Misc

Kaveh

Hey ... Im sorry,  I should have perhaps made it clear from the offset that I am in the UK. I didnt appreciate the vast difference in the approach to MI between the UK and US myself. And you probably right about the difficulties in Iran. It has been a long time since I was there but Im sure there is not much much progress in this area.

I can tell you now that I am a CBT therapist here and work in primary care with the mild to moderate end of MI.... its a a relatively new approach to us here but I am observing a big reduction in referrals to psychiatry. So something is working! As you say, better than popping pills and ppl feel more empowered. Please forgive me for with holding that information before!

And I agree with you that it was good to talk about something else for a change! I frequently feel there are too many political discussions here but I can never think of anything to start a discussion about....... well at least one that might be of interest to the community here.

Best wishes Kaveh

javaneh

Javaneh, To Answer Your Question...

I wasn't aware that you are in the U.K. That may be from where some of the "disagreement" stems. My apologies.

Here in the U.S., medication is the primary answer (for every ailment), and it is dispensed like candy. Very little if anything else is done here, which is sharp contrast not only to the U.K., but other parts of Europe as well. As far as Iran, my guess would be that the longstanding cultural "wall" that makes mental illness such an unspeakable taboo has something to do with it. (Makes me wonder who really needs the therapy over there!)

I agree that the best results would consist of a combination of treatments. CBT, and the talking therapy you mentioned, of course, with low dosage medication used as a supplement for severe clinical cases, rather than a primary protocol, and only as a last resort. I am a firm believer in the power of the mind, and how it plays such a huge role in one's overall well being.

Oh, I knew what you meant by premorbid :)

Thanks for taking the time to write back as much as you have. It was refreshing to have a conversation that wasn't political in nature.

All the best,

Kaveh

Kaveh

I think in the end we will have to agree to disagree on this matter,. However I want to answer some of the points you make.

I wonder...? When you have an illness, do you take medication? And some relief is better than no relief... surely? Kaveh if you have an injury, would you not take painkillers? It might not cure the injury but it will ease the pain. We are not talking about being overwieght or loosing hair here.... we are talking about people with major mental illness, significant enough that they consider ending their life as the best option. The fact that they see this as their best option is a symptom of the illness...... ! Its more and more clear that you have no exerience of major mental illness. I hope you never do.

In todays psychiatry, in the UK at least, the persons whole life is considered and that includes their physical, emotional and social circumstances. Medication isnt handed out indiscriminatley. It is the last option. Exercise programmes, CBT (cognitive behaviour therapy)  and other talking therapy's are attempted initially. And all of these are provided through the national health service. Of course it isnt like that in Iran, or even the US. I know.

In this instance I used the word 'premorbid' to describe the pre illness personality. Im sorry,  it is a medical term. 

There are long term benifits to medication in conjunction with other interventions. Medication is not the whole answer but it has its place in the scheme of things.

And out of curiosity Kaveh, in your opinion what path would yeild the best results?

I agree that we are  pill popping society. There is a pill for everything these days.... and I dont advocate that habit at all, but in the case of major mental illness such as depression, I know that it reduces the duration of illness, it relieves the affects, it liimits the effects of the illness on peoples lives eg they might not loose their job, their home etc  and it reduces the probability of future episodes.       

Kaveh I think we should leave our difference of opinion there. Obviously we view things from a different perspective, mine is a professional one and I am bound to think in medical terms.

Javaneh

Javaneh

While there are chemical imbalances in the brain, the long-standing protocol of using synthesized formulas as a substitute, in addition to not being a quick fix, they do not have long term benefits either. But they are prescribed with a "quick fix" mentality.

"Some relief" is simply inadequate, and unacceptable today. Your own post indicates that it only addresses symptoms, and that once the relief is established the individual can begin to enjoy their pre-morbid life once more.

But that's simply not true. Their life is still morbid. The only difference is the meds are masking the morbidity.

