163 new of 170 responses total.
I have a friend who's a clinical psychologist, who works with some severely messed-up people. His advice to people who are depressed is to drink a ton of water (more than you're thirsty for -- like a couple pints) and get out in the sun and exercise, even if it's just walking around the block five or six times. He doesn't claim this will work for everyone, because some really will need medication and/or therapy, but it should at least lessen the effects and in mild cases can lift the depression. I don't know why this works, exactly, but I've seen it do the trick, and he's got hands-on experience to back it up. Your mileage may vary, but his method costs nothing and is good for you even if it doesn't lift the depression, so it may be worth giving it a try.
When I worked at ASH, one of the things we did for people who were depressed was to strongly encourage them to get out and walk around the block a couple of times a day. It really does wonders even with folks who really need the medication. I also have had personal experience with depression and I have found that walking in the daylight makes a huge difference. Socializing helps too if I feel up to it but like others have described here, sometimes I am not. A walk around the block and good cry go a long way. I have also tried the water thing. Sometimes it works for me, sometimes it doesnt. The theory behind it is that a small bit of dehydration will make you feel low energy which can feel like depression. You wont necessarily feel thirsty. So drinking some extra water might help. I know that I feel really tired when I dont get enough water so there might be something to that. Personally, I think that doing something, no matter what, does help lift depression. Taking action helps depression. I think it even can help if that something is simply talking about it with others. This is why it is a real shame that there is a stigma attached to depression and therapy. It keeps people from taking action to deal with the depression and ends up making the illness worse.
In part, I think it's simply a part of larger picture. We're emerging from a culture that taught people to keep their problems under wraps, whether it be illness, addiction, abuse, you name it. Actually, I do think that everyone's moods can benefit to some degree with regular physical exerise of varying levels. In my case, I used to work out 2 hours everyday, and it felt really great. For me it was also a distraction, not just theraputic. A double-edged sword. I think it will be easier for me to do the things I enjoy, including physical exercise, sports, etc., once certain variables are more under control.
I think part of it might also be that in the past, people's daily lives involved a lot more physically hard work. And it was easy to get motivated to do all that exercise because if one didnt get up and farm the land, one ended up starving or in the poor house or whatever. People didnt have time to be depressed.
My grandmother says that about divorce. People didn't have the time to examine if their marriage was good - they were too busy working.
That does in fact make sense to me . . . For some, including myself, staying busy is a great way to forestall the worse parts of depression. The more one focuses on their work, be it manual labor or any other type, the easier it is to ignore, if you notice it at all. I was one of the ones without a clue.
People my age grew up facing the real possibility of global nuclear war and the expected result of most or all life on the planet being destroyed. We had bombing drills when I was in elementary school. My parents grew up during the Great Depression and World War II, then brought me into the world to face the aforementioned nuclear war. Their parents grew up when smallpox and polio killed and crippled many. The generation preceding them worked 15 hours a day on farms, every day. They came here from various places around Europe, for the most part, so they could enjoy that kind of luxurious lifestyle in relative peace. I don't think young people now have it all *that* tough.
One set of stressers got exchanged for another, that's all.
That's an interesting comparison. I like it because it says something about the way we look at depression. Everyone, I think, will agree that something's wrong if you're too busy to tell how your marriage is going. But I'll bet that "too busy to be depressed" sounded pretty good to you, at least at first. It sure sounded good to me.
Er, that was re #12.
Something I've noticed about mild or moderately depressed people is that they spend a whole lot of time thinking about themselves. They are doing this moment to moment thing measuring how they are doing in this situation and what is that person thinking about me and why in the world did I do that, etc. I'm not sure what comes first, they get depressed because they see themselves under such a microscope (who wouldn't) or the depression draws them into a "me" circle.
My guess is that it comes in all forms, and that even the "me" circle that you talk about shows up even in the most subtle of ways, including self-critical behaviours.
Good point, Mary. Yeah, I find that my mood goes down when I'm not working with kids as much, probably because when I'm working with a roomful of them I don't think of me nearly as much as I do when I'm not. The post-camp depression is the worst.
I get very self focused when I am depressed. I have no idea if the self focus comes first or not. I will have to pay attention to that.
Isnīt it a chicken - egg question? I honestly canīt tell which comes first. But, Mary certainly has got a point.
Exercise will definitely have a profound effect on mood. Most people don't get enough exercise -- the result of 20th century labor saving devices. So far as water goes -- if you're sendentary and you're going to get more exercise, you'll need more water, even if you were drinking "enough" before. More exercise means you need more oxygen which means you need more blood flow -- and hence more water. A lot of people don't drink enough. In former centuries, when water wasn't always safe to drink, natural selection favored people who didn't get as thirsty. Basically, long-term problems like heart problems were less bad than the short-term risk of cholera. I know I'm one of those people who don't get thirsty often enough, and sometimes it's a chore to drink what I know I should.
emotional modes i excel at when displaying include: glee, scorn, contempt,
lust, adoration, giddiness, anxiety usually of a contorted type, and
depression; i can do depression like a scarecrow of honey and suet coming
apart on the davenport; i can do depression like digging a dustbowl in my
stomach with a broken bottle of wine; i can even do a depression rich enough
to give my reflection in the mirror halitosis.
despite my talents in this latter modality, i gave it up. the reason i exude
these emotions with significant clarity (minimal disparity between interior
& exterior) is because i've been expressing them longer, more often, and more
freely than emotions i either tend to not have (like pity, remorse, and
boredom) or have in some way been restricted from expressing (such as sorrow,
anger, and pride). when i adore an object, or when i'm stimulated into (a
shallow wet bag of) anxiety, i don't make a mistake about how i feel, my body
responds along a thread woven back uninterrupted to early years. i'm better
at glee than at contempt; better at contempt than at lust. i was a gleeful
kid. i didn't take up contempt until 4th grade, when friends mike + stephan
and i entered personal competition making models of the solar system from
scratch. (i don't know where they are today, but if stephan isn't dead from
drugs -- he had an atrocious pair of parents to raise -- i expect and hope
he's excelling in some esoteric corner of some branch of science. about mike
i'm too unresolved to comment.) lust began occurring when i was 10, but i
didn't figure out how to display it until i was 17. frequency of occurrence
and opportunity for display has given me the chance to better learn
displayment in a shorter period of time than some other feelings.
