Drug-resistant depression ...

[Lex]

Most illnesses are to a degree "self-inflicted" whether cancer, obesity, diabetes, heart disease, etc etc.
...

I categorically disagree. I know people who have developed forms of cancer without ever smoking, drinking, or staying in the sun unprotected. I know a guy who was totally heathy and died within 6 months of being diagnosed with adrenal cell cancer. He was 37 and fit as a fiddle. I have a faulty heart valve and I am a healthy male in his mid-30s. I was born with it. You can not simply overlook genetic predisposition to disease and ailment or the fact that we all carry the genes for most ailments. It's simply a crap-shoot on how these genes line up (or don't) when the X and Y chromosome meet.

While there certainly ARE ailments that can be avoided by lifestyle (not smoking or drinking or extreme sun exposure), it is disengenuous to say that people should just do better and different when we know that (a) alcohol and tobacco companies have lied and misled people for decades and (b) our country allows mass marketing of said products, knowing full well what the long term drain on the health system is.

For a counter-example, Canada has graphic pictures of lung, mouth, and throat cancer on packages of cigarettes.This has curbed smoking, especially among teens and new smokers, tremendously. Something like that would NEVER fly in the US due to economic pressure from Big Tobacco.

It's no where near as cut-and-dry as we would like to believe.

 

[Rikter8]

Im in the same boat.

I haven't found any meds that can help yet, and I've been doing this for 10 years.
I've been through the bullshit doctors, head shrinkers, and all I've found is that they take your money... even the new one I just started going to.
Ultimately I believe that it's our Environment that surrounds us that depresses us more.

You need to make a change in your life, as I do.

Commit Suicide in the non-physical sense, Meaning, Evaluate your choices for education, employment and life elsewhere. Pick up, and move, if possible and try that.

That's my plan, but I need to finish my education first.
C

 

[naughty]

Thank you, Lex.

I think it is very very dangerous to make wide sweeping assumptions about individuals with certain disorders. Doctors are in fact finding more and more in cases of Depression, Diabetes, etc that there is ALOT they do not know and can not control by diet, exercise, etc. We are even seeing it stated on commercials.I know many individuals who are seriously abusive of their bodies who seemingly do not fall prey to disease while others though trying to live moderately succomb. Do your realize that this very attitude is what keeps many people from seeking the help they need from mental health care professionals or going to the doctor in the early stages of some of these very debillitating disorders? I have also been reading lately that because Depression suppresses the immune system, it makes the body more susceptible to all of the above disorders. SO It is a complicated experience. Yes, there are those who over eat or do not take care of their bodies as they should, but NO ONE asks to get Cancer, Diabetes, Heart Disease or Depression, and I think it is somewhat thoughtless to say so.

I categorically disagree. I know people who have developed forms of cancer without ever smoking, drinking, or staying in the sun unprotected. I know a guy who was totally heathy and died within 6 months of being diagnosed with adrenal cell cancer. He was 37 and fit as a fiddle. I have a faulty heart valve and I am a healthy male in his mid-30s. I was born with it. You can not simply overlook genetic predisposition to disease and ailment or the fact that we all carry the genes for most ailments. It's simply a crap-shoot on how these genes line up (or don't) when the X and Y chromosome meet.

While there certainly ARE ailments that can be avoided by lifestyle (not smoking or drinking or extreme sun exposure), it is disengenuous to say that people should just do better and different when we know that (a) alcohol and tobacco companies have lied and misled people for decades and (b) our country allows mass marketing of said products, knowing full well what the long term drain on the health system is.

For a counter-example, Canada has graphic pictures of lung, mouth, and throat cancer on packages of cigarettes.This has curbed smoking, especially among teens and new smokers, tremendously. Something like that would NEVER fly in the US due to economic pressure from Big Tobacco.

It's no where near as cut-and-dry as we would like to believe.

 

[baseball99]

Thank you, Lex.

