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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 4 to 28 of 28. Go back in thread:
Posted by Noa on September 22, 1999, at 22:38:38
In reply to Re: someone tell me what this is, posted by Elle on September 22, 1999, at 22:28:34
Jenny, I must respectfully disagree with you. Yes, it is possible to see elle's issues as BPD, but I think it is jumping the gun. BPD is such a broad, controversial, poorly defined diagnosis, that it is often possible to see many symptoms as fitting the bill of BPD, but a diagnosis of personality disorder doesn't, in my opinion, give much assistance in understanding what might help.
elle, keep in mind that while you are feeling depressed, it is hard to answer the doctor's question accurately. While you are depressed, you are more likely to feel like you have always been (and will always be) depressed. Somehow the memory of nondepressed times get overlooked. On the other hand, since I don't know you, it is possible you have been struggling with depression for a long time. It sounds, tho, like the death of you father precipitated a more severe depression, enough to prompt you to seek help, which is such a good thing to do. Yes, get support. A bereivement group, a therapist, whatever. As for judging whether you have always been depressed, tho, reserve judgment because your assessment might be clouded by your mood.
In answer to your question, depression is many things, it comes in many forms from mild to severe, from acute to chronic to cycling. Whether your depresssion is serious enough to be labeled as an illness is something to discuss with a professional in person. I think it is usually a good idea to consult a psychiatrist who specializes in psychopharmocology, if this is possible, rather than having your general doctor monitor your meds. As for a therapist, this could be from several different professional disciplines.
Glad you joined us, keep in touch.
Posted by Bob on September 22, 1999, at 22:42:39
In reply to someone tell me what this is, posted by elle on September 22, 1999, at 18:57:29
> What does this all mean? What is depression? Is it feeling so bad about how you look or where you came from that you don't ever feel like you are normal?
Elle,
It means you need more support than your family doctor can give you, but he was a good place to start. This is also a good place for support, but psycho-babble isn't enough, either. As for what depression is -- you can look at this site or other sites for all sorts of clinical information, such as the indicators that doctors use to diagnose someone as having some sort of depressive disorder. You can look at the things we say here, the descriptions of our experiences past or now. To me, they all sound unique but oh so familiar at the same time.
The bottom line is that you need to see a therapist -- MSW, CSW, psychologist, psychiatrist, whatever. What you experienced, particularly about your father's death, certainly qualifies as feeling depressed, but your own questions, your inability to answer your family doctor about how long you've felt this way all say that it may be more than a response to a loss. You need the support of someone trained to help you through these issues. Medication will help you feel better, but it won't change what you believe or how you act, how you treat yourself or others. For that, you need to talk to a pro. Ask your family doctor for a referral.
Don't feel ashamed for feeling this way. Don't blame yourself for it. Look around on this board and see what the rest of us have been through, and see the support that is here for you. You'll find that while many of us lean on the rest pretty heavily now and then, the leaners have a lot more to offer in return for what they gain.
Take care,
Bob
Posted by Ian on September 23, 1999, at 2:58:15
In reply to Re: someone tell me what this is, posted by Bob on September 22, 1999, at 22:42:39
I'm trying to quash my anti-psych tenndancies for the sake of the comradery on this board but I'm afraid personality disorder does it for me. There's a dozen or so personality disorders, infact there's one for everyone. They are dustbin diagnosis and surely one of the greatest insults out-your personality is a disorder! Anything that does not fit the sad,mad,hybrids of those two or the anxiety states gets lumped into PD.
