Will the real depression please stand up

[ixchelkali]

What rational reason can you think of for a person who is not depressed to commit suicide?

I had a friend who had advanced, terminal cancer. She decided that rather than spend her last days sick from chemotherapy and drugged on morphine for the pain, she would live as long as it was bearable and then end her own life. I don't think she was depressed. She was someone who loved life and had always accepted what it brought with gusto. She simply wanted to die on her own terms, peacefully, and in her own way.

I had another friend who was in terrible pain from a bad hip and was told she was not a candidate for hip replacement. She hated the immobility and the constant pain, and made what she considered to be a rational decision to end her life. She asked another friend to help her. That friend agreed, and then snitched on her to the mental health authorities. They treated her for depression and found a doctor to do a hip replacement. She later said that she was very glad her friend had ratted her out, and that she hadn't died. She said that suicide seemed like a rational choice, but that her pain and depression had kept her from seeing other options. She lived many more happy years.

Another friend had a son who suffered from schizophrenia. He had been treated for it without success, and had been hospitalized many times. He finally committed suicide, leaving a note saying that he just didn't want to live like that anymore. Was that a rational decision? Was he even capable of making a rational decision? Darned if I know.

I do think it is possible for suicide to be a rational decision in some (very narrow) circumstances, for some people. Unfortunately, I don't think people are always able to judge whether they're being rational, especially if they're depressed. I certainly don't feel qualified to make that judgement about someone else.

 

[Nielk]

I had a friend who had advanced, terminal cancer. She decided that rather than spend her last days sick from chemotherapy and drugged on morphine for the pain, she would live as long as it was bearable and then end her own life. I don't think she was depressed. She was someone who loved life and had always accepted what it brought with gusto. She simply wanted to die on her own terms, peacefully, and in her own way.

I had another friend who was in terrible pain from a bad hip and was told she was not a candidate for hip replacement. She hated the immobility and the constant pain, and made what she considered to be a rational decision to end her life. She asked another friend to help her. That friend agreed, and then snitched on her to the mental health authorities. They treated her for depression and found a doctor to do a hip replacement. She later said that she was very glad her friend had ratted her out, and that she hadn't died. She said that suicide seemed like a rational choice, but that her pain and depression had kept her from seeing other options. She lived many more happy years.

Another friend had a son who suffered from schizophrenia. He had been treated for it without success, and had been hospitalized many times. He finally committed suicide, leaving a note saying that he just didn't want to live like that anymore. Was that a rational decision? Was he even capable of making a rational decision? Darned if I know.

I do think it is possible for suicide to be a rational decision in some (very narrow) circumstances, for some people. Unfortunately, I don't think people are always able to judge whether they're being rational, especially if they're depressed. I certainly don't feel qualified to make that judgement about someone else.

I can understand the rational thinking of your friend who had terminal cancer and was suffering so much to want to end it on her own terms. (sorry about the loss)

I can also definitely understand the "do not resuscitate" wish.

But these are instances of people being so close to death. It's like they are already lying in a state of not being here fully.

I think our situation is very different. I think most of us are not near death (even if it feels that way). No one knows for sure when their time comes but, I think most of us still have many years to live and with the quality of life that we endure, I would not be surprised that many of us are in a depressed state but, they are afraid to speak up because they are afraid that this state of depression will take away their diagnosis of CFS.

You could have CFS and suffer from depression. One does not exclude the other.

 

[ixchelkali]

You could have CFS and suffer from depression. One does not exclude the other.

I agree completely. The wonder of it is that anyone can endure what many patients do on a daily basis for years and NOT be depressed. The hope and courage and humor and grit that I find among these seriously ill patients who have to put up with mistreatment, scorn, and neglect is an inspiration to me.

 

[Nielk]

I agree completely. The wonder of it is that anyone can endure what many patients do on a daily basis for years and NOT be depressed. The hope and courage and humor and grit that I find among these seriously ill patients who have to put up with mistreatment, scorn, and neglect is an inspiration to me.

Very well put. You are right there are some really amazing people here on this forum. I really admire them. They have tremendous inner strength. We really deserve a break and some good news coming our way.

 

[Carrigon]

I've said it for so many years. I am depressed because I am sick. Are we supposed to be happy we're sick? That would be really sick! Who wouldn't get depressed, you have your entire life stolen from you, your ability to work, go to school, have a social life, have any kind of a life at all. It's all taken away. The isolation and the pain and other symptoms often make us wish we were dead. How can anyone not start to get depressed from being this sick?

