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Sunday, February 19, 2012

An Invisible Menace: Big-leaguer Buchholz describes battle with depression

Taylor, that is.

For much of the past two years, he has put up a false front. A façade of a happy-go-lucky major league relief pitcher who loved the sport he had played since he was a 5-year-old in the Springfield Athletic Association.

“It was all a big lie,” Buchholz said. “I put this fake smile on and pretended everything was all right until I finally just cracked and said, ‘I need to get help.’ I hit a wall. There was something truly wrong with me.”

Buchholz, 30, has been diagnosed with a form of depression. He also suffers from an anxiety disorder.

Both issues manifested into a perfect storm for Buchholz, a perfectionist who was recovering from a long-term injury.

“Being a perfectionist is a double-edged sword,” said Buchholz, a Daily Times Player of the Year as a Springfield High senior in 2000. “You have to be one, to an extent, to succeed on that level. But I let that take over. Perfectionism led to a downward spiral for me.”

...“When I signed with the Mets (in February 2011) I told myself I was going to give it another shot and see where my mind and my body were,” Buchholz said. “I pretty much got through two months of the season and then at that point I said, ‘I’m over this.’ I couldn’t handle it any more mentally. It was breaking me down to the point where I didn’t like baseball. It was making me an unhappy person.”

Repoz Posted: February 19, 2012 at 05:37 PM | 54 comment(s) Login to Bookmark
  Tags: injury, mets, phillies, rockies

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   1. John DiFool2 Posted: February 19, 2012 at 06:31 PM (#4064424)
Not cool with neither the headline nor the text making it clear that this isn't about Clay Buchholz (until the final paragraph).
   2. Juilin Sandar to Conkling Speedwell (Arjun) Posted: February 19, 2012 at 06:41 PM (#4064426)
The little commentary thing above the article text does say "Taylor, that is.", though.
   3. Benji Posted: February 19, 2012 at 06:43 PM (#4064428)
Very sad story. I hope he can get his life back.
   4. Run Joe Run Posted: February 19, 2012 at 07:59 PM (#4064453)
I do hope he gets the help he needs. I am glad Buchholz and several other players have been open about depression and other similar illnesses. It makes it less taboo for the rest of society. For those of you too young to remember Jim Eisenrich was nearly jeered out of the major leagues and I doubt anyone had heard of his illness. Now Tourette's syndrome is commonly known.
   5. The Clarence Thomas of BBTF (scott) Posted: February 19, 2012 at 10:05 PM (#4064497)
As someone who suffers from depression, it's a sonofabitch. And it's hard to comprehend from a non-depressed person's standpoint, the whole thing is stupidly irrational.
   6. base ball chick Posted: February 19, 2012 at 10:53 PM (#4064509)
i remember the first time i saw him pitch in 2006 - it was one of those spring training exhibition games that they have in the ML stadium just before the season starts.

he had absolutely eye popping INCREDIBLE stuff - the first guy who had come up since oswalt who made me think - oh my GAWD we gots us an ACE

and until he hurt his shoulder 5 games in to the season, that is just how he pitched.

stupid kid/team - he pitched until he couldn't throw - and he wasn't never the same guy
what a waste

i'm glad he's getting the help he needs and i'm glad SOME people are coming around to the fact that depression is a medically treatable condition, not just sulking or something that you could "snap out of"

and if the astros hadn't had heads up asses, maybe they could have helped derek grigsby, the 03 first rounder, who quit after a year - one of the reasons the stupid owner didn't see why he should have to pay pretty much anything for any non-major league player
   7. Jim Wisinski Posted: February 19, 2012 at 11:29 PM (#4064527)
As someone who suffers from depression, it's a sonofabitch. And it's hard to comprehend from a non-depressed person's standpoint, the whole thing is stupidly irrational.


As someone who has in the past dealt with depression and suicidal thoughts it tends to piss me off when people who have not suffered from that try to give opinions on the subject or harshly judge those that consider or do take their own lives. If it's not something you've experienced yourself then there is absolutely no way you can have any idea what its like.
   8. A big pile of nonsense (gef the talking mongoose) Posted: February 19, 2012 at 11:52 PM (#4064537)
As someone who has in the past dealt with depression and suicidal thoughts it tends to piss me off when people who have not suffered from that try to give opinions on the subject or harshly judge those that consider or do take their own lives. If it's not something you've experienced yourself then there is absolutely no way you can have any idea what its like.


Amen.

