easy
bang on mate. what support does a depressed person get from a GP? a 3 minute appointment and a script for anti-d's. now off you pop i have properly ill patients to see you know!. ask 'em to refer you to counselling what do you get? erm . . . here is a list of voluntary organisations . . . try giving 'em a ring
that's it! woo hoo! cheers doc nice one. the NHS on this can be bloody crap. and all too often it's up to charitable organisations which you have to seek out. which you might not actually do, cos you're depressed and can't be arsed, and maybe you don't trust 'em. there are excellent counsellors out there, who give us it freely thank god. but there shoudn't be a need for them.
neil x x x ;-)
As a medic, I've been watching this thread and its predecessor - there's a lot of good commonsense advice in here, much of it the result of genuine personal experience. (Without trying to single out any one in particular, I'm thinking very much of comments by Neil in the fourth post in this thread and Mike in the eleventh post - both say pretty much what I would say.)
I'm very fortunate in that I've never really had significant problems in this area (at least none that didn't resolve spontaneously) but I have known many friends who have and had one relationship that simply imploded because of it. It is such a shame that much of society still sees any sort of mental health problem with nineteenth century vision!
The biggest problem with discussing depression is that the word alone means different things to different people:
1. depression meaning the same as sadness
2. depression meaning a more complex mood state, but not pathological
3. depression as a pathological symptom
4. depression as a diagnostic category
1. Depression as "sadness"
“I am depressed because my grandmother died last
Sadness is a normal emotional response to the loss of a person or thing to which we are attached, or sometimes the loss of a hope or ambition. It would be very wrong to regard this in terms of "disease." We can assume that the depressed or sad mood has an associated neurochemical state, but this doesn't mean there is a disorder.
2. Depression as a more complex mood state
We all have mood states in which we would describe ourselves as feeling depressed. This is often a mixture of emotions, and may include:
1. lowered self esteem
2. irritation or anger
3. a sense of helplessness
4. a degree of sadness
“I am depressed because I did not get the promotion I was expecting. The guy who got it joined the firm after me and is less
3. Depression as a pathological symptom
“I've been feeling depressed for four months. I feel terrible most of the time. It all started when I did not get the promotion I was expecting. The guy who got it joined the firm after me and is less
4. Depression as a diagnostic category
Medical practice identifies depression as a disorder by looking for clusters of specific features and symptoms.
“I've been feeling depressed for four months. I feel terrible most of the time. It all started when I did not get the promotion I was expecting. The guy who got it joined the firm after me and is less experienced. Now I've not got the energy to get through the working day, and I've had to take time off. I waken at 5 in the morning and worry about the next day. I know its my own fault, I've never been up to the job. I can't eat and I've lost half a
If a person experiences depressed mood which is prolonged and intense, like the man in the case above, we may suspect that he is suffering from a depressive disorder. The signs that are frequently used as diagnostic indicators include a number of biological symptoms commonly found in depressive disorder:
1. disturbed, commonly waking in the early morning after only three or four hours sleep.
2. appetite is reduced and weight decreases
3. the mood pattern changes in a daily rhythm, often being worse in the morning and improving slightly during the day (this may be referred to as "diurnal variation").
4. sexual interest is reduced
5. constipation may occur.
6. sometimes an inability to cry is also seen
A person who suffers from a depressive disorder cannot 'shake it off'. At this stage intervention is very helpful - true clinical depression is unlikely to be resolved without it. It's absolutely true to say that the benefits of intervention are maximised when other support is given alongside drugs - counselling and/or cognitive behaviour therapy - and simply the open support of friends and family.
It's also worth mentioning that where sleep disruption is an important factor in depression then that should also be considered for treatment as a key part of the management strategy (not for nothing is sleep deprivation used as a form of torture!).
Whilst I would in no way belittle the personal experiences of friends and fellow posters here at SH, I have to say that discussion of "sectioning" under the Mental Health Act or the use of ECT is premature and probably unhelpful here (depression on it's own is not really cause for involuntary admission!). The understanding that we have of depression grows all the time and it's a rare beast in that it is a mental health problem for which we have a relatively good biochemical model of what's actually happening - which is why new drugs are becoming more and more specific and, for many people, very effective.
The support of friends and family in helping someone to accept that they should seek further help is very important - this is often the most difficult step in the whole process. The pros and cons of exactly which treatment is best for any individual patient is really something that should be discussed with their family doctor or other professionals directly involved in their care. That said, as a general comment it is very true that due consideration should be given to drug interactions and that MUST include over-the-counter and alternative or complementary therapies (eg St John's Wort, which is believed to work in a similar way to SSRI antidepressants) - so tell your doctor what you are or have been taking! The way in which treatment finishes is also important - ideally there should be agreement between the patient and the doctor about both the when and the how so that a controlled withdrawl can be properly achieved where that is required (and in many cases this is the preferred approach).
Phew - that was longer than I intended! I'm sorry if it's a little non-specific but I hope you can appreciate that it would inappropriate make anything other than general comments in a forum like this. I do sympathise and it's been on my mind too as I've also spent many hours recently persuading a friend and colleague who was very afraid of the potential for stigmatisation, especially professionally, that she really did need to seek help for her depression. She has now been to see her GP who started her on fluoxetine and after a brief rough period (it can take a little while for the body to adapt!) she has very much levelled off and is sowly climbing in terms of both her mood and her outlook - about which I'm much relieved.
I wish you all the very best! (I'll stop short of doing the whole Frasier Crane thing and "wishing you all good mental health"...)
Regards,
G xx
:evil: 
