Depression

[RH33]

It's a year since I last self harmed. This coming on back of swollowing two boxes of paracetamol and whatever sleeping tablets I had left. I had around 200 cuts of differing depths on my legs.. My psychologist put me on a contract of safety. I break it she breaks off working with me. That would be disaterous for me as she provides me with so much support. She's private not NHS. 9 months ago she talked me off a platform edge.

Three weeks ago someone I knew chucked themselves in front of a train. Utterly devistated.

I'm now on my own and have my kids (Sun-Thus) best thing I did. I have an interview in few weeks to start volunteering and I'm in a much better place. In April I literally made a list of basics I had to do every day and from there took baby steps. It's been a long road and alot of work to stay well. I still have meltdowns where the BPD takes hold. But I can manage it better.

Stick in there, suicide isn't the answer, get help and talk.

Edited September 26, 2014 by Rowan

[Sergeant Wilson]

Stick in there, suicide isn't the answer, get help and talk.

I always doubted the "painless" bit as well.

[Guest The Phoenix]

It's a year since I last self harmed. This coming on back of swollowing two boxes of paracetamol and whatever sleeping tablets I had left. I had around 200 cuts of differing depths on my legs.. My psychologist put me on a contract of safety. I break it she breaks off working with me. That would be disaterous for me as she provides me with so much support. She's private not NHS. 9 months ago she talked me off a platform edge.

Three weeks ago someone I knew chucked themselves in front of a train. Utterly devistated.

I'm now on my own and have my kids (Sun-Thus) best thing I did. I have an interview in few weeks to start volunteering and I'm in a much better place. In April I literally made a list of basics I had to do every day and from there took baby steps. It's been a long road and alot of work to stay well. I still have meltdowns where the BPD takes hold. But I can manage it better.

Stick in there, suicide isn't the answer, get help and talk.

Unlike Ross County, you've made some great points.

You stick in there too.

TP

x

[RH33]

Unlike Ross County, you've made some great points. You stick in there too. TPx

Lol! County may break me again! Edited September 26, 2014 by Rowan

[JogaBonito]

It's a year since I last self harmed. This coming on back of swollowing two boxes of paracetamol and whatever sleeping tablets I had left. I had around 200 cuts of differing depths on my legs.. My psychologist put me on a contract of safety. I break it she breaks off working with me. That would be disaterous for me as she provides me with so much support. She's private not NHS. 9 months ago she talked me off a platform edge.

Three weeks ago someone I knew chucked themselves in front of a train. Utterly devistated.

I'm now on my own and have my kids (Sun-Thus) best thing I did. I have an interview in few weeks to start volunteering and I'm in a much better place. In April I literally made a list of basics I had to do every day and from there took baby steps. It's been a long road and alot of work to stay well. I still have meltdowns where the BPD takes hold. But I can manage it better.

Stick in there, suicide isn't the answer, get help and talk.

Congratulations on the 1 year goal. Don't stop now though, keep going!

I sympathise, it must be tough putting on a brave-face in front of the kids. Volunteering sounds like a fabulous idea though. The social contact and control will definitely help.

I wish you all the best. Definitely agree with the last point, I just could not stop thinking about suicide at one point.

Edited September 26, 2014 by JogaBonito

[BradHorse]

There's a certain irony in who it came from but the phrase 'suicide is a permanent solution to temporary problems' comes to mind a lot in regards to depression.

The fact he said it and didn't fully believe it only emphasizes the reality of depression.

[JogaBonito]

Interesting take on depression

Depression Re-examined: A New Way to Look at an Old PuzzlePosted by Harriet Hall on February 25, 2014 (84 Comments)

Depression affects approximately 10% of Americans. It can be fatal; I found estimates of suicide rates ranging from 2-15% of patients with major depression. When it doesn’t kill, it impairs functioning and can make life almost unbearably miserable. It is a frustrating condition because there is no lab test to diagnose it, no good explanation of its cause, and the treatments are far from ideal.

Jonathan Rottenberg is a psychologist and research scientist who began to study depression after his own recovery from a major depressive illness. He teaches psychology at the University of South Florida, where he is the director of the Mood and Emotion laboratory. He has launched the Come Out of the Dark campaign to start a better, richer national conversation about depression. In a new book The Depths: The Evolutionary Origins of the Depression Epidemic, he reviews insights from recent experiments and asks a number of difficult questions, such as why humans evolved to be subject to incapacitating depressions. He comes up with some startling hypotheses, including the idea that evolution favored depression because of its survival value and that depression is essentially a good thing. He offers his ideas as the basis of a paradigm shift.

