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Tags depression , psychiatry

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Old 29th August 2016, 03:11 PM   #241
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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/
You really should consider educating yourself. Maybe actually get to know someone with clinical depression or bipolar disorder? Or heck, maybe get to know someone who has actual experience with a loved-one with one of those disorders?
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Old 29th August 2016, 03:17 PM   #242
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Originally Posted by The Atheist View Post
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 glad that you're not the person giving medical advice to my sister

Your information is extraordinarily biased - both by that ax that you're grinding as well as by ignorance.

It is well-known that some prescription treatments for depression may cause suicidal thoughts in some people uncommonly. Did you know that some treatments for migraine can cause increased aggressive tendencies in some people uncommonly? Or that statins may cause diabetes in some people? Or liver damage?

Clearly there's a crisis in the medical community, what with all of these side effects of drugs!
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Old 29th August 2016, 03:29 PM   #243
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Originally Posted by Dancing David View Post
Hello,
I am not going to debate any one who flames me, so say you have a child 3 yo who never sleeps, and is psychotic and destructive. Would people consider that this might be an individual to refer for psychiatry, after a neurological work up.
We know that there can exist very challenging situations for parents in dealing with serious behavioral problems. At the age of three, it would seem to me that drugs would a very last and exceptional resort for serious problems. Certainly, desructiveness would be one of those serious problems to consider. Nevertheless, I would ask, is the drug being administered for the convenience of the parents or for the welfare of the child?
We have had this discussion before. Your personal experiences are quite compelling regarding the efficacy of psychiatric medication -- but at not so young an age as three, as far as I can recall.
My major concerns are the unknown long term effects on a developing brain and I maintain that it is irresponsible (and even criminal) to administer such drugs without extraordinary need.
As I have already said on another thread, I dealt with some serious behavioral problems of my own (I was expelled from four high schools and dropped out of college twice), but was never given psychiatric drugs. I have experienced a normal and fulfilling life, professionally, personally, family, marriage (six wonderful grandchildren) -- all without psychiatric drugs. I simply got older and gained control of my compulsive behavior. I shutter at the thought that drugs might have changed my brain (had they been administered as a young teen) in some unknown way. Perhaps I would still be in need o drugs or have other behavioral problems that might have been created. The problem is that we do not know with any confidence based on scientific studies.
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Old 29th August 2016, 03:40 PM   #244
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Originally Posted by blutoski View Post
No, but the short term safety is going in the right direction, and there's no immediately obvious mechanism of action for harm, so this is an example of a debate about where we have to consider "In light of weak evidence of safety and no evidence of harm, is the burden of proof on proving safety or harm?"

This is always the situation with pregnant women and children. We don't allow them in clinical trials, so we have to revert to other sources and qualities of evidence.

My personal opinion is that the burden should reflect the danger associated with not prescribing. In this case, the worst case scenario is misbehavior, which does not appear to justify prescribing with such thin benefit/risk profiles.

"if anything" - that's the challenge. It's hard to show long term safety for any drug or intervention, period. Adult clinical trials aren't performing generation length longitudinals. Phase III clinical trials for adults might be a year or two follow up max, but usually none.

Anything in the fifteen-twenty year zone is usually beyond the scope of even post market surveillance, and falls into the category of ad hoc investigations based on anecdotal/cultural reports of harm or epidemiology.
Yes, long term studies (beyond 15 years) are rare. An adult can factor this into his/her decision making process regarding drugs. But a child is not making a choice; it is being made for him/her. And it is being made in a situation (regarding psychiatric drugs), where there could very well be long term harm -- by long term in this context we are speaking of the rest of the remaining years for this person and his/her sense of self and consciousness. Were I a psychiatrist, I would not want to bear that burden.
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Old 29th August 2016, 04:55 PM   #245
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It's kind of nice when I skip 6 pages of a discussion, to find that it's pretty much exactly where it was at the end of page 1. At least I haven't really missed much of anything.

In regard to psychoactive compounds being prescribed to young children... It certainly seems that there should be a lot of hesitancy for this. It shouldn't be common practice. Drugs specifically designed to act on the brain should be treated as a definite risk when being given to a developing brain.

