Depression Question and
Answer
Q. Psychologists make it all sound so
easy. Just perk up and all will be well. Then tell me this!
What does a woman, a good friend of mine who is middle aged,
very well shaped and good looking, do when due to genetics
and perhaps due to a poor childhood when no one had the money
to pay for proper medical care, is beginning to loose her
teeth? Just about the time when "her time" had arrived, her
teeth started going bad. Now they are mostly gone from the
upper jaw, and she is told that she has no ridge to hold the
false teeth replacement. She tried the newest miracle... new
bone growth so that dental implantation could take place, but
it failed. She is so depressed that she has no desire to eat
anymore. She says food doesn't feel right. There is no
consistency or taste. So she has lost her appetite and is
dwindling away. What do you say to her Dear Doc? How do you
lift a person out of that type of depression? How do you
convince her that life is better than death? If she can't eat
anymore because she takes no pleasure in it.. no taste, no
joy of chewing, how can you make her enjoy? Is there an
antidepressant drug that she can take? I think not. She is a
lady who knows who she is, came to terms with that years ago,
and now fate has played a dirty trick on her. She was a
laughing bubbling person, but how can a person laugh when the
teeth have gone. I cry for her.
A. Thanks for writing. Your friend's
situation is indeed unfortunate and I am very sorry for her
situation. However, I would still say that getting depressed
about it isn't good for her, nor is it inevitable despite her
tragic circumstances. I'm sorry if I have given the
impression that getting over depression, especially with such
unfortunate circumstances, is easy. It takes a lot of work,
but it is possible. Essentially, your friend has two problems
for the price of one. First is the problem with her teeth,
which is quite real and very sad. Second is an emotional
problem about the first problem, in other words, getting
herself depressed about the situation with her teeth. I don't
know what, if anything, can be done about the teeth. I would
certainly suggest a second or third opinion, if she hasn't
done that. However, I do know what can be done about the
depression. She can fight it by learning self-management and
emotional management skills. I often work with people who
have had various kinds of traumatic, even tragic experiences.
With much work, they often are able to gain back quite a bit
of satisfaction, pleasure, interest in life and even optimism
despite facing serious health, financial, personal and other
kinds of problems. It sounds like a lot of your friend's loss
of pleasure isn't directly a matter of her oral health, but
of her being depressed. Loss of pleasure is a common sign of
depression. You are obviously very compassionate and caring
about your friend's plight and a very good friend. In the
long run, however, the most compassionate thing to do might
be to help her get some help for her depression. Her choice
is to let this situation get her down, or to try to make the
best of it. Getting over depression is not a simple matter of
just perking up, but a complex skill of identifying and
changing depression causing belief systems. This takes a lot
of hard, often difficult work, including learning how to not
feel sorry for yourself, acknowledging that bad things can
and do happen and developing an unconditional sense of well
being, peace of mind or serenity despite the fact that
tragedy is part of life. There is much pain and suffering in
life, which is very sad, but we have the resources to deal
with anything life can throw at us, once we learn how to tap
into these sources of strength. I wish your friend well and
sincerely hope she gets some help for her depression. Take
care.
Q. YOU LIST SO MANY MANY DX BUT i NEVER
SEE BI POLAR ANY. wHERE COULD I GO TO ASK QUESTIONS ON THIS
SUBJECT THANK YOU FOR YOUR HELP
A. Thanks for writing. The subject
of bipolar disorder does come up some in the question and
answer section of my site on depression and general
psychology. However, you are right, that I don't deal with it
extensively. The main reason for this is that bipolar
disorder is mainly a psychiatric or medical problem rather
than a psychological one, although there are psychological
elements to it. You might check out some of the good medical
sites on the web. There is also a self-help association
called the Depression and Manic Depression Association that
is a national support group for individuals suffering from
depression and bipolar and their families. They have a web
site at http://www.ndmda.org.
Q. I was on paxil for 3 months and it
seemed to help my depression, so I stopped taking it. Now I'm
feeling like I should be on medicine again, because I'm
feeling bad. I am concerned about going back on Paxil due to
the sexual dysfunction it caused. My doctor(family practice,
not psych) suggested Wellbutrin. Will this drug work as well
as the SSRIs? Does it have side effects that are sexually
related?
