![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 22 of 22. This is the beginning of the thread.
Posted by Libby on June 9, 2000, at 13:26:14
My diagnosis is major depression. My doc feels I have been depressed since adolescence and my family & friends unanimously agree that I have always been depressed, although infrequent manic episodes occur as well... For the past year, it seems like I am just juggling symptoms... What gets rid of the tearfulness creates sleep disturbances... What gets rid of the sleep disturbances causes weight gain... Is this what I have to look forward to for the rest of my life,
this constant trading of one symptom for another?
Do people who have been depressed for as long as me actually get well or just better?Libby
Posted by Cari on June 9, 2000, at 16:46:09
In reply to Once a depressive, always a depressive?, posted by Libby on June 9, 2000, at 13:26:14
I'd like an answer to this too. I'm in the same boat as you are... does severe depression EVER go away??? (and I'm definately not talking mild or moderate here) anyone know???
Posted by JohnL on June 10, 2000, at 4:52:28
In reply to Once a depressive, always a depressive?, posted by Libby on June 9, 2000, at 13:26:14
> Do people who have been depressed for as long as me actually get well or just better?
>
> LibbyPeople do actually get completely well. I've seen plenty of life-long sufferers get completely well right here at this website. But in my opinion, the recipe for success is this:
A patient who has done a lot of research.
A patient willing to try anything.
A physician willing to try anything.
And trying to make sense of the clues provided by drug reactions. When someone gets completely well, they can often look back with the benefit of hindsight and see that the clues were there all along.Depression is caused by about 10 different possible chemical imbalances. The symptoms are the same, but the causes are different. It's sad most physicians focus so much on just antidepressants, because ADs only address 3 of those 10, and usually just 1 of the 10--low serotonin.
The correct medication for the person's unique chemisty is characterized by complete recovery and few, if any, side effects. That indicates a close match in chemistry. The less a drug works, the longer it takes to work, and the more side effects there are, the farther away the drug is from targeting the real problem. You won't find that in research anywhere, but that's what I have seen over and over and over through the years in observing other sufferers. With all this in mind, it is pretty safe to assume that whatever medications you have tried so far have been off-target.
Every drug you've tried so far has provided clues. But like I said, it takes a well-studied patient and an open-minded phsycian to first recognize the clues, and secondly make some sense out of them.
Since psychiatry seems to me to be an educated guessing game, I think it makes sense to use the clues for making better guesses. For example, if someone has already tried 2 or 3 serotonin meds, then I would feel comfortable assuming the chemistry responsible is not serotonin, and our next best guess should probably not be a serotonin drug.
Unfortunately most phsycians are not trained to think that way. It's not their fault, it's just the way they were trained.
To shed some light on what I'm talking about, I would suggest you go to www.drjensen.com and browse around. And I would strongly encourage you to buy his book "The Successful Treatment of Brain Chemical Imbalance". Even if you just browse around his website, you will pick up some information you didn't already know, and you will likely discover something helpful that provides understanding and hope. For the regular uncomplicated depression I think conventional psychiatry is perfectly fine. But when things become complicated or prolonged, like in your case, then I think we need a different angle of attack. I am just one of hundreds of success stories that can attest to the validity of Dr Jensen's practices.
It seems more complicated than it really is. But it's not. Find out which of the 10 chemical imbalances is at fault. Then find the best drug in the appropriate class to target that chemistry. It takes an open minded patient/phsycian team to sample different meds in an effort to gather clues. The clues are all there for the taking.
JohnL
Posted by Cam W. on June 10, 2000, at 5:32:27
In reply to Re: Once a depressive, always a depressive?, posted by JohnL on June 10, 2000, at 4:52:28
Libby & Cari - John said it rather well [John, you getting residuals on that book, man ;^)]. Some depressions are reactive, in response to an extreme stress (the death of someone close for instance) and others do seem to have genetic features.It is thought that an uncoupling (breakdown) of the body's defense against stress (the HPA axis) is a major causitive factor in depressive states. This breakdown can be initiated an number of ways, depending upon what part of the HPA axis is broken. All of the neurotransmitters (serotonin, norepinephrine, dopamine, peptides, amino acids, etc) are all closely linked; the change in level of one will change the levels of all of them (usually in an effort to compensate for the lack of one of them). Like John said it depends on which neurotransmitter is malfunctioning, as to which antidepressant (and/or mood stabilizer) one should use. This is probably why some people have horrible reactions and increased depressions when taking some antidepressants.