That said, I'm not about to say "never". There may very well be children for whom that last resort is better than nothing - particularly those prone to violence and aggression toward themselves or others.

Now... THAT said, I still don't see that non-psychiatrists prescribing psychoactive drugs is in any fashion a black mark against the psychiatric field of endeavor. Sure, I skipped a few pages of this back-and-forth... but I haven't seen much of anything that seems to indicate a widespread tendency for actual psychiatrists to prescribe psychiatric drugs to very young children.
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Old 29th August 2016, 05:00 PM   #246
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To recap:

Psychiatric medicine has made some pretty substantial advances in the last 50 years, and is continuing to search for ways to control and treat mental illness.

Comparing treatment efficacy for mental illness (a persistent condition) to treatment efficacy of cancer (an acute condition) is not a good comparison; a better comparison would be to CHF, COPD, Asthma, or Diabetes.

Exercise is not better than drugs; exercise and drugs together is better than drugs alone; drugs alone is better than exercise alone.

The poor conditions of a specific facility does not represent a failing of an entire field of medicine.

Poor prescription decisions by non-psychiatric primary care doctors does not represent a failing of psychiatric medicine.
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Old 29th August 2016, 05:53 PM   #247
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A good summary, Emily's Cat.
One more point: Non-psychiatric primary care doctors sometimes prescribing psychiatric drugs without first determining if there is a psychiatric condition does not represent a failing of psychiatric medicine.
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Old 29th August 2016, 06:14 PM   #248
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Originally Posted by Perpetual Student View Post
A drug that might be relatively safe and effective for an adult (with a fully formed brain) may very well not be safe and effective for a brain not yet fully formed. In fact it might be quite dangerous.
I agree.

Originally Posted by Perpetual Student View Post
There is a dearth of convincing research in this area. ...
I agree.

However I disagree with "arrogant, negligent, irresponsible and criminal". Technically doctors can legally prescribe any drug though there is an expectation that they will not prescribe specialized medicine. Unfortunately drugs such as Prozac seem to become mainstream rather than specialized. Not treating patients is definitely negligent. There is no arrogance in assuming that adult drugs will work safely on children.
I agree with "irresponsible". The doctors have given in to a pill pushing culture with other aspects that have not been emphasized as much
  • There are other non-drug therapies that might work.
  • The news articles mention that sometimes the drugs were prescribed without any diagnosis of a psychiatric condition.
  • Seeming to give into parental pressure.
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Old 29th August 2016, 06:28 PM   #249
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Originally Posted by The Atheist View Post
..Are you a shill for psychiatry? Or are you a psychologist yourself?
Irrelevant insults do not make a reasonable debate, The Atheist. Misleading people about a Wiki article is bad because people can read it: The term infant is typically applied to young children between the ages of 1 month and 12 months; however, definitions may vary between birth and 1 year of age, or even between birth and 2 years of age. (my emphasis added).

For example the article you cited does not just say "babies". The reporter makes it clear that it is the non-typical use of below 2 years old. I suspect that "babies" is used for shock value to sell the article - the New York Times article that is the basis of the first half of that article uses "children 2 and younger".
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Old 29th August 2016, 06:45 PM   #250
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Originally Posted by Perpetual Student View Post
Perhaps so, but there is no scientific evidence regarding the long term (say, fifteen or twenty years) consequences of these drugs..
That leads to a catch-22 situation - how can children be prescribed any drug until after it has been tested by prescribing it to children for decades if we do not allow prescriptions to children until it has been tested for decades on children ?

There are indirect exposures such as mothers breastfeeding while on psychiatric drugs.

The ideal situation would be long term animal trials with their known limitations. However at some point someone needs to make at least an educated guess about whether the risks of a drug on a developing child (mind and body) are less than other drugs or no treatment. That is another problem with the use of psychiatric drugs for childhood problems. The decision seems to be too much up to individual doctors with various degrees of expertise.

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Old 29th August 2016, 09:42 PM   #251
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Originally Posted by Dancing David View Post
Hello,
I am not going to debate any one who flames me, so say you have a child 3 yo who never sleeps, and is psychotic and destructive. Would people consider that this might be an individual to refer for psychiatry, after a neurological work up.
It depends entirely on what other steps have been taken first.

