I've read many of the posts here for a while, and wonder if I have clinical depression -- and if I do, what is it? Can it be cured without my being sent off on a lithium holiday? I'm very leery of drugs because I work in a highly creative field and don't want to risk losing my meal ticket: My creative edge.
Please don't tell me that it stems from childhood sexual or physical abuse or parental alcoholism, which is a strain running through many of the replies and seems to be the answer de jour. There wasn't any in my family: No drinking, no beating kids or wives, no boozy aunts wanting me to take a bath with them, no odd men in the park showing off the surprise in their pants to me.
I'm also unaware of any depression in my immediate family, so I don't think this is something I inherited or absorbed from the environment. But I've been depressed for most of my adult life. The periods when I'm not depressed are becoming fewer and fewer, and farther and farther apart. Is there anything I can do about it? I don't think therapy will be of much good -- thanks to my selfless generosity scores of therapists have been able to send their children to some of the best private schools in the country. Psychiatrists, psychologists, and mumbo-jumbo artists: I've seen them all, and still go through these deep, and prolonged, bouts of depression. I end up feeling worse then when I started because, at the beginning, I have some glimmer of optimism that this time I might be "healed." But when, after six months or 16 months, nothing is any different, I end up feeling worse than I did when I dove onto the couch. So, I climb right off, figuring that I'm wasting their time and my money; after all, if I'm going to feel miserable anyway, I don't have to pay serious money to feel badly about myself -- I can feel that for free.
The latest episode has lasted almost four years and has robbed me of my self-esteem, my interest in anything around me, my interest in sex (and you can imagine how many girl friends that's cost me over the years). I'm terribly afraid of everything. I don't drink, don't do even mild drugs such as grass, don't overeat (in fact, I only eat one meal a day or I gain weight). I don't sleep very well, but that's nothing new either; even when I was a kid and teenager, I didn't sleep well. I'm not married, thankfully, so I'm not making someone else endure my miserable life, and I've cut myself off from friends or people in the office other than for work because I know I wouldn't want to be around anyone who has as many problems as me. So, here are my questions: 1. What is clinical depression? 2. Do I have it? 3. Can it be cured without drugs? 4. Why is therapy so helpful for some people, and so totally useless for others like me? 5. Should I just figure out some way to accept the fact that, whammo!, I'm one of those unlucky people who will always be depressed and stop whining about it. In other words, should I just get on with my life or get over my life?
Dick - 39 year old man Philadelphia PA
It sounds as if you have really been through it. At the end of this e-mail I explained the different types of depression and their symptoms. From your e-mail, which didn't list a lot of specific symptoms, I can't pinpoint the specific type, but to have depression that long it really has to be clinical depression and probably of a chemical nature.
There are only possibilities for why. First I would make sure that you rule out any medical problems. Diabetes, hypoglycemia, or a thyroid condition could cause feelings of depression. A good medical workup would be helpful as the body and the mind are really one. It sounds like the prominent feature is really psychological, but it makes sense to be thorough.
There are only a few reasons a person gets depressed. The choices are medical, situational, hormonal, trauma, or chemical. Often several are involved in a cluster. Sometimes it can be cured without drugs. For therapy to work you have to have an accurate diagnosis. At that point it is extremely personal. Therapy works when the clinician and the client match extremely well and when both are motivated to make it happen. That can be hard to find. Also some techniques tend to work with one client and not with another. We are all extremely different.
Many types of depression can be alleviated by simple talk therapy, but for depression to go on for many years it is almost certainly chemical and for that to occur there really has to be a hereditary base. I understand that you don't see it in your immediate family, but it has to be somewhere in your family tree.
The popular belief is that psychotropic drugs dull your senses and put you in a fog. My experience is quite different. When someone needs medication they are already in a fog and if you have a good clinician they will find the exact type and quantity that will bring a person back to their best self without undue side effects. If that can't be done then medication just can't be used. It sounds like your solution will at least have to be in part anti-depressants.
My usual tendency is to treat the whole person in a holistic fashion, but when medication is needed it makes sense to use them. There are several other techniques that I would like to mention. I usually use a combination of these in my practice and have found it helpful. Investigate EMDR, NET, TFT, and Hypnosis. They are all quick, painless, and natural. I would also go to chiropractor/acupuncturist who is familiar with Applied Kinesiology. I would ask them to evaluate you for vitamins and supplements that could help as well. I hope this has been helpful to you.
Jef Gazley, M.S. www.asktheinternettherapist.com
Some more info about depression:
There are many types of depressive disorders, the three most common being Major Depression, Dysthymia, and Atypical. These different types share similar symptoms, and the feelings of being very sad and hopeless. They vary, however, in length of condition and severity. There is also a distinction made between Situational Depression, which comes about due to life stresses ~ and Endogenous Depression, which is caused by a low amount of neurotransmitters. (brain chemicals) This is, to a large degree, usually genetic.
Symptoms of depression are:
- Sad mood / poor affect.
- Lack of interest.
- Up or down weight fluctuation.
- Insomnia or sleeping excessively.
- Feelings of worthlessness and hopelessness.
- Problems with short- term memory.
- Lack of concentration.
- Feeling suicidal.
Major depression needs five of these symptoms with no time limit, whereas dysthymia needs to have a two-year duration, but only two of the symptoms. Dysthymia is a more chronic condition whereas major depression is more acute.
Depression, regardless of type, is usually treated with psychotherapy (counseling), and, if serious enough, with medication. The medication is called an anti-depressant and works on the neurotransmitters. They include Elavil, Triavil, Imipramine, Prozac, Paxil, Zoloft, Anafranil, Luvox, and Effexor.
The medication often needs to be taken for 9 months to 2 ½ years and some people need to take them for their entire life. They are all rather safe, but sometimes have side effects like all medications. These include dry mouth, anxiety, headaches, weight fluctuation, and temporary sexual problems such as lack of libido (desire).