Nursing & Depression

ktwlpn, LPN · Oct 12, 2002

Originally posted by abrenrn

I suppose I am also a bit discomfited by the general sense I have gotten from a series of posings, i.e., somene who has had to put up with depressed family, lets us know just how annoying depressed people are to be around, really wants to know how meds make us feel - high, ... - and also wants to know if we are dangerous, unable to perform our duties cause, hey, he has to work with us.

Pardon me if I offend. I suppose Mario is trying to come to terms with living around depression. I am selfishly focused on my own illness and how it can be best treated. I've determined, for myself only, that the drill instructor image that is my normal state of depression, might not be the best one to get me out of it.

Don't you just think it's fantastic that he HAS THE CURE for our disease? And it's such a simple one,too....wow...right here in front of me...I mourn my wasted years....Sorry to be so harsh-but I am not one for keeping my feelings to myself....I really have a problem with the attitude and it permeates every thread---THIS is the right way to...FILL IN THE BLANK....Life according to Mario-tell me again how to raise my child? How to manage my relationship with my husband? How to get along with my fellow nurses at work? You-do not have children-are not married-are not a nurse-and you know nothing about depression because your preconceived notions have prevented you from learning ....And NO-I did not run out of my meds...it is not THAT TIME OF THE MONTH.....I am just fed up....I am going to have to use my filter option so that I can continue coming to this thread for the much needed support.....from people THAT KNOW AND UNDERSTAND DEPRESSION....I am NOT saying that only someone with an illness is qualified to treat an illness-but this THREAD on this topic has become like a support group.So why continue to offer these words of wisdom after more then one poster has stated that they are inappropriate?...Would you take a 6-pack to an AA meeting just because you are not an alcoholic and are just sitting in to learn about the disease?

Youda · Oct 12, 2002

Originally posted by ktwlpn
Again I will remind you-ativan is NOT a narcotic......

Ativan is a narcotic in the Benzodiazepine group of drugs. All drugs in this category are Class IV Narcotics/Controlled substances.

http://www.library.duq.edu/eresources/clinref/datasets/patch_f/html/chapter/mono/hf077600.htm#hf077600

Youda · Oct 12, 2002

There are many different approaches to depression besides just medication. Imagery, meditation, exercise, etc. The reminders of how to help ourselves is not out-of-line.

What you do not understand, Mario, is that there are different degrees of depression, as well as different kinds of depression. Some of the alternate therapies for depression that you mention are only effective for mild - moderate depression, or situational depression. They are generally ineffective for moderate - severe and chronic depression.

I think this fundamental differences in degrees of depression is a big factor in misunderstandings. For the typical person, those things help and can pull you out of the mire, and oftentimes they will help without other forms of therapy or interventions. So, someone who has not experienced the more severe forms often can't understand why someone else just doesn't "do something" and get on with life.

Severe and chronic depression always needs agressive therapy to get the person to the point where they can even manage the "activities of daily living." When in a severe depression, the person is unable to manage any aspect of their life, including seeking help.

So, it is frustrating. Because we so often need understanding and the help that has eluded us.

Take care all. And remember not to take yourselves too seriously. Well, try anyway.

sphinx, BSN, RN · Oct 12, 2002

I guess my take is.....imagery, well, I've never been able to do it. Never. Nor have I been able to do any progressive relaxation techniques. Recently I have found something I enjoy that I can focus on, not quite the same as imagery, none of that imagine your body and mind healing (I personally think that stuff is, uh.....well let's just say, not for me)...and when I focus on this, it helps me to not focus on other images (of wrecking my car, cutting, etc). As others have said, a drill sergeant is a little .......uhhh......lets just say not the right image for some people. No offense, Mario. And exercise? Yes, I think we all know that exercise has been shown to have some positive effects on mood. But when you are so low, so VERY low, you can't always get up the energy to even get out and take a walk. it is hard for me to face the outside world at work, that having to walk around the block seems like torture. Videos, treadmills and the like, even less appeal. Maybe if my depression can ease up a little I can supplement my meds by exercising, but for now, I can't bring myself to.....I feel like I am "stuck"....down in the pit. I *know* I need to make changes, and I am making steps.......and it is very hard, having to *force* myself to do so. But I have 2 kids, who need me, even when I feel like the worst mother on earth. I can't check out just now.

