[scorpiosis37]

I'm not sure if I'm depressed. I've been seeing my T almost 3 years, she knows me extremely well, and she doesn't think I am. She says the fact that I'm feeling "down" right now is situational. She may be right, but I'm not 100% sure. It's true that I've never been diagnosed with anything and I agree with T that I don't have distorted thinking, I've never been suicidal, I've never acted out, I've never been unable to function. The reason I started therapy was because I was getting out of a 5-year relationship and wanted someone to talk to. I stayed in therapy because I like having a supportive outlet and I like the relationship I have with my T. I also go through periods of time when I'm happier and periods of time when I'm less happy, like most people do. I'm also more of an introvert; I have friends, I go out, I love being in small groups of close friends, but I don't really like big, anonymous social gatherings. I'm friendly and get along well with most people, but I'm not a "social butterfly" and it takes me awhile to make close friends. But, when I do, they're a friend for life. I still have a few close friends in every city I've lived in, as I've moved to attend different universities for each of my degrees. My best friend in the world-- who's been my best friend since we were 16-- still lives in my hometown, which is 2,000 miles away. We talk every day, but it's not the same as having him here. My best friend in my current city is in a relationship and our friendship has changed since her relationship got more serious; she has less time for me, though we're still very close. I am, however, feeling like my social life is somewhat lacking. I'm around people, I have friends, I go out and stay active-- but it's not particularly satisfying right now. I don't feel as close to my friends here as I did before we all got in relationships and drifted a little bit-- trying to recover that connection hasn't been as easy as I hoped. Work is going well for me; I just finished a big project that I feel great about. However, when I was busy working on the project I was happier; now that it's over, I feel a little sad. Yes, I have another big project to work on, but I'm not as passionate about it. I often have the pattern of feeling a little down whenever I finish a big project because I have the time to sit and think about how I feel. When I'm busy, I'm so focused on the project that I don't have time to think about how I feel. Stuff with my family (all out of state) has also been a bit challenging lately (refer to b-day thread), but it isn't awful. Nothing about my life is awful; I'm just not happy. The social stuff is probably what has me down the most. That feeling like you're with people, but you're not 100% connected, so you just feel more alone. And I don't always feel that way. Last night, after I finally did go out for my birthday, I actually had a great time. But, after I got home, I started feeling down again. So I'm not sure if how I feel is "normal" or if I'm depressed. I'm not sure if I should just keep doing what I'm doing, and talk to my T, or whether I should ask to see a pdoc. I've never seen one. I'm not sure if I need to, because I'm perfectly functional-- I'm not in any kind of danger. I'm just kind of down. I'm not sure if it will naturally go away on its own, or if it's something that is worth visiting a pdoc about. I'm not sure if I would ever consider trying an anti-depressant or not. I don't think I NEED one, but maybe trying one would be helpful? I really don't know. Any thoughts?

To add: My biggest concern about seeing a pdoc or trying a med would be the fact that I have some (physical) health problems and I already feel like my doctors don't listen to me or take me seriously. The fact that I ask them questions, pursue second opinions, and "do my homework" rubs them the wrong way. They've already tried to tell me that maybe some of my problems are "in my head"-- so the last thing I need is to give them reason to believe that I DO have problems "in my head." And just in case you are wondering, my health problems are very much real; you can't fake tumors showing up on an MRI! The struggle I have is getting them to believe/ do anything about the constant pain. Just because I go to work every day and am able to function (on non-narcotic pain meds) causes them to believe I must not really be in that much pain. Since when is being strong and fighting through the pain to try and live a "normal" life a bad thing?

[Bill3]

Well, one way to think about whether you are depressed is to consider the list of criteria for a diagnosis of a major depressive episode. They are here:

http://www.mental-health-today.com/dep/dsm.htm

[scorpiosis37]

Originally Posted by Bill3

Well, one way to think about whether you are depressed is to consider the list of criteria for a diagnosis of a major depressive episode. They are here:

http://www.mental-health-today.com/dep/dsm.htm

Thanks! I read the link. I have 4 of the symptoms. It says you need 5 to qualify. That feels right. I'm really close, but not quite there. So what can I do?

[Bill3]

Well, you already have a T. Can you approach her with this new information? Perhaps you could talk with her about how she treats people who are definitely, clinically depressed and think about whether any/some of those steps make sense for you. I presume that one thing she always considers is referral to a Pdoc, so that could be part of this proposed discussion.

