Olivet mentioned here that chemical depression is a disease like diabetes that can be controlled through medication. I wholeheartedly agree with that assessment. However, how do you tell the difference between being depressed because you're in a bad marriage (Olivet's example) or some other similarly negative situation, and true chemical depression.
Are there blood tests? Brain Scans? How can I know for sure which situation I'm in?
[ April 20, 2004, 03:27 PM: Message edited by: peterh ]
Posted by JohnKeats (Member # 1261) on :
In my experience, you go to see a "doctor" and they "prescribe" you with something and if that makes you feel better, than you must be clinically depressed.
Posted by BYuCnslr (Member # 1857) on :
Go talk to a counselor. School counselors are trained a bit. Satyagraha
Posted by peterh (Member # 5208) on :
John, that's exactly what I don't want. I want to know if I need to be ingesting something that will change the chemistry in my brain (the only one I have) before I go screwing with it.
added: emphasis
[ April 20, 2004, 03:24 PM: Message edited by: peterh ]
Posted by Olivetta (Member # 6456) on :
Well, It is good to talk to professionals. There are doctors who have more experience than others with this sort of thing. And there are doctors who prescribe antidepressants for people and tell them it's for 'pain' (that actually happened to one of Ron's elderly family members). Oy.
In my case, I went in for therapy, and also saw a psychiatrist. It took better than a year to rule out everything else (thyroid, etc.), during which time my goal was te get OFF the (admittedly very light dose) of medication I was taking.
But when you put my history and family situation together, it just became fairly obvious. I was a scrawny, hyperactive energy ball before the first baby. After the first baby, I was much calmer and more relaxed. Second baby reset my levels down another notch. I was too close to see it at the time. The biggest clue was that there was NOTHING for me to be sad about, except that I felt sad. Usually. I think, depression is a combination of physiology and some sort of trigger. In my case, oddly enough, physiology WAS the trigger, as far as I could tell.
It was really frustrating at first, having therapists try to get me to 'admit' that I didn't love my husband or some such nonsense. *sigh* Idiots. Posted by katharina (Member # 827) on :
I apologize if this sounds simplistic, but could it be tied to any events? Or does it happen when you honestly cannot identify a trigger?
I have been depressed, but I'm pretty certain it wasn't clinical, because I can identify exactly why, and when those were taken care of, it went away.
If you are completely honest with yourself and still cannot identify any triggers and/or causes, that might be an indication.
Posted by rivka (Member # 4859) on :
Situational depression is, AFAIK, clearly associated with a specific situation. (In my case, for example, separation and divorce.) While meds may help, therapy is far more useful, IMO.
OTOH, depression that is not linked a particular event/situation OR that continues long after that situation is alleviated is more likely to be chemical, from what I'm read/heard. Which is not to say that therapy isn't also necessary in that case. It certainly is.
Posted by ludosti (Member # 1772) on :
Similar to what kat and Olivet mentioned, for me depression is when I am unhappy and despondant and there is no cause. Unhappiness is not the same as depression. Depression is when there is no logical reason for me to despair, but I do, when I cannot allow myself to be happy because I am too busy telling myself that I am worthless. In my case, I also withdraw from the people around me, cannot sleep, and don't enjoy things that I normally love.
Feel free to email me if you'd like, Peter. *big hug*
[ April 20, 2004, 03:40 PM: Message edited by: ludosti ]
Posted by peterh (Member # 5208) on :
kat, thanks for bringing it up. Yes, there are issues in my life right now, but that's the point. Some issues may remain with me for a very long time (out of my control) and I want to know if there's a reasonably simple way to distinguish between the two.
I've got a degree in human development. I have a sufficient understanding of depression to recongnize the reality of my situation. However, what I lack is the present ability to ascertain whether it's a result of the things going on in my life or physiology.
I have enough extended family members with depression issues (though none I know of has ever been medicated) to know that it's a possibility that it's been passed on to my DNA as well. For example, everyone tells me how similar I am to my grandfather (physically) who got depressed after WW2, became an alcoholic, and drank himself to death by the age of 55.
Posted by mackillian (Member # 586) on :
rivka, when did you learn to speak acronym?
peter, you've gotten some good info from people here.
olivia hit on what's called the stress-diathesis theory: you may have a genetic propensity toward depression, but it isn't expressed unless you hit some sort of situational trigger.
for some people, it's purely situational and will resolve when the situation is settled.
for others, it starts as situational, but continues for awhile and the brain chemistry is altered to the new, depressed chemistry (lowered serotonin levels), so an SSRI (selective serotonin reuptake inhibitor) is used to raise serotonin levels back to normal. sometimes, this med treatment is temporary (6-12 mos).
other times, you must continue on low doses of the SSRI for quite some time (1-2 years).
and other times, you might have to remain on them to keep your brain chemistry stable.
Other depression, where there is no apparent trigger, could just be the result of unbalanced brain chemistry, so the medications would likely be a lifetime event.
in the case of medications in treating psychiatric disorders, both the use of them drugs in conjunction with talk therapy leads to the better results of recovery. also, looking at quality of life with no meds and quality of life with--you have to make a decision about which would have you better off.
Definately talk to a professional, maybe starting with your primary care physician.
Posted by rivka (Member # 4859) on :
Oops, sorry. I'm a big TLA (and other lengths ) user. I like 'em -- tend to use 'em far more often than I should.
