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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by Rzip on January 25, 2001, at 12:11:58
Super,
Cognitive behavior therapy is found to be more effective in treating OCD than that of SSRI drugs. Original article is in the ARCH General Psychiatry (Vol. 53, Feb 1996). This is a very popular magazine, so you should be able to find it in any Universities. The article is by Jeffrey M. Schwartz and et. The title is "Systematic Changes in Cerebral Glucose Metabolic Rate After Successful Behavior Modification Treatment of Obsessive-Compulsive Disorder". I certainly do not have the qualifications to diagnose you with OCD. But since this is something that bothers you and interfers with your lifestyle. My advice is to go see a professional and put some happiness and control back into your life.
Statistically significant studies have shown that BMT (Behavior Modification Treatment) is at least equally as effective as medicine. I would argue that it is a safer treatment plan (therapy that is) than any drug on the market. Why? Because no one really knows much about any of the medicines currently being used to treat mental illness. Proof: check out the PB board. Seriously through, it wasn't until after WWII (1940s) that people realized that the scientific method can be applied to the mental health field. What this means is that all the studies being done in psychiatry is all too primitive, in comparison with the treatments for somatic diseases. Although, there are some instances, like Lithium for Bipolar where the medication is way more effective than psychotherapy. It is kind of hard to conduct therapy on someone who is maniac and out of perception. I don't know why I am writing so much.
Anyway, the point I wanted to bring to your attention is that BMT has proven to decrease glucose metabolic rates in the right head of the caudate nucleus (part of the brain). So, in this case affective therapy actually rewires the cortico-striato-thalamic (a brain region feedback pathway), which is the cause of OCD. A feedback pathway goes something like this Part A sends a signal to Part B to act out (in this case, think about eating). Under "normal" conditions, Part B is supposed to tell Part C that "Yes! The eating thought has been acknowledged. And no, we do not need another signal to think about food". So, Part C then loops back to Part A and tells it not to send another eating signal to Part B. Do you see the circular pattern? In patients with OCD, the looping back from Part C to Part A (or Part B to Part C) is turned off. Like in an electricity series circuit board, all switches should be ON. When one of the switches is not on, the electricity is not able to feedback upon itself. However, the electricity and the wiring is still there. I probably lost you already. I am trying to explain the signal pathways of OCD.
Just try to understand, in OCD cases, a part of your brain (Part A) is always sending signals to another part (Part B) to do think about food. BMT, psychotherapy has been shown to turn back on the signal pathway between Part B and Part C. And finally, the looping back of Part C to Part A.
Key point: Go in for BMT professional help.
- Rzip
Posted by PatJ. on January 27, 2001, at 23:09:46
In reply to Behavior Modification Treatment helps with OCD » super, posted by Rzip on January 25, 2001, at 12:11:58
It has also been established that Cognitive Behavioral Therapy (CBT) and medicine for OCD (not limited to SSRI) works for OCD. I personally know of many who have benefitted this way opposed to one or the other.
Posted by Rzip on January 28, 2001, at 1:14:03
In reply to Re: Behavior Modification Treatment helps with OCD, posted by PatJ. on January 27, 2001, at 23:09:46
> It has also been established that Cognitive Behavioral Therapy (CBT) and medicine for OCD (not limited to SSRI) works for OCD. I personally know of many who have benefitted this way opposed to one or the other.
I believe the point of the article is that CBT works as effectively as medicine. Either form effectively decrease the cerebral glucose metabolic rate of the right caudate nucleus. The question then becomes whether the combo is significantly more effective. Not necessarily so, since brain change is brain change however you look at it. Personally, I think the therapy should work faster just because an effective treatment requires the client to work at it. There is no faster route to recovery than a client's will to get better. I mean think of the somatic circumstances. Many miracles have occurred due to a patient's will to live. Since the mind and the body is interlocked, the same principle should be applied to psychiatric illnesses.
In this particular study (1996, which is historical by academic psychiatry standard), changes were observed via PET (positron emission tomographic) scan within 10 weeks. So the question then becomes, do the people afflicated with OCD experience systematic changes within 5 weeks or something (double dose success rate).
