Depresion - Not Something one can beat with will power alone

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Daphne

Trad climber
Northern California
Aug 12, 2014 - 07:12pm PT
^^^ go Paul!

Ignorance is definitely dangerous.

I sit with depressives of many clinical types in my practice. What they all have in common is negative self-talk. Wonky brain chemistry doesn't allow them to hold onto positive thoughts. It is why medication can be such a miracle-- when the chemistry changes, the possibility of positivity becomes more available.

But it isn't a certainty.

Someone in this thread said they go for any action that could possibly help, and that is really the best way to treat depression. Medication, psychotherapy (good psychotherapy and good psychiatry can be quite hard to find and very expensive, btw), nutrition, exercise, social engagement, community, being of service, spiritual development (whether that's formal religion or connecting with nature, it doesn't matter) acupuncture, dancing, really, all the things that are nourishing are needed to be integrated. And if you are depressed this is going to take time, sometimes a long time. Way more time than those people around you have patience for.

I also want to point out that it seems that Robin WIlliams was being treated for bi-polar disorder, a different animal from simply situational depression, dysthymic depression or even severe clinical depressive disorder. The brain chemistry in this case is balanced on a knife edge.






scrubbing bubbles

Social climber
Uranus
Aug 12, 2014 - 09:12pm PT
Here's to Daphne and Paul Souza, who seem to offer professional advice...kudos to Paul for opening his mailbox to anyone

This thread seems to have struck a nerve
Crimpergirl

Sport climber
Boulder, Colorado!
Aug 12, 2014 - 09:23pm PT
^ Agreed.

I feel sad for those who don't get it, or seemingly don't want to get it. I feel sad for the sadness/pain they cause others with their words. Tragic.

Tvash

climber
Seattle
Aug 12, 2014 - 09:23pm PT
I got my information from Stanford's School of Medicine page on depression, but what do they know?

One thing I look for in a therapist is their propensity for losing their sh#t when their erroneous information is challenged by data.

Ken M

Mountain climber
Los Angeles, Ca
Aug 13, 2014 - 12:16am PT
As a practicing medical physician, I also want to point out that there are a variety of medical problems that can show up as depression (the classic is low thyroid), or that can make depression worse. These things are actually common, and most people who have new onset of depression may benefit from a general medical workup.

In the medical school in which I teach (USC), I frequently point out that the burden of major depression may manifest a whole variety of medical symptoms. One approach that is often taken is to attempt to treat everything simultaneously, which can often result in a pile of pills to be taken.

Personally, I prefer to try to take the edge off only....this often results in a dramatic improvement. I also refer most patient for "talk therapy", which many patients find helpful in a number of ways.

For example, most depressed patients have a coexisting sleep disorder, and the chronic tiredness associated with that would wear anyone down. making that better helps most people, sometimes dramatically.

Stanford's ok. I guess.
colin rowe

Trad climber
scotland uk
Aug 13, 2014 - 02:57am PT
The evidence base for depression suggests Cognitive Behavioural Therapy combined with an anti-depressant. With mild to moderate depression behavioural activation will be used. This is a structured, behavioural approach which encourages goal driven activity despite an individual's current mood: goal driven rather than mood driven behaviour. The idea is to activate pleasurable activity. If climbing is something that once gave you pleasure, begin climbing again, despite your mood suggesting otherwise. Cognitions or thoughts can be considered behaviour too and unhelpful thoughts can be challenged too. There are many self-help books such as Christine Padesky's Mind over Mood that can be of help.
Tobia

Social climber
Denial
Aug 13, 2014 - 03:11am PT
I think about Juan occasionally, and the other people known to have lost their struggle with the black dog. I wrote Juan several emails when he was expressing his struggles on this thread. I don't know if he ever read them or got them. He never responded. I think of him and his desperation often.

I keep fighting, it keeps fighting and only time will tell who will finally overcome. It may end up being a draw.

There are a lot of opinions expressed here, some by professionals who treat depression by teaching coping skills and/or prescribing medicine to offset the disease or both. There are other opinions of speculation about the disease and some of those seem totally senseless.

As I stated up thread, I have been wrestling with this disease since I was born. Some of my earliest memories are dark. I can remember feeling all alone in a family of 9, in a kindergarten class of 25, in my bed late at night with two of my brothers sleeping beside me.

I have been categorized as having Borderline Personality Disorder (I interpret that as bordering on having a personality because of my extreme low self-esteem, total lack of self confidence and social grace). I also have three types of anxiety disorders, the Generalized Anxiety, Panic and Social types.

There seems to be two causative factors that allow the black dog to control my mind. Sometimes I wake up with him controlling my mind and then there are circumstances that seem to trigger his attack. I have been learning methods of resisting the latter of these two causes and have had some success.

The former, there is no control. It just happens. I have no more control over these attacks than I do the weather. I try to fight back, to get out of bed and exercise, work or engage other people; but it never works. I finally give up and just ride it out. It may last a day, other times a week or so.

In the past I was treated for Bipolar; but that was a long time ago, some 36 years, (when it was labeled manic depression). I never thought much of that because I rarely hit the manic stage that is common to people who suffer this disorder.

The TMS treatment I underwent helped tremendously in some ways; but not so much in other ways. Again there is no magic cure.
http://www.supertopo.com/climbing/thread.php?topic_id=2220943&msg=2220943#msg2220943

I have had one booster round since the initial program; but I can't afford another round and am not sure if I would benefit.

In the last 3 months I have had serious lows, the extreme ones where I contemplate death as the only solution. The pain is just overbearing, there is no hope and my Christian faith seems to wain. The only thing that stops me from following through are my two dogs and deciding how to do it. I also pray that the pain will end and it usually does; although during these episodes, I don't have any memory of not suffering the crippling effects, happiness is neither remembered and unimaginable.

Physical pain bears no resemblance to mental pain. I can and do endure physical pain, and in some veins I thrive on it; as in endurance sports. Mental pain has no bounds, no threshold and seemingly has the ability to cripple all other strengths. This is especially pertinent when considering that there seems no underlying cause of the anguish; such as the loss of a loved one, financial distress, a broken romance or any kind of assorted disappointments that are experienced in life.

My therapist discontinued my treatments because she had left the hospital where I started cognitive therapy with her. She left due to the corporate setting of a mental hospital to set up shop in a smaller group where she was less restricted. I was seeing her there; but she said that she was recommending me to another group because my suicidal tendencies worried her and caused her anxiety. The anxiety was her fear that I might follow through with my obsession with death and that she would feel responsible (not liable) and because she no longer worked in a hospital setting where she could get immediate feedback from the M.D.'s and other staff, she was not comfortable treating me.

That was a serious blow to my recovery, I had grown very comfortable expressing my thoughts, problems and fears to her. I felt like I was being abandoned, given up on. I felt just like I did when my wife left in the middle of the night, because, I believe she could not deal with the dog.

The fact of the matter is that her concerns were real. I have since met with her and she explained her concerns and the foundations of her decision. At the time of that visit, I was not depressed and it made sense to me. I felt guilty for causing her that much anguish.

I haven't started therapy with the recommended group she provided as I have a history with them. I spent about 5 years in the'90s with a therapist there, 2-3 times a week. They now charge $165/hour. They won't settle for the 80% medicare pays. So it is a useless proposition.

I don't think I will start over again, as it is very difficult to establish a level of trust with a therapist.

I have been "up" for four weeks now. I have riding my bike, socializing a little and taking care of the business of life, such as addressing financial problems, maintaining my property and dealing with issues that usually get brushed aside. It is hard to imagine what the black dog days or like when I feel this way.

The trouble with being up is I know I will sooner or late wake up with the dog on my back. It is inevitable; as involuntary as my heartbeat.

I take medicine for anxiety and a low voltage sleeping aid. I get 5 hours of sleep instead of two now. That in itself if is makes life worth living. Sleep is necessary to feel human.

Here is a link to a short video that someone emailed me today, because I have been using the term "black dog" every since I read that Winston Churchill used it to describe his struggle with depression.

It doesn't express the exact magnitude of my struggle, nor some other factors; but I believe it will show people who don't understand depression or feel like they are alone in their struggle the realities.

I don't think I will ever be cured, and I pray (today) that he never wins. When he is on me, I pray for death. I don't run away from it, I just grow weary of the struggle. Obviously part of my own therapy is write or talk about it, not just for my benefit; but for others who don't know the dog is on their heels.

One last thing, for the non-believers or people who are not Christian or a follower of some other faith, you are jeopardizing someone's hope that they can cope with this disease. Keep the negative vibes to yourself, what do you gain by discouraging someone from believing when they are struggling with surviving? In essence you are contributing to their demise. I was an atheist until I had given up all hope and had my 9mm at my temple, trying to find a reason not to off myself, the pain was too much to bear. If it wasn't for divine intervention I would be dead. You don't have to accept that as real; but I do because I experienced it. It is faith that props me up. So please don't present arguments about someone's personal believe when the topic of depression is at hand. Save it for another thread.

Well enough, I didn't set out to write as much as I did, I just wanted to post the video.

http://www.upworthy.com/what-is-depression-let-this-animation-with-a-dog-shed-light-on-it?c=ufb4

Dingus Milktoast

Gym climber
Maestro, Ecosystem Ministry, Fatcrackistan
Aug 13, 2014 - 03:44am PT
I think of Jeff Batten often as well. I never called him friend, though I should have.

I didn't see it coming. I didn't understand.

There was nothing I could have done, likely. Not that kind of relationship. He was a troll after all and like all trolls when he tried to be serious, when he tried to drop the veil and be himself?

He was rejected. Because of his own past.

I miss him.

I won't lash out toward the less than sensitive to who mock or denigrate such folk.

DMT
anita514

Gym climber
Great White North
Aug 13, 2014 - 04:02am PT
thanks for sharing, Tobia
micronut

Trad climber
Fresno/Clovis, ca
Aug 13, 2014 - 05:53am PT
Tobia thank you for sharing. Heavy stuff. I can't imagine what you're going through man. I hope you find the strength and courage to face today knowing that people around you need you and want you to enjoy today for what it is, a new day. Sometimes its one day at a time man.
I thought this thread could use some photos.  Looking south into Tuolu...
I thought this thread could use some photos. Looking south into Tuolumne Country on the approach to Conness.
Credit: micronut
Big Mike

Trad climber
BC
Aug 13, 2014 - 07:38am PT
Tobia. Wow. Thanks man.

I've suffered from depression for most of my life too. I was going to write this post this sping on my recovery thread but I never got around to it. Depression is a tough thing to write about. You don't even want to think about it when you're up and actually feel like being productive...


As a kid i experienced a lot of teasing and bullying, thanks to my size, as well as joining a tight knit group of kids who had been together since kindergarten in a small community that i had just moved to. I was never really accepted by them and was teased constantly. I ended up in the principal's office regularily for fighting back.

I thought often about killing myself often during all this, and it was always tough to find happiness. Most of my classmates who i did end up making friends with would always seem like they didn't want to be seen with me when the cool kids were around...

By grade six i had developed a pretty tough shell, and had learned to not care about others bullshit opinons... I became a loner pretty much, except for my best friend who had moved to my home town that year. He was a god send. I honestly don't know if i could have turned my life around without his compainonship.

Junior high got easier, as i devolped my shell more and more. By high school i simply didn't give a fvck about anyone else's opinion. I found snowboarding, my first real love. This gave me much joy.

Moving to Whistler was probably the best thing i could have done for my mental state after high school. Meeting new people with no pre concieved idea of who i was and making friends who actually seemed like they had my back. Riding a 100+ days a season and partying all the time, kept me distracted from my mental issues, but i would have lows during summers before i discovered mountain biking. The lows weren't as low anymore though, i don't remember any time during my twenties or early thirties where i actaully thought about pulling the trigger.

Then I broke my back. I knew from past experience that i simply could not let myself slide down that road. My counsellor, physios, nurses, and doctors, kept me going physically and emotionally and progress, and my friends and family plus all the great people who took the time to talk to me on my recovery thread really boosted my spirits. I know i walked out of Gf Strong because of this support, so thanks again supertopo for that!!!

When i got home though.. It was a different story... Life beat me down. Bigtime. I tried to remain postive but the false reality was cracking at the seams. I could not function as i used to and everything was now harder. I worked with a friend of sandra's who is a physical trainer at meadow park, which helped a lot. She got me motivated to get to the gym and train to get my body stronger. Then she hurt herself and couldn't train with me for awhile, and i crashed hard this time.

I sat at home all day, while the boys went to work. I was barely able to bring myself to do the required admin stuff to keep my business running. I smoked way too much and this fed into my apathy. I started to entertain thoughts of suicide again. What kept me from them was knowing how sad all my friends and family and the not wanting to disapoint the kind people at supertopo after all the supoort they had given.

Sandra tried to get me to see a shrink but i just never got there. I've always been suspect about them.. I know it could help but i'm pretty damn stubborn sometimes.

Finally one of my employees called me out on it and said "just come to work." "You need to get out of the house and you'll feel better." So i did. At first it really sucked, but then i did start to feel better and day to day stuff was easier.

Then we went to Yosemite for facelift, which was fun, but also annoying cause Sandra was sick and stressted to the max the whole time and i was limited in what i could actually accomplish and still dealing with a lot of pain issues. When i got home i kind slipped into a lull again. Not as bad as before, and when i started snowboarding again that helped a bit.

I no longer entertained thoughts of death but it was hard for me to get motivated to get up in the morning or if i did get out of bed, leave the general vicinity of my couch. Once again smoking just perpetuated the cycle. a couple things happened that helped break this spell. First, Tricouni called out of the blue to see how i was doing. That was definitely a shot in the arm as i've always enjoyed talking to glenn. We talked a bit about my depression and he told me to keep me chin up. Then chuck started bugging me about the nose, and i realized i had better get training if i was going to have a decent shot at that goal.

So i booked my personal trainer again for a month and got off my ass and got stronger. Then i went to Yosemite and met Chuck. After hanging out together and having lots of fun in the valley my brain had clicked. I never noticed when it happened but i've been stoked ever since.

I've had my ups and downs for sure, but never that low, don't care feeling i had all last winter.

I feel very lucky that my depression doesn't seem as severe as Juan's was, or Tobia's is. It's still there though, and i still have to deal with it. Luckily i've figured out some coping measures..
SC seagoat

Trad climber
Santa Cruz, or In What Time Zone Am I?
Aug 13, 2014 - 09:28am PT
Oh my. Mike and Tobia I feel as if the wind has been knocked out of me.
Thank you for still being here.

Susan
Tvash

climber
Seattle
Aug 13, 2014 - 10:45am PT
"The evidence base for depression suggests Cognitive Behavioural Therapy combined with an anti-depressant. With mild to moderate depression behavioural activation will be used. This is a structured, behavioural approach which encourages goal driven activity despite an individual's current mood: goal driven rather than mood driven behaviour. The idea is to activate pleasurable activity. If climbing is something that once gave you pleasure, begin climbing again, despite your mood suggesting otherwise. Cognitions or thoughts can be considered behaviour too and unhelpful thoughts can be challenged too. There are many self-help books such as Christine Padesky's Mind over Mood that can be of help."

Yup. Best post yet. This is what has worked best for myself and several friends - most of whom suffered little to no childhood trauma.

Healthy lifestyle assumed as a baseline, of course.

Sewellymon

climber
.....in a single wide......
Aug 13, 2014 - 11:07am PT
Ken M hit the nail on the head when her wrote, ".... most depressed patients have a coexisting sleep disorder, and the chronic tiredness associated with that would wear anyone down".

I'd been enjoying Ambien and when it started to no longer give me good REM sleep- when I started waking at 4 AM to the anxiety, I went south. Insomnia weakened my immune system, I got whooping cough and then all the other stress factors (marriage, fam, biz) avalanched in.

I did spend a lot of Sunday mornings at church (which I had never done B4). Probably would have been better off mt biking in the high country, but when you can barely climb outta bed, church is easier...
NutAgain!

Trad climber
South Pasadena, CA
Aug 13, 2014 - 12:22pm PT
I got my information from Stanford's School of Medicine page on depression, but what do they know?

When your main tool is a hammer, everything looks like a nail. I have a deep and abiding respect for science, engineering, and all things analytical. But we must also have humility to recognize how primitive we are in our development in some areas, and be careful that our guiding value of the scientific method does not transcend into a blind faith in our current level of scientific knowledge as the cure for all of our ills, or blind faith in the brand of an academic institution that is driven by a variety of agendas.

Tvash

climber
Seattle
Aug 13, 2014 - 12:48pm PT
My assertions also come from copious personal experience - friends included. I fail to see how Stanford's statistics with regards to the what is known about the fundamental causes of depression constitute an agenda, but YMMV.

