleased that people with the OP views have little to no influence over the care I or my loved ones receive. Certainly, I have the 'Psychiatry Industry' to thank for the continued health and well being of a couple of family members and for assisting me in understanding their needs.

I've learned that trying to reason with people having the OP view is like trying to reason with a delusional person (and I have tried to reason with a delusional person).
"Psychiatry Failure" is a subset of Psychiatry Denial, which is more than fringe these days, unfortunately.

RationalWiki has an entry: [Mental Illness Denial], and Dr. Novella has chimed in: [Mental Illness Denial]

I have some expectation that the future of Psychiatry Denial is one of declining popularity, as I suspect the prime driver is Scientology dollars, and they're on their last ropes these days.

When I was at APA last month, Scientology had their usual protest. They brought back their 'house of horrors' popup experience. It's like a carney haunted house, they guide groups through the temporary structure, with dioramas of trepanation, electrocutions, people tied to beds with rope, &c.
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Old 8th June 2016, 03:57 PM   #20
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Originally Posted by Pup View Post
Any company that could create a low-side-effect drug that, taken daily, effectively treated depression, with little potential for abuse, would be worth billions. Occam's razor suggests that companies are desperately trying but haven't been able to succeed, rather than that this (and similar needs) need pointed out to them as something important to work on.
Then point me to some examples of the research, because I'm not seeing it.

All I see is continuing push of drugs that already fail.

Originally Posted by blutoski View Post
Yes, and I also worked in a hospital for over a decade and my wife is a psychiatrist.
I actually understand the subject matter. I'm hoping to educate you about the definitions, you seem either to not understand them, or to not care. eg: solitary vs seclusion, for example.
In the case of seclusion v solitary, I've already said that the difference is minor enough to be irrelevant - in cases like Ashley.

Originally Posted by blutoski View Post
I don't think the article gives us enough detail to say what the actual conditions are, but I think my main point is that it sounds like it's contrary to psychiatric recommendations, so therefore not a good criticism of psychiatry, without exploring that comparison.
Well, since his condition and living conditions are the responsibility of the psychiatric wing of the health board, I'm struggling to see whose problem it is if not psychiatry.

Originally Posted by blutoski View Post
That's why I'm curious about your opinion about medicine in general, which has failed to make much more than a dent in cancer rates.
What utter nonsense - are you sure you're involved in the medical industry?

Let's have a look at the facts, shall we?

Every single demographic under age 44 has seen at least a 50% reduction in death rate since 1950. An 80% reduction in child cancer mortality is enormous.

"Failed to make a dent in" is absolute crap.

Originally Posted by blutoski View Post
OK, sure... but then I guess medicine is an industry, do you think they're all quacks because no cure for cancer?
Lovely strawman - I hear they're taking bids on Ebay for them right now.

Originally Posted by blutoski View Post
My wife is prescribing what are called 3rd generation antipsychotics that are less than a decade old, they're now the first line in BC.
Yep, and they don't even reduce the incidence of cardiac arrest and sudden death - a massive improvement!

Originally Posted by blutoski View Post
Hm, no I'm not sure what you would be presenting. Cancer is all cured now? I don't think I understand your thesis. My impression is that you think progress in psychiatry doesn't exist, whereas obviously it does. There has been progress in all fields of medicine, psychiatry included. I would say that psychiatry has had very rapid progress, and that is due to its very recent emergence as a field of study.
We're just going to have to disagree, then. No big deal - I just don't see where the progress has been made, apart some fine-tuning that might have increased effectiveness by a percent or two.

Your lack of data in support of your position is revealing.

Originally Posted by blutoski View Post
The main reason we've been able to deinstitutionalize the mentally ill is that we have better management options.
Funnily enough, that's exactly what I meant when I mentioned societal changes to the way they're cared for.

We agree there - it is physical. not medical improvement.

Originally Posted by blutoski View Post
Psychiatry has a combination of better talk therapy and more effective and tolerable medications, for when talk therapy is not effective enough to achieve the therapeutic goals.
Yep, talking is distinctly new.

Originally Posted by Dancing David View Post
The Atheist misses the boat again,

The most effective treatment fro autism is early identification and intervention not psychiatry
Nope - I agree with that entirely.