A. Thanks for writing.
Unfortunately, I can't answer your question directly about
the medications because I am a psychologist, not a
psychiatrist. I deal more with the software than the
hardware, in a manner of speaking. However, indirectly, I can
give you some suggestions that might help. In particular, I
would urge you to consider getting some cognitive-behavioral
therapy to help you learn how to "undepress" yourself without
medications or at least with a minimal dose so you are less
likely to be bothered by side effects. If you don't make
changes in your depression causing belief system and approach
to life, you are likely to slide back in to depressing
yourself once you get off the meds, as happened. You might
want to check out the depression section of my site, the
finding a therapist section and the suggested readings,
particularly "Feeling Good", by David Burns. One way of
thinking of depression is that it is a verb, not a noun. It
isn't something that happens to you, but it is something you
do as a way of trying to cope. The more you realize you
depress yourself (unintentionally, of course), the more power
you will have to overcome it without meds or with the least
meds possible. . Thanks for writing and good luck.
Q. I got a Doctors Degree from a major
university. set up a successful laboratory and then
disconnected the phones and walked away. I set up another
business a few months later. It made money. I kicked it down
and walked away. Now I have money.. buried in a hole..enough
money to to start or buy another business, but I don't want
to do it. The money will run out..I know this. Still I would
rather be dead then make the effort to start something up
again. Some have told me I am depressed and that Prozac is
the cure for my 52 year old disillusionment. They say I
change my mind all the time and that I always kick down the
House of Cards I have built. Some times I like what I am
doing. Mostly I don't like thinking this way. Probably I will
start another business. It will be successful...Then I will
kill it. Right Now......I am out here trying to understand I
am suffering from Cognitive Illusions I can overcome. I am
skeptical. I think I need help.
A. Thanks for writing. Of course, I
can't diagnose based on what you have told me, but there are
several issues that I would explore further. One is that some
people like the development part of building a business, then
get bored with the day to day operation. These people are
usually called entrepreneurs.
The other issues for you to consider is
that sometimes people get anxious when they achieve success.
Usually this is a form of fear of failure in that once you
are successful, you may fear that you won't continue being
successful. Sabotaging ourselves is a particularly human
talent. By killing the business, you might be avoiding facing
what you perceive would be unbearable - that the business
would fail.
The third issue is your question about
depression. Again, I can't diagnose, but a lot of what you
are saying sounds like you might be depressing yourself. As
for the Prosac, this can be a tool in dealing with
depression, but I don't think medication alone is the answer.
If you haven't already, please read the section on depression
at my site. Also, check out the suggested readings,
especially David Burns "Feeling Good" and any book by Albert
Ellis. I don't know if you need help, but it certainly might
be useful. Check out the section on finding a therapist. You
might also benefit for career counseling (see the career and
work issues section of my site). I have worked with quite a
few entrepreneurs over the years to help them clarify their
career directions. Using the internet for such counseling is
largely untried, but I have had success with one client using
this medium. Let me know if you are interested and we can
discuss how that would work, including some combination of
testing, e-mail, snail mail and telephone consultations. So
far, I have not tried personal counseling over the internet,
but some of my colleagues are experimenting with that.
Q. Hi.. Let me start out by saying I am
17 years old and do not have a credit card. I have lately
been suffering from on and off depression, and last friday
had thoughts of suicide : Like picturing my teacher finding
me dead, how students would react (i was in school thinking
about this) and what the funeral would be like, who would
come,etc. Before I divulge any more let me know if we could
work out some sort of alternative payment. Then, if we can
work that out, I would like to write a more detailed e-mail
describing my problems, so you can give me a better answer.
There are some underlying problems I think. The incident
Friday really scared me. Please consider helping me.
