Nursing & Depression - page 13

While visiting in the lounge one day, we discovered that every nurse there was on an anti-depressant. I have had 'Treatment Resistant Depression' for about 20 years--as long as I've been a nurse. ... Read More

  1. by   VivaLasViejas
    Boy, do I feel for you, sphinx! I know what you mean about all the paperwork---I'm a LTC nurse/care manager and ALL of mine has to be done by hand (my facility is still stuck in the Stone Age, no computers yet for us middle-management types). I hate to whine, but I too am suffering from major burnout and even my daily Paxil isn't enough to stop what's becoming a rapidly downhill course. I take an occasional Ativan to get a really good night's sleep, but I'm afraid to use it as often as I really need it, and anyway, there's something wrong with "needing" benzo's to cope with work!! Thanks to all on this thread for putting up with my b****ing, too.
  2. by   micro
    hey, all,
    thx for coming back
    i came back just to touch base.....
    keep coming back.........
    weekend off coming to close for me........
    back to work tomorrow..........
    oh, well
    siesta this p.m. was good.......weather just great.....
    and another day.........

    micro
  3. by   KarafromPhilly
    Until very recently I never let anyone at work know about my hx of depression, but I have been off work for eight weeks and when people ask I have let them know (that my meds were changed and it was disastrous for a while there). I am planning to put in my notice with my current employer and I just wanted to see how people would react. Everyone has been cool about it! I think a few people weren't quite sure what to say/were a little uncomfortable (one nurse said "I would never have known!"). So, I hope they think carefully about the fact that they have worked with someone who is capable and hardworking, and has also been disabled by mental illness at times.
  4. by   Youda
    oh, sphinx! Your story sounds vaguely familiar!

    KarafromPhilly, let us know if they continue to be OK with it.

    mjlrn97, if this place is doing this to you and you're still in your probation period? Let us know how you talk goes with your boss. Get assertive! I read somewhere today "learn to ask for what you need."

    And, micro, I think we're going to keep this thread alive from now on!
  5. by   Dave Frederick
    Taking back our power might help. May I suggest a solution.

    I think we can corrent all of the major problems in nursing by simply having all of us take the same day off. Let's say February 11th, 2003, all nurses on duty go home and no, I repeat no nurse comes into work that day. This would include all LPNS, RNs, ADNs, BSNs, MSNs, and RN/Phds. Exactly 24 hours later we return to work and see have some meaningful discussion with the powers in charge.
  6. by   Youda
    One major problem with that. All the nurses who are on duty at the time of the walk-out would have to stay for 24-hours until someone showed up to relieve them. It is patient abandonment to leave before you turn the care of your patients over to another. No If, ands, or buts about it. And since admin still had staffing, they wouldn't care and would have no incentive to talk or change a thing.
  7. by   Dave Frederick
    You missed something!! There would be NO nursing care for 24. How else would we make our point. Even the Yahoos in the ivory towers of administration would have to participate.
  8. by   Youda
    Hey, Dave! Yes, I understood the idea. I think it's a great idea. I wish it could be organized. I really do. But, the nurses on duty could not walk off. At 10:00 a.m., let's suppose, the walk-out was to begin, I couldn't leave because to do so is abandonment. There would be no one to relieve me, because they would all be out on protest, so I'd have to stay. Nursing care would continue, because to leave without a relief showing up would be abandonment, which is a huge no-no in nursing.
  9. by   carpe_de_em
    HELP! I NEED SOM HELP FROM SOMEONE WHO KNOWS HOW TO RESEARCH AN UNCOMMON TOPIC ON THE PROFESSIONAL (NOT LAY-PERSON) LEVEL

    My previous psych doc gave me Adderel for severe
    Treatment Resistant Depression. Now I've moved and my new psych doc will not prescribe it unless I can come up with documentation for use of Adderel in adults.

    Can anyone help?
  10. by   carpe_de_em
    HELP! I NEED SOM HELP FROM SOMEONE WHO KNOWS HOW TO RESEARCH AN UNCOMMON TOPIC ON THE PROFESSIONAL (NOT LAY-PERSON) LEVEL

    My previous psych doc gave me Adderel for severe
    Treatment Resistant Depression. Now I've moved and my new psych doc will not prescribe it unless I can come up with documentation for use of Adderel in adults.

