Ravings and Rantings

Welcome to my cloud! It's got a nice silver lining somewhere.....Some ranting, some raving--mostly positive stuff,lots of jokes (I can't stay serious). Nothing going on here that a pina colada or mohito can't fix.

Tuesday, January 03, 2006

This Is It!

This post was inspired by an email conversation with a friend earlier. It's about the misunderstood condition of depression. So if you don't like medical discussions, skip this one.

Part of why my marriage broke up, other than my disapproval of my ex's girlfriends, was that he (Steve) said that he didn't know how to handle my depression. Had never heard that term at that time, but I had cried for no reason at all since the age of at least 5, maybe younger. Also being molested by a parent as a child probably doesn't help either. My parents were the type that would have died, literally, before consulting psychiatrists.

There are forms of depression that respond to espisodes, such as a death in the family. Then there's a more ongoing kind of various strengths. The ongoing types are caused by an imbalance among three brain chemicals/hormones: seratonin, norepinephrine and dopamine. There are other chemicals involved, these are just the Big Three. And issues in these chemicals tend to run in families. No one has figured out exactly why yet.

Because the amounts of the hormones involved are extremely low, modern technology can't measure them. The only way to know which chemical is out of balance is to put the patient on a medication, wait three months (that's how long it takes for this stuff to build up to an effective level in your body), and see if there is an effect.

The reactions you can have to the med range from: feel no difference, feel angry for no reason, stop eating, or feel not as rotten. That last one is what you want. These are not happy pills, they just raise the threshold of how easy it is to 'get you down'. The right one makes a MAJOR difference.

The unfortunate tendency is for people to regard depression/dysthymia as mental illnesses. THEY ARE NOT MENTAL ILLNESSES!! at least in my humble view. They are physical illnesses that manifest themselves in behaviour, partly, but also in eating, activity levels, sleeping, ability to concentrate....let's put it this way, are diabetics regarded as 'nut jobs'? I didn't think so. How about people who are deficient in other chemicals/hormones such as Human Growth Hormone? Are they nut jobs? No, didn't think so either.

And on top of this, depression/dysthymia are rampant in society. The National Institutes of Mental Health (see link below) estimate that 9.5% of the U.S. population suffer from it (18.8 million people, and 2 million are over 65). The World Health Organization (WHO) predicts that by 2020 major depression will be second only to heart disease as the leading cause of disability worldwide (see second link from the bottom). It is very common for women to be on anti-depressants, especially the one I take, Paxil. Females have higher rates of major depression than males by a ratio of 2:1 (again see second link).

I do not see this as society's attempt to control women, I see it as women being more assertive in taking care of their health, and more directly in touch with their feelings than men tend to be (OK OK it's a generality and not always true). Depression is as common as the cold according to my pharmacist and knowledge of my friends' pharmaceutical histories. And even more prevalent among the elderly.

Why? Think about it. Aging involves betrayal by the body, and often enough, the brain. Serious illnesses that senior bear frequently have depression as a side effect. The loss of friends to death (or worse debilitating diseases) including spouses. Financial worries. Should-I-stay-in-my-home worries. Inability to exercise as a means of stress reduction. Loss of freedom and independence (e.g. driving). And too, usually the elderly suffering from depression are women. Why? Simple survival statistics.

So leaving gender considerations out of it, I have a few questions for you:

If you had a broken leg, wouldn't you get it set properly?
If you were bleeding profusely, wouldn't you get it bandaged?
If you:
-change eating habits (eating much more or much less--your clothes will tell you)
-no longer do things that used to give you enjoyment
-avoid or withdraw from friends and family
-change sleeping habits (sleeping much more or much less than before)

then it's time to see a doctor. FAST.

Because of the three months to see if the meds work time phase, it took me 8 years to finally find what worked. I think that doctors are smarter than that now and can diagnose what's needed more easily. There is a side benefit to the one I take: Paxil. It eliminates hot flashes. Yay.

