Intermittent depression...maybe...

[SilkRoad]

If you think you've had occasional low-level episodes of depression over the past seven years, interspersed with much happier times and also with non-"depressed" times but times when you've been lower than you probably should be...would you go to the doctor about it now?

I'm not quite sure what I'd say to the doctor. I had a checkup recently and a bunch of blood tests and basically everything is fine. I constantly have very low energy, though. I'm more prone to negative thinking than I probably should be and at least three times in the past seven years I've been thrown into dark periods which have lasted for months. I think the first one, seven years ago, lasted for well over a year and I should definitely have gone to the doctor over that, but I don't think I realised what I was in the middle of till later.

At the moment I feel...ok, but not terribly upbeat. I think I've gotten too used to feeling this way over several years. I've blamed it on stress and the cumulative effect of various difficult and unpleasant things happening in my life over many years...some of them 12 years ago or more.

I do seem to get sick (with colds, flus etc) an awful lot as well and lack motivation for things like my job (which is a pretty good one that generally I should enjoy) and activities with my church (very important to me as a general thing.)

I just don't feel that bad RIGHT NOW. It would have made more sense for me to go to the doctor to talk about depression in the spring, when I probably did have at least a low-level episode. I'm not that keen to go on meds either. I've had therapy a couple of years ago, but it wasn't for depression, it was for a phobia. I've never talked to a doctor about particularly feeling depressed.

I sort of feel like I should go to the doctor but it seems a bit weird to go and say "I think I've been depressed a few times in the past seven years, but probably not right now, and I'm a bit scared of the dark winter coming up, and I lack energy."

 

[Stanton Moore]

Try to develop an exercise habit that is easy enough that you are likely to keep it up. Jogging, cycling, fast walking are all good.

 

[SilkRoad]

Try to develop an exercise habit that is easy enough that you are likely to keep it up. Jogging, cycling, fast walking are all good.

I remember you mentioned exercise to me before... I do it intermittently but not nearly enough. I lack the motivation I know that's not a good excuse, but it's true. (I do walk fast a lot when I'm out walking, which is fairly often, but it's probably not regular enough.)

It's one of the things that sucks about being on my own. I have no one to motivate me. Or to help me motivate me. I notice even when I have a visitor from time to time that I get out of bed more easily in the morning.

 

[Stanton Moore]

I remember you mentioned exercise to me before... I do it intermittently but not nearly enough. I lack the motivation I know that's not a good excuse, but it's true. (I do walk fast a lot when I'm out walking, which is fairly often, but it's probably not regular enough.)

It's one of the things that sucks about being on my own. I have no one to motivate me. Or to help me motivate me. I notice even when I have a visitor from time to time that I get out of bed more easily in the morning.

I hear you on that. I prefer to drink beer, but it won't make me happy in the long run...I ran and cycled a lot over the summer, and got pretty fit in the process, but I've been on a recidivist slide into beer and pot since then, and my body is showing it, along with the concomitant depressive state that is my particular cross-to-bear.

 

[citizen cane]

A balanced diet can go a long way. Make sure you're getting adequate exposure to fresh air and sunlight, and make sure to mention any medications, supplements, etc that you take regularly however common and insignificant they may seem, as well as any dosage changes. Also, think about what wa or was not happening in your life during these high or low periods.

 

[SilkRoad]

Hmm...pot in particular will not help you with feeling depressed, from what I've heard...

I'm at least starting to eat better due to having become one of those annoying people who gets an organic fruit and veg box every week. It's a good start for sure, and easier for me to get into the habit than with exercise.

The doctor did applaud the fact that I was starting to eat better and suggested I get more exercise (also because I have some musculoskeletal pain in my shoulder/chest). I might need to actually sign on for Pilates or something - again, sometimes the only way to get myself to do something is to prepay for it.

I have definitely had episodes of depression though. The one seven years ago, in retrospect I have no doubt. I was crying all the time and feeling fairly hopeless. And the crying all the time etc lasted for more than a year. It was in the wake of a breakup. I couldn't sustain a positive mood for more than a few days. That was a long time ago and I have never had anything quite so bad, but I have had a couple of similar (though shorter and somewhat less severe) episodes. Including one earlier this year. They tend to be triggered by...disappointment of some sort (usually romantic!). I have tried to work on positive thinking and controlling my thoughts, as they trigger painful feelings and downward spirals, but there are times when it has felt nearly impossible.

I sort of told myself that if I have another episode even like the not-too-horrible-but-not-good one earlier this year, I should go to the doctor about it. But I'm scared to even contemplate another one of those, as they are so debilitating. And wondering if I should pre-empt it.

 

[SilkRoad]

A balanced diet can go a long way. Make sure you're getting adequate exposure to fresh air and sunlight, and make sure to mention any medications, supplements, etc that you take regularly however common and insignificant they may seem, as well as any dosage changes. Also, think about what wa or was not happening in your life during these high or low periods.

