Doctor Rants About Depression

[@isabellefaguy7351]

I was in diagnosed depression for over a decade and no pill helped me. What allowed me to get out of depression : 1) getting a regular income not based on my inhability to work full time, 2) getting a roof over my head (government funded housing), 3) getting to understand the incredible amount of several forms of abuse I had been subjected to since childhood and basically non stop. So I do understand that some person get depression probably purely because of biology, but I would bet that many people get it mostly if not entirely from socio-economic and socio-affective factors. I certainly know a lot of people for whom it has been the case.

[@snezeire]

Really appreciate you mentioning persistent depressive disorder. I find that it is the most confusing for people. We talk about high-functioning depression in my circles a lot. Being functional enough to do all the external things the world thinks you should do also leads to a lot of assumptions about how depressed you could actually be. Meanwhile, you can have lived years of your life without joy. This is not a contest, and all types of depression deserve help. But I was just glad to see the DPP shout out

[@meagandainty4346]

I wholeheartedly agree! I've lived with Generalised Anxiety Disorder for most of my life, but within the last 18 months, I have also been diagnosed with Persistent Depressive Disorder. I'm still figuring out what it means and how to best improve my quality of life, however, I find myself being constantly shocked by the lack of information and/or discussions about this disorder.

[@tiffanylynn8376]

More rants please! This was educational, informative, compassionate and in many ways therapeutic! You’ll make a fine Psychiatrist, looking forward to seeing where your journey takes you, and even if it take a right turn into another specialty your passion to consider peoples mental state as well as physical well change more lives than you could imagine ♥️

[@prapanthebachelorette6803]

Agree

[@deborahbasel184]

Thank you for taking Depression so seriously. I have Major Depression with regular episodes. I struggle to do anything. And although I have lived experience, my mind still tells me it's not so bad, others have it worse, etc, etc. More talks on Depression please.

[@jwater732]

Just to say thank you for your kindness. Therapy and meds saved my life. I've waited too long to ask for help and I've wasted too many years of my life. Do not be ashamed and don't wait. Post traumatic growth or whatever it is: best human feeling I've ever felt in all my life, I can't descrive it. Life can be sweet. : ) thanks.

[@ambershepherd2389]

I really enjoyed this! When I was 24 and had suffered melancholia for yrs, my Dad bought me my best friend, a staffy whom I absolutely adored and saved me during my darkest times. Get a dog is a great piece of advice for lonely, isolated dog-folk.

[@timheavyable]

I was diagnosed with MDD when 19 and the doctors mentioning being unable to appreciate sunsets really hit home. One of my earliest depressive thoughts hit me when I was 11. There was a sunset over the bay and I looked at it and thought ,That should seem beautiful to me but it means nothing, just nothing at all and I started crying. I was also abused as a child, as in I was raped by 2 men. Im male BTW. I have not slept properly for decades and do slip into psychosis. Im on antidepressants, antipsychotics ,mood stabilizer and sleeping pills. Can't hold down a job as I can take to bed for weeks at a time,won't wash,shave or even eat. Im 5.11 and weigh 133lbs. I have had a few genuine suicide attempts and practice self harm. Every day is a nightmare and I did self medicate with heroin and c

[@sofie1065]

Thanks a lot. You understand. I had both cancer (a very dangerous form) and depression. When I say depression is worse, some people are offended. But I stick by it. When I had cancer and was extremely ill with the chemo, there was not a minute in the day that I could enjoy. Too sick. But what I could do was hoping for better days. Serious depression will take any hope away. Plus: with cancer any abd everybody felt for me. They sent me cards, flowers, prayers... With depression... uh.... none of that. More like, get yourself together. On a lighter note: I survived both. You can get out of a depression. You really can. But seek help. At least, go see your GP.

[@jameswoodard4304]

I've struggled with Depression almost as long as I can remember. One of the hardest things for me in the long-term context (there are much worse things in the moment-to-moment or day-to-day) has been people's attitudes. It saddens and frustrates me that the popular image of "being depressed" to some people is still that some bad thing has happened to you and you are in a temporary rut with a time-limit on how long people should have to "put up" with you "being sad." No, that's just called mourning or adapting to loss and is a normal human process that everyone deals with. Major Depression is a medical/psychiatric *disorder* . I grew up in a very "pull yourself up by the bootstraps" culture. Though I appreciate having been instilled with a strong sense of personal responsibility, it's really difficult when people have a completely unrealistic notion of what Depression is and think they are actually helping you by getting angry and pushing you to "snap out of it." Especially if they are family members and they really are doing it out of love. People can actually cast moral judgment on you eventually for supposedly just being weak, lazy, and disappointing. Which is exactly what you need when fighting against depressive thinking! "Oh gee! I hadn't thought of that! Why don't I just *try harder* not to be 'sad' anymore! What would I ever do without such insightful advice?! I'll just go tell the blind kid next door that he'll stop running into things if he just opens his eyes! I'm sure he'll thank me for the advice!" I've never had cancer, but I've had family go through treatments. I'd never presume to compare the two myself. And I know it was not a rational way of thinking at all, but when I was young, I sometimes fantasized about being diagnosed with some chronic and potentially deadly illness so that people would appreciate and respect me "bravely" struggling to face a respectable illness every day and I'd have an excuse to skip all the stupid mundane everyday crap that's nearly impossible to manage in the worst depressive episodes. No one pesters a terminal cancer patient about why he forgot to empty the dishwasher, if he got his car registration taken care of, why his room is a bit of a mess, etc. I would never want to diminish the reality of cancer, and I know it's a nonsensical way of thinking, but you think pretty nonsensical things in the depths of a severe depressive episode. Thanks for your comment. It really helps put things in perspective.

