Nursing & Depression

[carpe_de_em]

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. Now I am totally burned out, on major meds, and am seeking disability d/t depression/anxiety.

I beleive years of long hours, high stress, high expectations and little appreciation (from management, not patients) has contributed to this.

How many other jobs consider you a tratior b/c you call in sick? And trying to get off for a sick child is an unforgivable sin. How many other jobs want you to work overtime on the days you are scheduled, call you at all hours of the night or day when you are off, first pleading w/ you to come in, then laying a guilt trip on you if you say "NO!" And let's not forget the mandatory inservices and CEU's that take time away from your family.

If any profession should understand the importance of the individuals' physical, mental, social and spiritual self it should be nursing--after all we are taught in nursing school about treating the patient as a whole, not just a disease! Why don't we treat our staff the same way.

Anyone out there in the same boat?

[mario_ragucci]

Im gonna play pretend and assert that I think only 7% of nurses take meds to help with their mental functioning. Thats a positive additude, and a recognition that nurses are people too. I can't let these threads paint a picture of all nurses. Some who have been in it for many years speak from experience and I listen.

I know there are many psych drugs, and I'd like to understand how it effects a person's additude and personality more.

Like, is there a certain look to being "depressed" more than the eyes and the gait? Facial expressions. Extremely short tempers. Sensitivity to anything beyond Martha Stewart or Oprah. :-)

I think women are more prone to certain bad mood spells that guys, and because of that, some women will shut any guy out when they are spiriling down. I can imagine that depression and psych meds could be wild cards if you work with the same coworkers.

[adrienurse, LPN]

Mario, I know you're so "medical model" and "everything can be explained on a molecular level" because you've been immersed in studies for A&P and Microbiology. There are just some things about illness, however, that need to be taken on faith. There is not an exact recipe for how to make a depressed nurse. Many factors are involved. Becoming a nurse will not necissarily predispose you to depression. The truth is, besides explaining how the drug works, for example inhibiting neurotransmitter reuptake, it is not fully understood how the drugs effect the personality or the person.

Also, one can only focus on the symptomology when diagnosing depression, it is not as simple as identifying a single look or behaviour. Remember, disorders such as depression are not even considered to be illness unless they start to interfere with physical health and welbeing. Finally, the sufferer is not always even aware that they are depressed due to the complexities of the human brain.

[Youda]

Originally posted by adrienurse

Finally, the sufferer is not always even aware that they are depressed due to the complexities of the human brain.

To make it even more intriquing from a "medical model" point of view is that researchers still can't figure out what causes depression, or even why some of the "psych meds" work. The current THEORY (perhaps only a hypothesis and not yet up to a theory) is an imbalance of the chemicals of the brain. My personal, unstudied, without any studies to back it up belief is that prolonged stress coupled with a genetic predisposition guarantees depression. Where one person would thrive on prolonged stress, such as those who enjoy a fast paced ER, others would find that a recipe for a full-blown clinical depression/anxiety.

In many cases, it isn't a cumlative effect, but a single event that triggers depression or anxiety such as a death or other traumatic (traumatic to that person) event.

But, I digress. To answer Mario's question, the symptoms are mostly subjective. There are some clinical manifestations, but they can't be used as diagnostic, such as: weight loss or gain, changes in baseline vital signs, insomnia or sleeping too much, etc. Obviously, those objective symptoms are too general to apply a diagnosis without the subjective input of the client. To further complicate the picture, many diseases can mimic a true clinical depression such as mild ketoacidosis in a diabetic or an electrolyte imbalance from use of diuretics or as an adverse side effect of a drug, all that will resolve the "depression" when the underlying factor is eliminated.

Adrienne mentioned a very real component in this. A person often doesn't know they are depressed. Again, it is often a situation when "health seeking behaviors" don't occur until you start to feel better.

It's an interesting topic to me (obviously). But, I would propose that eventually the causes for depression will be known. At this point, research is still at the Koch's Postulates era level, if you'll forgive the analogy. For the millions who suffer with this problem, we just take it one day at a time and rejoice in the days when we can.

[mario_ragucci]

Thank you very much for opening my mind to people and "depresssions." Your posts are fabulous to read, wow.

I still can't understand nuero-transmitters and how they work. i can't form a picture of something re-up-taking. What makes seratonin? My favorite psych instructor told a story about something called Amaloid (sp) plaque forming on neural-transmitters, and a link to altzhimers. Lifestyle.

I'd love to discover the chemical your brain makes when you sleep, and then make it, and give it to people. Thank you so much again for the most interesting perspectives on depression objectively.

