Category Archives: Doctors

Shake-up Or Wake-Up

The commotion over the study that said anti-depressants are a waste of time for all but the most severely depressed people, has continued to escalate.

It hit the middle editorial pages of my local city’s newspaper, and that means the story is big!

Much of the criticism that I have read of this study has been badly unscientific. A number of medical authorities seem to have come out with rather rash and half-baked defenses of their position.

Meanwhile there is a small debate building around the actual study itself which was published online in a format that allows comments.

For reference you can find the original study here:

Initial Severity and Antidepressant Benefits: A Meta-Analysis of Data Submitted to the Food and Drug Administration

This is an excerpt from my comments on the site:

It is interesting to see the commotion this study has caused, and rightly so.

Even more interesting has been the media reporting. They have been talking about the biological description of depression (eg biochemical imbalance in the brain) even as they are reporting that the drugs don’t work to anywhere near the level previously promoted.

The media is brainwashed to parrot what it has been told, even when there is a gaping hole in the theory.

Brain chemistry is not like insulin for diabetics.

It is also interesting to hear people who have received anti-depressants, and clinicians who prescribed them, somehow thinking they could not be responding to a placebo.

“All this evidence I have seen with my own eyes can’t be wrong” had been the catch-cry of quacks and the quasi-scientific, but it seems it is just the same here. Too many doctors, and patients, are not going about this scientifically.

If this paper is right then it says these drugs should not have gotten onto the market in the first place…

… We can’t offer talk therapy to all of the 5-15% of the western world that is supposedly “depressed”, but it’s no value overstating the benefits of medication either.

Far from being a step backwards I would like to see medicine, and psychiatry in particular, take this as a giant wake-up call for the 21st Century.

Hey, well I’m a wishful thinker 🙂

You can find all the direct comments on this landmark study here.

-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

Claiming The Title

There are so many people claiming the titles of Depression, or Bi-Polar these days.

There are certainly companies who spend a lot of time and money telling us that every possible emotion, other than a sort of flat-lined acceptance of inevitability is an illicit symptom of a pathology.

If your life seems dull and pointless, and you can’t think of anything to get excited about, you are depressed, it could be Depression and need to get yourself dosed with some new, but legal, drug.  If you are particularly happy, and your mind is clicking away coming up with amazing idea after amazing idea, you are just in a “Manic phase,” and in addition, though it feels good, it will soon be over.

These medical “titles” have escaped from the narrow confines of the psychiatric world into public and commercial use, and they are running havoc.

This is a trend and at least partly a marketing-driven trend at that.

Nobody makes any medication sales if you are not self-diagnosing as “ill” to get you to go see a “medical professional” in the first place.

Once you are in their office it is easy for most medical professionals to fit your situation into the idea that they have something on the shelf that can bring your emotional state back to being more appropriate.

Once you are taking something, it can often lead to you taking more, whether by increasing the original dose, or adding something to treat side-effects of the original pill, or because you are seeing a health professional who is helpful enough to find a title for something else you have.

Then what happens if you want to stop the pills?

Anarchy will ensue, of course.

Or will it?

The only way you can find out is to stop the pills “under medical supervision”.

Isn’t that an interesting Catch-22.

-Dr Martin Russell

Headaches Are Caused By…

When people come to me and complain about headaches, they usually are quick to suspect their headaches are caused by stress or some psychological worry.

After all if they thought their headaches were caused by something physical, that a physiotherapist could fix for example, they wouldn’t be seeing a psychological self help guy in the first place now would they.

However not every headache is caused by something physical or even something psychological, some are caused by…

“Aspirin-Deficiency Syndrome”.

Yes that’s right.

Perhaps you haven’t heard of Aspirin-Deficiency Syndrome before, however it is obvious that this is a cause of headaches, because rectifying the problem is a well known cure.

Simply take aspirin and more often than not your headache disappears, and that of course is because you are treating the fundamental cause of the headache ie aspirin-deficiency.

