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Depression

Discussion in 'The Vault' started by Dylan, Nov 27, 2011.

  1. darkstarexodus

    darkstarexodus Well-Known Member

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    ....in a negative 4-G turn....
    [quote author=Loch Ness Monster link=topic=47687.msg1434143#msg1434143 date=1322520600]

    I think the medications make the lows more bearable and less negative, frequent and harmful, but I have noticed that they make the highs less so. I think that counselling is the main mechanism for dealing with depressive episodes, the medication can provide the confidence and platform to actually get you to the counsellor.
    [/quote]

    This is an interesting and important point. Ive had patients mention to me on numerous occasions that their emotions are just flatter across the board, lacking the highs and lows alike. Which is one of many reasons why medication is usually not the entire solution but rather a piece of it, often the kickstarter. The problem is that so few primary care general practitioners have the specialised knowledge to do much more than prescribe an SSRI (and often do not know how to pick the one most appropriate to the specific patient. Getting referral to someone who is a mental health specialist is very very important. GPs simply dont have all the tools (and its not reasonable to expect them to).
     
  2. darkstarexodus

    darkstarexodus Well-Known Member

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    [quote author=robinhood link=topic=47687.msg1434073#msg1434073 date=1322510171]
    If this article is of no interest, fair enough. It is to me, so I'm posting it in case it is to anybody else: http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.0020392


    Best wishes to anybody who is currently suffering.


    x
    [/quote]

    Ive seen that article before I believe and it raises some interesting points, at least relating to the advertisement of antidepressants. I dont think anyone seriously believes that serotonin alone is involved in regulating mood. There are a whole host of neurotransmitters involved in mood and behaviour and it is no surprise that a number of medications that affect these systems different have a variety and positive and/or negative effects. Its worth nothing hat even the so-called Selective Serotonin Reuptake Inhibitors are only relatively selective. They affect serotonin far far more than other neurotransmitters but, like most drugs, they are not perfectly 'clean'. Medications affecting norepinephrine, dopamine, GABA, NMDA receptors and acetylcholine have a variety of effects from relaxation to delerium. While mental illnesses or depressions may have a number of characeristics in common, they may equally have as many differences, necessitating an individualised treatment plan.

    And this is why American-style prescription medication advertising is so very very wrong. Patients go into the doctors office looking for a certain medication based on its marketing when they have no basis on which to be requesting. What worked for their friend may not work for them and may even be harmful. Psychoactive medication is a valuable tool but, like many tools, can be useless or harmful when used inappropriately or without proper guidance.
     
  3. StevieM

    StevieM SCM's resident Beer Nazi, Wine Snob & Comic Geek Honorary Member

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    I have to thank the doctor that treated me.

    He was probably about the same age, didn't judge me or act like a prick at all (and I've had many that did).

    He supported me, understood me, and helped me, guided me to ways to manage myself. He also tackled the other issues, or tried to (high blood pressure = yes, booze intake = on a loser there).

    Made the difference.
     
  4. DHSC

    DHSC Well-Known Member

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    Good luck and best wishes to all those suffering. I hope you guys fight it and come out feeling better.
     
  5. Avmenon

    Avmenon Well-Known Member

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    One day at a time
     
  6. Mystic

    Mystic Moderator Moderator

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    Has anyone seen the work Stan Collymoore is doing on twitter? Auctioning off footballing shirts etc to raise money for Depression Alliance, another example of the great work he's doing for depression awareness and I must admit my respect for him is through the roof. Great work Stan.
     
  7. singlerider

    singlerider Throbbing Member Member

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    Some great contributions in here.

    I unwittingly grew up with depression. My old dear, throughout her life, as long as I can remember (and probably as long as she can remember) has always been severely depressed. My old man, who is somewhat emotionally retarded (though a very decent man) was therefore perhaps not the best choice of husband when it came to the understanding and empathy stakes.

    Unsurprisingly they divorced when I was 5. At that point I started to lose it a little as I bounced around schools - firstly being the only 6 year old in a 5 year olds nursery, then being the only 7 year old in the 8 year olds year. I was angry, got into fights a lot, cried a lot and very much projected the image of "victim" - resulting in a lot of bullying. This set a pattern of isolation for me, and throughout school I never really had any friends bar one, who is still my best friend to this day. When I was 7 and moved to a new school I was the only coloured kid in the entire school, and so the kids would delight in winding me up, singing Chingy Chongy Chinaman and all the other shit - they weren't really racist I think, just kids pushing another kid's buttons. But I still had an incredibly short temper, and so this would inevitably lead to fights, and seeing as I was still only just over 3 feet tall (the only kid smaller than me had spinal problems and was virtually the same size as he was when he popped out) this didn't end well for me. I regularly took a pasting off the entire class, and knew it was futile trying to make an issue of this as when I was racially abused in class the teachers would frequently laugh along. I hated the school and everybody in it, but was not allowed to change, so there I stayed.