[formernurse]

Mario, You ask if there is a "certain" look when someone is depressed. Believe me, unless you are a master of disguise, you will not mistake the look of depression. Having dealt with my own depressions for better than 20 years, and having taken antidepressants for the entire time, there is no way you wouldn't know when I'm experiencing a depressive mood.

[chrisrob]

good thread i have taken antidepressants but now i'm not sure if i was depressed or just burntout so much is expected from nurses we have so many different roles i.e mum/dad, wife.husband, son/daughter etc nurse. The nurse bit allows us to be under constant presure from patients their families docs other medical teams the media wow can they slaughter a nurse if she gets it wrong don't see them doing a full article on how they normaly always get it right sometimes i think we reach a point where we have just had enough veral and physical abuse and get 'tired' for want of a better word and where are our managers then they can see whats happening but just want there work area covered so you WILL pull that extra shift no matter that u promised your kids to go somewhere (guilt) somewhere we lose ourselves in all those roles so if taken antidepressents gives you beathing space to find 'YOU' again take them its not so easy to find time to do other things nurses are always playing catch up in their lives because they dont have time or there just to knackered after a shift to do anything but sleep so maybe if you look at the population as a whole there is more depression and stress out there not just in nursing but nurses are supposed to cope with everything so to the nurses who are on antidepresents and are depressed keep taking the pills if they keep you going advice to change your livestyles cant help becuse of the nature of the job and at the end of it most of us love being nurses and don't want to do anything else even if it does kill us LOL

[carpe_de_em]

THANKDS FOR ALL THE RESPONSES. DEPRESIION IS A DISEASE OF ISOLATION. I REALLY JUST WONDERED THREE THINGS:

[carpe_de_em]

SORRY ABOUT THAT -- HIT THE WRONG KEY AND OFF IT WENT. HERE IS WHAT I REALLY WANTED TO KNOW

ARE THERE OTHER NURESE OUT THERE WITH SEVERE DEPRESSION AND/OR ANXIETY DISORDER?

DO THEY FEEL LIKE THEY HAVE TO HIDE IT FROM ADMINISTRATION?

DO THEY FEEL LIKE NURSING ADMINISTRATION IS VERY INTOLERANT WITH THESE DISORDERS.

I HEARD COMEDIAN PAULA POUNDSTONE TO A LITTLE DITTY ON DEPRESSION. IT WENT SOMETHING LIKE THIS:

"IF I WAS IN THE BEDROOM IN BED WITH A PHYSICAL ILLNESS LIKE CANCER OR A HEART CONDITION, AND ALL THE FAMILY WAS IN THE LIVING ROOM. WHEN I DID GET UP OUT OF BED THEY WOULD ALL SAY 'LOOK AT HER, SHE'S SO BRAVE, SHE'S GETTING UP -- IN HER CONDITION.' BUT WITH DEPRESSION IT'S NOT THE SAME. IF I AM I THE BEDROOM IN BED WITH A DEPRESSIVE EPISODE AND THE FAMILY WERE ALL IN THE LIVING ROOM THEY WOULD BE SAYING 'WHY DOESN'T SHE JUST GET UP! IF SHE WOULD JUST GET UP AND DO SOMETHING SHE'D FEEL BETTER...'"

[Youda]

Yes, there are other nurses with anxiety and/or depression.

Personally, I don't "hide" anything from admin. I just don't tell them, because it's none of their business. I don't tell them when I'm on my period or when I fight with my boyfriend, either. It's none of their business.

Admin is intolerant of everything, in my experience. If you have the flu, they're intolerant. If you call-in because of anything and everything, they're intolerant.

Having said that, I will tell you that there have been a few times in my life when I worked for caring people who didn't treat me that way. They built up my self-esteem and gave me respect. So, don't put up with it. It doesn't matter if they understand or don't. Keep the focus on what YOU need. If your employer is contributing significantly to your depression/anxiety, then get the hell out of there!

PM or email me if you want to talk more. Sounds like you need a friend, carpe de em. :)

[mario_ragucci]

Originally posted by Youda

Personally, I don't "hide" anything from admin. I just don't tell them, because it's none of their business. I don't tell them when I'm on my period or when I fight with my boyfriend, either. It's none of their business.

Some people think you cannot hide depression, that clinical depression is strong stuff. Iy'd want your courtosey extension to tell me if you are emotionally unstable and could be off. If you work with or near me, your mood is my business. Pretty much people are my business. Being "yourself" can not include trashing other people with non-verbal.

Do the meds give you breathing space? I am so afraid to ask about the way psych meds make you feel. Is it like a buzz? Can you feel it when it works?

