Interesting comments about Secretariat. Genetics surely play a key role in whether or not a horse becomes a champion. But like humans, what also matters is its heart. Does it have the heart of a champion, and what are other variables that come into play? I suspect Secretariat had a very "privileged" upbringing. Let's compare this to a circus elephant:
When a new elephant is brought into a circus setting from the wilds of Africa (don't know if that still happens), it would normally be full of spirit and resistance (genetics). My understanding is the first thing trainers would do is tie a strong rope or cable around it's foot, and tie the other end to a tree. The elephant would struggle valiantly against this for long periods of time, until it finally realizes it can't free itself.
What the trainer then does is carry around a portable tree stump wherever he goes with the elephant, and when he wants to have it stay in one place for a while, he just puts one end of a rope around the elephant and the other end around the (fake) portable tree stump. Of course, the elephant doesn't know that it could easily break free, as it had already been ingrained with a sense of "learned helplessness".
Sadly, I see a somewhat similar scenario play out on these forums. So many here that are suicidal are so pessimistic that anything can be done to improve their lot. They repeatedly read depressing scenarios on this forum, often believing "nothing" can be done. Plus, they're told repeatedly by ENTs and other doctors that they just "have to get used to it". Seems to me they also become ingrained with a sense of "learned helplessness".
But I firmly believe life is far more maleable than people often come to believe. I know it's hard to see a way out of a deep personal crisis like intrusive tinnitus, but I believe literally everybody can do something (not matter how small) to improve their lot, in some way, shape or form. And a number of "little things" often end up making a BIG difference. It may not be a total cessation of tinnitus, and/or some other distressful ear condition, but much can be done to help ourselves, whether physically, and/or emotionally, and/or spiritually. The will to take initiatives to help ourselves in times of crisis goes well beyond genetics IMHO.
I find your Secretariat and Elephant analogy to be obtuse. We can put an elephant in the Kentucky derby as well. A race horse would win. Could put a snail, a turtle, fast dog or even a human in the Kentucky Derby as well against amateur horses of non privilege and a horse would win. Genetics.
You are a pretty serious nurture guy who denies genetics in my opinion of course...or places nurture ahead of genetics. What you are forgetting is, both your and my genetics...the strength of our minds and genetics are reason we can climb out of the abyss of despair that others live in and can't climb out of. I never came to this forum and wrote such obsessive things about offing myself. I struggled profoundly with tinnitus as many do when they first get it, but the 'norm' is, people climb out of the basement and live relatively normal lives even with obtrusive tinnitus. Who don't in my opinion? Those more profoundly mentally ill. You see it on this forum every day. They don't choose to be mentally ill, many times manifesting from a young age....choose to be schizophrenic or have bi-polar disorder, they are wired this way. Of course if an abused person with fragile genetics like a guy like Charles Manson with low IQ and psychotic disorder, he will do bad things to people and he did. But his abuse was only a subset of who he truly was, a mentally ill person with low IQ.
So Lane, you get by on Lithium if you still take it. You believe it detoxifies your brain and I believe it addresses what mental illness you have that I believe you were born with. I don't know if you come from privledge or not, but to me it doesn't matter. You seem pretty well educated. The book on Lithium is pretty well known and you can re-write its underlying true benefit if you like, but as with your 'nurture theory' I will have to disagree.
Btw, I believe you have a future in the Kentucky Derby. Race a non breed horse that you treat with more privilege aka nurture than the other horses and you should win.
Oh, and if you thinking about training a burglar to rob houses to make a little extra spending money. Don't choose one with anxiety disorder. You could coddle such a person and tell them they are the best, but I believe you will be swimming upstream....lol. You may have heard, he has nerves like a jewel thief. There are people that don't. They were born that way. People choose their profession and act out in their lives based upon their genetics. Just like Secretariat would hang back in a pack of race horses and then race by and show the other horses his true superiority.
Why Lithium keeps you down off the ledge. Lithium restores your brain chemistry that your genetics didn't give you. No different than a diabetic needing insulin. Genetics.
Also, never have a color blind person paint your house. Just a friendly tip....or a schizophrenic.
Lithium to treat bipolar disorder
Pharmacological treatment of bipolar disorder continues to be a challenge for psychiatrists today, since each phase of the disease usually requires a different therapeutic approach.
Nevertheless, during the last 50 years some changes in the trends of use of the different drugs available to treat this type of psychopathological alteration have been experienced.
In this sense, lithium has been, and continues to be, the drug par excellence for bipolar disorder. In fact, in the 1950s and 1960s it already had acceptance in Europe and is still maintained today.
Recently, the Collegial Medical Organization and the Ministry of Health and Consumer Affairs have developed a manual of action in the case of mania that collects the evidence in favor of the use of lithium in these pathologies.
Specifically, this study has demonstrated strong evidence for the use of lithium in acute mania, i.e. in those cases where manic symptoms are expressed autonomously.
Thus, the study demonstrated how in controlled and randomized trials of this type of psychopathologies, lithium achieved a good pharmacological response in practically all cases.
However, in this same study, lithium only obtained limited evidence on its effectiveness in treating cases of mixed mania, i.e. to intervene in those episodes presenting depressive symptoms and manic symptoms simultaneously.
In these cases, other drugs such as evaporate or cabramazepine demonstrated a greater effectiveness of treatment.
Thus, lithium has been shown to have a greater effectiveness in the treatment of manic episodes than in the treatment of mixed episodes, so the diagnosis of these characteristics of bipolar disorder becomes very important when specifying the therapeutic plan.
