Depressed, or just "Life?"

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RN58186

143 Posts

Specializes in Nephrology.

Part of the problem is that we have a common name - depression - identifying different things. There is the "I'm just in a bad mood today" depression and there is the major clinical depression that lasts for months or years. As one who has battled major depressive disorder for over 10 years, I try very hard to educate people that major depression is not the same as having a bad day or week. I had a cousin tell me "I was depressed once. I took a couple of days off work and I was fine". I had to wrok really hard not to yell at her that what she was calling depressed wasn't the same thing that I have been struggling with for so long. People don't get it. Yes, I take meds and have been in therapy for years. I have more than 15 mental health admissions for depression and numerous suicide attempts to my name. That is part of my life. I think mofomeat portrayed it very well. I still struggle, but am managing to work full time while continuing treatment, and for that I am grateful.

However, I have a friend who is on "permanent disability" for depression. She goes out with her grandkids daily, travels, pursues her hobbies, sleeps in "because I can" and meets with friends regularly. To me, she is making claim for a condition that is not there, and that impacts how people look at those of us who struggle legimately with mental health. She had a job that she did not like, and made no bones about the fact that she was looking for a way to get out of going to work. Yes, she had issues at one time, but she is well enough to work, but chooses not to. I believe she is lying to her doctor about how she is managing in the outside world so that he will keep signing off on her disability paperwork. She told me once that if she went back to work she would be able to spend as much time with her grandkids or have so much time for her hobbies. We'd all like to be paid to do hobbies and see family, but that is not the reality of the world we live in. People like her give a bad name to people who have true clinical depression.

So, yes, I think some people just don't want to deal with real life. There are struggles we face every day as human beings that we just need to learn to cope with. It doesn't need meds necessarily. But an ear to listen, a good friend is invaluable. We also need to be careful of painting all people with the same brush - there are people who need help but who because of the actions of others are not always taken seriously. And that is what frustrates me.

CompleteUnknown

352 Posts

and now for the long response:

I thank Jdoug (the OP) and the respondents on this intriguing post. I have a lot of ideas churning in my brain about the whole depression thing (thanks to 10+ years of liberals arts education) so I'm speaking from not only a clinical perspective, but a socio-cultural-what-the-f-is-the human-condition perspective.

Jdoug's friend should probably, because I am assuming that she lives in the United States and we are a very competitive country-seek some professional advice that will not be found on this forum. No offense to any of my fellow nurses but what we say here ain't going to reimburse her insurance company like a few strokes of a psychiatrist pen will. Also, I couldn't sleep knowing that the new child is being taken care of in that type of environment, while it's okay right now, could become bad very quickly.

There is the whole East/ West perspective on depression. Fact is that I'm assuming most forum members are participants of the western society and therefor have to appreciate depression from the Western perspective.

According to the WHO, by 2020, depression will be the number one cause of disability. It's cost to society is not measurable. And depression happens to be the number one lethal type of mental illness. Few people kill themselves due to schizophrenia or dissoaciative fugue. Depression causes more deaths than any other mental illness. Jdoug obviously knows that depression is a real and deadly affliction.

On the other hand, can I tell you how sick I am watching ads on TV for medications that are designed solely for the purpose of growing out your eyelashes and eyebrows? Ever heard of mascara? Gosh, even I have used mascara a few times in my life.

You also get the case of people who are not really clinically depressed who are just really competitive types who will get a fluoextine prescription just for the extra edge on the competition. That issue I haven't even begun to get my head around.

From a liberal arts perspective I'm reminded of novels and movies like Blade Runner and Johnny Mnemonic where people have debilitated from too much information. We are given entirely too many options and have too much information and are overloaded by choices, pressure to succeed. My parents were considered successful if my father got a job straight out of highschool and kept it, bought a house, a car and got a pension. Today, you have to have a masters degree ( I have one, but little good it does) and you will change jobs 100 times and there will be no pension and you wont be considered successful unless your child gets accepted into the most exclusive Montessori School, you win a Pulitizer or are deemed better looking than Paris Hilton by the latest reality TV show or You Tube channel.

So I would say that it is really tough these days. I cannot imagine being a child in this day in age when I spent my summers swimming in the lake all day and lollygagging with my best friends on my bike instead of taking Sullivan courses in order to ace not my SAT, but my PSAT!

