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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by DoYouKnowHim? on June 11, 2005, at 14:32:18
That's a depression, according to a book, that is not a true depression, but problems with living.
Anyone know anything about this? What is the best form of treatment for this?
Posted by Racer on June 11, 2005, at 15:15:45
In reply to Are there any meds for a neurotic depression?, posted by DoYouKnowHim? on June 11, 2005, at 14:32:18
As far as I've read, the term "neurotic" is out of favor these days in the psychiatric field. It used to be a sort of dichotomy between "psychotic" -- which was a more active, aggressive sort of picture -- and "neurotic" -- the more passive, fearful reaction to psychotic behavior. "Neurotic" really means something like nervous -- Neuro == nerves, right?
My guess is that what is being described by this book is a depression that has a great deal of anxiety involved. If that's the case, then yes -- there are drugs that help reduce the anxiety as well as the depression, so that someone can make the behavioral and situation changes necessary to improve their lives.
But, as we all know, there is no drug in the world that can make the changes for us. Therapy can help a great deal in working out both how to improve our situations, and what it is that has held us back from making those improvements ourselves.
Short answer: Therapy is the closest you'll get to a drug that fixes broken lives rather than Major Depressive Disorder.
Longer answer: Many drugs prescribed for depression can also reduce or control the related anxiety, as well, but to address the situational factors involved in an exogenous depression such as you're describing, therapy is required, with or without medications.
Posted by Maxime on June 11, 2005, at 15:49:31
In reply to Are there any meds for a neurotic depression?, posted by DoYouKnowHim? on June 11, 2005, at 14:32:18
> That's a depression, according to a book, that is not a true depression, but problems with living.
> Anyone know anything about this? What is the best form of treatment for this?My understand of the statement above is that it a depression caused by external factors ... a job, family problems etc as oppose to a biochemical imbalance in the brain.
In this case therapy would be the best choice. However, sometimes you still need an antidepressant to get through the stressful event. I think they used "neurotic" in the wrong context, or I am misinterpreting it.
Maxime
Posted by Phillipa on June 11, 2005, at 18:13:06
In reply to Re: Are there any meds for a neurotic depression? » DoYouKnowHim?, posted by Maxime on June 11, 2005, at 15:49:31
Neurotic, Someone who worries a lot unneccesarily? Fondly, Phillipa
Posted by Maxime on June 11, 2005, at 21:56:34
In reply to Re: Are there any meds for a neurotic depression?, posted by Phillipa on June 11, 2005, at 18:13:06
> Neurotic, Someone who worries a lot unneccesarily? Fondly, Phillipa
Neurotic = Woody Allen
Posted by Phillipa on June 11, 2005, at 22:31:41
In reply to Re: Are there any meds for a neurotic depression?, posted by Maxime on June 11, 2005, at 21:56:34
Never liked the man. Didn't approve of what he did with his adopted daughter either. Mia Farrow lived near me when I lived in CT. Fondly, Phillipa
Posted by Maxime on June 11, 2005, at 22:52:13
In reply to Re: Are there any meds for a neurotic depression? » Maxime, posted by Phillipa on June 11, 2005, at 22:31:41
Here are the synonyms I found for "neurotic depression.
Maxime
dysthymia, dysthymic disorder, chronic depression, depressive neurosis, anxiety depression, depressive reaction, neurotic depressive state, reactive depression
Posted by Jazzed on June 11, 2005, at 23:03:28
In reply to Are there any meds for a neurotic depression?, posted by DoYouKnowHim? on June 11, 2005, at 14:32:18
> That's a depression, according to a book, that is not a true depression, but problems with living.
> Anyone know anything about this? What is the best form of treatment for this?I get this all the time. Depression that's caused by external factors, which doesn't last as long as real depression. It can be started anything, from being overwhelmed with too much work, being fired, not getting along with someone, having an argument, knowing someone is unhappy with you, taking a med that makes you feel bad etc.... If you get this, you are very sensitive to external factors, they influence you internally. I read something about it somewhere just yesterday, and they were recommending the SSRIs for it, to take the edge off. I would guess if you want meds, you could do that, and therapy for coping skills.