[feralkittymom]

Honestly, you don't sound depressed to me. You're an academic, yes? We tend to ruminate and perhaps over analyze everything, I think. If you were clearly depressed, you wouldn't find enjoyment in the things that you do enjoy. There's a hopelessness and a helplessness that is profound and ever-present in depression, even in someone who is managing to function. At least that was how I felt.

That said, there may be something going on at the initiation of action stage, that prevents you from taking the actions more pro-actively that you know will result in your finding enjoyment. Whether that's something to treat with meds, I don't know. There are ADs though that have been used primarily to treat chronic pain, so that's also something to think about.

We do tend to live in an age and culture that I believe artificially boosts our expectations of what happiness looks like. We seem to have pathologized the normal ebb and flow of emotions into disorders that must be treated. I live overseas, and I don't find this attitude to be so prevalent.

[likelife]

I agree with feralkittymom that it doesn't sound so much like depression as it does a kind of persistent dissatisfaction with life. For what it's worth, I think the research says that antidepressants aren't all that effective for mild depression. Therapy tends to trump meds under those circumstances.

If you've got chronic pain, though, I wouldn't rule out the effect of that on your mood and your felt capacity to engage with others and in life. I would think that the effort of fighting through the pain would take a great deal of energy, leaving you somewhat depleted emotionally and otherwise.

To me it sounds like a perfectly normal reaction to whats going on in your life. I don´t know if you set really high standards for yourself both academically and personally? We all feel alone, tired and sad sometimes. It´s not a medical disorder it´s called being "HUMAN".
However: As I don´t know anything in details as to why you question being depressed and why you have physical pain, I would run this over with your T ( again) and a GP.
Some AD´s do target certain types of pain, as others have said. A medical doctor will be able to advice you. Also I would ask why they don´t want to provide you with more pain relieve. Not being taking seriously with a " pain" issue can inflict more pain. Usually it´s good to have an in detail explanation of why they choose to treat you the way the do. Maybe they have some other suggestions to offer.

[Nightlight]

What about dysthymia? I am capable of feeling happy, but tend to experience long periods of dissatisfaction. When I saw a psychiatrist that's what I was diagnosed with, despite the fact that I think I easily fit the criteria of major depression at most times. The psychiatrist thinks I experience episodes of major depression on top of dysthymia.

In my experience, medication is less effective for treating more persistent and lower levels of unhappiness, than it is for some of the more extreme symptoms of major depression. I'm still relying on therapy to help me with that the most, but it is a very slow process.

All in all, your description of how you feel does sound like a normal reaction to challenging situational factors. Not that that makes it easier to cope with, of course!

[scorpiosis37]

Originally Posted by lonelybychoice

To me it sounds like a perfectly normal reaction to whats going on in your life. I don´t know if you set really high standards for yourself both academically and personally? We all feel alone, tired and sad sometimes. It´s not a medical disorder it´s called being "human".
HOWEVER: As I don´t know anything in details as to why you question being depressed and why you have physical pain, I would run this over with your T ( again) and a GP.
Some AD´s do target certain types of pain, as others have said. A medical doctor will be able to advice you. Also I would ask why they don´t want to provide you with more pain relieve. Not being taking seriously with a " pain" issue can inflict more pain. Usually it´s good to have an in detail explanation of why they choose to treat you the way the do. Maybe they have some other suggestions to offer.

