Posted by SLS on December 20, 2010, at 5:51:55
In reply to Re: Sorry: stupid question for this group of (course), posted by Maxime on December 19, 2010, at 22:06:28
> My depression is so bad that my pdoc has requested that I contact him *every day* to give him an update.
What is it about your current mental state that worries your doctor?
Do you come to feel suicidal without a mood-congruent intensification of depression?
> Yet I hold down 3 jobs (only 1 full time), I do volunteer work and I take care of my mom who has Alzheimers. I have been accused by doctors ( in the past) that I must not be truly depressed if I do the things that I do.
Some doctors can be very ignorant of the widely variable presentations of the same depressive illness. Unless this variability is fully appreciated by the clinician, people are bound to fall through the holes present in the current inadequacies of diagnosis.
> So I don't think that doing all these things helps my depression, it just allows me to push the pain further down inside me which is probably the MOST unhealthy thing for anyone to do.
I guess this is a statement that can only display exactitude when describing your personal experience with depression. Depression has many faces. Pervasive feelings of sadness, anhedonia, apathy, lack of self-esteem, and self-hatred. However, when anergia, psychomotor retardation and amotivation become prominent in the presentation of depression, holding 3 jobs is impossible. For me to compare my inability to hold 1 job to your ability to maintain 3, it might at first appear that you are not as severely depressed as I am. However, you may experience an intensity of psychic pain that I do not. Comparing is tempting. It is only natural to want to evaluate another's depression in order to better understand your own. I believe that there is an effort made by some people to find vindication for their perceived "failures" and difficulties in life. To look for examples of depression that appear similar one's own, and whose "failures" in life are comparable, one realizes that depressive illness is real, ,debilitating, and not a demonstration of laziness. Even if true, it doesn't feel good for a persoon to think that their depression is the most severe or refractory to treatment. It is very likely that there exists someone in the world whose illness is worse than yours. If you are lucky, you might extract some gratitude from recognizing that your depression is not. I have witnessed people stricken with what is perhaps the most horrendous display of depression. The classic endogenous melancholic depression with severe psychomotor retardation causes the suffer to fold back in on themselves. People with this subtype of depression often remain fixed in one position for hours for lack of energy and inertia. At her mother's request to wait on me and serve me a glass of water, my eyes filled up with tears. To my anger and disgust, I witnessed her daughter walk across the kitchen, expending all of what precious energy she could muster in order to take just one step. She was dead inside. Within a few months, she was dead outside, too. To learn of her suicide filled me with profound sadness. It wasn't fair that someone should endure such torture; so much that life was deemed less valuable than death.
Depression must surely have many faces. Who can keep up with them all? The DSM? In my opinion, the sections of this diagnostic manual devoted to the descriptions of MDD and BD are primitive and embarrassing to read. It is no wonder that so many patients have little faith in the accuracy of a doctor's diagnosis. For now, resolving a workable diagnosis for an individual is an ongoing process, and often involves trial-and-error in the same way as does choice of treatment.
- ScottSome see things as they are and ask why.
I dream of things that never were and ask why not.
poster:SLS
thread:973794
URL: http://www.dr-bob.org/babble/20101218/msgs/974095.html