Original Depression-GAF thread

Follow @depressionGAF on twitter for updates on special IRC chats, mental health news, and other things possibly!

RECENT UPDATES

1.) NeoGAF user, erlim, made an amazing, moving, inspirational video as a tribute to his sister, who ended her own life following a struggle with depression. If you're struggling with your own mental health issues, listen to his message. Original thread here.

2.) check out deviljho's guide to getting started with mindfulness! He did an amazing job, and this is a very quick and easy way to get yourself started on the road to better mental health, even if you aren't ill.

3.) Check out Hyperbole and a Half's two part Adventures in Depression [one, two]. I've honestly never seen a better description of depression.

This thread is for gaffers and lurkers coping with mental health issues like depression. This thread is for supporting them and discussing these issues. Please have compassion and patience with others and yourselves in this thread. If you are in a crisis, please call for help and look at the resources.

*The information provided here is all meant to aid you and support you in getting the help you need. No amount of reading or posting on GAF can substitute for getting professional help.*


If you are thinking of hurting yourself, please get help right away! Go to the hospital emergency department - if you are thinking of ending your own life, it is a medical emergency. If you need help figuring out where to go, a suicide hotline can help.

NeoGAF's erlim made this amazing video as a tribute to his sister, who took her own life: The Forge - For Anybody Hurting.

US National Suicide Hotlines: 1-800-SUICIDE (784-2433) or 1-800-273-TALK (8255)
Hotlines by state

Canada Crisis lines by province

UK Samaritans Charity 08457 90 90 90*
Northern Ireland Lifeline: 0808 808 8000

Australia LifeLine 13 11 14
New Zealand Crisis Contacts

Crisis centers by country.

The Trevor Project 866 488 7386
"providing crisis intervention and suicide prevention services to lesbian, gay, bisexual, transgender, and questioning youth"

Veterans Crisis Line 1-800-273-8255 PRESS 1

“I still see my hands coming off the railing,” he said. As he crossed the chord in flight, Baldwin recalls, “I instantly realized that everything in my life that I’d thought was unfixable was totally fixable—except for having just jumped.”


Places to find help

US
NAMI

UK
SANE

EU
EUFAMI



Mental Health-GAF Resources:

[Depression-GAF is our established name, but it’s synonymous with Mental Health-GAF.]

Depression-GAF is a place for anyone suffering from mental illness, dealing with mental illness in friends and loved ones, or simply wanting to learn more.

It is hard to deal with mental illness. It will get difficult and frustrating, and that's a realistic expectation, but we want to help people heal and feel safe to examine their struggles and feel less alone.

Please note that your problems are decidedly real, even if you feel like you’re reading posts from people that have it way worse than you. It’s not a competition. Everyone is welcome.

This thread is the contact point for our various community efforts. To get the most out of things, make use of the contact list, the IRC chat, and the thread. We’re a tight-knit community, but we’re incredibly open to new members. The many friendships I’ve found in here have all started with single PMs.

All sorts of people watch the thread every day, and posts are often discussed in the various chats (IRC, Steam, Skype) before they are replied to. It’s very easy to become a part of that. And the people who are getting the most out of our community, and are seeing the most improvement, seem to be the folks who use all of the avenues we offer.

Depression-GAF all-star contact list - hit us up if you need to talk! I curate the list, so if you’re not sure who would be the best person to talk to, send me a message and I can lend you a hand. As always, let me know if you'd like to be added!

[Update. January 2016. I went ahead and removed the contact list. I haven't been able to curate it in a long time and we've had some turnover in the thread.

Most people are open to PMs. Don't be afraid to contact people from the thread with advice or to ask to talk!]

Depression-GAF Chat!


-or-
server: irc.mibbit.com
channel: #depression_gaf
password: sawap
(/nick NEWNAME to change your nick)

The channel is always active, with the most users in the evening hours. Special chats may be announced in the thread.

Moderators: swecide, bgls, Colin., jb1234, MikeDip

There is a Mental Illness-GAF anonymous email account, if for whatever reason you do not wish to be named in the thread. In general, it’s best if we can put a name (and avatar!) to a series of posts, but we realize that is not always an option

mentalillnessGAF@gmail.com - this does not get used much, so we never check it. You can
PM me (or anyone else you trust) if you'd like me to post something anonymously for you.



1) Have patience and compassion with people, including yourself. People in here are often very sick and trolling that would get a laugh elsewhere can have dire consequences. Consider how you respond to posts you don’t like. We get the occasional “Just man up!” type nonsense in here. Arguing with these posts is a waste of time. Our regulars will help deal with these people.

When someone doesn't take your advice or reply, don't take it personally. Some people just want acknowledgement of what they experienced and are not ready for change or ready to confront new possibilities.

While there are many people who read every post in the thread, it can move too quickly (or posts may be way beyond anything people are comfortable offering advice about - we’re not professionals!) for every post to get a response. We ask your patience with us. We try our best! If a post goes unanswered, politely ask for help, ask in chat, on steam, in a PM, or on skype.

2) Respect people’s privacy. It can be very hard to talk about your struggles here, all the more so if you don’t want other GAF communities you’re part of to know. Please keep the information shared here within this community, unless there is good reason to repost elsewhere (e.g. intervening with a suicidal member). We have an email account (discussed above) to post things anonymously in the thread, or you can assume a different handle in chat.

3.) Try to approach this thread with a positive or constructive mindset. We understand there are times you just need to vent and let your emotions out, and it's okay to do that too. We want to know how you really feel. However, realize who it might hurt, including yourself. This thread isn't meant to hurt people. Things go best when the venting takes a back seat to questions and discussion. If you have to vent, please understand that it is very difficult for others to respond appropriately to absolute statements - e.g. “I’ll never be happy!” - or incredibly hurtful statements (including ones about tearing oneself down) - e.g. “I’m an ugly loser.” - no matter how good their intentions. Many members will try their best to help, whatever the situation, though!

4.) Be open to what others have to say. Try to appreciate the different views and experiences that people have, and acknowledge that your experience is not absolute for others, and possibly even for yourself. You may not agree with all the advice or encouragement given, but people took their time to write it, so take time in considering it. Examine why or how it may or may not apply to you before outright rejecting or accepting it.

I ideally, if you’re not sure how to post about your own difficulties, heidern suggested this nice 3-point guide:

1) Description of your issues(the more detail the better).
2) What actions are you taking or planning to take? Or if you can't take actions, what difficulties are you having?
3) Specific things you'd like help/advice on. Ask questions.




"Why can't people just cheer up?"

Mental illnesses are easy to dismiss as somehow less real than, say, diabetes or cancer. But asking why someone can’t just cheer up is actually a lot like asking why they cannot make insulin, or shrink their own tumors. Mental illnesses are thought to be caused by a complex interplay of biological, psychological, and social factors, all of which are very real and very hard to change in an instant.

There’s a profound difference between being depressed and just feeling down, even if people say “I’m depressed” in both cases. Depression involves a negative mood out of proportion to life events, and which is not easily lifted. A bowl of ice cream may be all that’s needed on a crappy day, but depression is much more than that. The feeling may be analogous to waking up every day and feeling like your best friend just died. Or it may manifest as profound numbness, an indifference to all emotions. Realigning your thoughts is part of the healing process, but it’s not as simple as thinking a happy thought or two!

"Why even bother having this thread? It's depressing me."

Why? Because talking about it helps. It promotes awareness, lowers stigma, and lessens the sense of isolation.

Around 1 in 4 people around the world will meet the criteria for some form of mental illness in their lifetime. You probably know a family member or friend who suffers from one.

