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weirdly-specific-but-ok · 11 months ago

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WebMD Page for Aziraphale

As promised to you all, inspired by that video of Aziraphale as an antidepressant. The WebMD drug format, from your clearly deranged mascot, Asmi. This took way too much effort. For legal purposes, even though this blog is a lawless hellscape, this is a spoof. If you did like it, reblog it, maggoty loves of mine, because likes don't help visibility on tumblr, and I want everyone to be traumatised with my own specific brand of unhinged. No pressure though, be rebels muaha. That being said:

MENU > DRUGS & MEDICATIONS > AZIRAPHALE

COMMON BRAND(S): Guardian of the East Gate, Angel GENERIC NAME(S): Aziraphale

USES This medication is used to treat mood-related disorders ranging from depression to chronic loneliness and anxiety. It has also been proven effective in treatment of Compulsive Demonic Behavioural Disorder (CDBD) and Post Fall Stress Disorder (PFSD). The medication results in an overall improvement in mood (see Side Effects), morals, and lifestyle choices. This medication is sometimes described as a 'miracle-worker'. It is advisable to ensure that the correct dosage is taken at regular intervals. The doctor/God/Forces That Be may prescribe a lower dose at the start, gradually increasing frequency and amount over the course of millennia.

SIDE EFFECTS Documented side-effects include pining behaviour, severe withdrawal symptoms in case of suddenly stopping the medication, heart palpitations, stuttering or stammering, mood swings including irrational lashing out or defensive behaviour when faced with highly emotional situations, break-ups, misunderstands, obliviousness, amongst others. Despite the studies being limited to a single subject (see Crowley et. al. updated 2023) these effects are typically harmless in the long term. Life-altering effects may also be noted, including irretrievably falling in love, marriage, a positive character arc, tendencies to put oneself at risk to ensure continuation of medication, lifelong friendship, fate-defying romance and severe allergy to the idea of discontinuation of medication.

WARNINGS Casual or reckless consumption can be too fast for the medication, which will lessen its effects, leading to withdrawal symptoms. Withdrawal symptoms range from repeated indulging in CDBD and PFSD induced behaviours to alcoholism, depressive episodes, recklessness, listlessness, and prolonged car rides with no purpose. While the medication should not be consumed too fast, regularity is also advised. This is a long-term medication and not a short-term fix. Rare, short-term exposures will only worsen the side effects, withdrawal symptoms and may even reverse the drug effects.

PRECAUTIONS Ensure immortality so that the medication may be able to work its effect through the full course. Pre-existing trauma and heart conditions may require regular consultations with a therapist.

INTERACTIONS Drug interactions may change how the medication works or increase severity of side effects. This document does not include a comprehensive list of all drug interactions, please do adequate research and check instructions on the medication before proceeding with additional drugs. Aziraphale is known to have highly negative interactions with the toxin hellfire as well as the drugs Gabriel (only when sold as Supreme Archangel), Satan and Metatron (known toxin). Negative interference may occur due to most drugs from the class Heaven and Hell. Vague interference may occur with the drug class Homo sapiens.

OVERDOSE While less dangerous than withdrawal symptoms, overdose may lead to lack of personal space, miscommunication, and decrease in mood stability. Increased irritability is also common. Use with caution.

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REVIEWS (1) Effectiveness: 5 stars Ease of use: 4 stars Satisfaction: 100000000000000000000e stars

It must be noted that in the country where I live (India), advertisements for pharmaceutical drugs are legally prohibited on television and other media. Which is why I was very bewildered at the initial video. But WebMD is a universal phenomenon so this shall by my contribution to the fandom. Thank you @neil-gaiman, Good Omens has given me a lot of opportunities to exercise my brain in all the weirdest ways.

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anarchoherbalism · 6 months ago

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it's funny/sad to me how many anti-diy med people whip out their mood stabilizers or antidepressants as examples of irreplaceable pharmacueticals when actually, plants LOVE making alkaloids! Yes, there are BIG question marks in terms of keeping people alive that are scary. For example, some stopgaps exist for some types of diabetes-- therapuetic diets and mediating metabolic processes via plant-derived medicines give people much better odds of hanging on while further work towards community-based insulin production and/or alternative medications are being developed; but people are HUSTLING on insulin, HIV medication (antiretrovials), and other projects because we need more solutions NOW and ACUTELY, not just for the future.

Brain meds tho? That shits fucking gucci. On lock. Would it take YOU, PERSONALLY putting in research time and trying stuff out to land on something that works for your needs? Of course!!! Everyone taking virtually any medication goes through that process anyway! Are there direct analogs for you to switch to seamlessly from what you take now? No, you will likely have to take a different approach using different pharmacological basis--but even those bases exist already, many of them have simply been discarded in scientific research or clinical practice for reasons OTHER than their efficacy or risk* (such as socially-born risk like the war on drugs or good old market competition). AND, that's only if you are the most staunch evidence-based person out there; there's exponentially more information available if you're at all willing to experiment based on anecdotal evidence, something your doctor abso-fucking-lutely does nearly every time they customize a treatment plan, or choose between closely-related members of the same class of medication.

For most people, especially if you're starting from a place of skepticism, nobody's gonna hand you a resource you won't come up with some kind of beef with. GOOD. it means you have a critical eye. Hone that! Discard what you think is bullshit and hold on to the handful of principles in every source you think could be valuable and you will start building a base of knowledge and expertise that is practical and relevant to your own needs and context.

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c-ptsdrecovery · 2 years ago

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So, because of my problems with my antidepressants not working, I got an appointment with a new psychiatrist (the fifth? sixth? one I’ve seen over the course of my life), and I just had my first appointment with her today.

You know how great I was doing at the beginning of the year? So much energy, so much confidence, so much creativity, so much euphoria... Yeah, new psychiatrist thinks that was a hypomanic episode (and I think she’s probably right). She thinks what I have isn’t major depressive disorder, it’s bipolar 2.

Bipolar 1 is when you cycle between depression and mania. In Bipolar 2, you have at least one episode of hypomania (like mania but not as severe), and trouble with depressive episodes. The reason I had a really recognizable bout of hypomania at the beginning of the year is that if you have undiagnosed bipolar disorder and you get put on antidepressants, the antidepressants can sometimes trigger manic or hypomanic episodes. I did say that the last time I felt that good was when I first started on Effexor, so there’s definitely a pattern there. Also the time I started Wellbutrin I became FURIOUSLY angry, and anger can also be a sign of mania or hypomania. So.

It’s very common for bipolar disorder, and bipolar 2 in particular, to be misdiagnosed as depression. It can’t really be officially diagnosed as bipolar disorder until you’ve had at least one hypomanic episode that lasted at least like four days. But please note that if you start on an antidepressant and you start showing signs that might be mania or hypomania, definitely tell your doctor! Because you might have bipolar disorder instead.

