![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 145 to 169 of 200. Go back in thread:
Posted by Geezer on July 10, 2002, at 15:48:39
In reply to Re: Real Depression, posted by Gabbi on July 10, 2002, at 13:39:53
Hi Gabbi,
Very well said!!
Geezer
Posted by LostBoyinNC1 on July 10, 2002, at 22:24:22
In reply to Re: Real Depression, posted by Gabbi on July 10, 2002, at 13:39:53
> Why do People insist on having this argument. If it interferes with your life, its DEPRESSION Its not a bloody competition. If you have these depressed feelings that have broken free of their external causes and taken on a life of their own ITS DEPRESSION.
> As for the drug detractors, well in a perfect world no one would have to take prescriptions for anything, or wear glasses.
>
> But, and here I thank Andrew Solomon for his book "The noonday Demon" READ IT it is the ultimate book on depression, and though its not a 'self help" book its the only thing thats ever helped me feel better during a breakdown.
I dont know if Id call it the "ultimate" book on depression. I havent yet seen a book that adequately described my severe depression symptoms. In fact, most of the books Ive read that covered this topic were rather poor.Probably the best book Ive read so far when it comes to the topic of severe depression is Max Fink's "Electroshock: Restoring the Mind." I felt that book did a pretty good job of explaining how Ive felt like at times in my severe depression. Most of the books written about depression tend to focus on the purely emotional or psychological aspects of it and the people tend to introspect a lot in the books. Most books Ive seen covering mood disorders the vegetative problems (severe deterioration in sleep) arent talked about enough.
One thing that always gets on my nerves is when I read stuff about depression where its intellectualized. Like the person tries to read poetry or make their illness into an "issues" kind of thing. Mental illness has been intellectualized too much, largely because of the way its thought of by lay people (its just a "psychological" problem).
> We don't know what the side effects of all these anti-depressent drugs... true, but we DO know the side effects of untreated depression and that is at the very least a 15% suicide rate.
> In addition if you have your first depression treated it can prevent further breakdowns, however if you cycle on and off medication (and I did, I hated taking all those pills) and have subsequent depressive episodes, eventually those episodes have a great chance of increasing to the point where a technically minor disappointment can launch you into a major depressive episode. I think when this happens it must be the time when people who have never had depression think its a character flaw a "wimpy" quality: because it really must look silly to other people, but it is absolutely real to the person suffering. Whether or not they fit into someones arbitrary decision about what "depression" is.Its very true that going on and off antidepressants too frequently, bouncing on and off them, can cause these meds to lose their "punch" and effectiveness. I personally think a fair amount of treatment resistant depressions develop that way.
Posted by LostBoyinNC1 on July 10, 2002, at 22:30:41
In reply to Re: Real Depression, posted by LostBoyinNC1 on July 10, 2002, at 22:24:22
> Probably the best book Ive read so far when it comes to the topic of severe depression is Max Fink's "Electroshock: Restoring the Mind." I felt that book did a pretty good job of explaining how Ive felt like at times in my severe depression.
Let me clarify the above. I thought this book did a pretty good, but far from perfect job of describing the symptoms of severe depression. Like I said, I have not read a book yet that really described it correctly. If it was described correctly, it would sound like more of a physical problem than a "mental illness."
Posted by Bob on July 11, 2002, at 0:12:57
In reply to Re: Real Depression, posted by LostBoyinNC1 on July 10, 2002, at 22:24:22
> > In addition if you have your first depression treated it can prevent further breakdowns, however if you cycle on and off medication (and I did, I hated taking all those pills) and have subsequent depressive episodes, eventually those episodes have a great chance of increasing to the point where a technically minor disappointment can launch you into a major depressive episode. I think when this happens it must be the time when people who have never had depression think its a character flaw a "wimpy" quality: because it really must look silly to other people, but it is absolutely real to the person suffering. Whether or not they fit into someones arbitrary decision about what "depression" is.
>
> Its very true that going on and off antidepressants too frequently, bouncing on and off them, can cause these meds to lose their "punch" and effectiveness. I personally think a fair amount of treatment resistant depressions develop that way.
--------------------------------------------------Possibly there is some merit to the theory that TRD depressions can develop from med cycling. I wouldn't be one to argue with you, as I've done a great deal of med changing, and have only gotten worse. However, I don't think the patients can necessarily be blamed. I think people often find it very crushing to their spirit and physical feeling of well-being on the meds (I think the thought of enduring the side-effects for the rest of one's life, or at least long-term, is often horrifying for people) and so they go off them, or they try other meds that they pray don't have the unwanted side-effects. It's a harsh sentence to endure these meds for the rest of one's life. The current armamentarium is not very "patient-friendly", and we need to eventually come up with more tolerable treatments. If the treatments were tolerable and effective, people would not be playing musical meds nearly as much. It's only human to try to escape from the unnatural oppressive effects and feelings the meds cause.
Posted by LostBoyinNC1 on July 11, 2002, at 0:33:26
In reply to Re: Real Depression » LostBoyinNC1, posted by Bob on July 11, 2002, at 0:12:57
>
>
> Possibly there is some merit to the theory that TRD depressions can develop from med cycling.Possibly? I think more than possibly. Its a known fact that repeatedly going on and off the same antidepressant can cause it to lose its effectiveness and its activation. This is especially true if you "bounce" on and off the same AD within a short time frame, say a couple month period of time.
>I wouldn't be one to argue with you, as I've done a great deal of med changing, and have only gotten worse. However, I don't think the patients can necessarily be blamed. I think people often find it very crushing to their spirit and physical feeling of well-being on the meds (I think the thought of enduring the side-effects for the rest of one's life, or at least long-term, is often horrifying for people) and so they go off them, or they try other meds that they pray don't have the unwanted side-effects. It's a harsh sentence to endure these meds for the rest of one's life. The current armamentarium is not very "patient-friendly", and we need to eventually come up with more tolerable treatments. If the treatments were tolerable and effective, people would not be playing musical meds nearly as much. It's only human to try to escape from the unnatural oppressive effects and feelings the meds cause.
