30 replies to this topic

[Anewlife]

All the patients are meant to do regular exercise and meditate but only about 5% do.

They are encouraged to also read and draw and do puzzles.

Things that get suggested here.

Except anti psychotics rather than racetams and amphetamines.

[hippocampus]

Do you expect depressed people to be motivated? If they were motivated for exercise, meditation and so on, they wouldn't become depressed.

[Tom_]

In any acute psych ward, you are given meds, basic supportive psychotherapy, activities to keep you busy and sometimes more intesive psychotherapies.

You are only given anti-psychotics if you have a psychotic disorder, need mood stabilization (Bi-polar affective disorder, some personality problems) or as part of a treatment plan for treatment refractory depression. You are just as likley to be prescribed anti-epeleptics and antidepressants.

[hippocampus]

Well, antipsychotics are also prescribed for non-psychotic disorders, like OCD, Tourette's, bipolar and so on (the same way as antidepressants aren't prescribed for depression only; in fact it would be more appropriate to call them antiobsessives ...). Nowadays they are - unfortunately - prescribed also as sleeping aid pills instead of benzos, because of their side effects. I don't think I need to explain, why this is absolutely stupid and dangerous, but that's how it is.

[Godof Smallthings]

The manic episodes of bipolar I can include psychosis.

[Tom_]

Any episode of bi-polar can appear with psychotic symptoms however they are typically treated as seperate yet co-conurrent phenomna.

[penisbreath]

Do you expect depressed people to be motivated? If they were motivated for exercise, meditation and so on, they wouldn't become depressed.

And it's not like most standard pharmacological treatments leave you feeling better off. When you're emotionally/mentally neutered, it's hard to justify intensive exercise and meditation regimes.

[Tom_]

Hippocampus did you really just suggest the use of benzos over anti-depressants in insomnia?

Edited by Tom_, 29 April 2013 - 12:44 PM.

[tunt01]

Hippocampus did you really just suggest the use of benzos over anti-depressants?

Benzos are a nightmare. Family member is addicted. Two weeks ago this family member told me that Mexicans are trying to break into their house to use a Spanish version of Turbotax so that the Mexicans can do their taxes on this person's PC. So frustrating... need to vent. There, I'm done.

[nupi]

Hippocampus did you really just suggest the use of benzos over anti-depressants?

I think he suggested them over antipsychotics which makes some sense to me...

Two weeks ago this family member told me that Mexicans are trying to break into their house to use a Spanish version of Turbotax so that the Mexicans can do their taxes on this person's PC.

That however sounds more like psychosis than Benzo side effects...

Edited by nupi, 29 April 2013 - 12:39 PM.

[Tom_]

Benzo withdrawal can present with delusions - mostly paranoid. However there is also a good chance it could be a psychotic disorder. Either way s/he needs anti-psychotic treatment and to discontinue the benzos with say baclophen. AFTER seeing a psychiatrist.

Edited by Tom_, 29 April 2013 - 12:48 PM.

[tunt01]

That however sounds more like psychosis than Benzo side effects...

It's the Benzos. This person took Benzos for about 6 straight years. That's just the most outrageous thing they've said to me. Most of it is just constant paranoia/anxiety. Random phone calls asking where I am and what I am doing that very moment. Asking if I am in cahoots with someone against the person. Never ending conspiracy theories.

Imagine getting into a car with a person to drive them to the doctor (or any errand) once a week or two. Every car trip includes a repeated discussion of, "Did you hear a noise? Is it the engine? Listen! This car has a problem. We need to take it to the mechanic." On a car that has never had a problem in 8 years. The mechanic thinks the person is nuts. That's for sure. hahah.

Edited by prophets, 29 April 2013 - 05:00 PM.

[Tom_]

Antipsychotics and a psychiatrists visit. It could be a nonbenzo withdrawal syndrome psychosis that the benzos caused. That or onset of severe mental illness

[hippocampus]

Hippocampus did you really just suggest the use of benzos over anti-depressants in insomnia?

I was suggesting benzos over antipsychotics in insomnia, but that would be the last option I would recommend. Before this one should take care of sleep hygiene, then use light therapy, melatonin if needed and make lifestyle changes. Benzos should only be used occasionally.

[Tom_]

I agree you should be using a load of different tactics before benzo's (in most cases). Excluding Light therapy which is not a treatment for insomnia.

But you could also use, in this order melatonin agonists, antihistamines, sedating antidepressants (praxil, mirtazapine, TCA), benzos, major tranquilizers

[BioFreak]

Why not straight melatonin instead of a melatonin agonist?