This may be a gaming forum primarily, but people in here come from all walks of life and we want to promote a community that is more understanding of the struggles that some have to live with. People can and do get better, they work to cheer each other on, we play games together, we’re friends. There’s a lot to be said for not having to explain what depression is and why you can’t just feel better. We can skip that step in here and just hang out with people who know at least a bit about what we’re going through.

And you’d be surprised how much comedy comes from the depressed mind! It’s not all doom and gloom in here!

"I don't have depression/anxiety/bipolar disorder, but can I still post in this thread?"

Absolutely! But if you say “Just man up!” “Cheer up!” or anything of the sort, you will be literally crucified. Again, this thread should not hurt people. We ask for your understanding when things are difficult, frustrating, or don’t make sense to the non-depressed mind (you lucky dog, you!).

If you don’t “believe” in depression, we’d just as soon NOT have you visit. Tom Cruise, I’m looking at you, and I know your GAF account.

"This person just sounds like they are a huge whiner. What if they don't have depression and are just faking for attention?"
-or-
"Their problem don't sound so serious. They should stop whining. Why don't they just do XYZ? All their problems will be solved!"

Try to suspend judgment about people. You don't know what their actual life circumstances are like, what their experiences are. Not everyone will disclose everything that's going on in their lives for a number of reasons (in fact, very few people disclose even a fraction of what’s going on). Give people the benefit of the doubt and be constructive if you can.

It's okay to doubt someone, but this thread isn't about tearing people down and dissecting them. That energy is best used in other ways.


Disclaimer: Some serious issues may be out of the scope of most people's experiences and no one may have a good answer for you. But don't feel like you can't say anything about it. Just talking can help. Other people may be having the exact same issue(s).

*The information provided here is all meant to aid you in getting the help you need. No amount of reading or posting on GAF can substitute for getting professional help.*



1.) Depression


Questionnaires such as the Personal Health Questionnaire (PHQ-9) or Beck Depression Inventory are not necessarily diagnostic, but can be highly suggestive of a major depressive disorder.




(moving some stuff to Belmarduk's post - he needs to update the links, so they're still in my posts)

A word of caution: The Diagnostic and Statistical Manual of Mental Disorders (DSM), the bible of mental health, states that its use by people without clinical training can lead to inappropriate application of its contents. Appropriate use of the diagnostic criteria requires extensive clinical training, and its contents "cannot simply be applied in a cookbook fashion". At the end of the day, your specific diagnosis may not be as important as what you do about it. If you diagnose yourself with bipolar disorder and do not seek professional help, you’re hardly better off, are you?


Definitions

Anhedonia - a lack of interest in previously pleasurable activities.

Anorexia nervosa - an eating disorder characterized by immoderate food restriction and irrational fear of gaining weight, as well as a distorted body self-perception.

Anxiety disorder - characterized by excessive rumination, worrying, uneasiness, apprehension and fear about future uncertainties either based on real or imagined events, which may affect both physical and psychological health.

Attention deficit-hyperactivity disorder (ADHD) - a mental and neurobehavioral disorder characterized by either significant difficulties of inattention or hyperactivity and impulsiveness or a combination of the two.

Autism spectrum disorders - typically characterized by social deficits, communication difficulties, stereotyped or repetitive behaviors and interests, and in some cases, cognitive delays.

Bipolar disorder (historically known as manic–depressive disorder) - characterized by episodes of a frenzied state known as mania (or hypomania), typically alternating with episodes of depression.

Bulimia nervosa - an eating disorder characterized by binge eating and purging, or consuming a large amount of food in a short amount of time followed by an attempt to rid oneself of the food consumed (purging), typically by vomiting, taking a laxative or diuretic, and/or excessive exercise.

Compulsions - repetitive behaviors or mental acts that the person feels driven to perform in response to an obsession or according to rules that must be applied rigidly.

Delusion - a belief held with strong conviction despite superior evidence to the contrary.

Dysthymia - a condition related to unipolar depression, where the same physical and cognitive problems are evident, but they are not as severe and tend to last longer (usually at least 2 years).

Hallucination - a perception in the absence of a stimulus which has qualities of real perception. Different from dreams in that they are experienced during wakefulness. A hallucination can occur in any sensory modality. Auditory hallucinations are most common in schizophrenia.

Hypomania - a mood state characterized by persistent and pervasive elevated (euphoric) or irritable mood, as well as thoughts and behaviors that are consistent with such a mood state. Unlike with full mania, those with hypomanic symptoms are often fully functioning.

Major depressive disorder (MDD) (also known as clinical depression, major depression, unipolar depression) - a mental disorder characterized by episodes of all-encompassing low mood accompanied by low self-esteem and loss of interest or pleasure in normally enjoyable activities.

Mania - a state of abnormally elevated (euphoric) or irritable mood, arousal, and/or energy levels.

Mixed episode - a manic episode and a major depressive episode ocurring very close together in time, or even overlapping, odd as that sounds

Mood - an emotional state, different from emotions in that they are less specific, less intense, and less likely to be triggered by a particular stimulus or event. Moods generally have either a positive or negative valence. In other words, people typically speak of being in a good mood or a bad mood. Mood is an internal, subjective state but it often can be inferred from posture and other behaviors.

Personality disorder - a class of personality types and enduring behaviors associated with significant distress or disability, which appear to deviate from social expectations particularly in relating to other humans

Psychiatry - the medical specialty devoted to the study, diagnosis, treatment, and prevention of mental disorders. Psychiatrists are MDs. They employ psychotherapy and psychopharmacology (drug therapy) to treat mental illnesses.

Psychology - involves the scientific study and treatment of mental functions and behaviors. Clinical Psychologists are not medical doctors; the advanced degree is a PhD or a PsyD. The main tool of the psychologist is psychotherapy (talk therapy). In some places, psychologists may be able to prescribe some medications as well, but this is uncommon.

Psychotherapy - a general term referring to therapeutic interaction or treatment contracted between a trained professional and a client, patient, family, couple, or group.

Schizophrenia - a mental disorder characterized by a breakdown of thought processes and by a deficit of typical emotional responses. Common symptoms include auditory hallucinations, paranoid or bizarre delusions, or disorganized speech and thinking, and it is accompanied by significant social or occupational dysfunction.

Seasonal affective disorder (SAD) - a mood disorder in which people who have normal mental health throughout most of the year experience depressive symptoms in the late fall and winter or late spring and summer.

Substance abuse - also known as drug abuse, is a patterned use of a substance (drug) in which the user consumes the substance in amounts or with methods neither approved nor supervised by medical professionals.

Substance dependence - commonly called drug addiction, is a user's compulsive need to use drugs in order to function normally. When such substances are unobtainable, the user suffers from withdrawal.



Mental Disorders

The Diagnostic and Statistical Manual of Mental Disorders (DSM) [The DSM V is scheduled for publication this May] published by the American Psychiatric Association, “the psychiatric bible,” provides a common language and standard criteria for the classification of mental disorders. Diagnostic information is divided into 5 categories.

Axis I: All diagnostic categories except mental retardation and personality disorder
Common Axis I disorders include depression, anxiety disorders, bipolar disorder, ADHD, autism spectrum disorders, anorexia nervosa, bulimia nervosa, alcohol abuse, and schizophrenia.

Axis II: Personality disorders and mental retardation (developmental disorders, such as Autism, were moved from Axis II to Axis I in the DSM IV)
Common Axis II disorders include personality disorders: paranoid personality disorder, schizoid personality disorder, schizotypal personality disorder, borderline personality disorder, antisocial personality disorder, narcissistic personality disorder, histrionic personality disorder, avoidant personality disorder, dependent personality disorder, obsessive-compulsive personality disorder; and intellectual disabilities.

