Nursing & Depression

sjoe · Nov 4, 2002

sphinx--any time someone tells you "it's all in your head," just respond, "you can't fool me. there's nothing in my head."

sphinx, BSN, RN · Nov 4, 2002

sjoe....no one has to tell me that, I tell it to myself.

but I like your take on it anyway.

BTW, I mentioned earlier it was a good day for pain? well not this eveing. It's baaaaack! Oh well. Well, it's past midnight, I'm up this late cuz I had to finishe paperwork from Thursday and Friday when I just came home and fell right asleep. Tomorrow evening I am on call. Oh terrific. Oh well, I signed up for it, right? Right.

abrenrn · Nov 4, 2002

Sphinx - I left you a private message, I think might help.

Sometimes prayer works. And I'm not even sure I believe in god but sometimes seems like the last defense against despair. I don't know, maybe it should be the first.

May favorite type of intervention though - it can't hurt.

sphinx, BSN, RN · Nov 5, 2002

Here's my update:

The PA from my GI doc called me back, asked how I felt...I said not good, she said she wanted to see me today, would squeeze me in. I was busy, but figured I'd go in come hell or high water, and rearranged my schedule. I had to wait a bit, but she examined me, asked questions, yadda, yadda.......said that it doesn't appear I need to run out and have surgery today, but my GB does need to come out. She touched base with the GI doc and my own doc, who recommended a surgeon. GI doc said only clear liquids to rest my gut till I see the surgeon. Needless to say, even with a poor appetite, I do get hungry, and wanted to get in right away (yeah, and pain too!). I called, can't see the recommended surgeon for a while, but his associate is free tomorrow. Fine with me, I don't care who takes it out. Its a chole, not a heart transplant. Only thing is, by now it's 4pm, and I can't get ahold of my primary doc office to have her call in new referral for the different doc, and appointment is at 8. So what, I figure, I figure I'll get a referral dated for tomorrow, it probably won't have a time.......heck, I'll pay full price for the consult even! Other problem....surgeon wants me to pick up copy of HIDA scan. Radiology dept (the office section anyway, where they get that stuff for you) closed, and I doubt they open early enough for me to get them before an 8am appointment. Do I care? No. The surgeon's office can always get a faxed copy of the results easy enough, and the films can be picked up later. I didn't have the chance to talk to my boss. I doubt he'll say we need to take it out right away, but heck, he might? Who knows? Will make for a crazy week. Gotta get an estimate on the car tomorrow from the accident this weekend. Kids are off tomorrow. Cat has appointment Wed eve. It's getting harder to pill her, she bit me and drew blood today. And I hurt. I had icky broth for dinner, and am now having icky apple juice. Whoopie, life is grand. But at least things are happeneing.

carpe_de_em · Nov 6, 2002

I am excited to be back. I was off for a few days changing servers so I have missed out pages 16-18. I have printed them in hopes of cathcing up.

I'm begining to wonder. I am on some of the heavistmeds for depression/anxiety made. I feel like ****. My depression/anxiety is as bad if not worse than it's been in two years. I think about tapering off. I mean if they aren't doing and good. I can be just as depressed w/o meds as w/ them and be free of side affects.

carpe_de_em · Nov 6, 2002

I am excited to be back. I was off for a few days changing servers so I have missed out pages 16-18. I have printed them in hopes of cathcing up.

I'm begining to wonder. I am on some of the heavistmeds for depression/anxiety made. I feel like ****. My depression/anxiety is as bad if not worse than it's been in two years. I think about tapering off. I mean if they aren't doing and good. I can be just as depressed w/o meds as w/ them and be free of side affects.

carpe_de_em · Nov 6, 2002

I am excited to be back. I was off for a few days changing servers so I have missed out pages 16-18. I have printed them in hopes of cathcing up.

I'm begining to wonder. I am on some of the heavistmeds for depression/anxiety made. I feel like ****. My depression/anxiety is as bad if not worse than it's been in two years. I think about tapering off. I mean if they aren't doing and good. I can be just as depressed w/o meds as w/ them and be free of side affects.

sanakruz, ADN · Nov 6, 2002

carpedeem- I personally would want to taper off and then stop if I was getting little relief. Taper off rather than stop suddenly because of the withdrawal syndromes which are likely. Sounds like you may have a "blunted affect" which is a s/s depression, but could also be med related. This is a personal rather than professional speculation.(I'm not a Dr., I just play one on the internet....)

sphinx, BSN, RN · Nov 6, 2002

BTW all, I am having a lap chole on Friday, the 8th. Thank goodness, the pain is getting very bad! (like it wasn't already.........). They were gonna do it the 18th, but changed their mind. I am actually thinking positively for once, hoping that if I can get rid of this pain, it might help relieve some (a little even) depression.

cargal · Nov 6, 2002

Originally posted by sphinx
BTW all, I am having a lap chole on Friday, the 8th. Thank goodness, the pain is getting very bad! (like it wasn't already.........). They were gonna do it the 18th, but changed their mind. I am actually thinking positively for once, hoping that if I can get rid of this pain, it might help relieve some (a little even) depression.

I'm sending positive thoughts out to ya sphinx! I hope this helps alot to make you feel better. Good luck and let us know how you are doing, we'll be anxiously awaiting.

