Depression : State of mind or Medical condition

Apologies Dimple for critting you with the wall of text + 5!

I think GPs over-prescribe pretty much everything (I could have murdered some of them for antibiotic usage sometimes). But I feel in the time they have allocated to them with the resources they have available to them and with the variety of conditions they have to see then they have little choice but to do so sometimes. They would be damned if they did nothing. I do think medicating depression is a valid method of treatment for some people. I do not believe it is an absolute treatment though. I do believe the quality of GPs is highly variable - this we all know.

There is a problem that mental health has a lot of hangovers from "bad" (I mean lacking in an evidence base) practice going back to the whole mind-body duality thing. A tendency for practitioners traditionally to ignore the physical and genetic and overemphasise the environmental. Ironically then only treating the opposite way around.

Mental-health also suffers from the stigma associated with it and rather than challenge that practitioners have often found strength in that and promoted a strong political lobbying force. So there are lot of professional and scientific politics involved. This will have a knock on effect on patients, what is seen as valid treatment, what is even allowed to be researched etc. Thankfully this problem is decreasing. But care is compromised in patients with mental health problems due to unsound professional lobbying.

There is essentially a battle going on as we speak professionally between an old guard and a new guard shall we say - we even now have conditions that may have been labelled as mental health a few years back now falling under the remit of neuropsychiatry ie people are accepting the new ideas of the mechanics driving these conditions. Such a rapidly changing field is something no GP can get a hold on and therefore in the main I would expect most competent GPs would refer on now at the earliest opportunity and only instigate treatment themselves when they have a clear indication to. They have the name general for a reason. But then that is far from simple let me explain a bit further with an example;

Xordium: Hello Mr GP I am feeling a bit down - well to be honest I have been sleeping a lot lately very deeply not really moving you know when you wake up and well your arm is dead and you get pins and needles. I am not eating so well either and just getting angry with people. I am feeling really low but I don't know just don't seem to care just tired just want to lie down feel dizzy confused flat head just feels dull and my eyes all blurry. Just unhappy

Now what would you say to that - sounds depressed maybe I mean that may be your first thought. Unless you like neurology then maybe the pins and needles and the blurry eyes and dizziness would spring out at you and you'd think - stroke ... multiple sclerosis ... transient ischemic attack. How about if you like endocrine type stuff or renal then maybe you'd be thinking diabetes etc. And all the other types of doctor would draw something different out of that of those few words.

Now a poor GP has to guess the right route. But here is the kicker if that GP then refers on straight away what do you think all those other doctors will do - do you think the neuro chap will look at for diabetes or do you think he'll order an MRI straight away wasting resources and time to diagnosis.

So what we may have is a best case system.
 
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would someone who has been diagnosed with depression take a moment to tell me a little what it's like with day to day things such as getting out of bed, general appearence self grooming, eating habits etc i understand it may differ individually but would it be unfair to class it as a feeling of ''i can't be bothered, what does it matter?''

also, is it a case of feeling like having nothing to look forward to that makes you depressed and feeling like you're stuck in a rut?
 
cm1179 said:
would someone who has been diagnosed with depression take a moment to tell me a little what it's like with day to day things such as getting out of bed, general appearence self grooming, eating habits etc i understand it may differ individually but would it be unfair to class it as a feeling of ''i can't be bothered, what does it matter?''

also, is it a case of feeling like having nothing to look forward to that makes you depressed and feeling like you're stuck in a rut?
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Getting out of bed: It feels like much more effort than usual. When out of bed, the day will be full of things that I struggle to cope with (including simple stuff like interacting with people) or else I will be hiding away anyway. So staying in bed seems appealing.

Appearance: Seems less important. Do not really think about it as much due to muddled thinking and general apathy.

Eating: Genuinely reduced appetite much of the time anyway. Less motivation, especially if it means dragging myself out of bed during a particularly bad spell.

And it is more complicated than feeling stuck in a rut. For me, I feel emotionally deadened and even good things often fail to register. On the flip side, it does often make me calmer in a crisis but also all too indecisive to make much of a contribution (less so if I am having an agitated day).
 