i took up depression -- the optional, easy to swallow grape-flavored
child-formula depression -- when my family moved from the comfortably shitty
ranch house and trailer trash hood to the two a story subdivided
gentrification project, where we lived in a house of cards that rained down
quicker than i could keep the mawn lowed, so that'd be age 13. it was long
preceded by anxiety. anxiety is useful: it can be entertaining, funny, and
you can get work done. even sadness (i'm told, although i've tried out this
modality a handful of times only in the last year) can turn to song.
depression is like a nightmare spent eating spoonfuls out of a 5 lb bag of
quicklime.
by 'giving up' depression (oh if it were so), i mean, i think, that i replaced
it. suppose for sake of an argument that depression isn't itself an emotion
but a complex of sincerely beheld emotions gone unexpressed, thus a bilious
residue of stifled feelings, their potency choked and reduced to crap coating
the inside of your skull. imagine that every sincere emotion is NOT not-like
an orgasm; now attribute individual character and livelihood, here in the land
of make-believe, to each emotion and imagine the complaints of those
within you who never get to come, or at least not as much as the others
get to, or AT LEAST not as much as they get hard up for a pop. fucking
inhumane treatment of one's self, i'd believe.
is this an excessively cartoonish depiction of that oddball social enemy,
Depression -- an umbrella state of mind pushed open by complexes of
malnourished feelings? i don't go in for -- i'm not so far convinced of --
physical theories of mind, in which, say, every state of mind in an
individual ("in" an individual? a topic for another time.) corresponds
with a quantifiable brain-state; so i'm also not convinced that
depression, well and workably alleviated by rest, pharmaceuticals, and
exercise on sunny days, is solved (unknotted? discord!) other than by
expressing repressed thoughts and feelings. (belatedly noteworthy: i don't
think i want to include the phenomenon of depression in cases of clear
physical brain trauma, debilitating psychosis, and other messy odds and
ends, in the preceding exploration. not because i have some dividing line
in mind between these 'errors' or 'broken' people and the 'properly
working' humans to which the exploration applies -- i would have to accuse
myself of dense solipsism, nobody likes that. rather, instead, that the
capital-D depression much in the headlines yesterday and today is
something like an epidemic, which is of normative concern, mysterious in
origin But that we are human. possibly even contagious -- have you ever
caught a case of depression? answers below.
this is still murky, i think, but i don't intend to tell a man with a
butchered cortex that he just needs to let it all out to get rid of the
blues and expect it to work, even in cases where he could comprehend me. i
do wonder, though: people with life-changing brain injuries, and certainly
those with emergent psychosis, are probably disoriented (scared) enough
that without the ability to express it molts into depressed spells. this
is grossly speculative without being necessary but it occurred to me to
mention it.
so eat well, get plenty of exercise and rest, and strip yourself of all
self-censorship and inhibitions if you'd like to leave the poppy fields of
depression. and no, i'm not on meds delizia, you cocksucker.
*glee*
again, I would that people could be convinced that depression and other disorders aren't necessarily temporary states. Bipolar and some types of depressive disorders are chronic, but they can be managed. Perish the thought (but perhaps some would rather remain ignorant than do the research) that anyone would seriously believe they are contagious.
This is true - but many people get slapped with meds after an initial diagnosis, seek no counseling and thus, never get their meds readjusted.
26 what organizing cause do you suggest underlying chronic cases? or causes. do the causes of chronic cases lead us necessarily to pharmaceuticals as method of management? my suggestion of contagious depression is pointed at cases where organizing cause can smoked out with psychoanalysis; the easiest example of adapting depressive modes of thought and responsiveness to feelings is a depressive parent to dependent, learning child. if the child grown to adulthood becomes depressive, what is there to assure us that it's physical illness (mental as physical) and not complex of neurosis?
resp:28 Well, yes, trauma, family dysfunction (cases of nuture, not nature) could be treated fairly well without pharmacopia. The important thing to remember is that patients need to be informed and knowledgable of both the conditions and treatments they are receiving, know what options are available to them, and be sure that their doctor is willing to work with them to achieve the best possible outcome. Talking to my last psychiatrist was like talking to a brick wall sometimes. I'm glad I'm rid of him and hope to see someone new. I'm looking into Rapid Eye Therapy (RET) as a means to treat addiction; perhaps mood outlook might improve. It's nothing for sure, of course, but after 17 years of traditional counseling, I'm ready to try something new.
a friend of mine began RET six months ago. i don't know if she's still doing it, and i haven't heard any update. between me and my friends (we talk about our shrinks a lot) this usually means it wasn't successful, but i'm not prepared to settle on that conclusion. it sounded fascinating as hell when she told me about it. i've seen shrinks off and on since i was 14, and, of 8, 2 have been worth a damn. the first was a fluke, a chill fella who wore hawaiian shirts open at the chest and his hair long and in a tight braid. (a lot like happyboy, really.) because i was assigned to him by the court and because he was changing his schedule to work with alcohol-troubled teens in groups, i had to stop seeing him. the 2nd good shrink, my current one, was found on referral from the first one. this, along with the multitude of tales from friends and acquaintances on the difficulty of finding a decent shrink these days, combined with the decor of shrinks' offices changing over to pamphlets, calendars, clocks, inspirational posters, and stress-relief squeeze sponges all bearing the corporate logo of some pharmaceutical company or another, has suggested to me a crisis in the current state of american psychological mental health. email me if you'd like any contact info for my current so-called good shrink.