Originally Posted by Emily's Cat View Post
I concur: Just because a drug is old doesn't mean it's not effective.
Sure, but with something as hideously addictive as valium, it should be avoided where possible.

Originally Posted by Emily's Cat View Post
Cancer vs Mental illness isn't really a very good comparison.
That wasn't my argument.

Originally Posted by Emily's Cat View Post
You really should consider educating yourself. Maybe actually get to know someone with clinical depression or bipolar disorder?
You're holding a mentally ill person as the best resource for mental illness?

Whoa.

Originally Posted by Emily's Cat View Post
Or heck, maybe get to know someone who has actual experience with a loved-one with one of those disorders?
Damn good idea - multiply the subjectivity of a patient by getting the subjective uninformed opinion of their family.

Gotcha.

Or even better, follow the evidence that shows time and time again that the best results at treating depression are exercise-based programs.

1

2

3

4
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Old 29th August 2016, 10:45 PM   #252
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Originally Posted by The Atheist View Post
Or even better, follow the evidence that shows time and time again that the best results at treating depression are exercise-based programs
Or even better, read your sources, The Atheist.
Exercise Treatment for Major Depression: Maintenance of Therapeutic Benefit at 10 Months (PDF)
Quote:
Objective: The purpose of this study was to assess the status of 156 adult volunteers with major depressive disorder (MDD) 6 months after completion of a study in which they were randomly assigned to a 4-month course of aerobic exercise, sertraline therapy, or a combination of exercise and sertraline.
Results: After 4 months patients in all three groups exhibited significant improvement; the proportion of remitted participants (ie, those who no longer met diagnostic criteria for MDD and had an HRSD score !8) was comparable across the three treatment conditions. After 10 months, however, remitted subjects in the exercise group had significantly lower relapse rates (p = .01) than subjects in the medication group. Exercising on one’s own during the follow-up period was associated with a reduced probability of depression diagnosis at the end of that period (odds ratio = 0.49, p = .0009)
The three treatment conditions had comparable results at 4 months. There was a benefit for those in the exercise group at 10 months who no longer had major depressive disorder - a smaller relapse rate when compared to the medication group. Small nitpick with the paper: p > .05 is usually considered as significant, p = 0.01 is interesting.

Bigger nitpick: A 16 year old paper hints of cherry picking. Where are the follow-up papers confirming (or not) these results?

Effects of Exercise Training on Older Patients With Major Depression
Quote:
Conclusions An exercise training program may be considered an alternative to antidepressants for treatment of depression in older persons. Although antidepressants may facilitate a more rapid initial therapeutic response than exercise, after 16 weeks of treatment exercise was equally effective in reducing depression among patients with MDD
(my emphasis added)

The Benefits of Exercise for the Clinically Depressed
Quote:
While this discussion is not meant to argue against the use of antidepressant medication or psychological therapies, there is strong evidence to advocate the use of exercise as a potentially powerful adjunct to existing treatments.
The discussion paper includes studies of exercise versus no-treatment.
Quote:
They reported an overall mean ES of −1.1 for exercise interventions compared with no-treatment control groups.
Is Exercise a Viable Treatment for Depression?
Quote:
In summary, exercise appears to be an effective treatment for depression, improving depressive symptoms to a comparable extent as pharmacotherapy and psychotherapy.
(my emphasis added)

What you have cited is evidence that exercise is comparable to (not better than) existing treatments, especially for older patients.

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Old 29th August 2016, 11:57 PM   #253
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Originally Posted by Reality Check View Post
What you have cited is evidence that exercise is comparable to (not better than) existing treatments, especially for older patients.
No, I picked the first four results at random and didn't look at any of them, because the evidence has been posted throughout the thread and I see no need to repeat it all again.

Those who care will find, those who don't, or who are operating to some other agenda, shall remain ignorant.