I dont agree with you. I think most of the modern class antidepressants have a quite good side effect profile. What bothers me more is having to live in the "hell" of severe clinical depression. Thats ten times worse to me than living with some medication side effects.
Of course, there are a few drug side effects which are truly severe and unacceptable. Such as the EPS/TD movement disorders that atypical anti-psychotics can cause in depressives. Or blood sugar increases from Zyprexa or Seroquel that induces diabetes. Or MAOI hypertensive crisises. These are serious side effects to be avoided totally.
What I dont understand is people who think SSRI type side effects (weight gain, sexual dysfunction) are worse than living with the depression itself. I always come to the conclusion that most of these sorts of individuals dont have very severe depression to make the decision to go off an anti-depressant for what I consider to be trivial side effects.
I guess what Im saying is Id rather be able to sleep decently and be able to concentrate than have some weight gain or delayed orgasm side effects. Off ADs, my sleep and concentration fall apart, as do many other things.
Oddly enough, I find my sex drive increases on antidepressants. What kills my sex drive is untreated severe depression.
Posted by cybercafe on July 11, 2002, at 1:08:05
In reply to Re: Real Depression, posted by LostBoyinNC1 on July 11, 2002, at 0:33:26
> I dont agree with you. I think most of the modern class antidepressants have a quite good side effect profile. What bothers me more is having to live in the "hell" of severe clinical depression. Thats ten times worse to me than living with some medication side effects.
Yeah for sure there are no side effects so bad that I am willing to put up with severe depression for the rest of my life. And that includes movement disorders, .. or even growing a third eye... or if I found out meds took 20 years off my life.... (Discounting the existence of ECT,rTMS,MST, psychosurgery etc of course)...
However... I am sure that when people stop taking their meds they do not believe the symptoms are going to return. Or if they do -- they can't remember how serious they were -- just like when you're depressed it's difficult to remember the happy times in your life...
> Of course, there are a few drug side effects which are truly severe and unacceptable. Such as the EPS/TD movement disorders that atypical anti-psychotics can cause in depressives. Or blood sugar increases from Zyprexa or Seroquel that induces diabetes. Or MAOI hypertensive crisises. These are serious side effects to be avoided totally.
Ummm... I would rather cut out aged cheeses from my diet then have no libido :).... of course there are always augmentation strategies for SSRI users...
... I actually picked up a bit of a tremor from Effexor...
> What I dont understand is people who think SSRI type side effects (weight gain, sexual dysfunction) are worse than living with the depression itself. I always come to the... I can't imagine that.... I think it's more likely they don't think their depression will come back.... now why severe bipolars, psychotic individuals, those with histories of suicide, etc have to dump all of their medication within a day or two... take extreme measures like flushing it down the toilet.... this just doesn't seem like a good idea to me
>conclusion that most of these sorts of individuals dont have very severe depression to make the decision to go off an anti-depressant for what I consider to be trivial side effects.
Yep... ! Or to go take it even further... I have felt sorry for a lot of people who seemed to whine like they had serious problems... but when you offer them advice they just seem totally apathetic... like "yeah maybe i'll try that... or ... maybe i'll just do without medication... " DO WITHOUT MEDICATION?? ... the reason i'm on medication is because the only other option for me is suicide (or ECT etc etc)....
... i just wish i had started Parnate sooner... i love this med :)
> I guess what Im saying is Id rather be able to sleep decently and be able to concentrate than have some weight gain or delayed orgasm side effects. Off ADs, my sleep and concentration fall apart, as do many other things.actually sleep and concentration are secondary to relieving what i would call "unbearable suffering"...
.. that is why i am quite happy when i get a 20% response from a med... sure my life might still be in shambles... but at least i can go on ...
> Oddly enough, I find my sex drive increases on antidepressants. What kills my sex drive is untreated severe depression.... this coming from another Parnate user of course :)
Posted by Bob on July 11, 2002, at 10:43:38
In reply to Re: Real Depression, posted by cybercafe on July 11, 2002, at 1:08:05
> > I dont agree with you. I think most of the modern class antidepressants have a quite good side effect profile. What bothers me more is having to live in the "hell" of severe clinical depression. Thats ten times worse to me than living with some medication side effects.
-----The fact that, for you, the side effects don't bother you enough to stop the meds says nothing about other people. I've seen more than one article stating that antidepressants have worse side-effects than most prescription meds, save for maybe AIDS and chemo meds. That doesn't sound "good" to me.
-----> Yeah for sure there are no side effects so bad that I am willing to put up with severe depression for the rest of my life. And that includes movement disorders, .. or even growing a third eye... or if I found out meds took 20 years off my life.... (Discounting the existence of ECT,rTMS,MST, psychosurgery etc of course)...
-----You are talking about side effects that pose a significant and recognizable danger to physical health. I'm referring to side effects that reduce quality of life over the long term. Remember, I was trying to explain why I think people stop taking their meds, even when they're "working" so to speak.
>
> However... I am sure that when people stop taking their meds they do not believe the symptoms are going to return. Or if they do -- they can't remember how serious they were -- just like when you're depressed it's difficult to remember the happy times in your life...
-----Yes, in a way I believe you are correct. I also think that what happens in many cases is, people start feeling better psychologically, and then they are left with mainly the side effects as problems in their life. They may have come to terms with the fact that they need some sort of med, but they figure there MUST be something better out there than what they're taking.
-----
>
> > Of course, there are a few drug side effects which are truly severe and unacceptable. Such as the EPS/TD movement disorders that atypical anti-psychotics can cause in depressives. Or blood sugar increases from Zyprexa or Seroquel that induces diabetes. Or MAOI hypertensive crisises. These are serious side effects to be avoided totally.
-----Again, you are referring to health destroying side effects, not quality of life side effects. How about chronic constipation, weight gain on the order of 10% or greater, reduced or eradicated libido and ability to orgasm, constant sweating, hypersomnia, tiredness and fatigue, apathy, etc, etc, etc, etc, etc?
