AIBU - debate with DH and I about depression

[bandgeek]

AIBU to think that my DH is a total twunt as we have been having a massive argument reasonable debate about depression and anti depressants

He is of the opinion that there are far too many people out there claiming to have depression and on anti-depressants for no reason at all (and may I add I have been on anit-d's for the past 8 months!) and they should just buck themselves up and get on with it. I have told him he is talking utter pish and he has no idea of everyone's circumstances but he is having none of it!

It all started over a post on bloody Facebook with one of my friends status' saying that they 'give up'. Now whilst I agree with him that the constant attention seeking posts on Facebook from some people can be tiresome, it doesn't mean they don't have a reason to be depressed! He thinks that if you have food, shelter and warmth then you should count yourself lucky and that there are people worse off in the world than you.

This argument is getting nowhere fast and I've told him I am going to post this on MN to see if indeed he is talking utter crap!

I agree with AxisofEvil about overdiagnosis. Clinical depression is a terrible mental illness that can arrive out of the blue, to anyone and with no apparent triggers. It requires management and treatment. It is not the same as being desperately unhappy because something in life has gone wrong. That, arguably, is a normal aspect of the human condition and not an illness.

I agreed with you DH as I was growing up and saw my Mum suffer with depression. Why couldn't she pull herself together? Why did she need tablets to make her happy? Weren't we enough?

As an adult I have suffered from depression (oh the irony) and I feel ashamed for the way I treated my Mum, and I have a lot more sympathy regarding depression. I had days where I thought "Oh I should just pull myself together", but when you're looking into a black hole of hopelessness and despair, there is very little you can do to pull yourself back from it. Or so I found.

Well I think your dh has a point. If you are depressed and have depression, that that can be very serious and needs a diagnosis, treatment, help, support etc etc.
But i often think that people refer to it as depression when it is little more than feeling a bit down. or life being a bit tough. or there are tangible reasons, for your struggling, and any other person would struggle in those circumstances.
thats not depression.
I think the facebook person sounds like the later. if someone writes on facebook that they 'give up', then they probably have a problem that they need help with.

which is not the same as a clinical diagnosis of 'depression'.

I agree that depression is over diagnosed. Part of the problem is that mental illness can not be diagnosed in 5 minutes by an over worked GP.

Anti depressants are great for moderate or severe depression, but are counter productive for mild depression or a bit of stress.

However the patient needs to tackle the root cause of the depression. This is an excellent website.

www.livinglifetothefull.com/

I find it sad that people with mental illness are either expected to pull themselves together without help or are treated as completely and utterly helpless.
The reality is somewhere in the middle.

Once the person has had the chemical lift to get themselves out of despair then they need to work on their problems. Online CBT is cheap and effective.

I agree that there's a MASSIVE difference between clinical depression (terrible, debilitating illness) and situational depression. I have had situational depression. I recovered when I made a conscious choice to change my situation (although I appreciate that some people's circumstances are more complicated). I never had any help or a diagnosis for it.

My brother, however, got a diagnosis and spent years on the sick wallowing in his 'depression'. I can categorically say that his depression would have lifted if he had taken certain actions, but in his case he had this image of mental health issues as glamourous and used to maunder on about having mental health issues. He miraculously recovered after witnessing the spectacular meltdown of his then gf who genuinely did have MH issues. It brought home to him that mental illness is not glamourous and 'cool'

Having said that I would never ever judge someone who says they have depression as I don't know their circumstances. I KNEW my brother's so I can comment, but for a near stranger I would never dare to assume that they just need to 'get a grip'.

Antidepressants are helping me cope day to day with the depression that I have suffered since my mid teens, when I was bullied at school, and suffered terribly low self esteem. At the age of 13/14, I was suicidal - it was only lack of opportunity and knowledge that stopped me.

Please tell your dh from me that he is lucky he doesn't suffer this disease. I didn't choose to suffer from it, and if I could just pull myself together, and get out of it, does he honestly think I wouldn't have done it by now? Does he really believe that I chose to live a life blighted on a daily basis by something I could have cured so easily?

Of course, I far prefer to live a life constrained and restricted by my depression, unable to consider working, hating myself, feeling like a failure on an daily basis, unable to sleep at night, and unable to wake up in the mornings, failing my children and my husband every day - that is so much fun that I have chosen not to get better!!

I am in therapy at the moment, and am hoping that the improvements that I am seeing will continue, and that I will be able to start reducing my citalopram doseage, and eventually live without the drugs. Maybe even enjoy life.

I am not sure that it is always possible to seperate out clinical depression from reactive depression. It is very rare for clinical depression to appear out of the blue. There is usually a trigger, however small.

Serious mental illness like bipolar are rare. With proper management people can lead productive lives and achieve great things.

