Nursing & Depression

KarenKidsRN · Nov 22, 2002

originally posted by youda
karenkidrn, welcome to this wierd group! :balloons:

just out of curiosity, would you say you had a long line of problems similar to the one you described at work? maybe not as serious, but that made you feel that way?
************************************************
not really and especially not at work. been doing this for going on 26 years and never had a work related problem before i always manged to leave my personal problems at the front door and not take them into work with me. relationships outside of work are a whole other story.....
**********************************************************
i'm convinced that when they get around to mapping out every little thing about the human dna, they're going to find exactly what makes us susceptible to depression. i have an old merck manual that i bought when i first started nursing some 28 years ago. back then, the two diagnoses for depressions were either "depressive neurosis" or "psychotic depression." of course if you were a women, you got "involutional melancholia" which and i quote "the patient will often have exhibited such traits as intolerance, stubbornness, oversensitivity, avoidance of pleasure, worrying, apprehension and insecurity." betcha a women didn't write that!
is it any wonder that depression still carries this stigma when a mere 30 years ago "melancholia" could stick you in the state psych house for some male interpreted "avoidance of pleasure?" what is so sad is that the medical profession, of all people, should get some continuing education! i can forgive anyone if they don't keep up on topics outside their area of practice. but, to be 30 years behind? and these stigmas still perpetuated in nursing schools?
yeah, i'm with you, karen. i'll keep my business, my business.
[/b]

i guess you could look on the positive side and say we've come a long way in 30 years, but not far enough in my opinion. and there will always be some who refuse to understand that depression is an actual physically based illness and think that there is no such thing or that depressed people are just lazy or could fix themselves if they wanted to. no one ever tells a diabetic to "just snap out of it", but you can't explain to someone with a closed mind that needing meds for depression is no different than needing insulin for diabetes.

maybe in future generations that will change with all the evidence we now have from brain imaging studies, but i am not holding my breath that i will see a massive amount of acceptance and understanding in my lifetime.

mattsmom81 · Nov 22, 2002

I apologise for reacting in an oversensitive manner about the advice giving...and I appreciate all the comments....a big welcome to our newcomers...this is both a fun and serious thread and I enjoy it. It is good 'therapy' for me to write my feelings down too. :)

I remember 20 some years ago studying 'melancholia' too.....and 'agitated depression'...among other terms...also learned some very negative attitudes about depressives in nursing school unfortunately...and had some baggage of my own to deal with so my psych rotation was ...um..interesting.

My mother was one of these 'melancholia' women and as I grew into adulthood, I recognize my father's nonsupportive ways accelerated her depression.....she withdrew from him because he refused to care about her feelings. Much of it revolved around not being able to handle 4 kids...he was Catholic and refused to consider any form of birth control...so she worked herself to death around the house, miscarried a 5th child then blamed herself for the miscarriage the rest of her life. (because she wanted to miscarry) My siblings and I didn't know til we were grown we had another brother.

My childhood memories are of my mother drinking, drugging, and 3-4 times a year hospitalized for ECT's and to 'come off cold turkey' some drug or another. I could not talk to her until I was out of the house and married...and could finally gain some perspective on how her life felt to her. My father left me (as the oldest) in charge of my three siblings...while he chose to go out to the bars with his buddies....my Mom didn't drive and didn't have access to any $$$...didn't have any family or friends to confide in....my Dad controlled everything. And he treated me like a 'surrogate spouse' and turned me against my own Mother. I cry when I think of how isolated she became...agarophobic, fearful of people, conflict, making decisions, etc. Poor sweet woman. She was a gentle sweet naive thing who was just overwhelmed with ZERO support. There was no real help for her back in the 60's other than drugging and shocking her.... she was seen as weak, out of control, etc. and this is how her children saw her because my Father planted this in our brains too...

They're both gone now...I did make my peace with both of them before they died and I am glad...I apologised to my Mom and confronted my Dad and did see some heartfelt regret as we talked about my childhood days.

