I cn see it now, a bunch of middle aged suburbinites scoring this nasal spray from their local dealers when their doc refuses a script.

And a power hungry DA trying to railrod a few of them on his path to higher office

I saw the comment the other day where you asked him why he made his students hand-write their papers, and the only thing I could think of was that he’s possibly trying to determine who actually can spell and make a proper sentence without a word program auto correcting for them. I think it’s a stupid waste of time, personally, and agree with you that typing is much more efficient and easier to read (no one has bad handwriting with courier!). The only way I could see hand written papers being useful is if you’re an English teacher and want to gage the class on the first day (and it better be a short paper), and then maybe toward the end of the semester/year to see how well they’ve come along, but to do it throughout the semester/year is just absurd; it’s busywork and the students won’t appreciate it.

I would have that professor do his taxes without a calculator.

All good or all bad is how these Big Pharma/Big Health foods tend to play out here.

Long term use of prescription medications CAN cause liver damage (as do poisonous mushrooms).

Why chance it for something that can be fixed cognitively? And if they do get liver damage, how is this different from obese people or alcoholics we wind up paying higher premiums in health insurance costs because of their unwillingness to deal with their problems that they find unhealthy solutions for fixing...?

I am quite sure the obese person and the alcoholic have "social anxieties" they were self medicating so they wouldn't actually have to deal with their problems. I am sure anxiety is at the top of the list of why they ate, or drank...or...

If you can do without meds, you should. If you can't then you shouldn't.

(I've heard that the same maternal instinct and good mood for both men and women can be achieved through a nice dose of daily orgasms...?)

Same hormone...same well being and your body produces it naturally.

On a related (anti-tech) note, some college professor recently posted a comment about how he makes all his students handwrite their papers. Absolutely idiotic. The computer allows me to edit in a word or sentence without retyping the entire document. It's an enormous time-saver, and makes my life easier in myriad ways. I asked, did he also make his students walk to school instead of taking the bus, and spear their lunch instead of running out to the cafeteria or the 7-Eleven? (He never replied as to why he makes them handwrite his papers -- and I hope my taking him to task will make him stop.)

I HATED when professors did that! Was usually English department and others like them. Even heard of business classes (Accounting?) doing that in the recent past too.

Does that make us racist for calling someone a professor?

I, personally, cannot do without nasal spray because I am unable to breathe between my ears.

Same hormone...same well being and your body produces it naturally.

But imagine trying to explain to an autistic kid that he/she needs to masturbate more. Most adults without this disorder wouldn't be able to get through that conversation (and what a self-fucking shame that is!) Plus, how do you measure dosing?

Is there any indication that autistic people have reduced production of oxytocin? The reason why I ask is because glial cells might take this train off the tracks eventually. They are the regulator of brain function through chemistry in the human brain and the cause of developing a tolerance for consumed substances that directly effect cells that receive neurotransmitters. It would likely work better if the nasal spray was combined oxytocin and neurontin, the combination would reduce the glial adaptation to the introduced substance.

-Julie

"He never replied as to why he makes them handwrite his papers."

Maybe he's just a masochist. I could see this in language classes for Chinese or maybe Arabic, where the software may be expensive or hard to get. And in the case Chinese handwriting is a really important mark of an educated person, much more than a "good" accent, so there's some practical point in focusing on it. Otherwise it's a case of a college profesor acting like an 8th grade English teacher.

@ Julie - I was speaking specifically to the peeps who lack a social comfort level, not the autistic children. I think people who earnestly need to take meds should (obviously).

Then there are just others that want a quick fix for things they should be working on improving for their own benefit - and it is completely doable without meds. (Like, who isn't socially uncomfortable at times...)

Besides, demand goes up for this product and so does the price for the people that really need it.

I look at the macro level on this stuff. Ya know, if you are a human without autism and are socially awkward - work on it!

Try it without the pills! Sheesh.

Try it without the pills! Sheesh.

I agree completely. My dry humor was in there somewhere...I had the image of a poor kid with raw genitals going back to the doctor saying,

"But you told me to masturbate more!"

I personally think that most depression that people receive medication for is situational. If you resolve the issue, then the depression goes away, but by that time you are getting a daily pill that should 'fix' it, but does nothing but mess up your brain chemistry, and reduce the natural production of mood enhancers thereby ensuring 'rebound' depression if you every try to 'get off the meds'. There really are very few people who have clinical depression that should warrant medication. Do you realize that you only need to show symptoms of depression for 2 weeks to get a daily pill for the rest of your life?

I'm in the process of reading an interesting article about the evolutionary benefits of depression, and whether it should be treated as an illness. I haven't gotten through enough of it (and the research behind it) to provide any assessments, but it sure would explain a bunch.

-Julie

"Do you realize that you only need to show symptoms of depression for 2 weeks to get a daily pill for the rest of your life?"

