Addiction is a disease

[Dancing David]

Come on, Dave, if caffeine addiction was anything like addiction to serious drugs of abuse why is it unnecessary to make its purchase illegal? You don't even have to be 18.

You are comparing apples and oranges. You can find things in common, they are roundish and they are fruits and according to an Ignobel awarded study have similar chemical compositions, but everyone knows when you say you are comparing apples and oranges why they are not the same.

Please do a search on 'addiction criteria' and see what you find, most research will use what are called behavioral criteria in defining adddiction.

Then if you disagree with the usage of the term addiction we can discuss what to call things like sexual, gambling, exercise and karaoke addiction.

As stated before I am out there is using strictly a behavioral defintion for addiction, there are those who might agree with me.

Two really low level citation that indicate the direction I am headed in:

http://www.drugabuse.gov/Published_Articles/Essence.html
http://pubs.niaaa.nih.gov/publications/arh21-2/101.pdf

 

[calebprime]

Situational depression is much different and a daily battle with memorex, it is characterized by intrusive thoughts, intrusive reoccurring emotional trauma, and sadness. I suffered from the latter after a very bad breakup a few years ago. During that time which lasted about a year, I started drinking and forced myself to stay distracted. It worked. It reoccurs even today, a marriage of sadness and anger - enough that, if I don't force my attention away from it, my entire day can be ruined.

Of course not, but situations influence mood just as powerfully as imbalances. You can't treat someone from serious situational depression with antidepressants or even narcotics. Alcohol is really the only thing that works.
.

Uh, huh.

You seem to be operating under an artificial dichotomy. So how would you asses the situational component to depression?

Why would it matter, if you are planning to kill yourself, does it matter?


... please don't call numbing ones self with alcohol treatment. Most people I know who use to numb feelings are volitale after a while. What are you saying? Chronic use causes numbing? They are usualy more like Kirk.

Situational response to a situation is usualy like nine weeks long. Getting drunk doesn't help and is not treatment. The use of alcohol to deal with issues might be a hallmark of abuse or dependance.

listen to DD.

Funny line from the movie The Tall Guy: "The best cure for depair is to get well and truly hammered."

Problem is, hammered includes the hangover with the pounding headache, etc. Talk about vicious cycles.

It's a bit ad hom, but I can't help reading your posts as a rationalization to keep drinking. But it's your call...

 

[calebprime]

just checking my memory:

From a review of The Tall Guy:


Timothy Barlow (Who is Killing the Great Chefs of Europe-1978) appears as Mr. Morrow, the blind man. Morrow turns out to be allergic to his guide dog. Later he gives out that his philosophy on fighting despair is “getting well and truly hammered!” Anna Massey (daughter of Raymond Massey and a superb actor in her own right) takes a wonderful turn as Dexter’s agent, Mary Simmons. In a scene in her office Dexter gripes about a lack of acting jobs and she tells him that “73% of actors are unemployed.” Dexter points out that Roger Moore is still getting work. Massey smiles at him and says…“Yes, it’s a dark and mysterious world.”

 

[Skeptic Ginger]

Please read the DSM defintion/criteria for dependance and abuse, I am using behaviors in the psychological sense of behaviorism.

If we use the DSM criteria to derine what constitutes an addiction then yes is is based upon behaviors. Now how many people are going to have a detriment to daily functioning and negative consequences for caffine addiction compared to other substances? Very low, probably only a few out of millions and millions.

But David, this is my point. There are definitions and then there is the reality that the definitions only contain so much data. Surely you aren't suggesting a practitioner treat the two addictions the same? Why not? Simply a matter of degree?

If caffeine threatens to give your patient a life threatening arrhythmia, and he can't give it up because he's addicted, would your therapy and/or approach for that person be the same as your therapy and/or approach to the heroin addict who just relapsed for the 5th time two days out of an inpatient treatment program? Can you imagine any circumstances where you would in any way see those addictions in the same way, regardless of the definition of addiction?

Consensual sex regardless of the legal definition of rape is not a violent act where as real rape is. A custody dispute is rarely anything like kidnapping a stranger regardless if the legal system's definition is blind to the difference.

A definition alone is hardly the basis for understanding mental illness. Not to mention the role of common sense applying a definition.

 

[Dancing David]

But David, this is my point. There are definitions and then there is the reality that the definitions only contain so much data.

Uh, huh, and that has what to do with the defintion of addiction from behaviors. Different addictions will have different consequences. If a gambling addict has large credit debt and a caffine addict has irritability, so what? If it impacts thier lifes to the detriment of thier ability to maintain thier daily functioning then it doesn't matter. I have already said that I am using a behavioral defintion, many people are uncomfortable with the behavioral point of view and you may be one of them.

Surely you aren't suggesting a practitioner treat the two addictions the same?

Depends on the treatement, detox would be different, if the person has functional deficits from thier behaviors, then i would recomend what?
Changes in behavior.
The main problem with caffeine dependance is that the withdrawl period is rather prolonged. But when you meet people who are having caffeine abuse problems and possible dependance than the strategies are the same. Life style changes, relapse prevention and CBT. Many people believe that marijuana is not addictive or that exercise is not a potential mood altering behaviors, incredulity is not much of an argument. I have argued here and in other threads that addictions are dependant on a set of behaviors.

Have you read the research criteria for addiction yet? Many researchers skip the withdrawl syndromes for dependance.

Why not? Simply a matter of degree?

I don't recall stating what you seem to be arguing.

I believe in detox and I sort of believe in residential treatment, I am more a fan of IOP and relapse prevention. I don't personaly think that all the soul searching is nessecary, I prefer the DFD (Dont effing drink) and the Big Choice ((Jack Trimpey) models for myself. The soul searching and history exploring that people engage in in rehabilitation is more a way of passing time than useful. (But that is just a personal opinion, each should decide what they need to do to avoid using and avoid use.) I beleive that as a practioner , it is nessecary to gain the trust of the person and respond to thier stories honestly and calmly, but to always redirect it to personal accountability and relapse prevention.