Most of the time, I cope very well with it. But there are definitely times where I just want to cry or die. I have had very bad down days because of how sick I feel and not being able to do anything. And no amount of happy pills are going to ever fix a biological disease. IMO, taking antidepressants is just masking the truth. It's a fake sense of how you are and it doesn't fix anything. And often times, they work the opposite. I wasn't depressed when I got sick, I was just really sick. And I let my uncles talk me into taking an antidepressant. Well, it worked the opposite and all I thought of and dreamed of was suicide the whole time I was on it. And I swore from then on that I would never let anyone give me that junk again and I never have.

We don't need antidepressants, we need real biomedical treatments for our very real physical symptoms.

 

[PokerPlayer]

I see a lot of people not making the distinction between physical and psychological depression. We really need to define "depression". This argument is an argument over semantics, in other words, an argument over the definition of a word. I don't even think doctors understand this. I think their head would explode trying to understand this concept.

In my opinion, there is psychological depression, where there is a distinct pattern of negative thoughts as well as the lack of desire for a human being to achieve what they are physically capable of achieving.

Then, there is physical depression. This is when there is symptoms such as severe brain fog. My favorite and most telling symptom of physical depression is the inability to smell. Yes, when my condition was at its worse, I had 10% ability to smell as usual. We have forgotten what it is like to just smell the air in the morning and get pleasant memories of past times in our minds. The lack of ability to connect smells to memories and emotions is caused by a lack of dopamine signaling (pleasure). This is caused by the root of the illness (viral or whatnot), and our brain chemistry is altered in order to protect ourselves from the virus if I understand correctly.

A lot of the times, the physical causes of depression such as brain fog and inability to have pleasure can cause the psychological depression to start. We start entering into negative thought cycles which are extremely stressful to our body. I have entered in and out of psychological depression countless times. Yet, my physical depression remains 100% of the time.

It is true, if you can't distinctly smell the air and connect it to past memories and pleasureful events in your life, then you have depression. There is no shame in it. The illness is proven to lower dopamine signaling. What can you do?

This also leads me to say that what I am defining as physical depression will most likely be called by some other name in 20-50 years or however long it takes. This is because it is not psychologically based, but biologically based. And frankly, I find the word depression to be very patronizing to non-psychological depressed people because the rest of the world doesn't understand the concept of losing the ability to find pleasure having nothing to do with someone's psychological state of mind.

 

[Nielk]

Hi Pokerplayer,

I understand the lack of ability to feel pleasure at times. I understanf brain fog.
I don't understand your distinction between "physical" and "psychological" depression.
I guess my head is exploding trying to understand this distinction.

 

[PokerPlayer]

Well, I would say that psychological depression would happen when negative thought cycles are THE SOURCE of the physical depression. The negative thought cycles would cause stress within the body, which would have effects on the immune system and hormone system. This biological reaction would be initiated by stress signaling from the psychological thought process.

An illustration of a physical cause of depression is simple. A person with me/cfs has physical signs of depression such as inability to connect smells with memories/emotions. However, this biological status was not reached by a stressful thought process alone, but rather because of a virus.

What I think makes this all even more complicated, is that I believe "psychological" depression is really just psychological stress activating endogenous viruses (or dormant viruses within our bodies already). So in both cases you can have viral interactions. However, when people have a physical cause of depression such as me/cfs, they can more easily succumb to the psychological sort of depression which is caused by psychological stressors interaction on the immune system.

So really I guess I am saying that being depressed is always a sign of some sort of immune system breakdown, but there can be different causes, such as catching a virus, or being psychological stressed. I don't have citations to back this up, but there is plenty of writing on this if you google. Here is an example that goes into it a bit, its called the psychoneuroimmunology of depression http://www.acnp.org/g4/GN401000098/CH096.html

And thats not all. The further problem is created when a dr. describes a cfs/me patient as just "being depressed". Well, interestingly he could be both right and wrong at the same time. He is wrong because he thinks that depression is ONLY a psychological illness. So, he thinks that you just need to change your thinking. However, since depression could really be the activation of a virus within your body caused by psychological (or viral) stress, he is wrong. The crux of the problem is, I do believe that some people with cfs have a different onset. I think that slow onset cfs/me is more likely "depression". But since depression is actually an immunological interaction in the body, shutting down the psychological stressor that got your immune system into that mess can help. The problem is that it is not logical to assume that because psychological stress activated a virus, that stopping the psychological stress will ALWAYS allow your immune system to recover and defeat the virus.

