Depression Talk

If you’ve been online for more than ten minutes, you’ll know that there is a lot of conflicting information on just about any medcial condition, especially depression. Anitdepressants have been especially targeted with misinformation campaigns. Just type in “how antidepressants work” in YouTube’s search function and you’ll come up with hours of detailed and empassioned explanations why antidepressants are the biggest con since W was declaired President in 2000.

Antidepressants are big business and I am no fan of Big Pharma, but there are synthetic medications made that can be life-saving. (Unaffordable medication is my beef with Big Pharma — not he quality of some medications like Prozac). Just because it’s made in a factory doesn’t mean it’s no good for you.

Prozac has been around so long that it now comes in generic form, fluoxetine. In fact, I’ve only taken the generic form and never the brand name, but “Prozac” is easier to say. If you have depression, post traumatic stress disorder or are going through a prolonged state of grief, then you may be prescribed Prozac.

So, here’s a little film made by Illumistream, which is one of the more reputable medical YouTube channels. It just gives a basic description of how Prozac works or how it works for many people.

However, I’ve never had a “state of well being” produced from Prozac, as mentioned in the film. All it did for me was regulate my appetite and sleep patterns. But for me, that was enough to get my body stable and really listen to and apply cognitive-behavior therapies.

Hope this helps.

The UK tested ten popular antidepressants for moderate to severe depression and discovered that, contrary to what a 2006 American study showed and what Big Pharma has been telling us, not all antidepressants are alike. Two anitdepressants did just a wee bit better than eight others — Zoloft/Lustral (sertraline) and Lexapro/Cipralex (escitalopram).

These will most likely be the first drugs now prescribed for UK depressives. If they don’t work, then they would move on to other antidepressants.

Study Specs

This superstudy was a massive one, following over 26,000 patients from 1991 - 2007. Basically, what it did was compile information from 100 other antidrepressant studies in that time period. It was just published last week in Britian’s premeir medical journal, The Lancet.

The other antidepressants (which seemed to then be rated in no particular order) Prozac, Cymbalta, Celexa, Ixel (minalcipram), Efexor, Luvox, Zyban and Seroxat/Paxil.

Zoloft and Lexapro won Best In Show based on three factors:

• Cost (gotta be generic)
• How bad the side effects were, including nausea, sleep problems and sexual whoopsies
• How well a depressive improves

But, the study warns that if you are doing fine on your current medication PLEASE don’t switch.

What This Means

Patients have been telling their doctors for a long time that not all antidepressants are alike and act on them differently. It had been assumed that any differences were slight or just a result of the quirks of an individual patient.

So, this study will probably do more change to how doctors prescribe drugs than to actually anyone who takes these drugs. But if you’ve never been on antidepressants and have just been diagnosed with depression, then hopefully this will shorten the trial and error time of finding new medication.

Hope this helps.

Yet another in the “did they really need to do a study on that” department:

According to the UK’s National Health Services (NHS), the group of people in the UK with a spike in depression are middle-aged women. The study stops in 2007 and mostly compared numbers from 1993. It id d not give a total number count or take into account the total rise in the UK’s population from 1993 - 2007:

• For UK women aged 45 - 54, one in four will have a diagnoseable depressive illness. That’s up 21% since 1993.
• For UK women aged 55- 64, there was a 4% increase from 1993.
• 20% of all UK women, any age, had a diagnoseable depressive illness.

The study also notes that middle-aged people were most likely to commit suicide.

It’s A Man’s World

UK men also had a rise in depression numbers, but not very much. Of course, men may not seek treatment as much as women. The only group of men who had a rise in numbers were those who had just gone through a divorce. Those who had a divorce years ago, however, were peachy keen. (Very small joke there).

However, it is far easier to get prescription medications like antideprssants in England than it is in America. Also, getting to see your primary doctor is less expensive than in the America. A British man is not so proud or so daft as to ignore getting available help as an American man would.

Is It Just In the UK?

The numbers coming from the NHS reflect a global trend. Of course, in some countries, a woman can’t say she is depressed. She says she has a stomach ache or some other physical symptom. But in America, according to a CBS news report, more middle aged women are depressed than ever, or at least, are willing to admit it.

At middle age, you feel the pressure to make something of your life before it’s too late. By the time you become a senior, you realize making something of your life really doesn’t matter and you set about making the best of the time you have left. Well, that’s my opinion anyway.