I hope you think my personality is ordered enough to make me credible
Ian
Posted by jamie on September 23, 1999, at 3:51:25
In reply to someone tell me what this is, posted by elle on September 22, 1999, at 18:57:29
You described me perfectly. We seem so similar. Hey, all of us have ups and downs and grieving and such. But what you describe goes deeper than that for a prolonged period. Perhaps a lifetime. Normal ups and downs don't affect a persons life in any substantial way, but what you describe has shaped you from the core and interfered with normal functioning. I'm the same. I've had two docs and three psychs and one counselor. They all had the same diagnosis and I think it fits you perfectly...DYSTHYMIA. Chronic mild depressin with overlapping bouts of severe depression. I believe you suffer from dysthymia and is probably inherited. I feel stupid offering a diagnostic opinion over the net, but when it looks smells and sounds like a duck, it probably is a duck. I could spot this duck a mile away.
Posted by Ian on September 23, 1999, at 6:07:30
In reply to Re: someone tell me what this is, posted by jamie on September 23, 1999, at 3:51:25
Dys for anything abnormal dylexia,dysplastic,dysfunctional. Thmymia pertains to mood. Surely there can't be much about psychiatry that doesn't relate to dysthymia, asides from accepting it as a medical condtion-it exists because it does, isn't it best to try and make sense of it by exploring premises we've never questioned about ourselves. What was your childhood like are there any clues or am I trying to inappropriately be psychotherapeutic about everything. I'd value your answer as much for my own understanding as yours
Ian
Posted by elle on September 23, 1999, at 7:50:14
In reply to Re: someone tell me what this is, posted by Ian on September 23, 1999, at 6:07:30
> Dys for anything abnormal dylexia,dysplastic,dysfunctional. Thmymia pertains to mood. Surely there can't be much about psychiatry that doesn't relate to dysthymia, asides from accepting it as a medical condtion-it exists because it does, isn't it best to try and make sense of it by exploring premises we've never questioned about ourselves. What was your childhood like are there any clues or am I trying to inappropriately be psychotherapeutic about everything. I'd value your answer as much for my own understanding as yours
> IanMy childhood sucked. My parents were divorced and I had an abusive step father. My Mom looked the other way because she could not support us on her own. moved out as soon as I could. Slept with lots of men looking for what I thought was love, married an abusive man and finally raised myself and woke up. I divorced the man and 4 years later married my husband who is the finest man in the world. He is the one who advised me that my mood swings were not normal and wanted to go to counseling. He has assured me that he will nnever leave me and there will never be a divorce. He loves me completely. It is the most security i've ever had and I love him completely. I am so emotional over these responses. I am struggling with the realization that I need help. I should add that my father was distant but had some kind of mental health problems. He would come and see me then not hear from him for a while. He commited suicide and I spiralled down. I wish he had gotten help. I have never been suicidal. But don't feel like I enjoy life like other people. I have a good life, beautiful children, good children, awesome husband, faithful Catholic and sometimes get angry at God because I want to feel better but not sure what better is. Does anything here make sense?
Posted by Ian on September 23, 1999, at 9:10:58
In reply to Re: someone tell me what this is, posted by elle on September 23, 1999, at 7:50:14
Thoughts
Your father represented some kind if not a wholely satisfactory source security sounds like he may have been in part a friend.
With your father gone your husband represents the sole corroborating factor to your self worth. As you've lost your father recently perhaps a part of your mind is saying well what if and you fear losing him too for what ever reason.
I think what is important (but its easy for me to say without two kids in tow) is to diversify your security base i.e try to get out and get involve in some shared activity that will give you a sense of independance and boost your self esteem it could be a part time job or a shared hobby that gets you into a social environment and makes you feel valued as a part of that group. Your marriage is obviously going to be the number one relationship in your life but if you have a secondary network then it will mean you can relax a bit. Neurotic worries about your whether your husband has undying commitment are self defeating as they will strain things.
