Caution Doctor

This is a response to an unexpected article on the Habré psychiatrist with thirty-five years of experience of Alexander Gennadievich Danilin, also quite famous youtube vlogera. Before his article on Habré, I did not pay attention to his work, as it turned out, in vain.

But first, a short preface.
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For me, psychiatry is a painful and personal story. Unfortunately, this is a very specific area of ​​medicine in which esoteric and obscurantism very successfully resist scientific knowledge. The fact is that evidence-based medicine is generally a little over thirty years old. And the medical community only now with bloody vomit expels all homeopathy from itself. In psychiatry, due to objective factors, the process is the hardest. This area is still a preserve for charlatans, ignoramuses, idiots and science freaks with their own special interpretations and truths drawn from “philosophical reflections”. The revolution in neuroscience, particularly in psychology and psychiatry, is happening right now. Alas, not for everyone.
I am rather cold to not very competent psychiatrists who adhere to standard programs and methods of treatment for psychiatrists. However, they do what they have been taught. As a rule, this allows them to lead the patient out of an acute psychotic state. Well, then he will at least have a chance. Perhaps in the future they will develop better techniques, they will be better treated. But here the freaks, picking out their anti-scientific hypotheses from a known place and applying them in treating heavy patients, cause in me an acute unbearable desire to burn, burn, burn in the dragon flame. I know too well what their ignorance leads to.

I was in this hell, I burned in it.

A. Danilin, who posted his article on Habré: “The answer of the psychiatrist to the article“ Ill-healthy ”,” is a dangerous freak from science, and his article is gushing by delirium. At the same time, he manages to give advice to a patient with a very serious pathology.

His categorical from the first paragraph strikes:

Based on my experience, I want to say right away - the experiences described in the article are characteristic, first of all, for thyroiditis - an increased titer of antibodies to thyroid hormones.


Science doesn't work that way. Firstly, we live in the twenty-first century, our experience needs to be arranged in the form of research or refer to the research of other scientific groups. Because in this case we can all verify the correctness of such conclusions.

Thyroiditis - a violation of the functions of the thyroid gland, can actually lead (and often leads) to the violation of the functions of the higher nervous system. May adversely affect the mechanisms of thinking and memory. Disruption of connectedness of thinking can bring a schizotypical pattern to this mechanism. But it usually does not lead to protracted vigorous mania (in the part of publications, I see a mention like: “In some cases even psychotic symptoms are noted.”) Psychotic symptoms are not manic psychosis. I found only one strange article in the pub, linking a sharp maniac in ONE patient with ultra-high dosages of LT4, which he received. Yes, and then the wording of the authors: “We are very worried, I’m confused. But everything confuses me in this article , including a single patient.

On the contrary, everywhere it is noted that thyroiditis leads to depression. According to the key words “Thyroiditis depression”, pub medical publishes a little less than two hundred articles. Which, frankly, not a lot, but among them there are two dozen rather large studies on decent samples. You can also find material on the same keywords on risergate. I have not found any large studies confirming Danilin’s categorical opinion.

Also at Pabmede, you can find studies on the relationship of lithium drugs used to treat bipolar patients with impaired thyroid function. But the connection is inverse! Not thyroiditis leads to manic syndrome, and lithium-based pharmaceuticals, which suppress manic syndrome, can cause thyroiditis, as a side effect.

But, on the other hand, a lot of research talks about the connection between depression and thyroid function disorders. What is not surprising. Depression is not exactly the opposite of mania. Depression is a depressed mental state. The reasons for such oppression can be many. From beatings at school, chronic toothache and hormonal imbalance to problems with the immune system and neuroinflammation. When you are dealing with depression, the source of the problem may be anywhere, even in the little finger of the left foot. But the causes of energetic mania are most often localized inside the skull.

But the psychiatrist Danilin continues:

Such a condition is still referred to as “endogenous” (internal, having no objective reason) and is treated as schizophrenia, which the author can verify by reading the instructions for the drugs he takes.