Anyway, I’m starting on a mood stabilizer this week, and we’ll see how things go! More thoughts on this subject if it turns out that it actually is bipolar 2 instead of depression.

#bipolar 2 #bipolar ii #bipolar disorder #mood disorder #depression

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221bluescarf · 9 months ago

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Even though my doc said she'd be changing my diagnosis to schizophrenia I looked on my chart and it never changed from schizoaffective. She hasn't mentioned anything about the diagnosis in a long time either. I agree with this anyway, since my mood is a huge component. It's all a mess. But this is a good example of why it's good to avoid wrapping up your identity in your diagnosis. It is subject to change.

It is still important to get the right diagnosis because you can get the right treatment. Regardless of what the diagnosis says on paper right now I need a mood stabilizer and an antipsychotic and I can't take antidepressants. This is true whether my diagnosis is bipolar, schizoaffective, or schizophrenia. The bad part is when a doctor doesn't have the right diagnosis and/or doesn't take what you say or your symptoms seriously and you end up on meds you don't need or not enough meds.

I don't go around wearing my diagnosis on my t-shirt, but I do try to respect the online spaces I'm in.

Of course, some of this makes me feel like "I was right all along" in identifying my issues as schizoaffective disorder but I still respected her opinion.

#221bluescarf.txt #schizospec

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vamp1rex1c · 1 year ago

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my mom visited me today and said I look much better and calm

but of course I am, the only stress I have living in another state is uni, no family drama

besides, perhaps 4 pills of mood stabilizer, 3 of antidepressants/anxiolytics and 2 of antipsychotics are doing something

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vampsquerade · 2 years ago

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it’s late as hell in the night rn but i think i’m fine enough to come back for a bit. i’ve been put on antidepressants and mood stabilizers so for the moment i am stable and managed to take my time in writing in between my classes (W online courses they’re so easy and i finish everything in a day) so expect a lot of posts come tomorrow. and i mean a lot. thank you all for your patience, i sound like a broken record at this point but you guys caring about my mental health has kept me holding on to hope the entire time i was gone. it reminds me constantly that there are people who care, whether i’ve met them or not. sorry for also being shit at replying if you’ve dm’d me; i just sleep so much nowadays because my meds make me super sleepy and once i’m finished with work/homework i just fucking pass out. i think the most i’ve ever written when it came to working on the requests i’ve had saved i only worked on them for about two and a half hours a day…i used to write happily for five hours a day.

with this being said, requests will also be opening back up tomorrow and i think i’ll keep them open for about 4 days. so from saturday-tuesday i’ll have requests opened. i will change my rules a bit and will now add angst with a bad ending alongside angst with a good ending. please do keep your eyes open within the next coming days for multiple announcements i make. thank you all for your support and all the new followers i’ve gained in my absence—i hope all of you are doing well and if you’re not: please remember to take care of yourself and give yourself the love others give to you. it helps, i promise.

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mynoodlewillexplode · 2 years ago

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Things just still havent gotten any better medication/mental health wise. Last appointment my psychiatrist prescribed me a new antidepressant to help with the deep downs that I have been having.

Let's just say it did not go so well at all and just made me sink lower and lower into the depth of despair. Ontop of that It caused me to have 2 seizures which is a side effect of the new medication......so yay After that ordeal I completely stopped taking the meds.

I tried to call their office first thing on Monday but they said they would call me back and they never did. I stayed on the phone all day Wednesday trying to get a hold of the office till I finally got through.

After hearing what happened again they made appointment and was seen by my psychiatrist that day.

Of course that didnt go very well either. Everything she has prescribed me for depression I have nothing but side effects and bad ones at that. She seemed irritated and at a lose of what to do which was really disheartening .I already feel completely hopeless this just did not help at all....... she was not reassuring at all .

All in all we decided to up my mood stabilizer instead of adding depression meds to see how that goes.... I really dont have any hope in it, that is she doesnt know what to do as a professional then what do I do?

It's making me question everything about my mental health and my diagnoses. Is it the right one ? Am I just to far gone?

All I know is if this medication doesn't work or help and she doesnt have a next step I might have to find a new psychiatrist.....

#personal #coping #mental illness #mentally ill #bipolar

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thc2024 · 3 months ago

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Best Mental Hospital / Tulasi Healthcare

A mental hospital, also known as a psychiatric hospital or mental health facility, is a specialized institution dedicated to the diagnosis, treatment, and rehabilitation of individuals with mental health disorders. These institutions play a critical role in providing care for people who experience severe psychiatric conditions that may impair their ability to function in daily life. Mental hospitals are staffed by multidisciplinary teams, including psychiatrists, psychologists, nurses, social workers, and therapists, all working together to provide comprehensive mental health care.

The primary function of a mental hospital is to provide a safe and supportive environment where individuals can receive treatment for mental health conditions such as depression, schizophrenia, bipolar disorder, anxiety disorders, and more. These conditions can sometimes lead to behaviors that put the individual or others at risk, necessitating a controlled and structured environment. Mental hospitals offer 24-hour care, which is crucial for patients who need close monitoring or intensive treatment.

One of the core services provided in a mental hospital is psychiatric assessment and diagnosis. This process is essential for understanding the patient's condition and developing an individualized treatment plan. Patients often undergo evaluations that include interviews, psychological testing, and sometimes medical examinations to rule out underlying physical causes of psychiatric symptoms. Accurate diagnosis is vital in determining the appropriate course of treatment.

Treatment in mental hospitals typically involves a combination of medication and psychotherapy. Psychiatric medications, such as antidepressants, antipsychotics, and mood stabilizers, are used to manage symptoms and restore chemical balance in the brain. Psychotherapy, on the other hand, helps patients understand their thoughts, emotions, and behaviors. Cognitive-behavioral therapy (CBT), group therapy, and family therapy are common therapeutic approaches used in these settings. The goal is to help patients develop coping strategies, improve emotional regulation, and build healthier relationships.

Another important aspect of mental hospitals is crisis intervention. Patients admitted to these facilities are often in acute mental health crises, which may include suicidal ideation, self-harm, or violent behavior. Crisis intervention aims to stabilize the patient and prevent harm, both to themselves and others. This process often involves immediate medical attention, counseling, and short-term hospitalization to ensure the safety of the patient.

For many patients, a stay in a mental hospital is a temporary but critical step in their recovery journey. The duration of hospitalization can vary depending on the severity of the condition and the progress made during treatment. Some patients may need only a short stay, while others with more chronic conditions may require long-term care. Discharge planning is an integral part of the treatment process, as it ensures that patients receive ongoing care and support once they leave the hospital.