    My parents had diametrically opposing views - as far as my Mum was concerned, if ever anything went wrong then it was obviously because the school were picking on me and that the teachers had it in for me (she very much externalises her problems and blames it on her environment or the people around her, rather than it being herself). As far as my Dad was concerned I needed to work hard and do what the teachers told me (I don't think he's ever actually told me he loves me - it's not in his repertoire, it was only later in life I realised "Make sure you work hard" was his version of "Son, I love you and want you to have a happy life")

    I progressed from junior to middle school, staying at the same place, not making friends, not meeting girls (it was an all boys school) and being more an more of a loner. Every now and then I would try and ingratiate myself with a new crowd, but I would always try too hard to fit in and be like them and eventually something would happen along the lines of them mocking me, me becoming resentful and angry and starting a fight or flouncing off in an overly dramatical fashion. It's fair to say I did myself no favours. I tried hanging out with my brother and his friends, smoking puff and being rebellious, but there would always come a time when the big boys didn't want me cramping their style any more (usually after I'd punched one of them in the bollocks apropos of nothing - a bewildering habit I'd picked up and still don't understand to this day).

    At 13 I made my first proper friend, a kindred spirit with crazy parallels (both half Chinese, half English, born to a mother from up North and a father from far East, very similar outlooks on life, very similar experiences, same tastes in everything) - but neither of us hung out in school that much. It was almost like we didn't want the rest of them to associate us I guess, like if they put two and two together it might draw more attention to both of us or something. We'd meet up outside of school and have deep and meaningful conversations, or discuss books and films and shit, but in school we seemed to have an unspoken agreement that we wouldn't allow them to connect us.

    I guess this is around the time when I started to cotton on to the fact that I was a bit different to other people. I'd never really been aware of depression or anything like that, I guess to me it was just sort of normal because it's what I'd grown up with - I hadn't really ever considered that other people didn't seem to have a Mum that was mental and did mad things, or that other people didn't struggle to make friends or talk to people or fit in. Now that I started to notice these things I guess it sort of made them worse, the issue loomed larger in my mind. I spent less time trying to ingratiate myself with people and more time thinking about why I wasn't popular. I wrote bad teenage angsty poetry. I thought about cutting myself, but stopped because it hurt. I convinced myself I'd fallen in love with our lodger and used to sit in dark rooms thinking about her and how I could never be good enough (or old enough) for her. 13-16 I spent quite a lot of time on my own, reading books, playing games, riding my bike. My bro had left home so now it was just me and Mum, who was still reeling from my brother's teenage years and consequent departure, so she was always guilt tripping me and saying stuff like "Don't go out all the time, don't be like your brother" - as if I had a choice.

    Later teenage years brought more drugs, acid now and speed, and pills, which were great because when you're fucked you can talk to absolutely anybody, no matter how socially awkward you are, but on the flip side when they start to wear off all of those insecurities and hang ups become magnified tenfold. At this point I was doing quite a lot of speed, which was great to start with, cos it made you feel invincible and bouncy and when you first take it there's hardly any come down. All gain, no pain.

    After a while though it starts to get a bit shit. You wake up feeling dread, so you think "I'll have a cheeky little line to perk me up". Then you're fading by lunchtime, so you're in the bogs at school chopping up lines on the top of a toilet. At this point I figured it was maybe time to take a look in the mirror rather than at what was lined up on it. There was still the isolation. I'd moved school now, but same shit in a different place - kind of had sort of mates, but never really felt that integrated or that much of a part of things, always felt a bit like a hanger on. Had some friends outside of school, but really I had one actual friend who I'd gotten to know well, and then all of his mates that I used to hang around with. I was kind of accepted, but very much always an outsider.

    It probably didn't help that they were all a bunch of stoners and I'd turn up with a bag of speed.