In the case of Ashley, he missed that bus, and some people aren't content to let him rot.
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Old 8th June 2016, 04:14 PM   #21
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Originally Posted by The Atheist View Post
In the case of seclusion v solitary, I've already said that the difference is minor enough to be irrelevant - in cases like Ashley.
The difference between actual solitary confinement and long term seclusion is not irrelevant. Solitary confinement is someone in a cell all of the time with contact only with their guards. No one (not even you) is claiming that Ashley spent 5 years in a cell all of the time with contact only with their guards .
Ashley spent time outside the facility.
Ashley had visitors, e.g. his family. The article starts with Ashley walking with his family.
Ashley might interact with other patients.

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Old 8th June 2016, 04:33 PM   #22
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Originally Posted by The Atheist View Post
In the case of seclusion v solitary, I've already said that the difference is minor enough to be irrelevant - in cases like Ashley.
His is what's called an edge case, meaning, not representative of the field.

In contrast, your post is making accusations about the field. This is the logical fallacy of hasty generalization.



Originally Posted by The Atheist View Post
Well, since his condition and living conditions are the responsibility of the psychiatric wing of the health board, I'm struggling to see whose problem it is if not psychiatry.
Like I said, we'd have to see what their directives were. Ultimately yes, we can extrapolate from proximal to distal responsibility, but more detail will help us understand the focus of accountability. Technically, it's the President's responsibility, since the buck stops with him.



Originally Posted by The Atheist View Post
What utter nonsense - are you sure you're involved in the medical industry?

Let's have a look at the facts, shall we?

Every single demographic under age 44 has seen at least a 50% reduction in death rate since 1950. An 80% reduction in child cancer mortality is enormous.

"Failed to make a dent in" is absolute crap.
I didn't say 'death rates' I said 'cancer rates'. Our rates of cancer are rising (more people getting cancer). Of whom, a higher percentage survive than before. Net, though, is more people dying of cancer than ever before.

In contrast, mental illness incidence has been pretty stable (makes sense - not a lot of environmental causes, mostly strikes in early life so longer lifespans does not increase incidence much), and the portion of people who are able to manage a condition like schizophrenia has gone from 0% in 1955 to a 68% 'recovery rate' (meaning: no further incidents while maintaining their regimen). (The American Journal of Psychiatry (Vol. 144, No. 6, p. 718-735))

Based on your above stats, it sounds like psychiatry has had more success with schizophrenia than oncology has had with cancer... so why is oncology not an even bigger 'failure' ?





Originally Posted by The Atheist View Post
Yep, and they don't even reduce the incidence of cardiac arrest and sudden death - a massive improvement!
You'd have to be more specific. Which drugs are you talking about that have the same incidence of cardiac arrest and sudden death as which other drugs? I'm thinking of Paliperidone, for example, for schizophrenia, which does not report any such side effects. Weight gain, mostly.



Originally Posted by The Atheist View Post
We're just going to have to disagree, then. No big deal - I just don't see where the progress has been made, apart some fine-tuning that might have increased effectiveness by a percent or two.

Your lack of data in support of your position is revealing.
I'm hoping above citation will help.



Originally Posted by The Atheist View Post
Funnily enough, that's exactly what I meant when I mentioned societal changes to the way they're cared for.

We agree there - it is physical. not medical improvement.
I suppose... but that means you must agree that epidemiology cannot take credit for any contageous disease reduction, since it required associated social change to implement? Why is epidemiology not also a failure, then?



[quote=The Atheist;11323142]Yep, talking is distinctly new.[/qutoe]

Certainly you can't possibly believe that therapy is no different than 'talking' ?

(this is where the Psychiatry Denial becomes more evident)
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Old 8th June 2016, 04:51 PM   #23
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Originally Posted by The Atheist View Post
Then point me to some examples of the research, because I'm not seeing it.

All I see is continuing push of drugs that already fail.

One can search at https://clinicaltrials.gov/ to get an idea what's currently being researched, but there are generally hundreds of trials, not all for drugs, for any given condition. Articles like this are better for a quick overview:
20 New Antidepressants in the Pipeline 2015
A google search for the condition (autism, depression, etc.) and drug pipeline will usually bring up the latest research.
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Old 8th June 2016, 05:23 PM   #24
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Originally Posted by blutoski View Post
His is what's called an edge case, meaning, not representative of the field.

In contrast, your post is making accusations about the field. This is the logical fallacy of hasty generalization.
Generalisations that I've supported with quite a bit of evidence, but sure, Ashley's an outlier.