If caffeine threatens to give your patient a life threatening arrhythmia, and he can't give it up because he's addicted, would your therapy and/or approach for that person be the same as your therapy and/or approach to the heroin addict who just relapsed for the 5th time two days out of an inpatient treatment program?

The detox issues are important factors in certain addictions as I am sure you are more aware than I am, but the strategies are the same, as I said the consequences of use will vary from mood altering behaviors to other mood altering behaviors. Ya know who the hardest people are to crack? The work addicts.

Can you imagine any circumstances where you would in any way see those addictions in the same way, regardless of the definition of addiction?

If you don't like behaviorism, that is fine with me. It is my bias, some people don't like it.
Each person is different, you can't have cookie cutter approaches in general. As I said, gain trust, reflect the choices and consequences of thier choices, point out addicted thinking, suggest relapse prevention strategies.(After supervised detox and W/D in many cases) And don't buy into the addicted thinking, be calm friendly and supportive.

Consensual sex

I don't think fourteen year olds can give informed consent. They may be capable of agreeing and experimentation. But consent?
[/quote]
regardless of the legal definition of rape is not a violent act where as real rape is.
[/quote]
I agree, you are the one who mixed the metaphors. But should a forty year old have sex with a consenting fourteen year old, what is the difference bewteen a 40 year old and a 21 year old? How about 18 or 17? The law is the law. Is a person with a severe developmental disability capable of giving consent? How about a person with dementia?

A custody dispute is rarely anything like kidnapping a stranger regardless if the legal system's definition is blind to the difference.

I am sorry if your personal experience has led you to believe that but maybe thier are other situations as well.

Want to reconsider?
Is that really the general statement for all cases?

Let's see, what if the non-custodial parent is a drug addict and neglects the child?(Who is three, and left alone for twenty hours.) Or lives with a partner who rapes the child? Or what if the non-custodial parent is a rapist, of the child?

Please don't do that again, reducing child abuse to mere 'child custody' is glossing over the myriad of possibilities. Some people engage in stupid power struggles, some engage in dangerous power and control struggles.

I agree some people are really, really, really stupid when it comes to divorce but when domestic violence is involved I hate it when people refer to it as
"Just a custody disute".

I grant that most likely was not your intention.

A definition alone is hardly the basis for understanding mental illness. Not to mention the role of common sense applying a definition.

Uh huh, I am stating that addictions are based in behaviors. What do you believe they are based in?

 

[Skeptic Ginger]

I don't see it your way. I've worked with addicts and they are not simply addicted as someone who has a heavy caffeine habit. I just have to agree to disagree.

And I've never had a custody dispute so I don't know what that comment even means.

Kidnapping and custody disputes are just not the same. Maybe there are some things they have in common, again, I simply am not going to agree with you. I made no comment about relative harm, danger and so on so you are again, lumping everything into the same category as if I said NO aspects were the same.

 

[Dancing David]

I don't see it your way. I've worked with addicts and they are not simply addicted as someone who has a heavy caffeine habit. I just have to agree to disagree.

Okay. I agree that the consequences of the addictions are different, but I take my point of view to cover all modd altering behaviors. Having worked with a wide variety of people in desperate situation I just feel that there are addictions that are based upon something other than a strong physiological pattern with a substance of abuse.

I agree very strongly that the big four or big five substances of abuse are very different in the way that they impact people's lives than some other substances.

But then I have also worked with people who have compulsive spending, shoplifting and sexual addictions. I just happen to think that they fall along the abuse/dependance spectrum as well.

And I've never had a custody dispute so I don't know what that comment even means.

Kidnapping and custody disputes are just not the same.

Okay, I feel that it is a matter of jurisprudence, and that there are 'custody disputes' that involve the same level of risk and the exact same behaviors as 'stranger' kidnappings. It comes from working with victims of family violence. Some 'custody disputes' have a grave element of danger to them, and the issues are exactly the same as a 'stranger' kidnapping.

Maybe there are some things they have in common, again, I simply am not going to agree with you. I made no comment about relative harm, danger and so on so you are again, lumping everything into the same category as if I said NO aspects were the same.

If I misinterpreted your statement i apologise, I feel thier are 'custody disputes' that are as dangerous as 'stranger kidnapping', and for very good reasons fall into the same legal category..


And as a metaphor, twern't mine.


How would you define addiction?
The point I am playing to death is that, addictions are based upon behaviors. And yes the manifestation of the consequences of the behaviors are going to be drasticaly different for different addicted behaviors, just as someone with a paraphilia who likes a particular perfume ( say Eau d'Poo) for arousal is going to be very different from someone who has a paraphilia with an object of arousal that is much more inappropriate, and threatening to others.

 

[Skeptic Ginger]

Perhaps if you consider the difference between obsessive compulsive behavior and drug addiction you might understand my point of view a little better.

There is a difference continually chasing the elusive butterfly of the early highs one has with drug addiction. The euphoria of drug use is completely different from the reward of gambling or other compulsive behavior. There's a difference in how the reward one seeks has a large physical component in drug addiction and not all psychological as in the other kind of addictions you are comparing them with. Caffeine is just not a drug of abuse the same way heroin is. There is no euphoria. There is no high. If there was, you'd see meth addicts using it and they don't, not to get high anyway.

 

[Dancing David]

Perhaps if you consider the difference between obsessive compulsive behavior and drug addiction you might understand my point of view a little better.

Perhaps I do understand it, I just don't agree. I am familiar with both .

There is a difference continually chasing the elusive butterfly of the early highs one has with drug addiction. The euphoria of drug use is completely different from the reward of gambling or other compulsive behavior.