Also, like John says, the drugs are only treating a few of the issues involved in depression. You will not get well (have your depression go into remission) with drugs alone. You have work with the drugs in order to attain remission. Even most people with severe, genetically-linked depressions can achieve remission if treated properly (both medications AND psychotherapy). Some people will only need one or the other. Going into remission does not mean that you are "cured" of your depression. There will always be a risk of relapse. Some people need to take antidepressants for life to avoid remissions. Most people with a reactive depression will not remit if they are adequately treated on the initial depression. This may not be so for people with a genetically-linked depression.
I look at depression like this. We are all born with a bar (like a high jump bar) that determines the amount of stress needed to uncouple the HPA axis (set off a depression). Some people have a very high bar (good air traffic controllers) and some have a very low bar (bad postal employees). This bar will be adjusted as you age (especially until your mid-twenties, but probably beyond). Environmental factors come into play. A stressful childhood (physical or psychological abuse) will lower the bar; a healthy nuturing atmosphere will raise the bar. This is known in the biz as the stress/diathesis model of mental disorders and seem to apply to many disorders (eg depression, bipolar disorder, schizophrenia). Diathesis is just a fancy word for environment (sort of).
Hope this helps - Cam.
P.S. - Scott, don't give me sh** for posting. I just can't sleep and need something to do. To everyone else, I will be posting a response to your wonderful outpouring of sympathy for my family sometime next week. We really do appreciate it, but right now I would not be able to give an adequate response to your postings. Thanks much. (Oh, by the way, the funeral is on Tuesday at 3:00pm MDT. For everyone who wants to do something for my family, just keep us in your thoughts that day. Thanks again.) - Cam
Posted by Cindy W on June 10, 2000, at 9:43:38
In reply to Always a depressive? - Not necessarily., posted by Cam W. on June 10, 2000, at 5:32:27
Cam, I'll be thinking about you and your family.--Cindy W
>
> P.S. - Scott, don't give me sh** for posting. I just can't sleep and need something to do. To everyone else, I will be posting a response to your wonderful outpouring of sympathy for my family sometime next week. We really do appreciate it, but right now I would not be able to give an adequate response to your postings. Thanks much. (Oh, by the way, the funeral is on Tuesday at 3:00pm MDT. For everyone who wants to do something for my family, just keep us in your thoughts that day. Thanks again.) - Cam
Posted by Brenda on June 10, 2000, at 10:37:17
In reply to Always a depressive? - Not necessarily., posted by Cam W. on June 10, 2000, at 5:32:27
>
> Libby & Cari - John said it rather well [John, you getting residuals on that book, man ;^)]. Some depressions are reactive, in response to an extreme stress (the death of someone close for instance) and others do seem to have genetic features.
>
> It is thought that an uncoupling (breakdown) of the body's defense against stress (the HPA axis) is a major causitive factor in depressive states. This breakdown can be initiated an number of ways, depending upon what part of the HPA axis is broken. All of the neurotransmitters (serotonin, norepinephrine, dopamine, peptides, amino acids, etc) are all closely linked; the change in level of one will change the levels of all of them (usually in an effort to compensate for the lack of one of them). Like John said it depends on which neurotransmitter is malfunctioning, as to which antidepressant (and/or mood stabilizer) one should use. This is probably why some people have horrible reactions and increased depressions when taking some antidepressants.
>
> Also, like John says, the drugs are only treating a few of the issues involved in depression. You will not get well (have your depression go into remission) with drugs alone. You have work with the drugs in order to attain remission. Even most people with severe, genetically-linked depressions can achieve remission if treated properly (both medications AND psychotherapy). Some people will only need one or the other. Going into remission does not mean that you are "cured" of your depression. There will always be a risk of relapse. Some people need to take antidepressants for life to avoid remissions. Most people with a reactive depression will not remit if they are adequately treated on the initial depression. This may not be so for people with a genetically-linked depression.