Thank you. I hope the improved eating habits will help (and having lovely vegetables arrive on your doorstep every week sure motivates you to cook at least decently.) The low periods have always had triggers. But it has seemed as though I have at those times gone very low in comparison to the actual event, which may have been unpleasant and sad, but not horrific.

Fresh air and sunlight are a challenge too... I live in the UK, where it gets very dark in the winter, and it tends to be grey a lot (I've also lived in the Pacific Northwest and in Ireland, where it's basically the same.) And I live in a big city with a serious lack of fresh air... It also means my stress levels are high.

 

[Stanton Moore]

Docs will just put you on meds.

 

[SilkRoad]

Docs will just put you on meds.

Yeah, that's what I'm afraid of. Although, I was impressed that when I came to them about a phobia, they sent me to a therapist instead of prescribing meds. In the UK you can get that free on the public health service - bless the NHS.

But then I wonder if I shouldn't just give in and take a low dose if they prescribed me that. I know friends who have been helped by it.

Basically I don't feel too bad about my life. It's just that I have had a few episodes that have scared me and been debilitating and I'm afraid to have another. And I do feel tired and lethargic a lot and unmotivated, but maybe the lack of motivation is just my own thing to deal with.

 

[Stanton Moore]

Yeah, that's what I'm afraid of. Although, I was impressed that when I came to them about a phobia, they sent me to a therapist instead of prescribing meds. In the UK you can get that free on the public health service - bless the NHS.

But then I wonder if I shouldn't just give in and take a low dose if they prescribed me that. I know friends who have been helped by it.

Basically I don't feel too bad about my life. It's just that I have had a few episodes that have scared me and been debilitating and I'm afraid to have another. And I do feel tired and lethargic a lot and unmotivated, but maybe the lack of motivation is just my own thing to deal with.

I was on meds for years, and it never really helped much. Side effects were fairly debilitating too. Now I'm trying to beat this little monster through therapy, and lots of it. It seems to be working a little, but only time will tell. Basically, confronting bad shit that happened at the dawn of my life is the goal, but I cant' remember a lot of it, so catch-22, in some ways. I'm going to try hypnosis as well, and ayuwasca in December. Might as well hit it from all angles...

 

[SilkRoad]

I was on meds for years, and it never really helped much. Side effects were fairly debilitating too. Now I'm trying to beat this little monster through therapy, and lots of it. It seems to be working a little, but only time will tell. Basically, confronting bad shit that happened at the dawn of my life is the goal, but I cant' remember a lot of it, so catch-22, in some ways. I'm going to try hypnosis as well, and ayuwasca in December. Might as well hit it from all angles...

I know friends who've had therapy for depression through the NHS, too. I think they were in worse shape than I am though so I don't know if they'd consider it necessary. I don't know if you have to look suicidal! The therapy I had was for a fear of flying phobia and I said I was afraid I'd get to the point of never being able to get on a plane again, so...

 

[highlander]

Docs will just put you on meds.

Ask for Buproprion. It's supposed to have fewer side effects.

 

[SilkRoad]

What kind of side effects are depression meds generally supposed to have, anyway? I don't know much about this. I mean, particularly as I'm not feeling too bad at the moment it is likely that the side effects would outweigh the benefits.

 

[Stanton Moore]

I know friends who've had therapy for depression through the NHS, too. I think they were in worse shape than I am though so I don't know if they'd consider it necessary. I don't know if you have to look suicidal! The therapy I had was for a fear of flying phobia and I said I was afraid I'd get to the point of never being able to get on a plane again, so...

So-called 'mild' depression can be worse than major depression, because it's insidious and longer lasting, so 'looking suicidal' or not should never be a criterion for treatment. If it's detrimental to you, it's best to work it out as much as possible, or more crying jags are in the forecast.
I'm feeling a little better in the last week, but I went through months of crying all the time, for no discernible reason. I would wake up in the morning, and BAM, start sobbing. Any little thing could set it off. I’d try to get it together, and go to work. I guess it’s a bit trying, this business of life, or so my volcanic emotional eruptions would seem to indicate.

 

[Stanton Moore]

What kind of side effects are depression meds generally supposed to have, anyway? I don't know much about this. I mean, particularly as I'm not feeling too bad at the moment it is likely that the side effects would outweigh the benefits.

Insomnia, agitation, impotence, dry mouth, racing heart, a few others. Some meds will make you fat, especially the older ones, some will make you lose weight.

 

[SilkRoad]

Insomnia, agitation, impotence, dry mouth, racing heart, a few others. Some meds will make you fat, especially the older ones, some will make you lose weight.

Hmm...

Actually, something that made me "fat" wouldn't be so bad (up to a point!) as I'm a bit underweight!

 

[Undeclared]

I remember you mentioned exercise to me before... I do it intermittently but not nearly enough. I lack the motivation I know that's not a good excuse, but it's true. (I do walk fast a lot when I'm out walking, which is fairly often, but it's probably not regular enough.)