That depends on the nature of the mood altering behavior. I think that if you talk to sex, gambling and exercise addicts you will find the same processes at work. I have heard the same statement from people who engage in mood altering behaviors that I have heard from hard core junkies. The same stuuf about chasing the elusive 'original high'. I agree that actual compulsive behavior (which I draw a line from with addiction) is different. Compulsion usualy (but not always) has the subject having a panic attack if they do not engage in the compulsive behavior. While some addicts will report that, it is very different. The reaction to not being able to engage in a compulsion is often very different from an addict without thier mood altering behavior.

There's a difference in how the reward one seeks has a large physical component in drug addiction and not all psychological as in the other kind of addictions you are comparing them with.

See, there is the rub right there, I do not believe that there is a useful distinction to be made for the term 'psychological addiction', there are some very good reason I have these beliefs. My mani argument is that addiction can only be identified through the behaviors. For starters not everyone exposed to SoA with high addictive liabilities will become addicts, so there is a 'psychological' component to addiction. It is not 'all physiologica', for the SoA with the high addictive leabilities for a simple reason.

There is a biological basis to behavior. There is no duality between the mind and the brain. I have met people messed up with obsessive shopping as bad as any meth head.

Caffeine is just not a drug of abuse the same way heroin is.

I agree, it has a lower addictive liability for sure.

There is no euphoria. There is no high. If there was, you'd see meth addicts using it and they don't, not to get high anyway.

And when people get addicted to LSD, which has a negative addictive liability that means what?

I understand what you are trying to say, and I have had that POV. However, if one begins to take the black box approach and look at what comprises addiction, then I believe you end up with the behaviors.

I agree that the consequences of sexual addiction are very adifferent from the consequences of meth addiction, and that the consequences of gambling addiction are very different from the consequences of nicotine dependance.

I have had friends who are sexual addicts, and worked with people with many forms of mood altering behavior problems.

The sex addict sounds just like your average alcoholic or meth head. They act like them, they have the same issues as them (different consequences). If you take the statements of a meth addict and compare them to the statements of a sex addict, you find something interesting, as you do if you look at the behaviors.

I think XYZ about (mood altering behavior), I engage in this LMN to engage in my (Mood altering behavior), I have the following problems when I can't engage in my (mood altering behavior) ... I have lost CDE from engaging in my (mood altering behavior).

The issue for me is that the behaviors are the same, the actions are the same, the consequences vary but are actualy about the same, and in many cases are exactly the same.


So I argue that people who engage in sexual addiction think like meth heads, they act like meth heads, they have the same issues as meth heads. the two appear to have striking similarities. (Now granted a sex addict will not have psychosis and the fortyfive day rebound.)

So the argument goes as follows,

(And again many people are uncomfortable with behaviorism.)(And again the actual physiology of sexual addiction and methamphetamine are similar but different, a sexual addict will not have psychosis.)

The behaviors of meth addicts and sex addicts are the same.
The thoughts and feelings of sex addicts are the same.
The antecedants to use are the same.
The behaviors during times of not using are the same.
The process of changing the behaviors is the same.

If in the black box we can remove the term (meth addiction) and replace it with (sexual addiction) and acurately predict the behaviors than the two are the same process.

Now granted the caffeine addiction is a red herring, we are talking about something with a low addictive liability (if high physical dependance) and the consequences of use are substantialy mild.

The same is not true of gambling addiction and sexual addiction.

I don't expect people to agree with me, but there are reasons I feel the way i do. All addictions are behavioral in nature. It is the behaviors that make an addiction, not the nature of the mood altering behavior. There is really no difference bewteen the mechanisms of sexual addiction and meth addiction.

But then i know that I am out there in saying this.


Please define addiction.

 

[Skeptic Ginger]

We disagree then.

The problem with defining addiction is the definition alone does not include the distinction.

But here's another example. You find many animals such as pigs which will seek addictive drugs over sex and food. They won't do that for any other pleasures you might try to entice them with. There is more to addictive drugs than the psychological aspects you are confining the phenomena to and that your definition alone includes. And it isn't the physical addiction in my animal examples because you don't have to purposefully induce physical addiction in these animals. They do that on their own.

 

[SirPhilip]

Give me five or more questions that would determine that please. I have done assesment. You are ignoring the glaring point, which is this, there is no physical difference between endogenous and exogenous depression.

Someone's set mood is due to a relationship between outlook (which is directly influenced by circumstance) which affects their neurochemical balance, which in turn is responsible for their ability to cope with stress.

You seem to be operating under an artificial dichotomy. So how would you asses the situational component to depression?

I wouldn't. I'd let them identify the cause themselves; if a situation out of their control, mood brighteners/regulators only mask the cause: the situation. If it can't be resolved, you have the psychological impetus for substance addiction ('psychological addiction'). If it wasn't, a chemical imbalance causing a high receptivity to stress is much more likely, if not an average of negative circumstantial amounting for it, or a confluence of both, as is often the case. What part of this for you is so difficult to comprehend?

Did it last three weeks? (as I stated in my example).

Months, it was clearly attributable to caffeine, though.

Wrong, wrong, wrong. You are talking out of your imagination. A person who is severely depressed will give you many, many reasons for thier depression. I have interviewed plenty, have you? They will genraly ascribe greater meaning to minor events and have a laundry list of desperation.

If they do not identify a situation or event as constraining their outlook and mood negatively, obviously an imbalance is suggested (this again, isn't plainly obvious?). The stereotypical characterization of a chemically depressed person is someone who has no actual reason to be depressed or more personal, psychological issue that they can identify as the cause, but experiences bouts of very low mood/outlook which directly affect their productivity and social life - this again, is not plainly obvious to you?

Uh, huh. More assertion, it usualy takes at least six weeks if not longer for the symptoms of depression to begin to lessen. Where do you get your information?