>
> I look at depression like this. We are all born with a bar (like a high jump bar) that determines the amount of stress needed to uncouple the HPA axis (set off a depression). Some people have a very high bar (good air traffic controllers) and some have a very low bar (bad postal employees). This bar will be adjusted as you age (especially until your mid-twenties, but probably beyond). Environmental factors come into play. A stressful childhood (physical or psychological abuse) will lower the bar; a healthy nuturing atmosphere will raise the bar. This is known in the biz as the stress/diathesis model of mental disorders and seem to apply to many disorders (eg depression, bipolar disorder, schizophrenia). Diathesis is just a fancy word for environment (sort of).
>
> Hope this helps - Cam.
>
> P.S. - Scott, don't give me sh** for posting. I just can't sleep and need something to do. To everyone else, I will be posting a response to your wonderful outpouring of sympathy for my family sometime next week. We really do appreciate it, but right now I would not be able to give an adequate response to your postings. Thanks much. (Oh, by the way, the funeral is on Tuesday at 3:00pm MDT. For everyone who wants to do something for my family, just keep us in your thoughts that day. Thanks again.) - CamCam - your post re depression was very succinct. Re your note to Scott - when I saw your posts I wondered how you could still be caring for us at a time like this, but I know why. It's just what you said. The company of friends when you can't sleep and your mind can't fathom the deepness of your tragedy. I'll send my heart on the day of the service.
Brenda
Posted by Kerry on June 10, 2000, at 17:39:32
In reply to Once a depressive, always a depressive?, posted by Libby on June 9, 2000, at 13:26:14
I wonder this too. I've even wondered, since I haven't found the right medicine, if maybe I'm not really depressed but just screwed up. Does that make sense? I have all the symptoms of depression and have definitely been diagnosed, but sometimes I figure there's no hope at all for feeling better. I've felt like this since childhood. I remember the first time I planned suicide was when I was about 9 or 10. Am I just a moody, miserable bitch?
I am more hopeful after discovering Psychobabble--y'all have a lot of experience with what I'm talking about and have given me some good ideas about meds. to look into. Onward.
Posted by shar on June 10, 2000, at 21:51:56
In reply to Re: Once a depressive, always a depressive?, posted by Kerry on June 10, 2000, at 17:39:32
This is the first post I've seen that has given me hope of full remission of depression. I thought the best it would get is how I am now--head above water but not much more.
Thanks!!
Posted by BW on June 12, 2000, at 0:35:08
In reply to Re: Once a depressive, always a depressive?, posted by Kerry on June 10, 2000, at 17:39:32
That goes for me to. Thanks JohnL and Cam. You sound a lot more knowledgeable than my doc.I'll check at DrJensons site. Thanks Again
Posted by Kath on June 12, 2000, at 10:06:08
In reply to Re: To Cam-Always a depressive? - Not necessarily., posted by Brenda on June 10, 2000, at 10:37:17
Cam - Thanks so much for explaining - this post was very helpful to me. Does the HPA axis have to do with the ability for the neurotransmitters to get to the receptors that they're supposed to get to? I'm still trying to understand all this. I'm just taking an anti-depressant for the first time (Celexa - an SSRI). I think I have a pretty good idea how SSRI's work, but I hadn't heard HPA axis before.
My thoughts will certainly be with you & your family on Tuesday - ALL DAY.
Warm thoughts - Kath
> > Libby & Cari - John said it rather well [John, you getting residuals on that book, man ;^)]. Some depressions are reactive, in response to an extreme stress (the death of someone close for instance) and others do seem to have genetic features.
> >
> > It is thought that an uncoupling (breakdown) of the body's defense against stress (the HPA axis) is a major causitive factor in depressive states. This breakdown can be initiated an number of ways, depending upon what part of the HPA axis is broken. All of the neurotransmitters (serotonin, norepinephrine, dopamine, peptides, amino acids, etc) are all closely linked; the change in level of one will change the levels of all of them (usually in an effort to compensate for the lack of one of them). Like John said it depends on which neurotransmitter is malfunctioning, as to which antidepressant (and/or mood stabilizer) one should use. This is probably why some people have horrible reactions and increased depressions when taking some antidepressants.