Axis III: General medical condition; acute medical conditions and physical disorders
Common Axis III disorders include brain injuries, thyroid dysfunction, and other medical/physical disorders which may aggravate existing diseases or present symptoms similar to other disorders.

Axis IV: Psychosocial and environmental factors contributing to the disorder
Examples of things that may be listed in axis IV include marriage, divorce, the birth of a child, moving to a new town, job loss, or loss of a loved one.

Axis V: Global Assessment of Functioning (GAF!)
Axis V is reported as a score out of 100, providing a rough overall picture of psychological, social, and occupational functioning. A person free of any symptoms of a mental disorder will generally have a score in the 90s. A person who is a danger to himself or others, or who is unable even to maintain basic personal hygiene may score below 10. As with video game review scores, the difference between an 82 and an 80 is not important, but the difference between a 90 and a 20 is pretty important.




Self diagnosis is fun but of little practical concern unless it gets you to seek professional help. Likewise, the use of online tests for common mental illnesses is discouraged. These test are not generally scientifically validated or even constructed by mental health professionals.

Having repeated all that, how then are mental illnesses diagnosed?

There are two key points to remember:

1) A mental illness, by definition, impacts one’s ability to carry out the activities of day-to-day life. Preferring not to be in large crowds is not a mental illness; being unable to leave your house because you’re terrified of people, on the other hand? You might want professional help with that.

2) Currently, mental illnesses are clinical diagnoses, which is to say they are not based on laboratory tests, imaging studies, biopsy, etc. A diagnosis is made when a professional talks to and observes a patient. Attempts to develop genetic tests or biological markers for mental illnesses are being actively developed, and represent a holy grail for mental health researchers.

1.) Depression
The diagnostic criteria for major depressive disorder can be remembered with the acronym DIGS E CAPS.

Major Criteria
Depressed Mood
Interest (loss of, in formerly pleasurable activities. also called anhedonia)
Minor Criteria
Guilt
Sleep (changes in, either more or less)
Energy (lack of)
Concentration (difficulty with)
Appetite (changes in, either more or less)
Psychomotor (being excessively fidgety or unusually slowed)
Suicidality

The diagnosis of depression requires the presence of at least one major criterion, with a total of 5 or more of the DIGS E CAPS symptoms, for at least 2 weeks. The symptoms should not be due to a process such as bereavement following the loss of a loved one.

Questionnaires such as the Personal Health Questionnaire (PHQ-9) or Beck Depression Inventory are not necessarily diagnostic, but can be highly suggestive of a major depressive disorder.

The PHQ-9 is the easiest to calculate, so I recommend using it if you would like to post a score in the thread. You can calculate your score by taking DIGS E CAPS, thinking of the past 2 weeks, and awarding 1, 2, or 3 points if the symptoms have been present some days, more than half of the days, or nearly every day, respectively. If the symptom has not been present, award 0 points.


A PHQ-9 score of 20 out of 27 (note that the final question asks how difficult the problems have made things for you. It's not all about putting some number on your depression), is suggestive of severe depression.

A BDI score above 17 ("borderline clinical depression"), out of 63, is a suggested level at which you should seek medical help (again, subjective experience trumps the score - if your score is 15, but you want to die, get help!). A score over 30 suggests severe depression.

2.) Anxiety Disorders

The diagnostic criteria for several specific subtypes of anxiety disorder (including panic attacks, PTSD, OCD, and Phobias) can be found here.


The criteria for Generalized Anxiety Disorder:

Excessive anxiety, that is difficult to control, about a number of events or activities, occurring more days than not, for at least 6 months.

The anxiety and worry are associated with at least three of the following six symptoms (with at least some symptoms present for more days than not, for the past 6 months):
Restlessness or feeling keyed up or on edge
Being easily fatigued
Difficulty concentrating or mind going blank
Irritability
Muscle tension
Sleep disturbance

The Beck Anxiety Inventory may be suggestive of the presence and severity of an underlying anxiety disorder. You are asked to rate the presence of 21 different symptoms over the past month, with 0-3 points per symptom. A score greater than 36 gives the most cause for concern.


3.) Bipolar Disorder

There are two main forms of BPD. Type I involves episodes of frank mania, whereas the milder type II form involves episodes of hypomania.

Bipolar I disorder: characterized by the occurrence of 1 or more manic or mixed episodes.
Criteria for manic episode: a distinct period (1 week or more) of abnormally and persistently elevated, expansive, or irritable mood during which 3 (4 if mood is only irritable) or more of the following symptoms have persisted and have been present to a significant degree:
Inflated self-esteem or grandiosity
Decreased need for sleep
More talkative than usual or pressure to keep talking
Flight of ideas or subjective racing of thoughts
Distractibility
Increase in goal-directed activity
Excessive involvement in pleasurable activities that have a high potential for painful consequences.
Criteria for mixed episode:
Criteria are met both for a manic episode and for a major depressive episode during at least a 1-week period
Causes functional impairment, necessitates hospitalization, or there are psychotic features

Bipolar II disorder: characterized by the occurrence of 1 or more major depressive episodes and at least 1 hypomanic episode.
Criteria for hypomanic episode: these are the same as the criteria for mania, BUT the episode is not severe enough to cause marked impairment in functioning or hospitalization, and psychotic features are absent. It’s mania but less so.

The Young Mania Rating Scale is an 11-item inventory used to assess the severity of symptoms.


4.) Eating Disorders

Anorexia nervosa
Refusal to maintain body weight at or above a minimally normal weight (85% of that expected) for age and height
Intense fear of gaining weight or becoming fat, even though underweight.
Disturbance in the way in which one's body weight or shape is experienced, undue influence of body weight or shape on self-evaluation, or denial of the seriousness of the current low body weight.
In postmenarchial females, the absence of at least three consecutive menstrual cycles.

Bulimia
Recurrent episodes of binge eating characterized by BOTH of the following:
a. Eating in a discrete amount of time (within a 2 hour period), an amount that is definitely larger than most people would eat during a similar time period.
b. Sense of lack of control over eating during an episode.
Recurrent inappropriate compensatory behavior in order to prevent weight gain (self-induced vomiting, misuse of laxatives or diuretics, starvation, or compulsive exercising).
The binge eating and inappropriate compensatory behaviors both occur, on average, at least twice a week for three months.
Self-evaluation is unduly influenced by body shape and weight.
The disturbance does not occur exclusively during episodes of anorexia nervosa.


5.) Personality Disorders

The essential features of a personality disorder are impairments in personality (self and interpersonal) functioning and the presence of pathological personality traits.

DSM IV and V criteria for individual personality disorders can be found here.

2.) Anxiety Disorders

The diagnostic criteria for several specific subtypes of anxiety disorder (including panic attacks, PTSD, OCD, and Phobias) can be found here.



The Beck Anxiety Inventory may be suggestive of the presence and severity of an underlying anxiety disorder.

3.) Bipolar Disorder



The Young Mania Rating Scale is an 11-item inventory used to assess the severity of symptoms.


4.) Eating Disorders

Anorexia nervosa

Bulimia


5.) Personality Disorders


DSM IV and V criteria for individual personality disorders can be found here.


Therapies in psychiatry fall into 4 basic categories: drug therapies, talk therapies, other therapies, and bullshit quackery. Avoid that last one, if you can.

