Mental health

What is the best non-drug treatment to keep my father's brain sharp? My brother was chased into a swamp, by my mother, where he drowned and was eaten by alligators. Me and my brother were my father's reason for living and now he's completely hopeless and in a deep deep deep depression to the point where he will start to tremor and shake uncontrollable. He also lost both his parents in a house fire when he was 25, if that's relevant.

We've also tried therapy and he's not a candidate for it aside from getting benzos prescribed to him.

Just to recap, my question was asking if there are any evidence based approaches I can take to help preserve my father's mental well being?

Please help I don't wanna lose my only remaining family member.

Effexor is an SNRI wich increases norepinephrine (like adrenaline). Side effects of anxiety, increased blood pressure are common. If it worked well in the past you can give it a good trial and see if the anxiety fades away as your body gets used to the drug. They usually do.

You can also try just a regular SSRI. The newer ones like lexapro and Viibryd are very clean with minimal side effects, no dick problems. They work very well for anxiety and depression

Cognative behavioral therapy is a good option, but bipolar has such a great response rate to medications that you really should consider it. Especially if it is severe enough to start ruining your life

Do shit with him. Fish or golf or whatever he used to like doing or you guys did together. Show him you still need him, hopefully that will spark something

Company? Try to get in with any US hospital and do rotations with them. That should buy you in interview at their program if they like you

Look into acceptance and commitment therapy

You can read books on it or find a therapist to work through it with you

Basically teaches you how accept the fact that you may be anxious but still be able to push through and live your life as you see fit.

Pretty insightful. Worked well for myself when I was learning it.

I forgot to mention that we goto the gym every night together so that I can get him out of the house. That's actually how I started getting into being Jow Forums. I meant if there's anything besides that I can do for him.

Ty I’ll mention it to my therapist.

Thanks senpai, going to send out some mass emails to hospitals everywhere in New England and hopefully get something back.

Canada

Well I mean don’t be afraid to ask him for advice or help. It’ll help him realize he still has another kid. If it’s been a while, like more than just a few months, maybe even talks o him about it straight up. Explain your concerns and that you’re also saddened over what happened but that you’re even sadder because he’s the only family you have left and you won’t him to not be depressed anymore. Don’t be selfish about it, express that you want what’s best for him though

What do you reccomend to better bpd?

How in the fuck do I stop having panic attacks? Mentally I know what is going on and that I'm having an attack but my body immediately goes into fight or flight and it feels like I'm having a heart attack.

>Is there a consensus on continually increasing SSRI dosages to combat depressive symptoms or instead should adjunctive therapy be implemented in response, and if so what adjunctive therapy (for instance 110lb female, going from 25mg, 50mg, 75mg, to 100mg zoloft with no reduction in depressive symptoms within a period of 6 months)?

You gave the drug more than a fair trial. I would try augmenting with Remeron. Works synergisticly with SNRIs. Just watch out for weight gain. Alternatives would be to switch drugs. They all work a bit diffrent. Even drugs in the same class. The new SSRIs (Viibryd and Trintillex) have good results for treatment resistant depression.

>Why do almost none of the medications in psychiatry show efficacy without being used in combination with counseling when compared to placebo in controlled randomized trials?

Clinical trials are very selevctive of the "patients" that they can pick. They are more like "symptomatic volunteers" and do not really reflect actual complicated patients. The placebo effect has been getting very strong in the past years for all medications including BP meds etc

>How do you deal with the abysmally low adherence to medication regimens, besides making a lot of money off their continual office visits?

I try and figure out why they are noncompliant and attempt to inspire motivation for treatment

>Is there a more pretentious field of practice than psychiatry? Also, I've heard that pediatrics is the least respected from medical residents. How do others view your field relative to the say internal medicine?

Psychiatry used to be shit tier until about 5 years ago, then people saw its actually a pretty cool field with a good lifestyle so competition increased. 99% of the resident slots filled this year

I'm sorry I would love to help but this is too big to handle over Jow Forums. Try your best to coordinate care with your family

this is good advice

I had to go into therapy man. I lost a new job because I had my worst panic attack while there and was so humiliated I left. I really want to be normal again.