What's the difference between RET and EMDR?
what's EMDR?
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EMDR is Eye Movement Desensitization and Reprocessing. It's supposed to be a way to move irrationally strong feelings from seeming immediate to seeming more remote. My therapist wants me to try this for my anger with regard to my divorce.
RET= Rapid Eye Therapy. Apparently, RET and EMDR may be similar yet independently produced theories. I am not sure of the second, but RET is recreating and using rapid eye movement (REM) as in active sleep (dreaming stages) to reprocess thoughts and memories associated with certain traumas, addictions, etc.
RET is a philosophical, spiritual thing. EMDR is a psychological treatment. That's about all I know about them.
What are your thoughts on trying EMDR, John? Do you know yet how it's supposed to work? I suppose one of hardest things to do is to know where to begin? Despite the fact that a lot of the depression discussion can consist of chicken or egg first arguments sometimes, somtimes it's a matter of figuring out from which angle to begin, to help you focus on other things, progressively changing certain learned behaviours. (I don't know if that made sense to anyone.)
I've told my therapist I'm all right with trying it. He says he's worked with it for several years and seen it work a lot. I don't know how it's going to help me exactly. He gave me some examples. One was a mid-30's man who broke down and was unable to stand up to his mother whenever she was critical to him, going through EMDR and then he was at least able to say "no" to her. No one knows *how* it works, from what I understand. It just does. Okay, fine. I can live with that. It's supposed to take feelings that seem very immediate and move them into a part of your brain where they seem less immediate. It won't help me get over what he calls my grief over the divorce. It could help me get over being unable to control my inappropriate anger. The problem for me is, I don't consider my anger inappropriate. I guess I have to get over it anyway. That's a hard part for me. My depression is pretty specific and situational. I don't think I was depressed before the divorce came along. I don't know of a good way to deal with the divorce. That's my whole problem. I guess. I risk taking over this item and turning it into another divorce item. I don't want to do that.
Don't worry, I don't think we'll let that happen. :) On your anger in general . . . not admitting or not believing that the anger is inappropriate, I would think, may hinder your ability to make a success out of the EMDR.
Anger is inappropriate when you cannot control it and when expressing it does not do anybody any good.
re #39: Right, it is difficult for a therapist to help you solve a problem you don't want to solve, or don't regard as a problem. My therapist usually describes EMDR in idyllic terms. I have wondered what would happen if I asked him to help me get over my inappropriate inhibitions against attacking someone... surely such things can be used for different types of goals. I'm sure he would not be willing to help me in that way, though. re #40: The anger is inappropriate, or expressing it is inappropriate? What do you mean by "control"? Control when to feel it? I'm a failure at that. Control what happens as a result of it? To what degree? I haven't physically attacked anyone yet, or raised my blood pressure to the point where I have a stroke. I've said and done things I regretted because I was angry, both during my current divorce and accompanying depression, and in the past. Anger is an emotion. It's just there. It's not right and it's not wrong. It's a thing to be dealt with, like intelligence or a headache.
(Reports I've seen have said that EMDR shows zero effectiveness in trials which compared "correct" therapies versus "wrong" therapies for the disorder to be treated. You'll get something from the placebo effect, but that's no reason to pay someone a buncha dough.) (If you have an ethical problem with feeding scammers, even if it's your insurance company's money and not yours, avoiding EMDR is probably a good way to feel better about yourself.)
There are more useful ways to react to situations than with anger, whether or not you act on the anger. Anger can hurt the person feeling it (interfering with sleep or with doing something to improve the situation) and expressing it can make things worse. People who get angry assume that the other person did something specifically to hurt them, when they were probably just acting to help themselves and did not care much how it affected other people. It is less stressful if you can just try to forget what they did, or deal with the consequences without getting angry.
Anger is an inappropriate emotion? That reminds me of Marge Simpson when she gives advice to sad, depressed Lisa to push the emotion deep down to your toes and forget about it. (o yes, I get my ideas from the magic black box called tv :) Anger is quite natural as such. It only depends whether that emotion is justified. John is right, it's just an emotion. IMHO storing emotions in another part of the brain with EMDR seems pretty insensible to me, but I may have an entirely wrong impression of the process. I remember I have done RET for awhile.
Russ, do you have more information on that. Now I'm really curious. If you just point me to one of the beeter sites . .. or would APA or like groups be a decent place to start?
Re 43 Gee - I can't imagine why you aren't a therapist.
#44> The father on King of the Hill's advice is much simpler: "Swallow it. Just swallow it."
There is very little information on the WWW about EMDR, and I didn't think any of it was very objective. There are sites which promote it as an ideal therapy for almost anything, and others which denounce it as completely without basis (without saying anything about whether it's effective). My therapist is a proponent who says he's seen it work a lot; at least I know him somewhat and so I'll go with his opinion. When I give it a try, I'll bring back a report about what it was like.
Well, obviously, people respond differently to such therapies as they do with everything else. Good luck with it, John.
Thanks!
Re #45: Try searching csicop.org. Unfortunately all of my back issues of Skeptical Inquirer are buried pretty deeply (dead trees are nice for reading, lousy for searching). Re #48: If you look at the claims for EMDR and the claims once made for snake oil, they sound eerily similar. Probably for good reason, too.