Who knows, maybe in 100 years the standard treatment for depression will be immune modulators, it would make perfect sense. That is why I think there is so much at stake in searching for the cfs/me cure. It could potentially open the floodgates for massive advancements in how we treat health problems (by immunological means). This poses a real big problem for the current pharmaceutical powers that be. Imagine every antidepressant on the market being put out of business because it has now been discovered that fixing the immune system fixes the neurotransmitter problem in the brain.

In summary, depression can be an immunological illness. This means that the different "types" of cfs/me could have different viruses, one being "depression", maybe others being xmrv, I don't know.

In the distant future, I imagine psychiatry to be a relative easy field, where they know what is wrong with people's bodies and give them a treatment to fix it.
Howevever, I imagine psychology would be just as prominent, because we know that psychological stressors can the whole mess, so it is still a goal to find ways to reduce stress.

 

[Nielk]

Hi Pokerplyer,

Thank you for your elaborate explanation of your thoughts about the different types of depressions and how it involves our immune system.
I read your post three times and I'm not sure if it is because I'm so tired right now and can't concentrate well that I have a real hard time understanding it.
I believe that in a way, depression can cause an abnormality in our immune system that then allows it to develop viruses in our body.
I definitely agree with you that being stressed out and depressed can lead to biological disease. I think it's been pretty much accepted that immense stress can cause a heart attack or even cancer which are definitely biological diseases.
I was not depressed when I suddenly came down with a virus. It was only after a couple of years of desperation that I developed intermittent depression. You are saying that the depression might be an outcome from my immune dis-regulation?

 

[ixchelkali]

PokerPlayer, I think I understand the distinction you are making. It's the difference between a depression that begins with thoughts and emotions and one that starts with a biological, chemical imbalance in the brain. Of course, the two are connected, so it becomes a feedback loop.

But I think there's another distinction that needs to be made, and that is the difference between depression and grief. Many people, including many medical professionals, don't recognize the difference. Depression is a pathological state; getting stuck in a state that no longer pertains to the situation. Also, depression is a muting of emotions (especially happy ones), so that everything is kind of gray. Grief, on the other had, is an appropriate and perhaps even necessary response to loss. It is part of the process of adjusting to loss. Sadness is part of grief and it is also a normal human emotion. Grief and sadness are not pathological; they don't need to be fixed, they just need to be gotten through.

For people who have lost their health, their lifestyle, their livelihood, often their friends, grief and sadness are appropriate responses to a devastating situation. It doesn't mean they are depressed. It's a fine point, but one that I think we, and our doctors, should bear in mind.

 

[jewel]

For years, I tended to have days and weeks of feeling perfectly healthy in the summer months.. and inevitably, when this happened, I would think, "Ah, I'm over this! Yay! and I would begin to energetically plan for all of the things I would be doing." And, of course, I would "crash" whether then or in the early Fall (bad time for me). So, I started to realize that, if I have some sort of psychological "issue," it isn't depression, but rather denial! I very, very quickly turn to denial. Now, unfortunately, i do have many fewer of the feeling totally healthy times, but even when i'm eeking along, I am still not depressed. That said, I have been deeply, deeply discouraged, and if I were more seriously affected (such as bedbound or housebound most of the time), I likely would get depressed. I am deeply humbled and inspired by those of you who keep up the good fight against worse odds than I have had to cope with. Love, J.

 

[PokerPlayer]

Yeah, I kind of got going on a long rant. Today when I look at my post it looks confusing as heck, haha.

Anyway, yeah I just wanted to kind of make people think. What is depression? No one knows. We know that it always involves altered brain chemistry, and that it always involves increased inflammatory signaling in the brain from the immune system. So, what if depression is when psychological stress weakens our immune system enough for micro-bacteria or some sort of virus to wreak havoc on our body? That would mean that some people with cfs could just have "depression" but also a viral/bacterial illness, because that is the definition of what depression is.

A lot of research that could be done on the true biology of depression is not done, because the general public and even most md's have a very archaic view. Since using psychological intervention as well as antidepressants works 50% in reducing the mental stress responsible for immune system dysregulation, most people assume that those who do not get well just can't get over their negative thought cycles. Well, the real problem may be that the true underlying cause of depression (bacterial/viral) may just be too strong for the immune system to battle, and the body now needs medical intervention of which we have not developed yet.

