Regarding DEPRESSION

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Matt

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Well, I don't think I'd be assuming too much to suggest that there's a link between loneliness and depression.

For those of you who thought "No honeysuckle!", read on.

Since so many of us here are depressed, I thought it'd be helpful to have a little "information" thread about the topic. Learning about depression as an actual clinical condition really helps to put things into perspective, and - for me at least - it's somewhat comforting to know that my "unique" experiences are really shared by many others; so many, in fact, that it's been studied enough such that its diagnostic features - painful for anyone who must endure them - have been standardized.

Better yet, this standardization has allowed psychologists and biochemists to find various methods (of varying degrees of effectiveness, depending on the individual, of course) to battle this most monstrous of monsters. =]

That said, to clarify what clinical depression really is:

Depression is a mood disorder, which is a psychological disorder in which there's a disturbance in mood (duh) marked by prolonged emotion that impairs someone's entire emotional state.

Depressive disorders are mood disorders in which someone suffers depression without ever experiencing mania. The two types of depressive disorders are major depressive disorder and dysthymic disorder.

Major depressive disorder is characterized by a major depressive episode (of at least two weeks' duration) and depressed characteristics, like lethargy and hopelessness.

Symptoms include:

- Depressed mood most of the day
- Reduced interest or pleasure in all or most activities
- Significant weight loss or gain or significant decrease or interest in appetite
- Trouble sleeping or sleeping too much
- Agitation or retardation in muscular activity associated with mental processes
- Fatigue or loss of energy
- Feeling worthless or guilty in an excessive manner
- Problems in thinking, concentrating, or making decisions
- Recurrent thoughts of death/suicide

Five of these must be present in an episode to be considered as MDD.

I personally have dysthymic disorder, so I wrote a little more about that. :D :

Dysthymic disorder is a type of depressive disorder, and thus falls under the spectrum of mood disorders. It’s generally characterized by a chronically depressive mood that lasts for at least two years as an adult or one year as an adolescent. Unlike major depressive disorder, dysthymia involves no major symptoms so much as a continual day-to-day lifestyle of disrupted sleep patterns, increased or decreased appetite, difficulty making decisions, poor concentration, feelings of hopelessness, poor self-image, and drained energy (to be classified as dysthymia, two of these symptoms must occur, and they must not be absent for more than two months at a time). Despite no major depressive episodes, the long-lasting accumulative effects of these seemingly mild symptoms include work impairments, social isolation, and even high rates of suicide. An individual is not considered to have dysthymic disorder if his or her symptoms fall under the larger context of cyclothymic disorder or a chronic psychosis like delusional disorder or schizophrenia. Also, the individual’s symptoms cannot stem from the direct causation of general medical condition or the use of substances such as prescription medications. As with all psychological disorders, the symptoms must entail behavior that is deviant, maladaptive, or personally stressful.

As a mood disorder, dysthymia can involve a combination of biological, psychological, and sociocultural causes. Heredity has proved to play a strong role in acquiring mood disorders, as having a biological parent who suffers from a mood disorder drastically increases the risk of the offspring developing it as well. Those with mood disorders also exhibit several neurobiological abnormalities, including altered brain-wave activity during sleep, in which there is less slow-wave sleep and a quicker transition into REM sleep; thus, depressed individuals have trouble falling asleep and remaining asleep, and they wake up early in the morning feeling unrested and unable to fall back asleep. Additionally, depressed individuals exhibit constant hyperactivity in the endocrine system and a consequent inability to return to normal functioning after a stressful situation.

Psychologically, causes have been theorized in the psychodynamic, behavioral, and cognitive fields. Psychodynamic theorists suggest that depression is the manifestation of childhood experiences that hindered strong self-esteem. They also refer to Freud’s theory that depression is an internal clash of aggressive instincts and inability to openly express these feelings of frustration towards loved ones. Behavioral theorists suggest that stress leads people to withdraw inward, and the reduction of positive reinforcers that follows this leads to a spiral of only more withdrawing inward and more reduction of positive reinforcers, thus causing a self-perpetuating lifestyle of chronic depression. Behavioral theorists also emphasize the notion of learned helplessness, in which prolonged stress affects individuals with sentiments of unresponsive apathy and hopeless rumination. Cognitive theorists point out that depressed or even pessimistic individuals only think in negative terms, which thus only amplifies their depression.

A wide range of sociocultural factors can play a role in the development of dysthymia. Interpersonal relationships marked by an anxious, insecure attachment style are likely to cause depression, and a childhood of neglected love and attachment can develop a negative schema through which an individual interprets adult losses as extensions of childhood failure to develop enduring and close positive relationships. Additionally, a socioeconomic lifestyle of poverty poses many threats and stressors that make depression an easy trap to fall into. Also, the fast-paced, stressful lifestyles of industrialized, modernized societies increase individuals’ vulnerability to chronic depression.

Treatments for dysthymic disorder include both biological therapies and psychotherapy. Antidepressant drugs regulate mood, and include tricyclics, monoamine oxidase inhibitors, and selective serotonin reuptake inhibitors, but all three of these classes of drugs involve adverse side effects. Electroconvulsive therapy is sometimes used to treat severely depressed individuals, and although its administration involves little discomfort, its side effects of memory loss and other cognitive impairments is rather severe. Cognitive therapy is generally most preferable, for it strives to help change the mindsets of depressed individuals, and thus adverse side effects are nonexistent and relapse rates are low.


Also, there are three main classes of antidepressant drugs.