The violence that one hears about from time to time (e.g. mothers killing their children) I believe have more to do with hormone interplay with depression. They (I am quoting from a doctor here) wind up believing that the world is so bad that they don't want their kids to grow up in it. Now before someone gets to this point, wouldn't the symptoms have been extremely obvious??? But we'll leave the moralizing for another day. Again it could be the shame thing.

The bottom line is that sufferers with other supplement-dependent conditions are not regarded as having shameful conditions. Think about diabetics/insulin. People without sufficient Human Growth Hormone. Seratonin, norepinephrine and dopamine are no different. Well OK they affect different parts of the body, the brain. But the point is that there are so many hormones, chemicals in our bodies, so many systems, that can and do go haywire, why single out one for derision?

I have this pet theory that a lot of drug abuse, alcoholism and other compulsive behaviours such as over indulgence in gambling, sex, shopping, eating, and work all have a common purpose: to make the pain go away. Usually a depression-related pain, I'm guessing. I do know that the 'gambling school' in Ottawa (I attended to support someone else) explained it this way. And that this is why meds alone can't cure a compulsive illness. Meds AND talk therapy are needed.

Why do you need talk therapy as well as meds? Well, the meds take away the physical discomfort (and that's a MILD term for it) associated with depression/dysthymia. The confusion, the lack of energy, the diarrhea, the constant nausea, the trembling...there are so many physical symptoms we don't have room for them here. But they are many and FIERCE. It's hard to think with all that going on at the same time. And ALL those things happen at once. OK the meds eliminate them or control them. Now your body is at peace. You can sleep, a normal amount. Now is the time to think over the experience you're having. What the causes were, how you'd do things differently, what your options are. That's where talk therapy helps. A neutral and trained observer who's seen this before is an invaluable guide.

Meds and therapy can be short term, or if the situation is truly hormone-only caused, well, it's like diabetes (you're on the meds for a very long time with occasional check-ins with the doctor). There are other forms of therapy possible, including self-help (see second link from the bottom). But there are worse fates. Like being depressed! I'd never ever go back there again. Way too lonely and painful.

Here are some helpful links to people/places far more educated than I am on this subject, in case you're interested:
http://www.depression.com/
http://www.nimh.nih.gov/publicat/depression.cfm
http://www.dbsalliance.org/

And here's a test-yourself site
http://www.med.nyu.edu/psych/screens/depres.html

Here is a Canadian link that has a lot of info on treatment
http://www.mooddisorderscanada.ca/depression/who.htm

Hope this helped a bit, and thanks Friend (you know who you are) for inspiring this!

Bridg

31 Comments:

  • At 1/03/2006 09:25:00 AM, Blogger Heather said…

    You say depression is not a mental illness, yet you also say that 'talk therapy' is needed as well as meds. Surely, if depression is a purely physical illness (such as diabetes), then physical treatment should be enough?

    A general definition of mental illness is "health conditions that are characterised by alterations in thinking, mood or behaviour". It's the 'thinking' that sets depression apart from other physical illnesses. You can't compare a mental illness such as depression to something like a broken leg, it's non-comparable, it just doesn't work.

    I am all for the de-stigmatising of mental illness, however I think a part of this process requires acceptance by the sufferers of it. Instead of the 'mental illness is normal' mentality, how about the 'mental illness is not normal, however it is also nothing to be ashamed of' one?

    Perhaps I didn't explain that too well, but there is a fine distinction between the two.

    I hope this doesn't sound like I'm attacking you in any way. I admire you for both suffering through the awful thing that is depression and for posting about it like this. I do see where you're coming from with this post, I just want to show you there are different ways of looking at it while still being on the same 'side'.

    If that made the slightest bit of sense.

     
  • At 1/03/2006 11:06:00 AM, Blogger Bridget Jones said…

    Hi Heather, I understand where you're coming from.

    I might not have explained it all that well....my theory is that depression starts out as a biochemical shortage that one is either born with or develops as a result of emotional trauma.

    The kind that one is born with doesn't really require talk therapy.

    The trauma one does require talk therapy, not to deal with the biochemical aspects but to address the underlying causes (the trauma).

    I think that broken legs can be compared to depression in that both are health conditions that need treatment. It's more acceptable to have a broken leg treated than depression.