> >
> > Also, like John says, the drugs are only treating a few of the issues involved in depression. You will not get well (have your depression go into remission) with drugs alone. You have work with the drugs in order to attain remission. Even most people with severe, genetically-linked depressions can achieve remission if treated properly (both medications AND psychotherapy). Some people will only need one or the other. Going into remission does not mean that you are "cured" of your depression. There will always be a risk of relapse. Some people need to take antidepressants for life to avoid remissions. Most people with a reactive depression will not remit if they are adequately treated on the initial depression. This may not be so for people with a genetically-linked depression.
> >
> > I look at depression like this. We are all born with a bar (like a high jump bar) that determines the amount of stress needed to uncouple the HPA axis (set off a depression). Some people have a very high bar (good air traffic controllers) and some have a very low bar (bad postal employees). This bar will be adjusted as you age (especially until your mid-twenties, but probably beyond). Environmental factors come into play. A stressful childhood (physical or psychological abuse) will lower the bar; a healthy nuturing atmosphere will raise the bar. This is known in the biz as the stress/diathesis model of mental disorders and seem to apply to many disorders (eg depression, bipolar disorder, schizophrenia). Diathesis is just a fancy word for environment (sort of).
> >
> > Hope this helps - Cam.
> >
> > P.S. - Scott, don't give me sh** for posting. I just can't sleep and need something to do. To everyone else, I will be posting a response to your wonderful outpouring of sympathy for my family sometime next week. We really do appreciate it, but right now I would not be able to give an adequate response to your postings. Thanks much. (Oh, by the way, the funeral is on Tuesday at 3:00pm MDT. For everyone who wants to do something for my family, just keep us in your thoughts that day. Thanks again.) - Cam
>
> Cam - your post re depression was very succinct. Re your note to Scott - when I saw your posts I wondered how you could still be caring for us at a time like this, but I know why. It's just what you said. The company of friends when you can't sleep and your mind can't fathom the deepness of your tragedy. I'll send my heart on the day of the service.
> Brenda
Posted by Cam W. on June 12, 2000, at 11:03:22
In reply to To Cam-Always a depressive? ., posted by Kath on June 12, 2000, at 10:06:08
Kath - The HPA (hypothalamus-pituitary-adrenal) axis is the body's stress response mechanism. It normally works in a cycle:
The body is stressed (psychologically or physically) and this causes the hypothalamus to produce and secrete CRH (corticotropin releasing hormone). The CRH is secreted into a localized blood supply system between the hypothalamus and pituitary (hypophyseal portal system) and, with help from vasopressin, stimulates the anterior pituitary to produce and secrete ACTH (adrenocorticotropin hormone) into the body's blood circulatory system. The ACTH travel to the adrenal glands (atop the kidneys) and stimulates the adrenal glands to produce and secrete cortisol into the bloodstream. The cortisol goes to various body organs initiating the body's "flight or fright" responses (eg decreased energy to the digestive system, increased energy to muscles and attention). The cortisol also travels to the hypothalamus and pituitary in a biofeedback mechanism, shutting off (or slowing) the flow of CRH and ACTH.
The above occurs under normal conditions. In depression, researchers have found that the biofeedback mechanism has broken down and CRH and ACTH are produced and secreted in an uncontrolled manner. The body tries to regulate this, but ends up manifesting as the symptoms we call depression.
Where neurotransmitters (like serotonin, norepinephrine, dopamine, GABA, the amino acids, etc.) come mainly into play is in the regulation of the responses of the hypothalamus and pituitary. Through complex interactions and wiring (which I still can't fully visualize - damn!) the raphe nuclei (serotonin), the locus ceruleus (norepinephrine), and the basal ganglia/limbic system (dopamine) all try to counter the effects of the excess cortisol release [due to increased ACTH causing (or because of) the feedback mechanism breakdown]. The neurotransmitter receptors located on various brain structures and on neurons that control or regulate other neurons are stimulated or inhibited in response to these changes. Over time these changes cause the concentrations of one or more of the neurotransmitters and/or concentrations of the various receptor sub-types to be changed (possibly resulting in the observation that serotonin levels are decreased in many people who have depression).