It is our reaction and preception of life's events, rather than life's events that make us ill. I think the old fashioned style of councelling where the patient wallowed in their misery was counter productive. It encouraged learned helpness. I think that CBT is a better approach in many cases.

I am not sure that it is always possible to seperate out clinical depression from reactive depression. It is very rare for clinical depression to appear out of the blue. There is usually a trigger, however small.

Serious mental illness like bipolar are rare. With proper management people can lead productive lives and achieve great things.

It is our reaction and preception of life's events, rather than life's events that make us ill. I think the old fashioned style of councelling where the patient wallowed in their misery was counter productive. It encouraged learned helpness. I think that CBT is a better approach in many cases.

OK... Further to my other post...

Clinical depression covers BOTH endogenous depression (from within, no visible casue) AND reactive (situational) depression, which is caused by an event which most people woudl consider "depressing" - clinical depression simply means that the symptioms are observable, and have remained so for a length of time such that a clinical diagnosis is warranted.

GPS are not always in the best place to diagnose efficiently, and with the best results, anti depressants are the quickest, cheapest and fastest acting thing to dish out to prevent actual death. Changing your prescription to a new drug does NOT mean you need "stringer" meds, just that you need "different" meds.

Bipolar is not rare - 1% of the population is a LOTS of people (of which only 17% are able to sustain a full time job - largely imo as a result of stigma and lack of understandning)
Schizophrenia is ANOTHER 1% of the population
so for every 100 people you walk past in the street, chances are that 2 of them have one of those "severe and enduring" diagnoses - and that's just those two diagnoses.

However, "depression" is a term that is bandied about a lot, and which it is, for the person who WANTS to, fairly easy to get diagnosed with, so it's not unimaginable that some people will play the system.

This does not make depression any easier to deal with for those peoplew ho actually have it.

"Happy" is not the default setting for huimanity, one is not unwell purely because one is not happy, so no one should ever think that ADs will make you HAPPY, they won't, they will (if you are on the right one) improve your chemical balance and make you more able to cope with the reality of your life in a positive way. Just like taking insulin improves your chance of NOT dying from diabetes, but does not make you happy.

making oneself WELL is not the same as being happy, and people with depression just want to be well.

I have tried most ADs currently prescribed, I am not allowed to have them any more unless I am IN hospital, as my bipolar includes "switching" so ADs flip me into mania REALLY quickly. IT IS possible to have a fullfilling, rewarding and NORMAL life (I have post graduate qulas, and other than several long stays in hospital have worked full time, until maternity leave / SaHM)

Odysseus - my mum had severe depression too which is why I know it's a living hell for the sufferer, and often those close to them.

But you shouldn't feel bad now love, you were a child and didn't understand.

YANBU. As others have said, depression can be a chemical imbalance. On that basis, should people who have diabetes just 'decide' not to need insulin anymore?

My friend has just been diagnosed as bi polar after many, many miserable years. Some days she can't even speak. She is not wallowing!!

Thanks proudnsad I sometimes think that, "I was a child" but I still feel I should have known better. Anyway I'm just starting CBT to deal with my issues, so what goes around comes around - I can't help feeling I've got my comeuppance!

No way, Odysseus, it's not comeuppance, you definitely need to work on that misplaced guilt. That's a horrible burden to bear. Why and how on earth would a child understand depression?
You obviously have a propensity towards depression because your mum had it.
I had a brief brush with it many years ago but have escaped it for 20 years and am very happy (so you can be too!), the idea of getting it again is terrifying so I really feel for you.
Wishing you lots of luck x

Gosh, lots of posts here! Thanks everyone

I do feel much better now, I had a bad spell at the end of last year with panic attacks and anxiety but I generally feel much more positive these days. Am on a low dose fluoxetine and it has made a huge difference to me. Looking back I should have been been on them after the birth of my DD but I struggled on for 3 years, fool that I am.

I've tried telling him about the whole chemical imbalance thing but he argues that 'you're not telling me that all these peoople have a chemical balance'.

The one part that I did explode at was when he said that 'what does facebook user have to be depressed about??' when he doesn't even bloody well know her! It's just his assuming and generalising that totally exasperates me! Thing is, both of his sisters went on anti-d's after the death of their mum from cancer. He couldn't even understand then why they needed them.

Thanks for all your opinions and stories, rest assured I will be showing him this thread when he gets home from work

OP, why would sil's need ad's after the death of their mum. surely that is a classic case, of a loss that makes someone very sad and that they need time/help/support etc to get over. but grieveing and loss is not the same as chemical imbalance.

Grieving is NOT the same as chamical imbalance, BUT bereavement can trigger genuine depression, which is to say that the depression is deeper, than one might expect in the circumstances, and other of the DSM-IV symptoms are present for at least a specified amount of time.

situational DEPRESSION is still clinical depression. it's just that the TRIGGER is visible, and that the reaction is greater than one would expect.