According to a new study from the University of Toronto, all that’s needed to reduce postnatal depression by half is a good, long heart-to-heart chat. The study suggests the chat could be with a nurse, but also could be from another woman who survived pregnancy and childbirth. This heart-to-heart didn’t have to be face-to-face, but could be done by telephone.

Of course, a 100% way to prevent postnatal depression is not to get pregnant, but that blatantly obvious fact was not addressed in the study.

How The Study Worked

The study followed 701 Candian women through the web from their late term stages until 12 weeks after giving birth. The study noted that they originally has 21,000 pregnant women volunteer, from which they selected the 701 that fit the criteria as high-risk for getting postnatal depression. Just what are they doing in Canada, eh? (Sly wink).

Some of the 701 recieved the usual postnatal care while some others received phone calls referred to as “peer support”. About 80% of this group said they were satisfied with the peer support they were given and would recommend it to a friend. Certainly, there must be more things to do in Canada other than get pregnant.

About Postnatal Depression

All kidding aside, postnatal depression is a serious problem in women. Perhaps the most famous woman in the world who suffered from this was Brooke Shields. But, according to the BBC, one in ten women who give birth develop postnatal depression.

The ususal way to treat postnatal depression is with antidepressants under the care of a doctor or gyneologist. The symptoms can last from a few weeks until two years after the birth. Many women with postnatal depression won’t seek treatment because they don’t think they can be treated.

If you go into the hospital suddenly, you will still need to be on your antidepressants or whatever class of medication you need to take for your type of depression. A hospital is a very confusing place, and even more confusing if you are ill and disoriented.

So, when a nurse comes with your medication and calls it by another name, you can’t help but wonder if you are getting a generic version of the brand name you are used to hearing or getting the wrong medication. You’re not overrreacting by wondering if you are getting the wrong medication. Mistakes happen a lot, no matter what country you live in.

To give you one less thing to worry about when you’re at the hopsital, here’s a conversion list of popular brand name antidepressants and their generic names. This list is geared more for American readers, but I’ve tried to include Canadian or UK names when I find them. If I miss a name, feel free to admonish me and I’ll make a correction later. Hope this helps.

Elavil and Trypitzol: amitryplaine
Asendin: amoxipine
Wellbutrin and Wellbutrin XL: bupropion
Celexa: citalopram
Anafranil: clomipramine
Norpramin and Pertofane: desipramine
Prothiaden: dosulepin
Adapine and Sinequan: doxepin
Cymbalta: duloxetine
Lexapro and Cipralex: escitalopram
Luvox: fluvoxamine
Prozac: fluoxetine
Tofranil: imipramine
Marplan: isocarboxazid
Ludiomil: maprotiline
Remeron and Zispin: mirtazapine
Serzone: nefazodone
Aventyl and Pamelor and Allergron: nortryptaline
Paxil and Seroxat: paroxetine
Nardil: phenelzine
Vivactil: protriptyline
Zoloft or Lustral: sertraline
Parnate: tranylcypromine
Desyrel and Molipaxin: trazodone
Sermontil: trimipramine
Effexor or Efexor: venlafaxine

People with depression are often encouraged to learn how to manage their stress through non-chemical ways like light exercise, yoga, creating some art or meditation.  The point of mediation is to give your racing thoughts some rest.  Eventually, you can learn to slip into a meditative state of mind even in moments of stress.  Meditation isnt a substitute for medications, but it certainly can make the medications work more effectively.

For people in the West, meditation can be a pretty mysterious thing.   Trying to figure out what you are to be doing can be pretty stressful.

First Step: No Expectations

When you hear the world “meditation”, what image comes to mind?  Probably sitting in the lotus position admist clouds of incense for hours on end.  But I think that’s too limiting.  I think we all meditate every day without realising it.

If you ever get really caught up in something so that you loose all track of time, that can be a form of meditation.  Fully keeping your mind and sense in the present moment can be another form of mediation.  And, sitting on a pillow in the lotus position contemplating your navel is another form of meditation.

Don’t worry about getting it “wrong”.  Just keep on meditating.

The Dalai Lama

Surprise, suprise — I can’t mditate in the lotus position.  I can’t count my breaths or stare at a candleflame or any of the popular methods used in Mediation 101.  But I can concentrate on one thing at a time, when need be.  I think one way I do this is when watching any video of the Dalai Lama.  There’s something about him that’s captivating.

So, for mediatation practice, just sit and watch the video and try to do nothing else.  Hope this helps.