Generally speaking, the combination of drug therapy and talk therapy is the gold standard, offering better rates of recovery than either component alone. For depression, talk therapies and drug therapies are effective in about half of all patients, each. If you do both, it’s more like 75-80%.

A Note on Psychiatrists and Psychologists

Psychiatrist are medical doctors, with special training to diagnose and treat mental illnesses. Psychologists, on the other hand, are not medical doctors, but have advanced training in psychological theories and psychotherapy. A therapist may be a psychiatrist or a psychologist, but only the medical doctor gets to prescribe drugs. Each has their advantages and disadvantages.

A psychiatrist should have considerable expertise in tailoring drug therapy to an individual patient. The MD should also be better trained to recognize medical causes of mental illness, including things like thyroid dysfunction and medication side effects. However, most psychiatrists these days receive far more training in drug therapy than in talk therapy, so may lean heavily on the prescription pad and have little time, inclination, or expertise in psychotherapy.

[Note that psychiatric disorders may also be treated in general practice, internal medicine, or even specialties like cardiology. Nurse practitioners (who are generally able to prescribe some types of medications) and nurse specialists (who cannot personally prescribe medications but may monitor patients using medications) are increasingly common in psychiatric practice.]

A psychologist generally lacks the medical training necessary to prescribe drugs or delve into medical causes of psychiatric illness. However, the non-MD will have extensive training in one or more systems of psychotherapy, and may even be able to offer a mix of family or partner counseling in addition to individual psychotherapy.


Drug Therapy - Psychopharmacology

“A conceptually novel antidepressant that acted rapidly and safely in a high proportion of patients would almost certainly become the world’s bestselling drug.”
-Nature reviews Drug Discovery

The decision of whether, when, and how long to try drug therapy (along with what drug(s) to actually take) for a mental illness can be extremely complex. Psychiatric medications are somewhat unusual in that people generally do not have philosophical or moral objections to taking, say, antibiotics or drugs for Parkinson’s Disease. Psychiatric medications are believed by many to be completely ineffective placebo-like substances, to have dramatic negative consequences to a person’s normal mental functioning, or strangely, to do both at the same time (i.e. they’re both incredibly powerful and do absolutely nothing).

The decision to take psychiatric medications is ultimately personal, and should be made in conjunction with a medical expert, or, failing that, someone at least dressed like a doctor. Generally speaking, drug therapy will be more strongly suggested the more severe one’s illness is.

First, a few misconceptions about drug therapy:

“The drugs have been shown to do nothing!” - this sentiment is more often applied to antidepressants (ADs) than, say, Xanax (which, if anything, does a little too much). The actual debate in the medical community is not whether the drugs do anything at all, but rather how much good they do relative to their costs and side effects. The drugs have proven most effective for the most severely depressed. They seem less beneficial for the mildly depressed, but drug therapy is quicker, easier, and cheaper than talk therapy, so the drugs are still widely prescribed.

“ADs are just happy pills that will make you forget your real problems!” - many people WISH this was how the drugs worked. ADs do not make you feel happy, they make it POSSIBLE for you to feel happy. The discredited notion that ADs work to boost your neurotransmitter function persists because it provides an easy way to make sense of this. If you need serotonin to feel happy, and your brain simply does not make enough, it will be physically, biologically IMPOSSIBLE for you to feel that emotion. The drug acts to boost your available serotonin so that, given the right circumstances, you can squirt out some serotonin on your noodle and feel happy. Again, that’s not how any of this works, but it makes a lot of sense.

“You want to take drug X. Drug Y will give you terrible side effects!” - the individual response to drug therapy can be all over the map, for reasons that are not entirely understood. It is known that there is genetic variation in the genes encoding liver enzymes responsible for metabolizing most medications. Fast metabolizers may need much larger doses to see effects, whereas drug levels may unexpectedly climb in slow metabolizers .

Responses to drugs are idiosyncratic, so Sertraline may work great for your friend, but give you incredible headaches. There’s really no way of knowing. It can be helpful to know what did or did not work for close relatives (parents or siblings) - that has some predictive value. There’s no reason to think that a drug that worked for me will be a great drug for you, though (unless you’re a close relative, which would weird me out).

“Newer drugs are obviously better.” - All things being equal, unless there is some really compelling reason to take a new drug, ask for something available as a generic. All ADs are about equally effective, across the population. The newer antipsychotics have some distinct advantages over the older drugs, but patients often don’t have much say in how these drugs are prescribed (which is for the best, as these can be quite dangerous if not used correctly).

“Once you start, you have to take medications your entire life.” - some people will require life-long medication therapy, but that is not the norm. Initial drug therapy for depression lasts 6 months to a year before weaning off the medication is considered.

“I don’t want to be dependent on drugs. What if the economy collapses tomorrow!” - no one likes needing to take medications, but if your biology is out of whack, and a medication can restore the balance, I’m not sure I see the problem.

If the entire world does degenerate into chaos tomorrow, sure, you won’t be able to refill your Prozac. You also won’t be able to get your wheelchair serviced, get more contact lenses, or get a vaccine against a global epidemic of monkey pox (not to mention the difficulty getting your fresh water or posting on GAF) . And if you run out of insulin, you’re diabetes will be F’ed in the A (where the A is your pancreas). Please don’t let this be the reason you don’t try drug therapy.

“I’m feeling a little extra down today so I’m going to double my dose.” - psychiatric medications don’t really work like this, generally. They take time to work and attempting to rapidly alter your dose is just going to give you more side effects.

“I’ll get addicted!” - some medications, particularly the benzodiazepines and stimulants, can be very addictive. Use caution with all medications, particularly if you have a history of drug abuse. In general, the risk of addiction is much higher when drugs are used recreationally, not when they are taken as prescribed for the symptoms they were prescribed for. Be responsible and you’ll be in better shape.

“A natural remedy would be safer.” - cobra venom is 100% natural and it can kill you dead. Nature is not a benign entity. The benefit of taking a medication is that there are stringent standards of production and dosing. Natural remedies are not regulated to nearly the same degree, and even if dosing were carefully controlled in the products, the therapeutic doses for humans are most often completely unknown (if they exist at all).

This is not to say that just because something does not come from Novartis, it’s no good. Nature is full of wonderful medications like opium, right there for the pluckin’! The key is that herbal supplements and the like should be treated just like your regular medications. Let a doctor know if you are taking something like St. Johns Wort for your depression. Natural remedies can interact with your other medications and hurt you real bad.

“Bagels is paid a lot of money by the pharmaceutical industry to shill their products.” - the pay is a lot more modest than you’d think.

I’m definitely more interested in and accepting of drug therapy than many people in the thread, and I’m happy to ramble on at length about it, but I have no financial stake in whether or not you try Cymbalta - which, by the way, is just another incredible product from my good friends at Eli Lilly and co.



Medications for Depression

SSRIs/SNRIs - Selective Serotonin/Norepinephrine Reuptake Inhibitors. These drugs were thought to regulate the flow of neurotransmitters between synapses in the brain. The truth is way more complicated than that, and may involve such trendy concepts as neuroplasticity.

Following the launch of Prozac (Fluoxetine) in 1987, SSRIs became the most popular drugs for the treatment of depression, and subsequently some of the most widely prescribed drugs in the world. They are now used to treat anxiety, OCD, eating disorders, and chronic pain. They are preferred to older drugs not because of their improved efficacy, but because of their improved safety.

SSRIs take several weeks to have their full effects. Common side effects include headaches, sexual dysfunction, and upset stomachs.

The SSRIs Citalopram and Sertraline are the most prescribed antidepressants in the US, with 38 million prescriptions each in 2011.

