Split from: Severe Depression

[DoubtingStephen]

I'm struck by a tremendous sense of irony reading this thread. My first born son was a big lad with red hair, and I called him Big Red all of his life. He suffered from severe depression that dragged on for years until he was finally given a powerful psychoactive medication.

Within a month he was like a new man, happy, calm, and focused. I was delighted to see his situation so greatly relieved. Everyone who knew him saw the change.

Then he came to the conclusion that the medication had cured his depression, and he stopped taking it. He was dead of suicide within a few weeks.

Depression can be a life threatening illness and people suffering from depression should certainly be encouraged to seek professional medical care. And the point I want to stress is that the psychoactive drugs available today must be taken as directed and not treated lightly. It's a serious business messing with a person's brain, and pharmaceutical science has made tremendous strides in recent years, but it's a very dangerous situation and should never be brushed off lightly.

Medical professionals use standardized methods for diagnosing depression, or at least those standards are available.

 

[Dancing David]

Argument from authority, this soon? You decided to smack heads with me once again, and this isn't ambiguous, so counterpoints shouldn't be something I have to beg for if I'm off on something, now should it..

Not an argument from authority at all, that is your self reflection again. But you made a statement that "Anyone who is having intrusive, suicidal thoughts without any justification should get evaluated, as what they are suffering from is most likely chemical depression. ". And i would state that the safe course without a comprehensive history, is that some one who is having intrusive thoughts of suicide should most likely seek evaluation. Not the thought of "I wish i was dead" is not what i would call suicidal ideation. The thought"I should kill myself" is suicidal ideation. Someone who has intrusive thoughts of suicide should seek help. Unless it is a persistant low threat pattern, in which case CBT would be recommended.

Suicidal thoughts can arise due to a fixed, low-set mood as a result of dysthymia/anhedonia, or situations.

And again are they suicidal ideation "I should kill myself." or are they vauge death wishes and thoughts like "I wish i wasn't here" ? There are different levels of risk for the two. And even people with long term dysthymia can reach a point where they are actively considering ending thier life. That is a situation with appreciable risk, if they form a plan it goes to high risk. Now there is the whole messy "peri-suicidal' behavior but we might want to avoid the boderline stuff for now.

I assume you know what this is like, otherwise there is no point in a decent exchange with you, as you can't relate, and further will make another mess for me to clean up trying to invalidate valid things I explain in a lovingly verbally abusive way.

I notice you don't want to debate your waking 'sleep claim' here in the Science forum, if you do i shall galdly debate. You are good at the rhetoric and arm waving and have a fine point with the dagger. If there is substance behind the front is another matter. More words mean less.

I have had times of what I thought was dysthymia but it was actualy not. I thought that I was in the category of "depressed more days than not" but when i got into the evaluation the assesor picked uyp that the days i thought were good days were not good days, they were just 'not as depressed days' and therefore they were not dysthymie, because there was a pervasive depression.

I'm saying that common situational depression ("Nothing is going the way it should.."), not to be confused with psycho-physiological depression, such as PTSD, requires therapy, not drug dependency, unless diagnosed with chemical depression.

I am not sure that is they way I would frame the distinction, depression is depression, even if it is situational. When i did assesment (always under an MSWs or LCLPC or LPHA supervision) I tried to help the person assess thier functional impaitment. Were they having physical symptoms, were they having impaired functioning in the realms of self care, employment , education and/or education? Then there are the five criteria that have to be met for depression (could be different) and I personaly went with the time frame (more than a month) and if they had a past history of depression.

If they began to meet the physical symptoms and they were more than transient, and if they had major impairment in at least one area of functioning or middling impairment in two then I would lean towards major depression. Then the key is when you ask them "Do you think you are depressed." If they all start to line up with each other than depression, otherwise an adjustment disorder.

It is dangerous to encourage anyone who is not suffering from chemical depression, especially if you are in a position of authority, into a dependency on prescription drugs - not therapy or a combination of the two with a primary emphasis on therapy.

My personal preference was to always suggest the therapy or counseling, if they had issues that could be addressed in that arena. But many, many people did not want that, they chose to see the doctor only, despite any careful advice i might give them.

And again you are using the dependancy word again. That is a source of contention, what evidence do you have for dependancy upon ADs.

You could argue this is standard procedure, but I see too many people on anti-depressants for the wrong reasons; what really bothers me isn't what they are prescribed, but someone made them think something was to be gained, rather than a price to pay by shoving things under the rug.

Now that is a thorny personal issue, if someone wants to deal up thier issues that is up to them. Certainly they should make life changes that will decrease thier stress. And CBT will benefit most people with issues. But i can't go for any psychodynamic mumbo jumbo. If they don't want to deal with the issues that generate the stress, then all you can do is give them the options and the recomendation for therapy or counseling.