(I'm half-expecting a famously nonempathic individual -- I've come to think of him as Captain Asperger's, but shame on me for defaming another community of unfortunates -- to show up & go exhibit his remarkably tone-deaf schtick, but here's hoping that doesn't happen.)
   9. Zipperholes Posted: February 20, 2012 at 12:46 AM (#4064555)
60 Minutes had a fascinating segment tonight about the effectiveness of antidepressants. I doubt it revealed anything new, but as someone who doesn't know much about this, it was new to me: the claim that antidepressant drugs are no more effective than a placebo for the vast majority of mildly or moderately depressed people.

On one side was the doctor making this claim. But what was remarkable was that the representative defending the drugs said only 14% of people benefit.

Also remarkable is that drug companies don't publish the results of trials that don't show a benefit, and that two trials showing a benefit over a placebo is sufficient for FDA approval--regardless of the total number of trials.
   10. boteman is not here 'til October Posted: February 20, 2012 at 10:06 AM (#4064634)
There was a recent article on yet another news program raising the possibility that the effects of melancholia can be alleviated by treatments typically administered for thyroid problems. Not being a doctor I don't recall the specifics, but as expected endocrinologists resisted this notion as lacking proof.

If there exist better treatments than the current questionable family of anti-depressants, he should press for research to develop them. Heck, if all it takes is a high profile case such as this one where money would be no object to insist that the doctor try the endocrine approach and it helps, maybe that will open eyes and make significant progress.
   11. cercopithecus aethiops Posted: February 20, 2012 at 10:55 AM (#4064649)
But what was remarkable was that the representative defending the drugs said only 14% of people benefit.


I wouldn't want to be too disparaging of that comment. A treatment that benefits 14% of patients isn't such a bad thing unless there's another treatment that benefits a much higher percentage. Especially if the benefits manifest quickly. It certainly seems like it would be worth trying a drug for a few weeks for a 1 in 7 chance of being helped. And if there were a half a dozen such treatments that each benefited similar (but distinct) fractions of patients, then you'd actually be able to help a majority of people who suffer from depression by trying all the different options.

Heck, if all it takes is a high profile case such as this one where money would be no object to insist that the doctor try the endocrine approach and it helps, maybe that will open eyes and make significant progress.


The endocrine approach is only likely to help patients who have an endocrine component to their depression. Depression is not a single disease. There isn't going to be a single treatment.
   12. base ball chick Posted: February 20, 2012 at 12:19 PM (#4064693)
why people think that everybody's brain and problems with its chemistry is exactly the same i do not understand.

i suppose it is the same as people who think that if they personally see something a certain way, they, why everyone who doesn't see things exactly the same way is "wrong"

what i do know is that just leaving people to rot while saying - just "snap out of it" because you are lame is flat out inhumane.
   13. Tom T Posted: February 20, 2012 at 12:43 PM (#4064709)
But what was remarkable was that the representative defending the drugs said only 14% of people benefit.


This is typical in medical research. NIH relies on the old crutch of the "scientific method" to do research -- in other words, they only fund and pursue so-called hypothesis-driven research. The problem with this perspective is that NIH and most other funding agencies want simple, direct, and clearly testable single (as opposed to compound) hypotheses.

Of course, most disorders or diseases actually comprise many chemical (and some structural) elements being messed up. As a consequence, there is a vast multi-dimensional space that needs to be searched to find the true cause/cure for most diseases/disorders, but funding agencies will basically only fund proposals that say "this one thing is the root cause and we can fix it!" For the geometrically-inclined, this is basically a case where there is a true "cause" vector in three-dimensional space (stick one arm out at random) but rather than try to identify it through analysis of past literature and further testing, you'll look for that vector by randomly selecting other vectors in 3-space (i.e., stick out your other arm at random) and checking to see if they fix the problem. If you are lucky, that randomly chosen line is not perpendicular to the correct line and you end up solving a small portion of the problem, but you are (probability-wise) almost certain never to find the correct direction. This is why, for most treatments, a portion, but rarely the majority and basically never the entirety, of the populace benefits.

As a general rule, medical research is poorly grounded. Very few folks are thus willing to do broad testing/data collection to try to figure out the direction of the problem before trying to propose solutions. There are also sunk costs in previous lines of research to consider...and "smart" people are even less likely to accept that they should walk away from failed expenditures (cf. DOD's medically-related efforts, in particular).