Is there an epidemic of depression? Rates of depression have been rising in most but not all countries. Is it a real epidemic, or might we be seeing the influence of increased awareness through the media and better diagnosis? I’m not sure we have enough evidence to be certain at this point.

What is depression? Is it:

• A defect in brain chemistry? This is the basis of drug therapy. The chemistry imbalance hypothesis is simplistic, misleading, and essentially wrong. Antidepressants do indeed alter brain chemistry as they relieve symptoms, but that doesn’t necessarily mean that a chemical imbalance caused the problem, and it doesn’t explain what caused the imbalance or why it happened when it did.
• A defect in thoughts? This is the basis of cognitive behavioral therapy (CBT). Is mere thinking enough to think yourself into a depression or out of one? The evidence suggests otherwise.
• A defect in childhood experience? This is the basis of psychoanalysis. Freud’s theories have been largely discredited, and people with the most appalling childhoods can have normal adulthoods.
• Not a defect at all? This is what Rottenberg proposes.

Evolution did not design us to be happy. It designed us to survive and reproduce. The function of mood is to integrate internal with external information to enhance fitness. Mood affects behavior: an anxious mood focuses attention on threats; a good mood broadens attention and leads people to seek out variety; and a negative mood first mobilizes effort, then eventually de-escalates effort when a task proves hopeless, conserving resources that can later be used to better purpose. Our moods occur first: we feel happy or sad, we feel a need to explain why we feel that way, and we think of a reason that would explain the mood. The reasons we come up with are not necessarily the right ones, and often they are mere confabulations.

Low mood has its benefits. Non-depressed people tend to overestimate their abilities, are prone to positive illusions, and demonstrate overconfidence and blindness to faults. When depressed, people are more realistic; they are more deliberate, skeptical, and careful in processing information from the environment.

Low mood can be triggered in animals and humans by factors such as separation from the group, removal to an unfamiliar environment, the inability to escape from a stressful situation, the death of a significant other, scarce food resources, prolonged bodily pain, and social defeat. Low mood serves as an alarm system. It gets our attention and lets us know something is wrong. Depression allows us to stop, retreat to an emotional cocoon, analyze what went wrong, and hopefully change course to avoid future calamities.

But low mood has its costs, too. Whatever the benefits, there are plenty of negative effects like distorted thinking, delusions, suicide, difficulty in concentrating and functioning, and weakened executive functions in the brain.

A shallow depression can be adaptive, but a deep depression is maladaptive. There’s a continuum, and any cut-off point to divide normal from abnormal is arbitrary. Rottenberg thinks low moods used to be helpful in the environment where humans evolved, but that the environment has changed in ways that make low moods less advantageous today.

He describes animal and human experiments that shed light on depression. Animals show signs of depression too. Animals often act as if they are mourning after they lose a significant other. In the “tail test,” rats suspended by their tails conserve their resources better if they give up quickly and stop struggling. Their low mood resolves quickly when the stress is over. Adolescent girls who had depressive symptoms became more disengaged from goals over time, but the more disengaged they were, the better off they were in later assessments, reporting lower levels of depression. In another study, a negative mood was found to enhance the quality and concreteness of persuasive arguments. In a starvation experiment, subjects developed the signs of depression as their bodies reacted to conserve the insufficient calories. Their energy and concentration diminished, they lost all interest in sex, and they ruminated obsessively about food. By preventing action they couldn’t afford, depression contributed to their survival on scanty rations. Their depression lasted longer than the experiment; Rottenberg hypothesizes that this strategy is effective because it holds behavior in place until depleted resources can be rebuilt.

How does this normally-resilient mood system fall into deep depression? Prolonged shocks produced helpless behavior in dogs, so they didn’t even try to escape from shocks when it was possible to escape. Chronic mild stress in rats reduces their pleasure-seeking behavior for months afterwards; their responsiveness to rewards returns when they are given antidepressants. Undergoing several stressors at once increases the likelihood of depression in both animals and humans. Not every animal shows prolonged depression, just as not every human becomes depressed under equivalent stresses. Genetic variation is likely the reason: it has been estimated that 30-40% of susceptibility to depression in humans is genetic.

Some kind of loss is always present in depression, whether it be the death of a child or an imagined loss of status. Bereavement is one kind of depression, once thought to be a separate entity but now considered to be part of the same continuum.