(I think this is mostly correct, hopefully someone will fix any blunders I have made.)
The HPA axis works, in short by:
Stress causing the hypothalamus to release CRH which causes the pituitary to release ACTH which causes the adrenals to release cortisol which goes to various organs initiating the "flight or fright" responses and also cortisol travels back to the hypothalamus and pituitary to shut off the output of CRH and ACTH, respectively.
Depression is a result of a break down in this shut off and can possibly be initiated by a malfunction at any point in the chain.
Hope this is clear - Cam
Posted by stjames on June 12, 2000, at 12:12:18
In reply to JohnL/Cam: Full remission is a dream, posted by shar on June 10, 2000, at 21:51:56
> This is the first post I've seen that has given me hope of full remission of depression. I thought the best it would get is how I am now--head above water but not much more.
>
> Thanks!!James here...
I would say that if you have had several bouts of depression that your depression is chronic, ie for life. However this does not mean you can't treat it and have it go into full remission. You need to remember that remission is not a cure, the remission is because of the meds you take. I have been in remission for years, like since 1985. I tend to have break thru depressions every 5 yrs and a change in dose or meds quickly brings me back to normal.
Posted by Greg on June 12, 2000, at 13:01:10
In reply to Re: JohnL/Cam: Full remission is a dream, posted by stjames on June 12, 2000, at 12:12:18
> I would say that if you have had several bouts of depression that your depression is chronic, ie for life.
Good morning James,
Hope everything is well with you.
That is a powerful comment my friend, and I must say that I disagree. Having watched my Grandfather battle Cancer, and having worked with Cancer patients who have had several bouts of the illness and then go into full remission for the rest of their lives, I've seen that these things can happen, and believe that it has to be possible with depression as well. I know I'm comparing apples and oranges here, but...
Forever the optimist, I suppose.
Greg
Posted by Libby on June 12, 2000, at 16:14:02
In reply to Re: Once a depressive, always a depressive?, posted by JohnL on June 10, 2000, at 4:52:28
John, Cam & others... Thanks for the answers. The response makes me feel a little more hopeful about treatment... I will check out the reference you suggested, John. Cam, thanks for taking the
time to respond also... It is much appreciated...Libby
Posted by stjames on June 12, 2000, at 17:15:32
In reply to Re: JohnL/Cam: Full remission is a dream, posted by Greg on June 12, 2000, at 13:01:10
> > I would say that if you have had several bouts of depression that your depression is chronic, ie for life.
>
> Good morning James,
>
> Hope everything is well with you.
>
> That is a powerful comment my friend, and I must say that I disagree. Having watched my Grandfather battle Cancer, and having worked with Cancer patients who have had several bouts of the illness and then go into full remission for the rest of their lives, I've seen that these things can happen, and believe that it has to be possible with depression as well. I know I'm comparing apples and oranges here, but...
>
> Forever the optimist, I suppose.
>
> GregJames here....
I would point out that remission in cancer is caused by cutting out the cancer or killing it with powerful drugs. It is standard to call depression cronic if someone has several bouts.
It is important to realize that depression often comes and goes and if not treated it comes back stronger each time, getting more diffucult to treat. It is a powerful statement but it is accepted that people who have had several bouts of depression in their life are cronic.james
Posted by Kath on June 13, 2000, at 15:38:22
In reply to Re: To Cam-Always a depressive? . » Kath, posted by Cam W. on June 12, 2000, at 11:03:22
Cam - Thanks SO MUCH! I love to understand things & I'll have to read this over a few times to get it clear, but this is so useful for me. I'm thinking of you all today & my prayers are with you. Thanks for answering my question.