Posted by Bob on September 23, 1999, at 9:18:52
In reply to Re: someone tell me what this is, posted by elle on September 23, 1999, at 7:50:14
Ah, there ya have it! Bein' half Irish and have Polish meself, I'd say just pin it on being Catholic ... the human soul can only handle so much guilt before it crumbles, doncha know? ;^)
I know it's hard not to struggle with these self-admissions. Admitting that you're having an "episode" and getting the latest SSRI from you family doctor for a few months seems to be getting as fashionable as checking into a rehab facility (pardon me, the RIGHT rehab facility) in some circles. But admitting that you are depressed now and that you probably have been depressed for a long time can feel like a death sentence. For me, I was terrified of admitting that I did not have the power to arrange the affairs of my life to exactly what I wanted them to be, no matter how long it took. I didn't want to say that there was nothing I could have done to not be depressed for the last 30 years.
But elle, you have received such a great blessing in your current husband! I wish more disorderless folk had his enlightened attitude. It's okay to lean on him -- that's one reason why he married you, to provide that sort of support. It sounds like it's given you the strength to act, after all these years, to confront the source of your troubles and not just the issues that exacerbated them (though you certainly have shown a great deal of strength in getting yourself out of past abusive situations). Just keep focused on that strength that you do have and remember: acknowledging that you need someone's help and seeking that person out is not a sign of weakness--it's still another sign of strength. Take some pride in coming to see this, in coming to accept it, and share the gratitude you must feel for your husband's support. Don't look on entering therapy as a failure, because it isn't. It's a successful start to getting to the life you deserve.
It took me a long, long time to realize all this myself. I hope you can see it, and really take it to heart, sooner than I did.
Cheers,
Bob
Posted by Noa on September 23, 1999, at 13:48:14
In reply to Re: someone tell me what this is, posted by Bob on September 23, 1999, at 9:18:52
elle, you have been through a lot.
The fact that you father's death was by suicide adds a whole nuther dimension to your grief, which seems to have opened the gates for you. I agree with the others--you have strengths and sources of support in your life, but probably could benefit from widening the base, as Ian put it, I think.
Ian, wow. I have been finding myself in a fair amount of disagreement with you during many of these discussions, but here I concur on several things. One of them is the general uselessness of BPD as a diagnostic category, except for some theoretical discussions about psychodynamic psychology.
elle, treat yourself to some in-person support.
Posted by Ian on September 23, 1999, at 17:52:39
In reply to Re: someone tell me what this is, posted by Noa on September 23, 1999, at 13:48:14
Thanks Noa, I dont want to undermine anyones coping strategies by attacking drug therapies all the time if they are totally dependant on them butas youknow there are many things that make me uneasy about psychopharm for me to ever be a great advocate of it. The important thing I guess is everyone keeps talking and has respect each other intentions and I feel around here they are generally pretty good. I'm glad we've agreed on some common ground. Its great I can sit one side of the Atlantic and most of you other folks on the other side and just band ideas about. I have to say however pyschobabble has its own addictive properties. I'm going to Egypt next Tuesday for a holiday and I think I may have a slight psychobabble withdrawal syndrome.If they have any internet cafes I'll give you a quick update
Ian
Posted by elle on September 24, 1999, at 7:47:34
In reply to Ian: much appreciated Noa, posted by Ian on September 23, 1999, at 17:52:39
> if this depression is dysthemia (spelling?) is that treated by medication and counseling. for the few months I've been on Celexa I have felt better. Does that mean you stay on meds forever? I feel the depression peaking through the meds now. Not everyday but more than I would like. I just hate feeling like this.
Posted by Ian on September 24, 1999, at 8:31:54
In reply to Re: now what, posted by elle on September 24, 1999, at 7:47:34
Elle whilst browsing I found reference to a suicide survivors support group that is for relatives of people or close friends who have commited suicide. To get involved you just drop them a line at suicide-survivors-request@research.canon.com.au
I know its not the whole story but I thought it might help,
Ian
PS the page I found it on was www.grohol.com/helpme.htm
Posted by Noa on September 24, 1999, at 13:15:48
In reply to helpgroup, posted by Ian on September 24, 1999, at 8:31:54
The medicine can help with the neurotransmitters but cannot help you learn more effective ways to cope with life, nor can it help you "process" all that has happened to you. I think a combo of meds and therapy is a good idea. I agree with Ian--a support group can be another solid corner of your "base of support", given that you have been through a specific type of loss that can cause very difficult grieving.
