tag:blogger.com,1999:blog-26666124.post4102882666622618019..comments2024-03-18T03:28:36.581-04:00Comments on Shrink Rap: My Three Shrinks Podcast 32: Doctor Anonymous on Depression OverdiagnosisUnknownnoreply@blogger.comBlogger11125tag:blogger.com,1999:blog-26666124.post-36338821870155955442008-05-10T15:51:00.000-04:002008-05-10T15:51:00.000-04:00Greetings, Any thoughts on physician depression a...Greetings, Any thoughts on physician depression and suicide, and the implications for student training? See Newsweek article <A HREF="http://www.newsweek.com/id/132887/output/print" REL="nofollow">"Doctors Who Kill Themselves"</A> by D. Noonan 4-28-08. It's covering the PBS <A HREF="http://www.doctorswithdepression.org" REL="nofollow">"Struggling in Silence"</A> special.bhttps://www.blogger.com/profile/13311978324607076869noreply@blogger.comtag:blogger.com,1999:blog-26666124.post-76293705447296930772007-09-05T13:13:00.000-04:002007-09-05T13:13:00.000-04:00What happened to no anonymous comments?What happened to no anonymous comments?Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-26666124.post-33754367705911683912007-09-04T23:41:00.000-04:002007-09-04T23:41:00.000-04:00"Depression" as in Clinical Depression, to be dist..."Depression" as in Clinical Depression, to be distinguished from depression--the transient feeling of sadness-- is characterized by a constellation of symptoms that include:<BR/>Pervasive lowering of mood<BR/>Loss of interest <BR/>Lack of ability to feel pleasure<BR/>Undo feelings of guilt<BR/>Fatigue <BR/>Change in appetite<BR/>Disruption of sleep, often mid or early awakening<BR/>Loss of sex drive<BR/>Wishing for death to come<BR/>Thinking about suicide<BR/>Slowness of thoughts and movements <BR/>Colors may look duller<BR/>Unexplained aches and pains<BR/>Crying<BR/>Ruminations<BR/>Trouble concentrating<BR/>Loss of motivation<BR/>Delusion of impending doom<BR/>Hearing derogatory voices<BR/><BR/>...to name a few. You don't need all those symptoms to have a diagnosis of depression, a few will do, and so someone who is lying in bed, not partaking in life, crying and feeling guilty, presumably with pervasive sadness, is likely depressed and my personal and humble opinion is that getting help may well make a HUGE difference in this person's quality of life. <BR/><BR/>The issue of Over-Diagnosis comes when someone tells their doc "I'm depressed" and the doc doesn't do a full history and prescribes meds without a full assessment and a clear idea of what symptoms the medication is targeting.Dinahhttps://www.blogger.com/profile/09227988351623862689noreply@blogger.comtag:blogger.com,1999:blog-26666124.post-54255027833636138592007-09-04T23:27:00.000-04:002007-09-04T23:27:00.000-04:00In the podcast, Dr. A said that one of the reasons...In the podcast, Dr. A said that one of the reasons why depression is overdiagnosed is because of lack of personal responsibility. <BR/><BR/>Seems like this means that you're damned if you do seek a diagnosis and damned if you don't. If you don't, you take personal responsibility, but you can't break through the wall of the depression because you're spending so much time feeling guilty about all the things you aren't doing while you're lying in bed crying. If you do, then you're abdicating personal responsibility by claiming that you were lying in bed crying because of an illness called depression. Which makes you feel guilty all over again.<BR/><BR/>How is the person diagnosed with clinical depression supposed to break through the cycle described above?Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-26666124.post-43009338068292582932007-09-04T21:07:00.000-04:002007-09-04T21:07:00.000-04:00Dear Thinking Mom: Please don't worry, during upco...Dear Thinking Mom: Please don't worry, during upcoming podcast with Dr. Mark Komrad talking about psychiatry in the movies, that Monkey did not shut up.Dinahhttps://www.blogger.com/profile/09227988351623862689noreply@blogger.comtag:blogger.com,1999:blog-26666124.post-42744196322071897232007-09-04T13:26:00.000-04:002007-09-04T13:26:00.000-04:00I enjoyed this podcast (and Dr. A's BlogTalk, too)...I enjoyed this podcast (and Dr. A's BlogTalk, too)! Some thoughts:<BR/><BR/>1-You talked about the negative perception people often have about psychiatry. I certainly shared that lay public view before finding this blog, but feel differently now. A kinder, lighter, and more informed view of psychiatry comes across in a very credible way here (in a "grass roots" way). I can't speak for patients, but as a member of the general public, I am edified.<BR/><BR/>2-I would love it if you would talk more about the addictive qualities of dark chocolate. And if there are rehab centers for that. <BR/><BR/>3-I didn't hear Roy's bird, Monkey, in the background--can you put him on next time? <BR/><BR/>Thank you.Your Motherhttps://www.blogger.com/profile/07182456406888139759noreply@blogger.comtag:blogger.com,1999:blog-26666124.post-92103413163561804982007-09-03T11:57:00.000-04:002007-09-03T11:57:00.000-04:00I just caught up on podcasts last night. It was A...I just caught up on podcasts last night. It was AWESOME to have Dr. A in your 'cast.