The End Of The Anti-Depressant Era?

Good to see the recent spate of publicity for a study that hacks the legs out from under the antidepressant medication industry.

Currently the most viewed health article from the Washington Post website is about this study: “Only Severely Depressed Benefit From Antidepressants: Study“, and if you search Google News for the study’s author, Irving Kirsch, you find dozens of stories in the last 48 hours. It’s gone hot, and rightly so.

The whole 50 years of the Serotonin hypothesis that justifies these medications is a minefield of dressed-up science and warped philosophy.

It’s just over 20 years since the wonder drug Prozac came onto the market, and the field has just kept expanding with new variations on the theme.

All this was meant to be backed up by highly rigorous and validated science.

Well it was only last month that a study into the reporting of those research findings showed that the benefits of antidepressants was universally less than claimed. In some cases more than half of the reported benefit of a particular anti-depressant was shown to be due to selective reporting of the available research.

The current study goes even further and questions whether there is any benefit at all in anti-depressant except in severe cases of depression, and even in these cases there was very little effect.

As disheartening as this is for people who are depressed, I hope this study really starts to clear the air on this topic.

But a note…

What if you are currently taking ‘anti-depressants’? – or whatever these drugs should now be named instead.

Keep taking them for the moment at least.

Discuss with the person who prescribed them for you, and make sure you have alternative plans for managing your mood, and that you understand the process for weaning off the medication.

If you think there is nothing else that can help your depression, you might find new choices with this:

http://www.SelfHelpMeeting.com

-Dr Martin Russell

Following Up

Last year in September I wrote about a 47-year old professor, Randy Pausch, and his inspirational “Last Lecture” following his diagnosis with pancreatic cancer.

If you want to know why death is such an important part of being human, then view the video on my previous post.

Back then he had wide publicity, from Good Morning America to Oprah, from ABC World News to The Wall Street Journal.

So now for an update.

Just two weeks ago on February 15th Randy passed a special milestone…

“It was August 15th, 2007, when I was told I likely had “three to six months of good health left.”

Today is six months from that day.

….

The doctors weren’t wrong; they always said that if the palliative chemo worked, I’d buy more time, but that it was a long shot. And the doctors have done a brilliant job of tweaking my regimen to help my odds. How much longer this will work is hard to know, but I’m going to keep having fun every day I have left, no matter how many or how few of them I get.”

Randy had planned to give the lecture and then move interstate with his wife and family to spend his remaining time creating memories for them.

It didn’t work out as planned.

Yes he has moved, and yes he has taken his family, and yes he has also created some great memories with them. His website has the pictures to prove it.

But he also hit upon a nerve with his “Last Lecture”. The video was viewed over a million times in the first month, and currently on Google video has 4994 comments, and almost a 5 star rating.

This has given Randy a different addition to his plan for living and dying.

In January a book that fleshes out details from The Last Lecture came out and you can find it here:

www.TheLastLecture.com

What next with this?

I don’t know.

But when I spent 3 months working in palliative care I liked the medical term for when cancer goes away.

Remission.

Or, put another way, Re – Mission. Finding once again a purpose for life.

Who knows how much of what has happened with Randy is from the various treatments he has been trialed with, how much is his own personal health and fitness work, and how much is just sheer luck.

But if Randy does live on for a long time, then re-mission will be a very apt term.

Even more so because of Randy’s passion for Star Trek, and his childhood dream to be like Commander Kirk leading all those missions!

Could it really be that it is cancer will help him to achieve a childhood dream?

-Dr Martin Russell

Life Is A…

Medicine can be so arrogant sometimes.

How can doctors “save people’s lives” when people just die later of something else.

The latest cancer treatment announces it has reduced the mortality by half. Really. Please put the time-frame back in and say something like, “within the first 5 years after treatment.”

Human life is after all, as the saying goes, a sexually-transmitted terminal disease.