(Lazy GPs will prescribe ADs for bereavement, but really it is only when it tips over inot actual depresion that they will do any good, - other than a placebo efect - as you can't correct the balance of chemicals or make them work better if they are already balanced and working well)

Oooh I'm going to be unpopular, but never mind. I've had both clinical and situational depression. For the first, I had ADs, which made it worse. I took myself off them (gradually) and decided that the benefits of being more positive outweighed any disinclination I had to be more positive. I got better. The second time around, I used CBT on myself (I would prefer to think of it as 'counting my blessings') - eventually the positive messages overlaid the negative.

It IS possible to 'get a grip on yourself', but when it's said flippantly, it doesn't help. A middle ground between 'Poor me, I feel so bad, it's not my fault, and everyone has to look after me' and 'buck yourself up for god's sake' is needed.

Living with someone who is depressed (my mum for 15 years, for example) is INCREDIBLY AWFUL. I know it's awful for her, but it drains my soul. I can understand 100% your husband's comments OP. Sometimes I think depression can make those around the sufferer suffer as much, because it seems to selfish. I've never had the chance to be angry/upset/honest with my mum, because 'her depression' comes first, and has to be looked after before anything else. It pushes everything else into the shadows, and that breeds huge resentment.

YANBU, but, I'm sorry, I don't think your DH is either.

One thing I liked to think of when I was managing the mental health day service I worked at before I had DS.

However hard it is to deal with / live with / work with someone with mental health issues, it is always harder to BE the person with mental health issues.

it doesn't belittle the very difficult situation of being the "well" person, but it helped me to remember that whatever challenges the behaviour presents, those challenges are harder to deal with from the inside.

It is sooo hard to understand depression when you've never suffered from it. This is not the same as denying it exists or seeing how it effects the ones you love.

I made that mistake in my youth telling a close friend she was either 'just knackered' or 'it because of this.....you need to sort it like this a,b,c.....' Luckily she is still a good friend.

I agree with Mrs Indiana about dealing with relatives - depression can make a person very self centred (not selfish - that is something entirely different).

And of course your DH should be supporting you, even if he doesn't understand how it feels.

I'm confused.

Is there anyway to test the 'chemicals' that are imblanced?

[SDTG I hope you don't mind, but I am using you/your post to try to explain my question as your post covers all 3 aspects. It's really not aimed at you and I am really, really sorry you have been dealing with depression pretty much all of your life :( ]

How does it work that SDTG has been depressed since she was a teenager due to bullying and she needs AD's to help her cope - but with therapy she hopes to come off of them. Does that then mean that the depression isn't a chemical imbalance - so why do the AD's work?? Or is it that you are able to alter the chemical imbalance by changing the situational depression and if so, how so? Is there any research that shows situational depression creates a chemical imbalance becoming clinical depression?

I really would like to understand it so much better than I do, but everything you read is just so confusing and it's so much better to 'talk' to you guys.

Self-centred, yes, that's what I meant, not selfish. Thanks Doodler.

I think its understandable if someone with depression is a bit self centred. Severe mental illness attack the inner soul, it attacks life itself. Most of us would be pretty self centred if we were fighting for life.

Chipping - I absolutely don't mind at all, and I don't feel got at or anything.

I don't have an authoratative answer to your question, and am just answering it based on my opinions, and things I've learned in therapy.

I think that my depression is a mixture of chemical and reactive/situational depression - I suspect that the situational depression came first, because of the bullying and my parents and the school's lack of response to it, and that that had an effect on my neurochemistry - the mind affecting the body.

The antidepressants are helping me cope on a day-to-day basis at the moment by partially correcting the chemical imbalance, which enables me to have the mental, emotional and physical energy to deal with the deep-down roots of the depression, in my childhood.

Therapy isn't going to change what happened to me, but it is changing my response to it, and helping me move on. For example, my mental image of my bullies is of teenage boys, and obviously they are now in their mid-40s - and just as I have changed over the years, so they probably have too. Who knows, they might regret what they did, or have realised that it was wrong. Letting them grow up in my mind has let me move on from that teenage girl too - keeping them stuck there must have kept me stuck too.

I'm changing the way I think about things, and that is changing my depression, I think. I don't know if, once I have completed the therapy, my brain chemistry will have gradually changed too, or whether I will simply be better able to cope with the effects of my brain chemistry - it is a very interesting question, and I will probably raise it at our next therapy group, and see if anyone has a better answer.

I hope that rambling goes some way towards answering your questions, Chipping - and please, ask more questions, I won't get offended or hurt - promise!

i imagine that in third world countries ,the grief of watching your child die from preventable disease/lack of safe clean water probably overrides depression .