In recent years, there has been a shift in mental health care toward community-based treatment and outpatient services, with mental hospitals focusing more on acute care. However, they remain essential for individuals who need intensive support. Mental hospitals also play a role in destigmatizing mental illness by offering a compassionate approach to care, emphasizing the importance of mental health as part of overall well-being. Their existence underscores society’s growing recognition of mental health as a crucial aspect of human life, deserving the same attention and care as physical health.

Tulasi Healthcare is a widely renowned group of psychiatric hospital & Rehabilitation Centers in Delhi and Gurgaon, India providing specialized treatment for substance abuse disorders and mental illnesses.

#mental health #psychiatrist #mental hospital

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wahpsychiatryclinic · 4 months ago

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Mood Disorder vs Personality Disorder/Wah Psychiatry Clinic

When navigating the complex landscape of mental health, it's crucial to distinguish between mood disorders and personality disorders. Although these conditions may share some overlapping symptoms, they stem from different psychological roots and require distinct approaches to treatment. Understanding the difference between mood disorder and personality disorder is key to effective diagnosis and management. Are you or someone you care about dealing with a mental illness? You have to consider Wah Psychiatry Clinic for your mood disorder and personality disorder.

What Are Mood Disorders?

Mood disorders are a category of mental health conditions that primarily affect an individual's emotional state. People with mood disorders experience persistent feelings of sadness, happiness, or fluctuations between the two. These disorders can have a significant impact on daily life, affecting relationships, work, and overall well-being. Common types of mood disorders include:

Major Depressive Disorder (MDD): Characterized by prolonged periods of intense sadness or lack of interest in life.

Bipolar Disorder: Involves episodes of depression alternating with periods of mania or hypomania, which include elevated mood and increased activity levels.

Cyclothymic Disorder: A milder form of bipolar disorder with less severe mood swings.

Persistent Depressive Disorder (PDD): Also known as dysthymia, it is a chronic form of depression lasting for at least two years.

These conditions illustrate the mood instability often seen in mood disorders. The primary issue in mood disorders is the individual's fluctuating mood, which can range from extreme highs to severe lows. These fluctuations are more than just typical emotional responses and can significantly impair one's ability to function.

What Are Personality Disorders?

Personality disorders, on the other hand, are a group of mental health conditions characterized by enduring patterns of behavior, cognition, and inner experience that deviate significantly from the expectations of the individual's culture. These patterns are inflexible, pervasive, and lead to distress or impairment in social, occupational, or other areas of functioning. Key types of personality disorders include:

Borderline Personality Disorder (BPD): Marked by instability in moods, behavior, self-image, and functioning, often leading to impulsive actions and chaotic relationships.

Narcissistic Personality Disorder (NPD): Involves a long-term pattern of exaggerated self-importance, need for admiration, and lack of empathy for others.

Antisocial Personality Disorder (ASPD): Characterized by a disregard for the rights of others, deceitfulness, impulsivity, and often criminal behavior.

Avoidant Personality Disorder: Involves extreme shyness, feelings of inadequacy, and sensitivity to rejection.

The core issue in personality disorders is deeply ingrained, maladaptive patterns of thinking and behaving. These disorders are not simply about mood fluctuations; they are about a person’s overall personality functioning. Personality in psychiatry refers to these enduring traits that can make relationships and functioning difficult.

Mood Disorder vs Personality Disorder: The Key Differences

One of the most significant differences between mood disorders vs personality disorders lies in their onset and course. Mood disorders often present as episodic, meaning the symptoms can come and go or fluctuate over time. Personality disorders, however, tend to be more stable and enduring, manifesting as long-term patterns of behavior.

Mood disorders are often associated with chemical imbalances in the brain, particularly in neurotransmitters such as serotonin and dopamine. These imbalances can lead to prolonged periods of depression, mania, or mixed states. Treatment for mood disorders typically involves a combination of medication, such as antidepressants or mood stabilizers, and psychotherapy.

In contrast, personality disorders are more likely to develop due to a combination of genetic predisposition, early life experiences, and environmental factors. They represent an ingrained way of interacting with the world that can be difficult to change. Treatment often involves long-term psychotherapy aimed at addressing the underlying patterns of behavior, thoughts, and feelings.

Mood Instability and Its Role in Psychiatry

Mood instability is a hallmark of several psychiatric conditions, particularly mood disorders. However, it can also be present in personality disorders, especially in conditions like Borderline Personality Disorder. The difference between mood disorder and personality disorder can sometimes be challenging to discern because of this overlap in symptoms.

For instance, someone with Bipolar Disorder might experience mood swings that could be mistaken for a personality disorder. Conversely, a person with Borderline Personality Disorder might exhibit mood instability that mimics a mood disorder. This is why a comprehensive psychiatric evaluation is essential for an accurate diagnosis.

Signs of Mood Disorders and Personality Disorders

Recognizing the signs of mood disorders is crucial for seeking timely help. Common symptoms include:

Persistent feelings of sadness or low mood

Loss of interest in activities once enjoyed

Significant changes in appetite or weight

Sleep disturbances (insomnia or hypersomnia)

Fatigue or low energy

Feelings of worthlessness or excessive guilt

Difficulty concentrating or making decisions

Thoughts of death or suicide

Mood disorder signs can vary in intensity and duration but generally represent a significant departure from an individual's baseline mood.

In contrast, signs of personality disorders might include:

Persistent difficulties in relationships

Unstable or distorted self-image

Chronic feelings of emptiness

Impulsivity and risky behavior

Inflexible thinking patterns

Intense and unstable emotions

A pervasive sense of mistrust or paranoia

These signs reflect the deep-seated nature of personality disorders, where the individual's way of thinking, feeling, and behaving is consistently problematic across different areas of life.

Personality vs Mood Disorders: A Summary

In summary, the difference between personality disorder and mood disorder can be understood through the lens of stability and persistence. Personality disorders involve long-standing patterns of behavior that are pervasive across many areas of life, while mood disorders are more episodic and primarily affect an individual's emotional state.

Understanding these distinctions is essential for effective treatment and management. Whether dealing with a mood disorder or a personality disorder, seeking professional help from a psychiatrist or therapist is crucial. At Wah Psychiatry Clinic, we specialize in diagnosing and treating both mood and personality disorders, helping individuals achieve stability and improve their quality of life.

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neustartpsychiatry · 4 months ago

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Common Myths About Psychiatric Medication in Salem

Psychiatric medications can be life-changing for those managing mental health conditions, but they are often surrounded by misconceptions and myths. These misunderstandings can prevent people from seeking the help they need or cause unnecessary fear and hesitation about starting treatment. Here, we’ll debunk some of the most common myths about psychiatric medication and explain how medication management in Salem can support your mental health journey.

1. Myth: Psychiatric Medications Will Change Who You Are

One of the most pervasive myths is that psychiatric medications will alter your personality or change who you are fundamentally. This misconception can be a significant barrier for those considering medication.