How long do minor depressions last? There are no good treatments for minor depression, and doctors often resort to “watchful waiting.” This may be a mistake: a study showed that after a month, only 6% of patients had recovered. Another study found that 72% of people who had a minor depression were still bothered by one or more symptoms of depression when interviewed a year later. At any given time, 22% of the population has at least one significant symptom of depression. Mild depressions outnumber deep ones six to one. Low-level sadness is so ordinary it is often overlooked. But having a mild depression quintuples the risk of a later major depression.

Depression can be triggered by events, temperaments, and routines such as sleep patterns, night shifts, and artificial light. Fish with different temperaments have different success in different environments; the bold fish are more likely to enter a trap, while wary fish are slower to adapt to changing conditions. Humans have an additional problem: Rottenberg says “Homo sapiens has the distinction of being a species that can become depressed without a major environmental insult.” We think our way into deeper depressions by rumination and self-flagellation. We worry about remote or nonexistent possibilities. When we are depressed we think we ought to be able to fix ourselves; but we can’t, and that makes us even more depressed.

Sometimes depressed people can’t even get out of bed. This reflects a lack of goals. They don’t see any good reasons that would motivate them to get up. Humans can set goals in abstract domains where progress is hard to measure. When they hold on to failing goals, they become depressed. They need to disengage from the failing goals. Self-help books and the ideals of happiness in our society create high expectations and perceived failures. In the West the idea of happiness usually involves high levels of arousal like enthusiasm and excitement; in general, those who place the highest values on that kind of happiness tend to be the least happy. Asians tend to place greater value on low arousal states like calm and serenity.

According to Rottenberg, depression arises not from a defect, but from what we do well: thinking, using language, holding onto ambitious goals, and even our drive to be happy. Rottenberg says “The picture of depression that emerges is richer, more interesting, and in some ways more troubling than defect-model approaches would allow.”

He offers clues about how low moods can be better managed: appreciating the costs of thinking, sometimes accepting a low mood with equanimity, aiming for goals that are high but not too high, knowing when it is time to give up on a goal, and realizing that happiness is not itself a goal but “a fleeting byproduct of progress towards other goals.” Despite the evolutionary directive to become depressed, we retain a margin of control to shape its course.

We have learned that depression comes on more gradually and lifts more gradually than we once thought. We can’t predict whether a patient will respond to any treatment, but that doesn’t mean we shouldn’t keep trying. We used to think antidepressants took 6 weeks to show an effect, but we often see patients improving in the first two weeks, even those taking a placebo! Early improvement doesn’t predict final outcome. Early improvers may face fewer life problems, have an innate resilience, or maybe they are just lucky. Recovered patients may still have some residual depression and fear that a relapse could happen any time. A deep depression can re-program our mood system so that it favors a return to low mood states; but the same brain plasticity also allows for re-re-programming to a more normal state with treatments like mindfulness-based cognitive therapy, which attempts to disconnect sad moods from negative thoughts about the self. Mood can be rebuilt by changing the way we think, our environment, our relationships, and our health habits like sleep, diet, and exercise.

“Just like hunger or pain, moods are survival-relevant mental states that can bind together thoughts, feelings, and memories [and] change our mental priorities.” But they lead to mood-congruent memory, where we retrieve memories that match our current mood and are unable to call up contradictory memories. This can fortify us to change our situation, but it also tends to deepen the depression and makes us mentally less nimble.

Depression can be viewed as an opportunity. Rottenberg describes a patient who used her depression as a lens to re-evaluate everything in her life and re-set her priorities. Her life was better after the depressive episode than before.

Conclusion

Rottenberg calls his ideas the “mood science approach” to depression. He says:

The evolutionary perspective asks us to be patient, to learn to tolerate some degree of low mood, and to listen to what it is that low mood can tell us.

I don’t think his approach qualifies as a “paradigm shift,” but he does provide some valuable insights about this frustrating condition. Some of these insights are speculative, but most are based on recent animal and human research.