<BR/><BR/>I'm sorry I missed Doc A's live one, though; of course, I can listen to it after the fact, and I will!<BR/><BR/>I'm glad you three are back, and look forward to the variety of subjects, perspectives, opinions, and stuff that you bring us!Sarebearhttps://www.blogger.com/profile/09208596053319110470noreply@blogger.comtag:blogger.com,1999:blog-26666124.post-23558499591019603442007-09-02T23:02:00.000-04:002007-09-02T23:02:00.000-04:00My first comment is that Prof Hickie and Prof Park...My first comment is that Prof Hickie and Prof Parker are heads of the two "rival"* brain-stuff research institutes in Sydney. And they are also based at the two big, rival Sydney medical schools! Although Professor Hickie was previously at UNSW so we (at USyd) can never be too sure where his true allegiances lie....<BR/><BR/>* By rival research institutes, I'm sure they don't hate each other, just that they would be competing for the same research $$ and big name scientists. <BR/><BR/>I actually agree with some aspects of both sides as (I think... it didn't sound like Dr A!) Roy was saying - there is both under and over diagnosis of depression, in different populations. And over and under treatment. And I agree with (I think) Clink that semantics is a big part of the argument.<BR/><BR/>Regarding depression being "the new black"... I'm not sure that's the case. In some populations it is indeed quite acceptable to be "in therapy". Whether it is acceptable to be unable to get out of bed, not eating, thinking about dying... is a different matter.<BR/><BR/>In a discussion on another website, Professor Parker was criticised for "denying treatment to those who need it". Which, in my opinion, is garbage. He is all for promptly treating people who need it, and finding the most effective treatment for those people. <BR/><BR/>Handing out antidepressants to EVERYONE who presents to a GP with mild symptoms of short duration seems to be where the problem lies. <BR/><BR/>I think it's partly a resources/funding thing, and partly an attitude thing. In Australia, the resources/funding thing is actually in a rather interesting situation - mental health has been granted a pot load of money recently, but there aren't enough human resources to spend it on. A big jump forward has been the recent inclusion of psychologists under Medicare (ie. they are now subsidised). HOWEVER the problem is that the GP referral paperwork takes a long time - longer than a normal GP consultation. It's much less paperwork to refer to a psychiatrist! And even less paperwork to prescribe an SSRI...yayhttps://www.blogger.com/profile/10379949056966639467noreply@blogger.comtag:blogger.com,1999:blog-26666124.post-15196718369607844262007-09-02T20:41:00.000-04:002007-09-02T20:41:00.000-04:00Interesting podcast. Thanks. I guess my question...Interesting podcast. Thanks. I guess my question is...If there is so much overdiagnosis going on, why then did it take my the G.P's I saw approximately 15 years to diagnose me, and another 2 to refer me to a psychiatrist? I know others where this has happened too, so I'm not the only one.<BR/><BR/>I suspect part of the problem might be the atypical nature of my depression...I can be "up" and "sociable" for short periods when I have to...and authority figures tend to make me feel like I need to perform, but still I had many of the "physical" markers for depression everytime I went to see my family Dr...not sleeping, fatigued, gaining weight/and or losing weight, constant worrying (I expressed to my G.P when I was 23., "It is like I have a negative feedback loop stuck on replay inside my head"), ...crying!<BR/><BR/>...yes I cried almost everytime I was at the Drs...and no one clued in that I might be depressed? I don't get it. How does that happen?Aquahttps://www.blogger.com/profile/16230285017033299419noreply@blogger.comtag:blogger.com,1999:blog-26666124.post-5050303866560207852007-09-02T17:27:00.000-04:002007-09-02T17:27:00.000-04:00Dr. A + 3 shrinks. It's like a blog-cast dream cam...Dr. A + 3 shrinks. It's like a blog-cast dream came true! haven't listened to the podcast yet, but it's downloading as I speak! <BR/><BR/>Enjoy the last 32 hours of the long weekend...Rachhttps://www.blogger.com/profile/11897760883997811787noreply@blogger.comtag:blogger.com,1999:blog-26666124.post-72866498830744554412007-09-02T13:50:00.000-04:002007-09-02T13:50:00.000-04:00Thanks so much for the opportunity. I hope people ...Thanks so much for the opportunity. I hope people don't get sick of my voice with my show last week and this podcast. Yeesh!<BR/><BR/>Speaking of microphones, I was formerly using the snowball (just because it looked so cool). Now, I'm experimenting with logitech headphone/mic units.<BR/><BR/>People told me that they had trouble with the sound level on my show. I was considering investing in a "real microphone" (meaning studio grade) and also a mixer device, but I'm undecided right now.Dr. Ahttps://www.blogger.com/profile/05207266669522973903noreply@blogger.com