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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by zonked on June 12, 2011, at 10:57:12
Have been thinking about this a lot lately...
Prolonged, chronic depression = retreat from normal social interaction -> deterioration of confidence/social skills -> now, you've got depression PLUS social anxiety/panic disorder.
I was trying to think in my case, which came first? Definitely the depression.
-z
Posted by Phillipa on June 12, 2011, at 11:05:03
In reply to Can prolonged depression cause SAD/panic D/O?, posted by zonked on June 12, 2011, at 10:57:12
For me it's the opposite not even sure if depressed just down from pain from old age medical issues. Phillipa
Posted by floatingbridge on June 12, 2011, at 19:21:59
In reply to Can prolonged depression cause SAD/panic D/O?, posted by zonked on June 12, 2011, at 10:57:12
zonked,
Such excellent questions. I think SAD, social phobia, and panic disorders can existence on their own. I still don't understand the SP.
However, just about everyone would agree that the above left unchecked can and arguably will lead to depression.
All those tentative statements aside, yes, depression unchecked will lead to a myriad complications on every level.
Right now you've posted that you are being undertreated due to red tape AND you have major life stressors. That can very very likely invoke panic responses in anyone.
Regarding the SA, my hunch is that it will abate once your depression is adequately treated. And, I feel and hope, the panic will too.
Right now the gap between what you know you can do and where you are at is large and largely out of your control. Plus a loved one of yours is ill. Who wouldn't panic? So many factors are out of your hands.
I expect you to respond most excellently to Nardil. Put that statement in the library shelved and cross referenced to depressive and maladaptive.
Reread as often as necessary.
You'll be better soon.
Hang in there! We and I are pulling for you.
fb
Posted by jedi on June 13, 2011, at 3:12:17
In reply to Can prolonged depression cause SAD/panic D/O?, posted by zonked on June 12, 2011, at 10:57:12
> Have been thinking about this a lot lately...
>
> Prolonged, chronic depression = retreat from normal social interaction -> deterioration of confidence/social skills -> now, you've got depression PLUS social anxiety/panic disorder.
>
> I was trying to think in my case, which came first? Definitely the depression.
>
> -zHi z,
In my case I'm pretty sure the social anxiety predated the major depression. Actually, looking back, I suffered from social anxiety and dysthymia since my teenage years. The major depression followed much later in life. As a teenager I had severe rejection sensitivity, which is one of the diagnosing criteria for atypical depression. I really wish I would have been treated early in life for these disorders. Maybe, if it could have been nipped in an early stage I would not have had to go through the major atypical depression. I believe that social anxiety is under diagnosed and under treated. It can be debilitating and can affect all aspects of a person's life. From the choice of a mate to a choice of career. Huge impact on a life!I know the clonazepam is hard on you, but in my case, I believe it reacts synergistically with Nardil to help with my social anxiety and atypical depression. They both affect GABA, and this seems to be one of the keys to effective treatment of social anxiety.
Live long and prosper - no, that's Star Trek! May the Force be with You!
Jedi
Posted by floatingbridge on June 13, 2011, at 8:35:39
In reply to Re: Can prolonged depression cause SAD/panic D/O? » zonked, posted by jedi on June 13, 2011, at 3:12:17
Jedi,
I have often wondered about the term rejection sensitivity. It gets thrown about during the diagnostic process. So it can be treated in children you think?
I had it because I remember times of feeling intense mortification over otherwise insignificant events.
Now I ask because I 'sense' it in my child. He's not shy at all--chatting up strangers--and yet, often taking insult where none was intended, or suddenly collapsing in
embarrassment. He's 7. We /I coach him through this gently. Yet, is there an age (if this does not dissipate) when professional treatment would take place? What would be the treatment of choice in your opinion?
And regarding zonked, are you saying rejection sensitivity as a child = a 'more permanent' SA? If he hadn't suffered before, it is likely to abate? Yes?P.S. Klonopin works well for you with Nardil? Whew. Is that only with Nardil (in your case, of course)?