    I had some pretty low points. Like most angsty teenagers I had imagined the tears and the wailing and all the people struggling to fit in the church if I topped myself, it was such cringeworthy self-indulgent bollocks. But one day I reached a point where actually I was just fed up of being alive and decided that if this was what life was then I didn't want any part of it any more, I'd never really known (or at least could never remember) a days happiness, my whole life had been a struggle (emotionally - I'd never really wanted for material things) and if all I had to look forward to was 60 more years of this shite then stop the fucking ride, I'm getting off. I took a hosepipe and drove off up to the woods, didn't leave a note or anything like that, I wasn't really thinking about anyone else to be honest I just wanted it done. So I found a little tranquil spot and thought "Yeah, this'll do". I stuck the hosepipe in the exhaust and got back in the car and sat with my hand on the ignition key for about half an hour, and I don't mind admitting I cried like a little bitch (actually if I'm honest I'm crying thinking about it right now).

    Now, I don't give a fuck what anybody says - suicide is not 'the easy way out'. It is *hard* to take your own life, it is hard to sit there, knowing that if you turn the key and sit back you're gonna be dead in the next 20 minutes or so - and doing it that way doesn't even hurt, so fuck knows what it must be like slitting your wrists or something like that.

    Anybody who says that suicide is the easy way out is a cunt. Anyone who thinks it's a cowards way is a cunt. You don't know how much cojones it takes to kill yourself till you've tried to do it, and it's a fuck of a lot more than I've got. So the decision was made for me then and there, I tried it, I couldn't do it, so fuck up and stop whinging like a little bitch then. From that point on I vowed never to indulge myself those pathetic thoughts of "Wouldn't they all miss me" - firstly because if you're thinking about it like that then basically all you really want is a cuddle, but secondly because when push came to shove I didn't have what it takes.

    Now, the second accusation commonly levelled at suicide is that it's selfish - and that is a little fairer. Like I said, when I drove up to the woods that day I wasn't thinking about anyone else - I wasn't thinking about how much damage it would do or how much it would break my family's heart, I just wanted it all to stop.

    However, I would categorise depression not necessarily as a selfish illness, but one that makes you self-obsessed. It's not that you're wilfully putting yourself before others, but more that you can't see anything outside of the tiny bubble you're in - for instance I think on the whole when somebody who is depressed is confronted head on by somebody else's problem they can be incredibly empathetic and supportive and will often go out of their way to help them. It's just most of the time unless you actually make a point of saying "blah blah blah" they're oblivious to the world around them.

    For a depressive, their world really does revolve around them - every little thing can be twisted so that it all comes back to "What's wrong with me?" - even to the extent that the slightest little thing, the most innocuous incident, such as somebody running a bit late and doesn't have time to stop, or they got a parking ticket and are a bit pissed off - all of these things, in a depressives mind can get latched upon, magnified, twisted, taken out of context and completely misinterpreted and blown out of proportion until it becomes "They hate me". Even though that other person probably barely even noticed them or the 'incident' the depressive goes over it again and again and again, replaying it, editing it slightly, placing more emphasis on certain aspects, changing some of the tones, making the overall feel much darker - it's like "The Director's Cut" of your life if the Director was David Lynch. Everything becomes fucked up and sinister, and by the time you next see that person, you've replayed this thing so many times and turned it into such a big fucking deal that you start acting all weird.

    Now, the other person hasn't got a clue that all this shit has happened in your head, but they can pick up on the fact that you're now being all weird, so that puts them on edge and makes them feel slightly uncomfortable, and say what you like about depressives but one thing they generally are is quite perceptive and quite attuned to people if they think there is some kind of issue there (to the extent that they can create one if needs be). So if that other person is acting a bit weird, because the depressive is acting very strange (but doesn't realise it), then the depressive is definitely picking up on this and making it into an even bigger badder thing. Like so much of the stuff around depression, it's a total vicious circle - a positive feedback cycle that keeps reinforcing itself and getting worse and more intense.

    It can be so hard to drag yourself out of this rut. It can be hard to realise that something that may seem so significant to you can mean nothing to someone else. It sometimes slips your mind that not everybody is constantly concerned with how you're acting, or what you're saying, or how much of a cunt you think you're being.

    There have been other points in my life when I've been as low as I was on 'that day'. After I left home and went to uni a lot of issues came out (probably as a result of doing too much acid). Although I was ideologically opposed to anti-depressants (ironic, huh?) there came a time when I just felt like I couldn't do it on my own any more. By this time I actually had a good group of friends around me, who were supportive, but not understanding - how can you be unless you've been there?