I think it is very very dangerous to make wide sweeping assumptions about individuals with certain disorders. Doctors are in fact finding more and more in cases of Depression, Diabetes, etc that there is ALOT they do not know and can not control by diet, exercise, etc. We are even seeing it stated on commercials.I know many individuals who are seriously abusive of their bodies who seemingly do not fall prey to disease while others though trying to live moderately succomb. Do your realize that this very attitude is what keeps many people from seeking the help they need from mental health care professionals or going to the doctor in the early stages of some of these very debillitating disorders? I have also been reading lately that because Depression suppresses the immune system, it makes the body more susceptible to all of the above disorders. SO It is a complicated experience. Yes, there are those who over eat or do not take care of their bodies as they should, but NO ONE asks to get Cancer, Diabetes, Heart Disease or Depression, and I think it is somewhat thoughtless to say so.

I agree with Lex too, that the word "most" is not appropriate but i do feel very comfortable saying many, even many more than most people realize are influenced or caused by lifestyle. I'd be very careful what you believe from commercials.....some of the claims of pharmaceuticals have p-values of .1 or higher when anything above 0.05 is not considered significat. No one asks for cancer, heart disease, diabetes, etc.....however, 85-90% of all type 2 diabetics can basically cure their diabetes if they lost a significant amount of weight. Losing weight also decreases the likelihood of endometrial cancer. Unhealthy diets/lifestyles are also directly linked to heart disease, hypercholesterolemia, hypertriglyceridemia, hypertension, stroke and many more. Yes for many disorders there is genetic link. Take hypercholesterolemia for example. The main stay of treatment is a statin, but they dont even lower cholesterol that much if someone is not increasing their exercise and changing their lifestyle. The most common killer (heart/coronary artery disease, etc) can be severely reduced if people exercised more, lost weight, ate appropriately, lived healthier lifestyles, etc. To attribute all that to "genetic factors" shifts responsibility away from the very people who are in control of their own bodies. This shift in responsibility and lack of a healthy lifestyle is pretty much directly causing the obesity epidemics and increases in heart disease, strokes, and certain cancers.

 

[Lex]

I agree with Lex too, that the word "most" is not appropriate but i do feel very comfortable saying many, even many more than most people realize are influenced or caused by lifestyle. ...This shift in responsibility and lack of a healthy lifestyle is pretty much directly causing the obesity epidemics and increases in heart disease, strokes, and certain cancers.

Not disagreeing with you, baseball. I do think we would be remiss to not say that it is impossible to eat healthy unless you cook all your own foods and that companies and corporations in America (as a whole) do not support healthy lifestyles. Additionally, we market to gluttony in America. They can't sell you things if you don't feel bad about yourself. How many companies have gyms at the office or let employees take time off for mental health visits?

Exercise is expensive (if you want to join a gym) and many people do not understand that you have to make it a PRIORITY (in front of working) in order to stay healthy. Faulty thinking says: "I don't have time to exercise." WRONG. My thinking says "If I do not exercise and stay healthy there is no ME to go to work, teach school and suport my kids." *I* have to put 100% into myself so that I have a full cup from which to do all that needs to get done. Think about it.

You don't have to be a gym rat. I know I look like one, but I am rarely in the gym for more than 40 minutes 3 times a week (and 20 minutes of that is cardio). There are little things people can do. Don't take the elevator. I don't take the elevator unless I am going more than 4 flights up and I NEVER take the elevator DOWN. Walk around your office during lunch breaks. Drink more water--you should be urinating every 20-30 minutes to be properly hydrated. Additonally, there are exercises that you can do at home with household objects to stay fit.

Then there is food. Processed food is unbiquitous in America. Eating out, even at "nice" restaurants, is unhealthy. I was able to drop my cholestrol over 10 points back into a healthy range through a year of improved eating and exercise. Was it easy? No. I basically revamped my eating choices and ate the same lunch everyday (spinach salad with tuna, chicken or fish) along with the same snacks (organic yogurt, almonds, Kashi bars, etc.) with a sensible dinner. Monday through Friday I did this for a year. It sucked and got boring but it paid off.