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((inferno item #7 <----------> recovery item #21)) see also item:19
There's no real basis in snake oil - outside of the placebo effect -
and EMDR has a real basis, though it doesn't follow most of the research I've
read in the field, in eye positioning based on emotional states combined with
creating physiological states to influence psychological ones. Insofar as
I can tell, both phenomena are real, and therefore EMDR may have some basis
in fact.
from http://www.quackwatch.com/ Eye Movement Desensitization and Reprocessing (EMDR) EMDR is promoted for the treatment of post-traumatic stress, phobias, learning disorders, and many other mental and emotional problems. The method involves asking the client to recall the traumatic event as vividly as possible and rate certain feelings before and after visually tracking the therapist's finger as it is moved back and forth in front of the client's eyes [6]. EMDR's developer and leading proponent, Francine Shapiro, Ph.D., received her doctoral degree in 1988 and established the EMDR Institute to train mental health professionals. She and her associates have trained more than 22,000 clinicians worldwide in workshops that in 1997 cost $385 [7]. EMDR resembles various traditional behavioral therapies for reducing fears in that it requires clients to imagine traumatic events in a gradual fashion in the presence of a supportive therapist. However, controlled research has shown that EMDR's most distinctive feature (visual tracking) is unnecessary and is irrelevant to whatever benefits the patient may receive [8]. Recent reviews have concluded that the data claimed to support EMDR derive mostly from uncontrolled case reports and poorly designed controlled experiments and that the theory of EMDR clashes with scientific knowledge of the role of eye movements [9,10].
re #55: I've read that type of comment about EMDR, but the comment doesn't address whether it works or not. My therapist claims it does work. However, I think he's giving up on trying it on me at least to help with my biggest problem -- anger over my divorce -- since I think my anger is appropriate and not something that needs to be cured. So, those who were concerned (from the divorce item) that I was going for some quack therapy can relax about that. I at least have not tried it yet.
There's another article in USA Today, questioning the value of antidepressants. http://www.usatoday.com/news/healthscience/health/drugs/2002-07-08- antidepressants.htm The article says tests show they work only 18% better than placebos, which I expect means they helped 18% of people. Maybe I'm lucky, but I believe my Zoloft prescription is helping me a lot with my depression. It hasn't cured everything, but it's given me a break from hopeless despair to a much more normal state of mind.
Some of the best and most powerful treatments out there work because of the placebo effect. So your 18% is probably far too low an estimate.
As I recall, placebos work pretty well for depression, so wouldn't that mean antidepressants work pretty-well+18% ?
I can believe my own positive effects were a placebo effect, or at least partly so. I got even more depressed when it looked like it was going to be a month or two before I could see the psychiatrist who was to prescribe something for me. I felt a lot of hope once I got the prescription, and had one terrible day when I forgot to take it, not long after I'd started. Then I gradually but steadily started feeling less inescapably down. All of that could as easily be a placebo effect as a real medical improvement. I don't care what helped me, though. I've felt a lot better since taking the Zoloft than I did before that.
There's a variation on the placebo effect -- unfortunately, I don't remember what it's called -- that might be relevant too. I seem to remember hearing that a placebo with some tangible but irrelevant effect -- a caffeine pill, say -- will work better than a totally inactive placebo.
I too have found that the Zoloft has helped enormously; however I can still sense the underlying habits of thought that caused the problems in the first place. Man shall not live by drugs alone...or something. I'm actually finding it enormously difficult to remain semi-organized since starting on the medication. I'm quite sure it's related. Normally I often need to reach a certain state of agitation about something in order to get off my butt and go take care of it; since starting zoloft my reaction to nearly everything is along the lines of "aaah, who cares." Perspective, but at what cost?
I took Zoloft for 6 months. I found that it helped me quite a lot. It doesnt matter to me if it was a placebo effect or not.
#62> that sounds like my reaction to Paxil. I was still Socially Anxious, but I didn't care anymore. I still sat on my butt on the couch constantly, but it didn't depress me, and I was content with that. If I hadn't had the (substantial) physical side effects, I might still be on Paxil, to my own significant detriment.
I've been on Zoloft for eight years now. It helps. I have been told that I'll be on it forever, since for me it's more of a maintenance thing than not. I have a chronic chemical depression which doesn't react well to therapy or to muich of anything except the anti-depressants. I have noticed that I can function much better with it than I ever did without it, and since my mother's family has had similar long-term depression (both my grandmother and mother for sure, and most of the other female relatives) I am pretty sure it's genetic and not something I can just "snap out of" or deal with without my Zoloft.
apathy pills i found that taking apathy pills helped me not be depressed, but i hated the feeling of being apathetic. i also felt like i couldn't concentrate on something for very long. i also don't like being around people who take apathy pills. the people i know who take them are generally just as neurotic, they just don;t know it. or don't care. cocaine has a similar effect, only it makes you a real asshole - but it's okay, because you'll think "ahh, who cares". i apologize to those whom i may have offended.
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Yeah. Whatever.
One side effect the Zoloft has had on me, which would be a major detriment to most people, is the loss of my sex drive. I probably have an erection about 1 time per week these days. That's a fair amount less than before I started taking the prescription, though I was never the most sexual man anyway. As it is, this isn't much of a disadavantage to me. I don't want to date right now anyway, and don't expect I will until quite a while after the divorce is finalized.
Loss of sex drive would depress me.
heh yea .. even if i didn't want to date. lol@#67
Loss of sex drive is not enjoyable, but when you're celibate anyway, it's dispensable. I'd probably be even less happy if I had any sex drive, under the circumstances.
The psychiatrist was very concerned that I let her know if I should experience loss of sex drive as a side effect (I haven't). I *am* still capable of being excited or enthusiastic about things, but it takes more energy to get over the initial who-cares activation energy hump thingy. The biggest side effect I've noticed is being almost perpetually sleepy. I used to sleep 7-8 hours a night, these days I want about 10 hours and then I still have an overwhelming urge to nap in the afternoon.
I told my psychiatrist right from the start that I could tolerate the loss of my sex drive, given that I'm going through divorce anyway. He hasn't ever asked me about it, and was not interested when I mentioned it to him once.
I was on Prozac for a while, in college. I don't remember it making me apathetic or inactive -- actually, it made me more active, by lessening the depression that was robbing me of all my energy. I didn't have any side effects while I was on it, but I had some coming off.
The sense that I get is that different people respond to low serotonin levels in different ways. If your usual response is to get anxious, Prozac might calm you down. If your usual response is to get sluggish, Prozac might give you a bit of a boost.
