Nursing & Depression - page 16

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   Youda
    Interesting post, Anne. As most of you know, I've been wrestling with these kinds of things for awhile. Once I got a little more level with the anti-depressants, I felt that understanding stress and depression, what causes it, and how to cope with it, would help me in not getting here again.

    From what I'm reading, the factors are complex. But the Maslach Burnout Inventory identified three personality traits that tend to be more susceptible to work-related depression/burnout/stress.

    * idealistic professionals who have unrealistic expectations about the work situation;
    * accomodating, empathic people who pour too much of themselves into their jobs, and
    * an individual's reaction to stress coupled with their stress-coping mechanisms.

    So, my plan is to say NO more often. To do no more than what I need to do for my own patients. No extras anymore for employers, no matter how "short-staffed."

    Environmental work factors identified are:
    * role conflict;
    * ambiguity;
    * autonomy;
    * no opportunity to participate in decisions, and
    * lack of control of one's job.

    So, I've got to start insisting on being part of the decision-making process in things that involve me directly. I think, I hope, that there are ways to avoid depression and burnout. But, I think it's going to require a change in how I view myself in relationship to "others" and becoming more assertive, and valuing myself above my job, even if that means I have to flip hamburgers. I have a feeling, that if I stay out of depression and have a good attitude, I'll end up being the manager of that hamburger joint and earning more money anyway.

    Well, anyway, that's what I hoping. I'll let you know if it works!
  2. by   sanakruz
    AMEN ABRENRN!!!!
    There is definately a withdrawal syndrome from both effexor and paxil. I work in an out patient mental health clinic and this was brought to my attention by my clients, I researched and found plenty of anecdotal info on the www.There was a article in the Washington post in Aug of this year:"Quit Paxil,And Then Zap!"(washingtonpost.com) One must be a savvy consumer-I tell this to my clients too. There is a lot of misinformation out there as well. the church of scientology is very anti-psychiatry and is behind a class-action lawsuit in Texas against ritalin. This all relates to my pet complaint that there is something deeply wrong about the way we deliver help in our health care system- but you know what? sometimes I think I know how to fix it, and other times I sink into a melancholy over it. We all need to be on the same page somehow...(HOW??)
  3. by   tattooednursie
    I always really try o have a sense of humor about everything. All the time I try to ake jokes about everything, and make people laugh, but there are nights when I just go home and cry because some one I was attatched to dies on my shift, or some one had to die alone (my pet peeve) or if some one is dying and I feel they are not going to make it throug the night and I'm afraid that no one will be with them. I havnt exactly created a "hard shell" yet, and I don't know if I ever will.

    I get anxiety alot at work too. I have an ulcer that I have had since I was nine. It hadnt bothered me again until I became a CNA. now whenever I get upset or angry at work, and I hold in my feelings I get really SHARP pains in my stomach, and then for the est of the day i feel so nausiated that any foul smell makes me throw up, and in long term care, working with geriatrics and psychs, there is bound to be some BAD smells. I'm sure my co-workers think I'm bulimic or something. I think that I may begin taking anti depressants because I love the field of nursing even though it is stressful.
  4. by   abrenrn
    Thanks for the new data. I meant to mention something like that in my post, got caught up on my soapbox. Actually the standard or care, now, is to gradually remove antidepressants to avoid this withdrawal syndrome. No, they are not addicting. The sudden removal of any long term med is unsafe (never stop BP meds abruptly else rebound hypertension).

    Over many years of experience, I have found that these symptoms are uncomfortable but self limitting, generally pass within one or two weeks. In 1975 I described "zapping in my head" to my psychiatrist who told me "there is no withdrawal from antidepressants" and did not choose to explore an obvious description of neuralgic pain. Over time, I learned that any time I stoppd an antidepressant it would happen, last 2 weeks or so, then pass. I never bothered mentioning it to another psychiatrist as they would always say it was in my head (which, I guess, it was)
  5. by   sanakruz
    mandi
    I personally would not recommend antideprssants at this point. It's absolutely tragic and wrong that some dies alone and institutionalized. Unfortunately here in the US this happens alot. It has become a cultural norm. What is even worse is some turd is making money- The nursing home industry is private enterprise territory. here in CA it is well known that the staffing ratio mandated by law in the 1970's is woefully inadequate today.The dept of health services levies fines which do nothing because the industry factors that into their overhead cost! To get to the point, you are situationally depressed- not a pathological condition,but a natural reaction of a caring individual in the face of great injustice. Try to keep your sense of humor intact and explore lifestyle changes as a solution to your GI problems. Antidepressants on the market today are really a boon, but they should not be looked upon as a panacea for everything-They are powerful drugs with some really nasty potential sideeffects. And I dont think they should be advertised on TV!
  6. by   sanakruz
    abrenrn- we have 3 docs in our clinic. 2 are past 70. They do not listen to the clients- It can be apalling! The ones getting shafted the most are older women. Anyway,clients kept complaining to me(I'm the only nurse, an LVN) that generic paxil was not working as well as the brand name.My spin on this was to take their word for it but remain skeptical.One day I had a opportunity to corner a drug rep- He acknowleged that was real because of the difference in inactive ingredients used as fillers;it can affect the absorption rate and some people can develope ALLERGIES(!) Yesterday I found out that risperdol contains latex to make it easier to swallow! Yeow
  7. by   sanakruz
    Whoops! I mean Prozac not Paxil. Without insurance a consumer can spent $140.00 a month on a therapeutic dose regimen of prozac
  8. by   mattsmom81
    I don't claim to have all the answers for nurses suffering from depression and anxiety related to the career.