----->
>
> Ummm... I would rather cut out aged cheeses from my diet then have no libido :)
-----Sounds like Parnate is working wonders for you. What if (and God forbid) it didn't work for you any longer, and you had to try Nardil, or the host of other antidepressants, where you would have to cut out aged cheeses (and other things also) yet you didn't have a libido and gained significant weight, and were dizzy and weak all the time?
-----
> > What I dont understand is people who think SSRI type side effects (weight gain, sexual dysfunction) are worse than living with the depression itself. I always come to the
>
> ... I can't imagine that.... I think it's more likely they don't think their depression will come back.... now why severe bipolars, psychotic individuals, those with histories of suicide, etc have to dump all of their medication within a day or two... take extreme measures like flushing it down the toilet.... this just doesn't seem like a good idea to me
-----Well, it probably doesn't seem like a good idea because it isn't. However, one hallmark of mental illness is impaired judgement and irrationality. BTW, these diseases run the spectrum from minor disaffectation to full blown, "I'm going to commit suicide in the next 10 minutes" type depression. That's why many people aren't willing to put up with the way the meds make them feel. They have dysfunctionalities in their lives that they are trying to improve upon, but are not necessariy severely suicidal or physically incapacitated. Unfortunately, the same medecines are used for all conditions.
----->
>
> >conclusion that most of these sorts of individuals dont have very severe depression to make the decision to go off an anti-depressant for what I consider to be trivial side effects.
-----You may consider them trivial, but (if not most) don't. I don't hear very many people on an AD claiming that they love taking the drug and it is practically transparent for them. I just don't hear it. The side effects may seem trivial for you because if you don't take the med you know you will be facing suicide. Also you may be getting a pretty decent response from the meds. Many people don't.
----->
>
> Yep... ! Or to go take it even further... I have felt sorry for a lot of people who seemed to whine like they had serious problems... but when you offer them advice they just seem totally apathetic... like "yeah maybe i'll try that... or ... maybe i'll just do without medication... " DO WITHOUT MEDICATION?? ... the reason i'm on medication is because the only other option for me is suicide (or ECT etc etc)....
-----Yes, but that is not the case for everybody. Some people have mental problems that aren't necessarily causing suicidality, but are impairing their quality of life. It's a trade off that's as unique as the person taking the meds. No two illnesses are the same.
-----
>
> ... i just wish i had started Parnate sooner... i love this med :)
-----I'm glad to hear that med is working so well for you, and I hope it continues to help you.
-----
>
> .. that is why i am quite happy when i get a 20% response from a med... sure my life might still be in shambles... but at least i can go on ...
-----If you are happy with 20% response to meds, then you have obviously have given up on getting significantly better. I think the public expectation for mental health treatment is much, much higher than that. Progress has to be made.
-----
>
>
>
> > Oddly enough, I find my sex drive increases on antidepressants. What kills my sex drive is untreated severe depression.
-----I think having you sex drive increase on antidepressants definitely puts you in the minority.
-----
>
> ... this coming from another Parnate user of course :)
Posted by Geezer on July 11, 2002, at 10:56:27
In reply to Re: Real Depression, posted by LostBoyinNC1 on July 10, 2002, at 22:24:22
Hi LostBoy,
Not only do I agree with what you said I wish I could have said it as well.
I get very angry when someone intellectualize this illness. As soon as I hear "working on issues, relationships, recognizing triggers, blah, blah, blah" my blood pressure kicks up a notch. Psychology has nothing to do with real heavy duty depression (be it recurrent major depression or the bipolar version). As an illness it is much closer to a "slow rolling seizure disorder" where the intervals and severity of episodes may be to some degree controlled with medication. I have given up on any hopes of the lay public understanding this but I do resent the current theory, by the pdocs and tdocs, that the best treatment for real depression is the combination of drugs and cognative therapy.
If a doctor had chosen to give me the HONEST FACTS about this illness when I was very young his message would heve been brief and to the point. "From this day forward there will be times when your life will be a living hell. You will be faced with a 15% chance of killing yourself and all the talking in the world won't change a thing. Take your meds and do the best you can".
Thanks for your post.
Geezer
Posted by waterlily on July 11, 2002, at 13:58:01
In reply to Re: Real Depression, posted by LostBoyinNC1 on July 10, 2002, at 22:24:22
> One thing that always gets on my nerves is when I read stuff about depression where its intellectualized. Like the person tries to read poetry or make their illness into an "issues" kind of thing. Mental illness has been intellectualized too much, largely because of the way its thought of by lay people (its just a "psychological" problem).
I wholeheartedly agree with you on this. I get depression even when I'm on medication, and I end up blaming myself for it which makes it even worse. Even though I know intellectually that I have a hereditary depression (I'm third generation, my daughter is fourth), I still keep thinking that if I wasn't so week I would be able to shake this off. To this, my therapist asks "What makes you think that?" She sees this thing as a disease too and tries her best to get me to accept that, but I have a hard time internalizing it. I do defend the use of antidepressants when the subject comes up. My co-worker started talking about how too many people take antidepressants and that all you need to do is go shopping to shake depression. I just told her that you cannot truly understand major depression until you've suffered from it. Case closed.
Posted by Bob on July 11, 2002, at 15:49:20
In reply to Re: Real Depression, posted by Geezer on July 11, 2002, at 10:56:27
> Hi LostBoy,
>
> Not only do I agree with what you said I wish I could have said it as well.
>
> I get very angry when someone intellectualize this illness. As soon as I hear "working on issues, relationships, recognizing triggers, blah, blah, blah" my blood pressure kicks up a notch. Psychology has nothing to do with real heavy duty depression (be it recurrent major depression or the bipolar version). As an illness it is much closer to a "slow rolling seizure disorder" where the intervals and severity of episodes may be to some degree controlled with medication. I have given up on any hopes of the lay public understanding this but I do resent the current theory, by the pdocs and tdocs, that the best treatment for real depression is the combination of drugs and cognative therapy.
