An important, undiscussed point about depression

Strange coincidence, since we've been posting our thoughts and experiences with depression - I just heard a discussion about it on NPR. A psychiatrist was urging patients and their physicians to consider possible PHYSICAL causes:

1) car accident - even a minor one, like being struck from behind by another vehicle going 35mph - might have resulted in an undiagnosed brain injury/bruising/swelling that changed behavior and mood

2) medications that the patient has been taking for other, unrelated conditions - including "self-medication" with alcohol, pain killers, marijuana, occasional use of coke or amphetimines or sleeping pills or tranquilizers; drug interactions/incompatible combinations of prescribed and over-the-counter drugs.

3) heart disease (I had read about this before, and in fact I had a mild heart murmur diagnosed at about the same time I was diagnosed with depression. This didn't alter the need for an antidepressant, but along with a genetic predispotion to depression and/or alcoholism, it might have aggravated my condition. The cardiologist knew I had just started treatment for depression, and told me that there is a statistical connection between even mild heart problems and chronic depression - the link might be the consistent, although mild, shortage of oxygen and lack of energy. Undiagnosed, and without any serious heart symptoms like chest pains or frequent shortness of breath, the patient is simply aware that their energy level isn't the same as other people's, and they blame "laziness" or a lack of motivation. This perception of themselves aggravates the mood disorder. It might also explain why - in some depressives - exercise helps alleviate the condition.

This NPR doc's point was that many patients and psychiatrists go directly to the psychic causes of depression and/or treatment with psychotropic drugs without first ruling out injury, disease, drinking or drug use or the effects of having ended a program of medication.

He suggests that a complete physical and neurological checkup should be a first step when someone seeks treatment for depression. He was part of a multi-year study that took brain scans of depression patients, and found a significant percentage showed evidence of bruising or other conditions that may have resulted from head injuries that had been considered minor at the time they occurred.

Now all we need is a health care system that gives all of us access to brain scans, blood workups, electrocardiograms and complete physical workups in conjunction with the care of a psychiatrist we can afford to see more than two or thee times a year because - as in my case - my insurance covers hospitalization but not outpatient care. Then we might find out that depression isn't nearly as mysterious and difficult to treat as it seems to be. It just isn't taken seriously yet by insurers.

btw: until recently, many health insurers considered Alzheimers Disease to be a "mental illness" and didn't cover treatment or patient care. Studies like the ones outlined in "Listening To Prozac" are beginning to convince the medical and psychiatric worlds that brain function and body function are not separate, and that there may be no such thing as a "mental" illness that has no chemical or physical cause.

This is very interesting and worthy of note to anyone who thinks they may be suffering from depression or related disorders.

Despite my 2-year denial, marijuana was definately a contributor to my second phase of depression, as was lack of excercise to my first.

Many modern day occupations take us away from regular healthy excercise, even things like walking to the shops every day or riding a bike to work instead of driving or getting the bus. Such things should be borne in mind when wondering how to deal with depression.

Ax

Marijuana also played a key role in the relationship that led to my marriage. Talk about depressing...

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One might mention birth control pills and other endocrinological medications as laying a possible chemical basis for depression.

Originally posted by Pure
One might mention birth control pills and other endocrinological medications as laying a possible chemical basis for depression.

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Now I am depressed.

DS

I don't care what my psychiatrist says. I'm not depressed because I have an imbalance of serotonin. I'm depressed because my life sucks.

Boota, hon, for what it's worth from one who knows, it's most always a combination of chemistry, life and genes.

Take care,

Perdita

"...including "self-medication" with alcohol, pain killers, marijuana, occasional use of coke or amphetimines or sleeping pills or tranquilizers; drug interactions/incompatible combinations of prescribed and over-the-counter drugs. "

Y'know, maybe it's just me, but wether it's a cause for or an effect of depression, substance abuse just might need to be dealt with anyway.

/Ice

Boota said:

I don't care what my psychiatrist says. I'm not depressed because I have an imbalance of serotonin. I'm depressed because my life sucks.

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Yeah, sometimes there's that too.