Warm thoughts - Kath
Kath - The HPA (hypothalamus-pituitary-adrenal) axis is the body's stress response mechanism. It normally works in a cycle:
>
> The body is stressed (psychologically or physically) and this causes the hypothalamus to produce and secrete CRH (corticotropin releasing hormone). The CRH is secreted into a localized blood supply system between the hypothalamus and pituitary (hypophyseal portal system) and, with help from vasopressin, stimulates the anterior pituitary to produce and secrete ACTH (adrenocorticotropin hormone) into the body's blood circulatory system. The ACTH travel to the adrenal glands (atop the kidneys) and stimulates the adrenal glands to produce and secrete cortisol into the bloodstream. The cortisol goes to various body organs initiating the body's "flight or fright" responses (eg decreased energy to the digestive system, increased energy to muscles and attention). The cortisol also travels to the hypothalamus and pituitary in a biofeedback mechanism, shutting off (or slowing) the flow of CRH and ACTH.
>
> The above occurs under normal conditions. In depression, researchers have found that the biofeedback mechanism has broken down and CRH and ACTH are produced and secreted in an uncontrolled manner. The body tries to regulate this, but ends up manifesting as the symptoms we call depression.
>
> Where neurotransmitters (like serotonin, norepinephrine, dopamine, GABA, the amino acids, etc.) come mainly into play is in the regulation of the responses of the hypothalamus and pituitary. Through complex interactions and wiring (which I still can't fully visualize - damn!) the raphe nuclei (serotonin), the locus ceruleus (norepinephrine), and the basal ganglia/limbic system (dopamine) all try to counter the effects of the excess cortisol release [due to increased ACTH causing (or because of) the feedback mechanism breakdown]. The neurotransmitter receptors located on various brain structures and on neurons that control or regulate other neurons are stimulated or inhibited in response to these changes. Over time these changes cause the concentrations of one or more of the neurotransmitters and/or concentrations of the various receptor sub-types to be changed (possibly resulting in the observation that serotonin levels are decreased in many people who have depression).
>
> (I think this is mostly correct, hopefully someone will fix any blunders I have made.)
>
> The HPA axis works, in short by:
>
> Stress causing the hypothalamus to release CRH which causes the pituitary to release ACTH which causes the adrenals to release cortisol which goes to various organs initiating the "flight or fright" responses and also cortisol travels back to the hypothalamus and pituitary to shut off the output of CRH and ACTH, respectively.
>
> Depression is a result of a break down in this shut off and can possibly be initiated by a malfunction at any point in the chain.
>
> Hope this is clear - Cam
Posted by Tom on June 15, 2000, at 11:23:54
In reply to Re: JohnL/Cam: Full remission is a dream, posted by stjames on June 12, 2000, at 17:15:32
>I totally disagree. Drugs just sooth the pain. The real work to put your depression behind you permanently is done in therapy and how you live your life. My three rules for finding your deepest self and "curing" your depression:
1)Be 100% honest with yourself.
2)Don't be afraid to feel what your feeling.
3)Know yourself, accept yourself, and then learn to love yourself, even if your experiences don't lend themselves to a perfect image of yourself.Once all walls have been brought down then permanent healing will eventually come. Meds help until you get to that point.
One person's opinion.
> > I would say that if you have had several bouts of depression that your depression is chronic, ie for life.
> >
> > Good morning James,
> >
> > Hope everything is well with you.
> >
> > That is a powerful comment my friend, and I must say that I disagree. Having watched my Grandfather battle Cancer, and having worked with Cancer patients who have had several bouts of the illness and then go into full remission for the rest of their lives, I've seen that these things can happen, and believe that it has to be possible with depression as well. I know I'm comparing apples and oranges here, but...
> >
> > Forever the optimist, I suppose.
> >
> > Greg
>
> James here....
>
> I would point out that remission in cancer is caused by cutting out the cancer or killing it with powerful drugs. It is standard to call depression cronic if someone has several bouts.
> It is important to realize that depression often comes and goes and if not treated it comes back stronger each time, getting more diffucult to treat. It is a powerful statement but it is accepted that people who have had several bouts of depression in their life are cronic.
>
> james
Posted by shar on June 15, 2000, at 23:48:57
In reply to Full remission is a dream - disagree, posted by Tom on June 15, 2000, at 11:23:54
Tom wrote> >I totally disagree. Drugs just sooth the pain. The real work to put your depression behind you permanently is done in therapy and how you live your life
Tom:
Would that my meds soothed the pain. For me, it is more accurate to say meds relieve me of some of the worst symptoms. Certainly not all of the pain.Do you believe that physiology cannot cause depression? And, if it is physiological, will therapy alone get one to the point of living happily without using any meds?