YMMV. Posted by peterh (Member # 5208) on :
Thanks to all that are posting their opinions. I have been debating whether to share it here and skirting around this topic as it directly relation to myelf for some time.
It seems to me that there is no real way to tell if your serotonin levels are off without a baseline. However, shouldn't that be something that could be compared to a normative level for a give persons age/weight/etc?
If you can't tell, I'm extremely averse to counseling. I believe that I'm intelligent enough to do my own. Also, given my educational background, I have a hard time not seeing right through what most therapists are doing. And the idea that the only reason someone cares about my problems is because I'm giving them money, will never leave my mind while I'm in a session.
Posted by mackillian (Member # 586) on :
considering most people aren't paid enough to be doing it for the money...
but your feelings are your feelings.
but as of yet, we have no blood tests to determine serotonin levels.
Posted by katharina (Member # 827) on :
I know what you mean. It's hard to respond to someone when you can see behind the curtain.
Still, it may help. I would try it. Definitely go to someone LDS, as that will save a great deal of explaining in the beginning. It's not going to be a "Tell Me About Your Mother" situation - I think if you go to a behavioral therepist, they can suggest different behavior patterns instead of just plumbing into your psyche.
And...*grin* You're smart and educated, but not omniscient. It's possible there's stuff you don't know. Forgive me for this, but it's said with love (and knowledgable sympathy): Don't let your pride rob you of a chance for peace.
You ARE smart and able to handle things. If there are situations that you've had to adjust to, then where you are now is proof of that.
Posted by pooka (Member # 5003) on :
peter, *if there were* a serum seratonin level could look normal but your body's ability to use it might be out of whack. Prozac doesn't make more seratonin, it changes the way your body is using it.
For myself, I would prefer a three pronged approach: Therapy and biochemical intervention and behavior modification (regularizing meals and sleep and exercise patterns as much as possible). Fluctuations in neurotransmitter related activities can create demands on the way they are used in the body.
Edit: ** Thanks mack
[ April 20, 2004, 04:37 PM: Message edited by: pooka ]
Posted by Derrell (Member # 6062) on :
peter, the big thing that has me convinced that i suffer from clinical depression is the length of time that I've been depressed. I've been in a pretty constant state of depression for at least 20 years.
I also agree with what Katharina said. Talking to my bishop about it was difficult, but I'm glad I did.
[ April 20, 2004, 04:05 PM: Message edited by: Derrell ]
Posted by peterh (Member # 5208) on :
What!? Me proud!? I'm the most humble person I know. Just ask me...
No worries kat. I know exactly what you're saying. I've been to LDS social services before when my wife was struggling with depression (she is currently taking paxil) and honestly felt that it was a waste of time for me.
My wife finds it much more beneficial and they suggested things that helped, but I don't think it was anything that I couldn't have come up with on my own if I had spent the time I was there considering our situation on my own.
Posted by Bob_Scopatz (Member # 1227) on :
I think other people have covered pretty much everything I'd want to say on this subject, except that the term "chemically depressed" is probably a misnomer.
Chemical imbalance might be closer.
But essentially when dealing with a mood "disorder" you have to understand that the chemicals are only part of the equation. And the chemical treatments are only part of an effective treatment.
The good news is that the new drugs are a lot better than the old drugs and that even better drugs are probably on the horizon. Drugs that will treat the sleep and depression symptoms but not cause other side-effects, for example.
The other thing to note is that one should never, EVER obtain psychoactive drug prescriptions from a GP, gynecologist, or other type of physician who lacks psychiatric and/or counseling skills (or has an associate who performs that service). The reason is that treating the depression chemically is fine if it really is depression. But as we have seen here on Hatrack numerous times, and what experience will tell you once you get into any particular drug regimen, is that these things aren't so simple.
Raising the serotonin level probably would help the mood and sleep patterns of a majority of US adults. But does that mean they should be on the drugs? Why? Were they dysfunctional? Were they making bad decisions? Is elevated mood via chemistry a thing to be desired in and of itself?
What if there are other things besides depression going on? Bipolar disorder? Would you just treat the down side of bipolar and hope for the best? Not for long...I bet. And what if there are nutritional or hormonal problems expressing themselves in part through a mood alteration. You could miss some serious medical conditions by treating the symptoms.
Finally, I think there's a lot to be said for finding a counselor who understands your cultural outlook (i.e., a person who understands your religion, your work, etc.). But, there's also a lot to be said for ultimately seeking out a person who understands the brain chemistry and the mood alteration involved. It's no problem to seek counseling from more than one person. Especially if they play different roles in your treatment and/or offer different and valid perspectives.
Most of the therapy-resistant people I know who ultimately entered into therapy did so because they became absolutely desperate. And then they were usually glad they went and wondered why they'd waited so long.
Posted by Morbo (Member # 5309) on :
quote: depression that is not linked a particular event/situation OR that continues long after that situation is alleviated is more likely to be chemical
Rivka This is a good summary, Rivka. In my educated layman's opinion, the length of the depression is the key. If you are depressed for many weeks or months at a time, the cause is probably chemical. But Bob and Mackillian know more than I about the subject.
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I was too close to see it at the time. The biggest clue was that there was NOTHING for me to be sad about, except that I felt sad. Usually. I think, depression is a combination of physiology and some sort of trigger. In my case, oddly enough, physiology WAS the trigger, as far as I could tell.![[Wink]](wink.gif)
![[Big Grin]](biggrin.gif)