I used to try to reduce the stigma and guilt of obesity by telling obese patients that their tendency to store calories as fat was not a bad thing per se: it would give them a survival advantage over thinner people in a starvation environment or an environment of alternating feast and famine. But in our modern environment, where food is plentiful, the survival advantage is with the non-obese. I don’t think what I said made them lose weight more successfully, but I hope it provided some degree of comfort and reduced guilt. In the same way, Rottenberg’s concepts may help destigmatize depression. Depressed patients may feel better about their condition if they are told that it is a result of evolutionary traits that are basically good for us but that sometimes overdo it. If nothing else, the ideas and the experimental evidence Rottenberg presents provide plenty of food for thought.

http://www.sciencebasedmedicine.org/depression-re-examined-a-new-way-to-look-at-an-old-puzzle/

[SweeperDee]

Interesting take on depression

http://www.sciencebasedmedicine.org/depression-re-examined-a-new-way-to-look-at-an-old-puzzle/

If we aren't designed to be happy, then the dopamine-reward hypothesis is a complete evolutionary anomaly. The same goes with oxytocin production in the brain; there's no natural inclination to either happiness or unhappiness. If we were meant to be unhappy, these two chemicals, and their following effects and reactions wouldn't exist.

Depression, to me, is a product of chemical imbalances in the brain and environmental stressors (poor home life, social life, financial worries etc etc). Whether the chemical imbalance brings about the environmental stressors or vice versa is purely down to the individual case. What can be said is that due to humans purely unique idiosyncrasies and behaviour, we may never find a general unifying theory as to what causes depression, or any other mental illness; because we all process emotions differently, we all react to emotions differently, and no brain works the same as another.

Also just to add, that article seems to suggest that we should just become stoic mages; devoid of any sort of positive expectation from our lives, not good advice.

Edited September 27, 2014 by DonnieDarko

[Sergeant Wilson]

The same goes with oxytocin

Helps with your plooks though.

[JogaBonito]

If we aren't designed to be happy, then the dopamine-reward hypothesis is a complete evolutionary anomaly. The same goes with oxytocin production in the brain; there's no natural inclination to either happiness or unhappiness. If we were meant to be unhappy, these two chemicals, and their following effects and reactions wouldn't exist.

I wouldn't want to comment. I am totally out of my depth to the biochemistry of it all.

Depression, to me, is a product of chemical imbalances in the brain and environmental stressors (poor home life, social life, financial worries etc etc). Whether the chemical imbalance brings about the environmental stressors or vice versa is purely down to the individual case. What can be said is that due to humans purely unique idiosyncrasies and behaviour, we may never find a general unifying theory as to what causes depression, or any other mental illness; because we all process emotions differently, we all react to emotions differently, and no brain works the same as another.

I definitely share a similar view - here's an interesting take which probably on the same wavelength.

- https://www.sciencenews.org/blog/scicurious/stress-and-susceptible-brain?mode=blog&context=131

Also just to add, that article seems to suggest that we should just become stoic mages; devoid of any sort of positive expectation from our lives, not good advice.

I'm not sure if I agree, but you're definitely entitled to your interpretation.

Stuff.

[Fireplace]

I'm a poster on here but I've registered a new account to post on here, I hope that is OK. I don't want to post under my current name as I'm not comfortable with people knowing details of what I'm going to post about, I know a few people on here offline and have some family members who post. If the mods aren't comfortable with this then I'm happy for them to delete this account.

I've had problems with depression, anxiety, binge drinking and suicidal thoughts. This came to a head at the weekend when, after a monumental 12 hour drinking session, I tried to hang myself. I can't really remember what was going through my head at the time but the whole day had been spent lying to my girlfriend when she rang to see how I was, to family members who were looking for me and then just on a huge drink with people I barely really know. I've done this so many times but this time it just came to a head, I've let so many people down and it just seemed as though things would be better if I wasn't here. I tried to hang myself with a belt from a fence down an alleyway, I put my hands in my pockets and sat down but my body kind of jerked back just as I was about to black out and then I didn't do it. I phoned my girlfriend who got someone to come and get me. Yesterday I went to a mental health outreach centre and today I saw my GP, or a practice nurse at my GPs.

I'm feeling fucking shit to be honest - my family, my girlfriend and others have been impactged by this and I just feel so ashamed and embarrassed. I've not been able to be fully open with everyone about my behaviour - I generally get spells where I feel brilliant and invincible and go out bevvying and during those periods I've done some pretty desperate things - cheating on my girlfriend, taking drugs, blowing large ammounts of cash on god knows what. My partner is being so supportive but in the run up to this I've been seriously considering leaving her. I can't do that now, not after this. Also, the outreach centre and GP both immediately jumped on teh alcohol and stress angle but I've had these thoughts for a long time and not always relating to alcohol. Most NHS mental health care appears to involve leaflets and being told that no-one is available. I'm also worried about the affect of this on my work, I don't know how they will react if I try to self-certify. I don't want to tell my manager that this has happened but I don't think I want to go back at the moment.