So, anyway, Captain Asperger's take is pretty normal as far as most folks go...they have enough education to hear about standardized ways to approach research, but not enough education or experience to understand (or accept) that answers are never simple enough to be achieved through those standardized approaches.
   14. Ryan Lind Posted: February 20, 2012 at 12:46 PM (#4064712)
The drugs can help, but they are nothing close to a cure. For me, they helped more as an anti-anxiety, in that they treated a lot of physical symptoms of anxiety that I experienced -- dizziness, nausea, sweating, panic attacks, etc. Helping with the anxiety does help with the depression but it doesn't make the self-destructive thinking go away. You truly have to work very hard on how you think, and try to change the things you think about and the way you think about them. It's a lot of work and it really sucks. I feel like I'm always one moderately bad moment away from falling off the deep end.

What's truly depressing -- heh -- is that many therapists and even registered psychologists themselves don't really understand and have proven to mostly be a waste of time. You can't "snap out of it," obviously, but it ultimately is something you truly have to work on yourself, I think.

But what do I know ... I still fantasize about suicide several dozen times per day.
   15. cercopithecus aethiops Posted: February 20, 2012 at 01:03 PM (#4064722)
This is typical in medical research. NIH relies on the old crutch of the "scientific method" to do research -- in other words, they only fund and pursue so-called hypothesis-driven research. The problem with this perspective is that NIH and most other funding agencies want simple, direct, and clearly testable single (as opposed to compound) hypotheses.


Unless I'm misreading this badly, you are essentially saying that the people who have been responsible for pretty much all of the benefits of modern diagnostic and therapeutic medicine don't understand how medical research should be done. That's pretty damned arrogant.

Also, as someone who has both received NIH funding and reviewed NIH grant applications, I can categorically state that it simply isn't true. Yes, they're looking for hypothesis-driven proposals, and a hypothesis that isn't directly testable is basically worthless. But the hypotheses needn't be simple. Complex, compound hypotheses flow pretty directly from the results of testing simpler hypotheses, and get funded all the time.
   16. Don Geovany Soto (chris h.) Posted: February 20, 2012 at 01:20 PM (#4064743)
Also, there's plenty of drug research being done without NIH grants; private pharma companies can use whatever methods, theories or hypotheses they like, so long as they can back the results up with data (NOTE: I'm oversimplifying, there are plenty of rules about what they can or cannot do, but my overall point stands).

The endocrine approach is only likely to help patients who have an endocrine component to their depression. Depression is not a single disease. There isn't going to be a single treatment.


Agreed. I think the thinking is that people with depression probably ought to have some tests run to see if they are hypothyroid, etc. The symptoms can get missed. Both my wife and daughter are hypothyroid, and one of the side effects if they're off their meds is depression.
   17. The Clarence Thomas of BBTF (scott) Posted: February 20, 2012 at 01:24 PM (#4064746)
Also, the placebo effect can be remarkably strong. It's kind of a pity we don't have a way to have people opt in to receiving placebo prescriptions from their doctors if/when the doctor thinks it'd help.

Unless I'm misreading this badly


I think you might be, I personally took it as the NIH method being difficult to apply to symptoms that can come from myriad causes, and which might well have different treatments depending upon the person despite similar differential diagnoses.

edit: Also, in 50-100 years we're going to look back at today's medical knowledge and be like "holy crap, we were so ignorant!" Which is pretty impressive, since modern medicine is really only, what, a century or so into it's existence?
   18. Tom T Posted: February 20, 2012 at 03:10 PM (#4064844)
Unless I'm misreading this badly, you are essentially saying that the people who have been responsible for pretty much all of the benefits of modern diagnostic and therapeutic medicine don't understand how medical research should be done. That's pretty damned arrogant.


I think you might be, I personally took it as the NIH method being difficult to apply to symptoms that can come from myriad causes, and which might well have different treatments depending upon the person despite similar differential diagnoses.


This. The "single hypothesis" model for medical research (and treatment) is progressively becoming outmoded. NIH has made noises about trying to increase acceptance of proposals presenting multiple hypotheses, but it isn't yet clear that this mindset has reached all the way down to selection of reviewers by the Center for Scientific Review. One likely needs to examine each "disease" as a potential suite of disorders, and then try to figure out the causes of each biological/biochemical failure. Some of these may be the consequence of other failures, but often more than one thing is wrong. Historically, NIH primarily funded research looking for singular causes of disease/disorder, but findings in the cancer area seem to have encouraged a broadening of horizons. For example, we no longer talk about cancer solely on an anatomical structure level (i.e., brain cancer, breast cancer), but instead now talk about specific genetic variants of cancer (e.g., HER2neu positive breast cancers, etc.), and are targeting research to treating these definable sub-categories of disease. If we were to go back 20 years and claim "breast cancer is breast cancer" we'd be minus a lot of moms and wives right now.

