Posted by Shell on February 1, 2001, at 21:54:53
In reply to chemical imbalance or not or both?, posted by gwen on February 1, 2001, at 19:16:26
> OK, I'm confused.
>
> Today my pdoc and I were talking about another AD he'd added to my cocktail two weeks ago to see whether I felt anything and to see if the side effects I'd been having were dissipating or were tolerable enough to give the drug awhile longer before giving up on it.
>
> Meanwhile, I've been having problems with my boss at work for some time. But some big things got resolved between us in the last week, so a chunk of anger and resentment and stress has kinda gone away -- just like that.
>
> So within his quizzing me about the drug, this other thing about my boss came up, and he commented that maybe I wouldn't need this third drug after all.
>
> Now I have a friend who was on Prozac for a little while because her marriage was breaking up, but now she's off it and fine. I always thought that my depression (which my pdoc has termed chronic and treatment-resistant) was mostly a chemical imbalance, not so much event-related. I think it was triggered by events, but things have settled down in the last 3 years. Since then, my pdoc has quizzed me regularly to see whether the depression was lifting, but it never has, which is what makes me think it's more chemical. So why would he suggest that it might not be? At another point in the conversation on side effects, he said I've always been sensitive to drugs that help serotonin levels (such as this new one), to which I quipped that maybe I didn't need any serotonin. But he chuckled and said that I did because I've been irritable. In the end, we decided that I'd stay with it a little longer, so now I'm thinking in the chemical imbalance direction again.
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> I've read Listening to Prozac, and know a little about this debate. I also think this kindling theory is pretty relevant to my situation. But if depression is chronic, can a little less stress make that much difference?
>
> Am I asking the impossible, unanswerable question?
>
> Thanks for any input.First of all, I want to start by saying I am no expert and what I say is simply my opinion. Since even professionals have some disagreement on this topic, I can hardly pretend to have the answer.
I personally think there is both depression that is primarily situational, that which is primarily of a physiological nature (which often triggered by an event) and that which is caused by a combination of both factors.
I'm not sure that your doctor necessarily implied that he now feels that yours is more due to circumstances (at least not from what you have written). When you told him that a large source of stress had been eliminated, he said that the third drug might not be necessary. He did say *might not*. I think it is entirely possible for depression that is mostly caused by chemical imbalances to be made worse by an external stressor. When the stress is removed, it would make sense that the level of depression will lessen. A lower level of depression may require fewer medications and/or a smaller dose to treat (and with side effects being what they are, that is a good thing).
I think he was probably just thinking that since a large source of stress had been removed, it might reduce the severity of the depression (since the addtional stress had probably increased it) which might possibly eliminate the need for new medication that has had some negative side effects. It's as if you had some baseline level of depression with a biochemical cause which was increased by a stressful situation. Remove the stressor and the depresion returns to its baseline level.
And yes, I do believe that a little less stress can make a big difference in someone who is already predisposed to depression (but you said some "big things" had been worked out, so I tend to think it might have been more than a "little less stress".
I hope that all made sense..it's kinda late and I think I may be a little fuzzy.
Shell
poster:Shell
thread:53130
URL: http://www.dr-bob.org/babble/20010131/msgs/53138.html