MAOIs - Monoamine Oxidase Inhibitors. The MAOIs were the first ADs, discovered by accident during the development of drugs used to treat tuberculosis. These drugs act to inhibit the enzyme that breaks down serotonin and norepinephrine in the brain. These drugs tend to have more dramatic side effects (and may require dietary restrictions) and are less safe in an overdose than the SSRIs. Nevertheless, MAOIs are particularly useful in the treatment of depression that has failed to respond to SSRIs.

Tricyclics - the tricyclic antidepressants are the bridge between MAOIs and SSRIs. They tend to have worse side effects than the SSRIs and can be deadly in an overdose. They are generally used only if trials of SSRIs have been unsuccessful.

Other - bupropion is like an SSRI, but it has a unique action on dopamine reuptake. It is also special in that it generally does not cause sexual side effects, and is even added to SSRI therapy to combat sexual dysfunction. It is also FDA approved for smoking sensation.

Mirtazapine is a tetracyclic AD, but it otherwise a lot like the other ADs.

Trazodone binds to serotonin receptors and has actions as an antidepressant and anxiolytic, but is primarily used nowadays for the treatment of insomnia.

Natural - St Johns Wort is available as an herbal supplement and is thought to have SSRI-like properties.


Medications for Anxiety

Benzodiazepines - benzos act on the receptors for GABA, the major inhibitory neurotransmitter in the central nervous system. Benzos are fast acting anxiolytics, hypnotics (sleep promoting drugs), anticonvulsants, and muscle relaxants. They basically tamp down the firing of neurons in a way related to the action of alcohol. As such, they can be highly addictive and are among the most abused drugs in the world. They are primarily recommended for use in the short term, or for occasional use against acute episodes of anxiety.

Xanax is the most prescribed psychiatric medication in the US, with 48 million prescriptions in 2011. Due to its rapid onset and short duration of action, Xanax is a particularly addictive drug. Klonopin or Ativan may be safer choices.

SSRIs are also commonly used for the long-term treatment of anxiety disorders.
Buspirone is a serotonin receptor antagonist also used for the long-term treatment of anxiety.

Natural - Valerian root is sold as an herbal supplement. It is thought to have actions at GABA receptors similar to those of the benzodiazepines.

Antipsychotics/Neuroleptics

These drugs are primarily used for the treatment of bipolar disorder and schizophrenia, but may be used in the treatment of other psychiatric disorders as well. The older “typical” antipsychotics act by blocking dopaminergic pathways in the brain. The newer “atypical” antipsychotics also act on serotonergic pathways.

These drugs must be used with caution as the side effects can be very severe and even, in some cases, permanent. They can be life-changing therapies, but as is generally the case with strong medicines, they can be quite dangerous to mess around with. Geodon, Risperdol, and Seroquel are commonly prescribed atypical antipsychotics. Haldol is a widely used typical antipsychotic.

Seroquel is the best-selling antipsychotic in the US, with 14 million prescriptions in 2011.


Mood Stabilizers

Lithium is widely used in the treatment of bipolar disorder and as an add-on drug for depression. It is literally a salt of elemental lithium. If you remember your chemistry, lithium sits above sodium on the periodic table of elements. Whereas the body is filled with sodium, which has myriad functions in normal physiology, the body usually doesn’t contain much lithium. It’s chemically related to sodium, so it can substitute in all sorts of ways. It acts to decrease norepinephrine release and increase serotonin synthesis, among other things. Because lithium levels are regulated like sodium levels, which can vary over time, patients taking lithium have to have their blood levels measured regularly.

Depakote and Lamictal are anticonvulsant medications also used as mood stabilizers in the treatment of bipolar disorder. Among other things, they block sodium channels in the brain. Depakote is not safe for use during pregnancy as it causes birth defects.

Mood stablizers are often used as “anti-manics,” but Lamictal is primarily used to treat the depressive symptoms of bipolar disorder.

Medications for ADHD

Stimulants - stimulants may seem an odd choice for a disorder that includes hyperactivity as a prominent symptom, but amphetamine compounds such as Ritalin, Concerta, Adderall, and Vynase (along with Modafanil, a non-amphetamine) are thought to help the symptoms of ADD by stimulating parts of the brain involved in attention and concentration. They can be miracle drugs for patients with true ADD, but are also widely used recreationally (they belong to the same chemical family as crystal meth, obviously), and their use in children remains controversial.

Adderall had almost 10 million prescriptions in the US in 2011.

Non-stimulants - ADs are increasingly used for psychiatric conditions other than depression. SSRIs and burpopion (Wellbutrin) are used as second-line treatments for ADD.

Experimental Treatments

The search for the next blockbuster psychiatric drug continues, although a lack of promising new classes of compounds has dried up some of the enthusiasm (and hence research dollars) for drugs that act on the brain. Current avenues of research include psychedelic drugs like LSD and psilocybin (which are obviously hard to get funding to study); opioids - primarily the partial agonist buprenorphine, which produces less euphoria than, say, heroin (morphine was historically used to treat depression); the anesthetic ketamine, which, in very small IV doses, has been shown to produce an almost instantaneous, but short lived, antidepressant effect; caffeine and other adenosinergic drugs; and so-called triple-reuptake inhibitors, which act like SNRIs, but also inhibit the reuptake of dopamine.


Non-Drug Therapies

ECT - electroconvulsive therapy, or electroshock, involves electrically inducing seizures in anesthetized patients. This is an older therapy with a checkered past and a bad rap, but it remains the most effective form of therapy for depression. The modern use involves complete anesthesia and lower levels of electricity - it is completely undramatic to watch. There is no screaming or wild bodily convulsions.

The therapy remains expensive, requiring a large team, requires general anesthesia which instantly raises the risks, and memory loss may be a significant side effect. Nonetheless, the remission produced by ECT is rapid and profound in many cases.

Light Therapy - phototherapy, which involves exposure to blue light, outside of central vision, is used primarily for seasonal affective disorder (which is itself thought to be caused by the low levels of light in non-equatorial areas during the winter months) and certain kinds of sleep disorders. Phototherapy is also thought to provide modest benefit in non-seasonal forms of depression.

Exercise - exercise is generally beneficial for just about any medical condition. Adding exercise to any treatment program for depression improves outcomes. However, exercise as monotherapy for depression is thought efficacious only in mild cases.



Psychotherapy

Talk therapy is still a mainstay in the treatment of almost all forms of mental illness. Talk therapy is non-invasive, requires no medications, and consequently is largely free of the traditional side effects one associates with medical care. However, it is time consuming, expensive, may be difficult to find, and requires considerable work on the part of the patient to be maximally beneficial. Psychotherapy is often described as like exercise for the brain.

Psychotherapy may be received in the individual, couple, family, or group setting. It may be directed towards a particular area of ones life (marriage therapy, family therapy, occupational therapy), or may follow a particular system (psychoanalysis [Freud’s system - harder to find today], cognitive behavioral therapy (CBT), dialectical behavioral therapy (DBT), interpersonal dynamic therapy, and so on).

Psychologist and mathematician Bruce Wampold’s influential book, The Great Psychotherapy Debate, argued that psychotherapy is effective, but the type of treatment is not important. Rather, the fit between the therapist and the patient is of far greater importance.