But if you find that you can't enjoy things you used to enjoy - or that maybe your life doesn't suck more than average but seems more oppressive than it should - then there's something more to it than your circumstances.

Re: Re: An important, undiscussed point about depression

Icingsugar said:

"...including "self-medication" with alcohol, pain killers, marijuana, occasional use of coke or amphetimines or sleeping pills or tranquilizers; drug interactions/incompatible combinations of prescribed and over-the-counter drugs. "

Y'know, maybe it's just me, but wether it's a cause for or an effect of depression, substance abuse just might need to be dealt with anyway.

/Ice

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Yes, but note that the above isn't just about substance abuse. People taking prescription medications from more than one physician, or prescription meds and an occasional over-the-counter herbal "remedy," might suffer mood responses that go undiagnosed because there's no one prescribing physician who knows everything the patient is taking - and because most people aren't aware that over-the-counter herbal supplements are essentially drugs and can cause chemical reactions with prescription meds.

BTW, my pot-smoking days were halcyon times and were separated by many years from the onset of depression. One of the things I hate most about my depression is that on the one occasion a couple of years ago when I was offered a chance to indulge, it was a tense and entirely unpleasant experience.

My own reaction to marijuana was always an amplification of whatever I was feeling. There are some things that shouldn't be amplified.

I was kind of joking. Sort of. I read in a pamphlet on depression at my friend's kids' shrink about the imbalance of serotonin and that was the first thought that popped into my head. I've never seen a psychiatrist, but I'm sure that I am probably clinically depressed. I'm not worried about it, though. I have a lot of the tags, but I have too much drive to let it stop me. I'll smash through it like I do everything else in life. Actually, I'm probably more angry than depressed. I hate just about everything. But I'm pretty good natured about it.

Boota said:

I've never seen a psychiatrist, but I'm sure that I am probably clinically depressed. I'm not worried about it, though. I have a lot of the tags, but I have too much drive to let it stop me. I'll smash through it like I do everything else in life. Actually, I'm probably more angry than depressed.

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Just make sure you're aware if there's a progression - Or ask friends to be aware for you. We all thought we could tough it out at one time, and then you wake up one day and you've forgotten not only how you were planning to smash through it - but why you were going to bother.

That's when you're in danger. Because when you need the help, you might be incapable of asking for it.

shereads said:

Strange coincidence, since we've been posting our thoughts and experiences with depression - I just heard a discussion about it on NPR. A psychiatrist was urging patients and their physicians to consider possible PHYSICAL causes:

1) car accident - even a minor one, like being struck from behind by another vehicle going 35mph - might have resulted in an undiagnosed brain injury/bruising/swelling that changed behavior and mood

Click to expand...

How very interesting. I'd never heard this before. I wasn't in a car accident before my first bout of depression, but I did suffer a concussion... Of course, there were some other severe events that contributed to the depression, but now I'm wondering if this may have made it worse.

Hmm. Thanks, as ever, shereads.



Mhari, feeling really weird, posting on Lit from her parents' PC...

Re: Re: An important, undiscussed point about depression

Mhari said:

Mhari, feeling really weird, posting on Lit from her parents' PC...

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Ewww. That is wierd. I felt kind of creepy going to the public library in my mom's hometown to check my cyber-sex messages a few months ago. Just being in the same town AND using my mom's library card...plus the library shares a building with the sheriff's department, and this town is like To Kill A Mockingbird, circa 1930...

Ewww, Mhari!!

Hay Thats better than using your Sons laptop!

Hay Thats better than using your Sons laptop!

I could spend all day writing a list of things I used to enjoy that I don't care about anymore. (Sex being number one on the list.) Basically, the only thing I care about is writing. And even that doesn't always do it for me. I'm only sticking around to see what's going to happen next. I've got things working in both writing and music that could open some doors for me. If it does, great. If it doesn't, I don't care. I accepted years ago that I'm just killing time until I die.