>
> If a doctor had chosen to give me the HONEST FACTS about this illness when I was very young his message would heve been brief and to the point. "From this day forward there will be times when your life will be a living hell. You will be faced with a 15% chance of killing yourself and all the talking in the world won't change a thing. Take your meds and do the best you can".
>
> Thanks for your post.
>
> GeezerWell... now I'll chime in and say that I wish I had posted what YOU just said. Very, very well put. Especially that last paragraph, as a simple, straightforward summation of our condition. Everybody always harps on me getting therapy, which I do. However, I really don't think it has ever provided an ounce of help. For me, I've only seen changes with meds. Therapy starts leading to self-blame for your condition. I honestly believe that.
BTW, FWIW, if the doctor told people what you posted in your last paragraph there, it would cause a lot of up front consternation. They would never do that obviously. Besides, many people are afraid of the truth.
Posted by cybercafe on July 11, 2002, at 17:34:16
In reply to Re: Real Depression, posted by Geezer on July 11, 2002, at 10:56:27
> I get very angry when someone intellectualize this illness. As soon as I hear "working on issues, relationships, recognizing triggers, blah, blah, blah" my blood pressure kicks up a notch. Psychology has nothing to do with real heavy duty depression (be it recurrent major depression or the bipolar version). As an illness it is much closer to a "slow rolling seizure disorder" where the intervals and severity of episodes may be to some degree controlled with medication. I have given up on any hopes of the lay public understanding this but I do resent the current theory, by the pdocs and tdocs, that the best treatment for real depression is the combination of drugs and cognative therapy.
Yeah I agree with you totally except I would add that having someone to talk to can really help -- at least in more reactive/vegetative/atypical depressions (perhaps not retarded/melancholic/typical depressions)....
... I consider myself really smart + educated + wise and insightful... and used to think psychology probably isn't necessary for myself...... however... i was wrong ;)
... i think anything that breaks social isolation... especially if it is directed towards positive thinking can help in many cases...
.. but yes i totally agree there is NO WAY psychotherapy alone would allow for a 100% recovery.... i mean i would suspect many people would have difficulty getting to a psychotherapist without a decent med ....
... same for anxiety + agitation in my case ...
.. it helps... but 100% recovery? ... i can "face my fears" time and time again and they are still not reduced...... in fact i remember reading that clozapine is thought to decrease suicidality in psychotics by the break in social isolation you get from having weekly blood checks .... as well as relieve of negative symptoms, of course...
>
> If a doctor had chosen to give me the HONEST FACTS about this illness when I was very young his message would heve been brief and to the point. "From this day forward there will be times when your life will be a living hell. You will be faced with a 15% chance of killing yourself and all the talking in the world won't change a thing. Take your meds and do the best you can".a pleasure speaking with you gents ;)
cybercafe
Posted by cybercafe on July 12, 2002, at 2:39:57
In reply to Re: Real Depression » cybercafe, posted by Bob on July 11, 2002, at 10:43:38
> The fact that, for you, the side effects don't bother you enough to stop the meds says nothing about other people. I've seen more than one article stating that antidepressants have worse side-effects than most prescription meds, save for maybe AIDS and chemo meds. That doesn't sound "good" to me.
Actually that was a quote from LostBoy but I'll argue his side on this
---- my father is psychotic and takes perphenazine (Trilafon) ... he claims his side effects are
Severe chronic sinus infection, congestion
Rippled Cornea (visual impairment)
Anal Leakage
Asthma
Major weight gain
Much Sedation
About 20-30 points off his IQ... and a whole host of other symptoms he indicated were permanent ...
.. i'd say that is much worse, ... but in my case there was no question that i would be taking the medication no matter what ... i just don't see how there's any choice involved ...
.. fortunately i found out with antidepressants the side effects are very very mild...
> You are talking about side effects that pose a significant and recognizable danger to physical health. I'm referring to side effects that reduce quality of life over the long term. Remember, I was trying to explain why I think people stop taking their meds, even when they're "working" so to speak.
.... yep... but isn't the quality of life raised more by the antidepressants themselves?
>as problems in their life. They may have come to terms with the fact that they need some sort of med, but they figure there MUST be something better out there than what they're taking..... okay i thought we were talking about going off meds, not switching meds.... switching meds is many times worthwhile...
> Again, you are referring to health destroying side effects, not quality of life side effects. How about chronic constipation, weight gain on the order of 10% or greater, reduced or eradicated libido and ability to orgasm, constant sweating, hypersomnia, tiredness and fatigue, apathy, etc, etc, etc, etc, etc?
Chronic constipation is easy to deal with... i can recommend several different oil or fibre supplements... one pill you take once or twice a day with other properties (i.e. anti-oxidant, etc)
... as for the others... yes that can be bad... but i would switch meds rather than go off meds because of them myself... and if i felt i had tried most meds... i would just put up with them...
> Sounds like Parnate is working wonders for you. What if (and God forbid) it didn't work for you any longer, and you had to try Nardil, or the host of other antidepressants, where you would have to cut out aged cheeses (and other things also) yet you didn't have a libido and gained significant weight, and were dizzy and weak all the time?.... okay so you're saying that i'm 100% recovered, happy, non-depressed, but i have no libido, or were dizzy and weak? ... well i wouldn't be bothered, if i am happy :)
.... on the other hand... if i were always lying in bed ruminating about how horrible the side effects were, totally unproductive, miserable, unable to concentrate, unbearably depressed... well i would postulate that the antidepressant isn't working more than 50% :)>spectrum from minor disaffectation to full blown, "I'm going to commit suicide in the next 10 minutes" type depression. That's why many people aren't willing to put up with the way the meds make them feel. They have dysfunctionalities in their lives that they are
... sorry if i come off a bit harsh, ... i just hear from so many people claiming they suffer more than everyone else when their behaviour totally does not seem to support this....
... i imagine lostboy is the same way...
... hell in one support group i went to i was somewhat upset when i heard that we weren't allowed to offer people advice -- because i mistakenly believed other people were going through the same thing i was and i didn't want people to suffer needlessly....