In the area of psychological disorder (NIMH realm), I think the community has broadly adopted the idea of looking for suites of causes, as it is readily apparent that most of the problems do not arise from a single cause. However, the research is still often predicated on statements such as "Gene XYZ causes disorder flavor ABC" leading to studies that look for XYZ and tend not to mine for data regarding contributions from genes XYY or XZZ, etc. Efforts are being started to generate databases for subsequent data mining, but it isn't clear how readily various institutions will go for that approach (our IRB, for example, freaked out about our publishing a paper with a colleague from another University, because he wasn't on our IRB protocol...even after pointing out that the only data he'd seen were post-processed "anonymized" data, they still had a conniption).

Also, in 50-100 years we're going to look back at today's medical knowledge and be like "holy crap, we were so ignorant!" Which is pretty impressive, since modern medicine is really only, what, a century or so into it's existence?


And this, of course. I hope that nobody who does any form of medical research actually thinks we've yet fully answered any questions. I mean, yes, we have made a lot of research progress in medicine, but it doesn't seem reasonable to me to believe that this body of research was either (a) the only approach we could have taken, or (b) the optimal approach we could have taken. Unfortunately, a number of people (and many of them influential) in the health research community view both (a) and (b) as being true! One of the former Presidents of the American Academy of Pediatrics had just such an argument with a program director at NIH about leukemia, pointing out to him how we had essentially wasted 20 years going down a wrong path, just because they didn't want to fund more than one approach, but the director simply stated that there was no other way they could have gone. Similarly, I have had multiple NIDCD and NSF program directors talk about cochlear implants as being "perfect" devices that "can't be improved upon."
   19. Zipperholes Posted: February 20, 2012 at 09:31 PM (#4065154)
Also, the placebo effect can be remarkably strong. It's kind of a pity we don't have a way to have people opt in to receiving placebo prescriptions from their doctors if/when the doctor thinks it'd help.
Oh, yeah. The claim wasn't that people don't get better. They do. It was that among mildly and moderately depressed people, there's no difference (there's a difference, but it's not statistically significant) between the drugs and a sugar pill.
   20. Something Other Posted: February 20, 2012 at 09:44 PM (#4065164)
As someone who has in the past dealt with depression and suicidal thoughts it tends to piss me off when people who have not suffered from that try to give opinions on the subject or harshly judge those that consider or do take their own lives. If it's not something you've experienced yourself then there is absolutely no way you can have any idea what its like.

Amen.

(I'm half-expecting a famously nonempathic individual -- I've come to think of him as Captain Asperger's, but shame on me for defaming another community of unfortunates -- to show up & go exhibit his remarkably tone-deaf schtick, but here's hoping that doesn't happen.)
Having noticed that someone posting their story in the alcoholism/addiction thread got mocked a few days later here as a "Drunkie", I also hope that doesn't happen.

And as someone who's starting to feel a little down as the result of a long winter, I'm wondering if anti-depressants are described for what's been called Seasonal Affective Disorder.

Anyone know?
   21. The Clarence Thomas of BBTF (scott) Posted: February 20, 2012 at 10:19 PM (#4065177)
The claim wasn't that people don't get better. They do.


Right, which is why we totally should be able to sign a consent form when we first meet our GP that they can sugar pill us in some circumstances. The lack of side effects alone is a big bonus.

IIRC there's some evidence that placebos work even when the people taking them know it's a placebo. Which is both weird and awesome.
   22. Something Other Posted: February 22, 2012 at 03:36 AM (#4065936)
why people think that everybody's brain and problems with its chemistry is exactly the same i do not understand.
Exactly. No one (that I know of) thinks taking a supplement to combat a vitamin C deficiency is a sign of moral or character weakness. Why should it suddenly be different when it comes to the idea that some people's systems process serotonin inefficiently?

I've heard the strangest things come from all parts of the spectrum, including new age folks who believe that all illnesses, including cancer, come from an imbalance in chi. Since focus can change chi, the implication is that if you were more evolved you'd rebalance your chi and be rid of the illness. Not very much different from the "suck it up" types.