You seem to get yours from a series of undescriptive therapeutic terms that function as general guidelines, and which you are taken aback that I'm thinking instead of caring about. You simply refuse to think about or acknowledge any sense I make, and dispute every single thing I write.

More what? Can you clarify your statement, do you mean what? Most people I know who use to numb feelings are volitale after a while. What are you saying? Chronic use causes numbing? They are usualy more like Kirk.

Numbness (apathy?) has nothing to do with anhedonia, but drunkenness. Anhedonia is characterized as a washed out mood state caused by a deficit, primarily serotonin related.

That describes OCD or Major Depression with Anxiety. How is that different from someone with Major Depression having the same symptoms? What duration , frequency and length of occurance. What?

Derail. You are disputing that situations do not induce depression (which is ridiculous)? Depression is neurobiological, obviously, and you look like a halfwit assuming I was disputing it. A relationship however exists that doesn't take a rocket scientist to identify - most people can tell off the bat which one of the two, or both, are at play when they notice someone, otherwise on the ball, having a persistent very hard time.

Sounds like it is not situational, if it didn't resolve in a short period and with lifestyle changes. Perhaps CBT? (Cognitive Behavioral is good for what you describe as memorex.)

Of course it was situational - the disordered situation caused likewise, a disordered change in outlook that I was forced to adapt to. Had any chemically induced mood brightening occured, it would have simply threw a rug over it, and were I chemically depressed, it would have simply made the situation much harder to cope with. You disagree?

After a year it is no longer situational. It has taken up residence, the severity of the anxiety or depression would be assesed.

It was just situational depression, and whatever harshness associated with it disappears as soon as you begin to resolve it - in my case, through forgiveness.

Uh, huh? And what data, what research. What makes you say that medication will not alleviate symptoms. The perscription of narcotics is not advised for that use.

You simply refuse to actually think, don't you. Narcotics like cocaine and pu opioid receptor agonists, despite being the most effective antidepressants in existence, are not prescribed due to intrinsic addictiveness and an equally severe anhedonia, a chemically depressed person could very well commit suicide in such a situation. You aren't going to make me explain why that actually is, if this isn't outlined in whatever argument from authority playbook of vague therapeutic terms you've fortified your statements around, for what reason only you know. You should, due to experience, be making far more educated and detailed assumptions on some of these issues, than I'm able to.

Clearly, people suffer from depression induced either by a memory of a situation, with chemical balance simply functioning as a factor in coping with it. Drugs cannot directly treat depression caused by traumatic memories; the disordered situations themselves are the cause of the disordered outlook and corresponding mood state, and must be resolved. If they cannot be resolved, it persists like a slow burn.

Alcohol is not treatment. That is what you call addicted thinking?

I agree it isn't treatment, but for alleviating intrusive thoughts and emotional trauma, it's efficacy is unexcelled. Why do you think I flat out oppose associating habitual drinking with a disease? Because it is very clear why people habitually drink to the point of self-harm.

When you explain what you mean and how you can tell the difference?

Let me get this straight - you actually require me to explain to you how some people suffer from depression due to situations affecting their outlook in negative ways, and persisting, despite treatment with drugs and therapy, because the situations are unresolvable.

 

[SirPhilip]

I don't expect people to agree with me, but there are reasons I feel the way i do. All addictions are behavioral in nature. It is the behaviors that make an addiction, not the nature of the mood altering behavior.

Which makes zero sense, directly contradicts the plainly obvious, does not explain anything, presumes no cause or identifies any relationship, and assumes anyone genetically predisposed falls into any one of them randomly. I'm just sitting here in awe at the simple brilliance of this hypothetical on/off switch, that hooks anyone to the first vice they encounter, for the same exact reason, each time. It's like the E=Mc2 of sociobiology, I mean, who would have guessed World of Warcraft and sex addiction were the same thing!

There is really no difference bewteen the mechanisms of sexual addiction and meth addiction.

I'll frame this as nicely as possible: have you ever even popped an amphetamine or had sex? Or both, and developed what one could say a very understandable addiction.

 

[Dancing David]

We disagree then.

The problem with defining addiction is the definition alone does not include the distinction.

But here's another example. You find many animals such as pigs which will seek addictive drugs over sex and food. They won't do that for any other pleasures you might try to entice them with. There is more to addictive drugs than the psychological aspects you are confining the phenomena to and that your definition alone includes. And it isn't the physical addiction in my animal examples because you don't have to purposefully induce physical addiction in these animals. They do that on their own.

That is fine with me, I said that I am out there with my behavioral defintion. There are others who agree with me and those who disagree with me. that is fine. I understand what you say about defintion, I will try not to stick my finger in my eye when I point to the moon.

On the animal studies, that is something i am familiar with and have looked into, that is one of the indicators of addictive liability, although some have begun to use behavioral idicators for addictive liability. There is the LOTID (Length onset to dependance or something like that, I was reading anbout two months ago).

I am not sure what you mean by "purposely induce physical addiction", I can understand that you may not like the behavioral approach, and believe me I am a firm believer in the biological basis of behaviors (I am not a dualist).

You have a physical basis for all behaviors and it is rooted in physiology, which is part of why I argue that there are no psychological addictions. there are addictions and they are defrined by a set of behaviors, they are all physicaly based in a human being.

Back to the pig argument, where are you headed? If the physical character of a substance was all that was needed for an addiction then there would be very few people who are exposed to a substance that do not become addicts.

So there is a predisposition to addiction to various substances for some people, some will have a higher predisposition to addiction than aothers. Okay.

But there are people who live in families with very high rates of alcoholism and they do not become alcoholics, they have such prevalence in both sides of thier familes that they should have the same genetic mix as thier siblings. they are exposed to alcohol and use it, yet they do not become addicts. So there is some component that is not just bilogical, you can have the predisposition and not become an addict.

Besides asking you to define addiction, because it will be based upon behaviors (I think), something else occurs to me.

How would it be if i stated

"There are psychological factors to addiction."

