At 1 time, psychiatrists produced a distinction between two kinds of depressive sickness: melancholia, a significant, protracted, often lifelong gloominess of the spirit and the a lot more widespread “reactive” depression, whose comparable but less severe symptoms are normally in response to an adverse daily life occasion, such as unemployment, marital breakdown or bereavement. Back in 1980, the American Psychiatric Association abolished this distinction in favour of seeing depression on a continuum, more significant in some than other individuals, but usually responsive to medicine.
Subsequent, Prof Shorter argues that psychiatrists were also readily seduced by claims that Prozac-like medicines have a particular mechanism of action, bettering mood by boosting the ranges of serotonin in the brain. In reality, scientific understanding of the role of transmitters in mental sickness was, and remains, “trivial”.
“The complete Prozac story is a cautionary tale,” says Prof Shorter. “When it comes to both diagnosis and treatment, the early approaches are very typically far better.”
Dizzy at springtime
The conundrum featured in this column of the lady whose mild vertigo when lying down or turning in excess of in bed is exacerbated close to the spring equinox has prompted the notion that this have to be due to adjustments in strain in the middle ear – for which there are two attainable explanations.
The very first would be a hayfever-variety allergy, the place sensitivity to pollens in late March brings about narrowing of the Eustachian tube at the back of the throat, stopping fluid draining from the middle ear and adversely affecting balance.
Up coming, readers level out that the climate is typically unsettled at this time of year (therefore March “coming in like a lion and going out like a lamb”). The fall in barometric pressure in the days prior to a storm, for illustration, would result in the fluid in the middle ear to increase, with comparable consequences.
Mystery abdomen discomfort
This week’s health-related query comes courtesy of Mr HJ from Leeds, creating on behalf of his 12-12 months-old grandson, who has Sort 1 diabetes. This is effectively-managed on his present insulin regime, but for months he has been troubled by a consistent abdominal ache of this kind of severity as to wake him at evening, affecting his schooling due to exhaustion.
The typical scans and X-rays have failed to determine a cause and he has been labelled as possessing “chronic non-natural abdominal pain”, with the implications that the difficulty is psychological rather than physical. This obviously can not be the case. Does any person, he wonders, have a suggestion as to what may well be amiss?
E-mail healthcare concerns confidentially to Dr James LeFanu at drjames@telegraph.co.uk. Answers will be published every Friday, at telegraph.co.united kingdom/overall health
Doctor"s Diary: are medical professionals dependent on Prozac?
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