It is a situation where I realize that I have some pretty good things, I just couldn't care less. I'm not suicidal, I'm just really apathetic toward my own circumstance. I was looking over an email questionaire once and one line said: "Finish this - The best things in life...". And all I could think to put was "... are still not good enough."

I'm on the verge of potentially breaking into two markets that I have worked for my whole life, so I want to make it work. But, I still feel that even if I get everything I could possibly want, it still won't be good enough.

Oh well, you can't have everything. Where would you put it?

Sorry about the double post.

Boota said:

I'm on the verge of potentially breaking into two markets that I have worked for my whole life, so I want to make it work. But, I still feel that even if I get everything I could possibly want, it still won't be good enough.

Oh well, you can't have everything. Where would you put it? [/B]

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Boota, this is where you're reaching out for help and I wish some of us were qualified to offer it. If I could tell you how many times I said, "I'm not suicidal but..."

I was still saying it - to myself - when I began hoarding sleeping pills. "I'm not suicidal but in case I ever am, I'll be ready."

An observation, from someone who spent decades being obsessed with the idea of success and failure: for God's sake, give yourself permission to want something completely different than these things you've "worked for your whole life," and already know you don't really care to have. Sticking with professional goals that had long ago become meaningless to me was a mistake that I made at enormous cost to my peace of mind.

Being part of a society that worships success and defines it by the most shallow measures, is something that a lot of us absorb into our very bones, to the extent that even when we realize that our careers are not a source of satisfaction and might even be a source of self-loathing, we can't "run away," we think we have to "tough it out." Who the fuck says we have to?

Watch "American Beauty" and see how dignified Lester Burnham looks in the Mr. Smiley's hat, flipping burgers. That used to be my nightmare - that I'd end up in a menial job like the ones I had during college summers - and when it became almost inevitable - as it is now - that I would no longer be able to sustain my career at the salary level that pays my mortgage, I had to start re-evaluating what, exactly, I had accomplished with my focus on career.

I watched that movie twelve times during the months it was in the theaters, and came away able to accept that there are worse things in life than failing at a career, or failing to own a home, or even failing at relationships. Failing to recognize your life while it's actually happening to you is the one failure that has the power to hurt you. The rest is just you, judging you.

I'm not obsessed with anything. I think that would be a step up. The two markets I am getting ready to potentially break are also the only things that give me any pleasure at all. Writing and music are it for me. As far as success, I consider it a success already. I have a novel coming out and I have released 4 CD's. Regardless of how the CD's were received (which was very good), or how the novel does, I feel good about both of those things. If I don't want these two things, there is nothing else that even minorly interests me. (Believe it or not, I wrote a comedy. LOL.)

American Beauty is one of my favorite movies. I saw the same thing in Lester that you did. Happiness in simplicity. I'm interested in success, but only on my terms. And my definition of success might be considerably different than the average person's definition. I am trying to keep my life as simple as possible.

When I saw the symptoms of depression listed in that pamphlet, I recognized a lot of that in myself. But I recognized a lot of it in everyone. Going by what they listed, I don't think I know anyone who isn't depressed. In fact, I believe that MOST people's lives are just barely good enough to prevent suicide.

Sigmund Freud said that suicidal thoughts are just murderous impulses turned inward. I would have to agree with him, to a point. I've been suicidal before, but never to the point where I thought it was something that I would really do. Mostly just thinking about it. I did a little planning for a while. I incorporated it into my book. The main character does exactly what I did. I bought a calendar and everyday I would write one good reason to live. On the days when I couldn't think of a good reason I put a big red X. On New Years Eve I would count the X's versus the reasons to live. I had the gun sitting on my desk, absolutely ready to use it if the red X's outweighed the good reasons. The first year I did it I had 180 red X's. The second year I only had 102. The third year, I gave up in June. It was the little things that kept me in the game. Ice cream, or cartoons, or cold beer. A good movie or a great book. Stuff like that. The only rule I put on it was that another person couldn't be the good reason I gave.

I have the money in the bank to buy a home, but I haven't done it yet. For two reasons, mostly. One, I don't know where I want to live, and two, I wasn't sure even if I wanted to live. I held off on that for practical purposes. It's easier to handle cash in an estate than property. That was my train of thought.