In retrospect, they both probably did the best they could which is all any of us can do really....in this crazy stressed world. :)

Thanks for reading my rambling thoughts this am...and (((HUGS))) to all here. :)

Merry1 · Nov 22, 2002

There are good and bad in every proffession out there but I have found that the more rewarding the job is the more stress there is with it. How do mortal men deal with being Prez??..not enough antiacids or antiulcer medication in the Northern Hemisphere for me to think about that kind of pressure:)!

Back to depression, it is a chemical imbalance in cahoots with improper/inadequate coping skills, and the way most of us were raised(by ourselves) did not give us the correct skills do deal with the chemical imbalance. This is a theory I have and one I have found repeated many times over by many different people(including myself). It is easy to call it weakness but the truth of the matter is that we, as human beings, need each other, not to tear one another a new one but to lift one another to heights we didn't know we could achieve ourselves. Some can do it by playing golf, ridding horseback, or working out, others need a more chemical approach. Neither approach is wrong, this is a highly individual disease process and it takes an individual approach to treat it effectively.

micro, RN · Nov 23, 2002

been gone for awhile.....

ya know that thing called life....

think of you guys often........

be well all.......

this thread is great, although I have not kept current of late....

back to the ??? of the holidays and any change in depression.....

naaah!!!! yeahhhh!!!!!

if I work that is all right by me.......

holidays are bittersweet for me.....and the materialism of the season....has also blown me apart.........

of course that comes from the portion of the theory that depression is partially environmental, along with learned behavior.........

and I also know and know.....that there is a biochemical/physical component to depression.......

plus I make double time by working the holidays...........

luv to all,

micro

sphinx, BSN, RN · Nov 23, 2002

Hello all, well I finally saw my psychiatrist, and managed to tell him *everything* that has been going on with me of late. He feels, esp after I told him of my bad mood swings last week, that I *definately* have Bipolar disorder. This has been bandied around in the past, but I never had any well defined manic episodes. But he says that the moods swings I described are the clincher. So he added Lamictal to my other meds.....to taper up slowly, hopefully to avoid the rash side effect that apparently you can get by increasing too fast (?? have to admit, I don't know a whole lot about this one). I see him again in 3 weeks.

Just thought ya'll might be interested.

pc1004rn · Nov 23, 2002

i totally feel the same way. I can give you a perfect example to this. My nurse manager always ask how the night went every morning he comes in. One night while working, one of my patient fainted infront of me. I tried to assist him to the floor as softly as I can. (He was 6ft tall and was 173lbs, and I'm 5'3" and 105lbs) I fell on my knees first and then the patient fell, so you can imagin how my knee was feeling. First thing when my manager came in one of my co-worker told him about the incident. He didn't even ask her if I was ok. He didn't even come up to me and asked if I was ok. I know he was stressed about the Joint Commission being in the hospital, but he could of at least ask if I was ok. I was soooo disgusted. I'm really starting to hate working as a nurse. You're so busy that you just become a machine.

Oh by the way, I've been a nurse for about 4 months. Its really discouraging that I already feel this way.

KarafromPhilly · Nov 23, 2002

This is really interesting...speaking of brain chemistry...

http://www.post-gazette.com/healthscience/20021028braincellssci2p2.asp

Long Term Care Columnist / Guide · Nov 23, 2002

I'm glad to see this thread is still going after all this time.....haven't chimed in for awhile, but I think I need some advice at this point. As I said some time back, I've been on Paxil for about 18 months, and done pretty well until the past 2-3 months; but my job and other circumstances have been getting to me over time and I think I'm depressed again....only I'm not sure this time since I still can laugh and enjoy some things. However, I've been overeating for months..... get crabby and anxious at times...... plus I'm dealing with a lot of physical pain from muscle tension and God-knows-what is going on in my lower abdomen (started having hot flashes/night sweats about a yr. ago, periods are about as predictable as the weather etc. and I feel like I've got a 50# lead weight down there).