   23. Something Other Posted: February 22, 2012 at 04:08 AM (#4065942)
What's truly depressing -- heh -- is that many therapists and even registered psychologists themselves don't really understand and have proven to mostly be a waste of time. You can't "snap out of it," obviously, but it ultimately is something you truly have to work on yourself, I think.

But what do I know ... I still fantasize about suicide several dozen times per day.
I know that being told to hang in there can come across as shallow and uncomprehending, but I do hope you find what you need. A good therapist is invaluable, in my experience, and a poor one can be enormously destructive. A good therapist for an adult who's had a fair amount of life experience can often best serve as a guide rather than some sort of savior. I have a friend who says she gets a lot out of simply going and meeting her therapist once a week and using that to stay focused on what she needs to do. Without that weekly "review" she says she tends to drift, and that in its absence what might take two weeks to straighten out can take two months.
   24. Joe Bivens, Minor Genius Posted: February 22, 2012 at 07:22 AM (#4065945)
Never saw him depressed.
   25. Russ Posted: February 22, 2012 at 07:48 AM (#4065949)
I'm not really the tinfoil hat type, but a lot of the problems with the use (and abuse) of depression medication stem not only from issues with the research (of which there are many and I've actually been fortunate enough to have co-authored a nice paper -- and am writing a second -- on why this is true from a sampling and statistical perspective), but the an unholy alliance between the drug companies and the insurance companies.

Drugs are cheap relative to therapists, so although it is not clear that either of them works better for people, on average, with mild to moderate depression (depressed enough to cause substantial problems in their life, but not enough to put them or anyone else in danger), drugs are much more likely to be covered by insurance plans than therapists. And obviously drug companies are much more likely to invest money in getting primary care physicians to prescribe SSRI's or the like as opposed to prescribing someone to go talk to a licensed therapist.

The psychiatrist I collaborate with compares dealing with depression via drugs or therapy (which, as mentioned above, is probably an overly general term that covers a very wide range of specific symptoms that vary greatly in severity) to weight loss and exercise from a public health perspective.

1. Many people don't *need* formal "treatment" necessarily, but it makes them feel better and it gives them a feeling of control over their lives.
2. Different things works differently for different people, so there can't be a single cure-all approach to the problem.
3. For people with mild to moderate problems (either with weight or with depression), the key is basically to enact a lifestyle change, which is difficult and generally will happen slowly. Weight loss is about changing your relationship with food and depression is about changing your relationship with yourself.
4. There is great heterogeneity in outcome for people under different treatments, and the problem is never really solved, only managed to the point where today you can say there is no problem.

The $1 billion question is who should pay for therapy and who should pay for anti-depressants and/or psychotherapy for the mild-to-moderately depressed (in the same way that your public insurance, as we have in Canada, will not cover your trips to the gym, but will cover your gastric bypass surgery). The insurance folks will pay for drugs, but not for therapy, even though neither has been shown to be effective except for the most severe cases. It's very complicated.

And for someone with mild anxiety and a some mild depressive symptoms, psychotherapy was a godsend for me. But my therapist was an amazing woman who really helped me to get my business straight. The downside was that she left private practice to take a job somewhere else. I was better off with her than without her, but I learned enough that my life is still 3 times more manageable now than it was before I went to therapy.
   26. zenbitz Posted: February 22, 2012 at 02:15 PM (#4066256)
Medicine and Biology is today where the internet was in 1952.
   27. scotto Posted: February 22, 2012 at 02:42 PM (#4066277)
Having noticed that someone posting their story in the alcoholism/addiction thread got mocked a few days later here as a "Drunkie", I also hope that doesn't happen.


That's pretty reprehensible. I lurked that thread, and think it was one of the best that I've seen on this site since I can remember. I'm in the program, and really appreciated what you and others had to say.

And as someone who's starting to feel a little down as the result of a long winter, I'm wondering if anti-depressants are described for what's been called Seasonal Affective Disorder.

Anyone know?


I think Mirtazapine's been prescribed for SAD; it's an SSRI but acts somewhat differently than the ones commonly prescribed, so it's often an augment to standard SSRI treatment. I take it at night partly as a sleep aid (an off-label use) and partly as in conjunction with Wellbutrin for depression but recall my shrink suggesting that I double the Mirtazapine during winter, advice I haven't taken and wish I had, that or a trip to the tropics.

I'll jump in full on in support of therapy. It's done me a world of good for many reasons. One is that it's simply nice to talk regularly with someone who has little or no stake beyond helping you out; or at least a vastly different stake than most of the other people in your life.

