serotonin deficiency?

[boulergirl]

Recently I read an article about serotonin deficiency and noticed that I've experienced about 90% of the symptoms in every stage of deficiency (including the one in which the "garbage truck" arrives, meaning that loved ones tell you that you're a burden to those around you and bring everybody down). These symptoms have been a part of my life for at least a decade and seem to flare up around PMS week and maybe even a week before.

I've suspected for years that I have a problem with depression, or possibly PMDD, and have tried to ignore it. But my family members have begged me to please go to a doctor and get some help, maybe get on a low-dose antidepressant.

Now, I'm open to seeing a doctor (once I get health insurance), but I'm torn about this. For one thing, I realize that a lot of people in my life may NOT be supportive of my decision. I go to a church that is very much against psychology and I'm afraid of being scolded, judged, or rejected if I choose this route. People might never look at me the same way again, or they might view me as having a weak or unstable personality (especially those with a "pull-yourself-up-by-the-bootstraps" mentality). There's still a stigma attached to mental illness and this could affect me negatively in the future if I'm diagnosed. But if I choose not to deal with this...it could ruin my life anyway.

For now, I'm using a chart to monitor my symptoms in case I do finally see a doctor. As an adult, I need to make my own decision, but how do I deal with other people's reactions or prejudices?

[Bipley]

This is not the case with ssri's. There is no way to document a serotonin deficiency, there is no test for serotonin.There is no way to "track" serotonin to maintain a "proper" level.

Nonono!!!! The point is not what can be measured, the point is that we KNOW what the problem is and it isn't a matter of Momma didn't potty train me in the appropriate amount of time!

It IS a matter of a biological problem. That verrrry biological problem can be treated with appropriate medications. THAT is the point, not if we can measure using lab tests and other assorted "stuff" but if we can make the patient feel better.

We don't know about a lot of dx's, we just know the cure or treatment. That is the case in some forms of depression. Depression most certainly IS a biological issue vs. a form of weakness and I defy you to demonstrate otherwise.

[Bipley]

Dr. Kramer uses the diabetes analogy to point out that depression IS a disease:

Author Peter Kramer wants to give depression a bad name. The author of Listening to Prozac thinks that our culture has suffered from a centuries-long romance with sadness. Refuting claims that depression is a source of soulfulness and creativity, he identifies it as a debilitating disease that plagues millions of Americans. More important, he describes the latest scientific findings about depression and explains their implications for treating this grim malady.

Wow... I like this Kramer person already! I want this book. I'm quite serious, I believe it is time for a trip to amazon.com!

I do have a question though... what is it about depression? WHY do sooo many folks suffer from this? Is it something that wasn't dx'ed years ago or is it more common today? Lots of questions and likely, no answers.

I have taken Prozac once. After a major fire and issues I don't even care to discuss, I dealt with PTSD. A few weeks of Prozac and I was like a new woman. What did folks do before SSRIs?

[lsyorke, RN]

I'm not saying that depression doesn't exist. I'm saying that ssri's should not be taken lightly. They are not a benign, no adverse effect, no withdrawal group of drugs. They are known to cause psychotic reactions in people, they are known to cause suicidal ideation in those that were never suicidal before. Yes, some people have depression so bad that they need to look for pharmaceutical intervention. Pharmaceutical intervention should NEVER be the first choice in treatment. Cognitive behavioral therapy should be tried first.

It may be a biological problem with SOME people. But there are thousands of reasons that people go on ssri's that are NOT biological in nature. Is grieving biological, is being shy biological, is not being able to make a speech in front of a large group a biological problem? NO , these are life circumstances and lifestyles that need evaluating by a professional and coping mechanisms and techniques learned. Every case of depression/anxiety/panic/irritability is NOT biological in nature.

Patients have the right to make a risk benefit determination. By not recognizing that these drugs have risks and adverse effects leaves the patient in the dark when these adverse effects surface during use.

[Spidey's mom, ADN, BSN, RN]

I agree with patients making informed decisions.

But I disagree with your premise that depression is not a disease. I don't think you can compare depression with being shy or unable to speak before an audience.

A fresh look at how we think about depression is on the cutting edge of neurological brain research. Scientists at MIT are looking closely at this and Peter Kramer is working with them.

"Over a decade ago, Peter Kramer changed the way we think about depression in his best-selling book, "Listening to Prozac."

"He says that whenever he spoke publicly about the book there was always someone in the audience who would ask, "What if Van Gogh took Prozac?" -- suggesting that depression helped fuel his creativity and insight. And often, Kramer says that when he talks to his patients about relieving depression they worry that it will change their personality."

"In his new book, "Against Depression," Kramer tries to put those sentiments to rest. Kramer believes society romanticizes depression -- in ways that perpetuate the suffering. Depression is a disease, he says, just like cancer, malaria, or asthma and it should be treated that way."

". . .depression and depressive disorders should be treated as a disease; and that a little depression is no more good for you than a little arthritis or a little rheumatism. The aim in each case should be a complete cure."

************************

Dr. Kramer does cognitive therapy AND drug therapy.

There are definitely side-effects to all drugs and people need to be made aware of them.

But I don't think depression is only in a small number of cases, physiological. I think the majority of cases are physiological.

steph

[Bipley]

Pharmaceutical intervention should NEVER be the first choice in treatment. Cognitive behavioral therapy should be tried first.