Bipolar disorder or borderline personality disorder?

My gf has some sexual childhood trauma and she has really bad nightmares. They come and go but currently she's been having them a few times a week for the past couple months. She said sleeping pills helped but then her doc stopped them for other reasons. What else can she do?

You need coping techniques. Arm yourself with education. You need to understand that you are not going to die or lose control of your body. Know that it will pass in under 10 minutes. Drop what you are doing and take a walk, use the restroom etc.

Do not avoid situations where you think you will experience one. You should seek these out

PTSD responds well to therapy. How bad is it currently? If it is ruining her life then SSRIs are a good tool to allow her not to get stuck on thoughts

Anyone have experience with ADHD? I think I have it, I've tried so many ways to cope but no matter how hard I try I cannot focus on my school work for more than a few minutes. I'm currently talking w a psychologist to get diagnosed and possibly start medication.

mood stabilizer and antipsychotics, no bullshit

ssris bullshit and too much personality disorder to be able to follow any reasonable algorithm with a real life patients

of course
gen surg
gyn

its viewed as being lazy

t doing it for 10 years

Gimme what you know about modafinil. I work EMS and I'd like to find a chemical means to stay sharp for 20+ hours of straight work and I don't wanna fuck with amphetamines

Wakes up in the middle of the night maybe every other night. Sometimes will be able to sleep again, other times can't sleep for hours. Feels bad bc if I sleep with her she'll sleep really well but sleeping over every night isn't feasible rn. Oh and she says it's a recurring dream usually. Sometimes I'll notice her body jerk around in her sleep and it's kinda scary and I really wanna wake her up myself to get her out of the nightmare. During the day she's fine though.

That's a broad question
en.wikipedia.org/wiki/Modafinil
Some people swear by it, others say it doesn't do shit or makes them too "fuzzy" I use ritalin personally. Nice boost with less buzz than adderall

It is indicated for shift work so you should have no problem getting a prescription in the US

>chad braphog
haha, holy shit

Clonidine is given for nightmares like this, other sleeping meds would be appropriate to try in this case also. Avoid benzos

SSRI's by their nature cause erectile dysfunction

if it is an SSRI it will affect ED, lexapro included

antidepressants dont have much effect on borderline

it's not a brain chemistry issue, eg too little serotonin or too much dopamine

antidepressants can actually make it worse because they tend to increase norepinephrine activity, which causes anxiety

antipsychotics can have some use, but they are shit and just mute your personality

dialectical behaviour therapy is used to treat borderline

-t. someone with borderline struggling to get off cymbalta (SNRI) because of shit psychiatrists throwing medication at a problem they cant treat

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what do you think about the use of lithium in practice for mild or moderate depression?

which atypical or typical antipsychotics are your drugs of choice?

do you have issues with formulary requests and the like regarding insurance paying for your selected therapies?

not him, but please dont

the universal obscene weight gain causes more problems than lithium can solve, especially for depression

when you gain 70 pounds of fat in 3 months, your depression is going to be a lot worse

antipsychotics are horrible, universally causing metabolic diseases (which antidepressants also cause), drowsiness, weight gain, mood instability, and apathy

someone with depression shouldnt be put on antipsychotics because they just hide the symptoms and treat nothing

i spent 6 months on seroquel and while it is amazing for sleeping it is complete shit when taken during the day. expect to be a listless lazy dull drone that just walks around constantly hungry and yawning, with zero energy and zero motivation to do anything

No the older SSRIs inhibit nitric oxide synthase causing ED in about 10-50% of the population depending on the study. Lexapro was specially designed because it shows pure serotonin transporter inhibition with minimal off-target effects. ED is not higher than placebo in trials.

FUCK YOU AAAA

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>antipsychotics are horrible, universally causing metabolic diseases (which antidepressants also cause), drowsiness, weight gain, mood instability, and apathy

Not true at all. Patients actually lose weight on average with improvment of blood sugar on Geodon, Abilify, and Latuda. These are good choices for augmentation of an SSRI because they have strong alpha-2 blocking abilities > release more serotonin and also act as a seratonin 1A agonist

Typical Saturday night in the psych ED

Where do you, personally, draw the line between personality and disorder? Also what do you think of pic related? Do you think it's from increased awareness, broadening definition, or environmental?