There are abundant historical references to the use of cannabis as a suggested treatment for mood disorders like depression. (1) However, human studies are scant and the results are mixed. A 1947 study of 50 depressed patients administered synthetic THC found the drug beneficial to 36 of the participants. (2) A double-blind controlled study conducted three years later on 57 patients reported that the administration of small doses of synthetic THC did not improve their symptoms. (3) A pair of more recent studies also yield conflicting results. One reported that cannabis helped relieve depression in cancer patients, while the other determined that THC failed to improve depression in eight hospitalised patients. (4) A 1994 survey of 79 mental patients found that those who used cannabis reported relief from depression, anxiety, insomnia, and physical discomfort, as well as fewer hospitalizations. (5) Lastly, a 1996 study cited in the 1999 Institute of Medicine (IOM) report, "Marijuana and Medicine: Assessing the Science Base," found that Dronabinol (oral THC a.k.a. "Marinol") significantly assuaged mood disturbances and anorexia in 11 Alzheimer's patients. No side effects were observed. (6) The conflicting data concerning cannabis and depression should caution patients considering experimenting with the drug therapeutically. Additionally, cannabis' ability to occasionally produce paranoia and other dysphorias (typically among inexperienced users) could heighten some patient's feelings of depression. Cannabis' most promising potential to mitigate symptoms of depression likely lies with patients who have previous experience with it, and are failing to respond to traditional therapies. http://www.gwpharm.com/cann_ther_depr.html
Being single for a long time makes you lose part of your sex drive as well. (lack of practice, guess) That reminds me of dr. Ruth: 'use it or lose it'. Celibate by choice, but not the first choice. Yet, I am certain things might stirr again (grin) once I start dating again, or meet somebody I can relate to. One night stands just for physical pleasure has never been my cup of tea. Fortunately I am not really depressed about it.
Well, even if a person is single, one can still have a sex life. You know...develop a relationship with your hand ;)
Amen, sister, amen.
I read an article today in the Chicago Tribune "Depression looks more like a physical thing". http://www.chicagotribune.com/features/health/chi-0207070369jul07.story?col l=c hi%2Dleisurefamily%2Dhed Basically, it says advances in brain-imaging technology like PET and fMRI may indicate that depression may be more physical than functional. An excerpt: "Before we had the new imaging technology, we couldn't get inside the brain; it was just a black box," said Dr. Jan Fawcett, chief of psychiatry at Rush-Presbyterian-St. Luke's Medical Center. "Now, if you look at the PET scans of people with just depression, what you see is a shutting down of activity in their frontal lobes," he said. "It won't explain all depressions, but it'll explain many causes of depression. The most important thing it'll do is to show that depression should be considered a medical illness." The new findings should go a long way in helping to end the long-standing debate over whether depression is organic or functional. Organic means there are physical and chemical changes in the brain that produce depression; functional means it's purely psychological. "It used to be thought that there was nothing really physical in the brain that's causing depression," said Dr. Emil Coccaro, a University of Chicago professor of psychiatry. "Now we're actually starting to focus on the organic reasons for these behavioral problems and to locate where they are." A massive problem Understanding the causes of depression is vital because the problem is massive. About 1.5 million Americans suffer brain injuries each year, and 25 percent to 40 percent will experience depression, many of those with lifelong depression. Post #65 seems to go along with this. I wonder if regular short term depression (due to bad things happening like death of loved ones) tend to be functional and long and recurring depressions tend to have physical origins. I've been guilty in the past of suggesting to someone with depression that they just needed to change their attitude. A family member who later opted out of life, which made me very depressed for a while. But after a while, I found not dwelling on what happened, prevented depression. So the attitude thing seemed to work for me (after a while), but I probably wouldn't suggest that to someone with chronic or long term depression.
Hopefully this discovery will help reduce the stigma that's currently attached to depression and mental health care in general.
no kidding. This is good. I know there are studies for chemical causes of bipolar disorders; it shouldn't be unreal that unipolar disorders shouldn't have roots in chemical imbalance.
There are actually a lot of studies out there demonstrating that depression is biologically real, this is just the latest one to get picked up in the media. A friend of mine is a PhD in biopsychology, and it's frankly pretty well established -- understanding the mechanisms themselves, and the etiology of depression, is a different story.
While they have determined that depression is biologically real and that there are measurable differences in brain chemistry between those with depression and those who arent depressed, they have no idea what causes depression. They dont know if the observable brain chemistry of depressed people is the cause of depression or not. They have not ruled out functional depression.
All true.
There is also the understanding that MDs and Psychiatrists often prescribe antidepressants in combination with one another, though there are some that you cannot mix at all. Wellbutrin increases the levels of norepinphrine and dopamine and is primarily a stimulant to brain activity, and Celexa is an an SSRI. These drugs work with different chemicals in the brain.
...and nobody really understands why they work for depression.
or whether they do, for that matter (the effect of SSRIs isn't that much better than placebo).
True, though placebos can apparently work very well for depression...
Sure. Just don't tell people it's a placebo, and they do wonders. Which means that depression really IS heavily perspectually, but I don't think very many people really ever questioned that.
Well, yes-- cognitive therapy *is* a fairly good approach, and meds rarely are even close to 100% of the answer.
"perspectually"? Wow. How the Hell did I mangle it THAT bad? Oh well, I guess y'all knew what I meant.
It is definitely an issue that is not black and white. The reasons behind depression and what perpetuates depression are so many and the varying treatments--both medical and otherwis--so numerous that it makes sense that individuals perceived as having depression be considered on an indivisual basis.
Part of the problem, too, is that nobody's really sure where the line is between physical and psychological causes. After all, thoughts -- at least, as we understand them now -- are events in the brain, and the brain is a physical thing. It's very hard to come up with a medically useful definition of a psychological cause that will actually distinguish it from a physical one. But, like pornography, everyone's convinced that there is such a thing as a psychological problem, and that they know it when they see it.