Julie, I have to take issue with this. I've been around that loop, and I don't know of any competent practitioner who will prescribe antidepressants to someone who hasn't been in therapy for at least a year, unless it is so severe that the person cannot respond to therapy without it. SSRIs do not start working overnight; you have to start with a low-dose starter pack for at least two weeks, and it takes a month before you get significant benefit from it. Most people who have depression start by going to a psychologist, and they can't even prescribe.

Yes, there are hack doctors who will give them to anyone who walks in and says the magic words. Is that the drug's fault? There are also doctors who will hand out Oxycontin prescrips to anyone who walks in the door. Didn't you say a few months ago that you have a condition that causes you to have to take a lot of pain meds?

I consider Neurontin a hoax medicine. It has been prescribed for so much "off-label" crap, that it might as well be an orphan drug.

Is that the drug's fault?

I'm not saying that it is the drugs fault, nor am I saying that no one should take the medications, as there are some people who have depression that is not situational, and therefore will never get better with 'talk therapy'. However, I suspect that either my view is negatively skewed or your view is positively skewed. I would say that majority of the people I know are taking some type of anti-depressant, despite never having worked through their issues, and will for the rest of their lives.

Didn't you say a few months ago that you have a condition that causes you to have to take a lot of pain meds?

Yes, which again comes back to the idea the medications are tools. Everything else should be tried before lifelong medication is prescribed, because getting off of that medication (whether pain meds, anti-depressants, or any other medication) is awful and can cause more problems than the person originally had. No medication is without side effects, and the only way to minimize them is to not take the pills to begin with.

I consider Neurontin a hoax medicine. It has been prescribed for so much "off-label" crap, that it might as well be an orphan drug.

What Neurontin does best, and what it originally was used for is as a 'helper drug'. It increases the effectiveness and reduces tolerance of medications that interact directly with brain chemistry. There was a really interesting article in "Scientific American Mind" an issue back that went into the studies that show this use is effective (and also discusses glial cells and how they impact tolerance). But I agree that it isn't effective for as many uses as Big Pharma claims. It is not totally useless however.

-Julie

JulieW, I agree that we've both been throwing anecdotes at each other. Your post inspired me to go hunt up some stats on depression... little did I know what a ride I was in for. To sum it up, the research is all over the place; depending on whose paper you believe, anywhere between 5% and 20% of the adult population suffers from it. I'll go with the National Institute of Mental Health's numbers; they seem to be fairly reliable and they put it at 6.7% for adults in the U.S. (A lot of studies conflate clinical depression with bipolar disorder, which IHMO is a big mistake; the treatments aren't at all similar.)

Similarly, what little data I've found on the percentage of people taking antidepressants seems to be incongruous. I found one CDC study (seven years old now) that stated that 14% of the U.S. adult population is taking an antidepressant, but on the other hand, only one antidepressant (Paxil, at #19) was in the top-20 most prescribed drugs, and that accounted for only 0.7% of all prescriptions. So it's hard to tell how the percentage of people taking antidepressants lines up with the percentage of people who have clinical depression. (The picture is further complicated by secondary and off-label uses of some antidepressants, such as the prescribing of SSRIs for anxiety disorders.)

I'll note that it's pretty well established that chronic pain and chronic depression have negative long-term effects on the body. To avoid said negative effects, you don't need to be told to "manage" the condition; you need it to go the hell away if possible. So there's a set of risk tradeoffs. And that's without considering quality-of-life issues. SSRIs allow me to be a healthy, happy, and productive citizen, rather than a social dependent. I think that's worth accepting a bit of risk.

"(A lot of studies conflate clinical depression with bipolar disorder, which IHMO is a big mistake; the treatments aren't at all similar)"

I'm with you Cousin Dave. The numbers have always seemed off to me.

Re: Depression, CDave, JulieW

"I would say that majority of the people I know are taking some type of anti-depressant, despite never having worked through their issues, and will for the rest of their lives."

And I'll agree. Currently, every member of my immediate family (excepting myself) is on depression medication. None of these family members are in any kind of therapy. Each time they went to get signed up, all they had to do was say their sob story and the doctors signed them right up.

Cousin Dave, please understand the problem with your argument is that you say "Yes, there are hack doctors who will give them to anyone who walks in and says the magic words". Julie has no problem with the drug, but rather, the fact that people hand them out willy-nilly for situational depression, when the drugs should be really limited for chronic/clinical depression. And once you've been prescribed the drugs, the doctor never seems to suggest getting off of them, so unless you want to go off yourself, you've got yourself a lifetime prescription.

I think the depression numbers are all over, because the definition of depression is so hard to pin down. Like how bi-polar is usually lumped in with depression. And the whole wobbly "situational depression" thing.

As someone who is prone to long, blue funks and other symptoms, I try to stay away from the drug aspect because the side effects frighten me. Before they go out handing autism nose sprays, I hope they thoroughly, THOROUGHLY research the side effects. Seriously, when suicidal thoughts are one of the side effects of a drug, I'm not gonna risk it. I don't need any more help in that department.

corneredmom, you do raise some good points. Let me explain why I'm picking on Julie a little bit: Both her condition and my condition, as well as Amy's, are things that a significant percentage of the population views not as diseases or conditions to be treated, but as character defects. (In the case of one poll I've seen regarding clinical depression, it's 54%.) They regard Julie and Amy and myself as basically immoral recreational drug users who have found ways to cheat the system. They think we're going around high as kites all day and not pulling our weight in society.