Finally, I found a book that would be of help to people with depression.  Well, I’m cheating a little when I write that — I read this book when I was homeless in England, and I’ve rediscovered Life and How to Survive It this January.  Although published in 1993, the information still holds true today.

Yes — THAT John Cleese

 The book is a sequel to the best-seller Families and How to Survive Them (1984), but it’s not necessary to read that book in order to understand this book.  But it is a good idea to be familiar with who John Cleese is and what the stereotype of the British stiff upper-and-lower-lip is in order to grasp some of the ideas and the humor.

The other partner in crime is psychologist and psychotherapist Robin Skynner (who, sadly, passed away in 2000).  Suffice it to say that he was a very intelligent man who listened to his patients and was open to ideas.  He was also John Cleese’s therapist for many years.

The Set Up

The book is set up like a conversation written in script form that lasts for over 400 pages.  (Well, the English do like to talk).  This can be off putting, because there’s not a lot of white space to be easy on the eyes and makes organiazing ideas a little difficult to go back and find.  There are many summaries per chapter, though.

There are also a lot of really good cartoons by Bud Handelsman, but you generally have to read the text around it in order to get the cartoon’s gist.  They do help to break up the monotony of the page format.

Summary

Although the book is long, heavy and not very funny, there are a lot of ideas presented which can help people with depression see themselves, love and life in a better perspective.

Eli Lilly has been a BAAAAAAD company

Eli Lilly, maker of the antipsychotic drug Zyprexa, has agreed to pay $1.42 billion in a settlement over how they marketed Zyprexa in September 1999 to March 2001.  Eli Lilly sent out significant advertising materials and promotions to doctors using a fictious senior pateint named Martha.  Her problem?  Not being able to sleep well and having some trouble remembering things. 

However, Zyprexa is not approved for use in treating dementia or Alzheimer’s.  Also, Zyprexa in the elderly is reported to increase symtpoms of seniors with dementia getting a stroke. 

Whoops.

If You’re Not A Senoir, Don’t Worry

If you aren’t over 60 and have been prescribed Zyprexa for anxiety or depression, then you really don’t need to worry if you are taking the drug unnecesarily.  What Eli Lilly did here was promote an off-label use for their drug. 

Asking your therapist or doctor “What is this drug?  What is it for?”  is always a good idea.

Off Label Uses of Drugs

Many doctors do prescribe drugs for off-label uses.  I’m on one, verapamil, which is approved for lowering high blood pressure but not approved for what I take it for — migraine prevention.  In one sense, it is up to the doctor to make the decisions in prescribing medications for their patients.

However, the marketing for drugs to doctors has been amazingly intense, although this has died down in the last couple of years, but certainly could swing a doctor’s decision to choose which brand-name medicines to prescribe.   

It is possible that Zyprexa (or any other antipsychotic) will no longer be prescribed to anyone over 65, but I haven’t been able to find anything to back up that rumor.

Keep in mind that a lot of people with mental illnesses have been helped with Zyprexa.  If you have any concerns about Zyprexa or any medication you are taking, please contact your doctor or therapist.

Oh, great. I have a hard time remembering names as it is, because depression can make your concrentration fuzzy and now the self-help mental health program I’ve touted on this blog recently is undergoing a radical name change. A few years ago, they had a minor name change from Recovery, Incorporated to Recovery International but this name name change is a whopper — RI will now be (drumroll please):

Abraham Low Self-Help Systems.

Why the Name Change?

RI — no, wait, I guess it’s ALSHS now — has been vague on why the radical change of names and eventually, overhaul of the website. Even long-time members (like my Mom) are still scratching their heads over the decision from the Chicago-based headquarters. Most of the long-term members that I’ve talked to (oh, about five) say they are going to ignore the name change and call the group meetings “whatever they darn welll feel like”.

There is one possible reason for the name change — the word “recovery” does allude to addiction recovery, rather than recovery from anxious thughts and being a prisoner from your depression symptoms. Sooner rather than later, an alcoholic or drug addict wanders into a meeting, not realizing what it’s all about.

Other Groups With Recovery In The Name

There are many non-profit (and for-profit) organizations that use the word “recovery” in their name. These include:

• Christian Recovery International: This is a faith-based addiction program with another for vicims of abuse. Abraham Low Self-Help System is not affiliated with any religion and discourages any talk of religion or politics at the meetings.
• Abortion Recovery International: clueless fools who have no lives, so they have to browbeat others into feeling bad about theirs in order to feel morally superior. That’s my opinon. I’m pro-choice and anti-organized religion, if you can’t already tell.
• Crisis Recovery International: which includes a variety of service projects, including mental health help.