    My point, which I guess I didn't make that well, is to put forward a theory that depression is a physical condition that happens to have a behavioural impact.

    No it isn't normal..that's my point. It's something that requires treatment.

    You're right, mental illness per se has an awful stigma attached to it. I'm convinced that people look at it the wrong way. It's an illness that has physical origins.

    Glad we're on the same side!

    Bridg

     
  • At 1/03/2006 02:20:00 PM, Blogger Storm said…

    Great post. But I must comment that depression is classified as a mental illness.

     
  • At 1/03/2006 02:52:00 PM, Blogger jipzeecab said…

    That has to be one of the most informative posts ever written "off the cuff"...and evidently technically accurate enough that trained nurses are comfortable discussing it in a medical terms with you.
    A new word I never heard before today "dysthymia" popped up on another blog too...
    Knowledge and truth makes us all free..

     
  • At 1/03/2006 02:54:00 PM, Blogger Casually Me said…

    Diagnosed Bi-Polar here. I never cared what they diagnosed it as. I never thought that anyone putting me in a clas mattered much. I do care how it affects me and those around me. One thing I have learned is to not discuss this with people that don't understand. Some folks will never get it, and I'm ok with that.

     
  • At 1/03/2006 04:11:00 PM, Blogger tshsmom said…

    EXCELLENT post Bridg!!! You're doing the world a great service by sharing this info.
    Why is it that only people who have been through this, understand it? When our daughter was going through this in high school I had to threaten the principal with a restraining order. I asked him if he would treat a student with cancer the same way.
    You forgot one very important side effect: the drug that is tried sometimes puts the patient to sleep, or knocks them out. This was the case with our daughter. It only took us a year to find the correct med, but it worked miracles when combined with her visits to the psychologist!
    A huge pitfall that 95% of depressed people fall into, is to quit taking their meds. They feel so much better that they feel they can handle life without the meds. Our daughter fell into this trap several times before she resigned herself to staying on her meds (probably for life).
    You're right that people shouldn't call this a mental illness. It's actually classified as a neurological disorder, just like Z's Tourette's. Ironically, Z OVERPRODUCES the same brain chemicals that our daughter's brain UNDERPRODUCES. Ain't life a bitch? ;)

    Clinical depression (the kind you're born with) DOES benefit from "talk therapy". Meds help, but the patient needs to know how to deal with the feelings of hopelessness. Wallowing in self-pity is one of the many pitfalls that can be avoided with proper counseling.

    CM, feel free to discuss this with me or Bridg ANYTIME. You already KNOW that Bridg "gets it", and I have a bipolar son-in-law in addition to a clinically depressed daughter. I also have a schizophrenic mother-in-law. Our family has "been there, done that" with ALL the brain chemicals.

     
  • At 1/03/2006 06:46:00 PM, Blogger Bridget Jones said…

    Storm, you're right it is classified that way but I'm arguing that this classification is what keeps many people from getting help.

    I'm more of the school of thought that tshsmom's from.

    Jipzee thanks very much for your kind words. The person I was quoting was my doctor. Have been studying this thing for many years--want to understand the beast that made me suffer so much in the past.

    CM, my late father was an undiagnosed bi-polar but had rages instead of the 'giggly' highs. I think his life, and ours, could have been much much better or at least very different had he sought treatment. Classification of his illness as 'mental' was what kept him away from doctors/treatment. Had it been called anything else (more 'organ' based), he likely would have done something about it.

    Tshsmom, thanks!! I wrote the post in response to a conversation I was having with a pal. This stuff has stayed in the doghouse way too long. Am glad that the post got 6 comments and hope it gets a lot more. I sympathize with you and L coping with all that you've had to deal with. You're right, us chronic types do benefit from talk therapy also, if for no other reason than to learn how to deal with the ups and downs (esp downs) of life. You're right, I wallowed for years. Had forgotten about that. Schzophrenia has got to be the hardest thing to deal with. I dated someone who had that, bipolar disorder and psychoses at the same time. He had done drugs in high school (I think to self-medicate, unconsciously) and boy did that take its toll. Knew all of his family and all of them were very high achievers except this poor man. We aren't together anymore but the one thing I did do for him was get him back on his meds.