... now i have had lostboy give me really good advice in the past... and to make himself clear he has even said that I would be an IDIOT to take antipsychotics for anxiety... you know what?? ... i'm not offended at all... i would feel much worse if he kept his knowledge to himself...
... unfortunately just because
a. your doctor doesn't know what to do
and
b. you come up with good ideas your doctor has never heard ofdoesn't mean that
c. your doc is actually going to educate himself:(
> You may consider them trivial, but (if not most) don't. I don't hear very many people on an AD claiming that they love taking the drug and it is practically transparent for them. I just don't hear it. The side effects may seem trivial for you because if you don't take the med you know you will be facing suicide. Also you may be getting a pretty decent response from the meds. Many people don't.
.. yes if you don't get a good response there is no reason to stay on the med i think that is totally reasonable .. it is also reasonable to switch the med if it is your first.. if you aren't a treatment resistant bloke... to reduce bad side effects...... really though, i don't think lostboy was under the impression that the side effects you listed above were typical... yes in some cases i'm sure they can be much worse but what is typical? ...
.. and if i can back up lostboy's trivial statement... i refer you again to the top of my mail listing what my father tells me were his side effects... hell why not throw in movement disorders like TD and diabetes... these things don't go away ...
> Yes, but that is not the case for everybody. Some people have mental problems that aren't necessarily causing suicidality, but are impairing their quality of life. It's a trade off that's as unique as the person taking the meds. No two illnesses are the same.... exactly... i totally agree... the thing is, people don't come off saying "my mental problems are impairing my quality of life" ... they will say "these problems are absolutely horrible and i can't deal with them..." .. 2 months later "i had 5 pounds weight gain, so i decided to do without meds.. now i am taking nothing" ...
... i mean i really want to help people who have problems... and i feel really bad to think people who have serious problems may be looked over for those who have less serious but are more whiney... this goes for me trying to educate people i meet, and for me competing with other people for doc time...
.. i also wish people would stop using recreational drugs and screwing up their heads...
> > ... i just wish i had started Parnate sooner... i love this med :)
> -----
>
> I'm glad to hear that med is working so well for you, and I hope it continues to help you.thanks mate :)
> If you are happy with 20% response to meds, then you have obviously have given up on getting significantly better. I think the public expectation for mental health treatment is much, much higher than that. Progress has to be made.
... i won't settle for a 20% response, .. but i do see it as something positive ... something a lot better than 0% ...
... as for the public expectation being higher.. yes you're right.... i just wrote a letter to a university professor of psychiatry who had all of these noble claims about pdocs and continuing education ... pleeeeeeeeease! how can people have such distorted views...
... hell i would be happy if a doctor would ADMITT a patient is beyond his ability and refer or consult another doc...
take care ;)
Posted by jda1292 on July 12, 2002, at 22:58:16
In reply to Re: no sex drive anymore, posted by OldSchool on February 10, 2002, at 19:53:40
"I dont think you had real depression to begin with...you had what I call "Woody Allen" depression. Self esteem problems, dysthymia, situational depression, etc. "
You are a riot!!!
I had panic disorder so pad 6 years ago I could barely drive to work on back country roads! At that point in time I would have traded me 'John Thomas' for relief!, actually me 'twig and berries' What good is sex if you feel like dying?
I have a loving faithful wife that is not sex crazed and enjoys it a couple times a month. She enjoys it and so do I! It was tough with Paxil, but she loved to watch me suffer for an hour in bed while she got the rock hard weenie. Ejaculation was a problem, but if you keep at it, mine always worked.
I consider this good considering I have an 8 year old and a 5 year old.
I think a lot of people have 'Woody Allen' depression and anxiety, for I would give you my left nut rather than have a bad panic attack. Thank God for the drugs!
> > Well, I don't know your condition or what you're taking but I hear you cuz I been there done that.
> >
> > I will not tolerate sexual side effects with these drugs (it isn't a matter of whether I can or not -- I simply WILL not). I've been down the Paxil and Zoloft roads (forget Prozac) and found that for me the loss of sexual function exacerbated my depression GREATLY, while the drug's "benefit" was simply to flatten out my personality and mood. This is called "Turning Into A Zombie."
>
>
> You must not have real clinical depression then. Id gladly trade my left nut for a drug that blasted me out of clinical depression. I could care less if it caused delayed ejaculation in me, just so long as it actually worked good at achieving remission.
>
> I only care about REAL drug side effects like EPS, TD, neuroleptic induced parkinsons, MAOI hypertensive crises, etc. etc. etc. The typical SSRI side effects like weight gain, headaches, nausea, sexual dysfunction etc. seem like wussy trivial side effects to me after what Ive been thru.
>
> >
> > The loss of sexual function made me more frustrated than I had been, made me isolate because I was ashamed I couldn't "function" anymore, and the damage from those months and years of trying these drugs have taken their toll on my self-esteem.
>
> I dont think you had real depression to begin with...you had what I call "Woody Allen" depression. Self esteem problems, dysthymia, situational depression, etc.
>
> >Today the meds I take are not supposed to have sexual side effects, and yet I still have difficulties -- which are no doubt the aftermath of being put through the ringer with drugs that adversely affect sexual function, along with the original and continuing effects of the depression.
> >
>
> Again...to someone who has had the real deal...severe clinical depression these sorts of side effects mean diddly.
>
> > I know you're joking about the hooker (maybe not), and it's good to see you're trying to make light of the problem through humor, but the long term psychological damage sexual dysfunction can have on you is NOT GOOD.
>
> Neither is having major depression longterm...does weird and bad things to your body and health.
>
> >
> > Advice that was given me and which I pass along is:
> >
> > Talk to your doctor about getting OFF the meds you are on that are robbing you of your sex drive OR see whether you can add a med that makes you more spunky (i.e., the side effects of one drug that offsets the side effects of another drug. Serzone was quoted me as one drug that can offset sexual side effects in other drugs, for example...WB is anot supposed to adversely affect sex drive, etc.
>
> I agree, those with milder depressions would probably be better off trying to fix it without drugs.