Would we be better off removing the idea of “saving” people, or of “curing” disease?

“Cure” is often a bad description. Perhaps “life-long remission” is more accurate.

And in fact “getting ill” is not correct either. In this era of genetic fatalism how about “initial spontaneous relapse” for any new illness.

The bugs and nasties are all around us just waiting for us to succumb. Modern medical theory says that cancers are already in us being cleaned up by our immune system until the day that they escape and take their opportunity to wreak havoc.

Accepting the end will come brings importance to the fact that we are here now.

Are you waiting, or are you making the most of how your life is today?

-Dr Martin Russell

Pssst. Want A Phobia?

I want a phobia. Anybody got one to give me. I want to be phobic about being bored. Or maybe phobic about doing the same thing too many times. Or maybe I already am.

I’m told that Stephen King doesn’t just write about his phobia-producing monsters. He also makes use of them. Each time he wants to get himself back to writing, he imagines the worst of them leering over his shoulder, snorting onto his neck, screaming at him to get to work.

I could give it to everyone who walked in complaining of motivation problems – heh, heh, heh. Take one each morning and race into rest of the day.

Instead of hitting the sleep button on the alarm – just have a phobia about it. “I don’t know what happened – I was in bed asleep, I heard this noise, and I just had to  race out of the room. The quicker I get out to the car the better. Can I go now?”

Think I’m not being serious?

You might not think of things as phobias, but many people control themselves and others by phobias.

The Depression installed a phobia of wasting food in many who went through these experiences.

For sheer terror try telling a person in a domestic violence relationship to leave. What ever way the partner installed this phobia, it works only too well.

Here is a phobia. Think of the multi-millionaire entrepeneurs, especially those who stand up as motivational speakers, who describe their success this way.

“When I grew up my parents were dirt poor. We came from conditions so bad that I decided I would never let myself and my family be like that, and I would work to help others to get out of that.”

They then say, “Since I came so far, anyone can do this too.”

Yeah, by having a phobia of their childhood conditions severe enough to provide life-long terror motivation.

I prefer choice in my phobias.

What would phobia you like to have?

-Dr Martin Russell

It’s All In Your Head

A man came to me for hypnotherapy because he was vomiting. Not just any vomiting either. He had had to be hospitalized and rehydrated.

His doctor’s couldn’t find a cause, so they did what doctor’s do when they can’t explain something. They suspect it’s in your head, give it an impressive label like psychogenic hyperemesis, and then they send you off to someone like me.

I did no hypnotherapy in the first session with him. Instead I took a detailed history and asked him, and his wife who came with him, as many questions as I could.

In the end I explained to them that although I could give hypnotherapy a go, I could find no clear psychological reason why he would be vomiting. I had no other explain for why he was vomiting, but as far as I could work out it was not in his head.

His wife and he went away disappointed.

Later that year I was at the only counseling conference I have bothered to go to since I started my counseling work, and someone happened to present a series of cases of vomiting of unknown origin. My ears pricked up. The extra factor was that the people in each case needed to take lots of really hot showers or baths, up to 10-15 times a day so they could feel better.

The connection was found to be chronic high-dose marijuana use and severe, hospitalizing vomiting was a newly reported side-effect of cannabis!

Bingo!

I phoned up the man who had come to see me earlier that year and spoke to his wife.

Turned out he was in hospital again for dehydration and even worse than ever. So I arranged to go and visit him in hospital, and just in case he was going to deny any drug use I didn’t mention it on the phone.

When I got to the hospital I spoke to the doctors looking after him and they listed the battery of tests that they had run on him in this admission and previous ones. I was horrified to discover that they had already done a general drug screen, and it was negative for cannabis. My big idea was shattered.

I went in and spoke to the man and his wife, but it was true. He had no interest in hot showers. In fact he said to me he wished he did because then he could have been cured by simply stopping smoking. He was looking in particularly bad shape and was looking for any cure. I sat down and tried a little relaxation hypnosis with him, but it didn’t seem to help either of us.