   28. Something Other Posted: February 24, 2012 at 05:15 AM (#4067714)
Thanks, scotto--I'll look into Mirtazapine. I also don't mind any side effect that might nudge me into sleep in winter. Something about less physical exercise during the long months can make it difficult to turn off at night.

Yup--the 'neutral observer' aspect of therapy is one of its great virtues, imo.
   29. A big pile of nonsense (gef the talking mongoose) Posted: February 24, 2012 at 10:32 AM (#4067755)
But what do I know ... I still fantasize about suicide several dozen times per day.


Whereas most of the time I'm down to once every week, at least for now.

Homicide, though ...
   30. The Good Face Posted: February 24, 2012 at 11:24 AM (#4067788)
Having noticed that someone posting their story in the alcoholism/addiction thread got mocked a few days later here as a "Drunkie", I also hope that doesn't happen.


Since a certain subsection of posters on this site are apparently perfectly comfortable calling one poster here "Captain Aspergers," I don't really see why "drunkie" would be out of bounds.
   31. scotto Posted: February 24, 2012 at 11:34 AM (#4067794)
Since a certain subsection of posters on this site are apparently perfectly comfortable calling one poster here "Captain Aspergers," I don't really see why "drunkie" would be out of bounds.

Are you familiar with the "two wrongs don't make a right" rule?
   32. Ray (RDP) Posted: February 24, 2012 at 11:47 AM (#4067803)
(I'm half-expecting a famously nonempathic individual -- I've come to think of him as Captain Asperger's, but shame on me for defaming another community of unfortunates -- to show up & go exhibit his remarkably tone-deaf schtick, but here's hoping that doesn't happen.)


Having noticed that someone posting their story in the alcoholism/addiction thread got mocked a few days later here as a "Drunkie", I also hope that doesn't happen.


---

Never saw him depressed.


I just want to note the above before I get accused again by Something Other and his kin of "making the thread all about me." I hadn't commented in the thread, and I was nevertheless referenced, insulted, and called a name by the holier-than-thouers.

And, no, I didn't call anyone "Drunkie," or do anything of the kind. Not that "Captain Asperger's" is any better. You have to love the people who sling mud from atop their high horses.

(There. I guess the thread is All About Me now. Another highly intellectual discussion -- "Captain Asperger's." "Never saw him depressed." -- ruined.)
   33. The Good Face Posted: February 24, 2012 at 11:52 AM (#4067806)
Are you familiar with the "two wrongs don't make a right" rule?


I am. And I long ago decided that it's nonsense.

   34. snapper (history's 42nd greatest monster) Posted: February 24, 2012 at 12:09 PM (#4067816)

And, no, I didn't call anyone "Drunkie," or do anything of the kind. Not that "Captain Asperger's" is any better. You have to love the people who sling mud from atop their high horses.


If it makes you feel any better, I've been called worse.

Btw, who called who "Drunkie"? I miss all the good stuff ;-)
   35. A big pile of nonsense (gef the talking mongoose) Posted: February 24, 2012 at 12:09 PM (#4067817)
Interesting, isn't it, how no one apparently had the slightest doubt about who "Captain Asperger's" referred to? That's how sad your MO is (except of course when you say things I agree with, as during your truly admirable performance during the Paterno/Sandusky threads), though I suppose there's something to be said for consistency.
   36. A big pile of nonsense (gef the talking mongoose) Posted: February 24, 2012 at 12:11 PM (#4067820)
Why Drunky(sp)?
   37. Matt Clement of Alexandria Posted: February 24, 2012 at 12:18 PM (#4067830)
Btw, who called who "Drunkie"? I miss all the good stuff ;-)
I was wondering, too... so I done google'd it for us.

It was post #88 in this Mets thread that got significantly weirder, more vitriolic and more personal than any political thread I've ever seen on the site. What is the deal with Mets fans, anyway?
   38. snapper (history's 42nd greatest monster) Posted: February 24, 2012 at 12:21 PM (#4067834)
I was wondering, too... so I done google'd it for us.

It was post #88 in this Mets thread that got significantly weirder, more vitriolic and more personal than any political thread I've ever seen on the site. What is the deal with Mets fans, anyway?


Oh, that guys an ass. He's cursed me out for no apparent reason twice.
   39. A big pile of nonsense (gef the talking mongoose) Posted: February 24, 2012 at 12:48 PM (#4067858)
Good grief. That's absurd.