Thanks, lonely. As for the physical health side of it, I have a horrible neurologist but my insurance will not allow me to switch to someone else (I tried, over and over). Since my insurance is through the University I work for, I'm restricted to doctors at the University and, once you've been assigned, it's virtually impossible to switch. This doctor's online reviews back up everything that I've complained about (and he has been reported to the board, but the claim is still open). He is completely sexist and thinks all women are "hysterical" and that all of our problems are "in our head." He refused to give me the follow-up MRI HE recommended and he refused refill the prescription HE said I should be on consistently. In fact, I didn't think about this until now-- but maybe my mood issues are related to chemical withdrawl? I've been on a pain med that says "do not stop taking abruptly; you must decrease slowly"-- but my doctor refused to refill the prescription, even just enough so I could taper off safely. So, I've gone from taking 6 pain meds a day to none. The issue is that I have several benign brain tumors and several ovarian cysts, but my biggest physical complaint is neck pain. My x-rays show that I have a pinched nerve in my neck, but my doctor doesn't seem to believe that the pinched nerve is actually causing me any pain, or that the brain tumors could be contributing to the pain. Because my neck is so sensitive to touch that my clothes irritate it (and therefore I don't wear clothes with high necks), my doctor's genius response is that I must have a pyschological issue with clothes touching my neck-- and therefore, all of my pain is not real. Obviously, not true. I would love to wear clothes with necks-- it's cold where I live and I have so many cute sweaters-- the problem is that the rubbing against my neck HURTS. Everyone in my life (my family, friends, T) have all seen me curl up in pain, and have never doubted anything. My GP does not doubt me either, but her hands are tied. She tried to get me in to someone else, but my insurance won't let me. Anyway, my neurologist referred me to a biofeedback therapist-- I went, he evaluated me, and determined my pain is physical, NOT psychological-- and sent a report verifying this to my neurologist. However, he did not read it, only saw that I did not return to the biofeedback guy, told me I was non-compliant, and refused me the MRI and medication. I even had the biofeedback guy call the doctor's office on my behalf, explain that HE told me not to come back because I don't need biofeeback, and still, my neurologist refused to listen. He refuses to treat my neck (or monitor my brain tumors), so the only help I'm getting now is from a chiropractor. And, for the last 5 days, I've had no pain meds, either. I have a gyno who is monitoring my ovarian cysts, but she can't remove the one that really hurts without also removing my ovary. I already had surgery to remove one on the other ovary, which damaged the ovary, so they don't know if it's fully functional anymore. Since I want kids, I won't let my doc remove the other ovary unless I get to the point that I'm in so much pain, I just can't take it anymore. (That's another reason why I probably come across as having time pressure around marriage & kids. I want kids sooner rather than later, because I don't know if there will be a "later" to have biological kids). Okay, that's way more info on my medical stuff than you needed but-- well, that's what it is.

[Sila]

To be honest it sounds like he's basically doing 'medical malpractice'. I'm not sure what you'd be comfortable doing with that, but something has to be done if he's not treating you right.

[sunrise]

Originally Posted by scorpiosis37

I'm not sure if I'm depressed. I've been seeing my T almost 3 years, she knows me extremely well, and she doesn't think I am. She says the fact that I'm feeling "down" right now is situational.

It sounds like your T doesn't believe depression can be caused by life events and stressors, which is not true. Many people get depressed over life events, i.e. they have "situational depression"--I don't like that term myself. This causes changes in brain chemistry, and medications that act on neurotransmitters such as serotonin and dopamine, as many antidepressants do, can often be helpful in these cases.

Originally Posted by scorpiosis37

Thanks! I read the link. I have 4 of the symptoms. It says you need 5 to qualify. That feels right. I'm really close, but not quite there. So what can I do?

I'm not sure why having 4 symptoms instead of 5 would make a difference in your approach. Work on the things in therapy you want to work on, such as feeling more connected to people. If you want to consider medication, go see a pdoc for an assessment. Does it really matter if you have the exact criteria for major depression or dysthymia or social anxiety disorder, or whatever? You can focus in therapy and with a pdoc on what you want to change without having diagnosis A, B, or C. FWIW, many people visiting a pdoc the first time get broader diagnoses such as Mood Disorder NOS, Depressive Disorder NOS, Anxiety Disorder NOS, etc. It's not like you have to have a diagnosis of Major Depression in order to be helped by either type of provider.

Perhaps of relevance: I take a very low dose of a medication for ADHD that is commonly used to treat Major Depression: Wellbutrin. Even though I am not depressed, this medication not only helps with my ADHD but with my overall mood and outlook. Just a little bit of extra dopamine is something my body and mind seem to do well on.

I hope you will find a new neurologist.

Sorry to hear about your physical symptoms and they way this neurologist is treating you. No one should put up with something like this. I get really angry on your behalf. Since I don´t know what meds you were on six times a day it´s hard to say if this plays a part of your mood now. Hopefully you haven´t had any psychical withdrawel symptoms. To be refused a refill just like that and not being properly informed can take it´s toll on even the strongest of people. Not to mention the neck pain and the overian cyst issues and wanting to have kids sooner rather than later.
You really do have a lot going on.