First, who told you that endogenous causes are not causes? Of course, such states are classified as having an objective cause. Required. Without fail. The establishment of these reasons employed a huge number of research groups around the world.

Another question is that today the choice of a tool is not great for practicing psychiatrists. These are, in one way or another, antipsychotics, which act on the dopamine system, and several classes of mood monitors that regulate the glutamate / GABA balance by various mechanisms. Like drugs lithium, antikolvsant, calcium antagonists and (attention!) Thyroid hormones for relief of depressive states (not manic).

And the doctor pedals and continues to insist on his correspondence, unreasonable diagnosis:

Proceeding from the description, I consider the most likely physiological cause of the author's conditions to be thyroiditis.

And I think that after such statements it is necessary to deprive of a diploma and drive out of medicine with an eternal ban on the profession. Danilin makes a diagnosis (albeit with reservations) to a person whom he hasn’t even heard on the phone, while choosing from more than two dozen reasons for this pathology, he chose the most incredible, based only on absurd, unsubstantiated hypotheses.

Yes, I am an adept of holy pub medicine and evidence-based medicine. I am not interested in the conclusions based on “transcendental experience”. Moreover, they are contrary to common sense and a common understanding of the work of the hormonal system.

Danilin:

Increased emotional vulnerability, about which masterdak did not write anything, is most often associated with minimal organic disorders of the nervous system, usually resulting from birth trauma or hemodynamic disturbances in the pregnant woman’s body. Something like this happens:

The capillaries supplying blood to the nerve cells are very narrow vessels. At the slightest malfunction in the maternal labor or increase of blood viscosity, they fall down and die, and in their place the so-called gliosis, microscopic scars, is formed.

This mechanism leads to depression, impaired consciousness, impaired memory very often. The relationship between thyroiditis, hypersensitivity and emotional lability seems to be found in research. All my attempts to find adequate research on the connection between glioma and emotional lability or hypersensitivity remained unsuccessful. Can I see research linking gliosis and hypersensitivity?

Then the doctor is already fully transferred to the generation of delirium:

If this were to occur in the skin tissue, inflammation would first occur, and in its place - scar tissue. The brain is an aseptic environment, there are no bacteria here, there is no inflammation in the strict sense of the word, but the body’s defense systems will still struggle with the microtubule.

No inflammation in the brain? What? The inflammatory process, in the strictest sense itself, is of course possible in the brain. And in all types of fabrics. Both with the participation of a bacterial agent, and without. How can I say that? Such a statement is too illiterate even for a paramedic!

Further Danilin nevertheless stipulates:

I do not make diagnoses without examination. Relying on your posts, I only try to explain what happens in such situations with the human nervous system. And I do this only because all these processes are not of interest to domestic psychiatry.

With domestic psychiatry, everything is bad for the most part. Alexander G. vivid confirmation. Patients requiring special delicacy and a strictly scientific approach suffer from the dominance of freaks and ignoramuses. In psychiatry, the principle of harm is not particularly relevant, but freaks don't care.

Another paragraph:

alcohol stabilizes their (patients suffering from increased emotional vulnerability or sudden mood swings) mental state.

I just have nothing to say: alcohol is a famous “stabilizer” of emotional states! I even get lost, how can I formulate a search query for a pub.

And so, going through the delirium, we reach the next section:

The diagnosis of bipolar affective disorder today is a form of demagoguery intended for the patient. The doctor does not want to tell the patient that he suffers from schizophrenia, it is painfully a hopeless and difficult to explain diagnosis.