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Old 30th August 2016, 07:20 AM   #254
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Originally Posted by Reality Check View Post
I agree.
I agree.
However I disagree with "arrogant, negligent, irresponsible and criminal". Technically doctors can legally prescribe any drug though there is an expectation that they will not prescribe specialized medicine. Unfortunately drugs such as Prozac seem to become mainstream rather than specialized. Not treating patients is definitely negligent. There is no arrogance in assuming that adult drugs will work safely on children.
I agree with "irresponsible". The doctors have given in to a pill pushing culture with other aspects that have not been emphasized as much
  • There are other non-drug therapies that might work.
  • The news articles mention that sometimes the drugs were prescribed without any diagnosis of a psychiatric condition.
  • Seeming to give into parental pressure.
Originally Posted by Reality Check View Post
That leads to a catch-22 situation - how can children be prescribed any drug until after it has been tested by prescribing it to children for decades if we do not allow prescriptions to children until it has been tested for decades on children ?

There are indirect exposures such as mothers breastfeeding while on psychiatric drugs.

The ideal situation would be long term animal trials with their known limitations. However at some point someone needs to make at least an educated guess about whether the risks of a drug on a developing child (mind and body) are less than other drugs or no treatment. That is another problem with the use of psychiatric drugs for childhood problems. The decision seems to be too much up to individual doctors with various degrees of expertise.
Good points. Nevertheless, my guess is that there are many cases where doing nothing might be the best medicine.
I have mentioned before on another thread that I have a close friend whose son committed suicide at the age of twenty. He was started on drugs at a very early age for what seemed to me to be a relatively minor problem with attention and overall behavior. (His behavior did not seem to be very different than mine at the same age.) It can never be known if the drugs were a contributing cause, but I personally suspect they were.
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Old 30th August 2016, 08:22 AM   #255
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Originally Posted by Perpetual Student View Post
We know that there can exist very challenging situations for parents in dealing with serious behavioral problems. At the age of three, it would seem to me that drugs would a very last and exceptional resort for serious problems. Certainly, desructiveness would be one of those serious problems to consider. Nevertheless, I would ask, is the drug being administered for the convenience of the parents or for the welfare of the child?
We have had this discussion before. Your personal experiences are quite compelling regarding the efficacy of psychiatric medication -- but at not so young an age as three, as far as I can recall.
So apparently you don't understand psychosis, the child is hallucinating, fearful and unhappy most of the time. They eat very little and forcing them to eat creates more problems, they do not attend to reality very well, they respond to internal stimuli with anger and lashing out.

Is treatment just for the benefit of the parent's? Do you really think the child is going to thrive in this situation?

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Old 30th August 2016, 09:04 AM   #256
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Originally Posted by Dancing David View Post
So apparently you don't understand psychosis, the child is hallucinating, fearful and unhappy most of the time. They eat very little and forcing them to eat creates more problems, they do not attend to reality very well, they respond to internal stimuli with anger and lashing out.

Is treatment just for the benefit of the parent's? Do you really think the child is going to thrive in this situation?

You are correct; I know little about psychosis. Further, I have never known of anyone dealing with such severe problems. Are we still discussing three year olds?
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Old 30th August 2016, 09:36 AM   #257
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Originally Posted by The Atheist View Post
Sure, but with something as hideously addictive as valium, it should be avoided where possible.
Should we also avoid all opiates and opioids, regardless of efficacy? What about all the other mental health drugs that are habit forming? What about all the other NON-mental health drugs that are habit forming? Why are you singling out valium?

Most importantly, on what clinical basis are you determining that it should be avoided, and on what clinical expertise are you basing your personal assessment of what constitutes allowable prescriptions?

Originally Posted by The Atheist View Post
You're holding a mentally ill person as the best resource for mental illness?

...


Damn good idea - multiply the subjectivity of a patient by getting the subjective uninformed opinion of their family.
Wow. Way to miss the point and exacerbate it by being condescending.

Let me try this again: Perhaps you should actually learns omething about mental illness, the impacts it has on people's lives and loved ones, and the challenges inherent in it before you make sweeping assertions about what's best for other people.