I think we have too much artifact in our lives that are causing real medical and psychological problems. Remember that stress is a real cause of heart disease. I'm under 35 and grew up with a rotary telephone, can operate a computer running on BASIC and know how to use a can opener that isn't attached to the underside of a cabinet. This is not the way that life is supposed to be and I don't have any answers.

Again, I would suggest a lunch date and strong shoulder to cry on. From there, who knows.

(steps off the soap box)

This is why a holiday in a cabin or holiday apartment is such a stress reliever for me. I walk in, it's clean and spacious and immediately relaxing because there is no STUFF in there. All the flat surfaces are bare. There's a couple of saucepans in the cupboard and a few plates and mugs. A kettle and an old fashioned tin opener. 2 towels. You've only brought a few sets of clothes with you. You can actually live and breathe because you're not surrounded by clutter and all those items you thought you just had to have. When you've dirtied the few cups there are, you wash up. When you've worn your 3 lots of clothes, you throw them in the washing machine. You make simple meals because that's all you CAN do with what's there and it's almost fun to clean up after yourself and put those few plates back in the cupboard because there's room and you're not trying to squash things onto an overloaded shelf and shut the door quickly so you don't have to see it.

Removing the physical clutter and 'things' around you seems to also get a lot of the rubbish and clutter out of your mind - well it does for me anyway. I just need to learn how to do it at home. I wouldn't say I'm a hoarder (although hubby is) but even so I seem to have far too many things in my cupboards and on my shelves and even in my fridge.

romie

387 Posts

Specializes in Not specified.

RN 58186, your response completely resonates with me. I have been struggling with my own depression for years. The onset was about 2001 and I started taking meds in 2002. You appreciate how it terribly cyclical it is, even with the best intervention. I've enjoyed my years of remissions and have been devastated by it's unexpected recurrence. Its more than just feeling bad for a couple of days or weeks. Actually, some people with depression don't even feel sad or bad at all, they just lack energy and drive that they used to have. The fact of the matter is that the World Health Organization, which concerns itself largely with helping poor indigent people, is very concerned about depression, which some people may claim is a wealthy person's disease.

Just like patients who are s/p CABG off or on pump, using mammillary vs. saphenous grafts, every person dealing with depression is completely different. It's a MEDICAL condition. In some cases it can be as lethal than any s/p CABG can be and I've worked my share on ICU's and telemetry to know what I'm talking about.

There is a big difference between people like your friend on disability and people with debilitating depression. Real depression is like an invisible cage that traps you inside. If I had a choice between chronic depression and chronic paraplegia I would choose paraplegia. Being stuck in a mental cage is far worse than being stuck in a physical cage.

romie

387 Posts

Specializes in Not specified.

I think the nursing answer would be:

If a patient presented with Chest Pain, I would respond appropriate and implement the necessary interventions. I don't care if they are faking it or not, I'd rather not take the risk and it is not my place to judge.

If a patient presented with depression and stated that life was unbearable and overwhelming, I would respond appropriately and implement the necessary interventions. Again, I'm not going to take a risk and judge otherwise.

There is nothing like a patient suicide to make you rethink your ability and effectiveness as a nurse. It's worse than a patient falling on your watch, I presume.

I agree with your observation. I just spent one year working as the Heath Services Administrator in a medium sized jail and noticed the overwhelming amount of inmates on antidepressants and anxiolytic's. If they were not currently on those medications they were eagerly seeking them. I personally felt it was a lack of coping skills because the parents of this population never taught their children how to cope with difficult situations and how to take ownership of one's own life. I don't think that life has gotten more boring or more difficult to live because of technology. I personally think technology is a wonderful thing but when it replaces human contact and the human experience that is where the problem comes in. A good example is a child taking care of a virtual pet on their ipod or tablet versus having a real pet. I also suspect all the chemicals we ingest daily as part of our wonderful western diet could have an impact on chemical imbalances in the brain leading to an increase in those diagnosed with depression or anxiety. Of course, this is only my humble opinion.

N.U.R.S.E.