Here, demagogy, and illiterate, showing wild ignorance divorces Danilin. BAR is really a large group of pathologies of a manic and / or depressive nature with a wide variety of pathogenesis (causes). All this is known to every psychiatrist. In this case, BAR is treated with the same drugs that are prescribed to patients with schizophrenia, if the manic syndrome is clearly pronounced SHIZOTYPICAL in nature. No competent doctor will prescribe antipsychotics to a patient with BAR if the patient is stabilized by mood stabilizers and schizotypical thinking disorders are not observed. Another question, if the mood managers can not cope. Then the psychiatrist would be glad to appoint something more targeted, but he only had a saw and a hammer. Do not help drugs lithium or valporat - wilderness dopamine from despair.
As an example, my hypomaniacal is most likely associated with the anandamide suppression of GABA. At night, I turn into a very excited state. In the morning I could catch up on a dream. But now I get up at 6:15 to work. My psychiatrist is worried about my regimen, in which I sleep less than 3-4 hours a day during the week. Alas, he would be glad to appoint some of the CB-1 receptor antagonists. But such drugs are not yet on the market. They are only in development and when they are approved, it is not known. Therefore, he gently insists on taking Quetiapine at night. I gently refuse, but his motives are clear to me. Suppression of dopamine on D2 in my case will be too expensive, with my weakened focus of attention. I decided to deplete the central nervous system and take all the negative consequences of such a step, but not to touch dopamine. However, if I were the attending physician of such a patient, I would also insist on taking a mild neuroleptic in the absence of alternatives. Meditation in the MindFulness technique helps me a little. However, I am still a novice and do not have a great training and practice of meditation. Therefore, while the result of such exercises is very modest.

Next, Dr. A. Danilin gives a long conspiracy theory about the formation of the Soviet school of psychiatry. I will skip this section. What happened 70 years ago does not interest me, even if every word and every interpretation in this story is true. I'm more interested in what is happening in psychiatry and neuroscience now. Today.

But further in the text nonsense becomes fatter, and the partisans are even thicker:

“Single psychosis” is now and everywhere implied — even when your children are diagnosed with “childhood hypermobility syndrome” or “early childhood autism” - they are being treated for schizophrenia. Do not forget to carefully read the instructions to the drugs!
But it's not only that.

How long is child hyperactivity treated with antipsychotics? What did I miss? Where is it from?
In Russia, for the correction of ADHD certified Strattera. A crap drug that affects the norepinephrine system, but has no relation to antipsychotics.

And in the west, methylphenidate and amphetamine are used in the correction of ADHD. How long have amphetamines been shown to schizophrenics? Antipsychotics are antagonists of D2 recipes in their mass. And amphetamine and methylphenidate agonists. Their action is diametrically opposite.

Go ahead:

Being engaged in teaching self-hypnosis and self-hypnosis, I have great respect for meditation, but meditating at the same time, while taking antipsychotics and antidepressants, at least, is meaningless.

Danilin should stop self-hypnosis and self-hypnosis. And do self-education. I also look at meditative techniques with some hope. There are several reasons for this, which I will write about in more detail when I reach them in the “PsyGuide: Attention Deficit.” Cycle.

But when the brain chemistry is disturbed, you first need to normalize chemistry, and then engage in meditation. In an acute psychotic state, there can be no talk of meditation and speech.

Go through the text further:

Anxious thoughts are doubts in yourself and in your ability to answer for everything you do. The psyche knows one single way of liberation from disturbing thoughts - the feeling of one’s own greatness.

Well for Freudian / Jung? What is the basis of this statement? Besides, again everything is exactly the opposite.

A lot of mechanisms provoke anxiety. From the high content of anandamide in GABAergic neurons to low connectivity of insula and cingulate bark, as well as the imbalance of the hormones of Danilin's favorite thyroid.

As for the delusions of grandeur, then there is always the main player in favor of dopamine along the mesolimbic path. And with dopamine hyperstimulation, all studies report a reduction in anxiety.