I think we might be able to agree to that?

But I am not a fan of the vauge term 'psychological', so if I insert

"There are behavioral factors to addiction", does that make sense?

I have rationales for my thinking, seriously I am not just pedantic except that I don't like the etrm 'psychological addiction', because all thoughts, emotions and behaviors are physiologicaly based.

 

[Dancing David]

Someone's set mood is due to a relationship between outlook (which is directly influenced by circumstance) which affects their neurochemical balance, which in turn is responsible for their ability to cope with stress.

iIagree, that still doesn't say how you would distiguish between situational depression and endogenous depression. especialy since stress will bring out endogenous depression, making it exogenous?

I wouldn't. I'd let them identify the cause themselves; if a situation out of their control, mood brighteners/regulators only mask the cause: the situation. If it can't be resolved, you have the psychological impetus for substance addiction ('psychological addiction'). If it wasn't, a chemical imbalance causing a high receptivity to stress is much more likely, if not an average of negative circumstantial amounting for it, or a confluence of both, as is often the case. What part of this for you is so difficult to comprehend?

The part where yuo ay a depression is situational. depression is believed to be a physical action of the bodies regulatory system. If someone has endogenous depression and it only comes out under stress, then it is what? Situational or endogenous? I would say it is depression and go on from there.

Months, it was clearly attributable to caffeine, though.

then it could be depression related to the use of a substance.

If they do not identify a situation or event as constraining their outlook and mood negatively, obviously an imbalance is suggested (this again, isn't plainly obvious?). The stereotypical characterization of a chemically depressed person is someone who has no actual reason to be depressed or more personal, psychological issue that they can identify as the cause, but experiences bouts of very low mood/outlook which directly affect their productivity and social life - this again, is not plainly obvious to you?

That is obvious to you but not to me, I have assesed many people and talked with scads more on hotlines. here is the deal, a depressed person will identify thier situatrion as causing thier depression almost all the time. Very few peopel will identify that they are depressed for no reason. people with serious chemical depression (so called by you) will identify a multitude of situations in which they feel overwhelmed and helpless. And so your criterai makes no sense in treatment. the eprcentage of people who do not identify a situational component to depression is almost zero. And the ones who don'y are what percentage of depressed people?

I am not just taunting you here, when i am depressed I can identify thousands of reasons for my depression. Even though I have a serious physical component to my depression.

You seem to get yours from a series of undescriptive therapeutic terms that function as general guidelines, and which you are taken aback that I'm thinking instead of caring about. You simply refuse to think about or acknowledge any sense I make, and dispute every single thing I write.

Really, did you not say that antidepressants have a very quick effect in the treatment of depression.

I do think about what you write and try to understand it, do you do the same or just dismiss it out of hand?

this is what you said:

posted by SirPhilip
When treated with an antidepressant, they perk up immediately.

And having worked with hundreds of people who are getting treatment for depression I would say that is not true. they do not perk up immedeatly, it is actual one of the barriers to treatment. People want to respond quickley but sometimes it takes six weeks to even have an effect.

What did you think i was aying?
[/quote]

Numbness (apathy?) has nothing to do with anhedonia, but drunkenness. Anhedonia is characterized as a washed out mood state caused by a deficit, primarily serotonin related.
[/quote]
i believe I was responding to this "You can't treat someone from serious situational depression with antidepressants or even narcotics." and I believe that you can treat 'situational' depression with antidepressants.

Derail. You are disputing that situations do not induce depression (which is ridiculous)?

No I agree that situational depression or stress related depression occurs, how do you tell it from not situational depression?

Depression is neurobiological, obviously, and you look like a halfwit assuming I was disputing it. A relationship however exists that doesn't take a rocket scientist to identify - most people can tell off the bat which one of the two, or both, are at play when they notice someone, otherwise on the ball, having a persistent very hard time.

Except for the fact that people with serious biochemical depression will almost always identify a situation which has caused it.

Which is my point, when you work with people who have sitruational or endogenous depression or something in between the treatment is the same. they will both benefit from CBT and some will benefit from antidepressants.

Of course it was situational - the disordered situation caused likewise, a disordered change in outlook that I was forced to adapt to. Had any chemically induced mood brightening occured, it would have simply threw a rug over it, and were I chemically depressed, it would have simply made the situation much harder to cope with. You disagree?

Reducing the symptoms of depression with an effective antidepressant usualy makes people feel they are better able to cope, and the same is true of CBT. But seeking treatment is a personal choice.

I don't understand if soimeone has symptoms of depression why would reducing those symptoms "throw a rug over it" or "made it harder to cope". Grief is still there for people with treated depression.
[/quote]

It was just situational depression, and whatever harshness associated with it disappears as soon as you begin to resolve it - in my case, through forgiveness.
[/quote]
Good, i would just say a year is a long time to live with depression or anxiety, but i certainly waited twenty years to get help.

You simply refuse to actually think, don't you. Narcotics like cocaine and pu opioid receptor agonists, despite being the most effective antidepressants in existence

What evidence do you have that they treat depression, as in the long term reducution of symptoms? I wouldn't say they do more than cause a tempoarary shift in mood and are followed by a likely rebound.

Could you point me to where that would be called an anti-depressant in some research literature?

, are not prescribed due to intrinsic addictiveness and an equally severe anhedonia, a chemically depressed person could very well commit suicide in such a situation. You aren't going to make me explain why that actually is, if this isn't outlined in whatever argument from authority playbook of vague therapeutic terms you've fortified your statements around, for what reason only you know. You should, due to experience, be making far more educated and detailed assumptions on some of these issues, than I'm able to.

Uh huh, and where would you find evidence that narcotics can be used to treat depression? (addicted thinking?)

I have explained my rationales. And if something is unclear I will try again.