Why do we have depression? And I don’t mean about serotonin levels or bad childhoods or anything like that, but why would our bodies bother to make such a crippling disease in a large percentage of the population? What evolutionary advantage is there is having the most powerful species on the planet that get major depression or bipolar disorder?

Is The Planet Striking Back?

There’s one theory that mental illnesses is the way nature tries to reduce the human population. I’d try to find a link to this theory, but I’m too depressed to bother. We all have a lot of junk DNA in our cells that seemingly does nothing except wait around for circumstances to be exactly right before they kick into gear. Perhaps depression is a junk gene that kicks in only when the human population in a given area hits a certain point.

I don’t buy that theory, promarily because depression has been around for centuries (and possibly millenia) although it was called other names like melancholy or ennui. Just look at William Shakespeare’s most popular plays, Hamlet, and you see a textbook description of someone suffering from major depression.

Yet the human population has grown rather than shrunk after all of this time.

Evolution In Action

Another problem is that evolution doesn’t always make a species better in any way. Evolution does a lot of experiments and perhaps depression is one of those experiments. Some species have somehow hung on for millenia for no real known reason, such as the coelacanth, which is on the verge of extinction after 300 million years. I wonder if they’re depressed.

Could depression make some people better at survival skills or having empathy with others? I have no idea. What do you think?

Depression is a deadly disease. Most people with depression will act suicidal at one time or another — although not to the extreme that this poor sod does. He probably thought that killing himself was his only alternative. One thing that depression and the down phase of bipolar disorder does is that it severely narrows your decision-making process so that you can’t see any of the choices around you. And if you are affected by other symptoms of depression like sleep deprivation, chronic aches and pains and all-encompassing fatigue, then your thinking processes are even more narrowed.

Depression is like putting horse blinkers on so that you can only see one direction and not everything else around you.

Many depressives make wrong life choices in diet, exercise, sleep and chemicals that don’t kill you as quickly as a plunge ten feet from the edge of Niagra Falls. They wind up killing themselves in a far slower fashion than this fellow did.

I did do some Internet research tryng to discover who this fellow was, if he left a note behind or if his body was ever found, but I haven’t been able to find anything. Niagra Falls is so powerful that a body can never be found, such as with the case of a stunt gone wrong when, in June 5, 1990 a man named Jesse Sharp paddled over the edge in a kayak. His kayak was found, but he wasn’t. It’s thought he wasn’t trying to commit suicide, because he had dinner reservations for later that night.

In other words, if you feel depressed, get help. And don’t go to Niagra Falls.

I don’t remember a time when I haven’t been depressed. I wasn’t diagnosed with major depression (then called clinical depression) until my late teens, but I believe I was born depressed. There is controversy whether or not children get depression in the same way adults do and if children are misdiagnosed with major depression or bipolar disorder. But now there are some studes from both sides of the Pond about children and depression.

It Starts At School

A British study that lasted 40 years concludes that children with behavioral problems at school grow up into (surprise, suprise) adults with behaviorial problems and problems in just about all areas in their life, including depression. The study looked at 3,500 kids-now-adults. They were first observed between the ages of 13 - 15. They were then interviewed about 40 years later.

The study theorized that the most important factor in determining if a child is going to grow up a troubled adult is if they have behavioral problems at school. They say this is more important than genetics, home life or social class.

What To Do?

One way to help a child deal with depression or other problems is to not criticize them all of the time. Giving some praise and encouragement can help, even in the apocalyptic battleground that is school. This is according to a study conducted by the University of Missouri. They study followed 474 first graders for six years. The study hints that one of the reasons kids do poorly in school and act up is because they hate themselves. Giving them some encouragement can help them not hate themselves so much.

Personally, I think we should just get rid of school altogether. We don’t give schools enough money to try and do a decent job, so why bother? Let the kids run wild for a couple of years and maybe then schools will repopen with the funding they so desperately need.

I’m going to go out on a limb here and announce that I hate panic attacks. I hate them so much I’d sue them if I could. I’ve just gotten over my last panic attack a couple of hours ago with some TLC from my Mom and a gift of a Tramadol.