The Truth: Psychiatric medications are designed to help balance brain chemistry and reduce the symptoms of mental health conditions like depression, anxiety, and bipolar disorder. The goal is to help you feel more like yourself, not to change who you are. Effective psychiatric medication management focuses on finding the right balance so that you can live your life to the fullest without being hindered by symptoms.

2. Myth: You’ll Become Dependent on Medication

Another common myth is that taking psychiatric medication will inevitably lead to dependency or addiction. This belief can make people hesitant to start or continue with their prescribed treatment.

The Truth: While some medications, such as certain anxiolytics, can carry a risk of dependence if misused, most psychiatric medications, including antidepressants and mood stabilizers, are not addictive. These medications are intended for long-term use to manage symptoms effectively. Psychiatric medication management involves careful monitoring by healthcare providers to ensure that medications are used safely and appropriately.

3. Myth: Psychiatric Medications Are a Sign of Weakness

Many people believe that taking psychiatric medication is a sign of personal weakness or that they should be able to manage their mental health without medication. This stigma can prevent individuals from getting the help they need.

The Truth: Mental health conditions are medical issues, just like diabetes or high blood pressure. Taking medication to manage your mental health is not a sign of weakness but a proactive step toward wellness. In fact, it takes strength to acknowledge that you need help and to take the necessary steps to improve your health. Psychiatric Medication Management Salem provides the support and guidance needed to navigate this aspect of treatment with confidence.

4. Myth: Once You Start Taking Medication, You’ll Be on It for Life

Some people fear that once they start taking psychiatric medication, they’ll be dependent on it for the rest of their lives. This myth can cause hesitation in starting treatment.

The Truth: The duration of psychiatric medication use varies depending on the individual and their specific condition. Some people may need medication for a short period, while others may require long-term treatment. Your healthcare provider will work with you to regularly assess your needs and determine the best course of action. If appropriate, they may gradually reduce your medication under close supervision. Regular check-ins are a key part of psychiatric medication management to ensure that your treatment plan evolves with your needs.

5. Myth: Psychiatric Medications Have Too Many Side Effects

Another common concern is that psychiatric medications come with too many side effects, making them not worth taking.

The Truth: While all medications can have side effects, not everyone experiences them, and many side effects are temporary or manageable. It’s important to discuss any concerns with your healthcare provider, who can adjust the dosage or try a different medication if side effects become problematic. The goal of psychiatric medication management Salem is to find a treatment plan that offers maximum benefit with minimal side effects, allowing you to feel better without compromising your quality of life.

Conclusion

Understanding the truth about psychiatric medications is essential for making informed decisions about your mental health care. By debunking these common myths, we hope to encourage more people to seek the help they need without fear or hesitation. Psychiatric medication, when managed properly, can be a vital tool in your mental health journey.

If you have concerns about psychiatric medication or need expert guidance, consider reaching out to NeuStart Psychiatry. Their experienced team specializes in psychiatric medication management in Salem and is dedicated to helping you find the best treatment options for your unique needs.

#Online Psychiatry Services #Get Psychiatric Medication Online #Psychological Assessment Near Me #Mental Health Telehealth #Psychiatric Medication Management Salem

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kayleegibsons · 6 months ago

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Experience Advanced Healing with Ketamine Therapy in Irvine

In recent years, the field of mental health treatment has witnessed a promising advancement with the introduction of ketamine therapy. This innovative approach offers a new avenue for individuals struggling with severe depression, anxiety disorders, and other mental health conditions that have proven resistant to traditional treatments. Among the cities embracing this progressive Ketamine therapy is Irvine, where individuals are finding renewed hope and relief from their persistent mental health challenges.

What is Ketamine Therapy?

Ketamine is primarily known as an anesthetic used in medical settings, but its potential for treating mental health disorders has garnered significant attention. Ketamine therapy involves the administration of controlled doses of ketamine under medical supervision, typically through intravenous infusion or sometimes through nasal sprays or oral tablets. Unlike conventional antidepressants that may take weeks to show effects, ketamine often produces rapid results, sometimes within hours or days.

Mechanism of Action

The exact mechanism by which ketamine alleviates symptoms of depression and other mood disorders is still under study. However, it is believed to work by targeting neurotransmitters in the brain, particularly glutamate, which plays a crucial role in neural communication and mood regulation. Ketamine's rapid effects are thought to involve the restoration of synaptic connections and the growth of new brain cells in areas associated with mood and emotion.

Conditions Treated with Ketamine Therapy

Ketamine therapy has shown promising results in treating various mental health conditions, including:

Treatment-Resistant Depression: For individuals who have not responded to multiple antidepressant medications, ketamine can provide rapid relief and potentially long-lasting benefits.

Anxiety Disorders: Including generalized anxiety disorder, social anxiety disorder, and PTSD (Post-Traumatic Stress Disorder), ketamine therapy may help reduce anxiety symptoms quickly.

Bipolar Disorder: Ketamine has demonstrated efficacy in stabilizing mood swings associated with bipolar disorder, offering an alternative or adjunct to traditional mood stabilizers.

The Experience of Ketamine Therapy in Irvine

In Irvine, ketamine therapy is offered in specialized clinics under the care of trained medical professionals. These clinics provide a supportive environment where patients can undergo treatment in a safe and comfortable setting. The therapy typically involves an initial consultation to assess the patient's medical history, current symptoms, and suitability for ketamine treatment.

Treatment Process

Initial Assessment: Patients undergo a comprehensive evaluation to determine if ketamine therapy is appropriate for their condition. This assessment may include a review of medical history, psychiatric evaluation, and sometimes psychological testing.

Treatment Sessions: Ketamine is administered in a controlled environment, often as a series of sessions spaced over several weeks. During the session, patients are monitored closely to ensure safety and efficacy.

Monitoring and Adjustments: Throughout the treatment course, medical professionals monitor the patient's response to ketamine and may adjust the dosage or frequency of sessions to optimize outcomes.

Benefits of Ketamine Therapy

The benefits of ketamine therapy extend beyond its rapid onset of action. Patients undergoing ketamine treatment often report:

Quick Relief: Many individuals experience significant symptom relief shortly after beginning ketamine therapy, which can be life-changing for those who have struggled with severe and persistent symptoms.

Reduced Suicidal Thoughts: Ketamine has been noted for its ability to quickly reduce suicidal ideation in patients with severe depression, providing crucial support during acute crises.

Longer-Term Effects: While initial treatments may provide relief for weeks to months, some patients experience prolonged benefits with maintenance or booster sessions as recommended by their healthcare providers.

Considerations and Safety

Despite its promising results, ketamine therapy is not without considerations:

Side Effects: Common side effects include dissociation, dizziness, and nausea, which are typically mild and transient. These effects are closely monitored during treatment sessions.