About 6 months later I got a call from his wife. She was calling to let me know that her husband had died, and to say thankyou to me for my efforts.

A couple of months before his death they had in fact found a diagnosis. I think it was amyloidosis. I just remember the wife saying that the diagnosis had come up twice on episodes of the TV show “House”.

But instead of diagnosis in days like on TV, her husband’s diagnosis took years and by then it was too late stage.

I was very glad to get the feedback about what really happened.

I got feedback. She got a prematurely dead husband.

That’s all that is in my head now.

-Dr Martin Russell

A Night Out At The Movies

Last Friday night my wife and I left our 3 kids at my parents and went out to the movies.

Not such an unusual event perhaps, but these 2 movies were presented by an internationally renown hypnotherapist.

The movies were archival footage from the 1950’s that were an important part of the change in hypnosis become accepted as a medical therapy.

There were two films:
1954 – Hypnosis for pain-free Childbirth.
1956 – Thyroidectomy using hypnosis as the only anesthetic.

Both these films are still very impressive examples of hypnosis even today.

Childbirth is a common enough area for hypnosis, but the idea of complete control and elimination of pain during birth and delivery is still a very unusual one. It’s just not how these events are meant to be. Where is the screaming, the swearing, the drugs, the drama?

My wife had hypnosis in preparation for the birth of our third child, and both she and I were quite happy that most of the drama was on the midwife’s side rather than ours.

The footage of the thyroid operation was even more outstanding.

The thyroid is a gland in the front of the neck, and the surgery was to cut it out.

This woman used self-hypnosis in the dramatic and direct style of the 1950s, and made her neck go numb as if it had had a local anaesthetic injected into it.

Then as she lay back the surgeon set up the operating drapes and then took a scalpel and cut open the skin of her neck, pulled back the layers, clamped off the few bleeding blood vessels and proceeded to dissect away her thyroid.

The woman was aware and alert during the entire operation and at one point mentioned that she felt some pressure on her windpipe. They halted the operation, waited for that to settle, and when it was better went on to complete the operation without further interruption.

It was a great couple of historic movies of hypnosis.

There was just one further twist to the evening.

In the discussion at the end the hypnotherapist presenting the movies mentioned that he had had an operation on his knee the year before and had opted for chemical anaesthesia.

My wife wasn’t the only one to question why someone who had worked with the doctor who made these films, and who had been teaching hypnosis around the world for the past 30 years, would not have used hypnosis for his own operation.

Someone else in the audience asked the question for us, and reason this hypnotherapist gave was that he had too little time, only 3 days, to prepare for the surgery.

Hmmm.

This type of paradox is why I don’t talk much about hypnosis.

Hypnosis dramatically demonstrates what the human mind and body can do, but I haven’t seen people get great results from hypnosis on themselves without someone else guiding them.

Many self-help methods are best learnt directly in the presence of someone else, and hypnosis or self-hypnosis seems to me to one of these.

-Dr Martin Russell

The Strange Behavior Of Anorexia – Part 1

Many years ago now I went to a meeting of a local self-help group for people with eating disorders.

They didn’t usually allow outsiders to come along but because I am a medical doctor they were willing to make an exception. It seems that medical doctors don’t often ask to go along to self-help groups. At least that’s what various groups have told me when I have gone along.

That evening one of the topics for discussion was a recent tour that some of the volunteers, staff and members had done to the outlying communities around the state.

They were discussing how ignorant people were of anorexia and how badly education was needed.

One of the staff related a story from one of presenting a meeting to a group in a small town.

As they started up the meeting they asked for any questions or comments, and apparently a fat woman spoke up in a loud voice and said “Oh yeah, I would like a week of anorexia.”

The presenter was totally insulted, and outraged by this comment.

I had to agree with her. However I also had to agree with the woman who spoke up in the meeting.