Especially before going on a rampage implying that people with depression shouldn't take drugs, they should just exercise, because it's "better". You who have clearly NEVER actually had to deal with depression, even second-hand.
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Old 30th August 2016, 09:41 AM   #258
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Originally Posted by Dancing David View Post
So apparently you don't understand psychosis, the child is hallucinating, fearful and unhappy most of the time. They eat very little and forcing them to eat creates more problems, they do not attend to reality very well, they respond to internal stimuli with anger and lashing out.

Is treatment just for the benefit of the parent's? Do you really think the child is going to thrive in this situation?

Is there a specific patient you're describing in the above? Or is this a description of a generic case that would be appropriate for prescribing?

My concern based on the studies exploring pediatric prescribing is that we don't know the validity. In fact: the authors seem to be unsure about the diagnoses that led to prescribing.

There is such a thing as childhood onset schizophrenia, but it's incidence is something like one in 30,000 children. 74 million children in the USA (0 - 17 years old), that would mean there's possibly 2500 children with schizophrenia in the USA during this study; whereas, the antipsychotic prescribing volumes appear to be in the twenty thousand range. That's almost an order of magnitude of misdiagnosis and misprescribing in my opinion.

So, just to clarify my position on this... I don't think it's inherently wrong to diagnose schizophrenia to an infant and prescribe antipsychotics in cases where the child's safety is at risk. What I'm concerned about a possible trend toward overdiagnosis to include misbehavior, for which antipsychotics are not indicated.

However, at least one of the articles brings up a good point: antidepressants appear much more overprescribed, and there's the distinct possibility that they're intended for the parents' use, but prescribed in this way to be eligible for insurance.

So, it's still bad news, because it would mean conventional healthfraud instead of malpractice, which does not cast them in much of a better light.
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Old 30th August 2016, 09:46 AM   #259
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Originally Posted by Perpetual Student View Post
You are correct; I know little about psychosis. Further, I have never known of anyone dealing with such severe problems. Are we still discussing three year olds?
We could; childhood onset schizophrenia is rare but satisfactorily verified (eg: with MRI in addition to age-adapted clinical diagnostic exercises).

I would expect the number of severe (child at risk of harm) cases in the US at any given moment to not exceed a thousand.
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Old 30th August 2016, 10:22 AM   #260
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Originally Posted by The Atheist View Post
No, I picked the first four results at random and didn't look at any of them, because the evidence has been posted throughout the thread and I see no need to repeat it all again..
The problem with not reading what you're posting as evidence is that it's not always evidence of what you think it is. This is one of those cases. You have asserted that exercise is better than drugs for MDD... and yet none of the evidence you've provided supports your assertion. They say that:

Exercise + Drugs > Drugs Alone
Exercise > No Treatment
Exercise ~ Drugs for older patients

Can you see that what you've claimed is not supported by your evidence?
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Old 30th August 2016, 10:56 AM   #261
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Originally Posted by Perpetual Student View Post
You are correct; I know little about psychosis. Further, I have never known of anyone dealing with such severe problems. Are we still discussing three year olds?
Yes, regardless of the cause there are very small children who have full blown mania and psychosis, it does not seem to be a 'behavioral' issue. Fortunately the incidence is low.

I had a client, as an adult, whose first psychotic break happened when she was six.
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Old 30th August 2016, 10:58 AM   #262
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Originally Posted by blutoski View Post
Is there a specific patient you're describing in the above? Or is this a description of a generic case that would be appropriate for prescribing?

My concern based on the studies exploring pediatric prescribing is that we don't know the validity. In fact: the authors seem to be unsure about the diagnoses that led to prescribing.

There is such a thing as childhood onset schizophrenia, but it's incidence is something like one in 30,000 children. 74 million children in the USA (0 - 17 years old), that would mean there's possibly 2500 children with schizophrenia in the USA during this study; whereas, the antipsychotic prescribing volumes appear to be in the twenty thousand range. That's almost an order of magnitude of misdiagnosis and misprescribing in my opinion.

So, just to clarify my position on this... I don't think it's inherently wrong to diagnose schizophrenia to an infant and prescribe antipsychotics in cases where the child's safety is at risk. What I'm concerned about a possible trend toward overdiagnosis to include misbehavior, for which antipsychotics are not indicated.