    I sure do agree it's all the liability with zero authority, the endless demands on an exhausted, caring and giving group..that contributes to our depresion as a whole.

    Getting in touch with these feelings and acknowledging the 'truth'...that I alone cannot 'fix' healthcare, it is dysfunctional and runs on nurse abuse...this was something I had to acknowledge before I could begin to heal. But I am the oldest child of an alcholic...I am a 'savior' so this was hard for me.

    We are important...we are worthy human beings. We should not martyr or sacrifice ourselves... it is not worth it. LIFE however, is worth it...and we must strike healthy balances...find a job we can do that doesn't kill our spirit. Find joy in our family and friends, and most of all..DON'T buy into the blame that healthcare puts on nurses!!

    Depressed folks need to find a kind therapist to work out the feelings and begin a plan to get better. Meds alone are unlikely to help if you don't do the 'talk' work, IMO. Best wishes all...I'm working on feeling better too...every day!
  9. by   mattsmom81
    I don't claim to have all the answers for nurses suffering from depression and anxiety related to the career.

    I sure do agree it's all the liability with zero authority, the endless demands on an exhausted, caring and giving group..that contributes to our depresion as a whole.

    Getting in touch with these feelings and acknowledging the 'truth'...that I alone cannot 'fix' healthcare, it is dysfunctional and runs on nurse abuse...this was something I had to acknowledge before I could begin to heal. But I am the oldest child of an alcholic...I am a 'savior' so this was hard for me.

    We are important...we are worthy human beings. We should not martyr or sacrifice ourselves... it is not worth it. LIFE however, is worth it...and we must strike healthy balances...find a job we can do that doesn't kill our spirit. Find joy in our family and friends, and most of all..DON'T buy into the blame that healthcare puts on nurses!!

    Depressed folks need to find a kind therapist to work out the feelings and begin a plan to get better. Meds alone are unlikely to help if you don't do the 'talk' work, IMO. Best wishes all...I'm working on feeling better too...every day!
  10. by   Youda
    mattsmom81, I sure agree with you. Nurses are legally and morally responsible for the care of their patients. But, when we are consistently given unsafe staffing, high patient-to-staff ratios, poor and faulty equipment, it sets us all up for failure. Admin takes the position that whatever conditions we are given, we have to make it work, even when it is so unrealistic as to be "abusive." It isn't just all a personality type. We are set-up to fail, and bound to take the responsibility for those failures (check out any BON position statement or ask any lawyer). Yes, admin can get nailed, too, but they have the assets and legal department to protect them from the consequences. Nurses lose their livelihood. We are setup to be powerless and setup to fail. How can we NOT feel depressed or suffer burnout? Well, I have to get up tomorrow early so I can clean and winterize my 1984 transportation. When's the last time you saw anyone in admin driving an old clunker? We're setup to fail.
  11. by   abrenrn
    I am concerned about you, carpe deum. I feel strange posting on board but I am responding to a public post.

    Your last post, combined with earlier ones, makes me wonder if you have reached the true end of your rope. If you feel that is the case, go to a psych ER. If you have an HMO with separate company for psych, call them and say it is an emergency.

    People with severe untreated chronic pain and severe untreated depression often reach the point where suicide seems the only option. In depression, that belief is chemical. I know this from experience.

    From what I've read in your posts, you started sounding OK, ended up with a new psychiatrist (possibly due to a move), who will not continue a previously successful med regimen. You did not sound hopeless before, now, off the med, you do. Call your old doctor, ask for his help. Go to an ER. Just try these before you give up hope.

    Sorry for being personal. Just a sense I've gotten from your postings.
  12. by   mamabear
    Wow! After 200+ replies, I can say again only what worked/works for me:
    After years of depression, which I tried to treat with various combinations of alcohol, prescription drugs, anorexia, compulsive spending and sexual promiscuity , just to name a few, I finally found a decent, if expensive, shrink (25 miles away, no less) who tore through all my BS excuses/denial, found the right combination of meds (Synthroid, Estratest, Effexor and Remeron), and hooked me up with 12-Step programs.
    Everyone should be so fortunate. I realize that most people spend decades searching for the right whatever, never to find it or find only part of the answer. Don't give up, don't let the cost scare you off. It's your life, and it's the only one you get
  13. by   mario_ragucci
    Your imagination can help as well. Imagine you have a drill instructor who comes out of a box inside your hippocampus when ever you get the blues. This is the meanest, most unforgiving drill instructor whose mission is to keep you mentally fit. The drill instructor is a hardcore combination of your id, ego and super ego, and will never stop barking at you until you feel happy.
    Your imaginary drill instructor immediately harps on you about how the mind and body are really one, and the drill instructor makes fun of you and all the ways you come up with to avoid exercise. The anti-blues drill instructor shames you into exercising, and eases off you when you have reached your target heart rate. Once your imaginary drill instructor sees that you have broken a sweat for at least 20 minutes, he/she magically does an about face and marches back into your hippocampus and salutes you, until he/she is summoned again to come forth and chase your blues away.
    Mind and body are one.

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