[Tom_]

I suggested a treatment algorithm with both in. you try melatonin first say a dose of 0.3 up to a dose of 10-20mg if that doesn't work a melatonin agonist because they are way more powerful.

sleep hygiene + lifestyle changes, melatonin, melatonin agonist, antihistamines, sedating antidepressants, z drugs and clonazapam, benzos, major tranquilizers.

[nupi]

Excluding Light therapy which is not a treatment for insomnia.

It can be for onset insomnia if it's primarily driven by messed up circadian rhythms.

[Tom_]

Yes but onset insomnia are a different set of syndromes than circadian rhythm syndromes. Some of them just share symptoms like delayed sleep phase syndrome and insomnia both cause problems falling asleep at culturally sanctioned times.

The algorithm I suggested would only be useful in an insomniac disorder and then only some at that.

I would say sorry for being a fussy bastard but someone has to be the arse.

[nupi]

You ever got diagnosed with OCD? SCNR

[Tom_]

Who me? & SCNR?

Edited by Tom_, 30 April 2013 - 05:54 PM.

[nupi]

Yes you. And sorry could not resist

[Tom_]

Oh haha :L

I have symptoms.

All the psychiatric disorders I've ever carried are:

Depressive disorder (MDD and dysthymia) Chronic moderate symptoms with the odd severe outbreak /current
Generalized anxiety disorder /current
OCD
Mild Autistic disorder (asbergers - now only a few symptoms are really obvious) /nobody really seems all that sure
Dyslexia and dyspraxia /current
ADHD / i think so, nobody else does
Delayed sleep phase syndrome /current
Idiopathic insomnia, Idiopathic hypersomnia (paradoxical I know) /current
Obstructive and central sleep hypo/nea /current
upper airway resistance syndrome /current
mixed neurodevelopmental disorder
Emotionally unstable personality symptoms (not the full disorder (phrased by the psychiatrist I'm currently seeing as a psychological rut)) /current
Sub clinical manic and psychotic symptoms never lasting more than a few hours. /current
mild drug abuse /current

You could really call it: Multiple complex developmental disorder although its not an officially recognized syndrome.

Edited by Tom_, 30 April 2013 - 06:07 PM.

[nupi]

Out of those, I have symptoms of (self-diagnosed, the shrinks are pretty damn useless at giving me a label)
MDD (dysthmia usually)
SAD
GAD (and some related things)
Pure O (unless chewing nails or fingering your nose count as C)
Some Autism spectrum traits
Some ADD-PI traits
Mild drug abuse
Mild Hypersomnia if left to my own devices (I have no problem sleeping 10-12h per day if nothing is on the agenda)

I call it "slightly above than average screwedupness"

[Tom_]

I'm fairly confident with diagnostics especially in psychiatry, if you give me a list of symptoms I could give you some diagnoses, if of course you would like my opinion. You can PM me them or put them on here/a post.

It would certainly make an interesting discussion!

[hippocampus]

This is problem with psychiatry - one can be diagnosed with multiple disorders although this may just mean that she/he doesn't have all the symptoms by the book. Symptomatic + dimensional axial classification would be a lot better than this shit right now.

[Tom_]

All well and good for personality disorders much harder for other psychiatric disorders

[Heh]

The Psych Ward is a waste of time. They've never done anything to help me. They just annoy me, try to tell me what to do, and hold over my head the fact that they can hold me there longer, or lie and force me onto medication that makes my life even more miserable. It's like they can't do anything to fix the problem I'm having, wouldn't do anything to help me if they knew how, and plan on doing nothing but trying to get me to go in circles.

[Tom_]

You have to remember if nothing else what so ever, they don't serve to gain anything from lying to you, or forcing you onto medication they at the very least don't believe will help. They actually only have your and others safety in mind. In general the aim of a psychiciatric unit is a place of safety until you are safe to be released back down to outpatient care.

[Heh]

You have to remember if nothing else what so ever, they don't serve to gain anything from lying to you, or forcing you onto medication they at the very least don't believe will help. They actually only have your and others safety in mind. In general the aim of a psychiciatric unit is a place of safety until you are safe to be released back down to outpatient care.

Doesn't stop them from doing it. Didn't stop them from doing it to me. Therefore, it either doesn't seem to matter if they have anything to gain, or they are gaining something that you aren't aware of. Or maybe things are different outside the US (I see you are in England).

Edited by Joel, 02 May 2013 - 03:18 PM.