Patient Selection: Ketamine therapy is generally reserved for individuals who have not responded to conventional treatments or who require rapid relief due to the severity of their symptoms.

Conclusion

Ketamine therapy represents a significant advancement in the treatment of severe depression, anxiety disorders, and other mental health conditions. Its rapid onset of action and potential for long-lasting relief offer hope to individuals who have struggled with treatment-resistant symptoms. In Irvine, as in many other cities, specialized clinics provide a supportive environment where patients can undergo this transformative treatment under the care of experienced medical professionals. As research continues to explore its mechanisms and benefits, ketamine therapy stands as a beacon of hope for those seeking advanced healing beyond traditional approaches.

#Ketamine therapy is Irvine

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aaronanthonywohl · 1 year ago

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Navigating the Maze of Mental Health: An Insight into 7 Prominent Mental Disorders

Mental health is a vast and intricate domain that encompasses various conditions and challenges that individuals may encounter. Among these, seven major mental disorders stand out as significant contributors to the complexity of human psychology. In this article, we embark on a journey to explore these disorders, gaining a deeper understanding of their nuances, symptoms, and treatment options. Shedding light on these disorders is essential for raising mental health awareness and fostering empathy and support for those who face them.

Major Depressive Disorder (MDD)

Major Depressive Disorder, commonly known as depression, is a widespread mental health condition that casts a shadow over millions of lives. It is characterized by prolonged periods of intense sadness, feelings of hopelessness, and a loss of interest in or pleasure in once-enjoyed activities. MDD often comes with physical symptoms like changes in appetite, sleep disturbances, fatigue, and difficulties concentrating. Left unaddressed, depression can lead to suicidal thoughts and actions.

The treatment landscape for MDD includes psychotherapy, medication, or a combination of both. Psychotherapy helps individuals identify and cope with the underlying causes of their depression, while medication aims to rebalance neurotransmitter levels in the brain.

Generalized Anxiety Disorder (GAD)

Generalized anxiety disorder is a relentless companion for those who suffer from it. It manifests as excessive, uncontrollable worry about a myriad of events and activities, often accompanied by physical symptoms like restlessness, muscle tension, and sleep disruptions. This chronic anxiety can erode one's daily life, affecting work, relationships, and overall well-being.

To address GAD, mental health professionals typically employ cognitive-behavioral therapy (CBT) and medication, including anti-anxiety drugs or antidepressants. These interventions empower individuals to manage their anxiety and develop healthier coping mechanisms.

Schizophrenia

Schizophrenia is a complex mental disorder that challenges both individuals and their loved ones. It disrupts thinking, emotions, and behavior, presenting symptoms such as hallucinations (false sensory perceptions), delusions (false beliefs), disorganized thinking, and impaired social functioning. While the onset usually occurs in early adulthood, the course of the illness varies from person to person.

Effective treatment for schizophrenia often combines antipsychotic medications and psychotherapy. Rehabilitation programs also play a crucial role in helping individuals with schizophrenia build life skills and enhance their quality of life.

Bipolar Disorder

Bipolar disorder, formerly known as manic-depressive illness, is a rollercoaster of emotions that swings between manic or hypomanic episodes and depressive lows. During manic phases, individuals experience heightened energy, impulsivity, and an inflated sense of self-importance, while depressive episodes bring profound sadness and hopelessness.

Management of bipolar disorder typically entails mood-stabilizing medications, like lithium, coupled with psychotherapy. Keeping the disorder in check is paramount to preventing severe mood fluctuations and mitigating associated risks.

Obsessive-Compulsive Disorder (OCD)

Obsessive-Compulsive Disorder is an anxiety disorder characterized by intrusive, unwanted thoughts (obsessions) and repetitive behaviors or mental rituals (compulsions) performed to alleviate distress. While these compulsions may offer temporary relief, they can consume an inordinate amount of time and disrupt daily routines.

The most effective treatment for OCD is cognitive-behavioral therapy, particularly exposure and response prevention (ERP). Medications, such as selective serotonin reuptake inhibitors (SSRIs), may be prescribed to alleviate specific symptoms.

Post-Traumatic Stress Disorder (PTSD)

Post-Traumatic Stress Disorder emerges from the ashes of traumatic experiences such as combat, sexual assault, natural disasters, or accidents. Symptoms encompass flashbacks, nightmares, severe anxiety, and avoidance of situations that trigger memories of the trauma. PTSD can shatter one's life, impairing functioning and inducing emotional turmoil.

Treatment for PTSD centers around psychotherapy, including cognitive-behavioral therapy (CBT) and eye movement desensitization and reprocessing (EMDR). Medications like antidepressants and anti-anxiety drugs may also be prescribed to address specific symptoms.

Borderline Personality Disorder (BPD)

Borderline personality disorder is a tumultuous sea of emotions, self-image fluctuations, and rocky relationships. Individuals with BPD often grapple with intense mood swings, an overwhelming fear of abandonment, impulsive behaviors, and a propensity for self-harm. Building and maintaining stable relationships can be a herculean task for those affected.

Dialectical Behavior Therapy (DBT), a specialized form of therapy, is a primary approach to BPD treatment. This therapy empowers individuals to regulate their emotions, manage impulsivity, and sharpen interpersonal skills. Medications may also be prescribed to address specific symptoms or co-occurring conditions.

Mental disorders are intricate and multifaceted challenges that demand attention and compassion. The seven major mental disorders—major depressive disorder, generalized anxiety disorder, schizophrenia, bipolar disorder, obsessive-compulsive disorder, post-traumatic stress disorder, and borderline personality disorder—offer a glimpse into the diverse range of hurdles individuals may face.

Recognizing that these disorders are treatable is pivotal, and early intervention can pave the way to brighter outcomes. By seeking assistance from mental health professionals and extending support to those wrestling with these conditions, we can contribute to the advancement of mental health awareness and the dismantling of stigma. Through understanding and empathy, we can collectively foster a more caring and supportive society for all.

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eligalilei · 1 year ago

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'Bipolarity' and Med Reactions

Q: I had a manic reaction to an SSRI, and now my doctor wants to put me on a mood stabilizer? Is this justified, or even necessary? A: People act as if there's only one or a small set of types of 'bipolarity' or propensities for mania. People have highly variable susceptibilities for all kinds of states, and in the right conditions, one can be pushed to manifest, sometimes DSM-perfectly, nearly any pathology, with almost any degree of permanence. Of course, the overriding concern here, in practice, should be diathesis, not essence, and many are so distant from various sets of pathologies as for them not to be relevant.... but one can always have a really weird or traumatic year. Having certain kinds of activating reactions might be indicative of being near the edge of mania for some people.... others, I think, just react that way to SSRIs. So, like, reason to pause, but unless you absolutely need an antidepressant, one possible way to deal with this might just be not taking things that can cause mania. That said, you and your doctor are looking at this with more information, so it could very well be warranted, but just having a drug reaction in itself isn't necessarily grounds for a stabilizer being totally necessary, though, again, there could be other reasons. Also worth mentioning that depending on doses and variables, it could be a good add, in that it might both augment the antidepressant, lithium being a good example of this, or just make it more tolerable. An aside: I do not, under ordinary, or even many extraordinary, circumstances, become manic. ....but it has happened to me twice. Extreme fasting, sleep deprivation, drug use, trauma... can all serve as triggers, especially stacked. This said, there are many, many, things in psychiatric menagerie which 'kindle'. It may be said that many or most pathologies consist of a change to the potential topography, such that paths become worn, and form attractors and gravitational systems. This is especially relevant when the states become reinforcing, or give some kind of satisfaction, which changes the shape of space.