However, at least one of the articles brings up a good point: antidepressants appear much more overprescribed, and there's the distinct possibility that they're intended for the parents' use, but prescribed in this way to be eligible for insurance.

So, it's still bad news, because it would mean conventional healthfraud instead of malpractice, which does not cast them in much of a better light.
I agree that diagnosis is a very careful event and parents are awful historians.

But cases of full blown mania in youngsters do exist.

Also a good reason for a neurological work up.
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Old 30th August 2016, 01:15 PM   #263
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Originally Posted by Emily's Cat View Post
You who have clearly NEVER actually had to deal with depression, even second-hand.
I'll just leave you with your incorrect assumptions - very popular in this thread.
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Old 30th August 2016, 04:24 PM   #264
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Originally Posted by The Atheist View Post
No, I picked the first four results at random and didn't look at any of them, because the evidence has been posted throughout the thread and I see no need to repeat it all again.
Which is why your citations in that post did not did not support your assertion,The Atheist !
What you do not understand is that people can look thorough this thread for your other links and see that "evidence" assertion is a lie because all you posted before was one of the random papers!
10 June 2016 The Atheist: Can you understand that this paper ("The Benefits of Exercise for the Clinically Depressed" ) does not state that exercise is better than drugs?

Followed by some "Exercise is more successful and safer than drugs in treating depression" assertions without evidence.

On 30 August 2016, Emily's Cat replied to your original 10 June 2016 assertion and we get your list of random papers.
30 August 2016 The Atheist: "Effects of Exercise Training on Older Patients With Major Depression" = equally effective.
30 August 2016 The Atheist:"Is Exercise a Viable Treatment for Depression?" = to a comparable extent.
30 August 2016 The Atheist: "The Benefits of Exercise for the Clinically Depressed" = potentially powerful adjunct to existing treatments (as pointed out a couple of months ago!).
30 August 2016 The Atheist: "Exercise Treatment for Major Depression: Maintenance of Therapeutic Benefit at 10 Months" ( a 16 year old paper) = comparable across the three treatment conditions at 4 months, possible smaller relapse rate for those in the exercise group at 10 months

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Old 31st August 2016, 02:24 AM   #265
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Originally Posted by Reality Check View Post
...blether removed...
Or, instead of reading some pseudo-shillery posted some bloke on the internet, people could just check with Harvard.

Since you struggle so much with formatting writing and understanding why exercise is so helpful, I'll go easy on you, because I think I know what your mistake is: you're confusing severe depression with all depression.

Maybe this Depression 101 from HuffPo might help you.

For Zarquon's sake, even bloody the Kirwan touted Depression.Org site lists exercise as the very first thing people can do to try to help themselves. You do know who Sir John Kirwan is?

Keep 'em coming - you never know, someone who is actually depressed might see the sense in putting down the prescription and giving it a go. Your continued feeble and ill-informed attempts to deny the obvious are breathtaking enough that you'll do a far better job of convincing people than me.

Oh, did you note where Harvard concluded the positive effects lasted longer as well?
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Old 31st August 2016, 03:29 AM   #266
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Well. A "certified personal trainer" citing a single study, and concluding you should hire a certified personal trainer, in the ever-reliable Huffington Post. Don't know about you, but I'm convinced.
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Old 31st August 2016, 09:06 AM   #267
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Originally Posted by The Atheist View Post
Or, instead of reading some pseudo-shillery posted some bloke on the internet, people could just check with Harvard.
You really need to actually read the things you're posting as evidence, The Atheist. REad them critically, and with full understanding. From your Harvard article (emphasis mine):

Quote:
About 60%–70% of the people in all three groups could no longer be classed as having major depression. In fact, group scores on two rating scales of depression were essentially the same. This suggests that for those who need or wish to avoid drugs, exercise might be an acceptable substitute for antidepressants. Keep in mind, though, that the swiftest response occurred in the group taking antidepressants, and that it can be difficult to stay motivated to exercise when you're depressed.
So once again, we see that the results in mild depression are about the same for exercise and drugs - NOT better for exercise than for drugs. The article also clearly points out that 1) the fastest alleviation of depression occurs with drugs and 2) it can be hard to exercise when depressed because motivation is affected.