131 Posts

depression is subjective to some degree however we have not been taught how to deal with lifes challenges. although I suspect that we are allowed to verbally express our feelings instead of keeping them bottled up inside as days of old we were taught to do. However life does not always turned out like you planned and you may not have brought a parachute or a plan b or plan b gets busted. life is full of suprises there are no guarantees and sometimes we feel helpless or powerless to change things, thats why a wise person wrote the serenity prayer. sometimes you wonder why but we are affected by the choices that we have made and we must live with them the conseqences can be staggering you just never know one way or the other. we must be taught to deal with stressors or always try to deal better when things dont go as planned we can turn to Jesus, drugs or anything we feel will alleviate that void

Whispera, MSN, RN

3,458 Posts

Specializes in psych, addictions, hospice, education.

I believe people can be disabled by the kind of depression that is a response to terrible things happening, just as much as they can be disabled by chemical-imbalance-in-the-brain depression. If we see those two on a continuum from situational to chemical, there's a spot where they probably overlap, and it's difficult to see exactly where that spot is. I also believe situational depression can trigger chemical depression. Sometimes medications can help situational depression when it's unclear if it's all situational or not.

Depression is what the person says it is. It's not helpful to say someone with situational depression is suffering less than someone with chemical depression. It's still suffering. Both types can range from just-a-little to GOOD-GRIEF!!!

Some people respond to stress differently than others too. Some fall apart, some become hard, and some work to change the stress. We're all just different in personality. It's good to have coping skills and to develop the ones we have as well as to learn new ones. Until we have them, though, sometimes we suffer immensely...

Specializes in PDN; Burn; Phone triage.

I guess I find this question very interesting because I've been dx'd as clinically depressed (and anxious and anorexic and eventually borderline) since I was 12 or 13. And I was, like, actually clinically depressed spent-most-of-my-teenaged-years-in-psych-hospitals crazah.

I am currently very unhappy with many of my life choices. Marriage. Job. etc.

I personally think that divorcing the two sources of my depression has been the hardest thing that I've ever done. But it is possible.

sunny4you

10 Posts

Totally don't understand it, when so many people, especially women need so many lets say medication to help them cope with "LIFE" .... don't get me wrong, I'm not talking about those who actually have a psychological or physical imbalance/condition!!..There are too many volunteering positions or even causes that need human hands to participate or lend a hand to..so to speak....I don't get it....give me a break....if they would just stop focusing on themselves, they would get out of this rut....exercise as simple as walking is excellent too, and you can't wait for the desire for these feelings to occur, you have to push yourself outside to the local high school track or your neighborhood or even the sidewalk in your own neighborhood....it just requires pushing yourself.....lets say its a start....

netglow, ASN, RN

4,412 Posts

Well, if you do try meds for depression and you don't notice any change... one thing I'd say, if they help just a tiny bit, maybe just enough to get you up another rung of that ladder you are climbing to get out of the "pit of hell", go for it.

I think it takes a lot of things to get out of a depression, and if meds help great. Some people make to much a big deal of it all. It's just a pill. There I said it. You can do a lot worse to "harm" yourself IMHO. Relax, see if it works.

nmychair

4 Posts

I think that going through life can cause people to lose perception. My "aha" moment was a couple months after my mom died about 12 years ago (my dad and biggest hero died when I was 16, so death wasn't a stranger to me), i had quit my job and found no happiness at any turn. My husband would come home everyday to find me asleep in the closet after I had cried myself to sleep. He sent me to the doctor, I came home with meds and days became blurs. I woke up one day, six months into the medication haze and decided I would rather experience highs and lows than experience nothing at all. Ever since, I have made myself goals to accomplish. When one goal is met, I make another one, or two. Was this clinical depression? or situational depression? Personally I don't care what you call it, I call it "I need to stay busy to stay happy". A pill couldn't give me the goal driven happiness i feel right now. Let me say that I am a new graduate, so overwhelmed I may feel in the next couple of weeks but nonetheless I am penciling out my next set of goals (first of which is to find me an excellent mentor in the hospital I just became employed with).

Life isn't fair, isn't perfect, and the sun doesn't shine every day, we need the rain to grow. That being said, I think if you are truly depressed, you don't even feel like complaining, cause really what good does it do, is anything or anyone going to change? Those are the ones I fear are really suffering. If you have the energy to complain, then try using that energy to change.

Don't flame me, it is just my opinion, take it for what it is.

Sarah G

28 Posts

Specializes in ortho rehab, med surg, renal transplant.

I kinda think some of the stigma r/t mental illnesses has faded & people are more open & willing to talk about their problems. Choices for antidepressants have improved & with less side effects. This is an interesting thread, thanks for posting.

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