    I was prescribed Seroxat as an 18 year old, the significance of which DSE I'm sure will know and some of you may have heard in the news a while back: "Seroxat - the anti-depressant that can cause suicidal thoughts in young people!" and like people have said it didn't make me happy, it just robbed me of all emotion. I was taking them thinking "Surely they've got to have an effect at some point" but they never really seemed to help, I just felt apathetic. Although I wouldn't say I felt suicidal, they kind of made me feel like if I was crossing a road and a car came screeching round the corner, I probably couldn't be bothered to jump out of the way, if that makes sense?

    So I sacked them and figured there's only one thing in this world that can make me happy - me! And I did. I hit rock bottom and I bounced, and for the next few months I was overflowing with joy, I was extroverted, I was tactile, I was confident . . . I was happy for the first time in my life, and I realised that that is all you need to be happy - an acceptance of self and a will to be happy. You don't need counselling, or drugs, or anything really (although I'm not saying they won't all help) apart from the desire to be happy and the ability to accept yourself.

    Because ultimately (well, to my mind at least) that is what really differentiates between 'feeling a bit down' and 'being depressed'.

    It's the self-loathing.

    Everyone has bad days where shits gone wrong. Loved ones close to us die, we lose our jobs, money gets tight, our relationships break down - all kinds of bad shit happens to us that make us feel fucking miserable - and with good reason.

    But as lefty says in the first post (I think) depression doesn't need any of that. You could be the man of the moment, adored by those around you, well respected, well liked, have everything going for you and still be depressed.

    Why?

    Because none of that shit matters if you hate your fucking guts. Being depressed is like getting lumbered with the person you hate most in the world and never being able to get rid of them. From the moment you wake up in the morning to laying in bed at night they are there with you, constantly, inside your head. You can't turn them off, you can't drown them out, you can't ignore them. You can go out and get fucked up, but there they are tagging along like the unwanted geeky friend you've had to bring to the party that you're actually a little bit embarrassed about, but you can't tell them to fuck off. There they are making the shit conversation that you can torture yourself with for years to come. There they are saying or doing those embarrassing things with the people you like.

    And in the morning there they are again, when you feel shit and vulnerable and insecure, except now they've taken on a really dark side and are bullying you. They're pointing out your failures. They're reminding you of all of the cuntish things you've done. They're niggling away at you and picking all the really private and protected vulnerabilities you have because they know every single little secret you've got.

    And you can never get rid of them.

    Or at least, that's the way it feels - because unlike other non-terminal illnesses, for some bizarre reason when you have depression you feel like that's your lot and that you'll never be well again. Even if you've been here before and you've dragged yourself out of it, and after you've got out of it you've looked back an thought "That wasn't that hard, why didn't I do that earlier" when you're down at the bottom it feels like you'll never be able to pick yourself up.

    But you can. And you will.

    I'm very tempted to draw some correlation between my lack of drug taking now and my emotional stability, because for a few years after first discovering I could be happy I bounced between *really happy* and *really depressed* - at one point I couldn't leave the house because it was too daunting, even to post a letter in the postbox 100 yards down the road. But now I've been stable for a while.

    I've not exactly been happy, but I've certainly not been depressed. I guess you could call it 'content' - and for me that's good enough.

    Even more amazingly my Mum, who has been depressed her entire life, who has also tried to top herself and who had basically resigned herself to a lifetime of misery, has discovered painting, and through painting has discovered peace. When she paints, she can be normal. If she doesn't paint she's erratic, irrational, emotional unpredictable, paranoid, the lot.

    If she can make it, anyone can. You just have to accept yourself.

    Be wary of time spent alone, when you can think too much - wear out the body and you can wear out the mind. Don't be tempted to indulge yourself and think "I'll just think about this a little bit, even though I know it's probably not healthy" - it's like picking at a scab, do it too much and it'll scar. Make sure your internal dialogue is appropriate - always think "Would I speak to a friend this way?" If the answer is no, because you wouldn't say to a friend "You're pathetic, look at you, feeling sorry for yourself etc etc" then ask yourself why you feel it's okay to speak to yourself like that.

    And remember, it's not forever
     
  8. Avmenon

    Avmenon Well-Known Member

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    I really wish I had made the effort to get to MK from Bedford last year.

    Thanks, singe.
     
  9. Fabio

    Fabio Former mod, consistent c*** Honorary Member

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    cracking post single
     
  10. Avmenon

    Avmenon Well-Known Member

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    Your 4th post.

    is a good un
     
  11. Buddha

    Buddha Well-Known Member

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    Thanks Single, a pleasure to read you.
     