I really am fine. I will figure everything out. I always do.

You're not fine, and you know it.

The next step is to decide whether to access the help that's available, or to settle for things as they are and hope they don't get worse. If there are people in your life who care about you, and if you don't want to burden them with an incomprehensibly painful grief, please find out from a doctor if there's anything that can help you.

Boota said:

. . .When I saw the symptoms of depression listed in that pamphlet, I recognized a lot of that in myself. But I recognized a lot of it in everyone. Going by what they listed, I don't think I know anyone who isn't depressed. In fact, I believe that MOST people's lives are just barely good enough to prevent suicide.

. . .I really am fine. I will figure everything out. I always do.

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I must agree with shereads and say that I don't believe you are fine. Pessimism taken to that extreme degree just isn't healthy.

You seem to be quite intelligent; you are probably aware that true clinical depression is nearly impossible to "cure" without some type of help. (And of course you realize that reading a pamphlet is not an accurate diagnosis.)

If there hasn't been a significant event in your life to cause this (i.e. death of a family member, divorce, job loss, etc.) it seems dangerous and a bit "inappropriate" to have those feelings.

It isn't possible to be happy all of the time, of course. People who believe that are idiots. Most of the time would be nice!

I would see a medical doctor, honestly. Rule out physical causes.

Then suck it up and go see a psych. What can it hurt?

(Actually, we see a psychiatrist monthly. My young kids go to a terrific child psych to help control their ADHD. And both have recently started anti-depressants because their gifted brains cause them to stress about every damn thing!)

Living is stressful. If it wasn't we'd all be bored to tears.

Please think about seeking an expert's opinion on this.

Boota said:

When I saw the symptoms of depression listed in that pamphlet, I recognized a lot of that in myself. But I recognized a lot of it in everyone. Going by what they listed, I don't think I know anyone who isn't depressed. In fact, I believe that MOST people's lives are just barely good enough to prevent suicide.

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I worked in the pharmaceutical industry, and I can tell you that the big Pharma outfits spend more on marketing than they do on R&D (this is the truth). Those "Are you depressed?" tests and "Do you Suffer From AADD?" are put out by the marketing departments, and while they may have their roots in sound medicine, their purpose is to sell pills. Probably 90% of the population would test positive for whatever they're testing for. The Doctor gets his diagnosis and is able to treat it, and the patient gets some pills, so everyone's happy.

The pharma houses also spend an awful lot of money on educating doctors at special tax-deductable "seminars" in Hawaii and Cozumel and the like, where the symptoms of depression or AADD or whatever disease they're marketing drugs for this month are drummed into the doctors' heads, along with the company's new Drug of Choice.

The next time a fad diagnosis comes along--some vague disorder that they suddenly discover is endemic in the population--I'll bet you 10 to 1 that some company has just come out with a marketable treatment for it. That's the way it works.


---dr.M.

I noticed right away that the pamphlet was put out by a pharmaceutical company. I figured that was why the symptoms seemed so vague. You have to make sure that everyone needs your drug. They'd be out of luck with me. I refuse to take any pill for any reason. The last place I worked tried to get us all hooked on pain pills. It worked on most of the guys.

Maybe I'm not fine. Almost definitely, I'm pretty fucked up. But I wouldn't fix it for the world. This is where my creativity comes from. When I'm happy, I don't create. I don't even feel like it. And if I'm not creating I'm already dead.

Despite the tone of my posts, I'm really not a downer person. This is just a small part of who I am. If you were to ask the people who know me they wouldn't consider me to be someone who brings things down. I do have fun. I do fun things. It's not like every second of every day sucks, although I probably made it sound that way. I think a lot of my worst times are in the past. I'm not really pessimistic in most ways. If I was pessimistic I would never even bother submitting my writing to anyone. Or thinking that they are dickheads missing out on something good when they reject it. LOL.

I would like to thank all of you for your concern and your input. There may well be a problem, but I don't care to fix it. Generally, I like who I am. Even the bad parts.