Posted by Bob on September 24, 1999, at 22:43:46
In reply to Re: now what, posted by elle on September 24, 1999, at 7:47:34
> Does that mean you stay on meds forever?
That really sucks, doesn't it? It took me a couple of years on meds for that to *really* sink in, and when it did it put me two steps from the edge. At the time (it wasn't that long ago), I remember my GP blowing sunshine up my butt (pardon my French) telling me not to think of this as a life sentence ... he gave me this very interesting little history lesson of the progress of medicine in the 20th century ... zheesh, and he's old enough to be my little brother, not my father!
For me, it was very disconcerting and disheartening to feel that settle on my shoulders, but it faded like most side effects of the medicines I've had to take. At worst, yeah, you'll be managing your mood with, among other things like therapy and sunshine and lvoing relationships, a variety of pills for the rest of your life. But really, that's not the worst of it -- you could be faced with your depression and none of those things to help you out. Who knows? Maybe my GP is right and sometime in the next few or ten years some whizkid in a college lab is going to brew up a magic pill for us all.
Even if that doesn't happen, and you spend the next 50 years, 70 years, whatever, taking meds to allow yourself to feel happy and to be involved with your friends and family ... don't you think that what looks so bleak right now will look pretty damn good in hindsight?
I guess what finally sunk in for me, seeing as how therapy alone was not doing me a bit of good, is this: the way things are, I can either be on meds the rest of my life or go off meds for the rest of my life. The choice lies in *how long* I want that "rest of my life" to be and "how well" I would like the time in between to be.
Be strong, elle,
Bob
Posted by Melanie on September 25, 1999, at 20:54:12
In reply to Re: now what, posted by Bob on September 24, 1999, at 22:43:46
I just caught this post because I have had trouble getting in lately, but wanted to respond, late or not!
I agree with the thoughts about dysthymia superimposed with a major depressive episode. I, too realized that I was dysthymic after meeting people who really were happy!!! In looking at my family history, I can definitely see the genetic loading--I think all the female members of my family are depressed! This is what I thought was normal growing up. I finally realized, as an adult, that what I thought was good just wasn't as good as what others seemed to feel. Good to me was just being okay. Now, with meds, I still have depressed times, but life in general just doesn't seem as hard anymore. The meds help me regulate my emotions more effectively and keep me from reacting negatively to every possible life situation that throws obstacles in my way.
I would agree that supportive therapy is just as important as the meds. Changing your biochemistry is only the first step in getting it all together! It is really liberating to feel in control of your emotions, and therapy will help you do that. By the way, elle, you may need to adjust your meds several times before you find the dosage that works for you.
Good luck to you in this journey!!!
Peace,
Melanie
Posted by Ian on September 26, 1999, at 16:18:45
In reply to Re: now what, posted by Melanie on September 25, 1999, at 20:54:12
I'm going to be contentious please don't be too abusive in reply.
One of the problems with taking meds is one doesn't know what the natural course of say depression or psychosis would have been anyway. Some may critcise and say well suicide may be the result but its a bit ironic that tricyclic ADs are no too uncommonly the agents used in succesful suicides admittedly SSRIs are much safer. If a boat gets a hole punctured in its side we can either fix the hole if we know were it is or just pump out the water.If we leave the hole it doesn't sort itself out it may just get bigger and keeps on letting in the water, we may need to get a bigger pump and every time the pump is switched off its not long before the boat starts sinking, instead of thinking about the hole we just say the boat is full of water and we need a bigger pump. Some people dont think the hole is fixable or exist even but I'm not convinced, like neglected maintenance on any 'machine' the eventual repairs need to be more extensive if things aren't nipped in the bud early.