>
> >
> > Naturally it depends on what is wrong with you, what you have tried before and what does and doesn't work for your condition (we all respond differently to different drugs and as much as the docs know about the meds they are still in the dark about plenty -- hence we are all our own guinea pigs). If sexual side effects are bothering you even a little you have to take that seriously and demand your pdoc look into and discuss with you every other treatment possibility available for your condition.
> >
> > A lot has to do with diet and exercise, too. Exercise especially. Most of us are sitting on our beee-hinds typing away on this BB when we could be getting a half hour of aerobic exercise (even just fast walking). I know that's a big issue for me, one which definitely also affects my capacity to function sexually. I bet most of us with depression don't exercise nearly enough, and if we did we might be able to take less meds to get enough benefit and deal with less side effects. Just a thought my doc passed along to me.
>
> Exercise can really help mild depression probs.
>
> >
> > For men especially to be robbed of their sexual identity (being relegated to the status of eunuch) is perhaps the most discouraging and underrated liability of taking psychotropic medications which adversely affect sex drive. Whether it's right or wrong, many men equate their intrinsic self worth with their ability to "rise" to various sexual occasions (so to speak). That aspect of man isn't going to change. It is, however, up to each of us to work with our doctors to find solutions to our conditions that do not emasculate us.
> >
> > Sex is one of the easiest things to find in this world if you really want it. There are plenty of people who are willing to have sex for a price, infinitely more who would be willing to do so "recreationally" if approached with respect and honesty. Not isolating and making ourselves available to potential partners is part of the problem also. We can sit on a BB and type away and not be "out there" meeting people. Incidentally, as soon as I finish typing this, I'm outa here to head up to the local watering hole and see if I get lucky. It takes forcing yourself to be social, or else go to a strip club and get a lap dance, or whatever. But don't isolate. Perhaps the worst thing about drugs that rob us of our sexual abilities is that we are even denied the ability to masturbate.
>
> >
> > It's our choice whether we take the drugs prescribed for us and when we find the sexual side effects ruining us, our responsibility to take action. Believe me, I know -- I learned the "hard" way (bad pun).
> >
> > ethan
>
> All the women I meet are super horny and Im not. Its the depression, not the drugs. The drugs dont work good in me, so the best I ever get is about 30%. I used to have a sex drive, it kind of came back some on Wellbutrin. Remeron was good for sex too. It got real strong again for a few days on Amantadine here recently. But overall my sex drive is gone. Women dont want to be involved with a depressed guy with no sex drive. Honestly, I think women are the real sex fiends, not men. LOL I wish I could keep up with them but Im just worn out physically and mentally. Im 33 and feel like 83.
>
> Old School
Posted by Bob on July 13, 2002, at 13:14:51
In reply to Re: Real Depression, posted by cybercafe on July 12, 2002, at 2:39:57
> Actually that was a quote from LostBoy but I'll argue his side on this
>
> ---- my father is psychotic and takes perphenazine (Trilafon) ... he claims his side effects are
>
> Severe chronic sinus infection, congestion
> Rippled Cornea (visual impairment)
> Anal Leakage
> Asthma
> Major weight gain
> Much Sedation
> About 20-30 points off his IQ
>
> ... and a whole host of other symptoms he indicated were permanent ...
>
> .. i'd say that is much worse, ... but in my case there was no question that i would be taking the medication no matter what ... i just don't see how there's any choice involved ...
>There is no question that psychosis and the meds used to treat it are a whole other league of horror. I am truly sorry to hear about what your father goes through. It sounds quite unpleasant.
There is another "choice" for us, and a certain percentage of people eventually take it. I'm not advocating it at all, I'm just saying sometimes it gets to be too much for people.
> .... yep... but isn't the quality of life raised more by the antidepressants themselves?
Yes, in the vast majority of cases. However, it is all relative, and for each person becomes a trade-off between what their life is like off meds, and what it's like on. Sometimes, people's bodies are very intolerant of meds.
> Chronic constipation is easy to deal with... i can recommend several different oil or fibre supplements... one pill you take once or twice a day with other properties (i.e. anti-oxidant, etc)
Are you referring to fish oil?
> .... okay so you're saying that i'm 100% recovered, happy, non-depressed, but i have no libido, or were dizzy and weak? ... well i wouldn't be bothered, if i am happy :)
No, I'm not saying that, because in my personal experience, no such med exists.
> .... on the other hand... if i were always lying in bed ruminating about how horrible the side effects were, totally unproductive, miserable, unable to concentrate, unbearably depressed... well i would postulate that the antidepressant isn't working more than 50% :)
50%? You basically just described my life presently, and I wouldn't place it at 50%.
> ... sorry if i come off a bit harsh, ... i just hear from so many people claiming they suffer more than everyone else when their behaviour totally does not seem to support this....
Actually, I agree. When physical dysfunctionality comes into play it becomes a whole other ballgame.
> .. and if i can back up lostboy's trivial statement... i refer you again to the top of my mail listing what my father tells me were his side effects... hell why not throw in movement disorders like TD and diabetes... these things don't go away ...
No question, there are a host of horrific possible effects out there.
> .. i also wish people would stop using recreational drugs and screwing up their heads...Uh-huh. I never touched a rec drug in my life. My brain and autonomic nervous system got totally wacked all by itself. Lucky me.
> ... as for the public expectation being higher.. yes you're right.... i just wrote a letter to a university professor of psychiatry who had all of these noble claims about pdocs and continuing education ... pleeeeeeeeease! how can people have such distorted views...
> ... hell i would be happy if a doctor would ADMITT a patient is beyond his ability and refer or consult another doc...I think it comes from people not seeing the reality of the big picture. There are many people out there suffering unimaginably, and there are many drugs out there with many problems. We are not currently at a point where we can sit back and say that we have "excellent" tools to fight this problem. If you cold measure our progress towards a cure for mental illness in terms of sailing across the Atlantic, I think we'd still be well within sight of the port from which we'd disembarked.
> take care ;)
you as well.