The moral is you have the FIGHT all the group think and marketing and societal pressures in order to be healthy. And I think that is sad.

 

[joyboytoy79]

I am not surprised so many people are afraid to talk to their doctors. The accusatory tone so many doctors take with their patients these days is astounding... "First cause no harm" right? Then why make statements that cause emotional harm?

Yes, there are many things people can do to LOWER RISKS of attaining many diseases. MANY things! But if people don't feel comfortable talking to their doctors about their lifestyles, how is a doctor (a supposedly informed individual) going to be able to make a possitive impact? And why are supposed doctors making claims of preventability? Even as a lay person, i know many diseases aren't really "preventable."

For example: there is NOTHING that can prevent type 2 diabetes!! Let me spell it out: N O T H I N G. Yes, there are many things that can lower one's risk of becoming diabetic, but they simply LOWER RISKS. They do NOT PREVENT DIABETES. My mother is a Diabetes Education Specialist, she has counseled many, MANY people who have excellent eating habits, exercise regularly, and are otherwise at LOW RISK for developing diabetes, but still, are diabetic. One could argue that this is Type 1 diabetes, but with an onset at age 60, that's unlikely. The truth of the matter is we don't know what causes diabetes, we only know trends among those who do suffer from the disease.

When a doctor, as a trusted professional, makes statements that in essence places blame for being ill, he is doing HARM. With the exception of those with Munchausen Syndrome, nobody asks to be ill. For a doctor to place BLAME, is for a patient to become shameful. Shameful people are less likely to seek help. Those who don't seek help, are less likely to get help within a critical timeframe. Many diseases that can be successfully treated if caught early on are not caught because people are AFRAID to talk to their doctors! And who can blame them!!!

I would strongly advize any doctor to learn how to be sympathetic, to learn how to be compassionate. It is a GIFT to be in a possition to help people, and a gift that is squandered with arrogance and disdain. I would hope that any doctor who reads this seriously thinks about how he deals with his patients, and with society in general. If you encourage people to live a healthier lifestyle, instead of condemning them for not, you will help MANY MANY more people.

I am truely disgusted.

 

[baseball99]

we're arguing similar points.....currently the recommendation for exercise is 30 minutes more days than not during the week. This translates to, at the very least of 2hours/week of exercise. I am skeptical that most people cant find that. You also dont have to do 30 minutes of running in the gym. Every day i comment how poorly even hospitals are set up. Elevators are right in the front and stairwells are always in the corners. It should be the opposite. I think people should have keys to access elevators bc the average person doesnt need to use them for the most part. If you're fat, you should be using the stairs even more. Of course there are people who cant use stairs and elevators should be reserved for them. Simple things would help like parking further away, walking somewhere in the office rather than using the phone, using the stairs as often as possible, taking a pet for a walk, etc etc etc. Gyms can be expensive, but so can your future health. The gym i belong to is 10 bucks a month and has very convenient hours even for my cray schedule. There's a doc that works with obese patients and rales them whenever they try and point responsibility anywhere else

 

[snoozan]

Ok, so I'm fat. I've been battiling being overweight as long as I've been alive. I was a fat kid and got very thin through my teens and early 20s, went off of Wellbutrin and quit smoking, and gained weight. I got married and got pregnant and gained weight. I'm working my ass off to lose and it's hard, slow, and thankless.

I'm fortunate that I am tall and really do have a large frame so I can carry more weight than most women. But I'm still fat.

Is this my fault? Yes. I have asthma, obstructive sleep apnea, polycystic ovarian syndrome, and I'm bipolar and take medication known to cause weight gain. All of these things have influenced my weight in the upward direction. I don't eat a lot of fast food-- I don't even eat out all that much. Mostly I grab whatever I can eat and don't think about it because I'm completely consumed with work and caring for my son.

