The Permanent Mental Health Regime

[Maddy]

I understand the sentiment of the people wanting to poop on the idea of taking extra steps to maintain your mental/emotional health. Maybe this whole idea seems wishy washy. However, you probably are in a lucky position to have never been in dire straits in this regard -- some of us have not been so lucky.

Some people seem to zip through life with a U-Haul in tow; others, such as myself, are destined to lumber about in a moving van. For many of us, staying on course entails a fair bit of strategy, the unfortunate consequence of having an unwieldly, highly atypical, nervous system. On the bright side, being a little bit idiosyncratic ensures that we're never boring.

As someone else mentioned in the thread, finding a mrs. that doesn't drive me nuts has been especially challenging. At what point does one simply settle for someone that feels like less than a perfect match? I'm hoping no one on this forum has had to do that.

I can only speak for myself, but I'm convinced that pairing up is vastly overrated. I can count on one hand the couples I've known who have the kind of relationship that would be even remotely tolerable to me. And they all tend to be people with a much greater capacity for flexibility, filtering, and adaptation than I. In short, they're all "U-Haul" people. And besides, being alone has a number of highly underrated advantages, not the least of which is the ability to control one's immediate environment to alleviate stress or (for the aspies among us) to process all the stuff that rattles around like pachinko balls in our heads. For those of us who need long expanses of solitude like a fish needs water, being alone is a very effective, even necessary, strategy for staying balanced.

So, having identified yourself as someone who has had to take extra steps to maintain mental health, it seems strange to me that you would find yourself questioning whether you should "settle" for something less than ideal. if it's companionship you crave, how about a dog? I've heard it said, "You've never had a friend till you've had a dog," and it's true. If it's a warm body in bed that you need, you can't beat a cat. It's the hallmark of wisdom to know what you, as a unique individual, need and to create that for yourself regardless of what everybody else seems to think is important.

[Kriegsspiel]

So, having identified yourself as someone who has had to take extra steps to maintain mental health, it seems strange to me that you would find yourself questioning whether you should "settle" for something less than ideal. if it's companionship you crave, how about a dog? I've heard it said, "You've never had a friend till you've had a dog," and it's true. If it's a warm body in bed that you need, you can't beat a cat. It's the hallmark of wisdom to know what you, as a unique individual, need and to create that for yourself regardless of what everybody else seems to think is important.

I think Smith wants a human female, who could beat the cat in a sex contest. Possibly in conversation too.

[Smith1776]

So, having identified yourself as someone who has had to take extra steps to maintain mental health, it seems strange to me that you would find yourself questioning whether you should "settle" for something less than ideal. if it's companionship you crave, how about a dog? I've heard it said, "You've never had a friend till you've had a dog," and it's true. If it's a warm body in bed that you need, you can't beat a cat. It's the hallmark of wisdom to know what you, as a unique individual, need and to create that for yourself regardless of what everybody else seems to think is important.

I think Smith wants a human female, who could beat the cat in a sex contest. Possibly in conversation too.

Thank you for this.

Again, I wasn't meaning to get melodramatic with anyone in this thread or anything -- just trying to keep it real.

No point in talking about mental health if we're not going to be forthcoming about how people have social needs that are more than platonic. To say it's not an important contributor to mental/emotional health is to fool oneself.

I often flip flop on the issue. It's frequently a "grass is greener on the other side" sort of thing. When I'm single, marriage is on the mind. When I'm in a relationship, I'm thinking about how I miss... how shall I put it... my "freedom"?

[Smith1776]

For those of you following this thread, I've been doing some research.

Highly related to what we've been talking about is Glasser's choice theory. You can read about it here:

https://en.wikipedia.org/wiki/Glasser%2 ... ten_axioms

Here are the axioms:

1. The only person whose behavior we can control is our own.
2. All we can give another person is information.
3. All long-lasting psychological problems are relationship problems.
4. The problem relationship is always part of our present life.
5. What happened in the past has everything to do with what we are today, but we can only satisfy our basic needs right now and plan to continue satisfying them in the future.
6. We can only satisfy our needs by satisfying the pictures in our Quality World.
7. All we do is behave.
8. All behavior is Total Behavior and is made up of four components: acting, thinking, feeling and physiology
9. All Total Behavior is chosen, but we only have direct control over the acting and thinking components. We can only control our feeling and physiology indirectly through how we choose to act and think.
10. All Total Behavior is designated by verbs and named by the part that is the most recognizable.