As a personal anecdote, I had slow onset of this disease. It first started 3 years ago with severe anxiety and hot achey lower body as well as severe prostatitis symptoms. The cause of this could be 2 things. The first thing was 3 concussions I had playing high school football which always left me a bit light headed and nauseas after workouts, even years after the fact (hs football when I was 18, 21 when first got symptoms). The second possible cause could be that I went through severe psychological stress by playing a lot of online poker to make money. I made a lot of money, but losing days of as much as $4000 in a single day really stressed me out.

Then, I got bad depression symptoms as well. I started on an antidepressant and it took 4 months but everything went away and I was back to normal. I stopped the antidepressant and my symptoms came back after a few months. I tried all psychological intervention techniques, but nothing worked to stop my anxiety and depression symptoms this time, so after a long delay of 6 months or so I tried to go back on the antidepressant again. However, this time I was severely sensitive to the antidepressant. I tried many times to get on it again, using lower dosages, etc, but nothing worked. Then, I started working out really hard because I was told that was really good for anxiety and depression. Well, I basically beat my body into the ground working out every day and feeling worse every day as the weeks progressed. By week 10 or so of working out 6 days a week I could hardly go on a 2 mile run without feeling like I was out of breath and needing to collapse. Thats when i knew that there was a lot more to "anxiety" and "depression" than the simple archaic view that regular md's had. I researched on the net and found "Adrenal fatigue". I stuck with that for a while, but then I realized that all chronic fatigue syndrome sufferers have dysregulated adrenal hormones as well, so adrenal fatigue doesn't make any sense as a separate illness to cfs. So I decided I had cfs. But the more research I do into depression, the more I am skeptical that depression can definitely be the root cause of cfs as well, because depression can actually be a viral/bacterial illness.

I have now quit poker for life, eat a great diet, and am doing the rich van konyenburg methylation protocol. I still don't feel that great, although the deep depression symptoms are definitely clearing up pretty well. I still can't work out, it has been a year now since I last lifted weights. Working out makes me feel extremely wired for days on end, so bad that I can't sleep for days. That, plus I get worsened brain fog.

 

[Nielk]

Hi (past)Pokerplayer,

I am so sorry for all that you went through!
It's interesting that at first the anti depressants worked well for you. I am guessing that you went off them because you were feeling well and thought there was no need for them.
I never heard that depression could be a viral/bacterial illness but, then again I'm no expert by a long shot.
My guess, as you describe your story is that at some point you developed CFS and therefore became so sensitive to the medicine the second time around. It is so common for us PWCs to be over sensitive to medications.
I'm glad you found a way out of the depression. It was probably due to reducing the stresses in your life, taking better care of your body and the success with Rich's methylation protocol.
Did you figure all this out on your own or are you under the care of an MD?

 

[invisible ME]

Well, the real problem may be that the true underlying cause of depression (bacterial/viral) may just be too strong for the immune system to battle, and the body now needs medical intervention of which we have not developed yet.

I am starting to really believe that all these chronic diseases, "physical" or "psychological," have some kind of viral/bacterial component or underpinning. In a few years maybe everyone will look back and laugh at the distinctions we make between mental and physical health.

Whatever the cause, this thread makes it clear to me that we really need better ways to talk about the emotions that get lumped under the heading of "depression" - i.e. sadness, grief, discouragement, loneliness etc. And to develop ways to recognize when depression (or any of these emotions) has us spinning or spiraling.

I rarely suffer from "depression" anymore. But as I'm mostly bed/housebound, I know I need to find ways to stay in contact with people during times when I'm really down, so that there's someone other than just myself to pick up on potential warning signs.

Wow. That was hard to admit.

 

[PokerPlayer]

Hi (past)Pokerplayer,

I am so sorry for all that you went through!
It's interesting that at first the anti depressants worked well for you. I am guessing that you went off them because you were feeling well and thought there was no need for them.
I never heard that depression could be a viral/bacterial illness but, then again I'm no expert by a long shot.
My guess, as you describe your story is that at some point you developed CFS and therefore became so sensitive to the medicine the second time around. It is so common for us PWCs to be over sensitive to medications.
I'm glad you found a way out of the depression. It was probably due to reducing the stresses in your life, taking better care of your body and the success with Rich's methylation protocol.
Did you figure all this out on your own or are you under the care of an MD?

Hey Nielk,

Yeah antidepressants working at first, and then trying to restart them later when symptoms come back and not being able to was interesting. It really made me feel as though the underlying biological component had progressed.

Yeah, finding my way out of depression has been really tough. Definitely reducing stress, a lot of psychological techniques and letting go of desires. A lot of it was meditation, but I don't really meditate anymore because I found I always tried to hard. Instead, I just find a quiet place and sit down and stay still, but look around a lot and try to just be there and not worry about where my thinking goes or where my breathing goes.