Tell you what is anxiety disorder? This is when you leave the house, forgetting to take the rights and money even for lunch, work documents and the necessary drawings for the day. But at the same time, carefully making sure that both the phones and the power bank were fully charged, because every moment you listened to the instant messengers. Every second, waiting for a call that your closest person jumped out the window, disappeared, or died, while at the other end of the world you earn money to pay for his treatment with such psychiatrists. The entire focus of attention twenty hours a day is focused on the smartphone. Right now, now they will call you and tell you that your parents have died, friends have burned down, a nuclear apocalypse is coming, and you will die in it last, burying everything dear to you. Extremely unpleasant condition for the psyche. I had nothing to do with that megalomania during this period. By the way, Ritalin, which I try to avoid for reasons that I will also reveal in the “PsyGuide: Attention Deficit” cycle, at that time helped me not only focus on work tasks, but weakened anxiety. Dopamine D2 receptor stimulation reduces anxiety. With overstimulation, it can also cause delusions of grandeur.

How does Danilin succeed each time in his hypothesis-sucked from the finger so exactly miss the 180 degrees?

The arguments and comments of the doctor about nadmizg I miss. I just don't know what it is, where to look for it on an MRI.

You can further disassemble these pearls here:

All people taking antipsychotics and antidepressants, are involved in a protracted pharmacological experiment, the effectiveness of which in reality has not been proven ...

Or such:

On the contrary, German psychiatry has always believed that this disorder disappears without a trace. And there were no psychotropic drugs at the time of Kraepelin - this psychosis was treated with sanatorium conditions, water procedures, hypnosis and ... world travel.

What they thought before the advent of evidence-based medicine interests me a little. A hundred years ago, hemophilia could be considered to be completely cured by bleeding.

Forces at the end, so we will not be distracted by conspiracy and mythology, we go further:

Side effects of drugs are not complications. Side effects are part of the mandatory effects of the drug on the body, but not desirable for the patient's health and treatment goals.

I broke my brain from this phrase. Side effects are side effects. Complications are complications. Yes, we live in a non-ideal world. Antipsychotics, suppressing the dopamine system along the mesolimbic pathway, lead to suppression along the mesocortical one, which has a bad effect on the concentration of thinking, and in the long period leads to the inhibition of the prefrontal cortex and the degradation of its functions. We simply do not have such a highly selective drug that would block dopamine so selectively. The emergence of such drugs will mean a breakthrough in the treatment of schizophrenia. But while we have what we have. We pay the price we pay. What Danilin said, I did not understand.

Then Alexander G. reveals the truth to the patient:

Arispizol.
Antipsychotic (neuroleptic). The therapeutic effect of aripiprazole in schizophrenia is presumed to be due to a combination of partial agonistic activity against dopamine D2 and serotonin 5-HT1-receptors and antagonistic activity against serotonin 5-HT2 receptors. Aripiprazole has a high in vitro affinity for dopamine D2 and D3 receptors, serotonin 5-HT1a and 5-HT2a receptors ...
Unclear?
First, it becomes clear that they are treating you for schizophrenia.

Unclear.I already wrote that modern psychiatry does not have such a large set of tools. It doesn’t matter what they are being treated for, ideally (I hope it was) after the selection the patient gave the best answer to these drugs. What is being treated for is absolutely not clear from the instructions. At least to me. Danilin, who apparently draws knowledge straight from space, is generally understandable.

Then Alexander Danilin uses a prohibited technique, for the use of which I am immediately ready to grab onto the canister of gasoline. He is frightened by a long list of side effects of a patient with manic psychosis:

By participating in this experiment, you use drugs that have the following mandatory actions (listed as side effects): ... a
long list

The fact is that people who are forced to take such medicines, and so acutely experience the side effects that have antipsychotic drugs. The main one is general depression. Often this is the reason for refusing drugs, which sharply exacerbates the psychosis and can threaten the patient’s life. All of us who dealt with antipsychotics and mood stabilizers know the high price we have to pay to stay in mind. Those of us who have been able to get off the psychopharma with many years of hard work on ourselves are truly lucky. Alas, not everyone is given this, not everyone is allowed by their neurochemistry.

Be careful. Take care of yourself.