I believe that my depression, which has been a constant state with varying intensity for more than 30 years, is similar to having diabetes. As such, my meds function to correct a physical condition that causes depression.
Personal growth through therapy is a wonderful thing, I agree, and can help.
Take care--S
Posted by Tom on June 16, 2000, at 10:29:25
In reply to Full remission: what about physiology? » Tom, posted by shar on June 15, 2000, at 23:48:57
> Tom wrote> >I totally disagree. Drugs just sooth the pain. The real work to put your depression behind you permanently is done in therapy and how you live your life
>
> Tom:
> Would that my meds soothed the pain. For me, it is more accurate to say meds relieve me of some of the worst symptoms. Certainly not all of the pain.
>
> Do you believe that physiology cannot cause depression? And, if it is physiological, will therapy alone get one to the point of living happily without using any meds?
>
> I believe that my depression, which has been a constant state with varying intensity for more than 30 years, is similar to having diabetes. As such, my meds function to correct a physical condition that causes depression.
>
> Personal growth through therapy is a wonderful thing, I agree, and can help.
>
> Take care--SEmotional pain eventually goes away... once it is relieved into conciousness. That's the hard part. Some people never achieve this. I didn't say it was easy. The injured mind eventually lets go of the pain, in time, only when it is exposed to one's "self". It's not a crime to never get to the bottom of things. Alot of people never do, hence they are forced to medicate their pain their entire lives. Once the pain goes away, only scars will remain, and hopefully one can chuck the meds. I've seen this scenario play out as often as any other. Once again, one man's opinion...
Posted by Libby on June 16, 2000, at 11:04:52
In reply to Full remission is a dream - disagree, posted by Tom on June 15, 2000, at 11:23:54
Tom, these rules sound good, but I don't believe following them is an assurance against recurrent bouts of depression. It seem to me that what they do is help to restore a sense of control for depressed patients - and having a sense that one's behavior influences outcomes is important
to restoring depressed patients to "normal" mood & functioning.When I first read what you wrote, I tended to
strongly disagree because something about them didn't seem to fit my own experience. I won't chronicle the year prior to the onset of my latest bout of severe depression, but I will summarize. Three deaths very close to home,
all young people, all accidental. A best friend who experienced a psychotic break because of two of these deaths. A newly disabled mother, a severely retarded sister, and severely depressed daughter to care for. A reorganization/forced job change at work. Loss of career status and pay. Emergency surgery. All within a nine month period. I was hit constantly with things I couldn't control. When I went to therapy, I was taken there. Didn't think I had a problem because I was functioning ok. Everything was done. Everybody was cared for. I thought if I was patient and worked harder, things would get better, but hard work didn't seem to matter. If I worked hard and got one thing taken care of, another popped up and demanded my attention.
Eventually, I learned that my behavior didn't matter. The illusion that if we do "X" then "Y" will happen failed. The majority of the situations that led to this bout of my depression were NOT under my control. As I understand it, this kind of learned helplessness response is a basic characteristic of clinical depression.I read about a study performed to test a theory that depressed patients tend to UNDER estimate the degree of control they have over their environment. To their surprise, researchers found the depressed people were actually more accurate in estimating degree of control. It
was the control group who consistently OVER estimated their degree of control. I guess
the major finding here is that restoring the illusion of control is important. That's
what your suggestions address.However, once a person (like me) has been in situation after situation where the illusion has been completely shattered, then what? I don't struggle with the problem of HOW to restore it. I'm dealing with the question of whether it's even PREFERABLE to restore it. In my case, my mom has recovered for now, but she will get sick again and when she does, I will lose the ability to control my life. That's fact. Isn't it?
So why bother trying to rebuild a life based on the illusion of control when I know the truth may come along at any moment and rip the whole thing apart again.This is how my depressed brain works after a year of medication and therapy this time - five years of therapy and medication total.
For information, I am a chronically depressed person, with three major depressive episodes in the past fifteen years.