[Maddy]

Okay, I'm wierd. But animal companions are WAY better than sex.

Seriously, though. . . Haven't you just expressed the essential dilemma of nearly all men?

[dualstow]

At what point does one simply settle for someone that feels like less than a perfect match? I'm hoping no one on this forum has had to do that.

Adam, I have never been part of a perfect match. I have found someone who puts up with my flaws, and the good outweighs the bad. (I suppose the cat and I are a perfect match, but I also need another human in the house).

[Xan]

Okay, I'm wierd. But animal companions are WAY better than sex.

You only say that because you apparently have never found the right partner. Regardless, it's not an either/or.

YIKES!!! Where are you going with this??

Somewhere out there, there are dog/cat owners who also have good sex.

Oh. hmm. Okay then.

[Maddy]

It doesn’t take a scientific study to know that spending some time with a cuddly cat or friendly dog will probably put you in a better mood. That being said, researchers from Washington State University have found objective, physiological evidence that just 10 minutes spent petting a cat or dog will lower stress levels.

https://www.studyfinds.org/pet-your-wor ... rs-stress/

[WiseOne]

I agree with most of these points but I would add to stay as far away from the medical establishment as long as you can if you don't really think you are sick

Just had to comment on this - not only do I heartily agree with this, but you might be surprised to know that most specialists would say the same. There are way too many "worried well" seeking unneeded care and self-diagnosing with all kinds of crazy stuff like chronic Lyme, it's practically a national pastime.

Where I digress from my medical peers is on the issue of preventive medicine. Great idea in theory, but often worthless in practice. This is due to: 1) there is no such thing as a test or procedure with no adverse effects, 2) benefits are going to be accrued by a very small number of people, but everyone is subject to the adverse effects which makes the math pretty much insurmountable, and 3) benefits should be measured in terms of increased survival and not "risk of death" - which is 100% for every human on the planet, guaranteed. They aren't measured in those terms for the excellent reason that the numbers don't look good.

[boglerdude]

chronic Lyme

Is it real?

[dualstow]

I agree with most of these points but I would add to stay as far away from the medical establishment as long as you can if you don't really think you are sick

Just had to comment on this - not only do I heartily agree with this, but you might be surprised to know that most specialists would say the same. There are way too many "worried well" seeking unneeded care and self-diagnosing with all kinds of crazy stuff like chronic Lyme, it's practically a national pastime.

...

I wonder if I’m Worried Well/hypochondria lite. I had not been to the doctor in a couple years, but I went recently, because of some discomfort that hasn’t gone away in three months and counting. Could be nothing, but...nip it in the bud?

[WiseOne]

Dualstow, sounds like a completely reasonable doctor visit if it's something new and unexplained that's persisting.

It may not always be obvious but there is definitely a realm of routine glitches that just kinda come with the territory of being a human being. For example, a numb toe in women wearing fashionably pointy flats or heels, or achy backs in people who are carrying around an extra 50 lbs and sit all day. Seeing a doctor for these things and getting a bunch of tests and a magic pill that the doctor has to order because you know, you'd get upset if they didn't and give them a poor rating on healthgrades or whatever, is not doing good things for medical costs. The problem is that the tests and pills all have adverse effects, whether you realize it or not. Every doctor has a story of an innocuous "might-as-well-since-you're-here" test that led to a cascade of iatrogenic badness.

For thousands of years, people just kind of knew to take these things in stride, and doctors were there to deal with relatively rare events when something went obviously wrong. Now, people have been frightened into considering themselves machines that have to be constantly maintained by doctors, and every glitch could signify a life threatening condition. Physician organizations love this state of affairs, but individual physicians understand that the medical system was never intended to be this way.

[WiseOne]

chronic Lyme

Is it real?

NO. It's a cottage industry run for the benefit of a few quacks.