Tricyclics reduce symptoms in 60 to 70 percent of the cases, and they usually take 2 to 4 weeks to improve mood. But side effects include restlessness, faintness, trembling, sleepiness, and difficulty remembering.

MAO (monoamine oxidase) inhibitors are more toxic than tricyclics, but some people who don't respond to tricyclics do respond to MAO inhibitors. But MAO inhibitors can be especially risky because of their potential interactions with certain foods and drugs. Fermented foods like cheese and alcoholic beverages like red wine can interact with the MAO inhibitors to increase blood pressure and eventually cause a stroke.

Selective serotonin reuptake inhibitors (SSRIs) include Prozac, Paxil, and Zoloft, and they're popular because they reduce the symptoms of depression with fewer side effects than the other antidepressants. Still, possible side effects include insomnia, anxiety, headache, and diarrhea (yeeeah). They can also impair sexual functioning and produce severe withdrawal symptoms if ended too abruptly.

So, if you wish to use medication to help resolve your depression problem, you might want to consult a doctor and see if any of the SSRIs would be right for you.

Therapy, however, is a very effective way of battling depression. There are many types of therapy available, and a collective approach to therapy will produce the most improvement.

Personally, if you're like me, you probably won't want to talk to anyone about it - including psychologists. Thus why we're all here on this anonymous internet forum. :D Well, some "convenient" activities I've tried to help me through without having to open myself up to "outsiders" include both daily exercise (including both walking/jogging/running and weight training) and simply going outside to meditate. These are all simple, but extremely effective.

So...those are my two cents on depression. No doubt, some of you probably already knew most of this, though hopefully it'll help others who are deeply confused by such a chaotic condition. Alliteration not intended.
 
even though i dont agree w/the drugs... that was a very informative post Matt. thx 4 taking the time 2 post all of that 4 us
 
Hey great post Matt do you work in the pharmacy industry at all if not I am really impressed.

One of the new major class's you left out though and I really think they are some of the new best drugs for depression and anxiety.

They are the Serotonin-norepinephrine reuptake inhibitors. (SNRIs)
How they are different from your SSRI's is that they not only effect the serotonin but also the norepinephrine. Now why it is so important to effect norepinephrine as well is most the time with depression there is neuropathic pain which the SSRI doesn't treat at all and by not treating that half an SSRI is really only doing half the job. I worked at a state hospital for almost 2 years and I saw how much better SNRI's worked then just SSRI's. We even has less complaints about the side effects as well. The only real problem with SNRI's right now is they are fairly new and somewhat costly. But if you can afford them and are looking into medication for depression or anxiety I would suggest looking into SNRI's. My two personal favorites are Cymbalta and Effexor.
 
^ Cool, thanks for the update. :D

And no, I don't work in the pharmacy industry. But if I did, you wouldn't be impressed? :p
 
I can't imagine it would be very profitable.
 
thank you, Matt, for a very informative post, and Josh for the update :)

I also find it hard to talk about the problems, but I have sought out a therapist (couldn't handle it alone any more). and I must admit, I'm a little afraid of meds, of the side-effects, but also that if I can't work this out without pills, how will I handle further challenges of life...
 
Matt said:
^ Cool, thanks for the update. :D

And no, I don't work in the pharmacy industry. But if I did, you wouldn't be impressed? :p

Well not as impressed as a lot of it should be infomation you should already know but not working in a pharmacy I am very impressed you would go out and learn all of that.

Oh and hey seems you have a stalker lucky you.
 
aww poor matt.
you don't seem like a depressed person
but then again, who really knows right?
and you sound so dang clever in this post. x.x
 
Does being depressed mean you aren't clever?
Are clever people too smart to get depressed?
I don't think that's true at all, depressed people seem to think deeper into things than non-depressed people. And loads of very smart people have mood disorders.
And I'm not accusing you of saying that, nutellacat, but it sounded a bit like you were.
 
^ Lol, I think her last line was meant to be read separately from the preceding two, like a "oh and btw". :D
 
yup, prolly. But it sounded like she said... oh whatever.
but anyway, depression sucks. A few of my older family members are/were manic depressive and that really really is not fun. I mean, talk about family crisis. bleah.
 
Qui said:
... depressed people seem to think deeper into things than non-depressed people. And loads of very smart people have mood disorders.

fwiw...I very much agree with this also..

Depressed people can be very interesting to be with, and spend time with, and reading their writings, and listening to their music. Many seem to be asking questions that others do not.
 
Yup. totally. Most great musicians are either a little off mentally or on drugs that puts them off mentally or both. It just makes for a different (and therefor interesting) viewpoint. And authors and artists too.

However... this is different but also similar, one of my friends is on meds for his ADD and when he doesn't take his meds he is a really great guy, very nice, super cool, funny and loads of fun to be around. But when he takes his meds... watch out. He is mean and moody and sulky and he's a little violent and totally antisocial. It's really a problem for him and for all of his friends. So yeah, he's fun to be around. Unless he's taking his meds. So sometimes it is hard to be around people who have mood disorders.
 
I dunno, I'm a bit stubborn. I don't really want to take medication to make myself better. I think I just need to make myself better by changing my thought process and seek out what I want and enjoy(learn to accept myself).. yeah it's hard.. but I don't want to talk to therapists(who I feel are just doing their jobs and don't really care? ahh the paranoia in me) or taking medication. hmm, but I know that talking to others about your problems really help though(I just think I won't be able to talk about it with strangers). Thankfully I found a good friend on the internet and I can talk to her about my problems.. she makes me feel so much better! and sometimes gives me advice and support when I feel really down.
 

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