My point is, people like to make generalizations that because you're fat, you're lazy, unhealthy, slovenly, and don't give a shit about yourself. Nothing can be further from the truth for most people that are overweight. My mother and grandmother have both been obese for lengthy periods of time in their lives. I can't help but think there's a genetic component. Neither of these women are lazy or slovenly. Mostly, like me, they have been completely overwhelmed by the circumstances of their lives and have slowly put on weight.

It is hard to eat healthy when to do so you have to prepare most all food from scratch. Almost everything you get out is terrible for you, including the innocuous bagel and light cream cheese from Starbucks that will run you close to 1000 calories. It's very easy to think you're not eating that much if you don't start looking at nutrition information for everything you eat. Getting that nutrition info can be difficult and time-consuming.

My point is, it angers me that people point the finger at fat people (especially women) as examples of irresponsible slobs who are a burden on society and did it to themselves. I used to work a job where strong men would come in still sweaty from the gym and have me load 20 40-pound bags of topsoil into their cars. I work a job now where I'm on my feet and running, most of the time in heels and a suit, for 12-14 hours nonstop. I am not lazy and I'm also very strong physically.

Yes, I know I'm fat. I'm working on getting healthier and losing weight. But I resent being put into a group and being called lazy and burdensome. For some of us, the battle with our physical health is truly harder than others, even in matters where it seems to be our choice. It's just not fair to paint all people that are overweight with the same brush.

I am so sick of being looked at as a lesser person with no self-control and that attitude being okay. It's discriminatory and infuriating. If my doctor yelled at me for being fat and it all being my fault, I'd switch doctors immediately and maybe punch the motherfucker. What about all the studies that show how influential childhood obesity is on adults, yet my mother was told "a fat baby is a healthy baby," and so by getting me fat, she thought she was doing the right thing? The last time I was in the doctor's office, I cried because I've been dieting, exercising, and doing all the right things and still the weight is coming off very slowly. There are days that I just want to bang my head into a wall. Rather than chastise me, she commended me for the two dress sizes and pounds I have lost and suggested ways I could make this an easier process. A doctor calling a patient fat and yelling at them does nothing but make the patient feel worse and makes them less likely seek out medical help until it's an emergency. And this is a burden on the healthcare system much more than if it weren't such a stigma even with doctors to be overweight or smoke or anything else that is considered "asking for it."

Further, most doctors are not in the position to claim superiority over a patient for this or that habit. Last time I checked, doctors are just as bad with their health as a group as everyone else.

I'm going to go get some of my alotted 1200 calories for the day now.

Snoozan

 

[joyboytoy79]

(...) There's a doc that works with obese patients and rales them whenever they try and point responsibility anywhere else

Case in point.

 

[baseball99]

For example: there is NOTHING that can prevent type 2 diabetes!! Let me spell it out: N O T H I N G. Yes, there are many things that can lower one's risk of becoming diabetic, but they simply LOWER RISKS. They do NOT PREVENT DIABETES. My mother is a Diabetes Education Specialist, she has counseled many, MANY people who have excellent eating habits, exercise regularly, and are otherwise at LOW RISK for developing diabetes, but still, are diabetic. One could argue that this is Type 1 diabetes, but with an onset at age 60, that's unlikely. The truth of the matter is we don't know what causes diabetes, we only know trends among those who do suffer from the disease.

First off yes eating healthy, not being overweight or obese can prevent type 2 diabetes. The sheer pathophysiology of it makes this obvious. There are roughly 10-15% of type 2 diabetic where it is not due to weight and is believed to be an insulin receptor abnormality. Type 2 diabetics that are overweight have insulin resistance due to overstimulation of insulin receptors causing them to basically tone down their effectiveness at removing glucose from the blood. This higher level of glucose causes astounding microvascular effects. If someone who is type 2 diabetic loses enough weight, their insulin sensitivity can return to normal and they will no longer be dependent on medications.

Most people consistently confuse type 1 and type 2 diabetes.....type 2 diabetes is almost completely correlated with poor lifestyle choices, poor eating and being overweight. I know it hurts and can be insensitive but you also can not sugar coat (no pun intended) everything. Yes, its hard work, frustrating and difficult for people to lose weight and maintain a healthy lifestyle but it is ultimately in their hands. By not agreeing with that or sugarcoating it you are propogating the problem. It is very similar in the way the Bush administration wont support the use of condoms to prevent STD's.