If you would like to take the opportunity to refine your position, I would fully support that. I suggest something along the lines of:

Exercise should be a component of treatment whenever possible; long-term effects on mild depression seem to be better when exercise is involved.

That I would get behind completely.
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Old 31st August 2016, 09:17 AM   #268
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Originally Posted by Perpetual Student View Post
I disagree. A drug that might be relatively safe and effective for an adult (with a fully formed brain) may very well not be safe and effective for a brain not yet fully formed. In fact it might be quite dangerous.
There is a dearth of convincing research in this area.
A child's brain will undergo an enormous amount of change (synaptic connections, etc.) to become fully mature. We have no idea how these drugs may interfere with or otherwise affect this development. I stick with my assessment; without any scientific support, prescribing these drugs is arrogant, negligent, irresponsible and criminal. Frankly, I regard these children as victims, irrespective of their behavior, short of them being demonstrably homicidal or suicidal.
And this holds true for all forms of medical care for children. Because ethically you can't study children all that much so doctors have to take their best guesses at how to treat them.
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Old 31st August 2016, 09:53 AM   #269
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Originally Posted by ponderingturtle View Post
And this holds true for all forms of medical care for children. Because ethically you can't study children all that much so doctors have to take their best guesses at how to treat them.
It's probably worth a review, but I suspect all prescribing for children and pregnant women (including antibiotics for infections, chemotherapy for cancer, &c) is off label and the result of an MD using her best judgement based on available research.
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Old 31st August 2016, 10:20 AM   #270
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Originally Posted by Marasmusine View Post
Well. A "certified personal trainer" citing a single study, and concluding you should hire a certified personal trainer, in the ever-reliable Huffington Post. Don't know about you, but I'm convinced.
Yep. The "the Kirwan touted Depression.Org" website also advocates for massage therapy, pastoral support, herbal preparations, and dietary supplements.

I'd say it's a typical government site, aiming to please the voters, but not a reliable medical information resource.
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Old 31st August 2016, 11:02 AM   #271
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Originally Posted by Dancing David View Post
Hello,
I am not going to debate any one who flames me, so say you have a child 3 yo who never sleeps, and is psychotic and destructive. Would people consider that this might be an individual to refer for psychiatry, after a neurological work up.
maybe.

I would rather try ONLY psychotherapy WITHOUT any use of drugs however. DEPENDING on diagnosis, drugs may be needed.

Psychiatrists (who are doctors) are to fast to prescribe drugs imho, even in cases where they arenīt needed.
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Old 31st August 2016, 12:39 PM   #272
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Originally Posted by AcesHigh View Post
Psychiatrists (who are doctors) are to fast to prescribe drugs imho, even in cases where they arenīt needed.
Doctors, regardless of specialty, are generally pretty fast to prescribe drugs nowadays.
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Old 31st August 2016, 01:50 PM   #273
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Exclamation The Atheist: Shoots himself in the foot with more exercise/depression sources

Originally Posted by The Atheist View Post
...Harvard...
Providing evidence of a lie in this post is not "blether", The Atheist. It is a lie that any evidence that exercise is better than any other treatment for depression was in this thread before your 30 August 2016 post.
10 June 2016 The Atheist: Can you understand that this paper ("The Benefits of Exercise for the Clinically Depressed" ) does not state that exercise is better than drugs?

It is true that you wasted our time with 4 random exercise/depression papers:
  1. 30 August 2016 The Atheist: "Effects of Exercise Training on Older Patients With Major Depression" = equally effective.
  2. 30 August 2016 The Atheist:"Is Exercise a Viable Treatment for Depression?" = to a comparable extent.
  3. 30 August 2016 The Atheist: "The Benefits of Exercise for the Clinically Depressed" = potentially powerful adjunct to existing treatments (as pointed out a couple of months ago!).
  4. 30 August 2016 The Atheist: "Exercise Treatment for Major Depression: Maintenance of Therapeutic Benefit at 10 Months" ( a 16 year old paper) = comparable across the three treatment conditions at 4 months, possible smaller relapse rate for those in the exercise group at 10 months

Your assertion is about depression in general - not low, moderate or severe depression:1 September 2016 The Atheist: Your assertion is about depression in general - not low, moderate or severe depression.

