[psisci]

There are more misconceptions about depression amongst patients, professionals and the general public than most other psychiatric diagnoses. Depression, like most other major psychiatric illness is caused by a mix of genetic tendencies and environment. This is why some people can have many, serious negative life events and recover normally, and why others have few if any and suffer recurrant bouts of major depression. Depression is not sadness, and is not grief, although chronic sadness and grief can contribute to developing depression. When people say " I am depressed today" they are probably meaning sad, down, upset. Once someone has an episode of major depression they are much more likely to have it again especially if the depressive episode was not put into remission by proper treatment. For a single episode of depression the APA calls for antidepressant treatment that results in near symptom free functioning for a minimum of a year before considering tapering the medication. When someone has a second episode, 2 years of symptom free medication treatment are called for, and a 3rd episode usually means someone will need to be on medication for life. The #1 killer of women is cardio-vascular disease, and the #1 predictor of death following an initial heartattack is "Depression".

Dr. S.

[(JD)]

Good posting! Thanks ((((Dr Wylie))))

[drunksunflower]

That's far too negative for my thinking.

Medication for life after three depressive episodes?

That probably requires most of PC to be drugged up forever.

Are you sure you don't work for Pharmac?

[heyjoe]

Well if i wasnt depressed before i sure am now. I would guess the result wouldnt be much better for men either.

[psisci]

No it's not, the numbers are similar. The point is that Depression is not a bad day, or even just a bad feeling, but a fully integrated biological disease that has serious consequences if it is not treated.

[Direction]

Doc - I think it is your bluntness that is scaring people - it might all be true, but...

[psisci]

I am summarizing the current APA treatment guidelines. I guess I assume it will not help people if I sugar coat it all.

[drunksunflower]

</font><blockquote><div id="quote"><font class="small">Quote:</font>
Direction said:
Doc - I think it is your bluntness that is scaring people - it might all be true, but...

</div></font></blockquote><font class="post">

No, I like that he is blunt.

It's better than me being told that ... I should get a rich husband and then I won't be depressed ... by a dr in real life.

I just find it a bit blanket.

Psisci can you give us a bit more explaination or justification?

Refs would be great.

[desperado]

Yep; a combo of nature &amp; nurture, as I see it.

Dr. S. said: </font><blockquote><div id="quote"><font class="small">Quote:</font>
The #1 killer of women is cardio-vascular disease, and the #1 predictor of death following an initial heartattack is "Depression".

</div></font></blockquote><font class="post">

Very interesting (but not surprising).

I think I'll be on anti-dep meds for the balance of the rest of my life. (In conjunction w/ regular psychotherapy). Really stinks, but what other choice(s) do I have? I have pretty much tried them all (that I am aware of).

Btw, I prefer you being blunt vs. sugarcoating...........the truth hurts, but deceiving us won't help, either I don't think.....

Thx.

Des

[Direction]

Maybe I need to clarify - I guess what you had to say scares me...

Facing the fact that I've been misdiagnosed, and actually have bipolar has me a bit on edge.

[drunksunflower]

i could get argumentative, but I won't.

Some people believe they can get past it by mind over matter.

Are you discrediting self-will, psisci?

Des: I would never take the viewpoint you do, to me it is giving up

[psisci]

http://www.psychguides.com/ecgs6.php

http://www.psychguides.com/ecgs5.php

http://www.mentalhealth.com/dis/p20-md01.html

http://www.psych.org/psych_pract/tre.../MDD.watch.pdf

[psisci]

http://www.psych.org/psych_pract/tre.../MDD.watch.pdf

[oksomaybeimnuts]

Thanks for posting this {{{{{{{{{Dr.Wylie}}}}}}}}
i'm going to print it out so i have it for those people to read who always wonder why i can't just pull myself back up and smile. great information to have.