Jazzed
Posted by cockeyed on June 11, 2005, at 23:21:30
In reply to Are there any meds for a neurotic depression?, posted by DoYouKnowHim? on June 11, 2005, at 14:32:18
I sure hope so. Just last tuesday 6/7 my new T told me that the term neurotic depression was an older term for the kind of depression I seem to experience. Frankly, Scarlett, I don't give a d**n, because I've had bouts of depression since I was a kid. Sometimes overwhelming sadness, other times a grey hopelessness that sucks any real life out of living. I've found that SSRI's and some tranks help. I've had close family members who've died in mental institutions and I know that there are too many times when I'm not wrapped too tight. I suspect that this term is outdated because it implicitly minimizes someones plight. Not too long ago Fibromyalgia and other real problems and diseases, especially the syndrome of constant tiredness were considered to be "garbage diagnoses" I used to think that "whiplash" was an invention of ambulance chasers until my car got rear-ended and I got whiplashed but good. A sports-injury physician put me on a regimen of exercises and I was able, with the use of anti-inflammatory meds, get better.
My advice is throw away the book and get some up-to-date advice. Depression is depression and it can be hell. cockeyed.
Posted by Chairman_MAO on June 12, 2005, at 10:16:56
In reply to Are there any meds for a neurotic depression?, posted by DoYouKnowHim? on June 11, 2005, at 14:32:18
The following is just my intuition, really:
MAOIs (especially phenelzine), opioids (buprenorphine or tramadol are the only ones likely to be prescribed for most people), Cymbalta/Effexor + benzodiazepine. The most potent combination would probably be MAOI + opioid.
A popular remedy used between the 50s and the 70s was a psychostimulant + barbiturate (Dexamyl, Desbutal et al). I'll bet Dexedrine + benzodiazepine would also work well, but in general I feel the effect of MAOIs is more robust, and benzos can worsen depression. I really like opioids because they inhibit NE-induced firing of neurons in the locus coeruleus, thereby attenuating feelings of stress.
I am choc full of neuroses, dysthymic, and socially phobic (at times worsening into moderate agoraphobia) by default, and phenelzine + buprenorphine changes me into a competent-feeling , generally happy-go-lucky, sociable, generally optimistic person. I can still cry and feel stressed when appropriate, which I Could not do on SSRIs (which didn't even work).
---Evidence for functional release of endogenous opioids in the locus ceruleus during stress termination
by
Curtis AL, Bello NT, Valentino RJ.
The Children's Hospital of Philadelphia,
706 Abramson Pediatric Research Center,
Philadelphia, Pennsylvania 19104, USA.
J Neurosci 2001 Jul 1;21(13):RC152ABSTRACT
Endogenous opioids target noradrenergic locus ceruleus (LC) neurons and potently inhibit LC activity. Nonetheless, it has been difficult to demonstrate functional regulation of the LC-noradrenergic system by endogenous opioids because of the lack of effect of opiate antagonists. The present findings provide evidence that endogenous opioids regulate LC neuronal activity during the termination of a stressor. LC neuronal discharge was recorded from halothane-anesthetized rats before, during, and after hypotensive stress elicited by intravenous nitroprusside infusion. In naive rats, mean arterial blood pressure was temporally correlated with LC activity such that hypotension was associated with increased LC discharge and a return to the normotensive state was associated with a decrease in LC discharge below pre-stress values. After microinfusion of an antagonist of the stress neuropeptide corticotropin-releasing factor (CRF) into the LC, the increase in LC discharge associated with hypotension was prevented, whereas LC inhibition associated with termination of the challenge occurred at an earlier time and was of a greater magnitude. In contrast, microinfusion of naloxone into the LC completely abolished LC inhibition associated with termination of the stressor. Naloxone microinfusion did not prevent LC inhibition associated with hypertension produced by intravenous vasopressin administration, suggesting that endogenous opioids may be selectively engaged during the termination of hypotensive stress. These results provide evidence for a functional release of endogenous opioids within the LC. This action of endogenous opioids may serve to counterbalance excitatory effects of CRF on the LC-norepinephrine system, thereby limiting its activation by stress.
This is the end of the thread.
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