[Xan]

So WiseOne, would you mind clarifying your point of view specifically with regard to the battery of tests that GPs recommend as patients cross particular ages? (In my case, 40?) I'm not sure exactly what they are: colonoscopy, heart CT, etc?

[Kriegsspiel]

Doing a shit ton of exercise is good for your mental health.

Not feeling persistently stressed is big too. If you're stressed all the time, you need to fix it.

Resolve to have personal agency instead of acting like a victim.

[Maddy]

So WiseOne, would you mind clarifying your point of view specifically with regard to the battery of tests that GPs recommend as patients cross particular ages? (In my case, 40?) I'm not sure exactly what they are: colonoscopy, heart CT, etc?

I'd be interested in knowing this, too.

Machine Ghost is an example of someone who, by most normal standards, went hog wild on the preventive front. However, he seems to have put good use to the information he got from all the testing, modifying his diet and engaging in a regimen of supplements that he used to bring about objectively-verifiable metabolic changes, especially in terms of gut microbiome. He inspired me to begin doing blood sugar testing, which was a real eye-opener for me and which vastly improved a situation of debilitating fatigue. So I'm inclined to believe that while the majority of preventive tests that keep doctors' offices humming may not be warranted, there's a small segment of the population with sufficient motivation to make very good use of some of the stuff that's out there. . .

BTW, where is he?

[Kriegsspiel]

BTW, where is he?

He left California and subsequently froze to death

[jacksonM]

I agree with most of these points but I would add to stay as far away from the medical establishment as long as you can if you don't really think you are sick

Just had to comment on this - not only do I heartily agree with this, but you might be surprised to know that most specialists would say the same. There are way too many "worried well" seeking unneeded care and self-diagnosing with all kinds of crazy stuff like chronic Lyme, it's practically a national pastime.

...

I wonder if I’m Worried Well/hypochondria lite. I had not been to the doctor in a couple years, but I went recently, because of some discomfort that hasn’t gone away in three months and counting. Could be nothing, but...nip it in the bud?

I hope it's working out well for you but in my experience one of four things usually happens when you go to the doctor because of "some discomfort" that isn't going away as fast as you want it to.

1.) They will actually find something wrong with you that may even be life-threatening and you'll be glad you went. This was the case with my first wife but it took two different doctors treating her for allergies and three trips to the emergency room before someone finally ordered a chest xray for a 53-year-old lifelong smoker and ultimately discovered she had lung cancer. Unfortunately, it was too late by then.

2.) They will find that despite the symptoms you are complaining about there is really nothing wrong with you so it must be all in your head. I'd share my personal experience with what eventually turned out to be a tooth abscess by my own diagnosis using google but it would be too long of a story.

3.) You will be misdiagnosed because the doctor figures he/she has to tell you something and prescribe some kind of medicine for you because that is basically what you are paying for and expect, isn't it? Ditto #2, I have a couple of personal stories I can tell. None of them did me any lasting harm but they did keep me from finding out what was really wrong for long periods of time because I accepted what they said with actually NO evidence to back it up.

4.) You'll just get better on your own because your body has amazing healing powers. You may or may not attribute this to the treatment, like when you go to the doctor for a sinus infection and they prescribe antibiotics. When you read later on that antibiotics are ineffective at treating sinus infections and should not be prescribed you may start to question it but at least, in your mind, it worked.

For the record, I really do have a lot of respect medical professionals and don't mean to be completely negative. Someone like WiseOne who works in research has my greatest respect. Hard to think of a higher calling than dedicating your life to curing/preventing diseases. And when they are able to identify something with an accurate diagnosis I've found that most of them are very compassionate and professional. When my wife was finally diagnosed with lung cancer the oncologist we first went to even offered to treat her for free because he wasn't on our insurance plan.

[WiseOne]

So WiseOne, would you mind clarifying your point of view specifically with regard to the battery of tests that GPs recommend as patients cross particular ages? (In my case, 40?) I'm not sure exactly what they are: colonoscopy, heart CT, etc?

There is not a straightforward answer for everyone, because there are costs and benefits to each test and you have to decide for yourself whether the net is worthwhile to you. The problem I have is not necessarily with the preventive tests, it's that they are presented as an unqualified benefit that you have no choice but to participate in.