    Can anyone help?
  11. by   Youda
    carpe_de_em! :kiss :kiss
    You probably won't believe this, but I've been thinking about you, and worrying. I know how down you've been feeling. So, I was worried. As for research? I love research! Give me a few hours and I'll see what I can find!
  12. by   Youda
    Here's a clinical trial for treat resistant depression:
    http://host.veritasmedicine.com/inde...106596&rfr=abt

    Use of Adderall in adults for AD/HD with contact information at the bottom of the page.
    http://www.ncpamd.com/NewADD_Meds.htm

    And, I found a couple of things:
    Psychiatric Times Journal, July 2002, Vol. XIX, Issue 7
    Options for Treatment-Resistant Depression
    by Glen L. Stimmel, Pharm.D., BCPP, and Alice S. Myong, Pharm.D.
    http://www.mhsource.com/pt/p020750.html

    Use in geriatric populations for depression:
    Psychiatric Times May 1995 Vol. XII Issue 5
    by Michael A. Jenike, M.D.
    Neuropsychiatric Assessment and Treatment of Geriatric Depression
    http://www.mhsource.com/pt/p950529.html

    Let me know if you need more. This took me less than 30-minutes to find, so I know there's more out there. I found lots of anecdotal evidence. No where did I find anything showing FDA approval for Ritalin or Adderall for the treatment of depression. But, I did find several articles where the use of Ritalin/Adderall for the treatment of depression preceeded recent medication advancements with the SSRI groups. I found a couple of anecdotal articles where Adderall worked well for a couple of months for treatment resistant depression, but then exacerbated a psychotic episode. I found another couple of anecdotal evidence that warned against taking Adderall/Ritalin for depression. Mixed group of information. But, I know from my own experience in nursing, that prescribing Ritalin for depression is not uncommon, and was used extensively in the 80s and 90s.

    If this doesn't do it for you, I'll get into some more of the professional journals. Good luck!
  13. by   abrenrn
    I have read through this thread with great interest. First things first though:

    Seize the day, try to seize the physician. Why are you having to research this topic? Is he paying you for this? Is he board certified? If so, he is expected to meet certain standards including some famialiarity with accepted off-label uses of medications. The use of stimulants as an adunct for treatment resistant depression has been in the literature for at least four or five years. Why does he not know this? Why doesn't he at least try to discuss this with the physician who treated you before? Have you ever asked a patient to research some nursing intervention for you before you will consider it? This is substandard medical care.

    Youda - regarding FMLA - Do your employers know they are breaking the law? If it is a big organization, have you spoken to human resources? All you need for FMLA is the form filled out by a licensed physician (I'm not sure if NPs can sign) and they are legally required to honor it. If you haven't spoken to human resources, do so. If they know what they are doing, there next step will be damage control - and I doubt you will be the one to take the brunt.

    Mario - if your so damned curious about what antidepressants do, how they feel, take some and stop asking. If you are so curious about how medications feel, you may want to try lanoxin, insulin, inderal, whatever. Generally if you don't need something you don't take it, if you do need it, you take it.

    My take on depression and other "psychiatric disorders" - they are no different from "physical disorders" but instead of affecting the pancreas, say, they affect mood, behavior or thought processes. As far as I can see, most chronic illnesses result from a genetic predisposition to certain environmental insults. The susceptibility varies from none (some people can eat all the sugar and carbs they want and never get type 2 diabetes) to severe. Once you never saw children with this, now it's almost epidemic. The predisposition was always there, now they eat the diet that shows it. Some people will get it despite an almost perfect diet. It is a continuum of sorts.

    My guess is depression is the same thing. A genetic predisposition/ susceptibility to depression that occurs in the face of various environmental factors. Some may get depressed in the best environment, others will never get depressed. It's a continuum.

    DEEP THOUGHT Is it possible to be enabler without a user somewhere nearby? Might the enabler in other circumstances be seen as just a nice person? I'd love to hear responses to this. It seems like it might relate to nursing

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