Originally Posted by blutoski View Post
I didn't say 'death rates' I said 'cancer rates'. Our rates of cancer are rising (more people getting cancer). Of whom, a higher percentage survive than before. Net, though, is more people dying of cancer than ever before.
Now you're not even making sense.

There are a lot more people in the world, and they're living a lot longer, so there being more cancer is no great leap. Since it's not even known whether some of them are preventable, the comparison is plain stupid. Rates of lots of cancers have decreased and there's enormous effort to educate people out of dangerous behaviours - smoking and obesity being top of the list.

The fact is that progress in cancer treatment over the exact same time period is immense.

Originally Posted by blutoski View Post
Based on your above stats, it sounds like psychiatry has had more success with schizophrenia than oncology has had with cancer... so why is oncology not an even bigger 'failure' ?
I'd dispute that treatments have been more successful than cancer treatment, because the cancer treatment stops, Schizos keep taking pills, so the condition is controlled and only stays controlled while they swallow the pills.

I do agree schizo is one area where the psychiatric industry has a rare win, though.


Originally Posted by blutoski View Post
You'd have to be more specific. Which drugs are you talking about that have the same incidence of cardiac arrest and sudden death as which other drugs? I'm thinking of Paliperidone, for example, for schizophrenia, which does not report any such side effects. Weight gain, mostly.
The research I linked to compared new generation drug morbidity rates to first generation drugs, and in both cases, there is a marked increase of cardiac arrest & death.

The drugs appear to be a broad range of antipsychotics.

Originally Posted by blutoski View Post
I suppose... but that means you must agree that epidemiology cannot take credit for any contageous disease reduction, since it required associated social change to implement? Why is epidemiology not also a failure, then?
Seriously?

You want details of the reduction in deaths from epidemics in the past century? Happy to provide, but I bet you know the answer anyway.

Originally Posted by blutoski View Post
Certainly you can't possibly believe that therapy is no different than 'talking' ?

(this is where the Psychiatry Denial becomes more evident)
I gather they sometimes write things down, but therapy consists of 99% talking as far as I'm aware. I've never attended a session myself, but everyone I know who has reports that it is entirely talking.
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Old 8th June 2016, 05:31 PM   #25
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Originally Posted by Pup View Post
One can search at https://clinicaltrials.gov/ to get an idea what's currently being researched, but there are generally hundreds of trials, not all for drugs, for any given condition.
I used "antipsychotic" as a search term and the first 20 show nothing new going on.

https://clinicaltrials.gov/ct2/resul...&Search=Search

Originally Posted by Pup View Post
Articles like this are better for a quick overview:
20 New Antidepressants in the Pipeline 2015
From your link: ...certain drugs on the list exhibit novel mechanisms of action that could improve...

Yep, they could certainly improve.

It seems to be more a case of fine-tuning existing drugs than anything novel.

It did give me one laugh though - dextromethorphan being used. How long has that sucker been on the market? Patented 76 years ago.
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Old 8th June 2016, 05:40 PM   #26
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Originally Posted by The Atheist View Post
Schizos keep taking pills, so the condition is controlled and only stays controlled while they swallow the pills.
You know **** all about schizophrenia....
Quote:
5. Myth: Patients must be on medication all their lives. Reality: It may be a small percentage who need medication indefinitely.

http://www.mss.mb.ca/resource_materi...tails.php?id=6
With all due respect, stop posting your ignorant horse **** on the internet and learn the meaning of the words "DUE DILIGENCE"
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Old 8th June 2016, 07:08 PM   #27
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Originally Posted by The Atheist View Post

It did give me one laugh though - dextromethorphan being used. How long has that sucker been on the market? Patented 76 years ago.
A whole 2 years longer than penicillin, and nobody uses that any more.
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Old 8th June 2016, 07:44 PM   #28
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Originally Posted by Steve View Post
A whole 2 years longer than penicillin, and nobody uses that any more.
If they were using it to cure warts, you'd have a good analogy.

I actually think it's a good thing; they're trying something new.
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Old 8th June 2016, 07:47 PM   #29
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Originally Posted by Joey McGee View Post
With all due respect, stop posting your ignorant horse **** on the internet and learn the meaning of the words "DUE DILIGENCE"
More total dishonesty. Even your own link says:

Quote:
it was clear that a surprising number (at least 25%50%) were completely off their medications
It's clear that most sufferers stay on their meds.