The cause of type 1 diabetes is believed to be due to a viral infection in susceptible individuals and then their pancreatic beta cells are destroyed by an autoimmune process. 85-90% Type 2 diabetes is caused by downregulation of insulin receptors due to increased levels of glucose. Similar pathophysiology is seen in many disorders. 10-15% are from unknown cause and it believed to be viral too, in susceptible individuals.....however, it is irresponsible for every type 2 diabetic not to assume responsibility and work to remove weight. You'd have no idea how many people are put on certain diets in hospitals but still have famliy members bring them in mcdonalds.

I agree that you cant be insensitive or "blame" people but not directing the responsibility to the person is completely ineffective and will only worsen the problem. Everyone can make excuses and blame fast food, etc etc.....but it comes down to personal responsibility

 

[joyboytoy79]

First off yes eating healthy, not being overweight or obese can prevent type 2 diabetes. The sheer pathophysiology of it makes this obvious. There are roughly 10-15% of type 2 diabetic where it is not due to weight and is believed to be an insulin receptor abnormality. Type 2 diabetics that are overweight have insulin resistance due to overstimulation of insulin receptors causing them to basically tone down their effectiveness at removing glucose from the blood. This higher level of glucose causes astounding microvascular effects. If someone who is type 2 diabetic loses enough weight, their insulin sensitivity can return to normal and they will no longer be dependent on medications.

NO!!!

The very fact that there are roughly 10 - 15% of type 2 diabetics who are not overweight proves this is not PREVENTABLE! YES, you can reduce risks. Yes, many people can controll their diabetes diatetically. NO it is not preventable, and NO it is not "curable." IT IS RISK CONTROLLABLE. There is a difference, and it's a medical one, look it up.

Most people consistently confuse type 1 and type 2 diabetes.....type 2 diabetes is almost completely correlated with poor lifestyle choices, poor eating and being overweight. I know it hurts and can be insensitive but you also can not sugar coat (no pun intended) everything. Yes, its hard work, frustrating and difficult for people to lose weight and maintain a healthy lifestyle but it is ultimately in their hands. By not agreeing with that or sugarcoating it you are propogating the problem. It is very similar in the way the Bush administration wont support the use of condoms to prevent STD's.

I do not confuse Type 1 and Type 2 diabetes. My sister is Type 1, she is insulin dependant, and there is nothing that can change that (at least, not now). I worked as a nurses assistant in a nursing home full of residents with Type 2 diabetes. Most of them were diet controlled. I fundamentally understand the difference.

I also understand that encouraging people to make changes is not "sugar coating," and that blaming people for their disease DOES NO GOOD. It is exactly that type of thinking and behaviour in the medical community that encourages people with mental illnesses to avoid medical treatment. Every time i've gone to the ER in a "crisis" situation i've had at least one medical professional tell me that I was "over-reacting" or "fine." I've had several medical professionals tell me that it is my fault that i'm suicidal. Yes, ultimately I am responsible for my own medical health (including mental), but you know what? I NEED HELP SOMETIMES. Everyone does. And the best way a medical professional can help is by listening, and encouraging, and supporting... not by assigning resonsibility.

The cause of type 1 diabetes is believed to be due to a viral infection in susceptible individuals and then their pancreatic beta cells are destroyed by an autoimmune process. 85-90% Type 2 diabetes is caused by downregulation of insulin receptors due to increased levels of glucose. Similar pathophysiology is seen in many disorders. 10-15% are from unknown cause and it believed to be viral too, in susceptible individuals.....however, it is irresponsible for every type 2 diabetic not to assume responsibility and work to remove weight. You'd have no idea how many people are put on certain diets in hospitals but still have famliy members bring them in mcdonalds.