Unfortunately aspirin washes out of the body quickly so you need to keep taking it for the deficiency to be properly addressed.

Aspirin is a naturally occurring substance, although often deficient in the diet of many people in the world. For people who require a supplementation to their diet it can be conveniently found in the form of a tablet.

However aspirin-deficiency syndrome is not just a cause of headaches.

No. It is also a cause of all types of aches and pains, and even fevers and chills.

Aspirin-deficiency syndrome is a known factor in bowel cancer, heart disease, and even blood clotting disorders. It may even be an important factor in causing Alzheimer’s.

Here is short list of deficiency syndromes that can cause headaches:
– top of the list is Aspirin-deficiency Syndrome,
– Tylenol-deficiency syndrome,
– codeine-deficiency syndrome (sometimes confused as being withdrawal rebound headaches),
– caffiene-deficiency syndrome (also confused with withdrawal symptoms),
– manual-therapist-deficiency syndrome,
– bed-rest-deficiency syndrome…

Heck, ask your pharmacist to tell you what deficiency syndrome you have. Almost guaranteed, your headaches are caused by a deficiency of something they have on their shelves, and the cure follows from the diagnosis.

At least that’s the way alot of our society treats it. So hop on board.

-Dr Martin Russell

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Influencing Doctors

Survey after survey of doctors says that they don’t think that gifts influence their behavior.

Study after study says they are totally wrong.

The big pharmaceutical companies spend millions upon billions on advertising and promoting to doctors and one of the biggest ways they do so is by using gifts of all types.

Sometimes it’s pens, sometimes it’s meals and nights out, sometimes it’s travel and accommodation, there are various rules and guidelines in place but historically it can be almost anything.

The evidence is overwhelming that this sort of practice is highly effective at altering doctor’s behavior.

The most obvious evidence is that so much money is spent on it. Drug companies do have ways of monitoring the effect of their marketing to doctors. They have been able to study the results for themselves inside their own companies, and they clearly just want to do more of it.

Some of the research is done outside drug companies and therefore is available for us to analyze, and this research too comes up showing that doctors become more willing to prescribe drugs rather than non-drug treatments, pay less attention to the scientific evidence, and bias to favor a particular company’s drug.

That would be much less of a problem if it wasn’t for the perception that is widely held by doctor’s themselves that they are somehow “immune” to this influence, and that they are “too clever” to be swayed.

This self-delusion is wrong, and dangerous.

It’s easy for me. I’m in the luxurious position of not prescribing much at all these days, so I can accept as many gifts as I like for a new medication and my prescriptions still are zero.

I don’t get as many invitations or gifts these days.

Back when I did prescribe a lot more and did get more gifts I looked into this.

In my time I’ve come across a few doctors who do in fact acknowledge the influence of gifts in their own practice, and one in particular got taken to task by my local newspaper.

One of the most senior surgeons at my city’s biggest hospital wrote a book on how to prepare for surgery.

A tiny piece in the book suggested that patients should give a gift, like an expensive bottle of brandy, to their surgeon before they had an operation.

Among all his recommendations, this “bribe” got the attention.

The outcry was huge.

“Doctor’s are already rich enough, and now they are asking you to give them bribes too!”

“You can buy off your doctor with booze!”

Well, the newspaper didn’t quite go that far, but that was the impression they were giving. I bet it sold a few newspapers and demonstrated a lot about what influences them. But that’s not my field so I won’t go into that.

I was working as a volunteer with a local radio station at the time and I took the chance to interview this surgeon.

He was bemused as to what all the fuss was about. He openly acknowledged that surgeons get influenced by gifts, and he put it something like this…

“When you yourself need surgery and you are being wheeled into the operating theater, do you want your surgeon to think of you as the Xth case of Y operation for that day?

Or do you want to be thought of as ‘the patient who gave me ……’?

Surgeons are human too and it DOES influence how they handle you and your surgery.”

Unfortunately I’ve never seen this particular technique studied, so this is one piece of self help that I simply recommend from my own experience with doctors and other human beings.

-Dr Martin Russell