I wouldn't resign yourself too a life on meds just yet, your father's death would still be a valid cause for grief at this point irrespective of everything else that has happened to you.
Posted by Bob on September 26, 1999, at 18:14:56
In reply to Re: now what, posted by Ian on September 26, 1999, at 16:18:45
Ian,
In the case of an isolated, acute episode of depression your course may well be the right idea. Rather than a sinking boat, think of a listing boat, blown nearly over to capsizing by some unexpected event. It may right itself on its own, or it may need a little behavioral nudge by the crew going "highside". Why mess with your brain chemistry if everything was fine a few months ago.On the other hand, I've been living out the course of my depression for 30 years now. How long should I wait for my sailboat to right itself?
[Come to think of it, part of me wishes your side of the argument would win out far more often in acute cases. I've had a couple of "Oh, I was on Zoloft, too -- you'll be just fine in a month or two" smug remarks from returned-to-normals who think they now have a keen understanding of what I have to face each day, and I still haven't come back with either a tasteful enough or sarcastic enough response to wipe the smugness right off their faces yet ;^]
Cheers,
Bob
Posted by Noa on September 26, 1999, at 20:31:30
In reply to Re: now what, posted by Bob on September 26, 1999, at 18:14:56
> Ian,
My experience , and there is a lot of it, is that letting depression "run its course" has led to increasingly recurrent episodes, more severe in nature. And this is with a lot of great therapy in which I developed a lot of insight and did make some changes for the better. But face it, there is no quick fix for the hole and I am approaching mid point of my life. For the better part of forty years, I have struggled with this, am I supposed to keep on working on understanding it in hopes that even more insight will alleviate the pain? I don't think so. Without medicine, I have too many times when I can't even make good use of the therapy. Ian, I am sorry you were traumatized by the experience of being put on meds at 13 against your will. But your experience does not speak to many of us who have been helped by meds. Frankly, I think you are speaking from some sort of idealistic position, in hopes of working through what happened to you. It just doesn't generalize as well as you think it does.
Posted by dj on September 26, 1999, at 21:33:49
In reply to Re: now what, posted by Noa on September 26, 1999, at 20:31:30
Good points on all sides. However it would be nice if some folks besides Ian who had some successes with a non-meds. approach would put in their views if they've had success. Unfortuntalely any such creatures arent' about, however if you look at my last posting in the book section I refer to an on-line book by Julian Simons a distinguished economist who claims to have beaten years of depression via a cognitive approach. So...meds are not necessarily the only answer...
> > Ian,
> My experience , and there is a lot of it, is that letting depression "run its course" has led to increasingly recurrent episodes,.. . Ian, I am sorry you were traumatized by the experience of being put on meds at 13 against your will. But your experience does not speak to many of us who have been helped by meds... It just doesn't generalize as well as you think it does.
Posted by Melanie on September 29, 1999, at 17:04:37
In reply to Re: now what ???, posted by dj on September 26, 1999, at 21:33:49
I just want to add a few points. It may be simpler to think of depression as a physical disease, not a "mental illness." I mean, if you were diabetic, you would be encouraged to try dietary changes and exercise first, perhaps. But then, if you were unable to control the disease without medication, it would be risking your life not to use it. I tend to think of depression in the same way--why live in a fog when there are alternatives? Depressed people are more likely to suffer illnesses, be less productive at work, and be poor parents. Why chance it?
My point is this--if you have been diagnosed with major depression, or even dysthymia, you may need to come out of the depths a little before therapy will work. At that point, cognitive therapy, as was mentioned by someone else, could be especially helpful. But, in my experience most people can't "will" themselves un-depressed, no matter how much they want to. They simply don't have the energy to fight it anymore!
