Depresion - Not Something one can beat with will power alone

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hunter

Trad climber
NYC
Apr 2, 2010 - 08:14am PT
Lots of wisdom here, particularly from Largo.

I'd like to point out to Dr. F and other chemical fundamentalists that few if any neuropharmacologists (and yes, I am one) believe the strict chemical imbalance hypothesis of depression any more. In fact there is a substantial amount of data to suggest that most of the SSRI's are merely active placebos (that is they do something because they feel like they are doing something). Of course even that effect is useful, but to imagine that serotonin re-uptake is the reason for some or all depressions is almost as unscientific as the belief in jesus you deride. Depression is profoundly complicated and we scientists do not understand it very well at all. What is evident is that talk therapy is as effective as drugs in the short run (less than a year) and that the combination of drugs and therapy is better than either alone. Longer term it is not clear if drugs are useful at all: the few studies that have been done on longer term anti-depressant treatment have shown that patients are more likely to be depressed if they are on the drugs for more than a year. It is also clear that exercise and social support are equally important in predicting the outcome of a depression. That is the science, the rest isn't subject to our scrutiny as yet and much of it may never be, as our present scientific model isn't well adapted to the study of our inner lives.
mooser

Trad climber
seattle
Apr 2, 2010 - 08:44am PT
JL - your last post was really (from my perspective) excellent. You took a series of totalistic diatribes (from Dr. F), and brought reason and reflection back into the mix. I've really come to respect (for lack of a better term) your "appreciative agnosticism" on matters of spirituality and psychology.

And Juan, hang in there, man. You've got some great support from some pretty thoughtful and caring folks here. There are clearly quite a few who can look back at moments that seemed pretty bleak, and recognize how they got through--and are getting through. I hope their stories encourage you.

Tom Patterson
Dr. F.

climber
So Cal
Apr 2, 2010 - 08:45am PT
Thanks for all the feed back, it was lovely

and of course I have something to say

Of course I don't see things as right or wrong, black or white, good-bad

That is ridiculous evaluation of me, or my comments
We will leave my concept of god to another day.


My disagreement has been all around one single point, which Largo, and the rest of you miss.

Why the depression.

There is no other reason for me, and most others to be depressed.

But we are depressed, Why???

ITS NOT about thinking depressing thoughts, its not being in a depressing situation, not climbing enough

Our life can be unbelievably great, everything is perfect, spiritually in tune with God and your self, but we are still depressed

The why for me is brain chemistry, and most others, they bring you out of it, to an extent, and you can live a normal life again

So Largo's advice to change things, get out of your self, see a therapist, blah, blah
does not help, all those things were done, 1000x times

So when you get to the point of Juan, after he has realized that his will power, pulling himself up by his bootstraps, or anything else has not helped, that he should try drugs

since its his brain chemistry, that has made him depressed

But I also suggest you should also go without the drugs, to mix things up, if you feel inclined

Largo

Sport climber
The Big Wide Open Face
Apr 2, 2010 - 09:34am PT
Dr. Hunter wrote: "Depression is profoundly complicated and we scientists do not understand it very well at all."

Another factor with depression and other challenges that have a strong physical aspect, is that the symptomology changes a lot, meaning you're often looking at a moving target. One day it can be a sleep disorder, another day, anxiety, yet another, the blues, and so forth and so on. The reason why the strict medical model isn't especially useful for this is beause actual diseases don't present like this. For example, diabetes doesn't look like gout one day and influenza the next. So in this regards, listed to the scientist: "Pofoundly complicated."

It's my impression that understanding how causality works in human life is totally key in treating depression and other disorders like this. What's more, changing how we feel is the consequence of doing things diffrently - a little understood dynamic, and one of the reasons that talk therapy is often of little use in this. Also, the idea opf working a "program" is very useful in this regards.

JL
Reilly

Mountain climber
Monrovia, CA
Apr 2, 2010 - 09:44am PT
Dr Hunter,
Thanks for an excellent and succinct post! :-)
Thanks to Moosie, Allez, Largo, and others.

This can't be good:
"FAA: Pilots allowed to take antidepressants on job"
http://news.yahoo.com/s/ap/20100402/ap_on_bi_ge/us_pilots_antidepressants
pa

climber
Apr 2, 2010 - 09:49am PT
What is Chemistry, then?

The term comes originally from Arabic, then was latinized to
"keme" = "value". It is the science of matter. (Wikipedia)

Odd how the science of matter is named in terms of value.
A very insubstantial term to describe our most staunch idea of density.


One asks, Why the depression?
Perhaps, it is not a "matter" of Why, but of Who...
WBraun

climber
Apr 2, 2010 - 09:57am PT
"Why the depression."