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I'm on Wellbutrin for depression which is most likely just ADD. What pill combo have you seen the best results from for depression?

>Where do you, personally, draw the line between personality and disorder?
When it significantly effects your life to where you are not functioning or unable to live your life as you would like (skipping a party that you want to go to because you are depressed, anxious)

>Also what do you think of pic related?
We found out it is VERY important to diagnose autism as early as possible to provide language therapy and special education as soon as possible. This led to much better outcomes. So as we become more vigilant at diagnosing, the prevalence and incidence increase. However, we can not rule out environmental causes and still should be looked at

Very individual. Depends on your symptoms.

If you are more of someone with loss of interest and pleasure, decreased alertness, decreased confidence, then Wellbutrin is a great choice

If you are someone with guilt, anxiety, irritability, loneliness then an SSRI would likely have better results

What kinds of things make doctors think a patient is drug seeking? I'm in a difficult major in a college town and only just started going to the doctor for the depression. Do patients ever outright ask for Adderall or Ritalin and do they actually get it?

I would prescribe it to a college student if the following are met:

Symptoms began in childhood
No history of substance abuse (I will look up your prescribing history)
Meets criteria for ADHD causing significant impairment
Consents to random drug screening and pill count ( I wouldent actually do these unless I became suspicious)

These meds really do help people and I think everyone meeting criteria should have a chance to try them. I would just be genuine in your appointment and tell them you think you may have ADHD

>just go to canada
yeah dude, just go to a third world shithole with 80% indian doctors, some of the most underfunded hospitals in the developed world, entirely state funded so absolutely zero oversight on the entire budget being spent on middle management and HR people, ERs backed up for 10 hours because minorities think it's okay to waste everyones time over minor lacerations or a tummy ache, and wages HALF that of what american nurses/doctors make.

nigger, the guy is from the UK, he's very likely leaving speicfically because of how shit the NHS is, why would you think he's dumb enough to move to a country with the exact same mess of a healthcare system?

1) How do I know when being down is just being down and when I have major depression?

2) I have a fear of getting medicated for my depression if it comes to that, because I do not want to become reliant on medication forever. Provided that I am not suicidal and am still completing major life shit (going out every once in a while, going to work, etc), can I overcome major depression without medication?

>tried to get on meds for anxiety and depression
>doc told me there might be side effects and to just try to deal with them until my body got it figured out
>ended up getting extreme insomnia to the point of basically no sleep for a week
>this happened a couple different times with different meds

why

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Hi OP.

I was diagnosed with major depressive disorder after I had an episode back in October of last year.
I was on lexapro for a month but chose not to get it refilled after I ran out. They made me feel emotionally dead.

I've been going to therapy as well.

I found out that I have a really heavy guilt system. If I have sex, with someone I'm not in a relationship with, I start getting extremely anxious afterwords and worry and guilt myself into a wreck.

I feel very guilty about past mistakes I've made, even if I think I did them for the right reasons. Like breaking up with my gf of 4 years back in october.

Any theories as to why my guilt is so powerful?

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Explain transgenderism to me.

I just don't get it.

Don't know i this would be your field but but how much would an increase in test help me? Last time I tested I was at 490 and got a second test done last Friday. I can do the basic shit of the day but I have no overall long-term goals. Anything I set myself to I feel all around meh towards it. NTM my lifts stall at a certain weight and no matter what I do I cannot increase them. 5000 calories a day with proper macros and my deadlift never goes any higher than 300lbs. I feel with an increase it'll help both my gains and mental state. Thoughts?

I'm gonna start my psychiatry residency in August, any tips/advice?

Do mental disorders actually exist

I mean shit like ADD bipolar etc, its just an excuse for jews to give kids medicin and an excuse for parents doing a shitty job, right?