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inspirehealthandspirit · 1 year ago

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Sleep - 10 Tips for Falling Asleep

Sleep - it's what you need. You know you need sleep but can't get enough of it. Or maybe you think you're good with only getting 3-4 hours of sleep a night. After all, you can still function the next day, right? It wasn't until recently that I realized how important sleep really is for your health and wellness. It's more than just sleeping so you can rest. It is about having energy, thinking clearly, allowing your body to heal overnight, being in a better mood when you wake up, noticing you don't need to harm people who wake you up. 😉 Sure, you can take things for sleep assistance, but why not go the more natural route. It may be a little hard to start sleep training, but it will be worth it. Learn how to do sleep training in my online course here. March is National Sleep Awareness month; who knew? How fitting to discuss it now? Dr. Teralyn Sell, Psychotherapist and brain health expert, shares 5 great foods to keep in your stomach to help with drowsiness and improve sleep quality. “Sugar and alcohol negatively impact sleep due to the sharp rise and fall of blood sugar levels. You will notice that you will not sleep deeply or become ‘awake’ at 2 am (or just too early for your liking) because of the adrenaline rush due to reactive hypoglycemia. Additionally, though alcohol might help you fall asleep, it also disrupts every sleep phase causing you to not sleep deeply,” says Dr. Teralyn. Here are Dr. Teralyn Sell’s top 5 foods to help promote a better nights sleep naturally: Food #1: Collagen Protein Proteins such as collagen protein and poultry, have amino acids that break down into tryptophan. Tryptophan eventually creates serotonin and then melatonin which helps you sleep. Protein that is consumed before bed also helps to stabilize blood sugar keeping you asleep all night. Food #2: Chamomile tea Chamomile is a calming herb that has been shown to help with insomnia or disturbed sleep. It has been studied and found to be an anxiolytic and an antidepressant. Adding a bit of raw honey can add a layer of protection since honey has been linked to supporting the immune system. Food #3: Dark Chocolate For my chocolate lovers, this one's for you all so you don’t have to feel as guilty when you realize that half the box is gone. Dark chocolate is rich in magnesium. Magnesium is a natural relaxer. Taking a magnesium supplement before bed or soaking in Epsom salts can help you relax before bed and fall asleep easier. Magnesium has also been shown to help reduce restless leg syndrome which can impair sleep. Food #4: Tart Cherries Several research articles have been published that link drinking tart cherry juice to improved sleep. Tart cherries have a concentration of melatonin, a hormone that helps regulate circadian rhythm and can help to promote healthy sleep. Food #5: Oatmeal Oatmeal is a great meal to have for the plethora of health benefits that it provides outside of sleep. However, for our specific topic, oatmeal is considered an anxiolytic, which can be very calming and help you relax before bed. It can also help to stabilize blood sugar levels so you can experience a restful night’s sleep. Dr. Sell goes on to conclude by saying, “Caffeine impacts sleep starting in the morning. Caffeine is a stimulant that dampens your adrenals (you know the organ that helps you manage stress) Drinking 1 cup of caffeine 6 hours before bed reduces your deep sleep by 1 hr. Caffeine has a half-life of 3-5 hours. This means that if you start drinking caffeine in the morning, you will likely still have caffeine in your system as you try to sleep.” In addition to Dr. Sell's 5 Foods for Better Sleep, I recommend trying the following non-food-related techniques. Learn about the different sleep stages for Quality Sleep. Earthing/Grounding If you are unfamiliar with grounding, you can read about it here and learn how to use it for better sleep. Total Body Deep Breathing You can learn how to do this breathing in my Health and Wellness course. When I explain how to do this technique, it works like a charm and will put you fast asleep. Regulate Room Temperature This may seem obvious or perhaps not. But make sure your room is at the right temperature to feel comfortable falling asleep. Even if you're the slightest bit hot, you'll wake up or toss and turn all night trying to get comfortable. Everyone is different, so find the right temp for you. I prefer a slightly cool, almost cold room. Snuggle under the blankets, and I'm fast asleep. I cannot get comfortable or fall asleep if it's even remotely warm. Then I'm just miserable. So you know what you prefer, so make sure you have the right temp set to go at bedtime. Practice Stillness/Meditation/Grateful/I am statements While lying quietly in your bed, close your eyes, take three deep breaths, and become still. You can now practice saying three things you are grateful for that day. Take time to reflect on your day and find the things big or small that you are grateful for. Say them to yourself. (Lights should be off BTW-you're trying to fall asleep here and phones are put away too). In addition to stillness and gratitude, you can also practice saying your I am statements. Even more powerful is practicing I Am statements before getting out of bed in the morning. Do your best not the think too hard about these things. Your goal is to relax your mind and focus on positive feelings and not your to-do list. This way, you relax and eventually drift off to sleep. All while still practicing deep breathing. Lavender Essential Oil Rub lavender essential oil on your chest midline and lay down and take deep breaths and begin to relax. By placing it on your chest you can inhale the scent while taking deep breaths. Lavender is well known for its relaxation benefits. Check out all the other uses for lavender here. There are many tips and tricks to falling asleep. But the goal is to get enough QUALITY sleep. Undisturbed sleep. Waking up ten times a night to roll your partner over because of their loud snoring is not quality sleep. Trust, I know. Do what you have to do to get the sleep health you need and deserve. After a few nights, even weeks of uninterrupted and quality sleep, and you will never go back to sleeping any other way. You will appreciate and notice how much your attitude and well-being are linked to your sound sleeping. I wish you peace and guidance on your sleep journey. Take care and be well. Read the full article

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niftynightmare · 2 years ago

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Jim Phelps September 22, 2014 Hormones, Meds

High-Dose Thyroid Hormone As a Mood Stabilizer in Bipolar Disorder

This webpage describes the use of thyroid hormone as a treatment for rapid cycling bipolar disorder. If you did not arrive from my main page on Thyroid Hormone and Bipolar Disorder, you could start there for some basics about this hormone and why it is relevant for this illness.