Hopelessness
nature

climber
Tucson, AZ
Apr 2, 2010 - 10:01am PT
How you doing lately, Juan?
fattrad

Mountain climber
GOP Convention
Apr 2, 2010 - 10:04am PT
JDF,

You just do whatever it takes to feel better, talk, drugs, hugs, programs, therapy, etc.


The evil one
JEleazarian

Trad climber
Fresno CA
Apr 2, 2010 - 10:14am PT
Reilly,

Why do you say this?
This can't be good:
"FAA: Pilots allowed to take antidepressants on job"
http://news.yahoo.com/s/ap/20100402/ap_on_bi_ge/us_pilots_antidepressants

To me, that's simply the converse of the "depression is only a chemical imbalance" argument. As Dr. Hunter, Largo and others suggest, we still don't know that much about depression. My medication might merely work like an expensive placebo, but it certainly worked to get me back to (and maybe a little beyond) my pre-depressed self. Without many years of functioning at this level unmedicated, I wouldn't trust myself in any responsible position without proper medication. I, and those around me, have complete confidence in my performance now, however.

I think the thrust of the FAA reg change is to allow those whose depression is demonstrably under control to fly. Otherwise, the de facto rule would be that no one may pilot who suffers from depression. That would exlude a lot of extremely capable people.

John
Reilly

Mountain climber
Monrovia, CA
Apr 2, 2010 - 10:20am PT
John,
Since my knowledge of such is strictly anecdotal I supposed it
based on hearing how people aren't necessarily at their
sharpest when on anti-depressants. That wouldn't matter in most
professions. The FAA also has a time-honored tradition of
questionable decisions.
alexander-solzhenitsyn

climber
Bend OR
Apr 2, 2010 - 10:21am PT
I am big on excluding the depressing items from my life, as many as possible, this solution works very well for me.

then increasing the anti depressant things in my life
time on the mtn, time on the rink, laps in the pool, #s of favorite songs on the cassette collection, posters and decoration on the wall, hours a week spent with ppl whom arent [ozz boys pastime] and [anatomy]

I am also ok going through times of depression, my feeling is that there are many things in life that warrant being depressed from time to time

that this depression is a natural part of being alive, that it balances times of being quite happy
thereby not necessarily something to treat as an imbalance

* try a change in environment to see if anything changes
jstan

climber
Apr 2, 2010 - 10:21am PT
Where is the data supporting the assertion abnormally large numbers of climbers suffer from depression? Since the condition itself is not easily defined, there will have to be some solid data.

"And as Coz pointed out, a lot of it has to do with being "bound by self," or being crazy self-absorbed. That cycle also has to be broken by various means, one of which is being of service to others."

I have to say I get depressed on those weeks when I take the time to stare at my navel 24x7.

I have found choosing goals and then going all out for them leaves one little good navel gazing time. And then if one never forgets that quitting easily becomes a habit, depression becomes simply a waste of otherwise useful time.
Dr. F.

climber
So Cal
Apr 2, 2010 - 10:23am PT
JE, at least we can agree on some things
Thanks
JEleazarian

Trad climber
Fresno CA
Apr 2, 2010 - 10:34am PT
jstan,

I'd suggested the possibility (as opposed to asserting its existence) that the populations of climbers contains a higher proportion of people with depression. I think that was on a different thread, though.

The mental health professionals with whom I've dealt all say that lawyers have an abnormally high rate of depression. I know more lawyers than climbers (how's that for a really damning admission?) but I know more climbers who've committed suicide than lawyers who have done so. I based my conjecture on that observation.

John
JuanDeFuca

Big Wall climber
Peenemunde
Apr 2, 2010 - 10:40am PT
So I am a bit concerned. Do Antidepresives work?

Am I fighting a losing battle?

I really trying to hang in. But its not easy.

Juan

Dr. F.

climber
So Cal
Apr 2, 2010 - 10:45am PT
Studies have shown stress can be a factor of causing depression

Maybe the daily mental stress of climbing, being sketched out on a lead, long belays in the cold, the exhausting march to the top after a long day of slaving on a route, the devious descent, miles of boulder strewn talus fields that must be traversed

Climbing is very stressful a stress we happily volunteer for

My depression became severe after writing my first guidebook, the endless late lights working on it, the deadlines, the lose ends, maybe it was too much, along with my 40 hour a week job
Dr. F.

climber
So Cal
Apr 2, 2010 - 10:52am PT
Juan,

they work, they are not a placebo

The problem with them, like depression, is expressing it in terms that the non-depressed can comprehend

When you are not depressed from taking them, you can't say if they are working or not, since you aren't depressed, or maybe you are still a little depresesd

Its hard to tell if they are working or not
after saying that

I really think you should try them

There is one major problem with them, and this is were so much confusion lies

They may make you MORE depressed for awhile, the first 4-6 weeks are tough, thats when the teenagers commit suicide, They think "it should be working, but its not, I'm just getting worse, there is no hope, I might as well kill myself"

You have to give them time to build up in your system
drunkenmaster

Social climber
santa rosa
Apr 2, 2010 - 10:55am PT
just heard on the "news" that it is now legal to fly a plane on anti depressants - not sure what to think about this??
JEleazarian

Trad climber
Fresno CA
Apr 2, 2010 - 11:29am PT
JDF,

I'm not saying that antidepressants always work. I'm saying that professional help almost always makes things better, and I'm quite certain it will help you.