>1) How do I know when being down is just being down and when I have major depression?
see
>2) I have a fear of getting medicated for my depression if it comes to that, because I do not want to become reliant on medication forever. Provided that I am not suicidal and am still completing major life shit (going out every once in a while, going to work, etc), can I overcome major depression without medication?
Cognitive behavioral therapy appears to be equally effective. Find a therapist or read some books on CBT. Intense cardio.

I understand your fear of dependancy. I would try the above first if it was me also. Keep in mind that good studies have shown that after being on SSRIs for 10 months, 50% of patients who were taken off SSRis stay in complete remission for at least 5-10 years. Sounds like a good deal. Just remember it is just a tool to help you

why is ED listed as a side effect of lexapro?

Also, this paper says that ED is intrinsic to all SSRIs.

"The incidence of sexual dysfunction was similar between fluoxetine and escitalopram."

ncbi.nlm.nih.gov/pmc/articles/PMC6007725/

metabolic disease and a torrent of other shit side effects is associated with antipsychotics including abilify is well documented.

they may be beneficial for treating depression but that doesnt mean they are beneficial overall.

all of these shit drugs include weight gain and drowsiness on their list of side effects including abilify, its no different than seroquel

Possible side effect. Some SSRIs are more "activating". Was it Prozac?

Did you have an elevation of mood, racing thoughts, strange behavior? ANy bipolar in the family?

After three years of smooth sailing, I had a panic episode one week ago. Since then it's been a combination of occasional panic creeping in combined with physical symptoms of shortness of breath and congested nasal cavity. Can't tell if one is causing the other or vice versa. Please advise.
I'm with you man.

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How about you eat a healthy diet instead of hitting your macros with 5000 calories of milk and protein powder. Sleep more as well

Sorry to hear that. Yeah depression can really magnify guilt and you can tend to get stuck on negative thoughts. Then the more you try not to think about them, the more you end up thinking about them. Medication (optional) can likely help with the "stuck thoughts" and you will be able to let things go easier. In the meantime you can work through therapy. ACT therapy is very good at dealing with these thoughts. The goal is to be able to acknowledge that your action makes you feel guilty but accept this and move on.

Also stop fucking thots

I'm not sure what it was exactly. There's no history of anyone being bipolar as far as I'm aware, and honestly I have no idea what I felt during that time other than how outrageously tired I was. If anything it made my anxiety worse while I was desperately trying to sleep because I basically failed a class because of that insomnia and the med center that gave me the meds would just not write me any kind of note

antidepressants wont make you not suicidal

you need to see a clinical psychologist and have an assessment done

most psychiatrists or GPs wont hesitate to put you on an SSRI and aren't capable of diagnosing the source of your depression

even if you have a personality disorder most psychiatrists will still put you on SSRIs and antipsychotics as a precaution

before getting on an antidepressant always get a second opinion from a _clinical_ psychologist

Gender disphoria. It is something on my list to read up on myself. I have trouble relating so it is really tough to get a grasp of it.

Is there something like a reverse depression? Nothing really fazes me, even when everything is objectively really fucking shit internally I am almost always happy and calm. Also I often find myself having to pretend to be sad when someone tells me someone died or whatever

Name one thing that psychiatry has cured.

How do i deal with hating myself?
I (think) 'm a coward, a good for nothing idiot and i repeat that to myself everyday.
For example when i choose not to do anything about "X" situation and see what happens when i don't take the chance and someone else takes it, i thought i'd change but it keeps happening

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There is always some strange rationalization for it like trans having female brains but they said the same thing about gay people so it all sounds like bs.

Age? Not sure if low T is your problem or not. I would need to talk with you more and get into things. Testosterone is finally being looked at heavily in psych and some have already started prescribing it for mood disorders. Get 3 morning levels and average them. An aging clinic will likely prescribe it, but once you go down that road of TRT, it will be a huge hassle to go off

Nice! Intern year you are essentially a scribe to your attending in your medicine rotations. You learn a lot though. Inpatient psych is pretty fun. Just really push yourself and take advantage of having supervision while you have it. Take risks, get good at psychopharmacology

Holy shit man

>>Where do you, personally, draw the line between personality and disorder?
>When it significantly effects your life to where you are not functioning or unable to live your life as you would like (skipping a party that you want to go to because you are depressed, anxious)

Well fuck I skip major vacations and haven't tried to go on a date since I broke up with my ex over a year ago. I might be fucked.