I know what the believed causes of diabetes are. I also know that there is no conclusive evidence to support any of these hypotheses. The fact is we DO NOT KNOW FOR SURE WHAT CAUSES DIABETES. We have a lot of ideas that make sense, but we don't have any conclusive support. And yes, i do have an idea of how many people do not follow their diets, and i know that by the time someone is 60 years old they have habits that are hard to break. It is not a cut and dry "you are responsible for your own health and i can't help you" situation.

I agree that you cant be insensitive or "blame" people but not directing the responsibility to the person is completely ineffective and will only worsen the problem. Everyone can make excuses and blame fast food, etc etc.....but it comes down to personal responsibility

This is an example of how you or anyone else can "direct responsibility" in a healthy or helpful way:

"Jim, you're overweight, and it really puts you at a much higher risk of developing diabetes. I care about you and i don't want to see you suffer with that. These are some things you might try that can help you get your weight under controll (list out examples). I would also like to see you a bit more frequently as we work on your weight. If you hit any roadblocks, let me know. This isn't something I can fix for you, but as someone who cares i would like to help you fix it."

Does that place blame at all? NO! Does it outline a finite risk and a way to reduce it? YES! This is what the vast majority of people need. They do not need someone to say, "You're on your way to getting diabetes and if you don't do something about it now, it will be your own fault when it happens."

 

[Lex]

...
When a doctor, as a trusted professional, makes statements that in essence places blame for being ill, he is doing HARM. With the exception of those with Munchausen Syndrome, nobody asks to be ill. For a doctor to place BLAME, is for a patient to become shameful. Shameful people are less likely to seek help. Those who don't seek help, are less likely to get help within a critical timeframe. Many diseases that can be successfully treated if caught early on are not caught because people are AFRAID to talk to their doctors! And who can blame them!!!

I would strongly advize any doctor to learn how to be sympathetic, to learn how to be compassionate. It is a GIFT to be in a possition to help people, and a gift that is squandered with arrogance and disdain. I would hope that any doctor who reads this seriously thinks about how he deals with his patients, and with society in general. If you encourage people to live a healthier lifestyle, instead of condemning them for not, you will help MANY MANY more people.

I am truely disgusted.

Doctors also need to live by example. I know that medical conferences have been stressing to doctors that they, themsleves need to model healthy living in order to get their patients to listen to them.

 

[baseball99]

NO!!!

The very fact that there are roughly 10 - 15% of type 2 diabetics who are not overweight proves this is not PREVENTABLE! YES, you can reduce risks. Yes, many people can controll their diabetes diatetically. NO it is not preventable, and NO it is not "curable." IT IS RISK CONTROLLABLE. There is a difference, and it's a medical one, look it up.

the very fact there are roughly 85-90% of DM II who are overweight and have the capacity to "lose" their diabetes PROVES it is preventable!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! You can track families with high susceptibilities of developing DM II and members who remain thin and maintain a healthy diet dont develop it. Yes, I will agree with you in the respect, and i thought i was clear in the last post, that those 10-15% no known preventable cause currently exists or is known but for 85-90% not ever becoming obese is preventable, controls the risk and SEVERELY decreases your potential to ever develop DM II. You're right DMII is not "curable" in the respect once you develop DM II you are much more likely to have a lower threshold to develop insulin resistance. In cancer no one is ever labelled as "cured" theyre always "in remission"

I do not confuse Type 1 and Type 2 diabetes. My sister is Type 1, she is insulin dependant, and there is nothing that can change that (at least, not now). I worked as a nurses assistant in a nursing home full of residents with Type 2 diabetes. Most of them were diet controlled. I fundamentally understand the difference.

DM II is rampant, higher risks in certain ethnic groups, etc.....It is 85-90% preventable

I also understand that encouraging people to make changes is not "sugar coating," and that blaming people for their disease DOES NO GOOD. It is exactly that type of thinking and behaviour in the medical community that encourages people with mental illnesses to avoid medical treatment. Every time i've gone to the ER in a "crisis" situation i've had at least one medical professional tell me that I was "over-reacting" or "fine." I've had several medical professionals tell me that it is my fault that i'm suicidal. Yes, ultimately I am responsible for my own medical health (including mental), but you know what? I NEED HELP SOMETIMES. Everyone does. And the best way a medical professional can help is by listening, and encouraging, and supporting... not by assigning resonsibility.