Clearly, people suffer from depression induced either by a memory of a situation, with chemical balance simply functioning as a factor in coping with it. Drugs cannot directly treat depression caused by traumatic memories; the disordered situations themselves are the cause of the disordered outlook and corresponding mood state, and must be resolved. If they cannot be resolved, it persists like a slow burn.

That makes some sense to me, but if a trauma is the cause of the depression, as in PTSD, why should a person not take an antidepressant and work to resolve the issues? (If they choose to do so.)

I agree it isn't treatment, but for alleviating intrusive thoughts and emotional trauma, it's efficacy is unexcelled. Why do you think I flat out oppose associating habitual drinking with a disease? Because it is very clear why people habitually drink to the point of self-harm.

I would not choose to call that trearment myself, if i choose to drink to allieviate my OCD, I think it might make my symptoms worse. And they would most likely return as soon as I was sober.

However with setraline my OCD is treated very nicely, when I had to quit the med, it took about three months for me to reach florid symptoms.

Let me get this straight - you actually require me to explain to you how some people suffer from depression due to situations affecting their outlook in negative ways, and persisting, despite treatment with drugs and therapy, because the situations are unresolvable.

No I am asking how you weill tell the difference between the two, most severely depressed people can always identify some reason for them to be depressed. So given the idea that there is a population of people who have endogenous depression, that leaves us with what.

A very samll percentage of people with what you call "severe chemical depression" , alot of people with an endogenous predisposition to stress related depression and those who have solely stress related depression?

I can live with that, I would just add that in the second case. People with a predisposition to manifest depression due to stress there is going to be a hrd time distinguishing what is a stress that should lead a 'normal' person to have depression and therefore just be 'stress related'.

I see that you feel i am just trying to muddle issues, but if you don't understand something please ask, I will not just state "It is obvious" and throw my hands in the air. I will explain my thoughts and evidence, and I do change my mind quite frequently.

 

[Dancing David]

Which makes zero sense, directly contradicts the plainly obvious, does not explain anything, presumes no cause or identifies any relationship, and assumes anyone genetically predisposed falls into any one of them randomly. I'm just sitting here in awe at the simple brilliance of this hypothetical on/off switch, that hooks anyone to the first vice they encounter, for the same exact reason, each time. It's like the E=Mc2 of sociobiology, I mean, who would have guessed World of Warcraft and sex addiction were the same thing!

Ha ha , once again unable to understand or explain yourself you resort to a lack of substance. Which is rather lame for someone of your obvious talents.

I am not the one hooking people on the first exposure, I call you on your hyperbole, where did i say that?


I have stated repeatedly that there are people witha biological predisposition, and I did not say any one would fall into a particular addiction randomly.

And yes the mechanisms of addiction can be ascribed to mood altering behaviors.

Have you defined addiction yet, can you do so without reference to behavior?

I'll frame this as nicely as possible: have you ever even popped an amphetamine or had sex? Or both, and developed what one could say a very understandable addiction.

Have you ever met a sex addict?

Or are you just thinking that it is an 'understandable addiction' for some personal sophmoric reason. Yeah, your teeth falling out from meth addiction, that is understandable.

If your work life, physical health and relationships are trashed by a sex addiction, then I suppose all that matters is that it is 'understandable'.

What does that have to do with the defintion of addiction?

Define addiction.

Please share with me why there would be a difference between and understandable addiction or one that is not?

How would that effect treatment?

 

[Skeptic Ginger]

There is a threshold, Dave, which chemical addiction is triggered when it is reached. So a person with alcoholic genetic tendency can avoid the disease by not triggering it.

Same with cocaine, it isn't a single use that triggers addiction. That doesn't mean the drug is not universally addicting. It just means the pigs and rats don't have the ability to make the initial decision to avoid triggering the addiction. People do.

I believe when given a choice, all pigs and rats become addicted to cocaine. I don't recall how animals relate to alcohol. I'd have to review the studies. And if I'm wrong about the cocaine with pigs and rats, let me know. I'm going by memory and not looking too much up on this.

When I spoke of the animals becoming addicted, I was trying to exclude the argument not yet made that somehow the animals were purposefully addicted by the researchers and that was why they behaved as they did.

 

[SirPhilip]

listen to DD.

I am, I just can't yank his earplugs out. He dances like a Wu Li Master. Sigh, prep meditation people..

 

[SirPhilip]

Sweet & Sour Beef

Ha ha , once again unable to understand or explain yourself you resort to a lack of substance. Which is rather lame for someone of your obvious talents. I am not the one hooking people on the first exposure, I call you on your hyperbole, where did i say that?

A compliment and criticism in the same short paragraph. Hyperbole? Ok, I'll assume that was overdrive on my part; I can't believe anyone who was educated and had experience with the subject would take that position.

I have stated repeatedly that there are people witha biological predisposition, and I did not say any one would fall into a particular addiction randomly.

Biological predisposition is like an imaginary gravity well. It's something you genetically lack, and when a solution is found, it becomes habitual and is appropriately termed a medical issue, having no psychological or psychophysical origin. An example would be someone who has it all together, no issues or hang-ups, but a genetic predisposition toward, say, opioids. Athletes, who often have a low set mood and exercise "for the burn" (endorphins which are released from muscle tearing) are excellent examples. We then have a series of behaviors revolving around a firm genetic cause. In the case of serious athletes though, this dynamism has a very positive result, until it is taken to an extreme in the form of bodybuilding that is.

And yes the mechanisms of addiction can be ascribed to mood altering behaviors. Have you defined addiction yet, can you do so without reference to behavior?

Behavior is not the cause of addiction, but the effect of it, which is often simple to identify. The cause of the addiction just acts as an affector, constraining behavior into a predictable set of routines. Sure, the behaviors can identify the addiction, they aren't the cause however.

Have you ever met a sex addict?