To clarify, I am 100% not suicidal. I have this fucked up bimodal thing going on where half the time, I can see myself in a few years being and doing what I want to be, and the other half of the time, I just can't see my situation improving and think I'm going to be treading water where I am for the rest of my life. When I'm in that down phase, I don't think about killing myself. I might think about kinda giving up and not trying to improve things, but I don't think of not being alive or of ways to end my life. Just like quitting work and staying in bed all day.

Really a good question. To this day we still have no convincing evidence that they do exist when you put things up to hard science.

I got on lamotrigine and shit has been fucking miraculous for me. Lifted my depression within a few days and made me manic for a few weeks. I'd rather be insane than depressed.

maybe try a general DBT book, they all deal with inappropriate feelings of guilt

the keys are mindfulness (catching yourself when you start thinking about the past, ie ruminating), radical acceptance (the past is the past, it cant be changed), and learning skills to cope with these feelings

guilt (or shame) can be thought of as an ego trip, caused by acting against your personal values, and causes oneself undue suffering while doing nothing to change the behavior in the future.

remorse can be thought of as _nonjudgemental_ recognition of past unskillful actions and a pledge to act more skillfully in the future

remorse is a good thing, guilt is a bad thing. by learning basic mindfulness you can learn to step back a bit in your own head and catch the self-sabotaging thoughts like guilt before they cause a chain reaction of more bad thoughts and emotions

"im such a bad person, i should never be forgiven for what i've done, im horrible" only serves in making yourself feel miserable

"i recognize that what i did is was not in accordance with my values, and i will strive to not act unskillfully in the future"

it sounds like you are having inappropriate feelings of guilt. it doesnt sound like you have done anything wrong. in this case what you need to do is firmly identify your core values, and then ask yourself if your feeling of guilt is inappropriate (does it violate any of your values?) or if your negative feelings are disproportionate (are you feeling worse about it than you rationally should?).

anyways DBT (dialectical behaviour therapy) is fantastically helpful for things like this

What’s your favourite movie and why

Do you think it's possible that many of the mental disorders people have is not just because of something internal but due to the fact that in some ways we're living in a highly dysfunctional society?

>why is ED listed as a side effect of lexapro?
because it is a reported side-effect. People also reported ED with placebo at the same prevalence as Lexapro. Your article is sexual dysfunction, not ED. There is a difference.
ctrlf (ED is intrinsic to all SSRIs) no results.
That wording implies 100% of patients taking SSRIs will get ED. That is not the case. It is a risk and if you develop ED, you can switch to Wellbutrin and the problem is solved.

>metabolic disease and a torrent of other shit side effects is associated with antipsychotics including abilify is well documented.

Anti psychotics are VERY complex and each one is radically different than the next, even though they are in the same class.

"Weight and BMI decreased from baseline to endpoint by 4.5 ± 3.4 kg and 1.6 ± 1.2 kg/m2, respectively, at weekly rates of 0.37 kg and 0.13 kg/m2, respectively (all p < 0.00001). 48% of patients had at least 5% weight loss. Obesity rate decreased from 88% to 35% (p < 0.0001). Waist circumference decreased 1.6 inches (p = 0.0001). Overall, mood did not change. Patients with at least moderate baseline mood symptoms experienced significant mood improvement, despite 72% patients decreasing/discontinuing weight gain-implicated psychotropic medications. Seven patients discontinued ZIP early: 3 for weight loss inefficacy, and 1 each for viral gastroenteritis, loss of consciousness, pneumonia with hypomania, and lost to follow up."
ncbi.nlm.nih.gov/pubmed/21371718

no mental ailment like these can ever be cured. You can only treat them and make them less bad

physical symptoms increase anxiety which increase psychical symptoms which increase anxiety

What worked in the past? Really the best treatment is education and talking yourself through it. Know that it won't last over 10 minutes

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There is an adjustment phase lasting about 1 week while your nerves adjust to the medication. That is the likely scenario from what you told me here. Does not seem like mania.