  12. Avmenon

    Avmenon Well-Known Member

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    I've also heard some people say that suicide is just a cry for help, or even attention. I don't think it is at all. I think in most cases people who think about that aren't thinking about killing themselves, they dont want to 'die'. They just want the feelings of sadness and uselessness to go away. They want to stop waking up and thinking 'why bother with another day of this'. It's just going to end the same way as last night did.

    Those who don't end it all probably think or hope that things may eventually get better and those feelings eventually diminish. Can't live without any hope at all. Couldnt support this club anyway haha, being a Liverpool fan is all about hope, for one thing.

    Singe's point about suicide not being the coward's way out is dead on (pardon the expression)...it's one thing to think 'wouldnt it be nice if i were dead and didnt have all these feelings...'self-loathing' is in fact the best description i've heard (thanks Singe)...it's quite another to actually take the steps to end it...its not surprising, because they DON'T want to die.

    They just want it to stop hurting, they want to stop feeling useless, they want to stop thinking about all the regrets and mistakes they've made in their lives, and how they've wasted their life.

    I guess they take one step at a time, and try to fix what they did wrong and that if they keep doing that every day as often as they can; those feelings eventually arent there anymore.
     
  13. LeTallecWiz

    LeTallecWiz Mo(ssa)d Administrator

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    Thanks for sharing that Single - I'll buy you 3 beers next time you pop into this area (but not when you're undercover, ok?)
     
  14. doctor_mac

    doctor_mac My cowboy name is Garland Justice Moderator

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    Wow Single. Glad you didn't turn the key. Thanks for sharing that. And good to hear that you're now content- you deserve it.
     
  15. TheFasterBlade

    TheFasterBlade ************************ Member

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    Your post really moved me Singlerider.

    Thank you for your honesty. I can relate, as my Mum has suffered from depression most of her adult life.

    I always felt a bit guilty that I could enjoy things she couldn't. Things she should have enjoyed more than me.
     
  16. LeTallecWiz

    LeTallecWiz Mo(ssa)d Administrator

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    Not sure if it's entirely relevant, but it's bloody powerful ... and the last line I think is a fitting 'message' to any of us:

    Whats goin on..
     
  17. Delinquent

    Delinquent Very Active Member

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    Wow, single. That's inspirational.
     
  18. the count

    the count SCM's least favourite muppet Honorary Member

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    I hope this ends up in the vaults as it is a wonderful thread, well worth rereading again and again.
    Not that I enjoy reading about other people's woes but it is so full of honesty and bravery it would be a shame if it wasn't preserved.

    Hats off to all the lads who have contributed so openly to a wonderful thread
     
  19. Avmenon

    Avmenon Well-Known Member

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    Single's post alobe would put this in the vault; and thats before even including the other excellent posts in here..
     
  20. darkstarexodus

    darkstarexodus Well-Known Member

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    Amazing post Single, all of it. Particularly the part about internal dialogue. Such fantastic advice and really stated simply in a way that I think few people would think of on their own but which makes so much sense.


    ---------

    One of the struggles I have regarding depression treatment in my particular workplace is the fact that antidepressants are pretty widely prescribed for First Nations (aboriginal, Indian) patients. Not sure if anyone is particularly familiar with Canadian history but the residential school system in the early to mid 20th century caused amazing damage to a large, significant portion of the aboriginal population. It is not solely responsible for but has contributed to ridiculously high rates of mental health disorders, substance abuse, an absence of parenting skills. sexual dysfunction, poverty and issues of identity and shame. These are significant issues which need to.be treated. However there are not the resources for mental health workers in northern communities and all too often these issues either go untreated or are treated solely with medication. My job as a pharmacist is to offer counselling and support related to the medications I dispense. However, over 70% of my patients live in remote, fly-in reserves and I will likely never see or speak with them, let alone offer proper support. And First Nations people are notoriously non-compliant with medication regimens. As most anyone who has been on antidepressants can tell you, when you stop them abruptly (or sometimes miss doses or occasionally even if youre late taking your dose) you often experience adverse effects. Now the doctors frequently just fax in a prescription and give very little info to the patient and, other than sending the info sheet, I dont have the opportunity to offer very much information. I wonder if this is doing more harm than help for the majority of these patients. They are certainly being underserved (by the healthcare system and by Canada in general) but are they actually being harmed?
     

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