Posted by cybercafe on July 15, 2002, at 0:13:44
In reply to Re: Real Depression » cybercafe, posted by Bob on July 13, 2002, at 13:14:51
> There is no question that psychosis and the meds used to treat it are a whole other league of horror. I am truly sorry to hear about what your father goes through. It sounds quite unpleasant.
... well it did at first -- then i said to myself "this has been ill for 45 years and never once attempted suicide -- he must be reasonably happy" ... and later i discussed taking a different med with him, and he has zero desire to change meds so.... i am convinced you can have quite a few miserable side effects and still be a happy fellow
> There is another "choice" for us, and a certain percentage of people eventually take it. I'm not advocating it at all, I'm just saying sometimes it gets to be too much for people.
.. yeah... but the thing that bothers me is there are so many treatments available that people havn't had the chance to explore... i'd like to think imparting knowledge can greatly improve upon this
> Are you referring to fish oil?
actually i tried flax seed oil for constipation i think.. but i only used it once or twice and the problem went away (damn it)...
... if only i had known about it during those years of paxil and metamucillibido, or were dizzy and weak? ... well i wouldn't be bothered, if i am happy :)
>
> No, I'm not saying that, because in my personal experience, no such med exists.oh... how many meds have you tried and if you have communicated your feelings to your doctor, does he consider you a 100% success or otherwise?
> 50%? You basically just described my life presently, and I wouldn't place it at 50%.
... hmmm... i always thought if you tried all the stimulants, opiods, augmentation strategies and so fourth there was always ECT ...
> Uh-huh. I never touched a rec drug in my life. My brain and autonomic nervous system got totally wacked all by itself. Lucky me.
.. same here... but i am expecting a 100% recovery sooner or later... most likely through an augmentation strategy ...
... i'm actually pretty much 100% when i'm around people, but feel like crap otherwise...
.. why are you doing worse than 50%, .. are you waiting for the current med to kick in?
> I think it comes from people not seeing the reality of the big picture. There are many people out there suffering unimaginably, and there are many drugs out there with many problems. We are not currently at a point wherehmmm... besides antidepressants taking so long to work (possibly managable with pindolol?) and permanent movement disorders what do you see as major problems with current drugs?
>we can sit back and say that we have "excellent" tools to fight this problem. If you cold measure
... i think excellent tools can be misused and turned into horrible tools.....
>our progress towards a cure for mental illness in terms of sailing across the Atlantic, I think we'd still be well within sight of the port from which we'd disembarked.
cure? .... i'll get back to you on that when i finish reading up on gene expression ;)
> > take care ;)
>
> you as well.are you doing any better?
what steps would you have to take to improve your condition?
Posted by Gabbi on July 16, 2002, at 20:09:44
In reply to Re: Real Depression, posted by Geezer on July 10, 2002, at 15:48:39
Posted by Gabbi on July 16, 2002, at 20:16:58
In reply to Re: Real Depression » LostBoyinNC1, posted by Bob on July 11, 2002, at 0:12:57
In no way, no way did I mean to infer that it is the patients fault that they quit their treatment and get worse. I finally learned my lesson after 10 years. It is humiliating to feel that you are not in control, and a minor point its just a huge nuisance to get refills, remember to bring them, and also a huge societal pressure as well as our own self-doubt wondering "am I just lazy" "Am I being melodramatic?" And though its fortunate that depression is finally being given legitimate recognition, its also a double edged sword. Because now that many of us have discovered what has been wrong for many years, we're accused of jumping on the bandwagon..as in "What'll it be next week chronic fatigue"
Posted by Gabbi on July 16, 2002, at 20:31:03
In reply to Re: Real Depression, posted by Geezer on July 11, 2002, at 10:56:27
I completely agree... that "issues" stuff is a bad day, maybe a bad week. Its true that continued trauma can eventually alter brain chemistry enough too create "organic" major depression. But depression to me is frightening because there is no "tangible problem" if there was an "issue" I could work on it. As it is One morning I'll wake up in another dimension of terror, hopelessness and fear, and be told to "relax"
I'm sorry to mention his name again but much of the reason I appreciated Andrew Solomons book so much was that he came as close as anyone I've ever heard to be able to describe depression to people who have never suffered it.
Being a sufferer himself, and a "success" before his first breakdown he managed to have many people listen. Its unfortunate that to get through to people you have to be "successful" in societal terms, but it did get people who think its laziness or weekness or lack of will to listen. He still admits that though he is "managing now" he can't say that he will never take his own life if the suffering outweighs the joy.
Posted by Gabbi on July 16, 2002, at 21:06:17
In reply to Re: quitting meds » Bob, posted by Gabbi on July 16, 2002, at 20:16:58
First off, I should never have said "Atlas of depression is the Ultimate book" I know better than to make those kind of "factual statements" on something that is an opinion. And I'm a little embarassed.
Additionally don't think this is anything other than a sincere enquiry of your opinion.
If you read the book and didn't really appreciate it I'm not going to write back telling you why you should. (its a personal pet peeve)
I consider myself a real cynic when it comes to books on depression,or most things actually.
Did you read Andrew Solomons book and still
remain unimpressed.
After a slew of "inner child, heal your mood, eat your way to mental health, toxic psychiatry, books or readable but reductive anecdotal books. I thought this one was truly remarkable, and I really apreciated that the author states first off that "no book can span the suffering of people with depression". If the book left you cold it at least its acknowledged!.I found his personal,historical,scientific, and cultural references and vivid descriptions stunning. But was most impressed by his scrupulous investigation of sources and balanced approach.
I'm just curious, not saying YOU HAVE TO READ IT It will change your life. Because we know, (well I should speak for myself) I know that external "things" don't make a dent when I'm in that indescribable(SP?) horror.
And God knows most of us have tried everything money allows.