From a personal point of view, I would have to say depression must have a fair physical basis. I've been diagnosed with dysthymia (as has my father and brother). All three of us have tried various drugs (I took Paxil, my brother took Zoloft, I don't know what else dad tried), and NONE of us responded well to those. All three of us responded well to wellbutrin (I felt like I was on speed, which was what I needed to get up and get going). Also, all three of us eventually quit taking wellbutrin because it wasn't helping any more. This was over different time spans for each of us, and we didn't necessarily know any of the others were or weren't taking anything. So it's a small sample, but to ME it points pretty clearly to some sort of genetic link. I've also thought of going back on wellbutrin, but when i call the psychiatric center to see if there is information on antidepressant tolerance they refer me to my insurance company, which is less than helpful.
That's the biggest barrier to getting competent care for mental heath, besides the shortcomings of individual patient involved -- Insurance Companies.
yeah =P Insurance coverage for mental health sucks.
But that at least keeps the cost of insurance a bit lower. Zoloft is also used for obsessive-compulsive disorder and other things. Serotonin seems to have lots of different functions.
My insurance for my mental health care is actually quite good.
My insurance coverage is pretty decent for mental health. But they way that administer the mental health portion of their services is not. You have to call a specific number and tghey'll give you a list of names from a list, and you go and see if they are taking patients. So you can't even go to the therapist you want if they do not take your insurance. So I dedcided that I would go on my own and find a therapist and opay for it myself. It's not cheap, but I didn't like the alternative and could afford to avoid it. I get the prescriptions for antidepressants from my MD, who is cleared to speak with my psychologist. So insurance does in fact help me out
My health insurance is through MIT. They jump three feet in the air, rush you to the mental health center, and hand out one free straitjacket for each friend brought in with depression. Something to do with the suicide rate....
Hey, Carolyn, have you heard about ehnotorious prof in Harvard's chem program? A couple of this guy's studends committed suicide. This was before either you or I got to Boston
Yes; last I heard (which was a couple of years ago) he was being forced into retirement. I've heard some pretty crazy stories about the way he treats his students and particularly his postdocs. My undergrad advisor worked for him for about a week (was called up for military duty, I believe?) and really really hates him--he went to work for someone else on his return. According to his story, he went to say goodbye before leaving and the secretary wouldn't let him in, saying that the prof was busy. The door to the prof's office was standing wide open and he was sitting at his desk at the time.
I would have shouted "Fuck you, then; burn in hell," but then I'm rather fiery if my sincerity was to be so blatantly disregarded like that.
Yeah . . . I heard story after story from my friends in the grad chem program. If he's being forced into retirement, that's definitely for the students' benefit! Grad school as it is can be rather difficult emotionaly/mentally; you don't need professors making it worse.
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I thought I would give this item a kick in the pants rather than add more to the bummed item, which is chugging along at a good pace without clogging up the works. As noted in the bummed item recently, somewhere between my Dr. and the pharmacist, one of my medications was screwed up. Although I was frustrated and wanted to get this cleared up, I though this would also be a good oportunity to find out if I needed both medications, while making a damn concerted effort to get this cleared up and not simply stop taking one of them. Well, nearly two weeks later and five days since running out of my Wellbutrin, I've been taking Celexa by itself, and still trying to clear up the mess. I am pretty sure it has affected my mood, and my roommate, Mooncat, has noted as much. I'm more irritable, close to crying, in the numb state all at the same time. How have have any of you fared under similar circumstances, and what did you do to get through them?
I haven't had any problems with depression, but I will say this: You stand a much better chance if you take charge of your own health here. Grab your doctor by the throat and demand detailed explanations; if you have any risk of remembering them then write it all down. Keep a log of what you take each day and how you felt, and look back at it periodically for patterns.
I'd been on Navane for about 8 years when some of the newer sedatives
came out. My Psychiatrist suggested a change to Risperdal, which I arssented
to. Even the smallest dossage turned out to be too much, an we switched to.5mg
by cutting the smallest tablet dose in half. I was one of the few who didn't
metabolize it well, and ended up calling his answering service. My only
comment was "either take me off this medication, or I'm going to admit myself"
he switched me back to Navane, and i was okay in a couple of hours.
Except for my behavior while i was on Risperdal. that helped to end
my employment at what I concidered a pretty good job, with decent bosses and
quality benefits. It's been pretty tough since then, but I'm stable on
Zyprexa, at 12.5 mg per day.
Treating the depressive side of bipolar seems to be a trickier job. I don't respond well to the common anti-depressants. I got addicted to Prozac, Paxil made me aggressive, and Zoloft sent me to giddy heights (I don't experience full-blown mania). Currently, I take Depakote alone, but even that still has down sides-- still lethargic, and still fat. My med nurse hates it and seems to be looking to transfer me to a new med soon.. something he and the psychiatrist are looking at. Can't remember the name, but the sedative side effect isn't there, and it gives a bit of a mood boost. I'll have to look more into it (and it will be a while before we start it). resp:109 I fully concur with what Scott says. *anyone* being treated for any sort of mental health problem *must* be fully aware of the treatment and meds they are receiving. It is sooo important, because chemistry from person to person is so individualistic that this is a black art in some respects. You need to be aware of how you are feeling, and report this very clearly to your doctor. Zyprexa drugs me out.
resp:109 and resp:111 - That's what's so bloody irritating. I gave my Dr. and psycholoist clearance to be able to speak, though I'm due to sign another release in November. I confirmed the dosage with my doctor a couple of weeks before this happened. I call to confirm again if there's a dosage change, and normally I'm quick to notice if there's been a mistake. I know without a doubt that this dosage was, for now, the minimum required dosage, given how I felt before adding the additional mg. for one of the medications, and the lack of one of these prescriptions is evident for me in how I feel, and the folks I see most often are aware of it also. This is a great step for someone who was not always aware of these things before. It seems in this case that my Doctor's memory is worse than mine. I'm trying to decide if this is my fault, or if this is a good indication that I need to seek a new physician. I'm meeting with my therapist tonight, so hopefully this wil be resolved before too long.