Also, apologies to Ray for the vituperation. We rarely see eye-to-eye, but name-calling's not good.
   40. JJ1986 Posted: February 24, 2012 at 12:52 PM (#4067868)
Oh, that guys an ass. He's cursed me out for no apparent reason twice.


Isn't he Rob Base?
   41. BDC Posted: February 24, 2012 at 01:02 PM (#4067876)
the representative defending the drugs said only 14% of people benefit

It occurs to me that if a drug is overprescribed, then that 14% may represent a much larger percentage of the people who actually should be getting it for a specific condition. It could be like saying that only 14% of those told by old-school doctors to take 2 aspirin and call them in the morning really got any benefit from the aspirin. Aspirin could still be great for the appropriate complaint.

One problem with such reporting is (as several posters here have indicated) that it's really hard to convey research design and findings in a few soundbites. Take this from yesterday's New York Times, on the benefit of colonoscopy:

the death rate from colorectal cancer was cut by 53 percent in those who had the test and whose doctors removed precancerous growths


That's really all you got on Page One; following the story inside, you get slightly more:

A team of researchers led by Dr. Sidney J. Winawer, a gastroenterologist at Memorial Sloan-Kettering Cancer Center in New York City, followed 2,602 patients who had adenomatous polyps removed during colonoscopies from 1980 to 1990. Doctors compared their death rate from colorectal cancer with that of the general population, where 25.4 deaths from the disease would have been expected in a group the same size. But among the polyp group, there were only 12 deaths from colorectal cancer, which translates into a 53 percent reduction in the death rate.


And then you have to wonder about all the other ways in which such a study could be designed and measured, and the implications of the questions being asked and the composition of the groups being studied. And this is a pretty significant, simple finding that basically should just make you go out and get a colonoscopy and afterwards thank God. (Though even at that, someone who had a colonoscopy and didn't have polyps in the first place might still be illogically tempted to ask "do I benefit at all, now?") Much research that gets sound-bitten is way more complex than this, and harder to draw emphatic conclusions from.
   42. Forsch 10 From Navarone (Dayn) Posted: February 24, 2012 at 01:06 PM (#4067879)
Therapy plus meds changed my life. It's merely an anecdote, but I shudder to think of where I'd be right now without them both.
   43. snapper (history's 42nd greatest monster) Posted: February 24, 2012 at 01:12 PM (#4067883)

Isn't he Rob Base?


Arbitol Dijaler? I have no idea. For a little while I though Chris Dial had changed his handle, but then the dickishness convinced me otherwise and I checked.

Any idea what happen to Chris?
   44. snapper (history's 42nd greatest monster) Posted: February 24, 2012 at 01:13 PM (#4067886)
Therapy plus meds changed my life. It's merely an anecdote, but I shudder to think of where I'd be right now without them both.

I have had a very minor experience with depression (actually caused by a drug - Zyrtec), so I can believe it.

It was a really weird sensation; just being down all the time for no apparent reason.
   45. JJ1986 Posted: February 24, 2012 at 01:14 PM (#4067887)
Any idea what happen to Chris?


Chris is Foghorn Leghorn now. I've only seen him posting about college football.
   46. A big pile of nonsense (gef the talking mongoose) Posted: February 24, 2012 at 01:15 PM (#4067889)
Hmmmm. I need to go read that NYT story, having been advised last year to up my colonoscopy frequency from whatever's normal for people over 50 (every 10 years?) to, I think, every couple of years. (Not surprising, given my mother's death from colon cancer & my own case of Crohn's, which as it happens has me reaching for a hydrocodon for pain even as I type this. Woo-hoo!) I guess the GI guy found more polyps than he liked. Oh, well: I've been resigned for at least half my life to developing colon cancer, anyway.

Edit: And now I can't remember if I just took a hydrocodn or not. Apparently, I need to regard early onset Alzheimer's as a clearer & more present danger than colon cancer ...
   47. A big pile of nonsense (gef the talking mongoose) Posted: February 24, 2012 at 01:24 PM (#4067897)
Therapy plus meds changed my life. It's merely an anecdote, but I shudder to think of where I'd be right now without them both.


I've been on Celexa/Lexapro for 11-odd years now. I have no desire to explore how I'd feel without it. (Whereas the doctor just never got around to reauthorizing my 4-or-so-years-long prescription of Depakote a few years back, & I haven't missed too many beats since then.) Before that, I was on Trazodone for a couple of years, but that was purely for the off-label purpose of sleep problems.