As for some of the health stuff, I went to a top notch psychiatrist and he told me to fix up my diet to more paleo style and to take stuff like vitamin d, vitamin e, vitamin a, iodine, etc. The methylation protocol I decided upon doing by searching forums and looking at what people were having success with. I have improved a decent amount with these changes, and I feel I am on the cusp of being able to do some low intensity weight lifting (but not aerobic work like jogging or bicycling, because I learned these are hard on people with fatigue problems).

I do feel myself begin to have depression symptoms worsened when I spend time on the computer looking up more treatments and trying to educate myself further. As this leads me to question my current treatment regime and causes psychological stress which manifests itself as physical depression symptoms very quickly, which then leads me to think negatively easier because of worsened brain fog/social interactions.

 

[Nielk]

Hi pastpokerplayer (I just gave you a new name)

I, too feel that it's kind of a dilemma whether to be active on forums.
There are many advantages. You get a lot of information yet, it could be too much and one doesn't know what to apply since we all react differently. It is a great means of support though. Where else can we feel like we can sound off about our physical and emotional feelings and be understood? I have gotten so much support on this forum when I needed it.
Sometimes participating becomes too much and one starts to dwell on their problems too much, so we need to take a break from it. I guess everyone has to find the right balance that works for them.

Even though you say that you don't meditate anymore, it sounds like you are able to calm yourself and stay still-be in the moment. That's great. It sounds like you are definitely on the right track to recovery.

I wish you the best,
Nielk

 

[PokerPlayer]

Haha Nielk,

Thats a good name. Its funny because I actually don't like poker because of what it let me do to myself. It has been a good lesson to me though, I have learned in true real life that greed can strike everything good about life down to nothing if you let it take control. I have learned that I don't need to be a high achieving person, I just need to be happy, make other people happy, and treat others with respect. I have also learned that I have a lot more to learn and I need to keep my eyes open.

I definitely agree with you. It is almost certain that spending a lot of time on a forum will hinder recovery. I mean, looking at it objectively, if a healthy person spent a lot of time reading forums about this kind of stuff I can see it making them depressed. So yeah, it is a balance act. I find I do best looking at stuff for an hour about 2 times per week. But this week I have been bad : ) The more time I spend on the internet, the less energy I have to do real life things though

Wish you the best as well,
- Rob

 

[Nielk]

Hi Rob,

I give you a lot of credit. Poker playing can get very addictive - especially when you are making a killing but, you moved on and learned a great lesson from it. You know now where your priorities are. Too bad you had to get sick to get to this point. You are on the right road now.
I applaud you
Nielk

 

[Mark]

This seems like a reasonable place to post this news story I just came across, regarding depression.

http://www.scienceagogo.com/news/20101107220930data_trunc_sys.shtml

There are a few things I don't like about the piece but it's relevant to themes in this thread. One tricky aspect is the suggestion that "depression may be the outcome of an inflammatory process occurring in the brain". That's obviously liable to lead to some tricky problems for those who are committed to the line that ME/CFS is distinct from depression because it's a physical illness, and who cite levels of markers for inflammation in support of the physical basis of ME/CFS. But I think the answer has been well expressed already on this thread: depression, too, is a physical illness.

The thing I really don't like in this article is the old "hygiene hypothesis". I've been irritated by that hypothesis for many years: the idea is that the reason that rates of allergies etc are on the increase is because we are growing up in environments that are too clean, too sanitised, and we aren't being exposed to the environmental factors that our immune systems need in order to 'train themselves'. What I find irritating about the hygiene hypothesis is that it seems to have gained such widespread recognition, and is taken so seriously, in the complete absence of any evidence in support of it. It's quite obvious there is and can be no such evidence, because any such evidence regarding clean environments would have an equally valid (and in my view far more likely) explanation, namely that modern cleaning products are to blame for the rise in allergies. That surely must be an equally likely hypothesis: these super-clean environments that are hypothesised as the cause of the problem - how did they get so super-clean, eh?

Anyway, none of that is particularly on topic with this thread, but I thought this bit of research might be of interest to those following this thread.

 

[SaveMe]

DONT TELL ME I HAVE DEPRESSION, DOCTOR!

because I was perfectly healthy, getting things done, making good grades then BAAAM!! this freaking brain fog hit me out of the blue. I had a distinct shift in my cognitive function. It felt like early Alzheimers.

CAN ANYONE OF YOU RELATE?

Any body who tells me im depressed is a freakin retard