So how do you choose a therapist? For most people, the keys decisions are to see a therapist at all and then whether to stick with that therapist. A referring physician will often recommend a therapist, or friends, internet review sites, etc can be consulted. Availability of appointments and insurance coverage may ultimately limit ones choices, however. Once you are in therapy, it’s important to consider if the approach seems suited to your particular problem(s) and needs - most people do not want psychoanalysis any more, you might have a particular interest in mindfulness, you might want to focus on interpersonal interactions - and whether you have a good working relationship with your therapist. I wish there were more hard and fast advice I could give here, but it’s going to be up to you to find the kind of person you can work with. If you are paralyzed by options (unlikely in today’s mental health climate), take a look at CBT. It’s a very popular, common, well researched system of therapy.

General tips from Pau:
1. If you have insurance, call 'em and see if they cover mental health. If they do, they'll probably have a website where there's a database of therapists that take that insurance in your area.

2. Talk to your GP about it and ask if they can refer you to a therapist.

3. Depending on what city you're in, there might be options for cheap sessions without insurance. This will usually be a center that can refer you to someone in the city.

4. If you're in college, there should be a counseling center on campus. They typically don't see you long term, but they can refer you to other resources. Take advantage of help on campus as it's often covered by your tuition.

Extra special thanks to Prax for helping to write all of the good bits of the OP; Regular special thanks to BelMArduk and Mort for being part of the discussion as we wrote; Just thanks to Smiley90, Hermii, Pau, Uchip (banned, but not forgotten), AdventureRacing, SpartanForce, ClassyPenguin, Curtisaur, heidern, Oomikami, Nithidia, and RionaaM (if I missed your name, I apologize!) for sharing their thoughts and ideas for the OP. And thanks to swe for making chat easier to join!

And double special thanks to FillerB for sad GAF man OT banners!






Work in Progress!

>> Deviljho's introduction to mindfulness is a great place to start on the path to overcoming depression or anxiety. And if you are mentally healthy at the moment, it will pay off later to have tried these exercises. Even if you have never suffered from a mental illness, deviljho's guide is just great exercise for your brain!

U.S. Addiction Hotline: 1-800-662-HELP

The Reasons to Go On Living Project
Stories from people who decided to go on living following suicide attempts

Books - Nonfiction


Kay Jamison is a John Hopkins Psychologist who suffers from bipolar disorder. Her memoir, An Unquiet Mind, is an excellent place to start if you’d like to learn more about BPD.

Night Falls Fast is the best single volume on all aspects of suicide. It’s an incredibly moving book, highly recommended to anyone dealing with the aftermath of the suicide of a loved one.

Touched with Fire explores the link between BPD (and unipolar depression) and the artistic temperament.



Noonday Demon: Less information about the molecular basis of (some forms of? some part of?) depression than a receptor biologist like myself may want, but just tons of good information. The author was on the program "Speaking of Faith," on an episode entitled "The Soul in Depression." Very interesting.

Unholy Ghosts: some eloquent writing about depression.

William Styron’s “memoir of madness”, Darkness Visible, is the best 84 pages about depression you’l ever read. A great place to start.

[URL="http://www.amazon.com/Madness-Brief-History-Roy-Porter/dp/0192802674/ref=sr_1_5?s=books&ie=UTF8&qid=1366216555&sr=1-5&keywords=madness"]
[/URL]












Film


A documentary inspired by this amazingNew Yorker article. A film maker filmed the Golden Gate bridge for one year and recorded over two dozen people leaping to their death (many others were talked out of jumping). A powerful film about the dramatic effects a suicide has on the people left behind.


Podcats
MEOW. Typo, but let's keep it.


Lunch: “I'd like to recommend the Mental Illness Happy Hour, a podcast in which Paul Gilmartin speaks with various people (mostly comedians) about their experiences with mental illness. A lot of people in this thread seem to be under the belief that they're alone in their experiences and that other people don't have the same issues with anxiety, depression, lack of motivation, and the like, and the Mental Illness Happy Hour and its 108 episodes are a testament to how untrue that is. As such though, a lot of the episodes reiterate the same points, so I'd suggest going through the list of the top episodes of each year, as each episode is filled with really incredible stories and advice and make for fantastic and rather cathartic listening.”


Scholarly Resources


A surprisingly readable, small-ish text about the major neurotransmitters in your brain, what they're doing in there, and how they function in disease and pharmacology. Includes discussions of the major psychiatric disorders including coverage of the main drugs of abuse. A good place to start if you really want to dig in to the topic.


The latest original research into the molecular causes of psychiatric disorders. Look at the blog, the news, and the roundup of the latest articles if you're not too familiar with the scientific literature.

And to send this thread on a hopeful vibe:

Don't forget. Always somewhere, someone is fighting for you. As long as you remember...You are not alone.

Click to expand...

Thanks for this thread.

Long time lurker of depression-age.

It always good to know you're not alone in grappling these type of issues. I've suffered from depression and social anxiety for a long time; sometimes you feel totally alone. In that respect, the first thread helped me a lot just knowing I wasn't alone in my loneliness

Oh shit, looking at some of those definitions I think I have sort of figured out what I had.

It was Dysthymia I guess. I had some kind of depression(probably still have it but its much more mild) and it was linked with a strange and awkward sensation in my low back. Ive been taking effexor for a while now and it has really helped me in that area.

Subscribed for lurking. Can't offer much advice but i'll give it a try now and then.

NeOak said:

Subscribed for lurking. Can't offer much advice but i'll give it a try now and then.

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Nah you help. I haven't thanked you before on the old thread, but thanks for kicking me up when I'm completely hopeless. Helped that someone was actually listening.

Not a great start to the thread for anyone with OCD >_>

(Joking about Bel Marduk's post. The OT itself is great. Thanks to Bagel and everyone else who contributed to the making of this.)

This is a great thread. I fully support this. Nice work A+++

Suggestions for improvement are welcome! It's a lot of information - I wanted it to be a nice overview of all of our thread stuff, an outline of some mental health topics to get people started, and then there will be the section with resources - books, movie, blogs, whatever - but not TOO unwieldy. I hope stuff like chat and thread contacts are easier to find now and aren't lost in all my WORDZ!

I'll keep cleaning it up and try to make some banners so it's not just a wall of text.

Let me know what it needs!

And WELCOME!

Thanks dude

Bel Marduk said:

Can Dr. Bagels prescribe me stuff yet?

Click to expand...

a mod should delete this

I've gotten really good at dealing with depression at home but what about at work? I scan documents for 5 hours from 430pm to 930pm every weekday by myself in a room as part of a workstudy. Its hard to not let my mind wonder. I bring headphones and listen to podcasts and college lectures online but lately ive gotten super down. Any suggestions? I cant listen to music, any song about a relationship or things of that romantic nature just cause bad thoughts (thoughts that im otherwise rational about and able to manage during the day)

Im gonna get a stress clencher or ball for sure. I always get super angry when depressed and it might hell to releive some of that anxiety.

Sub_Level said:

I've gotten really good at dealing with depression at home but what about at work? I scan documents for 5 hours from 430pm to 930pm every weekday by myself in a room as part of a workstudy. Its hard to not let my mind wonder. I bring headphones and listen to podcasts and college lectures online but lately ive gotten super down. Any suggestions? I cant listen to music, any song about a relationship or things of that romantic nature just cause bad thoughts (thoughts that im otherwise rational about and able to manage during the day)

Im gonna get a stress clencher or ball for sure. I always get super angry when depressed and it might hell to releive some of that anxiety.

Click to expand...

I found what helps me when I need to focus on a task I listen to neutral things, such as nature environmental sounds. I found that listening to rain helps me focus.

Bronze Bells, gongs and singing bowls for one hour

30 minutes of rain

He also composes some nice music that doesn't have any words but helps relax:
Asian Breeze

Browse through his channel though, he has nice music/nature sounds.