Long Term Care Columnist / Guide · Oct 13, 2002

You said it, sphinx! Frankly, I can't imagine how anyone who's never experienced true clinical depression could possibly be in a position to advise those of us who have. Exercise??!! When I'm in a funk, you couldn't get me off the couch with a load of dynamite, because there is probably nothing on earth a depressed person is LESS likely to do. It's one thing when I'm only a little blue, and even I know that getting outside and doing something physical will make me feel better. But when I'm drowning in a cesspool of depression, the last thing I want or need is a "drill sergeant"in my head (or anywhere else) making me feel more guilty and worthless than I already do. No offense, Mario, but if your picture and the content of your posts are any indication of your age, you have quite a lot of growing up to do. I think you have a good heart, and I hope it's only a lack of education and life experience that causes you to belittle things you don't understand. But you sometimes come across as intolerant, even flippant when it comes to things you can't explain with numbers and logic. What if depression were a physical disorder, like cancer? Would you, as a nurse, suggest to the patient that he just needs to go for a run and he'll be OK? Would you tell him that his disease can be managed by getting tough with himself and forcing himself to do something he has no energy for? Exercise IS beneficial once the acute illness has been brought under control, and in fact produces endorphins that reduce pain and contribute to an increased sense of well-being. But it's hardly a cure-all, and to suggest that a depressed pt. get off his duff and do some jumping jacks only shows how much you have yet to learn about this devastating disorder....not to mention compassion for those who suffer from it.

mario_ragucci · Oct 13, 2002

Please don't attack me because I describe things I would do. I am well aware of what i say, and would never tell anyone what they should do disrespectfully. And I wouldn't judge anyone, lest I be judged.

Just because a person sounds off about what they do doesn't mean everyone else should do it. I ain't telling anyone to jump jacks or get blown off a devan. Only do I want to make a plug for diet and exercise, and give my perspective. If you have a serious form of clinical depression, and don't/can't want to consider what I say, you are free to forget me. But don't embarrass me and say I said stuff I never said. I'm gonna be 38 in December, and don't need/want anyone to openly berate/disrespect me. Does hostility accompany depression?

Youda · Oct 13, 2002

When we have spent a fortune on therapies, medications, missed time from work, etc., etc., etc. Does anyone really think we would put ourself through all this if exercise and imagery was all it took to make us feel better?

Or do people believe that we are just such neurotics that we prefer drug side-effects, damaged careers, painful ntrospection, tears, dreams and plans unfullfilled, and damaged relationships? And if we'd just "do something" our lives would be "normal?"

Does anyone think this is a choice? Does anyone doubt that if a drill sargeant would cure it, we wouldn't all be lining up to get one?

If someone said they had a verifiable cure for cancer, would all cancer victims get on the next plane to get it? If depression were that simple, wouldn't we all be signing up for aerobics classes?

If I were drowning, would you throw me an anchor?

Long Term Care Columnist / Guide · Oct 13, 2002

Thanks, Youda....you always seem to be there at the right time with the right thing to say.

Mario, you really shouldn't take things so literally. OK, I was a bit hard on you just now, but my point was not to berate or disrespect you---it was to dispute what I felt was an assumption on your part that depression is not a "real" illness. And if I came across as hostile, I'm sorry. But as one of the millions of Americans who deal with the stigma of mental disorders, I felt you were ill-informed, and my intent was to provide information, not piss you off. However, it can't be news to you that some of the things you've said in your posts have upset people, and I'm certainly not the first one to call you on it.

As for being almost 38, you ought to be flattered, kiddo--you don't look it!

mario_ragucci · Oct 13, 2002

Awwww, no worries mate! :-) I'm just trying to get to know things. People I love are depressed, and I understand a little. I'm not depressed! Me just tryng to understand. :-) Drama is okay. For me, the drill instructor I imagine is my friend in the end.