I don't know if I can agree with you here. If you look at objective studies done on this type of therapy and mental illness, you will find that cognitive behavioral therapy in TRUE mental illness is about as likely to be effective as therapy in those suffering from diabetes. You simply cannot lower blood suger through cognitive therapy and you cannot change SSRI receptors through cognitive tx. Therapists including PhDs used to be the norm, now that people are learning about objective studies and actual results from therapy, they are leaving their PhDs for MDs who look at mental illness through psychiatric colored glasses. In other words, it is a biological illness just as ... yes, diabetes. If you find a way to live a happy life with a BS of 800, you will likely find a true clincally depressed patient treated effectively with talk therapy.

It may be a biological problem with SOME people. But there are thousands of reasons that people go on ssri's that are NOT biological in nature. Is grieving biological

Isn't this the true test of a quality psychiatrist? If a doc can't understand the depression is due to the loss of a S/O of 50 years, it isn't the tx that is at fault, it is the doc.

Patients have the right to make a risk benefit determination.

Absolutely! They also have the bloody right to know that talk therapy is less effective than biological means of treating a truely medical disorder.

[Bipley]

A fresh look at how we think about depression is on the cutting edge of neurological brain research. Scientists at MIT are looking closely at this and Peter Kramer is working with them.

Very true. Not sure about this Peter Kramer person but I do know about neuro research. I have a friend on another board that does JUST this very research. He is a wealth of information. It is more than fascinating to read what he has to write. He writes about what others dream of. Only his stuff is based on true clinical research.

Verrrry interesting reading.

[psalm, RN]

...hugs to you, dear OP. As for your church, and as a born again person myself, remember that Christianity is not a competition!! If you are busy and tired, your "friend" shouldn't compare herself with you!! People look on the outside but God looks on the heart. I am praying for you to get whatever help you need...be it counseling, meds, rest, a physical (thyroid?), different friends, most of all know you are loved.

[psalm, RN]

...hugs to you, dear OP. As for your church, and as a born again person myself, remember that Christianity is not a competition!! If you are busy and tired, your "friend" shouldn't compare herself with you!! People look on the outside but God looks on the heart. I am praying for you to get whatever help you need...be it counseling, meds, rest, a physical (thyroid?), different friends, most of all know you are loved.

[Spidey's mom, ADN, BSN, RN]

Very true. Not sure about this Peter Kramer person but I do know about neuro research. I have a friend on another board that does JUST this very research. He is a wealth of information. It is more than fascinating to read what he has to write. He writes about what others dream of. Only his stuff is based on true clinical research.

Verrrry interesting reading.

Hey, I have a friend too. That's where I get all my links to research.

Here is the website at MIT.

http://web.mit.edu/picower/

Here is the specific page with research - including depression.

http://web.mit.edu/picower/news/index.html

steph

[lsyorke, RN]

I don't know if I can agree with you here.

I'm not asking you to agree with me. I'm asking the OP to do the research on ssri's before taking them. If she feels her situation is bad enough that the risk benefit ratio is good for her, then so be it. But to tell anyone that medication is the answer and therapy isn't is naive. Baseing your advice on one researcher is scary. There is new information coming out on ssri's daily and to ignore the new findings is not doing a service to our patients. The FDA will hold hearings on the suicidality/aggression increase in adults next year.

I don't deny mental illness. I don't deny depression. I do believe that these drugs are horribly overprescribed by doctors without proper evaluation.Yes, they are lifesaving in some instances, in others they are not.

I spend my days walking people through ssri withdrawal. I have thousands that the first question is "Why didn't my psychiatrist tell me that getting off this drug was going to be this bad?". My goal is to make people aware that this possibility exists.

To the OP. Find a good psychiatrist. Ask the questions and if you decide that ssri's are needed in your situation start taking them totally informed.

[Daytonite, BSN, RN]

for the op. . .go see whatever health professional you feel you need to. nobody needs to know. i doubt you'll spill the beans because you will be cautious of it. by the way, in order to get a prescription for any kind of antidepressant you will either have to see your general physician or internist or a psychiatrist. those are the only two who can prescribe. a lcsw can evaluate you, and i'm not sure if they can make specific recommendations on medications, but they can't prescribe. i've been going to a chiropractor for several years for back problems. they have helped me more than my back surgery, the epidurals i had, or the pain control i endured. i have two doctors in my family. i just don't reveal this to them. they think i've just gotten better from all their suggested treatment. i don't reveal the intimate details of my relationship with my husband to my family either. we all have some things we don't reveal to others. it's a shame to look at them as being a burden. another way to look at this, is to realize that by telling your relatives what you are doing is only going to make them feel stressed out and upset. and you don't want to do that, do you?

[Sable's mom]

Boulergirl,

I haven't posted in a VERY long time, but MUST post here. #1 - I have been on Zoloft for over 10 years. I tried talk therapy for several years and all the people involved in my case (MD,MSW,PhD, et al) agreed that it was a medical problem, not a mental one. #2 - The drugs have not changed my personality - they simply allow me to come out of the dark cave I spent so much time in. #3 - Another good book is "Happiness is a Choice" by Meier. The title is awful, but he talks about things from a Christian perspective and also used the diabetes analogy, as well as hypothyroidism.

Please DO NOT let others opinions determine your health care - you must do what is best for you. God gave you the ability to think, don't give this ability up for your church, your family, or your peers. You will remain in my thoughts and prayers.