It's difficult sometimes; don't let me kid you. You have to somehow learn what your brain is saying. You have to trust your doctor somewhat, but you also have to know when to give him/her the boot if s(he) isn't providing you with the care you need. Same with counselors and therapists too. You also get out what you put in. It can be a dance.
Depression is difficult all around. It's hard to even *want* to seek treatment; you don't have any hope and it's hard to want to bother with doing something when you don't have any expectations. It would be extremely hard for me to give up my current therapist and go out to seek out another one. I'm going through overwhelming turmoil. I don't want to change anything more than what I have to. I have to get better. I have to go on with my life. For me, anyway, the way I proceed is to pick a direction and try to keep moving in it. I have to trust that my therapist and psychiatrist know what they're doing, because I sure don't. I'm doing better than I was 6 months ago. I believe that. I'll be doing better yet in another 6 months. I *have* to believe that. But sometimes, when I stop and think, it feels like I'm really just as desperate and unmotivated and angry as I was at the start of the year, but just masking it a little with the medication I'm taking.
Well, as you've no doubt read already in teh Happy and Bummed items, this bit seems to be taken care of now, much to my relief. I agree, Jon, that it is a struggle to understand what your brain is saying to you. I think the initial struggle is in making yourself listen, as opposed to engaing in activities or behaviours that drown out the "noise," so to speak.
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even less than 12 miles of rollerblading can help a LOT!
Yes, they both can.
I think one of the most irritating things I have to deal with are those who don't know what this is like and assume you're not trying hard enough. this has nothing to do with anyone here. Mooncat and I were discussing this last night.
It's true of any condition that people experience that isn't one
hundred percent visible and immediate.
Cut your finger badly at work and people will rush to your side; get
CTS or long-term spinal injuries from years of poorly designed office
equipment and people look at you as if you're trying to get out of work.
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I occasionally forget to take my zoloft for one or two days. I tend to notice the effect pretty quickly--certainly after one day, often after two. I get quite sad and unmotivated. Taking it again after forgetting is also likely to lead to mini-mood-swings, which is mildly annoying. Isn't motivation and lack thereof a fascinating problem?
<grins> resp:120 - That's pretty much the conclusion we'd come to. Sorry if it sounded as if I was whining. I've actually been very good about not forgetting. In all, I've done so maybe once or twice. The last week simply reminded me of what life was becoming before I started taking the Wellbutrin and Celexa. Unfortunately that means I *do* have to take them, but that doesn't mean I'll have to take them forever. I'm simply thankful that I had an inkling that something was wrong, and that I took the steps to confront it.
Actually, cutting ones' finger at work doesn't mean that folks will leap to your side. (Speaks the voice of experience -- I cut my right index finger badly enough to need eleven stitches last August, and I was in a brace for six weeks, and in rehab to learn how to move it again for another two months. It was NOT something that everyone understood -- it looked like such a little cut, but I'd nicked the tendon.) I've had more luck with people understanding depression, but our awareness may be heightened by the fact that we have had one coworker suicide and two family members of another coworker suicide, as well as a few attempts by even other coworkers.
Wow. An honest question, Twila. What kind of environment is it in which you work?
My co-workers have been very understanding about my depression, and quick to offer help (mainly to listen) if I wanted to talk about the divorce. It seems like everyone has been through a divorce. I've had countless 1.5 hour "lunches", just driving around or going to therapy. Lots of days when I just sat staring at my computer, or pounding angrily away at the keyboard; no one objected and they've pitched in and carried the load for me a lot. I work at a great place. I strongly recommend working at a great place when you're divorcing and depressed.
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Re #126:
What place is this? And are they/might they be hiring soon?
I work at Sterling Commerce. To answer your question about hiring soon: we're owned by SBC. (It's part of the telecom industry, so I do not see hiring coming in the near future.) There are rumors SBC wants to sell Sterling Commerce, which could have the effect of getting us away from the problems of the telecom industry, but would much more likely be preceded by downsizing. SBC employees got an e-mail today about "voluntary unpaid time off". It doesn't apply to Sterling Commerce, but nonetheless, I didn't see it as a positive indication for the immediate future.
I wholeheartedly agree with John about being in a great work environment when going through something stressful, whether it divorce or whatever. Because of the graciousness I got, I am a very loyal employee.
What kind of environment? It's an office for a non profit publishing organization. About 75 employees here in Ann Arbor.
I was just curious, as you mentioned the suicides. I agree with Brooke and John. My boss is very supportive. I decided to tell him as I was concerned about job performance, and wanted to assure him that this was not willful on my part. I was glad to learn that none of this was noticed as having an affect on my work, especially since I was improving at my job the entire time.
Actually, it's kind of surprising to me that we have had so many. Because it's such a low pressure place, with a lot of support.
Well, I'm sure it may have made the burden somewhat easier, or at least one can hope. It's good that you *do* have a supportive environment in which to work.
Yup. One of my colleagues recently suffered from a breakdown. She is on sick leave now for the time being. As I understand it she is currently spooked by skeletons from the past. What kind of past she hasn't hasn't revealed yet, but I dread it has to do with over affectionate daddies. Although I am no therapist I sympathise with her. At least I know what she has been through. What complicates the whole thing is that she for now refuses to seek professional help. She is scared what it will bringto surface. It tried to explain that letting things keep on festering doesn't help either. Certainly as she is affected by it now. To make things worse she has had a burglar in her house.
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I got a hint in that direction (but not in so many words) from another colleague, who's in closer contact with her than me. I won't pry.
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I did. Also because it helped me so much.