Nitpick anyway, since I've admitted that schizo is the glaring success story of psychiatry.

Despite the obvious:

Quote:
the frequent increase of covert and overt side effects which are unpleasant or undesirable (e.g. dyskinesia, dystonia. akinesia, akathisia, obesity, impotence, dry mouth, weight gain)
That's from your link, sorry.
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Old 8th June 2016, 07:57 PM   #30
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Originally Posted by The Atheist View Post
More total dishonesty. Even your own link says:



It's clear that most sufferers stay on their meds.
HuhLARRYUSSS!!!
Quote:
it was clear that a surprising number (at least 25%50%) were completely off their medications, suffered no further signs and symptoms of schizophrenia, and were functioning well.
Which meanns they functioned well off their meds, which supports the title of the subsection which you have completely taken out of context. Goddamnit why anyone would take you seriously just blows my mind. Does it say what you said, that schizos have to stay on meds? IT SAYS THE COMPLETE OPPOSITE! Yet you stand here in denial saying it supports your view, that's *********** funny bro, that's why I come back here, if you ever admit to being a troll I'll be so sad don't do that to me.

Quote:
Nitpick anyway, since I've admitted that schizo is the glaring success story of psychiatry.
In a narrow way you've demonstrated you don't understand.

Look, the outcome of this is obvious. No one cares what you think except for that idiot you keep telling us about that listens to you at the coffee shop.

Edited by zooterkin:  <SNIP>
Edited for rule 11

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Old 9th June 2016, 12:54 PM   #31
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Meanwhile, back to the actual topic, another point that shows the total lack of progress of the psychiatric industry is the fact that depression is probably better served by prescribing exercise than drugs.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC474733/
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Old 9th June 2016, 02:35 PM   #32
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Originally Posted by The Atheist View Post
Meanwhile, back to the actual topic, another point that shows the total lack of progress of the psychiatric industry is the fact that depression is probably better served by prescribing exercise than drugs.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC474733/
A lie about The Benefits of Exercise for the Clinically Depressed, The Atheist. The article does not state that exercise is better than standard treatments. It is that addition of therapies such as exercise to standard treatments (this is called an adjunct treatment) improves outcomes as in the abstract:
Quote:
Millions of Americans suffer from clinical depression each year. Most depressed patients first seek treatment from their primary care providers. Generally, depressed patients treated in primary care settings receive pharmacologic therapy alone. There is evidence to suggest that the addition of cognitive-behavioral therapies, specifically exercise, can improve treatment outcomes for many patients. Exercise is a behavioral intervention that has shown great promise in alleviating symptoms of depression. The current review discusses the growing body of research examining the exercise-depression relationship that supports the efficacy of exercise as an adjunct treatment. Databases searched were Medline, PsycLit, PubMed, and SportsDiscus from the years 1996 through 2003. Terms used in the search were clinical depression, depression, exercise, and physical activity. Further, because primary care physicians deliver important mental health services to the majority of depressed patients, several specific recommendations are made regarding counseling these patients on the adoption and maintenance of exercise programs.
If you do not want to make the "actual topic" look like displays of the inability of understanding English then you need to read and understand your citations.

For that matter what is the actual subject?
The title suggests a fantasy about "The Ongoing Failure of Pyschiatry" when all medicine has ongoing failures (where is the cure for cancer !).
The OP is about the use of long-term seclusion which is a practice which is not recommended by psychiatrists any more - an Ongoing Success of Psychiatry!

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Old 9th June 2016, 02:58 PM   #33
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Originally Posted by Reality Check View Post
A lie ...
No lie involved, but your view is different to mine, mostly because like the industry itself, you're ignoring important points.

It is known that many depression treatment drugs cause increased suicidal feelings. That's why the drug companies lied about that. It is a serious flaw in drug treatment that exercise does not have.

To me, that alone makes any successful treatment "better" than drugs.

I'm happy to list more reasons if you continue with your silly defence of the drugs.

Just to clarify - the thread is about reasons the psychiatric industry should hang its collective head in shame and the lack of progress made in the past 70 years, since the first use of antipsychotics.