Resources from the old thread. I need more non-depression stuff.


NAMI National Alliance on Mental Illness

"The Bridge" A documentary inspired by this New Yorker article I linked above. A film maker filmed the Golden Gate bridge for one year and recorded over two dozen people leaping to their death (many others were talked out of jumping). A powerful film about the dramatic effects a suicide has on the people left behind.



Night Falls Fast: Understanding Suicide

The best single volume on suicide. The author, Kay Jamison, is a Johns Hopkins professor with bipolar disorder. She has an autobiography, An Unquiet Mind, and a book exploring the relationship between mental illness and the artistic temperament:




The Noonday Demon: An Atlas of Depression



Less information about the molecular basis of (some forms of? some part of?) depression than a receptor biologist like myself may want, but just tons of good information.

The author was on the program "Speaking of Faith," on an episode entitled "The Soul in Depression." Very interesting.

Unholy Ghost: Writers on Depression



Shrink Rap - three psychiatrists discuss their work. they have a book and a podcast, too.

How to Good-bye Depression: If You Constrict Anus 100 Times Everyday. Malarkey? or Effective Way?



Not quite as amazing as the title, but still a classic in the field. I'm not sure what field that would be, but whatever it is, this is a classic.


The Antidepressant Era



Introduction to Neuropsychopharmacology



A surprisingly readable, small-ish text about the major neurotransmitters in your brain, what they're doing in there, and how they function in disease and pharmacology. Includes discussions of the major psychiatric disorders including coverage of the main drugs of abuse. A good place to start if you really want to dig in to the topic.





The latest original research into the molecular causes of psychiatric disorders. Look at the blog, the news, and the roundup of the latest articles if you're not too familiar with the scientific literature.

Hey, good thread.
I often lurk in the Depression thread, though i never really posted there.. yet.

Since Oomikami posted some relaxing music, i often use Simon Wilkinson's to that effect.
Unfortunately there are only samples on Youtube, though they are relatively cheap on his site (linked in the descriptions of each video).

Polaris.

Nebula Drift.

Through the Ergosphere.

Antartica.

Whenever i feel anxiety building up, if i have the chance i turn off the lights and sit back listening to this stuff, and it kinda helps, don't know if it'll work for anyone else though.

Another to that effect would be Barn Owl's Ancestral Star.

You added me to the contacts list <3

The link is broken

Also, I'm laughing at how Bel ruined the flow of the OP. Classy!

&

Nowhere near normal - OCD Memoir

Bagels, thank you very much for this thread, there's lots of interesting things there and very helpful as you've always been.

Subscribed.

I think I might try this "going to the movies alone" thing on Saturday, after my finals are over. Everybody's saying it's much better than they expected and less awkward than they thought, so I'll see.

Also, on the topic of motivation: The literally only thing that's helped me (apart from sheer panic once it's the night before) have been walks. Tons of them. I'm at the point where I go for a 45min-1h walk at least every 2nd day. Put music on, it clears my head for a couple hours so I can actually get some work done without heaving my thoughts shift back to bad things immediately.

UrbanRats said:

Hey, good thread.
I often lurk in the Depression thread, though i never really posted there.. yet.

Since Oomikami posted some relaxing music, i often use Simon Wilkinson's to that effect.
Unfortunately there are only samples on Youtube, though they are relatively cheap on his site (linked in the descriptions of each video).

Polaris.

Nebula Drift.

Through the Ergosphere.

Antartica.

Whenever i feel anxiety building up, if i have the chance i turn off the lights and sit back listening to this stuff, and it kinda helps, don't know if it'll work for anyone else though.

Another to that effect would be Barn Owl's Ancestral Star.

Click to expand...

It's nice to have our lurkers at least say hello!

RionaaM said:

You added me to the contacts list <3

The link is broken

Also, I'm laughing at how Bel ruined the flow of the OP. Classy!

Spoiler

I can't be angry at someone with a Division Bell avatar. That album is SO good it should be made illegal.

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Fixed!

MickD said:

&

Nowhere near normal - OCD Memoir

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Thanks! It'll be in the resource post.

Great job everyone who worked on this thread. Lots of good information and resources.

MickD said:

&

Nowhere near normal - OCD Memoir

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I have that first book.

Wilsongt said:

I have that first book.

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Is it any good?

Beautiful OT. Subbed.

Feel free to add me to the contact list.

RatskyWatsky said:

Is it any good?

Click to expand...

I've skimmed through it a bit. It has some good information in there, and a lot of it definitely applies to me.

Yes, the OT is terrific. Thank you for the hard work.

(I read "Night Falls Fast" the other week. It's devastating in its power.)

Good job bagels.

jb1234 said:

Yes, the OT is terrific. Thank you for the hard work.

(I read "Night Falls Fast" the other week. It's devastating in its power.)

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Thanks to everyone for the kind words. It's an ugly wall of text, but a lot of work went into that! I had lots of help with the first post from Prax, who basically wrote all of the nice stuff about the thread. Suggestions and additions are rolling in as I correct little things here and there. Thanks to everyone for their input before it went up and their feedback now. I hope it helps the discussion, and it seems like more people are already finding the IRC channel. Not having to repost stuff over and over should be really nice.

And when stuff like the depression-GAF anthology comes out, I can add it to the OP.

Bagels said:

Thanks to everyone for the kind words. It's an ugly wall of text, but a lot of work went into that! I had lots of help with the first post from Prax, who basically wrote all of the nice stuff about the thread. Suggestions and additions are rolling in as I correct little things here and there. Thanks to everyone for their input before it went up and their feedback now. I hope it helps the discussion, and it seems like more people are already finding the IRC channel. Not having to repost stuff over and over should be really nice.

And when stuff like the depression-GAF anthology comes out, I can add it to the OP.

Click to expand...

Oh, also, not sure, but you might wanna add this: http://mindcheck.ca/

It's a helpline-website that was set up/launched by the Canucks in response to one of our players committing suicide because he was depressed. Canucks have been huge on community awareness ever since. The website itself isn't about the Canucks, but about help/awareness, so it might be worth adding. Check it out if you want.

Reposting from the old thread

Windam and neojubei: Have you guys considered electroconvulsive therapy?

If nothing else is working, it may be worth a shot. As far as I know it has helped people overcome depression that did not respond well to other medications.

I know I've mentioned this you neojubei in the past. Did you ever look into it dude?

I have a question.

I've been depressed for a year or so now, so I want to make an appointment with my doctor to talk about it and maybe ask for some anxiety medication, since my anxiety has been getting pretty bad recently. I'm 23 but I'm on my parents insurance, will the bill they get specify reasons for my visit / prescriptions I get? I know this sounds like something a 14 year old would ask, but I've tried discussing it with my parents and they just give me the "stop stressing" line and are anti meds.

Ermac said:

I have a question.

I've been depressed for a year or so now, so I want to make an appointment with my doctor to talk about it and maybe ask for some anxiety medication, since my anxiety has been getting pretty bad recently. I'm 23 but I'm on my parents insurance, will the bill they get specify reasons for my visit / prescriptions I get? I know this sounds like something a 14 year old would ask, but I've tried discussing it with my parents and they just give me the "stop stressing" line and are anti meds.

Click to expand...

Very likely, yeah. You might want to consider paying for it yourself. Can't speak for the doctor appointment but if the medication is generic, it shouldn't be too expensive.

Hypnotherapy--is this a valid form of psychotherapy treatment?

CornBurrito said:

Reposting from the old thread

Windam and neojubei: Have you guys considered electroconvulsive therapy?