[@sofie1065]

@@jameswoodard4304 I know man. It is though.

[@irmenotu]

Ketamine therapy saved my life from suicide and depression. It can be hard to access but it's worth it.

[@ebrennie]

I have treatment resistant MDD. Lifelong. I do not have a single memory where it wasn’t there. I was misdiagnosed as a child. I wasn’t treated for the right disease until I had a job with benefits in my late 20s. I have tried 40+ medications, every kind of therapy, and TMS, the latter of which proved to be a failed hail mary. I spent my entire savings - my down payment on a house - on that pass cuz insurance wouldn’t cover any of it. Took disability leave to do it and lost my job. I will never own a home, and haven’t been able to find a decent job with decent pay to save another penny since then. Not much to hope for in a scenario like this. I’m a scientist. Graduated top of my class, but none of it matters because when you have MDD, you either hide it or get fired.

[@TheNurseWhoLovedMe89]

That one liner for how to bring up the topic of suicide with someone was really helpful - thank you! It would be really helpful if you could talk about things that can look like depression but might not be depression. This came up recently because my psychiatrist said that he isn’t sure if I have depression or if it’s just the trauma (PTSD). I didn’t really understand what he meant, but my clinical psychologist said that it would be relating to the Window of Tolerance being very restricted for people with post traumatic stress, so the low moods can look like depression because of that. So… I kind of understand? But also, I wouldn’t be unhappy with another explanation/viewpoint either 🤷🏻‍♀️😅 Thank you again - your rants are awesome! 🙌🏻✨

[@arabellalivesey9056]

Something I've really only come to realise recently in regards to my own issues with mental health is truly how little we actually know about the brain. I'm medicated for both depression/anxiety and ADHD and science really doesn't seem to be able to explain how these disorders are characterised in the brain, we only really know that certain medications are effective in treating them. I was quite concerned at all of the people who are now questioning or even abruptly stopping taking SSRIs given the recent umbrella review on serotonin theory. It is kind of scary to recognise that even if we know certain drugs work for mental conditions, we don't truly know how.

[@rominaceballos3733]

I am finally seeking assistance for my mental health and I have been trying to find a private clinical psychologist in my area northern suburbs of Victoria Australia but unfortunately no one is accepting new clients !!! It’s been really disheartening and underwhelming ☹️. I am even struggling to find them for my clients (I am a case manager for people who are homeless).

[@Uhlbelk]

Want to point out what I think is the best identifier of depression. Anhedonia. When someone stops enjoying things they have always enjoyed in the past, that is a huge red flag for depression. Maybe they found something that has replaced that interest. But if they don't have any real interest in things that normally they enjoy, try to get them some help.

[@bethlaustsen6510]

Evolutionarily depression does make some sense. Hundreds of years ago we use to have a whole season of rest and recuperation (winter) where our only job was to stay warm and alive. It's not like the spring and summer which was busy with farming and preparing for the Winter. Humans today don't have that season off. We work at the same pace all year round. Our bodies were not built for this constant stress and so depression affects us. It's like a biological over reaction/ overload to modern existence.

[@handyhacker11]

I believe multiple mechanism can cause dysfunction in the brain relating to depression but they all relate. Depends for example whether it's a problem with neurotransmitters or their enzymes vs cytokine induced sickness behavior i.e. inflammation purposefully shutting the brain down vs. something in your life causing your brain to resignate & downregulate

[@sethsims7414]

I've always thought that the depressions with more physiological symptoms are the ones that respond better to drugs. I've had some really bad ones where I lost 100+ lbs and had months of insomnia. Exercise and drugs were more effective at blunting those symptoms. They really don't touch the longer term dysthymic and reactive type depressions.

[@adorablespore]

I have depression and also both a cat and a dog. Whilst the dog can appear more eager for my attention and is a reason to get out the house, they can also have much bigger problems and require consistent training. A cat is much easier to cope with (especially when times are hard already) and they form a very strong and loving bond with 'their person'

[@amber76OH]

You're amazing 👏 thank you for being so helpful. You're healing the world , even if it's one person at a time 💛🐶😊

[@turbo95912]

Funny you mentioned not using SSRIs for bipolar disorder. Before I was formally diagnosed with schizoaffective disorder bipolar type, I was started on an SSRI and it made me have the weirdest dreams and I couldn’t slow down at all which brought my doctor to the diagnosis of bipolar 2 disorder. This was back in 2019.