What if they forget to take them? What if they don't have the money for a co-pay or for the full price of the meds?

Mental health plays a role in physical health, but are still two separate things. But they're treated with a one size fits all way of thinking. Overweight? Take a pill. Losing your hair? Take a pill. Can't get it up? Take a pill. Want to kill yourself? Take a pill.

It just seems that everyone is easily inclined to go that route, as it is the path of least resistance, when we need to take the path of best results.

Hmmm..... there is some truth in what you say but with respect

Kaveh 

although what you say is not inaccurate in some instances, ie chemical substitutes do not resolve the of cause of a mental illness such as depression ,  never the less mental illnesses  eg depression are caused by a chemical imbalence in the brain. There is a differance between a reactionary depression, which is usually temporary and perhaps a natural reaction to some adverse life event or a social, emotional  or physical circumstance, where the individual is likely to recover after a period of time, with support and a depression so deep that an individual will consider,  let alone act on suicidal thoughts.

In some cases a reactionary depression can become so deep rooted that it becomes clinical. Medication at an early stage can help prevent this.

Chemical preparations do in most cases restore the chemical imbalences in time and allow that individal some relief from the negative affects of the illness such as  sleep disturbance, changes in appetite, negative thoughts, irrational thoughts, feelings of hopelessness and desparation, apathy, lack of concentration ... there are many more. Once that relief is established and some stability is regained, the individual can begin to enjoy their pre morbid life once more.   

Medication is far from a quick fix and if you had ever experienced or known any one with clinical depression you would see that there is a place for medication.

Just for the record I don't advocate the use of medication unless necessary but I have observed the benefits of it.

Javaneh

Another deleted comment...

Yesterday I posted a comment that this young man found what is called a permanent solution to a temporary problem, and for some reason beyond rational comprehension, it was deleted.

This person may have felt that there was no way out other than this, which is even more tragic than the act of suicide itself. One of the strongest character traits of Iranians is the sense of family, which is the strongest emotional support system anyone of us can have. Where was it in this case?

Does this have to do with school? Family? Finances? Living under a regime that micromanages every part of life and will not give you a moment's peace? We don't know. What I do know is that we don't open up to trained professionals when it comes to mental and emotional health, perhaps out of stubborn pride or fear of embarrassment.

Javaneh: Chemical anti-depressants are dispensed like candy, and are only harmful in the long run. After 20 years in psychiatry you should know that better than most people. These synthesized concoctions only mask symptoms, and fail to address the root cause, and while the cause may be chemical, it's usually in conjunction with other factors. The chemical imbalance is caused by physical stresses, which may be a result of emotional issues.

They all play a role. But they're all ignored for a quick fix.

My sympathy to this boy's family, whoever they are.

Javaneh... you're right. No, Mehdi... you're right... no...

Actually there is truth to both statements... albeit with a little clarification.  Anti-depressants and/or anxiety drugs serve a great purpose whenn prescribed correctly.  Ritalin is neither one.  Ritalin is used primarily for ADD/ADHD.  Other than leaving you a little spacey, it produces no suicidal inclinations.  Other drugs have EXTREMELY different effects on adults and children.  Effexor is an example.  It DOES increase (NOT CAUSE) suicidal tendencies in children/teen agers without the same effect on adults.  Not being a medical doctor, I couldn't really tell you why but it is a fact.  Pros and cons over anti-depressants could well be a long running blog...lol.  Just like anything else, constant evaluation is necessary.  In conclusion... it's fair to say that it's a possibility but not likely that drugs were involved.  The bottom line is no one really knows what was going on inside this poor soul's head... or heart. 

Suicide... "a permanent solution to a temporary problem".

what a tragedy. Another

what a tragedy. Another victim of oppressed society. Shame on IRI.

Mehdi I dont know where

Mehdi I dont know where you get your evidence for that statement? In my 20 yr experience of working in psychiatry I have found the opposite to be true.