If nothing else is working, it may be worth a shot. As far as I know it has helped people overcome depression that did not respond well to other medications.

I know I've mentioned this you neojubei in the past. Did you ever look into it dude?

Click to expand...

I'm wary of the long-term/general side effects of electroshock. Don't think I'd do it.

From the old thread, since I really can't stress enough how beneficial this podcast has been:

I'd like to recommend the Mental Illness Happy Hour, a podcast in which Paul Gilmartin speaks with various people (mostly comedians) about their experiences with mental illness. A lot of people in this thread seem to be under the belief that they're alone in their experiences and that other people don't have the same issues with anxiety, depression, lack of motivation, and the like, and the Mental Illness Happy Hour and its 108 episodes are a testament to how untrue that is. As such though, a lot of the episodes reiterate the same points, so I'd suggest going through the list of the top episodes of each year, as each episode is filled with really incredible stories and advice and make for fantastic and rather cathartic listening.

Click to expand...

Windam said:

I'm wary of the long-term/general side effects of electroshock. Don't think I'd do it.

Click to expand...

I don't get this at all Windam. In the other thread you mention that you have given up all hope and wish you could die, and you are worried about the long-term side effects of ECT?

If you have truly given up all hope you have nothing to lose and everything to gain.

Verbal Intercourse said:

Hypnotherapy--is this a valid form of psychotherapy treatment?

Click to expand...

I'm going to have to say "no" based on my basic research into it. The skeptics dictionary covers it a bit well:

While it is true that some hypnotherapists can help some people lose weight, quit smoking, or overcome their fear of flying, it is also true that cognitive-behavioral therapy (CBT) can do the same without any mumbo-jumbo about trance states or brain waves. There have been many scientific studies on the effectiveness of CBT. For example, one systematic study found that CBT improves weight loss in people who are overweight or obese. Another systematic study found that CBT appears to be an effective and acceptable treatment for adult out-patients with chronic fatigue syndrome. Finding high quality scientific evidence for hypnotherapy, however, poses a major problem. As R. Barker Bausell says: hypnosis and the placebo effect are "so heavily reliant upon the effects of suggestion and belief that it would be hard to imagine how a credible placebo control could ever be devised for a hypnotism study" (2007: 268). Even if you could devise a hypnosis study that isolated the role of suggestion and belief, how would you do "fake" hypnosis?

Hypnotherapy is said to be effective for such things as helping people lose weight, quit smoking, or overcome a phobia. Most of the evidence for the effectiveness of hypnotherapy is anecdotal, despite the claims of such groups as the American Society of Clinical Hypnosis (ASCH). Not surprisingly, all the anecdotes are positive! Nobody collects examples of failures or tells the world about their "incomplete successes." If one compares the characteristics of the placebo effect and those of hypnotherapy it is hard to distinguish the difference between these two ducks. Both work because participants believe they work and they occur in a clinical setting where the client is highly motivated for the therapy to work and the provider has all the accoutrements of the healing arts. Suggestion is the heart and soul of both. Hypnosis adds such things as asking the client to relax (important for suggestion to work) or to concentrate on something (which may be completely superfluous).

Some hypnotherapists seem to use CBT in their work and it may well be that the CBT and the placebo effect are what accounts for a success here or there with a highly motivated client

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Subbed. I've had some issues over the years and maybe getting some of the pollution in my system will help me get back on track when I can't steer clear on my own.

Ermac said:

I have a question.

I've been depressed for a year or so now, so I want to make an appointment with my doctor to talk about it and maybe ask for some anxiety medication, since my anxiety has been getting pretty bad recently. I'm 23 but I'm on my parents insurance, will the bill they get specify reasons for my visit / prescriptions I get? I know this sounds like something a 14 year old would ask, but I've tried discussing it with my parents and they just give me the "stop stressing" line and are anti meds.

Click to expand...

Explain your situation to the psychiatrist/secretary/counsellor. Usually you can have the first "meet and greet" session for free. Or when you call to make an appointment to somewhere you've been reccomended, tell the person over the phone. They will go out of their way to accomodate privacy. Call a pharmacy ahead and ask too. I'd even write out a quick, short paragraph explaining your situation so when you need to explain it, it's easier. A lot of places have generic medical prescription pads. Also, patient privacy is taken seriously. Just make yourself heard. They might go out of their way to help make it work for you.

CornBurrito said:

I don't get this at all Windam. In the other thread you mention that you have given up all hope and wish you could die, and you are worried about the long-term side effects of ECT?

If you have truly given up all hope you have nothing to lose and everything to gain.

Click to expand...

I don't understand myself right now. But if it does help and I suffer some adverse effect from it down the line, I wouldn't do it. My health is awful enough as it is. Sorry if I'm making no sense, I'm just tired, irritated and in pain and stress. I'll just stop now.

Windam said:

I don't understand myself right now. But if it does help and I suffer some adverse effect from it down the line, I wouldn't do it. My health is awful enough as it is. Sorry if I'm making no sense, I'm just tired, irritated and in pain and stress. I'll just stop now.

Click to expand...

No, it is fine dude. Keep posting. Talking about this stuff is beneficial in the long run.

I probably chose the wrong words, since my post came off as a bit too harsh I think.

Couldn't help but notice the new topic - never checked the old one (I may or may not have a compulsive streak to only bother reading it I read it all sometimes), so I figured I'd check this. expanding the scope of the issues could be helpful for some, considering all the info that was posted.


Since people are posting music, here's my anti-depressive (pre-emptive, I guess) of choice - the lyrics seem to fit the theme here and the actual music grows from quiet to bouncy at a nice pace.

Also, this is downright uplifting to me, although it might feel a bit too strong for some

Smiley90 said:

I think I might try this "going to the movies alone" thing on Saturday, after my finals are over. Everybody's saying it's much better than they expected and less awkward than they thought, so I'll see.

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I did it quite a few times, especially during the college days, since I had a few theatres nearby and didn't expect my movie interests to always fit with my friends'. It was sort of impulsive most of the times, since the places were nearby.

The prospect of going out dancing by myself, however, does make me a bit more nervious - the convenience of the movies isn't there due to the locations, there's the unpredictable judgement of doormen (might affect the price of entry or the ability to enter at all), and the issue of transportation on the way out since I have no car, not to mention the pending awareness that I'd be there by myself all the time. For movies, I just focus on the story while I'm there.
On the other hand, spontaneous dancing of music I like does wonders for my mood, or at least it has on most occasions I went with friends... decisions decisions...

For Los Angeles area people here is the County Mental Health website
http://dmh.lacounty.gov/wps/portal/dmh
and outpatient health facilities in LA
http://losangeles.networkofcare.org/mh/services/subcategory.aspx?tax=RM-6500&cid=37

Really good free public health services. I get my therapy and psychiatric help from them. They'll work with you to get help even if not insured and they could get you into the LA Care (medicaid) and low cost health coverage.

Verbal Intercourse said:

Hypnotherapy--is this a valid form of psychotherapy treatment?

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Honestly? I do not know. I ran across i again while reading about different types of therapy. I've never tried it, never seen it, and haven't read any studies. Anybody else have any info?

It sounds hokey? But I always thought hypnotism was a t least a real phenomenon. I just reall don't know.

Science based medicine article on hypnotherapy
http://www.sciencebasedmedicine.org/index.php/hypnotherapy-for-pain-and-other-conditions/

Sup, I have anxiety and social phobia. Both are kept well in line with escilatopram oxalade! Been a lifesaver for me this drug! Also quitting pot helped.

Peace!