- Rzip
Posted by Shell on January 28, 2001, at 23:14:15
In reply to Behavior Modification Treatment helps with OCD » super, posted by Rzip on January 25, 2001, at 12:11:58
I am always surprised when I hear about therapy for OCD. When I was diagnosed, the psychologist intially wanted to do behavior modification therapy, as he thought I might have an anxiety disorder. After talking more and testing me, he diagnosed OCD and referred me to my family doctor for medication. He then told me that we were no longer going to do therapy of any kind (and that I no longer needed to see him), because OCD is a totally organic disorder, best treated by medication. He pretty much told me that nothing he could do would make a difference and that it would be a waste of time and money to continue.
Live and learn, I suppose. I never did get any therapy, but Prozac was effective. I have to wonder now how much better things would have gone had I had both.
Shell
Posted by PatJ. on January 29, 2001, at 10:29:05
In reply to Double dose with the combo? » PatJ., posted by Rzip on January 28, 2001, at 1:14:03
> > It has also been established that Cognitive Behavioral Therapy (CBT) and medicine for OCD (not limited to SSRI) works for OCD. I personally know of many who have benefitted this way opposed to one or the other.
>
> I believe the point of the article is that CBT works as effectively as medicine. Either form effectively decrease the cerebral glucose metabolic rate of the right caudate nucleus. The question then becomes whether the combo is significantly more effective. Not necessarily so, since brain change is brain change however you look at it. Personally, I think the therapy should work faster just because an effective treatment requires the client to work at it. There is no faster route to recovery than a client's will to get better. I mean think of the somatic circumstances. Many miracles have occurred due to a patient's will to live. Since the mind and the body is interlocked, the same principle should be applied to psychiatric illnesses.
>
> In this particular study (1996, which is historical by academic psychiatry standard), changes were observed via PET (positron emission tomographic) scan within 10 weeks. So the question then becomes, do the people afflicated with OCD experience systematic changes within 5 weeks or something (double dose success rate).
>
> - RzipDear Rzip,
Often people who have OCD are so disturbed about it that they seek medicine for faster relief even if the meds. take awhile. CBT or BMT often take a long time for people with OCD and does not work to relieve it completely for everyone, sorry to say, but I am one of them and know others. The CBT and BMT techniques must be used continually and sometimes people give up on it for awhile, too. For me it did not take it away completely but a technique I use decreases it and I have to practice it daily. The medicine has slowed it down enough to deal with it-I was frantic about my symptoms and I couldn't even deal with going to a counselor befores taking the meds and slowing it down. If someone can befefit from CBT or BMT without psychotropic drugs I think that is great and I am sure there are many who can and do but I just wanted to say that there are also many like me who had it so bad and were so tormented so bad by it that I needed the medicine to slow it down to make it manageable. That is not said to underestimate how much anyone is disturbed by OCD but it is known to be very hard to treat. I tried therapy without medicine, too, and for me it did not work alone but together with it. There are also times for me when the techniques don't work and the meds. don't work and I just have to sit tight and wait for them to work again. Such is life. I didn't mean to imply that BMT or CBT cannot work alone for anyone-I think it's great when it does and wish it had been that way for me but am satified now anyways.
Posted by Tammy on January 23, 2002, at 22:33:01
In reply to Re: Double dose with the combo? » Rzip, posted by PatJ. on January 29, 2001, at 10:29:05
when i was 20, some freak thing happened and boom i was afraid of germs...... went to see a psych dr. 3x i felt he wasnt helping me if he could be there and see what i was going thru on a daily basis and coach me then he wasnt helping....but in the back of my mind he did bring out good points..... he said i have to obcess about something and each time it gets bigger of what im obcessing about....... well let me tell u after that, with no meds, and no therapy... it took me 8 yrs to talk myself out of it graduallyyyyyyyyy.... and still to this day im 31 im still not totally over it..... but i am 95% better then i ever thought id be....... but some germs do still ring a bell that i have to still take care of :) ex. toilet seats, using my coat/foot to open doors and i dont take the first thing on the shelf i have to reach back 2 or 3.... and i never by the last one of anything..... :) :) :) it was a struggle but when i narrowed it down to only a couple of phobia's that i could manage, i picked up another i guess my brain thought damn she got that down pat so lets see how she handles elevators....... all of a sudden i cant get on an elevators......
sigh
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