DangerMoose said:
Getting out of bed: It feels like much more effort than usual. When out of bed, the day will be full of things that I struggle to cope with (including simple stuff like interacting with people) or else I will be hiding away anyway. So staying in bed seems appealing.

Appearance: Seems less important. Do not really think about it as much due to muddled thinking and general apathy.

Eating: Genuinely reduced appetite much of the time anyway. Less motivation, especially if it means dragging myself out of bed during a particularly bad spell.

And it is more complicated than feeling stuck in a rut. For me, I feel emotionally deadened and even good things often fail to register. On the flip side, it does often make me calmer in a crisis but also all too indecisive to make much of a contribution (less so if I am having an agitated day).
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so in your experience depression makes you more emotionless than over emotional?
 
paradisiac said:
so in your experience depression makes you more emotionless than over emotional?
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That is typical for me, yes. But if too much happens to drag me out of my all too teeny, tiny comfort zone, it does sometimes turn into a more agitated state where I can go to pieces over nothing. So I am not sure if the emotionless thing is more my brain's way of trying to batten down the hatches and avoid stuff it can't deal with.
 
DangerMoose said:
That is typical for me, yes. But if too much happens to drag me out of my all too teeny, tiny comfort zone, it does sometimes turn into a more agitated state where I can go to pieces over nothing. So I am not sure if the emotionless thing is more my brain's way of trying to batten down the hatches and avoid stuff it can't deal with.
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so do you try to detatch yourself from whats going on around you? like your not really there/involved (emotionally i mean, not like a crazy person that thinks their life is a dream :p)
 
DangerMoose said:
That is typical for me, yes. But if too much happens to drag me out of my all too teeny, tiny comfort zone, it does sometimes turn into a more agitated state where I can go to pieces over nothing. So I am not sure if the emotionless thing is more my brain's way of trying to batten down the hatches and avoid stuff it can't deal with.
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i really appreciate your openness and honesty and i hope i haven't or don't offend but i am trying to relate. we all have down days but i understand depression is completely different.

i hope you don't mind my ignorance in asking this but can you still feel uplifted by music or laugh at a film ie you want to put the song or film on to recieve that feeling or is there no effort to want to put it on as you don't want the feeling'? or say a comedy film is on tv, do you become engrossed in the comedy or would it not register?

i understand i haven't worded that in the most tactful way and i hope i don't sound too condescending or intrusive. i would just like to know a little more...
 
DangerMoose said:
Not necessarily consciously trying to do so but yes, I do feel detached from things.
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thats really interesting. does this make relationships (including with friends and family not just partners) really hard to have. i mean, do people distance themselves from you (or do you push them away) because of this apparent lack of emotion from you?
 
cm1179 said:
i really appreciate your openness and honesty and i hope i haven't or don't offend but i am trying to relate. we all have down days but i understand depression is completely different.

i hope you don't mind my ignorance in asking this but can you still feel uplifted by music or laugh at a film ie you want to put the song or film on to recieve that feeling or is there no effort to want to put it on as you don't want the feeling'? or say a comedy film is on tv, do you become engrossed in the comedy or would it not register?

i understand i haven't worded that in the most tactful way and i hope i don't sound too condescending or intrusive. i would just like to know a little more...
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That is OK. I guess I have opened up a little more than I intended to here anyway.

I do put music on that I like, though the effect ends to be more distracting or sometimes soothing. Uplifting music does not seem to register so much and some things I used to like tend to grate on my nerves so my tastes have changed somewhat. Less things make me laugh and the effect is usually short lived and superficial but I do still find things that get through. Oddly, sometimes laughter feels a little uncomfortable and alien. Sometimes I feel like I am just watching to kill time and the emotional content does not really register.

And yes, I am about as much fun to be around at the moment as I probably come across here.
 
paradisiac said:
thats really interesting. does this make relationships (including with friends and family not just partners) really hard to have. i mean, do people distance themselves from you (or do you push them away) because of this apparent lack of emotion from you?
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Yes. I can tell this causes frustration in those close to me and it sometimes feels like they are avoiding me. Others, I think they just do not know what to do so keep a respectful distance. Written communication is definitely easier though. Can't you tell?
 