Really Big Warning

Do not do what I did and pop a pill that was not prescribed for me. I was desperate and I was willing to risk death in order to stop the panic attack and my migraine, which had been going on for about fifteen hours. Tramadol is a whopping massive painkiller, usually given to people with chronic arthritis, chronic back problems or people recovering from surgery. It’s an opiod painkiller and also can sedate you silly.

About My Panic Attacks

I get panic attacks when I am in physcial pain. Getting beat up triggers them; having stomach flu triggers them or having a migraine for more than twelve hours. This is not to be confused with people diagnosed with panic attack disorder (PAD) or even general anxiety disorder (GAD). That’s basically when you have panic attacks even though you are not in pain or facing imminent threat of being in pain. And please don’t quote me on that, because I’m on tramadol. Right now, I’m transfixed with the symmetrical differences between a semi-colon and an apostrophe.

This Ain’t Good

Although I’m very glad that the panic attack and the migraine have finally come to an end and I have able to actually get some work done today, I am a bit sorry I had to resort to begging for drugs from my Mom. Must go back to reading the Dalai Lama.

(THUD)

Continuing where we picked off from yesterday, why would Gentiles get the assumption that Jews are the most depressed people in the world? And how have Jews handled depression when they do get depressed? Remember, I’m not Jewish (at least, not that I know of), so I’m not exactly an expert on Jewish culture, although I am a big fan of many Jewish comedians.

Cultural References

Depression used to be called melancholia. Figures in Jewish folk history such as King Saul and King Solomon were described as having melancholia. Sigmund Freud, the father of psychoanalysis, cigar afficianado and who treated depressives, was Jewish. In literature and plays such as Fiddler on the Roof, and movies by Woody Allen, Jews are depicted as being gloomy and pessimistic. Even the Yiddish word “kvetch” is used in American slang for “complaining”.

More Specifics

In Jewish culture, men and women are encouraged to express their true feelings to friends and family members, whether those feelings are happy or depressed. Jewish sons are expected not to keep any secrets from their parents, especially their mothers. Jewish men also have the responsibility of sitting shiva (a time of mourning) for one week after a close relative has passed. Part of the holiday Yom Kippur is observing ten days of atonement for one’s sins. In Jewish culture, (not just those who practicve Judaism) individuals are urged to remember the history of the Jewish people and their oppression from genocide to pogroms.

Turning Depression Into Laughter

Many popular comedy writers and comedians have been Jewish, including George Burns, Sid Ceasar, Woody Allen, Carl Reiner, the Marx Brothers, Jerry Seinfeld, Richard Lewis and Mel Brooks. Comedy has been a part of Jewish culture for centuries as a way of dealing with depressing events and times. Much of what is called “Jewish humor” is self-deprecating storytelling, with lots of physical humor that can make the comedian look ridiculous. Absurd and humorous situations can be found in the Torah as a teaching method.

Melancholia — now called depression — is a disease and not a cultural affliction. Clinical depression is thought to be caused by chemical imbalances in the brain. Stressful situations can intensify the symptoms of depression. Please don’t use this article in the place of a doctor’s diagnosis.

Off to collapse now. (Thud).

In doing research for another client, I discovered that some people — even educated people — believe that Jews are more depressed than people from other cultural backgrounds. I’m not Jewish (at least, not that I’m aware of) but I had a feeling that the belief that Jews are the most depressed people in the world was not a correct one. Personally, I vote for Native Americans being the most depressed people in the world, but that’s just an opinion.

With the extreme persecution that the Jewish people have gone through over the centuries, it is no wonder that they are thought of as being naturally depressed. Symptoms of depression are more allowed to be shown in public than in some other cultures, which may give the appearance that most Jews are depressed.

Any Studies Done?

According to a 1999 study published in The Academy of Psychosomatic Medicine (”Vulnerability of Jews to Affective Disorders,”), there is no difference between the amount of depression in Jewish women and in any other religion looked at (including Christianity). But the rate for depression among Jewish men was twice as high as in any other religion. The study’s authors concluded that drinking alcohol was the reason for the high incidence of depression among this group, not their Jewish heritage or religion.

Influence of Alcohol

However, Jewish men have a low rate of alcoholism, 2.8% compared to non-Jewish men’s rate of 14%. The study inferred that many non-Jewish alcoholics were depressed but didn’t go to the doctor for help and thus chose alcohol for self-medication. Perhaps Milton Berle put it best when he said, “Jewish men don’t drink much because it interferes with their suffering.”