It's one of the things that sucks about being on my own. I have no one to motivate me. Or to help me motivate me. I notice even when I have a visitor from time to time that I get out of bed more easily in the morning.

Engage in a sport that can be done alone or even with friends. Don't you have interests besides things that involve being indoors or completely still? If it's outside, fun, and your moving, then it doesn't matter what you do. You could take a friend along or just zone out and focus on what your doing.
Basically something to get you off your obtuse state of mind that entrails with irritability. It can be anything.

 

[SilkRoad]

Engage in a sport that can be done alone or even with friends. Don't you have interests besides things that involve being indoors or completely still? If it's outside, fun, and your moving, then it doesn't matter what you do. You could take a friend along or just zone out and focus on what your doing.
Basically something to get you off your obtuse state of mind that entrails with irritability. It can be anything.

I do walk a lot because I live in a city I love walking around, and when I get going, it can be for at least a couple of miles, briskly. I might not be doing so bad on the exercise side in that respect, but I should probably start keeping note of when/where to get a better idea.

 

[Stanton Moore]

Hmm...

Actually, something that made me "fat" wouldn't be so bad (up to a point!) as I'm a bit underweight!

It's hard to lose weight. Maybe you should stay at the weight you are?

 

[Lark]

I just don't feel that bad RIGHT NOW. It would have made more sense for me to go to the doctor to talk about depression in the spring, when I probably did have at least a low-level episode. I'm not that keen to go on meds either. I've had therapy a couple of years ago, but it wasn't for depression, it was for a phobia. I've never talked to a doctor about particularly feeling depressed.

I sort of feel like I should go to the doctor but it seems a bit weird to go and say "I think I've been depressed a few times in the past seven years, but probably not right now, and I'm a bit scared of the dark winter coming up, and I lack energy."

OK, first off remember that I'm no professional when it comes to medical illness so I'll have to majorly qualify my advice accordingly.

That said, I would ask what are your expectations of the Dr. why speak to them as opposed to anyone else?

Depression can be endogenuous, organic and a medical disorder but I suspect that you would have much less control and experience much more distress, very possibly you'd not consider yourself ill either, on the other hand it could be exogenous (I dont know if I'm spelling these terms correctly but I'm familiar with the concepts) or situational depression, which would be something which you could experience intermittantly, its much more commonplace and it would be suspiscious if in certain situations people dont experience it to be frank.

Endogenous depression would be caused by lesions on the brain or brain abnormalities or other disordered or abnormal hormonal or body chemistry, it can be symptomatic of something else, there was a lot of misdiagnosed depressive or bio-polar disease before diabetes was as well understood as what it is today but generally its not a consequence of environmental or situational triggers, either life space events or sensitivites to toxins or food stuffs.

Situational depression is caused by life space events, although some people are more susceptible than others, vulnerability can be a result of trauma, at any time, the over taxing of existing copeing strategies, the adoption of the wrong sorts of copeing strategies, such as avoiding or dodging problems which wont go away instead of properly identifying realistic solutions, or vulnerability which is organic/physical/medical such as injuries besides trauma, like abusing substances over a prolonged period of time.

Doctors are likely only going to tell you something like this and suggest pharmaceuticals which will counter any bio-chemical imbalances, they could prescribe rest or a period of sick leave from work or make a referral to some sort of therapist but that's it in all likelihood. Despite its history at a time medicine, even psychiatry, perhaps even particularly psychiatry, is very circumscribed when it comes to mental ill health, often if its inorganic and behavioural or emotional they dont want to know, its someone elses terrain.

Martin Seligman, who wrote about learned helplessness and learned optimism also wrote a book called What you can change, and what you cant, which is among one of the most objective assessments of mental health, medicine and therapy, to say that it is skeptical about the remedies which medicine and therapy can provide when what is being hoped for is in some way transformative would be putting it mildly. On the other hand he does suggest that with insight and foreknowledge, carefully considering triggers, patterns, consequences, some sort of realistic copeing could be worked out for the inevitable or at least expected tribulations.

On a different note, I've experienced this kind of thing, although I've experienced violence or challenges which could make it explicable sometimes (on one occasion a Dr. told me when I was experiencing chest pain I'd attributed to a flu or something that I'd experienced a number of assaults and perhaps just needed a vacation, he was willing to sign sick lines if that was what it took).

Anyway, I was convinced I was having a sort of good year, bad year cycle, at that time I read Bertrand Russell's Conquest of Happiness and it really helped, its not a self-help book, its not really therapy either, its not even really what I'd consider philosophy (unless in a sort of really practical, personal sense) but its a good book on the topic of happiness and misery, the most important thing I took away from it is actually in the title, happiness isnt a given, it can require struggle at times and effort. Medicine or therapy could help clear some obsticles or perhaps highlight what the obsticles are but it doesnt change that. At least not much.