Today I had my first EMDR session. EMDR is Eye Movement Desensitization and Reprocessing; it's a technique for alleviating bad feelings about yourself by "reprocessing" them, thinking them through a different way and then feeling better about them. Though it's called "Eye Movement Desensitization and Reprocessing", my therapist does not use anything that requires one to move his eyes. He had me put on speakers and hold onto a vibrating buzzer gizmo (with one part in each hand), then go through some of the details of my divorce. The divorce is what's got me depressed. At intervals of a minute or so, he'd stop and ask me what I was thinking about, then we'd go on. It was pretty intensely emotional for me. You'll have to forgive me if I don't go into details right now. The idea was to shift some of the ideas around some in my brain, or something. I'm not too familiar with the theory, but it's supposed to provide permanent relief from the stuff that's being reprocessed. I'm going to continue doing this at times for a while. Right now I don't have much of an opinion on whether it did any good. I can say, it was a very difficult session in therapy.
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I appreciate the kind thought, Todd, but it wasn't huge. It was just difficult.
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Well, I appreciate the kind thoughts. Thank you! I don't know if I just burned out during yesterday's session in therapy, or made some real progress because of the EMDR, but I feel enormously better today than I did yesterday. I have been burning with anger for over a week now, but not today. That's quite a relief.
Well, about two weeks after the lapse of the Welbutrin due to errors not my own, I'm feeling better. I was secretly hoping that there'd be no change in mood and that we could reevaluate it, since Wellbutrin is such a mild antidepressant and I also have Celexa. It's an amazing thing, to realize how I had felt/could have felt like without it. Okay, so meds aren't the cure-all, but for now, it's definitely proving beneficial. I'm glad that I actually feel like coming up with things to do to get back in shape. It means to me that I have recovered some motivation. I can't wait to try out my new in-line skates.
Take care, girl! (hugs)
I may have to exchange the blades for a pair a half-size larger, but I did venture out and try them yesterday.
I've noticed gently varying responses to missing doses of Zoloft. Sometimes I'm having a good day and can miss a day without enormous repercussions, but far more usually I start getting extremely depressed. Sometimes the depression has a relevant and believable cause, sometimes I catch myself making mountains out of molehills to have something to be depressed about. It's sort of a nasty cycle. But there is a very marked effect to missing doses. I think next time I see the psychiatrist I'll ask about future plans. Have other people who are still reading this item ever gone off Zoloft? Were there side effects? What was the trigger that made you decide to stop taking it?
I was on Zoloft for 6 months once. It really helped me. Interestingly, when I stopped taking it, I didnt get depressed again. I had no bad side effects from stopping it. In fact, it was nice to finally get rid of the weird side effects the drug had.
May I ask what side effects? I haven't really noticed many. Did they phase you out/decrease your dosage, or just stop cold turkey?
I had a similar experience with Effexor -- a noticeable effect when I started, but not much by way of "withdrawl symptoms" when I stopped. I've been told that's just because it takes a long time to get out of your system, but I think it was also that I stopped taking it at a time when I was stable enough to stay cheery on my own for a while.
I'm taking Zoloft and have been for about 7 months now. I see my psychiatrist in a couple of weeks, and am expecting him to tell me to stay on it for another few months. My therapist tells me I will not go back to being as depressed as I was when I started taking it, but I can't just quit taking it; I have to go through whatever their method is for stopping. I intend to do that. I've had one noticeable side effect; I've had almost no sexual desire for the entire time I've been taking it. I hadn't had any plans to have an active sex life anyway, but it's pretty weird to go for a week or two at a time without a single lustful thought. I have self-image problems anyway, and this contributes somewhat to them. Zoloft can have other side effects as well, such as dizziness, increased appetite (which may well come from getting past the depression itself), lack of sleep, and headaches.
If you want the worst possible view of Zoloft, here's a site that says it causes sucide, aggression, hypertension, is addictive, and has other side effects I haven't read about: http://www.zoloft-side-effects-lawyer.com/default.htm
The side effects I had on Zoloft were: decreased appetite (ok, I liked this one!) no sex drive at all blurred vision I went off Zoloft kind of by accident. I had a Rx for 6 months. I forgot to make my follow up appointment in time so I ran out of the Zoloft about a month before I could get into see the doctor. By the time I saw her, I had been off it for a while with no ill effects. I just stopped taking it and had no ill effects from that.
True on the decreased sex drive. That's actually not a bad thing; with Don across the country and potential temptation upstairs it's kind of a plus. However, I'm definitely still capable of responding; just less likely to initiate and don't miss it as much. I'm not really noticing any appetite effects. My weight has changed slightly but this is due to it being off- season for hockey more than anything else.
It's interesting that 3 of us in a row had a lack of sex drive while on Zoloft. I had understood that to be uncommon, and not usually that severe. I thought I was far outside the norm with that one. It's a personal topic, but thanks for letting me know it happened to you as well.
It was great. For 6 whole months I didnt wake up in some strange man's bed even once ;)
Slynne - the secret is to get up and go home to your own bed.
That wont solve my problem of waking up in some strange woman's bed though! Sheesh, that happens *all* the time.
Get up and go home to your own couch? ;)
Finally, a solution!
I haven't noticed a decreased sex drive with either the Celexa or Welbutrin. Then again, this is probably because I've never had a "normal" sex drive to begin with. The more I am working on this, the more I realize I'm more buried than I thought. Ah, well, here's to progress! Strange man's bed . . . How does this work exactly? I usually found out the guy's name first before I fell asleep. ;)
Just because you know his name, it doesnt mean the guy's not strange
I've never woken up in a bed belonging to a person who wasn't strange. :)
I wake up in a strange man's bed every single day! Try to beat that, haha.
Never sleep with someone crazier than you are. That makes waking up better, even if he or she is strange.
Oh, I don't know - waking up with a strange man in your bed has it's rewards - if you do it right.
<delayed smug glowy grin>
<hi fives lynne>
resp:162 Wellbutrin is working okay for me, but it's pretty much the only one I can take (SSRIs usually produce bad upswings)
You have several choices: