Posted by lizzyg on May 17, 2002, at 11:31:29
In reply to Re: Looking good, Scott » lizzyg, posted by SLS on May 10, 2002, at 7:54:53
Dear Scott
Many thanks for a thoughtful and well-written note. If this is you with cognitive impairment, seeing you fully functioning must be almost scary!
> You said: I guess a didactic argument can be made that the reduction in the frequency and severity of your depressive episodes is due to a reduction of depressive pressure facilitated by the changes you have made in your lifestyle and your psychological relationship with the depression once it is triggered.
Your hypothesis is logical but, coming back to the nature versus nurture discussion that sparked this off, might I propose a simpler (simplistic?) argument? Viz: The reduction in the frequency and severity of my depressive episodes is due to an increase in neurotransmitters, brought about initially by antidepressant therapy, then perpetuated by physical/lifestyle adjustments (lots of exercise, eating well, sleeping the right amount, continuing with pleasurable activities and avoiding alcoholic excess [although the last point is more difficult in Europe when it's such a way of life!]).
> Concerning your own symptoms you said: Regarding the reduction of my experience of depressed mood and anxiety, I can't exclude the contribution of the psychological improvements that I have worked (and continue to work) toward. One issue that I have resolved significantly is perfectionism... ...I have thus broadened the scope of "depressive pressures" to remove or mitigate so as to include just about anything that produces psychosocial stress.
The psychological improvements you've made are obviously extremely useful, but from what I've read it seems your depression has a large biological component, so do you feel you've done all you can on the physical/behavioural side? I think somatic and sensory stimulation is very important, which is why those old cures for melancholy - cold baths, beating with birch twigs etc - might have had some validity! ('Be not solitary, be not idle' - Robert Burton, 1621) For example, in my younger days, after going to a nightclub or or anywhere with loud music, I'd feel the depression had lifted for a while. It's been my personal experience that inactivity can trigger or worsen depression, and maybe removing too many psychosocial stressors is a bad thing. I certainly feel much better if I go to work and interact with people when depressed. Although it's often difficult to get the motivation to do these things, I've always found them beneficial. Agree or disagree?
I think you're spot on when you say that, for me, prophylaxis is the key. And also recognising the prodromal symptoms so medication can be started straight away to nip the depression in the bud. Hope you continue to find ways of lessening the burden, too. Thanks again for your wise words, Scott.
Best wishes
Lizzy
poster:lizzyg
thread:105245
URL: http://www.dr-bob.org/babble/20020517/msgs/106777.html