There is a major difference between "blaming" and giving responsibility. No one I ever see is blamed. In fact I can think of blaming one patient for one thing ever and it was something I can talk about in another thread but this patient deserved it and they also deserved to be arrested and never let out of prison or near children ever again.
People need to understand they ultimately are responsible for their health or lack there of. Just like you place responsibility of an alcoholic on them you can place the same responsibility on "MOST" obese people. No amount of medication can replace or cure when peopel refuse to alter their lifestyle

I know what the believed causes of diabetes are. I also know that there is no conclusive evidence to support any of these hypotheses. The fact is we DO NOT KNOW FOR SURE WHAT CAUSES DIABETES. We have a lot of ideas that make sense, but we don't have any conclusive support. And yes, i do have an idea of how many people do not follow their diets, and i know that by the time someone is 60 years old they have habits that are hard to break. It is not a cut and dry "you are responsible for your own health and i can't help you" situation.

If i remember correctly insulin resistance and downregulation has been shown in lab studies. Downregulation is an interesting, almost seemingly ineffective means the body uses for many processes.

This is an example of how you or anyone else can "direct responsibility" in a healthy or helpful way:

"Jim, you're overweight, and it really puts you at a much higher risk of developing diabetes. I care about you and i don't want to see you suffer with that. These are some things you might try that can help you get your weight under controll (list out examples). I would also like to see you a bit more frequently as we work on your weight. If you hit any roadblocks, let me know. This isn't something I can fix for you, but as someone who cares i would like to help you fix it."

Does that place blame at all? NO! Does it outline a finite risk and a way to reduce it? YES! This is what the vast majority of people need. They do not need someone to say, "You're on your way to getting diabetes and if you don't do something about it now, it will be your own fault when it happens."

That example is nice in a happy little world where people take responsibility and are compliant. Every single patient for a phsyical exam gets the same questions and advice and offered help if needed. Every smoker is encouraged to quit with help, programs and aid. Every obese patient is offered the same. Every drug abuser the same. No one is ever blamed, yelled at or feels bad. However, compliance and willingness to change is almost non-existant. THere is a huge change in those that want and are willing to work at it. I worked with a leading diabetes researcher, well actually 2, who made/helped patients lose 20% of their body weight, altered lifestyle and kept the weight off BEFORE they were sent for gastric bypass surgery or banding. Why? Because it has only proven effective in poeople who make those changes and virtually useless with a high failure rate in those that dont. Everyone wants a quick fix and now gastric bypass surgery is the latest fad. It is very very very effective with a change in diet and lifestyle but I have seen patients with gastric bypass who have lost >200 pounds and a year later put 250 back on. Now there options are so limited its not even funny

It's all similar to a teen we treated for repeated STD's. It seemed like every month he was in the office for treatment of another STD. He didnt get blamed for his sexual activity but we were desperately trying to get through to him that his health and sexual life were his responsibility. Ultimately it got through to him but only because he took the responsibility. He didnt blame computer porn (fast food), being 17 year old hornball (older individual), enticing gorgeous women with huge breasts (fatty foods) or anything else. HE had to take responsibility and until he did so we were there to help treat him and talk with him, give him good medical advice, even beg him to think about his future but it absolutely did not change until HE took responsibility

 

[baseball99]

Doctors also need to live by example. I know that medical conferences have been stressing to doctors that they, themsleves need to model healthy living in order to get their patients to listen to them.

You're absolutely right, there is a lot of the "pot calling the kettle black" in the medical community. How can a fat doctor convince type 2 diabetics to lose weight. Interestingly every single doctor where i work is slim, exercises and model examples.....however i have definitely been disguisted by many others

 

[Nelly Gay]

is it really necessary to type in big bold font?