Another young life lost. This is trully sad.

Javaneh

Yes Lets watch Clinton instead

yes some people here are right lets not watch these clip and please do not post such a video here, lets just forget about the real problems that exist in our country and instead lets talk about what Clinton will say or do in the next few days.

Thanks jj for posting these video, it is sad but yet true, our young Iranian youth are depressed and lets find out what we must do to help them out.

It was posted. But it is MY

It was posted. But it is MY CHOICE to click to watch it or not. (and i chose not to.) But i think it has value... people, this is as much news as a series of photos of happy-go-lucky iranians at sizdeh-bedar or another parade, or an opinion piece on this or that. An I applaud JJ for his boldness and willingness to cross the line where it may seem fuzzy. This is reality people and a part of life. Exercise your judicious right to click or not to click as you see fit.

I just couldn't watch it

I guess we are too sensitive. Unbelievable. What makes a person to end his or her life. I can't understand it.

He was probably on Ritalin or some anti-depressant

Suicide and senseless violence is a well-knows result of anti-depressants.

I did not click to watch

I did not click to watch this clip due to many personal reasons, but from reading all these comments apparently it's a suicide act by a student.

My question is : WHO taped this act ? is it for real? someone is comitting suicide and one stays away just to tape the incident?

Any reply from people who watched it? please?

very sad clip

A young and bright minded life ended, for what for nothing. Suicide, depression, prostitution and drug use are on the rise all as a result of 30 years IRI's rule and dictatorship.

But I can't just blame IRII. All of us are at fault. An individual gets what it deserves in life. A society gets what it deserves as whole. We are oppressed, depressed and poor people who are afraid to speak out and believe by shutting our mouth and not defending ourselves someone from heaven will come and rescue us.

We are Shiites. Shiites believe in been victims. For centuries we made ourselves victims.

Damn me and Damn us

What's the harm

I read many comments against posting the video clip of a suicide, however, I failed to see ane good reason for it.

This video clip shows a struggling individual perhaps someone who wouldn't take his life if he had access to proper medical care. By seeing and hearing about these cases, perhaps one person among those of us that see it might be able to do something positive and that something might save a life or lives in the future ... and a that's worth it ... it is surely better than sticking one's head in snow!!

VERY disturbing

please remove.
what good does this do? we can't even understand what he says, and at the end , BOOM, he kills himself.
DO I not have enough on my mind already? Please remove.

agar fekr mikonid ke didane

agar fekr mikonid ke didane hamchin videoee zaroori nist majboor nistin ke rooye link click konid. dast az in estebdad zehnie iroonitoon bardarin va befahmid ke hamchin chiz hayi bayad tooye news bashe va dide beshe, dar zemn khanoome setareh sabety fekr nemikonam ke moghayeseye yek daneshjooye daneshgahe harvarde gharghe nemat o emkanat ba yek daneshjooye bichareye daneshgahe hamedan!!!!! zaroori mibood!!!! video ye ghamangizi bood, roohe adam ro pajmorde mikone vali bad nist ke bazi vaghta ye nim negahi ham be haghighat va chizi ke doro baremoon migzare bendazim.

i won't click on this

But I am still disturbed that you would post it. Is anything that draws attention to this site fair game for being posted?

why would you post something

why would you post something like this??? I did not even click to watch it but I wanted to make sure it was known that posting something like this makes me lose respect for this site. What is the point? What good comes out of making a spectacle out of someone else's demise? Where has your sense of decency and respect gone. The line has been crossed once again. Shame on you.

hamadan student's suicide

This was really not necessary for us to see. Maybe if it was a politically motivated suicide, but just a student gone mad over expulsion for whatever reason is really not "news" or necessary to witness. There are several suicides every year in most Universities, Harvard stopped grading freshmen because so many of them committed suicide when they did not do well, so it is not a particularly "Iranian" incident either. Just a sad clip that would be better left unexposed.
Setareh Sabety