I know I need to go see my doctor, but part of my problem is thinking I'm in all this pain only because I'm severely overweight and it would go away if I could just lose about 70 pounds. I'm also afraid to find out that I need a hysterectomy, not that I care in the least about losing my uterus (I'm almost 44 and it's time for grandchildren, not more of my own), but because I literally cannot afford to take the 4-6 weeks off to have the surgery and get through the recovery process. So the end result is, I don't go to the doctor.

In the meantime, my job as a LTC resident care manager is nothing but stress, stress, stress, even though I really love the residents and the people I work with. We had a terrible survey, and even though most of our F-tags were for things that previous employees did or failed to do, guess who has to fix all of it?!

The fact that I am able to function as well as I do probably has a lot to do with the antidepressant I'm already on, but my emotions have been somewhat flattened by the meds so I can't really tell if I'm depressed. It feels a lot like it, and my sister says she thinks I am, but this is so different from all of the other depressive episodes I've gone through in my life that I just don't know for sure what's happening to me.

I guess this all sounds pretty mixed up, but I'm bouncing it off you guys because you too are nurses and know all the same stuff I do, and I know enough not to trust my own perspective right now. The peri-menopause angle complicates matters somewhat, because this could be hormone-related as much as anything else at this point in my life, but I do NOT want to take anything for it if I can possibly help it, not just because of the recent studies but because I never could tolerate birth-control pills, so I'm really leery about anything with estrogen in it.

Anyway, if any of you can toss a few nuggets of wisdom my way, I'd sure appreciate it. I am NOT having a good time these days.

sphinx, BSN, RN · Dec 6, 2002

Thought I'd pull this thread up to update anyone who may be interested (ie, has read all my many ramblings and has wondered what the heck I've done about it).....Well, I last posted my new dx of bipolar. New med still not helping, and no sign of any "highs", although some intense irritablility, which tends to be a big sign for me. Anyway......so, still been very depressed, and so much stuff keeps piling on at home, then I was back at work last week. Because of the date my disability ended and the holiday, I only worked 3 days, but in that time, was given a case load of 23 brand new patients, only 3 of which I knew from before. So, my stress factor has been kicking in, trying to sort out who is who, what their diagnosis is, what are their needs, when do they need a visit, etc etc......all the while, depressed, and you know how it can be hard to concentrate when so low. Monday was busy, and I was oncall, so worked 12 hours total. Now, get this.....my son had been sick since the day before turkey day. I figured a cough and cold, give it time to go away, he was at his Dad's Thu and Fri, and our house the weekend. I noticed his cough wasn't better, but it hadn't been too long, so I figured, oh I'll give it till the beginning of the week, it's certainly not anything to call the oncall doc about. Monday he was starting to look crummy, and still coughing bad. Feeling guily and not wanting to call in after being out so long, I dosed with cough suppressant and sent him to school (mom of the year!). Tuesday he was indeniably not well....coughing very badly, just looked awful, rings around his eyes, complaining of tightness in his chest. I listened to his lungs, but he was coughiong so hard.....I thought it sounded funky in the LLL, but wasn't sure. My hubby had to go in, as his boss was off, and he had to do several things at work, so I reluctantly called in. We spend several hours waiting at Dr office, Radioilogy office, pharmacy......he has pneumonia LLL, of course. Dr says he should stay home a couple days at least to rest. Vince was upset because the next day he had a field trip he soooooo wanted to go on. My husband was able to arrange to work from home that day, because I had to go in for mandatory education day (all our mandatory stuff in 1 day per year).One part of the day was a staff member, who I know works with bereavment groups, but also other stuff, and has been having "gripe sessions" at these education days, all confidential, to give feedback, so hopefully changes can be made (that is one good thing about my agency, when change is needed, we get heard, and steps do get taken, and we often reap the rewards. She went round the room having everyone say something about the job that they found stressful or made them unhappy. I was next to last, and trying so hard not to break into tears. I decided honesty was the best policy, knowing that my words wouldn't leave that room. I said that I have been depressed lately (didn't say it was long term, though), and had some things at home recently, and that right now, work is overwhelming me so much. That I can't concentrate or get organized, that I felt I wasn't giving as good care as I ought, etc. Of course I'm all weepy too, but didn't drag on (I don't do that when talking, only writing haha). I said that I'd considered asking my supservisor for decreased hours after I got back from disability, but when I got back, found out that in the 2 weeks I was out, 2 nurses had left for other jobs in the agency, and I felt I couldn't ask, as our team is already short staffed. Well, as you may guess, everyone told me to take care of myself first, that she can only say no, I wouldn't know unless I try, etc. Another girl suggested I may even try a job in the office, if one is available. So, even though I have been told these things MANY times (sound familiar), hearing it from my coworkers (including 2 members of my team who would be inconvenienced if I went part time) bolstered my confidence. I decided to talk to my boss as soon as I was in the office. My son stayed home yesterday, and I took him to my moms at 11:30, so I saw patients, but just late, didn't get home till 6:30, and the office closes at 5. I had left a message on my supe's voice mail, quite tearful unfortunatly, that I needed to talk to her. Well, my son was still sick today (ugh) (but improving, cough is now productive, and though he still c/o his chest hurting, he looks a lot better after sleeping late) . So.......I am stuck calling in again. Did some phone visits from home though, so did do somethings, but not much, considering. My boss called me, and even though I'd have rather talked to her in person, she wanted to talk as soon as possible, as I had sounded so bad on my message. I told her basically what I'd told the group at education day. She told he that the absences were hard on the team, yadda yadda (I knew that already), but that I need to take care of myself first. She said she would have to talk to one of the "higher ups" (I guess that's what she'd be) and get back to me, as she is not sure what is possible. And if all that is available is evenings, I just can't do that (that is the only time I see my kids, and why I left hospital nursing). So, we will see. But-wanted to get you up to date and let you know I finally overcame my fear of making this step, and am trying to put myself first this time.