I’m sure many people have wanted to lose weight by a week of anorexia, and I’m sure that many people with anorexia would be delighted to have a switch to turn it off after a week. Just try it for a while, if you don’t like it, turn it off and move on.

In fact the real problem with anorexia is that there is no such magic on/off switch, or at least that’s how it seems.

Anorexia, ie not eating enough to maintain a “healthy” weight, is a seemingly strange behavior for a human being. But nevertheless people do it.

Whenever you come across a strange behavior you can ask the same question as you would with your emotions as I described in a previous post, “Under what circumstances would this behavior actually be entirely appropriate?”

Have a think about it, even leave a comment with your opinion, and in Part 2 I’ll tell you what I came up with when I first asked this question myself.

Find Part 2 here. 

-Dr Martin Russell

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Reply To Gary Craig – Or EFT Is Bunkum? – Part 4

Gary Craig, the creator of Emotional Freedom Technique left a note on the blog about my posts on EFT (Part 1, Part 2 & Part 3)

He suggests I look into the research on EFT that he links to and comments on at his www.emofree.com website, and I will do so in coming posts.

However he also has this to say…

“… your explanation of how EFT works in Part 2 of your EFT Bunkum series falls seriously short. If you are interested in discussing this, please correspond with me directly and not publicly.”

Following this I spoke with Gary, and he confirmed he didn’t want to discuss this publicly but gave me his thoughts for my own use.

With those ideas in mind I’ve wanted to complete this series and include the extra information about EFT, but I am happy to let Gary speak for himself and not put words in his mouth.

So what I say here is based on what is already publicly available online.

First let me agree with Gary Craig.

My assessment of EFT is indeed “seriously short”.

That is because EFT is no longer limited by Chinese medicine and concept of Chi energy flow.

EFT is now into the realms of quantum healing, which has much more diverse and wonderful qualities.

This has brought up a new technique of “surrogate” or “intentional” EFT.

What is “surrogate” or “intentional” EFT? Well here is one simple example from Gary Craig’s emofree.com website:

I stood in the kitchen and could hear [my 3-year old and 5-year old children in their bedrooms] coughing. I focused on each one individually and tapped myself while focusing on each one, calling them by name. Within fifteen minutes I was headed for bed and it was very quiet in their rooms. I just smiled. Of course I have no way of knowing if what I did caused them to quiet so quickly, but I do enjoy believing so.

GARY CRAIG COMMENT: I, too, have no way of knowing if your “intentional EFT” did the trick here. It could have been coincidence. What I don’t think is coincidence, however, are the numerous reports of success using these “way out there” intentional procedures. I have done it myself on several occasions.

What Gary is saying is that you can tap with the intention to help someone else, and the other person will improve.

Even more “way out there” are the claims that you can tap on yourself without the person even being there, or you can simply IMAGINE tapping without doing any physical action, and the results will happen for that person too.

This makes EFT closer to the idea of “prayer” which does have a history of being researched as a healing tool.

Most importantly this quantum version of EFT goes way beyond the claims of Chinese medicine at least the way I understand it. It also goes far beyond the theory I proposed for how EFT works.

There is no published research on “surrogate” or “intentional” EFT, but there are lots and lots of impressive case studies, so how do I explain these?

I suggest a combination of 3 things:

  1. Coincidence:- as Gary Craig mentions above,
  2. Non-verbal/unconscious communication:- the mother being calmer from the tapping was “noticed” by her children, perhaps in the noises they could hear from their rooms, and
  3. Selection-bias:- if the tapping hadn’t worked the mother would have forgotten the incident, but it worked so she made special note of it and even wrote to Gary about it.

Perhaps it would be simpler if quantum energy was the sole explanation, but all the above 3 effects are enough to explain it for me.

So my original explanation was indeed too short. The current work in quantum EFT requires me to add 3 more explanations to cover it all.

-Dr Martin Russell