It is if your vision is very poor ....
-10 . at the last count .

 

[Nelly Gay]

Doctors also need to live by example. I know that medical conferences have been stressing to doctors that they, themsleves need to model healthy living in order to get their patients to listen to them.

I saw a specialist in gastric by-pass surgery who told me I (at around 16stones) was TOO thin for surgery (cost £12,000).
He had the good grace to admit to being much fatter than me .

 

[OKFarmer]

Nelly,

As a pharmacist who has worked in a mental health hospital, I will tell you that medications are a very minute part of a treatment program. Sorry, but you will not have your depression fixed by any of the drugs out there. Medications that treat depression regulate the level of neurotransmitters in your brain only.

True depression has to be treated by a regimen that includes lifestyle change, behavioural modification, counseling, setting of positive goals, and yes often medication.

As far as the medications go, many doctors try to use the SSRI's as primary therapy. Mixed action anti-depressants sometimes are more effective. A combination of a SSRI and a TCA can sometimes be more beneficial. Ask your doctor to try safe combinations of various medications while you work on the issues that lead to your condition. Do you take other medications? Beta-blockers like metoprolol, atenolol, etc can cause people prone to depression to experience it where they did not before.

Therapy that many know as Electroshock can be very beneficial. It is not what you see in the movies where a deviant is set into Old Sparky and fried till he behaves. Mild to moderate levels of electricity are used to reset the electrical impulses of the brain. Often a shock session will be required 1 to 4 times a year.

The main thing is to treat the cause of your depression rather than chasing after a cure... you won't find one in a bottle.

 

[naughty]

Baseball,

What do you think of cases where one medication for one health issue can trigger problems in another area? I know at least three individuals with acute respiratory problems who were told my their doctors that they were pushed into diabetes because of their much needed respiratory medications. THey may have had a predisposition towards diabetes but all of these people were active and ate relatively healthy diets....

 

[baseball99]

Baseball,

What do you think of cases where one medication for one health issue can trigger problems in another area? I know at least three individuals with acute respiratory problems who were told my their doctors that they were pushed into diabetes because of their much needed respiratory medications. THey may have had a predisposition towards diabetes but all of these people were active and ate relatively healthy diets....

You are absolutely 100% correct. Some medications, steroids are notorious for this, can cause elevated blood glucose (sugar) levels, which can in turn cause insulin resistance. Usually when you remove the offending agent the hyperglycemia (elevated blood glucose) returns to normal, but not in everyone. Many drugs have side effects of weight gain, most including many of the antidepressants. Sadly enough many of the people that take oral steroids for COPD (which actually is controversial bc of the pathophysiology) or asthma (proven benefit) can have blood sugars that are erratic. However, the most common cause of COPD is smoking related and everyone now knows the risks/dangers of smoking and can ultimately prevent that complication in themselves years down the road by quitting. You are absolutely right and I did forget about that group that you are speaking about. The thing is, they still are a major minority in comparison to people developing DMII bc of being overweight. DMII has strong genetic links, which can be circumvented with diet and exercise for most people

 

[jimcord]

Stating up front that I work as a professional sales rep for a drug company that deal with mental health (but not for depression).

I am a firm believer in medication when all other efforts fail, such as: lifestyle modification, therapy, light treatment or many other treatments that are available. I will not support St. Johns Wart due to many CLINICAL trials that have repeatedly shown that it is not effective and may have other implications with other medications such as birth control pills.

I do believe that you should talk to a MEDICAL PROFESSIONAL and seek out their opinion and options for your condition and what treatment options are available to you. I would hate to make a blanket statment that medications are over prescribed in general when YOU may actually benefit from them. It would be a shame to all of us if your depression was to worsen and as many unfortunately do, one takes one's own life or you do harm to yourself or others.

After seeking professional opinions that you trust, make whatever decision is best for you, but please seek opinions and help from those who can actually offer you help or services to treat your depression.

Wishing you the best of health and happiness!