    Thank and bless you all for your feedback and reading that post...(((hugs))) Bridg

     
  • At 1/03/2006 06:52:00 PM, Blogger Bridget Jones said…

    p.s. tshsmom, you are also right about the meds putting you to sleep. Some of them do (amitriptyline for example). Others are 'brighteners', which is why I take Paxil. It actually helps you wake up. I insisted on being put on it because I was tired of being half asleep.

    And CM, Tshsmom is right. You can talk to either of us about this stuff, we sure have been there. You're right to care about how it impacts you and others around you (and also right about letting others think what/as they will). I'm just worried for people like my late dad who could/need treatment and won't get it due to the stigmatization of the illness. If I could wave a magic wand to get rid of the image I would.

    Tshsmom, thanks for the news that it's classified as a neurological disorder. That's much more accurate of the biochemical mechanism anyway and certainly is less negative than 'mental illness'.

    Bridg

     
  • At 1/03/2006 08:22:00 PM, Blogger tshsmom said…

    Event triggered depression is still classified as a mental illness, but Clinical Depression is DEFINITELY a neurological disorder.
    Event triggered depression is curable and doesn't require lifelong medication. At this time, Clinical Depression is an incurable brain dysfunction. Bridg is right; it does seem to be genetic in nature. Research is our only hope for a cure!

     
  • At 1/03/2006 10:29:00 PM, Blogger Heather said…

    It's not the classification on it's own that scares people away, it's the stigma attached to the illness itself. Rather than just changing the words, we should be (and are) working on destigmatising the illnesses themselves.

    Depression is a psychological disorder, it is classified in the DSM under 'mood disorders' in Axis 1. It doesn't just have physical and behavioural impact, it has emotional impact (which does manifest itself in behaviour, which I think is what you meant, but it's important to distinguish it on its own). It influences thoughts and moods - mental processes, which is why it is a mental illness.

    Your theory is interesting, but maybe emotional trauma triggers a chemical imbalance that is already there, rather than actually causing the imbalance itself. This too is just a theory of course, more research needs to be done on the topic, but it does make sense and explain why two people can go through the same external events and one come out okay and the other depressed.

    As someone else pointed out, whether they can trace their depression to a specific trigger or not, sufferers still require talk therapy. As I said before, mental illnesses by definition have an emotional impact, and meds alone can't fix that.

    As for clinical depression being incurable, well, 'clinical' just means it has been diagnosed according to set symptoms. Episodic depression (which I'm assuming is what tshsmom meant by 'event triggered') is also clinical. Both episodic depression and other forms, such as dysthymic disorder, can be recovered from. It does vary, according to many factors such as the person, their symptoms, and how competent their doctor is, but it is definitely not incurable.

     
  • At 1/03/2006 11:29:00 PM, Blogger Bridget Jones said…

    This comment has been removed by a blog administrator.

     
  • At 1/03/2006 11:32:00 PM, Blogger Bridget Jones said…

    At 1/03/2006 11:29:03 PM, Bridget Jones said...
    Hi welcome back Heather! I agree with tshsmom about the neurological basis of the disease. What the dysfunction is called makes a big difference in people seeking treatment BECAUSE of the stigmatization. Why do we not refer to AIDS as VD, when that's how it's transmitted primarily? In fact, why isn't VD VD anymore? I bet stigmatization has a great deal to do with it.

    I agree that there's an emotional impact, but so do other serious illnesses such as epilepsy...I think you see where I'm heading. There's an education aspect to where I'm heading but also a strong drive to use language that is less demeaning to those who have it. The symptoms are bad enough without implying that those unfortunate enough to have inherited/contracted/experienced the illness are losing their minds. And whether we admit it out loud or not, this is exactly what the phrase 'mental illness' implies and how other interpret it.

    Research has found genetic links (yay) and noticed changes in brain chemistry between those going through emotional trauma of depression and those who are not. Which causes which at the moment is a chicken and egg question that I really hope will be settled soon.