Here's a few examples that I feel like I can intelligently say something about:

1. Mammograms. The problem with breast cancer is that about 90% of detected cancers are ones that would never become clinically evident. The ones that kill you arise very quickly, within a few months, so that to guarantee catching one on a mammo before you can detect it yourself you'd have to get a test about every 3 months. Further, there is NO evidence that the slight time advantage you might get from a mammogram will improve your chances of surviving one of these killers (there's been at least one study I know of showing zero difference in survival time based on cancer size at detection.) So, breast cancer is simply not amenable to screening, from scratch. Meanwhile, every time you hear of someone being diagnosed with breast cancer via mammogram, you can be sure that they are going through biopsy, resection, chemo and radiation for something that in all likelihood is harmless. These are not harmless interventions, and may have lifelong consequences.

You can make a reasoned case that mammograms have more political than scientific value, and that women are truly being done a major disservice. In any case, don't get one more often than every 2 years, and stop by age 75 - that's the current recommendations. If you're at high risk due to carrying a BRCA1 or 2 gene, this is a different story...if I had that situation I'd probably go for bilateral mastectomy.

2. Colonoscopy. This is a more useful cancer screening test, since colon cancer behaves in a way that makes it possible to screen for it: it starts slowly and can be easily nipped in the bud by removing polyps. The problem is that colonoscopy carries a risk of bowel perforation that increases with age. Currently, the risk is considered to be greater than the benefit after age 70. If you've had one clean colonoscopy and have no family history of colon cancer, it might be reasonable to call it quits at that point.

3. Hypertension and dyslipidemia: The extent to which these are predictive of cardiovascular events is probably way overblown. The studies were mainly funded by drug companies, which of course stand to gain enormously. It is pretty clear that there is a statistical association between these and disease, but that does not prove that modulating them will reduce disease risk - in fact it could even be harmful. It's sort of like trying to cure a cold by giving you aspirin for your sore throat; the aspirin will take care of the symptom, but you still have the cold. In fact, C-reactive protein is a better predictor of heart disease than lipid profile, and half of people with first time heart attacks have normal lipids. The few studies out there not industry-funded, coincidentally, show very little if any benefit of treatment. The statistics in the studies that do show benefit have been severely manipulated, and selective in their reporting.

If you've had a heart attack or stroke, there is useful data that a statin and/or beta blocker can increase your time to the next event. (However we don't know why they work...it is clear that statins don't exert their benefit by reducing cholesterol; it's now thought to be an anti-inflammatory effect.) If you haven't, there is simply no convincing data out there that you can benefit from taking one of these drugs. Side effects of statins (muscle damage that can be irreversible) and beta blockers (depression, loss of exercise tolerance) are well known. This is not exactly an orthodox position though, so you should do your own research on the topic.

4. Hopefully everyone already knows that prostate cancer screening has been declared useless.

[Maddy]

Meanwhile, every time you hear of someone being diagnosed with breast cancer via mammogram, you can be sure that they are going through biopsy, resection, chemo and radiation for something that in all likelihood is harmless.

Whoa.

[Mountaineer]

So WiseOne, would you mind clarifying your point of view specifically with regard to the battery of tests that GPs recommend as patients cross particular ages? (In my case, 40?) I'm not sure exactly what they are: colonoscopy, heart CT, etc?

There is not a straightforward answer for everyone, because there are costs and benefits to each test and you have to decide for yourself whether the net is worthwhile to you. The problem I have is not necessarily with the preventive tests, it's that they are presented as an unqualified benefit that you have no choice but to participate in.

Here's a few examples that I feel like I can intelligently say something about:

1. Mammograms. The problem with breast cancer is that about 90% of detected cancers are ones that would never become clinically evident. The ones that kill you arise very quickly, within a few months, so that to guarantee catching one on a mammo before you can detect it yourself you'd have to get a test about every 3 months. Further, there is NO evidence that the slight time advantage you might get from a mammogram will improve your chances of surviving one of these killers (there's been at least one study I know of showing zero difference in survival time based on cancer size at detection.) So, breast cancer is simply not amenable to screening, from scratch. Meanwhile, every time you hear of someone being diagnosed with breast cancer via mammogram, you can be sure that they are going through biopsy, resection, chemo and radiation for something that in all likelihood is harmless. These are not harmless interventions, and may have lifelong consequences.

