Psycho-Babble Medication | about biological treatments | Framed
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Re: Adam

Posted by Elizabeth on October 27, 1999, at 21:37:17

In reply to Re: Adam, posted by Adam on October 22, 1999, at 12:08:06

> But, you think of the term "depression" and then think of all the subtypes of depression, it's a bit
> like saying to somebody with hepatitis B that they've got an infection. Gosh there's melancholia,
> dysthymia, cyclothymia, seasonal affective disorder, hysteriod dysphoria, typical, atypical, psychotic,
> bipolar, and on and on.

And many of these overlap...e.g., hysteroid dysphoria is a subtype of atypical depression, or bipolar depression may have melancholic features. It's not a one-dimensional thing either, and it's a continuum, not a bunch of entirely separate disorders.

My mother has reversed vegetative signs (overeating, cravings for sweets, and hypersomnia when depressed), while I have typical vegetative signs (early morning insomnia, appetite loss), and I know of at least one other case of this sort of thing (only in the other direction: mother with melancholia and daughter with atypical depression), so it does seem they are related.

> I think some diagnoses are pretty cut and dry (bipolar, which has its
> depressive phases), and some are fairly subtle. I've been called melancholic by one doctor and
> prescribed desipramine, and I've been called dysthymic by another and prescribed SSRIs. One of my
> favorites was a guy who, when I described some of my OCD-related symptoms suggested I might be
> psychotic (this is not depression, of course, but you see what I mean).

Well, there's always psychotic depression!

Anyway, it remains to be seen just how meaningful these various subtypes are. The ones that predict treatment response, as far as I know, are atypical depression, melancholia, psychotic features, seasonal pattern, and bipolar vs. unipolar.

> For what I've got, whatever it is, I think the best diagnosis I have ever had was the simplest: major
> depression. What do you do with such a diagnosis? The answer is try a bunch of stuff until you find
> what works. As it turns out, the doctor's first choice was probably the best: an MAOI plus CBT.

You actually find CBT helpful? How so? (Specifics.)

> Some day, maybe, someone like me will walk into a hospital, and a number or routine tests will be taken.
> I'll get blood tests to check out all my hormones, etc. (never done before I checked myself into the
> hospital this year), maybe they'll take a sample of CSF,


> and perhaps do an MRI or SPECT or some other
> advanced imaging to look at my brain structure.

Hopefully not SPECT...they tend not to like to run tests on people that involve injecting radioactive material, unless they have to!

> Maybe initial clues based on these tests and some psy-
> chological diagnostics will lead the team to look at some specific genes (either the products of those
> genes or the sequences themselves) to see if I might be a good responder. The process won't be so sub-
> jective. Some day. Imagine the time that could be saved, and the unhappyness that could be prevented.

You're an optimist, Adam. I mean that in a good way.




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