    I can say that my dysthymia is under control, but certainly not cured. Am very much looking forward to being able to say that it is cured and am (slightly) jealous of those whose depression is episode related.

    yay research! Keep going...Bridg

     
  • At 1/04/2006 01:21:00 AM, Blogger ann said…

    I understand what you are trying to say, Bridg. And I agree that we need to get rid of the stigma surrounding depression.

    If we say depression is simply a physical disorder, then we will rely only on drug therapies. As a result, we would be ignoring talk therapy (that's been very effective in treating different types of depression). Yes, some people need antidepressants to deal with the symptoms of depression (likely due to a genetic predisposition), but there are many people that would also benefit from talk therapy to deal with the many issues involved in depression.

    Depression is physical, emotional and mental. Saying it is only physical takes away some great tools we have in the fight against depression. And we need to use every tool possible in this particular fight.

     
  • At 1/04/2006 07:24:00 AM, Blogger Heather said…

    VDs are now STDs because it helped the awareness campaign by improving the clarity of the health officials' warnings. It wasn't a stigma thing, and if it was then it didn't work because STDs have just as much stigma attached to them. This is because of the nature of the diseases. You could call them 'Lovely Beautiful Rose Diseases' and it would still have the stigma, because everyone would know what it meant (or think they know).

    The emotional impact of epilepsy is extremely different to the emotional impact of depression (although some long-term illnesses like epilepsy can trigger depression), because depression is primarily a mood disorder.

    The term 'mental illness' is only demeaning because of the misconceptions of the general public, so I still say it is these misconceptions that need to be addressed rather than the term itself. Taken literally, the term is quite accurate and not demeaning at all. There's nothing in it that implies the person suffering it is losing their mind, just that their mind is 'sick' (in the literal sense).

    I'm not at all doubting the phsyical impacts of mental illnesses, and I do apologise if that's how it sounded. Like you said, it's a chicken and egg type question, I'm just saying you have to acknowledge the equal existence of both the chicken and the egg.

    I'm glad for you that your dysthemia is under control. I suppose it's a grass is always greener sort of thing - people with episodic depression are probably slightly jealous of you (although their lows are less frequent, they do tend to be lower). Not saying that any sort of depression is at all something to be jealous of - quite the opposite!

    Oh, and I must thank you for the healthy discussion, it's just what I've been needing :)

     
  • At 1/04/2006 03:02:00 PM, Blogger Avery's mom said…

    very brave post bridge! I love that you spoke about this topic because it does affect so many of us women (and men too)
    Talk therapy does so much good, everyone should have councilling on a regular basis, it helps you chart your path in life and lets you get out some of the junk that needs to be tossed aside.

     
  • At 1/04/2006 03:40:00 PM, Blogger tshsmom said…

    I guess we're ALL in agreement about de-stigmatizing "mental illnesses". A horse by any other name is still a frigging horse!

    Open dialogue on this subject is the greatest help. People need to know that they're not alone in their plight.

    Umm, Bridg? We DID have a healthy discussion here. Normally we have perverted discussions. WOW, this is sooo WEIRD! Don't want to make a habit of this, but it was cool.

     
  • At 1/04/2006 07:02:00 PM, Blogger Bridget Jones said…

    Heather, Ann, Avery's Mom,CM tshsmom, and everyone who read without commenting thanks so much for jumping in here!

    I wrote that post to educate but also open a dialogue more generally not just on this site but everywhere.

    Let me say first to respond to the latest comments that I agree with Ann and Heather, acknowledging the existence of the chicken and the egg.

    There is a major need to destigmatize these kinds of illness(thinking of my undiagnosed parent and the unbelieveable physical, emotional and mental trauma he inflicted on 6 individuals, lifelong as a consequence).

    Heather and Ann, you sound like professional health care workers...if this is true, then you likely interpret things differently than I would. All I can say is that greater acceptance/less negative imagery is badly needed. I like the 'neurological disorder' idea better simply because it escapes the existing image.

    I don't think that anything could adequately reflect all the dimensions of pain and impacts that this one illness I wrote about causes. There are others far worse (e.g. schizophrenia). That's a type of pain I can't begin to imagine.