To summarize the information below: several independent research groups have been studying this treatment approach. The results are not conclusive, primarily because we need several more studies to confirm the initial results. Only one so far is a “randomized trial” comparing results versus a placebo treatment. But the results so far are quite promising, and the risk levels appear to be very low, so this approach is worth at least knowing about. For patients who have tried many other approaches, this represents one more alternative. Because the risks appear to be so low, it might even be worth considering early in the usual progression through standard mood stabilizer medication options. More data on its effectiveness would be nice, of course.

This high-dose approach has been described by a research group which has done most of the investigations, in a review article which provides a nifty summary if you are trying to get references to your doctors. Because otherwise your job will be quite difficult in this respect, I have taken the liberty of giving you a direct link to this document, which follows my summary below. All errors in interpretation are my responsibility. (If anyone objects to my having made this paper available in this fashion, please let me know and I will remove the link.)

The Hardest Evidence: a randomized trial

The only randomized trial of this approach was published in early 2014.Stamm Bottom line: high-dose thyroid was better than placebo, but only in women, not in men. And (very satisfying, I’d been nursing this hunch for years) it worked better in women who started the trial with a high TSH. This is hard evidence, because of all the work it took to produce this study with no big money behind it. At the rate it took to get these data, we’ll not likely seen another study like this for quite a while.

Skip to the next section, Who Might Benefit, unless you really want the details of this study.

Here are their results, first for women and men together; then for women only, then men only. Note the remarkable placebo response among the men, wiping out any difference with thyroid. When men’s results are mixed with the women’s, the men’s placebo response limits the “statistical significance” of the results in the overall group (A).

HighDo1

HighDo2

HighDo3

There are plenty of quibbles possible here. First, the sample size is so small, maybe that’s why the results are not more strikingly significant. Imagine what these results might look like if the authors had been able to recruit hundreds of patients, as was done in the (industry-supported) study of quetiapine. Looks to me like the trend here is very strongly positive, just as quetiapine was; the lack of “statistical significance” can be attributed to the small sample size — as long as one presumes that a larger sample would have shown the same pattern of results.

The dosing: 100 mcg daily in week 1, 200 mcg/day in week 2, 300 mcg/day in week three to six. (Really). Patients were all on mood stabilizers, optimized by blood level; over half were also on antidepressants.

Negative effects: of the 31 subjects receiving thyroid, one had mild hyperthyroidism, one got a rash, and one became manic. None had ECG changes, increases in blood pressure, nor weight loss.

Conclusion: at least in women, this strategy has been shown to be superior to placebo in a randomized trial. Based on these new data, but also on some complex thyroid physiology, the authors are much less enthusiastic about the likelihood of response to this treatment in men.

Who might benefit?

Most of the open-trial data on this treatment approach has focused on patients with rapid cycling bipolar disorder. The Berlin randomized trial described above focused on bipolar depression. Treatment-resistant” depression, whether bipolar or unipolar (a very difficult distinction in this group of patients), may also respond to this approach.

What are the risks, and side effects?

Surprisingly, this approach is generally tolerated very well. You would think that people would become hyperthyroid, which would lead to the following symptoms:

heat intolerance (hot when others are comfortable, sweating when no one else is, wearing fewer clothes than others)

loose stool or diarrhea

irregular menses

tremor

feeling “wired” or agitated

increased resting pulse rate

But that does not seem to happen for patients who do well with this approach. Pulse rates to go up, generally about 10-20 beats per minute. Some minor symptoms from the above list were noted by some patients, but not to the point of requiring a treatment change. The researchers note that in patients who do not have bipolar disorder, high-dose thyroid would be expected to produce

substantial levels of these symptoms.

Heart risk

Becoming hyperthyroid on your own, because your thyroid gland is not working properly, has been associated with an increased frequency of an abnormal heart rhythm called “atrial fibrillation”. This is not lethal, but it is uncomfortable. Heart pumping capacity decreases by about half, and people feel quite strange. They often go to the emergency room, where generally this abnormal rhythm can be corrected.

But does taking thyroid hormone cause this same increased frequency of atrial fibrillation? in other words, does it make a difference, when the thyroid hormone comes into your body from the outside, instead of when you make it (due to a hyperthyroid state) from the inside? This is not known. All we can say at this point is that in following the patients who are using this high-dose thyroid approach, the researchers have not seen episodes of atrial fibrillation. Of course, at this point they may not have seen enough patients to catch the few cases which might arise from this treatment, so we cannot yet say that thyroid hormone from the outside is different in this respect.

Bone risk

To reiterate from my Basics page:

Risk #2, Bone: This only applies if you stay on high doses of thyroid treatment, presumably because you and your doctor have decided that the treatment is working really well. If you try the treatment and conclude in a month or two that it is not working, this risk is not an issue. A risk that has been associated with staying hyperthyroid due to an overactive thyroid gland is osteoporosis — loss of calcium in your bones, with a risk of fractures, especially when you get older.

But so far, In a 5-year follow-up of patients being treated with high doses of thyroid hormone for bipolar disorder, this was not a problem. Bone density decreased, because the average age in this study was 50, and we all are going down at that age (so to speak; it’s the voice of experience…). But there was no more bone loss than was seen in people of the same age and gender who were not being treated.Ricken

A massive review of high-dose thyroid treatment and bone density also concluded that the risk is either non-existent or at least lower than that of multiple other common treatments for bipolar disorder.Kelly For more see details of bone risk in thyroid treatment.

Agitation

Once in every 15 or 20 patients or so it seems that even low doses of thyroid hormone cause a feeling of agitation and muscle tension and anxiety. This goes away when the dose is lowered or the thyroid is stopped; it takes about 3-4 days to fade away. Very unpleasant. This is a short-term risk I now warn my patients about. I’ve seen it even when the patient’s TSH is quite high, meaning we’re not seeing this agitation because the thyroid dose is “too high”. For example, one patient has a TSH around 4 and cannot take even one quarter of a 25 mcg T4 pill without getting this agitation thing. I have several patients like that.

A case reportRao describes a patient who had agitation and depression at the same time, associated with being hyperthyroid (symptoms resolved when her own thyroid hormone production was lowered). So it seems that in addition to inducing hyperthyroid symptoms, high doses of thyroid hormone could induce a “mixed state”, or something like it. Unfortunately, mixed states are relatively common in people with rapid cycling, the very ones who might theoretically benefit from the high-dose thyroid strategy. Neverthelss one must keep in mind the possibility that if a person is on the high-dose approach and having “mixed state” symptoms, this could be from the thyroid dose.