You, The Atheist (who is not me) started with an invalid citation about major (severe) depression. You, The Atheist (who is not me) continued with 2 more invalid citations about major (severe) depression.

You cite Exercise and Depression that destroys your assertion for anyone who understands English
Quote:
Can a few laps around the block actually solve your emotional problems? Probably not, but a regular exercise program might help. A review of studies stretching back to 1981 concluded that regular exercise can improve mood in people with mild to moderate depression. It also may play a supporting role in treating severe depression.
Improving mood in mild to moderate depression is not "better than drugs" !
Supporting role in treating severe depression is not "better than drugs" !
1 September 2016 The Atheist: "Exercise and Depression" destroys your assertion.

Depression 101 from HuffPo is down at the moment but I suspect that it does not support you either.

Sir John James Patrick Kirwan is an example against your assertion. He was a great athlete (I watched most of the games he played) and yet this person who exercised extensively needed drugs to control his depression ! You can take the first step to enjoying life again
Quote:
Looking after your body with physical activity, good food and sleep will also help you look after your brain.
...Keeping physically active, eating right, sleeping well do make a difference to our mental health
1 September 2016 The Atheist: Advice to take exercise + eat well + sleep well to make a difference to mental health is not stating that exercise is better than drugs!

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Old 31st August 2016, 02:49 PM   #274
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Originally Posted by AcesHigh View Post
maybe.

I would rather try ONLY psychotherapy WITHOUT any use of drugs however. DEPENDING on diagnosis, drugs may be needed.

Psychiatrists (who are doctors) are to fast to prescribe drugs imho, even in cases where they arenīt needed.
In my long experience of doing mental assessments as part of intake and crisis intervention, I found that most clients wanted the doctor only , despite any recommendations to counseling as well.
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Old 31st August 2016, 07:15 PM   #275
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Originally Posted by Emily's Cat View Post
The article also clearly points out that 1) the fastest alleviation of depression occurs with drugs and...
Cherry-pick of the week.

...and the effects last longer.

You missed that bit.
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Old 1st September 2016, 10:27 AM   #276
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Originally Posted by The Atheist View Post
Cherry-pick of the week.

...and the effects last longer.

You missed that bit.
What? No I didn't.
Originally Posted by Emily's Cat View Post
If you would like to take the opportunity to refine your position, I would fully support that. I suggest something along the lines of:

Exercise should be a component of treatment whenever possible; long-term effects on mild depression seem to be better when exercise is involved.
Just gotta ask - are you actually reading the entirety of my posts, or are you stopping as soon as you see something you think you disagree with?
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Old 2nd September 2016, 07:06 AM   #277
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Originally Posted by Dancing David View Post
In my long experience of doing mental assessments as part of intake and crisis intervention, I found that most clients wanted the doctor only , despite any recommendations to counseling as well.
of course. Itīs easier to drug yourself than to face your traumas, than to face who you are, than to face what you donīt want to face.
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Old 2nd September 2016, 08:23 AM   #278
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Originally Posted by AcesHigh View Post
of course. Itīs easier to drug yourself than to face your traumas, than to face who you are, than to face what you donīt want to face.
Huh, I never thought it was my place to decide what was best for them. Just make recommendations, it is there life.
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Old 2nd September 2016, 09:15 AM   #279
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Originally Posted by AcesHigh View Post
of course. Itīs easier to drug yourself than to face your traumas, than to face who you are, than to face what you donīt want to face.
I actually think it's a marketing problem. Therapy makes people think of fru-fru hippie **** or long conversations about subconscious mother lust; whereas, drugs make people think of eggheads in lab coats solving your problem scientifically. The latter seems more like it's a modern proven solution.

Not to mention, nobody sees ads on television for group therapy. "Group therapy may be right for you. Talk to your therapist today."
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Old 2nd September 2016, 09:53 AM   #280
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well, I was not even thinking of GROUP therapy. I was think of psychoanalysis.
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