    I didn't mean to compare the 'mental' or brain impacts of epilepsy to depression, only the need for medication to maintain some sort of stability to a chemical imbalance type situation (you know, like insulin dependent diabetics). All of those illnesses have different physical causes and effects but what they do have in common is the need to take some sort of medication to maintain a normal (or as close to normal as you can get nowdays) state.

    I agree with all of you re talk therapy. Drugs alone, unless you have the flue or something like that, are kinda dangerous/nowhere near as useful as talk therapy.

    I went to a GP 20 years ago who said that most of his patients just needed someone to talk to.

    Tshsmom, this was fun! Won't do it all the time but man it felt good, huh?

    Bridg

     
  • At 1/04/2006 09:30:00 PM, Blogger Heather said…

    Heather and Ann, you sound like professional health care workers

    Hey thanks that made my day... I'm really just an 18 year old uni student who thinks I know everything :P I am studying all this sort of thing at uni though, and have a lot of interest in the topic.

    As for destigmatising, discussions like this one is exactly what we need more of, not only among those of us who are already aware but everyone else too. Good on you for starting it!

     
  • At 1/04/2006 10:00:00 PM, Blogger Bridget Jones said…

    Heather, WOW when I was your age (OMG did I just SAY that????) there is no way that I would have been as articulate as you. Excellent future ahead of you, that's for sure.

    Love the open dialogue and thrilled to contribute to it. Hope it catches on.....and thank YOU for being the first to jump in..Bridg

     
  • At 1/04/2006 10:30:00 PM, Blogger tshsmom said…

    Heather, you CAN'T be 18, or you wouldn't admit that you don't know everything! Congrats, you're WAY ahead of your time.
    Don't let the cynicism of us old ladies get you down.
    You have a very bright future ahead of you.

     
  • At 1/05/2006 08:33:00 AM, Blogger Heather said…

    Haha, wow, compliments, I should post here more often! Old ladies are awesome :P

     
  • At 1/05/2006 07:02:00 PM, Blogger Bridget Jones said…

    Tshsmom, as usual I agree with everything you said!!

    Heather--I told Mom that you called us old ladies. She said for you to go right to bed with no supper!!

    heh heh heh

    Bridg

     
  • At 1/05/2006 07:09:00 PM, Blogger tshsmom said…

    Thanks Heather!

    Bridg, I started the old lady thing. It's not like we can deny it or anything. ;)

     
  • At 1/05/2006 07:32:00 PM, Blogger Bridget Jones said…

    Tshsmom, you're right!!!

    Thanks Heather!!

    Tshsmom goes to bed with no supper.....

    Nah, couldn't do that to my bud (sniffles a bit)

    You're right, we're ancient....tee hee hee

     
  • At 1/05/2006 08:03:00 PM, Blogger tshsmom said…

    I could use some going to bed w/o supper!
    We may be ancient, but we still ROCK! ;)

     
  • At 1/05/2006 08:43:00 PM, Blogger Bridget Jones said…

    ME too tshsmom! We do rock!

    And anyone who doesn't think so will get (da da dummmmmm) THE BOOT!!!

     
  • At 1/05/2006 09:57:00 PM, Blogger Heather said…

    Don't forget, age is only a number (although some of these numbers are considerably higher than others ;) ). You both rock anyway, of course.

     
  • At 1/06/2006 03:08:00 PM, Blogger tshsmom said…

    Don't push your luck Heather. ;)

     
  • At 1/06/2006 09:36:00 PM, Blogger Bridget Jones said…

    Thanks Heather, I imagine you were referring to our IQ's. (smirk)

    Tshsmom--as usual, hits the nail right on the head!!!

    Man i wish we worked in the same office...place....

     
  • At 1/07/2006 01:23:00 PM, Blogger tshsmom said…

    We WOULD be a force to be reckoned with! I don't think any business could survive the two of us together. ;)

     
  • At 1/07/2006 01:48:00 PM, Blogger Bridget Jones said…

    tshsmom, totally agree but it would be fun to try!!!

     

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