Tests to do before starting

Several groups of patients would not be suitable for this treatment approach, and so must be sought before treatment begins. These include:

High thyroid levels (hyperthyroid)

Cardiac history (previous heart attack, severe high blood pressure, previous abnormal rhythms, low cardiac output (“heart failure”))

Pregnancy or breast-feeding

Already low bone density, or age greater than 70, or dementia

The researchers also recommend some procedures which may require modification for use in the real world, as opposed to a research setting. For example, they recommend a measure of bone density (an expensive test) before treatment begins, whereas I think it makes more sense to limit this to women who have other reasons for concern about bone density, or at least those who do so well on the treatment that it will be continued long-term. An electrocardiogram is recommended for patients with a history of heart rhythm problems, and a consultation with an endocrinologist/internist for patients with a history of thyroid abnormalities.

Doses used for starting

Which form: T3 or T4?

As you know (if you don’t, read my Thyroid Basics page), there are two forms of thyroid hormone, T3 (triiodothyronine, liothyronine/Cytomel) and T4 (levothyroxine). Both of them have been used in this “hypermetabolic” treatment of bipolar depression. The randomized trial referred to above used T4. You could assume that because this has been the form which has been more widely used in research (namely the UCLA group and their spin-offs), that is the form which should be considered for this approach in the hands of most average psychiatrists.

However, a remarkable pioneer, Dr. Tammas Kelly, in Colorado, has gathered a huge number of patients that he has treated with the other form, T3. He is carefully analyzed the results achieved with this approach, and published them a well respected psychiatric journal (Journal of Affective Disorders).Kelly He clearly has one of the largest patient samples ever studied with this approach.

While I have generally used T4, following the UCLA approach, Dr. Kelly is strongly in favor of T3. There has never been a direct comparison of the 2 approaches. T3 has some significant advantages. Indeed, a recent large federally funded study found T3 better than lithium for treatment-resistant major depression: same degree of benefit, with less side effects and need to discontinue on that basis.STAR*D

So, which one to use? at this point, it’s rather a toss-up. If you saw Dr. Kelly, he’d give you T3. If you saw me, I’d give you T4, because that’s the one I have more experience with.

T4 doses (the UCLA review description)

Starting Dose(mcg per day) Dose Increase(mcg/day)

Normal thyroid(TSH in the normal range) 100 100/week

“Subclinical” hypothyroidism”(TSH elevated) 25-50 Slow*

Overt hypothyroidism(TSH elevated, T4/T3 low) 25-50 Slow*

*reach euthyroid status in 6-8 weeks

Lab tests during follow-up

In this high-dose approach, think about what will happen to TSH. If you followed the story about TSH lab result interpretation (How is Thyroid Measured?, here), you will understand that high dose thyroid treatment drives TSH down to very low levels, zero or close to zero. When starting this treatment, everyone should be prepared to see the TSH go that low. This should not be a surprise, and it should be accepted as part of the plan.

What about the other lab tests, like the T4 level, or T3 level? In the article linked below, the researchers with the most experience using this approach recommend allowing an increase in T4 up to 150% of the starting T4 level. In a personal communication, one of the researchers talked in terms of “150% of the upper limit of normal“, which is obviously likely a little higher number. As for T3, if we had our good reliable measure of this one hormone, especially one that was cheap, this might be the best marker of all, as it is closer to what might be the important physiological endpoint. The researchers point out that if this one is not elevated, perhaps the patient is not really hyperthyroid?

To summarize this issue: there is no accepted laboratory marker indicating the upper limit of this process if the patient him or herself does not have signs or symptoms of hyperthyroidism. This is still being worked out in research. Obviously what matters is to prevent bad outcomes that might be associated with “too high a dose”. But how can we say what it is too high, except based on bad outcomes or on some understanding of the physiology? (as you’ll see below, not much of the relevant physiology is understood)

Think about it this way: if the patient does not have signs and symptoms of hyperthyroidism, but the laboratory studies are in the “hyperthyroid” range, who is correct — the lab results, or the patient? It is such a person really “hyperthyroid”? Is she or he really at increased risk of atrial fibrillation and decreased bone density?

Remember, these risks were originally recognized in patients who were “naturally hyperthyroid”: they were made hyperthyroid by their own gland, not by someone giving them thyroid hormone. We do not yet know if high-dose thyroid creates the same risks, presuming that the patient is not symptomatic. For now, I think we can summarize by saying that there is no consensus on how to judge how much thyroid hormone is too much. Going to 300 mcg, as used in the randomized trial in Berlin, seems a reasonable upper limit for now. In cases where many other approaches have been tried, going to 400 mcg or even a little higher seems justifiable. I personally will be using “T4 up to 150% of the upper limit of normal”.

If this seems radical, or daring, or even “Western cowboy style” medicine, think about the kinds of risks to which we expose patients when we use a medication that has just been approved by the FDA. How shall we define the upper limits of acceptable treatment? What are the risks of going to that level, or beyond? how much risk are we taking just getting to levels that manufacture has already deemed acceptable? When a medication is new, these are almost completely unknown — perhaps even more unknown than the risks of the thyroid approach discussed here.

How does this work?

Seems like a strange idea, using these high doses. Does anyone know how this ends up having a mood stabilizer effect? Basically, the answer is no. Remember, T3 is the active version of thyroid hormone. The researchers point out that when someone becomes spontaneously hyperthyroid, from their own thyroid gland overproduction, they have increased levels of T3 as well as T4. When T4 thyroid is given as a pill, from the outside, even at high doses, T3 levels are not abnormal. In this respect, the patient is not “hyperthyroid”, at least in the same sense as if TSH went to zero from his or her own thyroid production. Thyroid hormone control is extremely complicated. Using high doses of thyroid is simply bumping a system we don’t understand very well. Unfortunately, this is what similar to the situation we face using nearly any medication for bipolar disorder (although our understanding of the causes of bipolar disorder is improving rapidly).

How to Explain This to Your Doctors

Most primary care physicians and endocrinologists have never heard anything about this high-dose approach. But some physicians have been using thyroid hormone for patients with mood problems for years, without a clear rationale. In their opinion, it just seemed to work and not cause too much trouble. Because there was no research behind this approach, it was thought to be almost irresponsible, at least by some endocrinologists. Therefore, if you are considering high-dose thyroid, you are very likely to run into resistance to the idea from other doctors. You can send them to this webpage, if they will go, but for many doctors you might need to walk in with a review article from a source with very good credentials on this issue. Because you could not easily put your hand on this otherwise, and you are so likely to need it, I offer you a link below to a PDF you can print. (Again, if anyone objects to my having made this available, please let me know and I will take it down and post an explanation of the objection.)

The Article You Will Need to Take to Your Doctors

(updated 11/2014)

Want to know more? Try Dr. Kelly’s 2018 book, The Art and Science of Thyroid Supplementation for the Treatment of Bipolar Depression.

Antidepressants in Bipolar II: What the Experts Do

Do Benzos Treat Depression?

Olanzapine vs. Asenapine

How to Microdose Medications