I don´t know anything about U.S. health issurance, but if possible I would definately seek out a second opinion. Or perhaps even pay for it myself.

I have seen patients being on strong opoids or struggling with over the counter meds for years, because they got the wrong kind of treatment. AD´s and other types of meds as already written in other posts may help. Again your gp should be able to inform you.
The way you descriebe your neck pain and not being able to wear turtle necks is really " interesting". Meaning a qualified medical pain specialist maybe able to " put the pieces together" to give you the treatment you need and give you proper info.
So seriously..Don´t settle for less when it comes to pain issues ( too)

Pretty much just repeating what´s already been said. Also the fact that it´s normal to have an human emotional reaction to all of this.

[Bill3]

I second lonelybychoice's idea of considering (if possible) paying for some (more?) of your care under discussion here yourself so that you are free to choose your own neurologist.

[Ike McCaslin]

Mis-managed health care sucks. I would see if your T can evaluate you for dysthymia, it's a possibility. As to the finishing projects and feeling down, Walker Percy likened finishing a novel with a type of post-partum depression. He claims it is common in the creative process to feel depressed after you complete something you invest yourself so heavily in. My .02 cents.

[sconnie892]

I would chime in with asking t about dysthymia also. It took my t a year to come to that diagnosis for me.

I am sorry you are dealing with insurance red tape and some poor health care professionals. It may be worth looking into the insurance laws in your state. (Assuming you live in the US?) At some point if refusal to cover things becomes a "quality of life issue" you might have enough sway to get them to cover it. And as someone who just went through an less than acceptable doctor's appointment, I say don't be afraid to complain about your neurologist. It can be scary to call a professional on his/her behaviors and practices, but remember that you deserve the best care you can get.

[Anne2.0]

Originally Posted by sconnie892

It may be worth looking into the insurance laws in your state. (Assuming you live in the US?) At some point if refusal to cover things becomes a "quality of life issue" you might have enough sway to get them to cover it. And as someone who just went through an less than acceptable doctor's appointment, I say don't be afraid to complain about your neurologist. It can be scary to call a professional on his/her behaviors and practices, but remember that you deserve the best care you can get.

This is great advice. I would go one step further and recommend that you see a medical malpractice lawyer for a consultation. It may cost you $200 or so (although many lawyers offer a free first consultation). Seeking a consultation doesn't mean that you have a file a lawsuit or do anything legally, but it might help just to find out what legal action you may be able to take.

Sometimes in university towns, the university buys up many attorneys with little contracts, so that some firms and lawyers can't even deal with people employed by the university or on the university's health care system (conflict of interest). If your university is not in the biggest city in your state, look for an attorney in the biggest city. Otherwise, calling your state bar association for a referral might be useful.

Scorpiosis....It sounds like you have a full plate right now and any combination of a few of those issues would make anyone seem depressed. I also have seen experiences when a large project is completed, a certain amount of let down in the following weeks. I have friends who from time to time will take an anti depressant for 6 months or so, as life is not always easy or fun and it helps to balance them. The medication route could be easily handled by a Family Physician and utilized for a short time span. I agree with the others, maybe a second opinion out of pocket on the neck pain. Perhaps a complaint letter to your insurance company or University HR as to how you are not feeling adequately cared for by your current physician and you would like to request a different one... Good luck.

[EeyoreSmile]

I'd just like to chime in that in my case, my depression has never stopped me from being functional. I meet all of my work, social, family and volunteer engagements every week without fail... Some days I hate waking up in the morning, dread driving there and relish days when I can just lie around. I have some more extreme symptoms than you Scorpiosis, but I do think that with all of those things going on you should consider your focus shifting for a while in therapy... And with your birthday having happened, and the holidays and the new year, this can be a stressful time for a lot of people, and that can be addressed without a diagnosis.. my shrink has never given me a diagnosis... but we work on the mood, the thoughts, the patterns and some of the stress I put on myself.

i also feel the same way as you do with accomplishments.. I realized that my life is very accomplishment driven and I am fully functional because more and more obligations keep me from dealing with my feelings and myself. I think it could be difficult to cope with especially if it's new for you to feel this way.. work with your T to decide what you can do to feel better and maybe how to relieve some of the dissatisfaction... and I understand about having biological kids and I think that you shouldn't underestimate the effect of that forecast on you. Have a great weekend. Feel better.