Blessings,

carpe_de_em · Nov 7, 2002

sphinx--i'm glad you are getting something done about one of your problems. my heart goes out to you. your hurt, emotional and physical pain are a lot to bear.

younda--I thought your reply to sphinx about possible physical problems was really good. you are a thoughtful and caring person.

sjoe--lol at your "all in the head" comment. That one goes straight to my sister, who struggles w/ depression but has a wonderful sense of humor.

psychnurse--what is a "blunted affect?'

i cannot understand my moods and their changes. yesterday i slept all day. this am i fought a panic attact. pulse 160, resp 44, throat tight, etc. tonight i feel pretty good, just don't ask me to go out of the house. that leads to panic attacks. it never gets better. i've struggled w/ this stuff for 20+ years and am sick of it. sick of going to doctors. sick of not knowing how i am going to feel the nest day, let alone the next minute! it's never going to end and that is what ticks me off. i feel cheated out of so much. i haven't enjoyed a holiday in years. and now christmeas is upon us. my only strengths are: sheer determanation to live, a healty relationship w/ my significant other, and my faith in God. but, boy, i'm tired.

cargal · Nov 7, 2002

This is an interesting article from the Pgh Post Gazette. If this is true, think of other ways new brain cells may be stimulated to grow: from sunlight or a light box, from activity, ie reading, from spirituality, etc. I want new brain cells! That gives me another thought, perhaps humor stimulates a hormone that may stimulate new brain cells. I'm the scientist of the family, could you tell?

Anyway, here's the article:

New brain-cell production may be linked to depression

Monday, October 28, 2002

By Malcolm Ritter, The Associated Press

It was one of the most startling brain discoveries in recent history: the finding, announced in 1998, that people keep making new brain cells well into adulthood.

Now, scientists are looking into another surprising idea, that waning and waxing of this brain-cell birth contributes to depression and the effects of antidepressants.

It's more than an academic question. If it's true, it could help unlock the riddle of just what goes wrong in the brain to bring on the mood disease. And it could help lead to better treatments.

The theory focuses on the hippocampus, a structure deep in the brain that plays a key role in learning and memory. This is where scientists reported finding new cells in autopsied adult brains in 1998.

The idea that the rate of brain-cell birth, called neurogenesis, in the hippocampus affects depression is still in its infancy. It has met skepticism in the field. And even its advocates stress that a decrease in neurogenesis in the hippocampus would clearly not be the only brain change involved in depression.

So far the evidence for the theory is only sketchy. But it's hard to ignore a pattern in some recent findings in lab animals:

Stress, which plays a key role in triggering depression, suppresses neurogenesis in the hippocampus.

Antidepressants, on the other hand, encourage the birth of new brain cells.

Animals must take antidepressants for two or three weeks before they bump up the birth rate of brain cells, and the cells take maybe another two weeks to start functioning. That's consistent with the lag time antidepressants show before they lift mood in people.

If an antidepressant is given during a period of chronic stress, it prevents the decline in neurogenesis that normally occurs.

Exercise, which combats depression in people, also promotes neurogenesis in the hippocampus.

Scientists have also found evidence that the hippocampus shrinks in people who have had long-standing depression, although they haven't pinned that on a shortfall in new brain cells. The finding might just reflect shrinkage of existing brain cells instead.

All in all, the evidence shows correlations between reduced neurogenesis and depression, but there isn't a smoking gun demonstrating cause-and-effect yet, says Fred Gage of the Salk Institute for Biological Studies in San Diego.

Gage, who reported the 1998 findings, suspects a link to depression.

Barry Jacobs, a neuroscientist at Princeton University who published the theory with Gage in 2000, is now emphasizing the other side of the coin: the possibility that increased neurogenesis promotes recovery from depression.

"I think there are probably many more things that can plunge a person into depression, and I'm not even sure the critical trigger is this change in the hippocampus," Jacobs said. "Once they've tumbled down into depression, it may be that the change [in neurogenesis] is what keeps them depressed."

The idea, he speculated, is that the shortfall in new brain cells might impair a depressed person's ability to make the mental changes needed to climb back out of it.

If boosting neurogenesis really would help people recover from depression, it could give scientists a new target for creating better antidepressants -- even if a shortfall in neurogenesis doesn't have much to do with creating the depression in the first place.

Dr. Ronald Duman of Yale University, who studies how antidepressants work and how they spur neurogenesis, said one benefit could be faster-acting medications.

"That's really the silver bullet the field has been looking for," Duman said. "If you have a depressed, suicidal person who comes in for treatment, you don't want to have to put them on a drug for four to six weeks" to get an initial response, especially when the first drug tried might fail to work.

Antidepressants might work in part by spurring neurogenesis in the hippocampus, and that could prove to be one important action to shoot for in new drugs, he said.

Still, Duman believes the drugs must exert effects elsewhere in the brain, too. After all, depression brings a bundle of problems -- abnormalities in sexual drive, eating and sleeping, for example. So it makes sense that several regions of the brain are troubled, and that they all have to change for the disease to lift.

Some scientists doubt that brain-cell production in the hippocampus contributes to depression.

Given the known jobs of the hippocampus on one hand, and the symptoms of depression on the other, "it feels like a pretty strange path to get from a hippocampus that's not working very well to increased risk of depression," said Robert M. Sapolsky of Stanford University.

Sapolsky does think there might be a link, but in the other direction: Depression might hamper neurogenesis in the hippocampus. If that's true, he said, it might explain certain memory problems that sometimes appear in depression.

Everybody agrees that new research, and even new research methods, will be needed to demonstrate whether brain-cell birth has anything to do with depression.

Whatever the relationship between depression and brain-cell birth, the whole line of research illustrates an important and under-appreciated fact about depression.

"This is not self-indulgence, this is not failure of will," Sapolsky said. "This is as biological a disease as diabetes."

Nursing & Depression

Nurses and Depression/Anxiety