DangerMoose said:
Yes. I can tell this causes frustration in those close to me and it sometimes feels like they are avoiding me. Others, I think they just do not know what to do so keep a respectful distance. Written communication is definitely easier though. Can't you tell?
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so you dont find people try to over compencate by trying to get emotion out of you, they tend to distance themselves?

yeh, i believe written communication can sometimes be the best way to get your thoughts out, without having that feeling people are judging you.
 
With regards to drugs, they are a useful crutch sometimes (to help people start to overcome problems) but they can also be over relied upon.

I think depression falls in with a lot of other symptoms - low self esteem, stress etc, which all have effects on the individual, and they get grouped together. For example not feeling part of a group may just be you don't feel valued because of self esteem issues, it doesn't mean you're depressed.
 
DangerMoose said:
I do put music on that I like, though the effect ends to be more distracting or sometimes soothing.
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i remember when i split from a girl i loved (nearly 10 yrs ago now) and i was in a very low place for a while and music was the one thing i really found sanctuary in and the most confusing thing of all was i couldn't work out whether i was depressed or not.

the one thing that helped was the thought in my brain that was telling me to snap out of it and look to the future. in my own (unqualified and slightly naive way) that was the only thing that confirmed to me that i wasn't depressed and was simply on a low and feeling sorry for myself. is that the difference, the fact that there is nothing telling someone who is diagnosed as depressed, having that little inkling to kick themselves up the arse and know that the feeling will go?

i apologise for my bluntness and lack of tact, i mean not to offend if i have.
 
paradisiac said:
so you dont find people try to over compencate by trying to get emotion out of you, they tend to distance themselves?
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I think part of the problem is that the person I am around the most, my wife, tends to be picking up the slack a lot when it comes to looking after our son so she is occupied and gets stressed a lot. But when we are alone, there tends to be some attempts, as if she can just snap me out of it. I wish that she could.
 
DangerMoose said:
I think part of the problem is that the person I am around the most, my wife, tends to be picking up the slack a lot when it comes to looking after our son so she is occupied and gets stressed a lot. But when we are alone, there tends to be some attempts, as if she can just snap me out of it. I wish that she could.
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the thing that intreges me, is you clearly know you have a problem, you dont want to have the problem, but its still there.
like others have said, they feel they are not depressed as they have a wanting to snap out of it, but so do you. so what makes some people pick themselves up, and what stops others?

(i dont mean any of that in a partonising or offensive way)
 
cm1179 said:
i remember when i split from a girl i loved (nearly 10 yrs ago now) and i was in a very low place for a while and music was the one thing i really found sanctuary in and the most confusing thing of all was i couldn't work out whether i was depressed or not.

the one thing that helped was the thought in my brain that was telling me to snap out of it and look to the future. in my own (unqualified and slightly naive way) that was the only thing that confirmed to me that i wasn't depressed and was simply on a low and feeling sorry for myself. is that the difference, the fact that there is nothing telling someone who is diagnosed as depressed, having that little inkling to kick themselves up the arse and know that the feeling will go?

i apologise for my bluntness and lack of tact, i mean not to offend if i have.
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I don't know. I do have urges to try things to drag myself out of it. Resurrecting old hobbies I had lost interest in, trying new tv programs, films and music. It may be that there is something out there that will work and I have just not found it yet. I think when I have had milder bouts in the past there has been things to boost me out of it but this time I have sunk deeper than I can ever remember and nothing has worked so far. I guess part of the challenge is for one stringing enough thoughts together to formulate a plan to cheer myself up and, for another, to maintain interest in it for long enough to have a chance of working. A lot of the time I simply cannot focus on things for long. At worst, even reading a paragraph in a book results in me practising my thousand yard stare.

And if anyone reading this is thinking "just pull yourself together", I can assure you this is a thought I have a lot as well.
 
paradisiac said:
so what makes some people pick themselves up, and what stops others?
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What makes one person move forward with their life after an amputation and what makes another fall into the situation some people on here describe. Motivation, capability, possibility along with support structures amongst a whole load of other things. Once again you are looking a symptom - depressed mood -that can have a variety of causes. The causes will often dictate how well someone can change that mood.

What is positive though is that a number of people have described, in this thread, how they are feeling and people are wanting to understand and most importantly do accept. That is a significant shift in perception and comprehension by society.
 
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