90 new of 170 responses total.
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: