Depression as a disease?

[.Poppy.]

I'm not sure if this belongs on the HA board or not, but it is health related so I decided to post it here.

I just read a very sad article about a teen who killed himself. His family tried to get him help and despite telling ER staff that he was going to kill himself and exactly how he was going to do it, they still sent him home.

I then read the comments about how depression is a disease like any physical disease and it can lead to death untreated just like anything else.

And that scared the hell out of me.

I already know I suffer from anxiety and depression. I've seen a psychiatrist. I've had therapy and will start again with a new therapist in July. I'm on meds (which offer me yet another thing to worry about --- I am still SO TERRIFIED of side effects or that they're going to hurt me in some way).

Thing is, thanks to the meds and the therapy I've received, my anxiety is considerably better. Not perfect, but better. I've had some really great times where I've had a somewhat minor freakout and it really only lasted a couple of minutes before I was able to talk myself down.

It's the depression that scares me. The exhaustion. The despair. The stubborn part inside me that says I can be happy and I can have a good life right before the darkness screams "no, you can't, you're worthless...". I was reading my journal the other day and I've thought these negative things about myself for YEARS. I'm not necessarily suicidal, but I'd be lying if I said I didn't just want to lie down and sleep forever. I'm so afraid that the meds are going to hurt me, or that the depression is going to get worse and I AM going to become suicidal. I'm afraid I'm going to lose control of my own mind, which of all the HA things I've feared, is by FAR the worst.

It's like a nasty cycle. I don't know how to break it. How do you stop being afraid of yourself?

[ServerError]

I have a feeling Terry will have something to say on this one.

Clinical depression is a physical disease in so much as certain chemicals are out of whack in the brain. It's why doctors prescribe medication that raises feel-good chemicals.

However, depression is treatable. I remind myself of this on a regular basis. Also, bear in mind that your fear about extreme depression is being worsened by anxiety. The fact you don't want to die is a positive you should hold onto.

I don't want to say too much more as I don't feel I have the degree of knowledge necessary. But for what it's worth, you are certainly not worthless.

[Fishmanpa]

Depression is an illness as is anxiety. I watched depression destroy my ex wife and it was the reason for our divorce. She finally sought help and is doing better. I saw what anxiety and depression has done to my daughter but again, she got help and is doing great. Left untreated it sometimes can cause someone to take their life and I had it happen to a friend. The ER is really not the place to take someone with suicidal thoughts IMO. While they may be able to refer you, they're not able to treat it or even quell it with the exception of some diazepam or some other chill pill.

In the states, a family member or doctor can get someone into a mental health facility if they pose a threat to themselves and/or others (sectioning) and I know there are similar provisions in England. We don't know all the details of what happened to that teen but apparently he slipped through the cracks and unfortunately it happens.

The key here is treating it which you're doing. Concerning the meds? I've seen a marked improvement in your posts so I believe that along with professional help has really improved your outlook and put you on the path to healing.

The meds subject is a can of worms and everyone has their own opinion. I believe, just like with a physical illness, if meds are needed to maintain or improve your quality of life, the benefits far outweigh the risks.

Don't over think it. You're doing great. Keep up the good work ;) Others should be inspired by the progress you've made.

Positive thoughts

[.Poppy.]

ServerError - what a nasty cycle, huh? It seems my anxiety worsens my depression and my depression stirs up my anxiety...ugh.

Fishmanpa - you always have such kind words, thank you.

I think it's a good thing that I consider myself to be stubborn. I WANT to defeat this and find meaning and good qualities in myself and my life again. For me, it seems to center around self-hatred and control. I get anxious about needing to control things, then when I realize I can't control everything I feel very, very down because what's the point of trying when it's all up to chance anyway?

I'm working on coping skills and have a new therapist picked out that I'm optimistic about. I'm trying really hard to listen to the (very small) voice inside that says "you are smart, you are worthwhile, you are capable, you are beautiful" instead of the other one that constantly rains it out in a massive thunderstorm of fear and hate.

But, fight on.

[MyNameIsTerry]

I'm trying really hard to listen to the (very small) voice inside that says "you are smart, you are worthwhile, you are capable, you are beautiful" instead of the other one that constantly rains it out in a massive thunderstorm of fear and hate.

I think that's what I see as a major area for you. Self confidence, self worth, self esteem. They say self esteem is made up of other elements including self confidence so working on the elements can add to the whole.

Depression can be as we know it as psychological as a mood disorder or organic in that this latter form means it stems from another physical disorder/disease. However, depression in the sense of the mood disorders we talk of is not a disease. People say that meaning the same when they say something "is a cancer on society" or out of ignorance.

It certainly doesn't have an inevitable outcome. And it doesn't lead to death, it can't. It no more leads to death than does driving. If depression had a consequence of death as it's prognosis, it would be getting the same money behind it as diseases that do. People often overemphasise with subjects that are emotionally important to them, sometimes because of bad experiences they've had which you can understand, and some people just do that for anything in their lives whether it is a serious issue or what shade a Kardashian is applying to themselves today ("OMG!"). You have to separate language our and look to the balanced people in such debates, who will stick out a mile.

The thing is, Poppy, modern society talk about depression often from a lack of understanding. Some people say "I'm depressed" when they really are just feeling some low mood. There is a massive difference between depression and feeling down. My dad had depression for 2 years and he said he would just lie in bed for weeks at a time, nothing mattered...and he was a hard working family man before this (and was again afterwards). A breakdown did that to him but he clawed his own way back out of it with his family supporting him and has been depression free for over 40 years.

You will see websites claiming depression is incurable just as you will see the same for anxiety. Try telling my dad he has been cured the last 40 years. In the normal cycle of life he has been through trouble & hard times, worked endless hours for very little to pay bills and just survive. But no relapse. At his stage of life he has lost quite a few brothers & sisters, parents, friends, etc. No relapse. Any of that could make someone relapse. His depression isn't managed, it's gone.

Something to also consider with depression is that we often just call it that but it's a much more complex animal. Calling all depression under that label is like calling all anxiety as anxiety, but look how complex & different anxiety can be. Some forms of mood disorder can be very challenging (Bipolar, Major Depressive Disorder, Psychotic Depression, etc) and some are less extreme.

Some people do take their lives. But some people also take their lives over other things too that other people don't. Sadly, this case has some issues in it that need to be investigated to ensure it doesn't happen again, but it can & may.

Whilst an ER might not be the best place, it's certainly the best place to get immediate help from any medical professional. ER's are driven to respond fast. Someone like this would just be supervised (hopefully) until an on call psychiatrist could get to review them I would assume, just like over here. That doctor could then invoke a section process or would just send them home over here if they weren't a threat to themselves or others. Family can do the same, as can anyone really, because you just contact a doctor who invokes it and then people turn up to conduct the process. Sadly over here there are bed shortages on top of this so some people get released too quickly and the cycle continues.

Having a plan to take your life is a red flag but they follow this up with questions about how likely you are do take action on a plan and if you can persuade them that you have enough to live for, they will be see a lower risk. I used to fill this in at every session with my CBT therapist and she said it was formality for duty of care so they can pick up on those who could need more help. Over here we have a Mental Health Act that binds all these people in law to ensure people are referred to sectioning processes if they pick up on them.

It's a horrible thing to hear or read for anyone. I worked with a guy who came home to find his teenage son had taken his life and he had no idea how he felt. My best friend years ago got married, all was great, and one day he got home to find she had tried to take her life and he got her sectioned to get the help she needed. She was much better after that. She had buried herself in debt and never told anyone and it just got too much. Admitting it all meant she got help from her husband to sort what she couldn't see a way out of.

It's very important to have support. You have your mum & dad on board and you know you can always talk to us lot on here. You are far from alone as some of these people can be. You are taking steps that these people often can't see as a possibility and so you have people looking out for you.

Your doctor will know about how antidepressants present greater risks in younger people so they take greater care to monitor. But in terms of side effects, once you get through the first 4-6 weeks, if they are gone, it's unlikely you will get any more. The worry over depression is not then about the med, it's just your condition but you are working on that and have support and I'm sure you would tell someone or at least talk on here if you felt there was a problem developing.