I might as well tell my full story, because I hope that if you see how low depression took me, and therefore how far I've recovered, you'll see that what looks hopeless is not so.

Since 1991, I've had the highest legal peer-reviewed rating (Martindale-Hubbell "AV") and through the 1990's, at least, had a very admired, successful and lucrative law practice. Although I had momentary bouts of depression since at least 1994, they always went away on their own, so I didn't think I had a medical condition.

That changed in about 2002. Gradually, over the next few years, I grew unable to accomplish even the simplest of tasks at work without monumental effort. In addition, I slowly stopped climbing (a sure sign of illness!), playing the piano, cycling, and just about everything else that I formerly enjoyed. In addition, by then, my wife said I'd become very withdrawn. I slept inordinately. Both my wife and my secretary worried that I was suffering from depression, but I blew them off. I thought that I'd just snap out of it, and anything that was behind in the office would be cured by a couple of extra Saturdays of work.

I was wrong. Finally, in 2005, one client for whom I started litigation, but then stalled, had enough. She said she was coming to my office to see the results of the litigation I'd promised her. I knew it would take her about 45 minutes to get there. Desperate not to be confronted with my inaction, I made up a pleading, and even faked a court order. That latter act was one of forgery and counterfeiting under federal law, and something no sane lawyer would do. I gave her the "order," hoping to shut her up long enough for me to do my job.

Well, the good news was that the immorality of my action really did wake me up. Within a few minutes of her leaving my office, I was so appalled with what I'd done (or to my way of thinking, what I'd become -- a liar) that I immediately sought professional help. A few days later, I went to the court to tell them what happened. Unbeknownst to me, my client was already there, and the court clerk suspected what I'd done before I fessed up. My client had also already gone to the FBI, and my legal goose was cooked.

By then, though, I was hooked up with a physician and a psychologist, each of whom shared my Christian faith. I got good medication and good therapy. I also hooked up with a group of lawyers dealing with mental health and substance abuse issues (although the latter has never been an issue for me, the two often go hand-in-hand. Probably a form of self-medication.)

Talk about an inopportune time to regain my sanity! I saw in my immediate future at least the following: (1) the end of my career; (2) the destruction of my reputation; (3) abject poverty; and (4) no discernable way out. In fact, reality was worse in all respects except no. (4).

My wife had not worked outside our home or my office for almost 20 years, and had let her nursing license lapse. I knew my law license wouldn't remain for long, and I had already decided that I could not take any more new clients, and that I needed to refer all of my existing ones out so that I could end my practice. Unfortunately, our debts still remained. I had to file personal bankruptcy. I resigned from the Bar. I was indicted for forgery, pled guilty, and was sentenced to six months in federal prison. Had I known all this when I first went for help, i certainly would have seen no way out.

Nonetheless, several amazing things started happening then. First and foremost, friends started coming out of the woodwork. Virtually all of the legal community lined up to help me. My church rallied around us. My family did the same. Instead of rejecting me, they came to me. It was like being at my own funeral, and hearing all those nice things people say about you. Perhaps as importantly, they all knew that something had been wrong with me, and were delighted that I was finally doing something about it. Although I cannot excuse my dishonesty, everyone I care about has foregiven that dishonesty.

As my mental ability returned, so did my business opportunities. I had been, in addition to an attorney, an econometrician since 1973. My old roommate from college needed econometric help, and came to me. We're still working together. In addition, after serving my sentence (which I treated like a vacation, but that's another story), two lawyers I'd trained 20 years before hired me to be a sort of in-house scholar. The combination of these two jobs, plus my wife rejoining the nursing profession, is providing sufficient income. More importantly I am the happiest I have been in decades. Even though I'm 58 and had to start over at age 56 when I got out of prison, I see a good future for us.

I hope you conclude that whatever is in your future, it can't be much worse (and, I hope, it is much less worse) than what I went through. We all can help. You're not facing a hopeless battle.

Unfortunately for my comments, but fortunately for my wallet, I need to do some paying work now, but email me if you need someone who's been through the Valley of the Shadow of Death, but now fears no evil. That offer stands, by the way, for anyone dealing with depression.

John
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