I'm sorry for saying anything i know nothing about. Forgive me, and watch me gasp this swan song of withdrawl from this thead. I'll just hang up and read what yall have to say :-) Love, Mario

micro, RN · Oct 13, 2002

Mario, You don't have to swan song out.........

We all know about life and living. We is all human and in this world together.

Hey to all, I am very glad that there are those of you there that are willing to share and be yourself here.....it is nice to know and to let others know that they are not alone. Depression can be a very lonely disease........and that can just capitulate onto itself.

Clinical depression is not a fun thing, and I use the wrong word usage almost intentionally here.

There is still such a stigma out there about depression, alcoholism, other mental illnesses, that even those dealing with such do not see it for the "disease" process it is. That does not help, when even medical professionals view it differently and yes, even nurses out there, on the work front, in the middle of their own working stress do not give the patient with such a diagnosis the credence and respect as they would with someone with a "physical" illness.

Depression, alcoholism, alzheimers, schizophrenia are as much physical diseases as the more thought of physical diseases, except with the emotional/mental aspects apparent in the symptomology of it.

I don't even know what I am trying to say here.......as I am going to take a power nap before I go off to work another pm. I am just glad that I now have doc's that do see depression and other for what it is.....without the stigma and treat it and me accordingly.

Hi, my name is micro and yep, I do suffer from depression, "clinical", etc. but that doesn't stop me from being human.......

medications necessary........

drinking & eating better, drinking 0

lost some weight and increase in exercise.....

but the insidious process that depression is.....

#1 is being all right with self......

I am okay, I am human #1

but if you are in the depths of depression, you do not have the energy or ability to do anything.........

I am glad that I am "somewhat" above that today

if any wisdom, from my side of the river and depression and life:

It is what you do with life that matters. There is always choices.........Being alive lends you to being the human condition.

One day at a time,

Life if okay, and okay is good,

micro :)

mario_ragucci · Oct 13, 2002

Raindrops keep falling on my head

but that doesn't mean my eyes will soon be turning red, crying is not for me.

Okay, to all the folks who appreciate mental imadgry, in this song, the guy says that "he talked to the sun, and said to the sun that you can not get things done by sleeping on the job."

Only a baffoon would suggest you can talk to a star, and suggest that a star works and has a job. The sun is nothing but a huge fussion reaction!

To suggest you talk to the sun is suicide because you would surely melt even before you approaced Mercury's orbit.

"But theres one thing, I know, the blues they send to meet me, won't defeat me, it won't be long till happiness steps up to great me!"

Youda · Oct 13, 2002

Mario! I am going to have to take you by the shoulders and shake you!

You are stuck on your understanding of depression because you have never experienced the more severe forms of it. Because of this, you believe that all depression is manageable and curable (or at least resolveable) by the methods you use! This is only effective in mild or situational depression!

From your attempts to understand depression and your questions to us, you have formed the erronerous idea that all depression responds to minor interventions.

You don't yet understand or recognize these things about severe of "clinical" depression:

it is physically and mentally, totally, debilitating

it is does not respond to "home" remedies such as exercise or imagery

it does not respond to the same medications in the same way in all people

it is so misunderstood by others as to make it frustrating to the sufferer and this misunderstanding of the disease process only exacerbates the severity of the disease

it is presumably caused by a physiological chemical imbalance such as diabetes or hypothyroidism or hyperkalemia, etc.

it requires aggressive intervention and close monitoring just as a MI would require in a cardiac patient

and finally . . .

the "patient" loses the ability to perform many ADL functions

there are physiological as well as psychological manifestations of the disease.

If I may make a metaphor or an anology:

you believe that a migraine can be treated the same as a headache, or that

a benign tumor can be treated the same as a metastatic tumor, or that mild depression can be treated the same as severe depression.

I appreciate, dear Mario, your positive approach and good humor. I'd give you a hug if I could! But, you are seriously missing the seriousness of this disease and its implications!

Go do some more study on this one! If we can educate just one misguided healthcare worker about clinical depression, then maybe you can help someone else who suffers as we do during your practice. But, you will be a sad failure if you don't listen to what we are saying now!

Nursing & Depression

Nurses and Depression/Anxiety