So, I guess what I'm saying is that for an otherwise healthy person experiencing situational depression, such as due to grief, psychotherapeutic intervention may be all you need. But for ongoing, long-lasting depression that is pervasive, medication may be the impetus you need to clear your head enough to let therapy be effective. However, if you have been dysthymic and experience a major life stressor, like a death, then that could just push you over the edge. With the advent of SSRI's, there's no reason to be afraid to do a trial of medication to see if it is right for you.
Just a few more thoughts to add to the mix!
Posted by Dee on September 29, 1999, at 21:58:38
In reply to Re: now what ???, posted by Melanie on September 29, 1999, at 17:04:37
Melanie,
Words of wisdom.
Posted by Bob on September 29, 1999, at 23:37:16
In reply to Re: now what ???, posted by Dee on September 29, 1999, at 21:58:38
NAMI prefers "brain disorder" instead of "mental illness", and I find myself using disorder quite often -- I've got too much socialized ugliness tied up in "mental illness" to identify with it as something to wear on my outside, when talking with others about my condition (but the nasty voice in me does love to bring it up for a little intrapersonal torture now and then). Anyway...
Learning disabilities are generally considered to be brain disorders, not learned behaviors. All the same, LD children can be taught to get around their disabilities. One famous (in learning psychology, that is) example is how non-LD readers tend to (a) summarize what they read, (b) do self-tests on the material, (C) try to clarify what they don't understand, and (d) try to predict what will happen next in a story, and they learn to do this "spontaneously" -- they don't have to be explicitly taught to do so. Most LD children never pick up these skills on their own. All the same, they can be taught to use these skills successfully. It's not wishful thinking that makes them better readers. It's learning coping strategies that circumvent their biologically-driven shortcomings as thinkers.
The brain is an incredibly "plastic" thing. My dad had a stroke that took out his ability to read. He could speak, he could listen, he could even write with his still perfect elementary-school-teacher penmanship ... but five minutes later, he could not tell you what he had written. Still, at 65 years of age and with a few months of therapy, his brain rewired itself (without the aid of any learn-to-read medication) so that he *could* read again.
Cognitive therapy is more than wishful thinking.
Bob(not that I'd rely on it ... I think I know too much about how it works, so that nasty voice just has a field day sabotaging it ;^)
Posted by Noa on September 30, 1999, at 18:06:48
In reply to Playing the devil's advocate, posted by Bob on September 29, 1999, at 23:37:16
. All the same, LD children can be taught to get around their disabilities.
Just as with depression, it depends on the severity of the LD. Some can learn compensatory strategies that enable them to function ok, others don't do as well. Having spent lots of time around severely LD people, I question how generalizable that study is to more severe LDs.
Posted by Bob on September 30, 1999, at 19:40:23
In reply to Re: Playing the devil's advocate, posted by Noa on September 30, 1999, at 18:06:48
> Having spent lots of time around severely LD people, I question how generalizable that study is to more severe LDs.
Depends on how you are defining LD. Standard defn. is average or better IQ but with at least one identifiable cognitive deficit. In other words, functioning fine in all respects except for X. If you're grouping into LD folks with IQ<90 or so, then there is reason to question. Otherwise, the technique in the study (its called reciprocal teaching, for the educators out there who may be wondering what I'm talking about) has been replicated many times over. Turns out the technique works pretty damn well with regular kids, too.
But ain't that how it goes anyway? If you look at that list from NAMI of reasonable accommodations that have been held up in court, they are all things any GOOD supervisor should be doing anyway!
sheesh
Bob
Posted by Noa on September 30, 1999, at 21:11:28
In reply to Re: Playing the devil's advocate, posted by Bob on September 30, 1999, at 19:40:23
I'm talking about average or higher intelligence too, but the people I know have several areas affected by LD, not the classic dyslexia only kind of person, more like dyslexia, dyscalculia, dysgraphia, executive function disorders, auditory processing difficulties, etc etc. Having more than one LD complicates the situation exponentially.
This is the end of the thread.
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