Accordingly, they would like to ban the drugs that we depend on, to try to force us to "straighten up". They'll tell us things like "it's all in your head", "get tough, be a man", "you're just making that up so people will feel sorry for you", or "you could beat it without drugs if you tried, but you're just too lazy to try". Pair that up with the anything-manmade-is-bad sort of environmentalism, and the conventional populist suspicion of big companies who do things that are hard to understand, and you've got political pressure groups. Those groups succeeded in getting Vioxx banned, despite the fact that Vioxx immensely improved the quality of life for many people who took it, and for a lot of those people, nothing else works.

These groups do not have any problem with either making up things, or with taking information that is true and taking it out of context or blowing it out of proportion. One reason that I wanted to dig into the depression stats is the widely-spread belief/rumor that a substantial percentage of the population is on antidepressants. I have not found any evidence to support that, although the little bit of data I have found doesn't convincingly refute it either. A frequently cited stat is that antidepressant prescribing has tripled since 1985 or so. Yes, that's true. It's also true that SSRIs didn't exist in 1985, and the antidepressant drugs that did exist then were crap. That's why they weren't prescribed more. I went one round with a tricyclic in my teenage years, and it was bad mojo. I swore off further drug treatment after that, and went the next twenty-five years trying to manage without the drugs. But clinical depression tends to get worse as you get older, and finally about ten years ago, the therapist that I had been seeing for about six months suggested that I give an SSRI a try. I can tell you that SSRIs are infinitely better at treating the problem without severe side effects. That's why antidepressant use has gone up since 1985: the ones we have now actually work. I'll bet Julie could tell a similar story; there have been huge advances in opioid painkillers in the past ten years. They're prescribed more because they work better.

As for the suicide thing, I'll have to go look up that some more. But I'll be surprised if I find anything abnormal there among SSRI users. The pressure groups like to trumped anecdotes of SSRI users who committed suicide, without comparing those numbers either to the general population or to depression sufferers who are not treated with drugs. Point: people who have clinical depression often want to kill themselves. Because, you know, they're depressed. If you live with it for years and you don't see any way out, you start questioning whether it's worth it. However... to actually do it, you have to motivate yourself to get off the couch and go do something. Thinking about the amount of work you'll have to do first -- buy a gun, update your will, write a note, etc. -- makes your head hurt, and after a while you decide it's too much effort and you go back to watching TV.

Well, guess what happens when you start on SSRIs: you start to feel a bit better. Not much, but enough that you can actually motivate yourself to do something. So there's a window of vulnerability, a point early in the treatment where the patient hasn't seen enough improvement to get rid of the desire for oblivion, but has seen just enough improvement that they can motivate themselves to do it. This was something that kind of surprised a lot of the therapists when it was first noticed. Teens are particularly vulnerable to it, since they may not see any way that they can improve their situation in the short term, without emancipation.

The other probable cause is SSRIs being prescribed to mis-diagnosed bipolar patients. SSRIs can make bipolar disorder worse. Again, this is something that the treatment community had to learn the hard way. Some of the SSRIs were originally pushed for bipolar treatment because everyone assumed that the mental mechanisms were similar. Some weren't, but doctors went off-label and tried it anyway because it seemed to make sense and the initial research had been inconclusive.

There are huge quality of life issues at stake. A lot of people misinterpret the bit in the Hippocratic oath about "first, do no harm". The definition of "harm" is "don't do anything to make the patient's overall situation worse", not "don't do anything that causes any degree of harm whatsoever". If it were the latter, surgery would be illegal; clearly, cutting into a patient's body is traumatic and does harm.

So I'm looking at Julie's situation. By her account, her last doctor is now in jail for trying to help his patients live their lives without chronic pain. She found another one, but eventually Julie and people like her are going to run out of doctors who are willing to take the risk. If and when that happens, then quite possibly Julie can't work or live her life anymore, which would be a loss to society. The elitist grundyism has succeeded in blurring the line between abuse and legitimate use of the painkilling drugs, to the point where all uses are now considered immoral. I can see the possibility of the same thing happening to both SSRIs and to Ritalin, and quite frankly, I'm worried. I'm not sure how I would continue to function without SSRIs. And if Ritalin is banned, then Amy might not be able to work anymore, and I would certainly miss her columns and her books. Productive people get their lives crushed; they lose and society is worse off for not having them around. I fail to see where the upside is here.

And getting back to the topic, it's the same with the autism spray. Yes, it will probably have some side effects. Let's say it increases the risk of having a heart attck, after the age of 50, by 10%. Is that worse than having autism? It's the same with the Vioxx. I have a friend with rheumatoid arthritis whose life was turned around by Vioxx, and it's now gone back to the way it was. She should have been allowed to look at the risk stats and make her own decision about that, rather than a bunch of smug political pressure groups making it for her.