These same people eventually discover another class of natural anti-depressants that inspired Huxley's Brave New World: the opioid kingdom, then discover the law of diminishing returns the hard way, and become heroes or statistics.

Ah, a gateway theory, i have never heard that one, that ADs lead to opiate addictions, I suppose it could happen. But it is not a common occurance, I sure met a lot of people who were already prescribed pain killers.

And for the quick shop method, it is more likely a GP than an mental health professional.

 

[Dancing David]

Dancing David will, watch.

Your psychic powers are impessive, but inaccurate, perhaps you should try to read minds. My recird is well established in mant threads on this topic. When I did assesments i would usualy only recommend the refferal to the doctor if they were having physical symptoms or had major imapirment in functionsing. Otherwise if they insisted they wanted to see the doctor then i would recommend it, especialy if I was told to do so in the 'eyeball' assesment review.

The obvious, I know - it's probably going to be reiterated over-and-over again soon, too.

Completely agree. Although people often sort themselves out. I mostly blame pharmaceutical companies' marketing.

I blame alcohol and substance abuse, especialy caffine. People often think they should be able to get by on low levels of sleep and high levels of stress. they often don't want to examine the causes of thier stress. They run like mad all day, they run all day at hiome, they drink like fish and smoke like chimney and persue spiteful love objects, they spend money they don't have and try to save thier more worthless relatives. Then they wonder why they get depressed.

Marketing in general is a problem it motivates people to do all sorts of unhealthy stuff.

 

[Dancing David]

I won't link to that forum here but you should see the medication section. half the posts are about how xanax and other addictive drugs are a wonderful cure for the problem.

Ah the joys of addicted thinking, xanax and ativan have high sedation profiles that make them drugs of choice, and then xanax has a high withdrawl profile, and is considered to be addictive. Always can tell a substance problem when people say "I know what i need and it is Xanax."

That doesn't bother though because it's like talking to a wall, they are already doomed. Medication is a last resort to the problem.

Nothing like using gasoline to put out a fire.

The best post ever was on in that section was on using opium to deal with anxiety issues...

Ah, those damn opiates, they even clean the windows and balance the check book. Anxiety and opiates, add a bottle of gin and there goes your breathing.

I did report that one and it was removed. That medication section really needs to be moderated properly or just closed because it gives tons of bad advice.

I hate having to take medication but I deal with it. In my case it's a serve issue though. By no means is the answer to every problem medication. Nothing is wrong with therapy though provided the therapist is researched and properly qualified.

Yeah for sceptics, ask the questions! Question thier methods and make sure they set observable goals. No integration of disparate pieces... or resolving trauma. Heal the wounds, learn the skills. Or as we used to say prop em up, patch em up, teach em to dodge and shove em out the door.

 

[SirPhilip]

Your psychic powers are impessive, but inaccurate, perhaps you should try to read minds.

My recird is well established in mant threads on this topic. When I did assesments i would usualy only recommend the refferal to the doctor if they were having physical symptoms or had major imapirment in functionsing. Otherwise if they insisted they wanted to see the doctor then i would recommend it, especialy if I was told to do so in the 'eyeball' assesment review.

Cool. You do by experience on the other hand, understand it? I ask this because some inquired whether depression as a result of rebound, genetic chemical imbalance, substance use was different from situational depression. I'd say it falls into three general types:

Chemical depression as characterized when a physical imbalance constrains someone's mood and thoughts into a negative mindset, regardless of the situation.

Situational depression as characterized when a hopeless event causes someone's mood and thoughts to temporarily be constrained into a negative mindset on a specific subject (such as loss of a loved one, job, being victimized).

Psychophysical 'Depression' as characterized as a rarer, more tragic form where events and subsequent recall of them trigger physiological changes as well as behavior, as if the events re-occur. The depression, I would assume, being caused by a loss of self control.

I blame alcohol and substance abuse, especialy caffine. People often think they should be able to get by on low levels of sleep and high levels of stress. they often don't want to examine the causes of thier stress. They run like mad all day, they run all day at hiome, they drink like fish and smoke like chimney and persue spiteful love objects, they spend money they don't have and try to save thier more worthless relatives. Then they wonder why they get depressed.

No disagreement there. I had a spectacular caffeine regime throughout high school. I would drink at least a gallon to two gallons of green tea every two days, and suffered the consequences in cognitive performance and mood swings.

 

[Dancing David]

I agree with th overuse of caffine, the issue I have is that people overextend themselves (sometimes they dont have choice), they work longer gours, they work hard at home, they overextend themselves on the weekend, all through the miracle of caffine. When someone tries to sleep after consuming caffine all day they are not likley to get quality sleep, if you sleep less than your body requires it wears you out, which adds to the stress. Then you factor in the use of alcohol, the desire for people to watch TV until one in the morning and you have people trying to function on low levels of sleep.

Stress and lack of sleep, a recipe for disaster.