Compared to surgery, oncology and most other parts of medicine, psychiatry is in the dark ages.
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Old 9th June 2016, 03:01 PM   #34
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Oh, and from a convenient thread on a similar subject on the efficacy of anti-depressives:

https://www.statnews.com/2016/06/08/...ts-teens-kids/

Exercise is better, the end.
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Old 9th June 2016, 03:20 PM   #35
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Question The Atheist: Can you understand that this paper is not exercise is better than drugs

Originally Posted by The Atheist View Post
No lie involved, ....
A fact less post that shows inability to understand basic medical terminology is bad, The Atheist.
An adjunct treatment is one that is added to an existing, primary treatment.
The paper you cited is about the adjunct + primary treatments together being better than the primary treatment by itself: The Benefits of Exercise for the Clinically Depressed

Thus it is a lie to state that this paper shows that exercise is better than "drugs". Adding ignorance is also bad - the primary treatment for the clinically depressed is not only drugs.
10 June 2016 The Atheist: Can you understand that this paper does not state that exercise is better than drugs?
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Old 9th June 2016, 03:26 PM   #36
Reality Check
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Originally Posted by The Atheist View Post
Oh, and from a convenient thread on a similar subject on the efficacy of anti-depressives:

https://www.statnews.com/2016/06/08/...ts-teens-kids/

Exercise is better, the end.
Not understanding a paper does not make exercise better than anything, The Atheist.
10 June 2016 The Atheist: A paper showing continued testing of drugs used in psychiatry is not a failure of psychiatry
10 June 2016 The Atheist: A paper not about exercise is not about exercise!

10 June 2016 The Atheist: Can you understand that this paper does not state that exercise is better than drugs?
So far the answer is no.
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Old 9th June 2016, 04:04 PM   #37
The Atheist
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Originally Posted by Reality Check View Post
Thus it is a lie to state that this paper shows that exercise is better than "drugs".
I didn't say it did. I said that exercise is better than drugs and posted one piece of information.

I have since posted more, and have offered as much more as you like, there is ample evidence.

For some reason you seem to be unable to grasp that.

Originally Posted by Reality Check View Post
Can you understand that this paper does not state that exercise is better than drugs?
You know, anyone would think I hadn't answered your question about the subject of the thread just this morning:

Originally Posted by Me
the thread is about reasons the psychiatric industry should hang its collective head in shame and the lack of progress made in the past 70 years, since the first use of antipsychotics.
I used that paper to show the ongoing failure of the psychiatric industry's drugs, and mentioned the "exercise is better" at the end, because the evidence is enormous that that is correct. Again, I made no suggestion that it proves the case, yet you jump on it with a demented response, because you assume that's what I'm saying.

You are building strawmen yet again.
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Old 9th June 2016, 04:16 PM   #38
Reality Check
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Originally Posted by The Atheist View Post
I said that exercise is better than drugs and posted one piece of information.
Citing that paper was the lie - any one who understand the abstract can see that the paper does not say that exercise is better than drugs. It says that exercise + primary treatment is better than primary treatment.

I explained your mistake and so far have no acknowledgement that you understand it.
10 June 2016 The Atheist: Can you understand that this paper does not state that exercise is better than drugs?

So this thread is about your opinion that there has been a "lack of progress" in psychiatry in the last 70 years ?
The fact that psychiatry has progressed in the past 70 years makes that opinion a fantasy. If the opinion is a demand that psychiatry should be able to cure all psychiatric disorders then we have a delusion. The best we have is a demand that psychiatry should cater to your idea of the progress it should make.

Last edited by Reality Check; 9th June 2016 at 04:24 PM.
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Old 9th June 2016, 05:19 PM   #39
Joey McGee
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Originally Posted by The Atheist View Post
Meanwhile
Wow I completely destroyed every bit of your persona and argument and you pull a Trump, thanks
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Old 9th June 2016, 06:15 PM   #40
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I can only speak for myself. I have been on Venlafaxine since last summer. It has helped alleviate my depression and anxiety. I used to have episodes where I was convinced that I was visiting alternate universes; however, I don't have those episodes anymore. The first couple of weeks on the medicine, I had some moderate stomach discomfort. Those symptoms disappeared. Before that, I was on Celexa for many years. Before that, I was on Prozac for many years. Although all three medicines have helped me, I think that my newest medicine is the most helpful.

Because of these medicines, I am able to be married, hold a job, do volunteer work, have hobbies, and do other things that I might not be able to do if I weren't on those medicines.

This is only my experience. Other people have other experiences.
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