I swear if I hear one more person recommend more Vitamin B or spew another version of
"I saw this guy on Oprah with no arms no legs skin cancer and cerebral palsy and he's happier than you are....I will become homicidal rather than suicidal. Gabbi
Posted by Geezer on July 16, 2002, at 21:24:32
In reply to Re: Oh ya!, posted by Gabbi on July 16, 2002, at 20:31:03
> I completely agree... that "issues" stuff is a bad day, maybe a bad week. Its true that continued trauma can eventually alter brain chemistry enough too create "organic" major depression. But depression to me is frightening because there is no "tangible problem" if there was an "issue" I could work on it. As it is One morning I'll wake up in another dimension of terror, hopelessness and fear, and be told to "relax"
>
> I'm sorry to mention his name again but much of the reason I appreciated Andrew Solomons book so much was that he came as close as anyone I've ever heard to be able to describe depression to people who have never suffered it.
> Being a sufferer himself, and a "success" before his first breakdown he managed to have many people listen. Its unfortunate that to get through to people you have to be "successful" in societal terms, but it did get people who think its laziness or weekness or lack of will to listen. He still admits that though he is "managing now" he can't say that he will never take his own life if the suffering outweighs the joy.Thanks Gabbi,
There are issues and then there are ISSUES. Lets take an example: On December 30, 1943 my father was a first leut. in a B-24 bomber flying missions against Hitlers war machine. On that date he was shot down by enemy fighters and made it safely to the ground by parachute. Until June of 1944 he was active with the French Maque (French resistance fighters), arrested by the Gestapo in June and was brutally treated by his interagoters. It was his good luck to have enough of his Air Force uniform left to avoid being classified a spy and facing almost certain death in a Natzi death camp (you didn't have to be Jewish). When he came home he had what we now call Post Tramatic Stress Syndrom - not major depression. I was 15 months old when he came home. Now THAT IS AN ISSUE but has nothing to do with my Bipolar II. That I got by way of genetics from my mother.
I do pretty well on Depakote, Lamictal, and just added Prozac (again). We have come a long way from the hair shirts and fire hoses of the old asylums....but we have a long,long way to go and we are not going to get there with some tdoc blubbering about issues, relationships, etc.
I am hopeful about gentic research and post mortum studies on suicide patients with REAL DEPRESSION.....heaven knows we need EMPIRICAL STUDIES.
Thanks for your post,
Geezer
Posted by Gabbi on July 16, 2002, at 21:37:40
In reply to Re: Oh ya!, posted by Geezer on July 16, 2002, at 21:24:32
Agreed absolutely, as with the issues referring from a spending problem to a Concentration camp, no wonder we ourselves on this particular board probably miscommunicate unintentionally all the time. There is hardly a word available to describe anything in a significant way. Awesome terrible horrifying amazing, they sound so trite.
Just a little rant,
and a Thank-you
and for all its worth.. I wish you the best of luck but mostly understanding and some useful treatment thrown in.I'm a cyclical refractory major unipolor depressive myself,its hard even write that seriously, but thats it. I've not completed the 'final act' because of what it would do to those left behind, but my only real hope to have my Own reason to live is waiting for that successful research.
Thanks
Gabbi
Posted by Gabbi on July 16, 2002, at 22:21:34
In reply to question for Lostboynci and forgive my punctuation, posted by Gabbi on July 16, 2002, at 21:06:17
Belongs on the Book board Sorry
Posted by Geezer on July 17, 2002, at 10:09:15
In reply to Re: Oh ya!, posted by Gabbi on July 16, 2002, at 21:37:40
Hey Gabbi,
Nope the "final act" is just not permitted. Pdoc told me the same thing...."If you kill yourself no amount of treatment will help your children".
You may have noted in one of my earlier posts, I have seen 4 different pdocs in the past year, 2 vote Major/Recurrent/Unipolar the other 2 vote Bipolar II/Depressed. According to Akiskal's "sliding scale continuum" we all fit somewhere between pure Unipolar Major Depression and full blown Bipolar I. At this point I don't give a damn.....just give me some relief.
Have you had experience with any trial study meds. through University research programs? I haven't read all of your posts - could you give your major symptoms and drugs you have tried?
Best regards,
Geezer
Posted by mist on July 17, 2002, at 13:06:13
In reply to Re: Oh ya!, posted by Gabbi on July 16, 2002, at 20:31:03
I think psychological issues can produce symptoms of depression in some people. Depression is simply a condition, there is not one cause for it. Nature/nurture is a two way street.
I also don't agree with the idea that people who think their depression has psychological causes are "not really depressed," or "not as depressed as those with 'biological' depression (again, that's a false dichotomy anyway—it's not either/or). In my case, I believe psychological factors were significant in my becoming depressed. Last year when I was severely depressed not only was I unable to work, but when I was at my worst, I couldn't even compose a post. My ability to think let alone do anything was severely affected. I could say (in response to some of the "more depressed than thou" statements I've read on this board), that anyone who posts here isn't that depressed because they can compose a post. I don't want to play that game, but I think it's something to keep in mind for people who want to make light of others' depression just because they happen to be aware of more than one factor contributing to it.
Posted by Ritch on July 17, 2002, at 13:27:18
In reply to I disagree., posted by mist on July 17, 2002, at 13:06:13
> I think psychological issues can produce symptoms of depression in some people. Depression is simply a condition, there is not one cause for it. Nature/nurture is a two way street.
>
> I also don't agree with the idea that people who think their depression has psychological causes are "not really depressed," or "not as depressed as those with 'biological' depression (again, that's a false dichotomy anyway—it's not either/or). In my case, I believe psychological factors were significant in my becoming depressed. Last year when I was severely depressed not only was I unable to work, but when I was at my worst, I couldn't even compose a post. My ability to think let alone do anything was severely affected. I could say (in response to some of the "more depressed than thou" statements I've read on this board), that anyone who posts here isn't that depressed because they can compose a post. I don't want to play that game, but I think it's something to keep in mind for people who want to make light of others' depression just because they happen to be aware of more than one factor contributing to it.
Mist,I agree with you about the ability to post when depression gets especially bad-especially that anergic, melancholic, dishrag type of depression. You just can't really think (slowed thoughts), and just don't have much to say. It is just like everything (including yourself) is nothing but a big boring zero. Unless of course you are experiencing mixed bipolar stuff-that can be very different!
Mitch
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