[micro, RN]

Originally posted by carpe_de_em

SORRY ABOUT THAT -- HIT THE WRONG KEY AND OFF IT WENT. HERE IS WHAT I REALLY WANTED TO KNOW

ARE THERE OTHER NURESE OUT THERE WITH SEVERE DEPRESSION AND/OR ANXIETY DISORDER?

DO THEY FEEL LIKE THEY HAVE TO HIDE IT FROM ADMINISTRATION?

DO THEY FEEL LIKE NURSING ADMINISTRATION IS VERY INTOLERANT WITH THESE DISORDERS.

I HEARD COMEDIAN PAULA POUNDSTONE TO A LITTLE DITTY ON DEPRESSION. IT WENT SOMETHING LIKE THIS:

"IF I WAS IN THE BEDROOM IN BED WITH A PHYSICAL ILLNESS LIKE CANCER OR A HEART CONDITION, AND ALL THE FAMILY WAS IN THE LIVING ROOM. WHEN I DID GET UP OUT OF BED THEY WOULD ALL SAY 'LOOK AT HER, SHE'S SO BRAVE, SHE'S GETTING UP -- IN HER CONDITION.' BUT WITH DEPRESSION IT'S NOT THE SAME. IF I AM I THE BEDROOM IN BED WITH A DEPRESSIVE EPISODE AND THE FAMILY WERE ALL IN THE LIVING ROOM THEY WOULD BE SAYING 'WHY DOESN'T SHE JUST GET UP! IF SHE WOULD JUST GET UP AND DO SOMETHING SHE'D FEEL BETTER...'"

can only answer for myself

carpe-de-em

1) yes

2) yes

3) yes and no

thx for the paula poundstone "take"

so agree.........

yes, people's health and mood do affect me if you are my teamworker and i am yours......

it is why we must all take care of our health to be good nurses,

take care of #1, because otherwise you are of no good to anyone else.......

but the stigma of depression and other ......... still exists even in health care, sad to say from lateral team members to administration........

it is a fine line you walk and choices you make when you choose to share.............

Mario,

I for one can only answer for myself. Legitimate question and not rudely asked at all.

Do I feel it when it works, no not really. But I can tell when it is not working.

Will share more, but publicly only share (probably way too much already about micro).

Mental health is still an area that even in health care, we have so much stigma about, I for one am glad that people such as carpe-de-em and Mario and others continue to raise questions about it.

We are part of a whole. If we do understand all aspects of our physical/mental/cognitive being, we cannot effectively work as nurses or within this world in an effective way, either professionally or personally.

micro and out

[Youda]

Originally posted by mario_ragucci

Some people think you cannot hide depression, that clinical depression is strong stuff. Iy'd want your courtosey extension to tell me if you are emotionally unstable and could be off. If you work with or near me, your mood is my business. Pretty much people are my business. Being "yourself" can not include trashing other people with non-verbal.

Do the meds give you breathing space? I am so afraid to ask about the way psych meds make you feel. Is it like a buzz? Can you feel it when it works?

My BON publishes its position that it is up to each nurse, "through a process of self-examination," to determine if s/he is fit for duty and able to perform responsibly and prudently. I take that charge very seriously, as a matter of ethical responsibility. If I'm at work, I can do the job. If I'm not there, I can't. It's that simple. I'd hope anyone suffering from any illness do the same.

We could spend hours talking about people's moods and how they affect their co-workers. But, as a member of a health care TEAM, I expect my co-workers to treat me with respect, as I try to treat them. That means that when they come to work upset because of whatever, I try to be supportive or ignore it, depending on the situation. I've worked many a shift when someone else's problems affected the unit. Someone going through a divorce, just finding out your kid is on drugs, etc. Not everyone is going to be HAPPY all the time. I give myself permission to be human, just as I allow others to be human. That being said, I am much more concerned about my patient care, recognizing that relationships with coworkers are important, too. I don't feel the least little bit of need to tell a co-worker about "depression" or anything else. The kind of immobilizing depression that you fear will result in a co-worker being dangerous around you wouldn't happen. When depression is that bad, the person wouldn't be able to get out of bed or leave the house. They'd call in sick.

Depression can be hidden easily. I do it all the time. In fact, I make special efforts to be more cheerful when I'm at my lowest. I may close my front door at the end of the day and break down into tears, but no one else is going to see it, especially my patients.

To answer your other question. Can you feel an antibiotic working? How about lanoxin? How about Micardis? No, you can't "feel" it working. What those meds do, as well as antidepressants, is restore the body to closer homeostasis. Don't confuse antidepressants with control substances which act in an entirely different way and give a false sense of well-being or elation.