[@Ashepnasty]

I’ve got 2 dogs. They make every day better, they are my best friends.

[@jameswoodard4304]

A dog is great! It's a source of unconditional unfeigned affection 24/7, someone you don't have anything to prove to or have to wonder what they think of you, and caring for them is really low-energy and simple but forces you to get out of your own head and think about somebody else. That last point has always been really useful for me. Depression can really cause you to be unhealthily self-focused and cacoon emotionally in on yourself. Having to get up at somewhat regular intervals to feed, and water, and let outside a fun and loyal friend really helps in those "can't find enough give-a-damn to get out of bed" days. I could let myself starve for a day or two, but not my boy! And you get rewarded by highly dopaminergic/seratoninergic face licks! Just don't get a high-mantenance high-energy breed or they could become an obnoxious burden you're not prepared to handle which isn't fair to them and will just make you more depressed.

[@hatzbatzsystem]

We are diagnosed with: major depressive disorder, Schizo-affective, generalized anxiety, adhd, Dissociative Identity Disorder, CPTSD, ummmmm so far think that's it, but our Alters have, that we aren't formally diagnosed is ocd, tourettes, siezure, absent siezure, blind, deaf, Dyslexia, all that comes to mind atm lol

[@mentalitydesignvideo]

To understand depression in humans one must first understand depression in animals. To wit: the dogs that were involved in experiments with learned helplessness (and suffered electric shocks with no way to escape them, as opposed to dogs that also received electric shocks but their cages were built so that with some effort they could escape them), after their release developed severe depression, became apathetic, stopped eating and died. In other words, a prospect of unending suffering with no possibility of escape is enough to drive an animal into the deepest depression and to hasten death. No genetic predisposition (vs other lab animals), no adverse childhood experiences, no faulty thinking, etc. A single variable -- whether life is worth living or is a horror with no possibility of escape. I think the parallels to human condition are all too clear.

[@IdkIdk-pv1mx]

With SAD diagnosed in we like to ask about periods of irritability too. Hope that helps u understand why it’s in the dsm

[@Uhlbelk]

I work in a prison. 90% of the mental health patients are placed on haldol. Its sad.

[@Imbapiranha]

The following may sound heartless, but it's only meant to answer the question "How did it make it through evolution?": Depression makes a lot of sense from an evolutionary perspective. It forces full commitment to solving emotional struggle in order to find a way to get back to dealing with the group. It also makes members that are having trouble functioning in the group isolate themselves, reducing the burden on the others. Doing the unthinkable for vastly maladjusted individuals also benefits the group as their bad adjustment is likely to coincide with lower resource generation than resource spending. That being said, the frame has gone completely haywire. Tribal times and fight for survival is long past. Depressive episodes go unchecked and there is rarely enough social interaction for a good chance to find back to a group. This makes depression utterly useless in the face of huge societies and considering the value most people can bring to the world, it is also a big waste of resources.

[@laraoneal7284]

The brain is definitely FASCINATING.

[@barefootfiona]

Sorry Syl, I love you, but the CBT apps are not something I'd be shouting from the rooftops about. It's an extremely alienating experience to go to a doctor seeking help and to be referred to a robot. Talk therapy, including CBT, works because it is interpersonal. The apps can support but are not at all a replacement for interpersonal talk therapy.

[@benjiw2374]

What sort of sexual disfunctions would someone experience on SSRI's?

[@DrSyl]

I've heard of decreased labido, retrograde ejaculation in men, inability to ejaculate in men, difficulty in achieving orgasm in female. But it's sometimes worth having decreased labido if it means depression is better controlled. There are newer Antidepressants that aren't SSRIs like agomelatine or bupropion (not new) that have less sexual side effects. Remember always talk to your doctor before changing or stopping medicines PLEASE

[@benjiw2374]

@@DrSyl Thanks, I actually came off Citalopram cold turkey last year after 4 years of taking it consistently. I'd say whole heartedly it was the worst decision I ever made, back on the meds and feeling normal now but it took 6 months before I felt human again. I certainly will be consulting with a doctor in the future. I didn't realize how bad it would be!

[@WouldntULikeToKnow.]

​@@benjiw2374 oof, going cold turkey has to be rough. Glad you're doing better now!

[@hannah5245]

Don’t just pontificate/rant about left brain brainy stuff! Just feel it ! But unless you spell out all of the underlying emotions, saturate your whole being with deep sadness that cycles/recycles itself, you’re only ranting about surface of things. Depression is getting in touch with deep seated gut stuff to be brought up to the heart and vomited out. It’s all of right brain stuff.

[@kieranbrennan7350]

Personally I think most mild to moderate depression episodes don’t need medicines and can be managed with exercise, cbt, immersion in nature and particularly social interaction.