Thanks,
fb
Posted by jedi on June 13, 2011, at 14:39:38
In reply to Re: Can prolonged depression cause SAD/panic D/O? » jedi, posted by floatingbridge on June 13, 2011, at 8:35:39
Hi fb,
I don't think I'm going to be much help on this one. I do know that clonazepam affects GABA with or without Nardil and is used to treat social and generalized anxiety. The SSRIs are first line with Paxil being the most studied.
http://www.ncbi.nlm.nih.gov/pubmed/19238127
http://www.ncbi.nlm.nih.gov/pubmed/17092192
http://www.ncbi.nlm.nih.gov/pubmed/12607230
http://www.ncbi.nlm.nih.gov/pubmed/11801236
http://www.ncbi.nlm.nih.gov/pubmed/11206035I have not studied therapy on children at all. I'm always looking for signs in my 17 year old daughter, since depression and anxiety disorders are in both sides of her family. Here a a few full length studies.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2806488/?tool=pubmed
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2925835/?tool=pubmed
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2789287/?tool=pubmed
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2737677/?tool=pubmed
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2694921/?tool=pubmed
http://www.cnsspectrums.com/aspx/articledetail.aspx?articleid=375My best guess is that short term social anxiety related to depression would have a more favorable prognosis than someone who had suffered years with social anxiety since childhood. This disorder can affect a persons life in so many ways. Long term social anxiety would obviously affect so many decisions on the direction your life takes.
Mostly my opinion,
Jedi
Posted by floatingbridge on June 13, 2011, at 17:00:16
In reply to Re: Can prolonged depression cause SAD/panic D/O? » floatingbridge, posted by jedi on June 13, 2011, at 14:39:38
Jedi, thank you so much :-)
I have lots of reading ahead!
I didn't know you were a dad. Hope your girl is doing fine. You, too.
fb
Opinions most welcome.
Posted by phillipa on June 13, 2011, at 19:27:08
In reply to Re: Can prolonged depression cause SAD/panic D/O? » zonked, posted by jedi on June 13, 2011, at 3:12:17
Hi Jedi long time no talk. Love Phillipa
Posted by Questionmark on June 16, 2011, at 19:08:01
In reply to Can prolonged depression cause SAD/panic D/O?, posted by zonked on June 12, 2011, at 10:57:12
Very good question. And one i've surprisingly never thought about (only the opposite). But i think yes, definitely.
Posted by Questionmark on June 16, 2011, at 19:18:01
In reply to Re: Can prolonged depression cause SAD/panic D/O? » jedi, posted by floatingbridge on June 13, 2011, at 8:35:39
You bring up some really good points.
Yeah, when i was a kid, i was very boisterous and outgoing, yet i was still extrEmely sensitive, and easily embarrassed and what not (even compared to most children of course).Sorry i can't advise on therapy for him (although I would strongly advise doing everything possible to avoid pharmaceutical intervention in children), but i would say this. It might be beneficial to see a good psychologist yourself so he/she could give you advice on how best to get your son to be less "rejection-sensitive." Maybe he/she would say that joking around with him in certain ways could be helpful. I'm not sure.
I do think "coaching" him in this as you said, is a great idea though. If you can try to get him to understand that people often say things or make jokes that seem hurtful or embarrassing, but are not intended to be, that might be able to help him too.
> I have often wondered about the term rejection sensitivity. It gets thrown about during the diagnostic process. So it can be treated in children you think?
>
> I had it because I remember times of feeling intense mortification over otherwise insignificant events.
>
> Now I ask because I 'sense' it in my child. He's not shy at all--chatting up strangers--and yet, often taking insult where none was intended, or suddenly collapsing in
> embarrassment. He's 7. We /I coach him through this gently. Yet, is there an age (if this does not dissipate) when professional treatment would take place? What would be the treatment of choice in your opinion?
>
>
> And regarding zonked, are you saying rejection sensitivity as a child = a 'more permanent' SA? If he hadn't suffered before, it is likely to abate? Yes?
>
> P.S. Klonopin works well for you with Nardil? Whew. Is that only with Nardil (in your case, of course)?
>
> Thanks,
>
> fb
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