Thanks for your consideration...
Libby>My three rules for finding your deepest self and "curing" your depression:
>
> 1)Be 100% honest with yourself.
> 2)Don't be afraid to feel what your feeling.
> 3)Know yourself, accept yourself, and then learn to love yourself, even if your experiences don't lend themselves to a perfect image of yourself.
>
> Once all walls have been brought down then permanent healing will eventually come. Meds help until you get to that point.
>
> One person's opinion.
>
>
>
> > > I would say that if you have had several bouts of depression that your depression is chronic, ie for life.
> > >
> > > Good morning James,
> > >
> > > Hope everything is well with you.
> > >
> > > That is a powerful comment my friend, and I must say that I disagree. Having watched my Grandfather battle Cancer, and having worked with Cancer patients who have had several bouts of the illness and then go into full remission for the rest of their lives, I've seen that these things can happen, and believe that it has to be possible with depression as well. I know I'm comparing apples and oranges here, but...
> > >
> > > Forever the optimist, I suppose.
> > >
> > > Greg
> >
> > James here....
> >
> > I would point out that remission in cancer is caused by cutting out the cancer or killing it with powerful drugs. It is standard to call depression cronic if someone has several bouts.
> > It is important to realize that depression often comes and goes and if not treated it comes back stronger each time, getting more diffucult to treat. It is a powerful statement but it is accepted that people who have had several bouts of depression in their life are cronic.
> >
> > james
Posted by Tom on June 16, 2000, at 12:58:47
In reply to Re: Full remission the illusion of control, posted by Libby on June 16, 2000, at 11:04:52
>Libby,
First off let me say that I totally empathize with your situation, having experienced all kinds of disorders due to my father's death when I was a young boy. This most recent depression has been the grand-daddy of them all. But at least I've gotten to the bottom of things for the first time in my life.
I guess what I want to stress about my recipe for moving beyond depression is... it's not easy! The recipe is very easy; the ingredients can be extremely difficult to find though. Sometimes life experience is so adverse that one can never move beyond chronic pain. Sometimes it just overwhelms a person, to the point that emotional pain can't be overcome, be it for whatever reason. But I do believe one thing about all this chaos; time heals all wounds. First we need to "cleanse" the wound(s), then incorporate all the painful events into our lives. We do need to feel the pain. Every joy and every pain is a miracle of life.
If the pain is too much, search for the right med (I'm not anti-med). I believe my viewpoint offers the most hope for moving beyond adverse life experiences that create the monster called depression.
Tom
Posted by Libby on June 16, 2000, at 15:04:34
In reply to Re: Full remission the illusion of control » Libby, posted by Tom on June 16, 2000, at 12:58:47
Tom, thanks for the explanation. I agree that the "right" course would seem to be working through the feelings in therp. That's not been possible for me yet.
The symptoms of my depression this time are different than previous episodes in that I am
not aware of my low mood. Those around me are,
but I'm not. The only "pain" I feel is the nagging fear that I've permanently lost all
motivation.Amyway, thanks for your suggestions. Don't
mean to dis them. It's just that I haven't gotten to the point where I can apply them
yet. I'm sure someone who is motivated
to get well would do well with them.Thanks...
L.> First off let me say that I totally empathize with your situation, having experienced all kinds of disorders due to my father's death when I was a young boy. This most recent depression has been the grand-daddy of them all. But at least I've gotten to the bottom of things for the first time in my life.
>
> I guess what I want to stress about my recipe for moving beyond depression is... it's not easy! The recipe is very easy; the ingredients can be extremely difficult to find though. Sometimes life experience is so adverse that one can never move beyond chronic pain. Sometimes it just overwhelms a person, to the point that emotional pain can't be overcome, be it for whatever reason. But I do believe one thing about all this chaos; time heals all wounds. First we need to "cleanse" the wound(s), then incorporate all the painful events into our lives. We do need to feel the pain. Every joy and every pain is a miracle of life.
>
> If the pain is too much, search for the right med (I'm not anti-med). I believe my viewpoint offers the most hope for moving beyond adverse life experiences that create the monster called depression.
>
> Tom
This is the end of the thread.
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