You can make a reasoned case that mammograms have more political than scientific value, and that women are truly being done a major disservice. In any case, don't get one more often than every 2 years, and stop by age 75 - that's the current recommendations. If you're at high risk due to carrying a BRCA1 or 2 gene, this is a different story...if I had that situation I'd probably go for bilateral mastectomy.

2. Colonoscopy. This is a more useful cancer screening test, since colon cancer behaves in a way that makes it possible to screen for it: it starts slowly and can be easily nipped in the bud by removing polyps. The problem is that colonoscopy carries a risk of bowel perforation that increases with age. Currently, the risk is considered to be greater than the benefit after age 70. If you've had one clean colonoscopy and have no family history of colon cancer, it might be reasonable to call it quits at that point.

3. Hypertension and dyslipidemia: The extent to which these are predictive of cardiovascular events is probably way overblown. The studies were mainly funded by drug companies, which of course stand to gain enormously. It is pretty clear that there is a statistical association between these and disease, but that does not prove that modulating them will reduce disease risk - in fact it could even be harmful. It's sort of like trying to cure a cold by giving you aspirin for your sore throat; the aspirin will take care of the symptom, but you still have the cold. In fact, C-reactive protein is a better predictor of heart disease than lipid profile, and half of people with first time heart attacks have normal lipids. The few studies out there not industry-funded, coincidentally, show very little if any benefit of treatment. The statistics in the studies that do show benefit have been severely manipulated, and selective in their reporting.

If you've had a heart attack or stroke, there is useful data that a statin and/or beta blocker can increase your time to the next event. (However we don't know why they work...it is clear that statins don't exert their benefit by reducing cholesterol; it's now thought to be an anti-inflammatory effect.) If you haven't, there is simply no convincing data out there that you can benefit from taking one of these drugs. Side effects of statins (muscle damage that can be irreversible) and beta blockers (depression, loss of exercise tolerance) are well known. This is not exactly an orthodox position though, so you should do your own research on the topic.

4. Hopefully everyone already knows that prostate cancer screening has been declared useless.

Thank you WiseOne. This gives me some specific things to discuss with my physician at the next visit. I appreciate the time you took to answer Xan's question.

... Mountaineer

[dualstow]

So WiseOne, would you mind clarifying your point of view specifically with regard to the battery of tests that GPs recommend as patients cross particular ages? (In my case, 40?) I'm not sure exactly what they are: colonoscopy, heart CT, etc?

There is not a straightforward answer for everyone,
...
Here's a few examples that I feel like I can intelligently say something about:

1. Mammograms. ...
2. Colonoscopy. ...
3. Hypertension and dyslipidemia:
...
4. Hopefully everyone already knows that prostate cancer screening has been declared useless.

I only remember Ben Stiller urging men to get tested. I just reviewed that after reading your post. Hmm.
https://www.healthnewsreview.org/2016/1 ... te-cancer/

[WiseOne]

Great article, thanks for posting it dualstow! You could take that article and substitute "mammogram" for "PSA test" and "breast" for "prostate", and the concepts would be the same.

Interestingly, this is potential fodder for the "left is eating itself" thread. The reason why you'll never see an article like that written about breast cancer screening is that the writer will instantly be stoned to death (figuratively of course) for being anti-women. It is ironic indeed that women are, in fact, victims of breast cancer screening politics.

[Kriegsspiel]

4. Hopefully everyone already knows that prostate cancer screening has been declared useless.

I only remember Ben Stiller urging men to get tested. I just reviewed that after reading your post. Hmm.
https://www.healthnewsreview.org/2016/1 ... te-cancer/

All I know about prostates is they're up in your butthole region. Of course, I didn't know you should not get it checked out, but it's welcome info.

he reason why you'll never see an article like that written about breast cancer screening is that the writer will instantly be stoned to death (figuratively of course) for being anti-women. It is ironic indeed that women are, in fact, victims of breast cancer screening politics.

[dualstow]

All I know about prostates is they're up in your butthole region.

Hopefully just one.