You have achieved permanent hypo-mania. The state of mind everyone strives for. Congratulations.

Chronic escitalopram treatment induces erectile dysfunction by decreasing nitric oxide bioavailability mediated by increased nicotinamide adenine dinucleotide phosphate oxidase activity and reactive oxygen species production.

ncbi.nlm.nih.gov/pubmed/24242893

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Cognative behavioral therapy. Find a therapist or read books on it.

Achieve some goals in your life. The more you achieve, the higher your self esteem raises. Follow your values and try not to stray from them

Yeah I don't believe it. I feel like it is more of a sexual fantasy like transvestism or grass is greener situation

>Anti psychotics are VERY complex and each one is radically different than the next

Weight gain, Drowsiness:
All antipsychotics included in this summary (Zyprexa, Abilify, Seroquel, Risperdal, Geodon)

ncbi.nlm.nih.gov/books/NBK100371/table/consantipsych.tu2/

The use of antipsychotics increases the risk not only of diabetes but also of metabolic syndrome, which is sometimes referred to as syndrome X. While a standard definition of metabolic syndrome does not exist, metabolic syndrome is generally thought to include weight gain and hypertriglyceridemia along with increased insulin, glucose, and low-density lipoprotein cholesterol levels.

ncbi.nlm.nih.gov/pmc/articles/PMC487012/

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mental illness was documented my the ancient greeks but it seems intuitive that technology and instant gratification is fucking with our brains

In October I was tboned by a drunk driver. Lost:
>spleen
>30lbs of muscle

Gained:
>Concussion, to the point that I couldn't walk unassisted for 6 weeks
>Depression

Is the depression a lingering result of the concussion or just the awful feels of losing my gains?

Read past the title bro. Look at the drugs in the figure. There is no Geodon or Abilify causing weight gain.

Did you even read this?
"Open adjunctive ziprasidone associated with weight loss in obese and overweight bipolar disorder patients."
ncbi.nlm.nih.gov/pubmed/21371718

Just admit you were wrong and move on. You learned something today.

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Not even OP but you have every right to feel shitty. Having something like that happen will do that. That shit sucks man, I'm sorry that happened to you.

If anyone that would ever consider drunk driving and risk fucking people up like this sees this post, could you please kindly just kill yourself?

Concussion is known to cause depression. Losing gains sucks as well. I hope you make a heroic recovery. Did you get a shitload of settlement money?

i pasted you what i was referencing, what is confusing about this?

that's interesting geodon has the lowest weight gain risk of the antipsychotics, but it's still a risk. that's the problem. it might be the least shittiest antipsychotic (actually ranks in the middle for side effects), but its still an antipsychotic

you can toot all the horns that antipsychotic#423 has the lowest this, or the best that, but they all still cause a bunch of shit you dont want

the manufacturer themselves list an average weight gain of around 5 pounds. and drowsiness is still a side effect of geodon which makes sense because it still has affinity for histamine receptors just like all the others

i dont know what you are trying to do. metabolic syndrome, drowsiness, and weight gain is fully documented in antipsychotics. trying to argue that they dont increase your risk is futile

none of them so far are worth it

how do I stop procrastinating?
Does this have to do with my sleep habits?

Well these symptoms have been appearing and seemingly reinforcing themselves for a week straight now, and they last more like 30-60 mins. Hard to sleep also as a result. Currently trying brrsthing exercises and varying dose times of clonazepam, diphenhydramine, and ephedrine hcl. Bronkaid appears surprisingly effective, but still just a patch.

Your original post
>universal obscene weight gain

Your post now
>average weight gain of around 5 pounds

Thank you for admitting you were wrong. Now you will never forget it.

Every medication has risks. That is why you only prescribe if the benefits outweigh the risks. For many patients the benefits are HUGE and they have fantastic outcomes. People with full blown psychosis for years have gotten their entire life back after starting clozapine, the "scariest' of them all. Think critically and don't be afraid of meds.

I would stop all stimulants as they may be causing much of the anxiety, switch to a nasal spray