[bellaviolet]

i knew about the genetics part.... depression runs in my family like i'm sure alot of others too.... but my "non-depressed" family members know about that too but still tell me often to just cheer up. some people i guess will never get it no matter how many facts you show them.
i've also had many "serious negative life events".... deaths in family etc..... but my depression began well before any of them. though these events definitely didnt help the situation. but it does seem a little extreme to say 3 episodes and automatically meds for life. kind of like 3 strikes you're out.

[drunksunflower]

The first thing I take from your articles is that you believe most female depression is related to hormones.

The second thing I take from your articles is that you reference things that are convoluted in themselves.

What I think would be wonderful is a psisci synopsis of what non-situational depression is.

You do have time, you had time to post those articles

Thank you Dr. S., at least you are making people here think. That is appreciated.

[psisci]

These are expert concensus guidelines, created by a group of nationally renowned experts in psychology and psychiatry. No, major depression is not really hormonally mediated in either males or females, but there are conditions that are, like thyroid dysfunction that can mimic depression, PMDD and post-partum depression. I agree wiht the APA's summary guidelines on treating depression, but it varies alot from person to person.

[drunksunflower]

There is no 'k' in 'renowned' and there is no 'k' in 'mimic' either.

Some people are fine with thyroid, they are female, and they don't have premenstrual dysphoric disorder because there is no coincidence with their cycle. They aren't old enough for older lady stuff, either.

How do you explain that?

[(JD)]

I think it might be important at this juncture to remember that there are plenty of hormones that regulate the human body, not just the "female" or "male" type. Many chemicals are actually hormones, though we tend to forget that.

I tend to agree with the findings especially about the third major relapse probably requiring life long treatment. Further study might convince the naysayers also. Of course, Dr Wiley is not discussing fits of the "blues" but real major episodic depression, I think.

[drunksunflower]

So Sky, you are saying people do not have real depression on here?

Me, for example, ive taken 3 days off work this week under guise of working from home, i cant handle ppl, i dont wnat to go out co sim a mess.

but i still manage to get my work DONE.

so i'm having blues. not depression. correct?

[psisci]

Very good point _sky, and it is very true. Hormones are the slow way our body regulates itself, but are much more powerful than the fast ways (IE. GABA, glutamate, eletrolyte transmission etc.) Hormones are like the cycles of the moon and sun as compared to seconds (mentioned above).

[drunksunflower]

This also seems to be a point of contention.

Someone who manages to go to work every day is not depression by DSM criteria, because there is supposed to be proper impairment in functioning.

If you go to work, you are functioning.

So then, it's just 'blues', not depression.

?

The DSM lists 4 levels of severity of depression...mild, moderate, severe and severe with psychotic symptoms. So one can have depression, and still work....depending on the severity.

Em

Can you explain this one sentence further?

The #1 killer of women is cardio-vascular disease, and the #1 predictor of death following an initial heartattack is "Depression".

So, someone who lives with depression, then has a heart attack has a higher risk of dying from the attack? So your point is that people with depression should ensure it's being properly treated....in case they have a heart attack?

Or are you saying, if I have a heart attack, I'd better be alert for signs of depression...cuz that someone makes me more at risk for? I'm lost.

Please don't read any tone into this post; I'm just trying to understand that sentence.

em

[drunksunflower]

</font><blockquote><div id="quote"><font class="small">Quote:</font>
emily4040 said:
Can you explain this one sentence further?

The #1 killer of women is cardio-vascular disease, and the #1 predictor of death following an initial heartattack is "Depression".

So, someone who lives with depression, then has a heart attack has a higher risk of dying from the attack? So your point is that people with depression should ensure it's being properly treated....in case they have a heart attack?

Or are you saying, if I have a heart attack, I'd better be alert for signs of depression...cuz that someone makes me more at risk for? I'm lost.

Please don't read any tone into this post; I'm just trying to understand that sentence.

em

</div></font></blockquote><font class="post">

I think he is referring to the co-morbidity of physical and psychological issues?

I don't know either

So ... I work. I am not as sick as someone who doesn't work.

That's the explanation I needed ... thank you