Thanks for all the support you've given me.

sphinx, BSN, RN · Dec 6, 2002

mjlrn....

wanted to let ya know I did read your post.........want you to know I'm not ignoring you or anything, but just that I don't have much advice. I haven't exacly been doing so well myself. You mentioned perimenopaus.....couldn't the mood problems be related to that (hormone fluctuations, bla bla), which may be why it feels different than your past depressions?? Just a thought, I'm clueless. Why is it you are afraid you'll need a hysterectomy? Is it just the heavy belly, or are you having other problems?

Anyway.....what do I know? Just wanted to offer my support, whatever that is worth.

Hang in there

Heather

sanakruz, ADN · Dec 6, 2002

Sphinx this is good news! I've seen many people get well on lamictal- It's pricey- the rash is serious, tho. STOP if you get it- The big risk is Stevens-Johnson syndrome- Let some one SEE the rash to actually CLEAR you to keep taking it.

sanakruz, ADN · Dec 6, 2002

mjlrn- Many of my folks have gained weight from Paxil, but not prozac- The drugs are chemically very similar; paxil has a short halflife which may explain the withdrawal syndrome. Think about asking for a change to lexapro- like celexa without the usual complaints( which off the top of my head I cant remember...) Constipation? It's escitalopam vs citalopam (celexa) Celexa was only available in Europe while prozac was only available here. Very similar drugs. If you switch to prozac take only the brand name.

Lifestyle changes also need to be considered. Black Cohoosh is highly recommened for menopausal symptoms. I am considering trying this myself,I'll be 47 in Mar. and wake up sweating about 3x weekly and cant get back to sleep. These are early morning wakenings and I lie there and worry about money, my kids, stuff from the past that I have no frigging control over or abilty to change. I have considered anti depressants also- many years ago I took protipytaline. Effective but awful side effects. Major depression recurs in 50% of those with a single episode,so.. I think it's often hard to tell with women our age because "issues "overlap. I have cried at work 3 times in the last 2 weeks. I really dislike my boss. That is a gentle word for my feelings about him. I am the only nurse here. I love my patients and most of my co-workers. So a definative dx would be nice, dont you think?

Nursing & Depression

Nurses and Depression/Anxiety