Haven't seen a therapist, really, in a little over 10 years. *sigh*
   48. Joe Bivens, Minor Genius Posted: February 24, 2012 at 08:17 PM (#4068232)
Chris Dial can be found performing his brand of whatever it is that he does in the Lounge. He's there all week, most every week. Come, and try the veal.

Ray, I was joking with/about you. I don't hate you.
   49. Weekly Journalist Posted: February 24, 2012 at 08:49 PM (#4068243)
If you're not depressed for irrational reasons, but because your life materially sucks (hate you wife, hate your job, poor, in debt, etc.) then I doubt antidepressants or therapy would help much. Am I right in saying that?
   50. base ball chick Posted: February 24, 2012 at 08:57 PM (#4068247)
WJ
i would think that if you life sucked for very good reasons that therapy would be the most helpful. it does not mean you would NOT have benefit from meds.

that studdy about colon cancer is pretty stupid because they don't say how many people there were total, how many of those people had the colonscopy, and what number of each did/did not have the scope ever had colon cancer and exactly when they were discovered to have it.

as for the light thingy, they sell full spectrum lights and special lights you can sit in front of that are like sunlight without the burning rays.
   51. Jose Can Still Seabiscuit Posted: February 24, 2012 at 09:26 PM (#4068263)
If you're not depressed for irrational reasons, but because your life materially sucks (hate you wife, hate your job, poor, in debt, etc.) then I doubt antidepressants or therapy would help much. Am I right in saying that?


The problem is that people who are depressed are not equipped to deal with the small issues that everyone encounters from time to time. When major things happen that would depress anyone the effects are exacerbated. Because of that the meds or therapy could help just to get them to a point of "normalcy" to be able to deal with those events.
   52. scotto Posted: February 25, 2012 at 03:31 PM (#4068649)
True, Jose. Being depressed is much, much more than being unhappy. I doubt I could describe it adequately, and William Styron spent a whole book trying to. He's a much better writer than I am. But I'm vain, so I'll give it a shot.

Imagine that you're lying on the train tracks, and a train is coming your way. You know it's coming your way. You know that you should move or you'll die. But you can't move, not because you don't want to and not because you're unwilling but you're somehow incapable of it. So you lie there knowing what it is you need to do but not doing it, which certainly isn't helping matters at all. Now imagine that you've got people all around you telling you to move, wondering what it is that's wrong with you that keeps you from moving, speculating that it's because you're a loser or you don't love them enough or it's their fault and other stuff, telling you that you deserve to get run over by the train if you don't move, and so forth. It's kind of like that, only worse.

This metaphor works for alcoholism, too, and alcoholism and depression go together like Abbott and Costello.
   53. BDC Posted: February 25, 2012 at 05:26 PM (#4068720)
that studdy about colon cancer is pretty stupid

The story admits that the study was a simple comparison based on large samples (it compared death rates among people who'd had polyps removed to death rates in the entire population). But that's not stupid. When you see a large trend in a large population, it's convincing evidence that there's something going on. Apparently nobody'd ever tried before to see if such a large trend even existed.
   54. CrosbyBird Posted: February 26, 2012 at 08:31 PM (#4069202)
I'll jump in full on in support of therapy. It's done me a world of good for many reasons. One is that it's simply nice to talk regularly with someone who has little or no stake beyond helping you out; or at least a vastly different stake than most of the other people in your life.

That's what I've found. I can't exactly put my finger on something specific that therapy does, but the general benefits are pretty nice if you've got health care that covers it. I think it's a mix of having a safe environment to talk about how I feel without scaring friends and family (or worse, convincing them to "help" me) or feeling like a burden, and also a reminder that I'm taking an active step in trying to attack the problem with a trained professional.

I've really never experienced serious thoughts of suicide; I tend to favor much slower paths of self-destruction like binges (eating, spending, and video games), isolation, and stopping my meds for no good reason. I still haven't found a consistently good medication without bad side-effects.

I think people often confuse depression with sadness, because they understand sadness. I think in some ways it's like schizophrenia: I empathize with it but I don't get it, and I probably wouldn't really empathize well if I did not have my own related experiences.

Depression is a weight that you carry that makes everything harder to do, but it's also a fog around you that makes it harder to think. I take medication that helps with the fog, but also increases anxiety, and anxiety can be literally paralyzing. I've actually had moments (thankfully quite rare) where I couldn't move: my arm was pinned under my body and in pain from pins and needles but I couldn't turn my body to move it.

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