Yes. I know several World of Warcraft addicts, It's fascinating watching them thrust back and forth toward the desk, mouth agape and face flushed red, when an ogre wearing a colored skirt "pwns" them with a white hot explosion of woo. Don't turn this into a similar dialogue I had with Larson about why he wasn't able to logically identify why he didn't want anyone except authority figures to have guns.

Or are you just thinking that it is an 'understandable addiction' for some personal sophmoric reason. Yeah, your teeth falling out from meth addiction, that is understandable.

You either know what I meant by that or you don't.

If your work life, physical health and relationships are trashed by a sex addiction, then I suppose all that matters is that it is 'understandable'.

Well, I'm glad you at least changed the subject this time. A sex addict is someone like De Sade, whose works I'm fond of - mostly for their sharp edge and comic relief. But most of his behavior is simply on principle - he was a naturalist who was repulsed by religious hypocrisy at a time such a thing was unheard of, and developed a strong attraction to the taboo. I went through a similar phase.

What does that have to do with the defintion of addiction?
Define addiction.

I've defined it in simple, clear English several times already. People become addicted because they enjoy something a lot, do it often, and do not have a meaningful alternative in their lives, despite often recognizing the addiction is self-defeating. Even sex addiction has a clear psychological basis, as in the case with Michael Jackson, other times psychophysical, like in the case with Sade.

My opinion on habitual drinking is based on my own experience, the fact I hit a slump once, and suddenly found drinking useful, it provided insight why other people do it habitually. It is very effective as a psychological balm, legal, available, and cheap.

Please share with me why there would be a difference between and understandable addiction or one that is not?

Why people become addicted to one thing or another almost always has a psychological basis, which they can identify. Some people however have serious issues and are on a different island altogether in that regard. The addiction acts as a self-defeating coping mechanism.

You may have heard "denial" often used in conjunction with habitual drinking, this is because it acts as a psychological balm to divorce intrusive thoughts welling up from one's situation. I would be frankly, astonished if Bush, who has a unique distinction as being disliked literally, by an entire planet, no longer drinks.

How would that effect treatment?

Treatment amounts to coaching, and if the problem is diagnosed as psychophysical, as in the case with someone who has genetically, a low set mood and who deals with situations badly, medical treatment. It never goes beyond that, unless you either still the waters of whatever psychological undercurrent the addiction originates from, or develop a close personal relationship with them, in which case they will go out of their way for you to "change".

 

[Dancing David]

There is a threshold, Dave, which chemical addiction is triggered when it is reached. So a person with alcoholic genetic tendency can avoid the disease by not triggering it.

I agree to that and then in my usual fashion i would point out that is a behavior modification as are the changes that are made to stop the cycle of addiction. I am not sure on the research of what the threshold it, the stuff I was reading about the length of time to onset of dependancy seemed to indicate that it was dose related in alcohol, in that higher levels of alcohol use (dose per usage) were part of triggering the alcohol addiction in young adults (the population studied).

I was just pointing out that while there is the biological side of addiction (the predisposition not the biological basis of life) there is also the component often labels as psychological. In that there are people who seem to have a high biological predisposition but don't become addicted.

And instead of the term psychological I prefer to use behaviors.

And believe it or not I did not start with my behavioral perspective, I used to have quite a biological determinism POV with regards to addiction.

Same with cocaine, it isn't a single use that triggers addiction. That doesn't mean the drug is not universally addicting. It just means the pigs and rats don't have the ability to make the initial decision to avoid triggering the addiction. People do.

And as far as I know you are right, rats will self administer cocaine intravenously for about a month and then they die. Which would indicate a very high addictive liability. I only wonder about the behavioral(psychological) stuff because of the people I know who have used large amounts of cocaine for an extended period and not become addicted (two actualy). They walked away from it and had no withdrawl (at least that they reported when asked).

I would also point out that people have the ability to avoid the triggering situation even after they have engaged in addicted behaviors. that is the basis of the relapse prevention model that I am fond of. The point to the behavioral approach to addiction is actualy the same one used for many issues.

You have to identify the behaviors and antecedants for the target behavior. To be an addict actualy requires large amounts of time and effort to sustain the addiction, there is a cascade of behaviors that leads to the actual act of engaging in the addiction.

But then my bias as a behaviorist is very obvious by now.

I agree that heroin, cocaine and meth addiction sure look like they involve a powerful SoA/D, but wghen I started to meet people who were sex addicts and gambling addicts I noticed this strange thing. They have the same patterns of behavior and in many ways they are very similar, there appears to be a very strong force that drives those people to engage in thier mood altering behavior. And it wasn't until I met a person who was an alcoholic with the karaoke addiction that i really began to wonder.

I came about this POV after trainings upon trainings upon training upon addiction and working with the MISA (mentaly ill substance abuser) population, many of whom are hard core addicts. So while I am out there in my strong behavioral belief. There are others who share my POV.
[/quote]

I believe when given a choice, all pigs and rats become addicted to cocaine. I don't recall how animals relate to alcohol.
[/quote]
Alcohol has a much lower addictive liability, there is a much smaller section of alcohol use amongst lab animals.

I wonder if a pig or rat outside of that boring old cage would engage in the same level of bar pressing to administer the SoA. I guess they would, but it would be a hard study to design, what is the natural setting for a pig or rat?
Nicotine and cocaine score the highest and are way above heroin.

I'd have to review the studies. And if I'm wrong about the cocaine with pigs and rats, let me know. I'm going by memory and not looking too much up on this.

When I spoke of the animals becoming addicted, I was trying to exclude the argument not yet made that somehow the animals were purposefully addicted by the researchers and that was why they behaved as they did.

I wouldn't do that.(You do usualy use electric shock to teach the poor little rat to press the bar in the first place, so perhaps there is some foreshadowing there.) I do believe that there is a high addictive potential for certain substances but that the addiction istelf is a series of behaviors.

I am sure I could be proved wrong in the future.