My objective was a narrow one - to refute the aforementioned inaccurate assertion that depression is caused solely by trauma. Both the data and my personal experience show that it clearly is not. Like so many other afflictions, there is a strong genetic component.

I just had lunch with a friend who suffers from periodic depression yesterday. She had a wonderful childhood and no major trauma in her adult life, either.

Why this is controversial at all is beyond me.
Tobia

Social climber
Denial
Aug 13, 2014 - 06:15pm PT
I appreciate all the encouragement. Big Mike, we have a lot of common. I was treated differently at school because of being ADD; which didn't have a name back then. Too me it was all fun, at least on the surface because I kept everyone entertained and the teachers didn't have a clue as to what do with me, of course it wasn't so much when being disciplined for grades or behavior. Especially when I got home. My father was an "A" student his whole life and entered college when he was 15. He had little patience with my shenanigans.

I doubt there are 2 cases of depression that are the same. I believe I know as much from experience, self-education and the trials and error approach to medication as the psychiatrist I see now. That might not be an accurate statement nor realistic; but it is a very educated guess. He will suggest medicines and I will veto; because I have tried them in the past. I pretty much have the meds narrowed down. I know medicine simply does not work on me, other than Xanax (any medication that works by causing temporary amnesia would be effective on an elephant).

Twash, I agree about the genetics, as well as the sleep factor. As well as the trauma. I suffered social trauma as reactions to my depression; but trauma was not a cause. It is an inherent trait that I recall being or feeling different in my earliest memories. That isn't to say that trauma won't cause depressive illness.

The TMS treatment increased my nightly sleep from 1-2 hours to 4-5. After years of sleeping only a couple of hours, 4 or 5 seem like a vacation. Sleep is a wonderful thing. I do take a med to help insure sleep, Doxepin; which seems to have zero side effects. And the doc suggested that one.
Depression is very much a part of my genetic code, mostly in the Sicilian strands. It does seem that certain members of family are more susceptible than others. I happen to be the one in my immediate family that suffers from it the most. My father showed signs of it, as does my sister; but on a whole different level. I have no idea why they have inherit coping skills that I wasn't blessed with. But then again I have skills that they don't.

Endurance exercises (running, cycling and swimming) have always been the mainstays of beating back the dog. That was fine and dandy until I lost the ability to run with back problems. I thought pain meds were the greatest anti-depressants there were for a short period. It didn't take long to figure out how that works. Lucky for me, I don't have the addiction gene.

I started to run again and that was a great booster. I have had to convert to cycling now because my knees are gone; but it doesn't matter.

It is easy too write about this stuff when I am not in the doldrums, It is meaningless when I the dog is around. I write in hopes that other people will not feel alone if they suffer this affliction.

I also write to defend those who take the desperate final step and read or hear criticism from their family, spouses or friends. People don't take their lives without feeling pain for those they leave behind. It isn't as selfish act as so many people see it. In some cases the people they leave behind are the reasons they give up; not because they don't care about them, just the opposite.

I compare suicide to the actions some people take when pinned under a large and heavy machine and are all alone. They pull out a pocket life and sever the limb, believing this is the only way out the situation. And that is exactly what most suicides are, the only means of ending a very painful situation (life). They severe the limb. I can't think of any more drastic. Free soloing is one extreme; but they don't do it with the intention of dying.

That is not to say I recommend it. I hope and pray my life doesn't end that way. Or anyone I know and don't know. But for those that have come to end by their own hands, I beg you to believe they didn't do it out of selfishness or cowardliness.

So as many have said in this thread and other threads that deal with this topic, seek help, even if it is from a Labrador. Fight the good fight, until you can't. Just make sure you always can. This is easy for me to say right now because the evil dog is no where near.
Big Mike

Trad climber
BC
Aug 13, 2014 - 06:33pm PT
Tobia- I hear ya. Feel free to drop me a line whenever. Thanks for putting my problems in perspective.. Lol fight the good fight brother.
drljefe

climber
El Presidio San Augustin del Tucson
Aug 13, 2014 - 06:38pm PT
Interesting, that as long as I've had dog's of my own, they've all been black.
Something about The Black Dog.


Solace to you all.
Tobia

Social climber
Denial
Aug 13, 2014 - 06:42pm PT
Mr. Jefe, I have had a lifetime of black labs (the loving, swimming kind).
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