I'm hoping that this is part of the way I can come out of this, I felt terrible yesterday and today I'm feeling very down. I know I won't do anything like what I did at the weekend again, that's what everyone is scared of though. I'm assuming I won't do it.

[RH33]

Ill send you pm.

[BinoBalls]

Very sorry to read that problem but thanks for sharing.

Alcohol always seems to magnify whatever problems you may have. Certainly a 12 hour binge is one serious session and although it obviously doesn't completely explain your issues, my (unqualified) advice is to stop drinking for a while, or at least cut down. I think that's one piece of action you can hopefully take yourself in the short term. It may also put your family and friends at some ease.

Do not feel embarrassed. Remember it's an illness and we don't choose to feel this way.

I tend to find I get extremely low for a few days after a night out. So if you have depression anyway, alcohol is only fuelling the flames.

[Lyle Lanley]

An wee update on myself.

Feeling a lot better at the moment and the first time i've been really happy for the first time in many months (well except watching Hibs).

Fireplace - if you ever want a PM to someone to talk to, i'll happily speak to you.

[EdgarusQPFC]

Wee update. Still sticking in at work and have someone in my life who means a lot to me. Although we have had problems with a guy who also likes her and refuses to accept that she wants to be with me. We are getting through it, but it's not been easy. She's worth it though.

[Lyle Lanley]

Wee update. Still sticking in at work and have someone in my life who means a lot to me. Although we have had problems with a guy who also likes her and refuses to accept that she wants to be with me. We are getting through it, but it's not been easy. She's worth it though.

I'll take a pm mate as i've been through similar before.

[Fireplace]

Thanks for the replies and PMs.

At least you're not Seamus, Fireplace.

Hopefully.

I'm not. Always look on the bright side.

Edited October 9, 2014 by Fireplace

[paddymcp]

Anyone suffering from Depression or some form should avoid alcohol in my opinion. The irony being I use alcohol to help with my anxiety and un-diagnosed depression. A coping mechanism of course. My anxiety and lack of confidence is such that i'm that inhibited to be the person i want to be and the creativity and love i feel i have to give is supressed and so avoid situations that i truly desire. So the alcohol temporarily nulifies these stresses and makes me become this relentless uninhibited force of life who's the creature, author, architect and soul of the party and basks in the attention of it all - without fear or skepticism. If I could capture they moments and live by them life would be wonderful but they moments and nights are followed by death-would-be-helpful hangover where we go to some dark places which is often perpetuated by ruminating of the previous nights events and wondering what you said there and how you came across then and basically torturing the mind into submission until you slowly sober up and return to the same tongue tied sceptical depressed self pitying tense man and live that life for a few days and return to the previous chain of events i have already referred to. Drugs also play a part in my life. Sometimes the alcohol doesn't cut it and the fear of losing control i.e. get absolutely steaming (we dont do half measures) and be as vulnerable as one human can be we will regularly take MDMA and basically anything we can get our hands on to alert and stimulate the brain and to keep the 'falseness' alive. Drugs like MDMA are good in the sense that they provide you with an absolute clarity in thought and sense and you see things for what they are. Its quite beautiful - but the side effects are quite hideous - depression, lack of sleep, just head messed up in general - such as with alcohol. Basically one endeavours to live a life of joy yet sabotages himself from it for reasons unknown to himself.

That was just a randum scrambling of my thoughts there. Probably doesnt make sense to alot but such is life.

Edited October 9, 2014 by paddymcp

[Boo Khaki]

Bloody ironic that alcohol is pretty damned effective in taking the edge off Hypomania. I go and get shitfaced, immediately feel more level, come out of my manic state, then all depressive hell breaks loose. It's lose/lose really.

Edited October 10, 2014 by Boo Khaki

[JogaBonito]

Not posted in a while (last one was way back in p64) but just want to say to those, keep your head up, get help if you have the opportunity (so many evidence-based treatments) and reach out to friends and family for support (the latter point could not be stressed any highly!). Get your sleep in check too.

Don't be like me and f**k about inconsistently with meds, stick your head in the sand, not claim benefits when it's on offer and just lie in bed, wasting away a year and a half of your life in solitude.

I'm feeling hopeful and just want to let you all know, you can do it!

Best.

^^ Spoke too soon. Past couple of weeks have been absolutely torrid. I've sorted a job interview for Tuesday though. However, I can't help but have that niggling feeling that maybe I'm not ready - everyone keeps telling me to take my time (I just can't lie about doing nothing, I've done it for far too long!).