 

[Dancing David]

Cool. You do by experience on the other hand, understand it? I ask this because some inquired whether depression as a result of rebound, genetic chemical imbalance, substance use was different from situational depression. I'd say it falls into three general types:

What rebound is that?

Chemical depression as characterized when a physical imbalance constrains someone's mood and thoughts into a negative mindset, regardless of the situation.

Situational depression as characterized when a hopeless event causes someone's mood and thoughts to temporarily be constrained into a negative mindset on a specific subject (such as loss of a loved one, job, being victimized).

The risk of suicide has nothing to do with the lenth of time of the depressed mood.

Psychophysical 'Depression' as characterized as a rarer, more tragic form where events and subsequent recall of them trigger physiological changes as well as behavior, as if the events re-occur. The depression, I would assume, being caused by a loss of self control.

I would say that I can't agree to your categories but I can understand them, I take a functional behavior approach. It does not matter what the situation is, what matters is the functional impairment.

My main concern is this, the risk of suicde is not based upon any of that, it is based upon the following:

1.Thoughts of deliberately ending ones life.
2. Plans of ending ones life.
3. Intent of ending ones life.
4.Person's perception that means to be used is lethal.
5.Past history of suicide attempts.
6. The triad of impairment, judgement and impulse control.

Then there are the factors associated with higher risk of suicide which are numerous: Age, chronic pain, gender, substance abuse, access to lethal means, sociopathy, chronic illness and lack of supports. (There are more as well).

So anyone having intrusive thoughts of suicide , "I should kill myself", should seek help and contact regardless of the situation. This includes calling the crisis line. People who have histories of chronic thoughts of harming themselves should definitly seek help.

Anyone who has intrusive thoughts of ending thier life should seek evaluation, the crisis line is great. The risk is not based upon the situational causes of the stress. The risk is based upon the precense of the suicidal ideation, especialy when it involves a plan.

Even if the person is attention seeking, they should seek professional assistance (friends should tell them this) because the risk is there, people kill themselves when they don't mean to.

 

[aggle-rithm]

Situational depression as characterized when a hopeless event causes someone's mood and thoughts to temporarily be constrained into a negative mindset on a specific subject (such as loss of a loved one, job, being victimized).

The problem a lot of people have, and the reason that they don't seek treatment, is that depression can ALWAYS be attributed to some environmental stimulus. People are good at drawing connections like this, prompted by the unshakeable belief that any mental state is necessarily the consequence of an external experience. If I'm depressed it must be because the bank account is low, or because little Timmy isn't doing well in school, or any other ordinary problem that most people have no problem dealing with.

When I was a teenager I used to get severe depressive episodes every other year, during the summer. These episodes would be jump-started by something I read or saw on television. In a sense, they could be called situational depression, because there was a recognizable "cause", but the real problem was an underlying imbalance that allowed the depression to take hold with only the slightest provocation.

 

[skeptifem]

I agree with th overuse of caffine, the issue I have is that people overextend themselves (sometimes they dont have choice), they work longer gours, they work hard at home, they overextend themselves on the weekend, all through the miracle of caffine. When someone tries to sleep after consuming caffine all day they are not likley to get quality sleep, if you sleep less than your body requires it wears you out, which adds to the stress. Then you factor in the use of alcohol, the desire for people to watch TV until one in the morning and you have people trying to function on low levels of sleep.

Stress and lack of sleep, a recipe for disaster.

oh yeah, im sure doctors never suggest patients dont consume caffiene when they have sleeping problems lol

 

[Dancing David]

oh yeah, im sure doctors never suggest patients dont consume caffiene when they have sleeping problems lol

That was more an observation on the behavior of USers (those who live in the US) more than anything else. Doctors surely do recomend and people ignore. Doctors recomend a whole lot of stuff people ignore.

If you have been to stress management seminar than you know the main cause of stress is overextension of personal resources. I don't blame caffine, I think it's overuse leads to alot of problems (in that it supports people in thier crazy do everything lifestyle), then the pursuit and maintainence of relationships with destructive people, then the assistance to destructive family memebers. Alcohol of course dominates in the substances of abuse, by far the leader of the pack.

 

[Dancing David]

The problem a lot of people have, and the reason that they don't seek treatment, is that depression can ALWAYS be attributed to some environmental stimulus. People are good at drawing connections like this, prompted by the unshakeable belief that any mental state is necessarily the consequence of an external experience. If I'm depressed it must be because the bank account is low, or because little Timmy isn't doing well in school, or any other ordinary problem that most people have no problem dealing with.

When I was a teenager I used to get severe depressive episodes every other year, during the summer. These episodes would be jump-started by something I read or saw on television. In a sense, they could be called situational depression, because there was a recognizable "cause", but the real problem was an underlying imbalance that allowed the depression to take hold with only the slightest provocation.

Hear here!