It is only recently that i came to understand that apparent free will may just be an illusion, so perhaps the ability to modify behaviors through the exercise of choice is an illusion as well.

 

[SirPhilip]

iIagree, that still doesn't say how you would distiguish between situational depression and endogenous depression. especialy since stress will bring out endogenous depression, making it exogenous?

Depression is situation dependent, but a confluence of two simple factors: psychological (the enviornment) and sociobiological (medically definable causes for functional mental or emotional impairment).

The part where yuo ay a depression is situational. depression is believed to be a physical action of the bodies regulatory system.

Yes, and? If I self-induce chemical depression, I'm going to have a very lousy day regardless of anything that happens. Under anhedonia, I would not be able to positively respond to say, winning the lottery. If this deficiency isn't there, and an unpleasant series of events occur, my mood will similarly be affected. Why do you think I distinguished a relationship between the two.

That is obvious to you but not to me, I have assesed many people and talked with scads more on hotlines. here is the deal, a depressed person will identify thier situatrion as causing thier depression almost all the time. Very few peopel will identify that they are depressed for no reason. people with serious chemical depression (so called by you) will identify a multitude of situations in which they feel overwhelmed and helpless. And so your criterai makes no sense in treatment. the eprcentage of people who do not identify a situational component to depression is almost zero. And the ones who don'y are what percentage of depressed people?

Ok, now this is insighful. That is correct, someone with chemical depression often considers "everything depressing", that is, without reasonable cause. Events are viewed through a washed out, grey and emotionally ineffectual lens. Their lives are like a continuous C-SPAN marathon. Someone with purely psychological depression does not have this deficit, but trauma due to a situation and memorex cause persistent disruption in outlook and productivity. I can't believe you find this difficult to distinguish?

I am not just taunting you here, when i am depressed I can identify thousands of reasons for my depression. Even though I have a serious physical component to my depression.

That is clearly chemical depression. It's like wearing glasses that distort everything as shades of grey. A chemically depressed person is not capable of interpreting events in a positive manner because the mechanisms involved in this are disrupted. Hence, a medical condition. The problem vanishes like a gentle breeze when this deficit is corrected.

Really, did you not say that antidepressants have a very quick effect in the treatment of depression.

See above. Not what I meant: the problem vanishes when the deficit is corrected, when this occurs, you perk up immediately. How effective SSRIs/SNRI's are at actually correcting this I'll have to bow to your experience, as I have none..

i believe I was responding to this "You can't treat someone from serious situational depression with antidepressants or even narcotics." and I believe that you can treat 'situational' depression with antidepressants.

Chemically depressed people are often not able to distinguish between how they interpret situations and the fact the reason they are doing this is due to a deficit. Serotonin induced anhedonia, by contrast, is characterized by emotional retardation and despair.

No I agree that situational depression or stress related depression occurs, how do you tell it from not situational depression?

A chemically depressed person cannot identify the cause, it is identified as a variety of reasons, or they instantly diagnose themselves by admitting "..everything is so damn depressing!". Most people don't realize that a neurobiological mechanism exists that regulates the ability to positively interpret the world around you - often it is interpreted as a "crisis" of religious gravity!

Except for the fact that people with serious biochemical depression will almost always identify a situation which has caused it.

Any unpleasant or disordered situation will have a magnified negative effect on their mood. They mistakenly interpret the event as the cause.

Which is my point, when you work with people who have sitruational or endogenous depression or something in between the treatment is the same. they will both benefit from CBT and some will benefit from antidepressants.

No disagreement, that should always be applied.

I don't understand if soimeone has symptoms of depression why would reducing those symptoms "throw a rug over it" or "made it harder to cope". Grief is still there for people with treated depression.

If someone has purely chemical depression, the problem is superficial. It is corrected by treatment. Psychological depression cannot be treated by anything, but can be masked by narcotics and alcohol. Only resolving the disordered situation works; often that is impossible, as any Iraq war vet, or oxycodone, alcohol and sex addled Hollywood star will tell you.

Good, i would just say a year is a long time to live with depression or anxiety, but i certainly waited twenty years to get help.

Indeed, it is very difficult for those with a genetic low set mood to distinguish. They have no subjective frame of reference, except everyone else coping much more positively.

What evidence do you have that they treat depression, as in the long term reducution of symptoms? I wouldn't say they do more than cause a tempoarary shift in mood and are followed by a likely rebound.

The only problem is the rebound, which in the case of an addict, is horrific. Pu agonist opioids are very dangerous if a chemically depressed person becomes addicted to them. Delta opioid agonists, such as mitragynine however aren't, in fact their rebound is trivial - certainly compared to an SSRI from what I've read. As a side note, it was found that saliva contained the precursor to an endogenous morphine like chemical.

The only real 'globally' effective antidepressent in existence is Tramadol hydrochloride, which combines a lightly acting pu opioid receptor agonist which also acts as an SSRI, and is freely available without prescription. The combination provides the best of both worlds, and has a dosage ceiling of about 300mg, the only drawback being the somewhat harsh rebound if stopped cold at maximum dosage, but easily stepped down from.

Could you point me to where that would be called an anti-depressant in some research literature?

This is actually a fascinating research question, as opioid agonists seem, despite the rebound, to instantly and globally treat depression.

That makes some sense to me, but if a trauma is the cause of the depression, as in PTSD, why should a person not take an antidepressant and work to resolve the issues? (If they choose to do so.)

They should, although I don't see how a regulator like an SSRI will do anything unless the person has a deficit. I'll bow to your experience in this regard..

A very samll percentage of people with what you call "severe chemical depression" , alot of people with an endogenous predisposition to stress related depression and those who have solely stress related depression?

All chemical depression magnifies stress, anxiety, intrusive negative thoughts. If someone is psychologically depressed, the process is reversed: memorex of a actual hopeless, negative and depressing event affects mood balance. This is turning into a Taoist dialogue.