As regards the hippomanic phases, it has been demonstrated that lithium is an effective drug to attenuate its symptoms, to stabilize the mood and to recover an optimal operation.
This was evidenced by a retrospective study by Tone on the efficacy of lithium to reverse hippomanic phases in a total of 129 people with type II bipolar disorder.
In addition, in this same study, the effects of lithium were studied to treat the manic symptoms presented in a total of 188 individuals diagnosed with type I bipolar disorder.
In this second review of Tone, it was found that the efficacy of lithium was more effective in treating hyperthymic symptoms (manic episodes and hippomanic episodes) than in treating hypothermic symptoms (depressive episodes).
Finally, it should be noted that other types of drugs are often added to the treatment with lithium for bipolar disorder.
Multiple studies have shown that certain antipsychotics interact well with lithium and increase the potential for treatment to reverse the symptoms of bipolar disorder.
More specifically, in the manual developed by the Collegiate Medical Organization and the Ministry of Health and Consumer Affairs, Haloperidol, Risperidone, Olanzapine, Quetiapine and Arpiprazole were found to be optimal drugs to accompany treatment with lithium.
Finally, it should be noted that, as demonstrated by Goodwin and Jamison in 1990, lithium is a drug suitable for the maintenance treatment of bipolar disorder since it reduces the frequency, duration and intensity of manic, hippomanic and depressive episodes.
Thus, from all of this we can draw the following conclusions about the efficacy of lithium for bipolar disorder:
- Lithium is the drug most commonly used to treat bipolar disorders.
- Together with other mood stabilizers like Carbamazepine or Valrico Acid is the first choice treatment.
- Lithium is used more frequently than Carbamazepine and Valrico Acid to demonstrate higher rates of efficacy in the treatment of bipolar disorder.
- Lithium is especially effective in treating the manic and hippomanic symptoms of bipolar disorder and achieving a decrease in mood by stabilizing the patient's affection.
- The combination of lithium with some antipsychotics is probably the most effective therapeutic combination to treat manic episodes.
- The combination of lithium and antipsychotics to treat hippomanic episodes is also effective; however, because of the lower severity of these episodes, it is often not necessary to add antipsychotics to lithium treatment.
- Despite being a suitable drug to treat mixed episodes, its effectiveness is somewhat reduced when compared to the effect it causes in the treatment of manic or hippomanic episodes.
- The efficacy of lithium to treat depression episodes is much lower than for treating episodes of mania or hypomania.
- Lithium is used to treat depressive episodes of bipolar disorder but is usually more expendable to treat depressive episodes of depression.
- Lithium is a medicine suitable for the maintenance treatment of bipolar disorder.
Depression and Bipolar Disorder
Depression and bipolar disorder are two mental illnesses that are part of the same diagnostic group; however, they are rarely interpreted as similar disorders.
In fact, depression is often interpreted as a fairly common psychological disorder, while bipolar disorder is often seen as a rather extravagant mental disorder.
However, the differences between the two disorders are not so conspicuous and both constitute an alteration of mood.
Depression
For its part, depression is characterized by the suffering of depressive episodes that modify the mood of the person.
The suffering of this type of episodes is determined by presenting a depressive mood, and a loss of interest and / or a decrease in the capacity to experience pleasure.
Likewise, during the depressive episode the person usually experiences sadness, vague physical complaints, alterations of the appetite, of the dream and of the libido, difficulties to concentrate, agitation or psychomotor slowing.
Finally, the thinking becomes pessimistic and can be impregnated with ideas of handicap and guilt. Ideas of death or suicide may also arise.
Thus, the diagnosis of depression is made by connoting the presence of at least one depressive episode like the one just discussed.
Bipolar disorder
In bipolar disorder, unlike depression, a greater number of different episodes may be experienced.
Firstly, it should be noted that in this disorder one can experience exactly the same depressive episode that is experienced in depression, so that the similarities between the two alterations are immediately apparent.
However, bipolar disorder and depression also differ in many other characteristics.
These characteristics are mainly based on the fact that in bipolar disorder not only are experienced depressive episodes, but also have to present other types of episodes.
One of them is the mania episode. This episode is defined by a period of time equal to or greater than one week in which an abnormal and persistently elevated mood occurs.
In mania, there are states of euphoria, constant expansiveness and recurrent moments of irritability.
Also, symptoms such as excessive self-esteem, grandiosity, decreased sleep, verbiage, brain drain, distraction or disinhibition often appear frequently.
Thus, mania would be an episode in contrast to depression, where instead of a decrease in mood, it rises above normal.
Another episode that can occur in bipolar disorder is hypomania.
The clinic of these episodes is identical to that explained in the manic episodes but it presents in a lower intensity and does not usually cause a clear deterioration in the person who suffers it.
Finally, the last episode that may appear is the mixed episode, which is characterized by the simultaneous appearance of manic symptomatology and depressive symptomatology.
Differences and similarities between depression and bipolar disorder
Thus, when we relate depression to bipolar disorder we can state the following conclusions.
- In both disorders there is an alteration of mood.
- Both disorders may present with depressive episodes.
- Bipolar disorder differs from depression by the presence of manic, hippomanic or mixed episodes with symptoms opposite to those presented in depression.
- Both disorders require a stabilization of the mood to return an optimum affective functioning.
Thus, it is not surprising that a drug that manages to stimulate mood, such as lithium, becomes a suitable drug to treat this type of psychological alterations.