A. Thanks for writing. I would be
glad to try to help you and work out alternative payment
arrangements. For one, you could just send me a check or
money order. There are a number of things you can do right
away, though. If you haven't, please read the section on
depression at my site and try some of the anti-depression
methods presented there. Also get one or more of the books
under the suggested readings, particularly the book, "Feeling
Good", by David Burns or any of Dr. Ellis' books. The most
important thing for you is to get some individual counseling.
You might want to read the section on "finding a therapist"
at my site. You could also talk to your school counselor.
There are low cost or no cost sources of counseling in most
areas, so check with your local psychological association or
crisis help line. Thoughts of suicide are a definite warning
sign, so you are right to be concerned. Fortunately, the vast
majority of the time such thoughts are passing and rarely
acted on. Nevertheless, it is certainly important to get some
help. I will be glad to try to help you too as much as I can
over the internet. Take care and thanks again for writing. -
Q. I have recently started taking Prozac
for "dysthymia". I have a couple of questions about the
medication that my doctor couldn't answer. 1) Could Prozac
cause more frequent outbreaks of herpes? I have had two
outbreaks in the month that I have been taking Prozac, I
hadn't had an actual outbreak for several months prior to
this. 2) Do you think that taking Prozac every other day or
even every third day could help me recover my libido? Taking
20 mg. every day virtually destroyed my sex drive. I hate to
stop taking it altogether because, except for this awful side
effect, the Prozac has done wonders for my life. However, my
husband and I miss my libido! Any suggestions?
A. Hi! Thanks for your questions.
Unfortunately, I can't answer the specific questions you
posed because, as a psychologist, I don't prescribe
medication. You might want to check in the Physicians Desk
Reference (PDR) for side effects of prosac. As for lowering
the dose, side effects are often more pronounced with higher
doses, so that may well be true with prosac. What I can do is
suggest that you also get involved in cognitive-behavioral
therapy in addition to taking medications. Such therapy is
often as effective as medication alone or at least you might
be better able to lower the dosage. Read the section on
depression at my site, if you haven't and try some of the
specific anti-depression strategies. Also, on the suggested
readings, try David Burn's book on "Feeling Good", or any of
Albert Ellis's books. Also check out the "finding a
therapist" site for ideas about locating a
cognitive-behavioral therapist. Your Doctor may also be able
to give you a referral to a cognitive-behavioral therapist.
Good luck and take care.
Q. Can you help? The spelling of this
drug is probably not quite right — Moclobomide or Modobomide?????
versus SSI antidepressants like Prozac/Lovan/Zoloft. I would
greatly appreciate your assistance. Sorry I can't be more
specific about the spelling, my doctor's writing is
appalling. Aren't they all??? Thanks
A. Thanks for writing, but your
question is out of my expertise. As a psychologist, not a
psychiatrist, I help people learn how to get over depression
using cognitive-behavioral therapy. I do not prescribe
medications, although I often refer my clients for medication
when needed as a complement to my treatment. The important
thing is to not only take medications, but to make an effort
to learn how to manage your feelings. To learn more about
this, read the depression section of my site and try some of
the specific anti-depression strategies. Also check out David
Burns' "Feeling Good", in the suggested readings section. YOu
might also want to read the "finding a therapist" section. As
for your specific question, probably the best bet is to call
your doctor. You can also check out meds in the Physicians
Desk Reference. There are also some good web sites for
medical questions. Good luck and thanks again.
Q. Hi. I am a college student and really
have no money to send, so you obviously do not have to answer
my question. I am doing a abnormal psychology presentation on
the etiology of mood disorders specifically depression. I
wanted to know if you could give me some names of resources
that I can find up to date info on this. I am even more
specifically looking at sociocultural and biological causes
of depression. Or if you have any personal positions on
causes I would greatly appreciate your help.
A. Your question is an excellent,
although difficult one. The cognitive-behavioral theory of
depression is that it is caused by irrational or unrealistic
thinking. In other words, depression is a verb, not a noun.
We depress ourselves by thinking depressing thoughts. It is a
way of trying to cope with life, albeit not a very effective
one. Of course, you might ask why do people think depressing
thoughts if it causes depression. First, most people don't
realize they are depressing themselves. The mind is very
powerful and it is easy to get needlessly upset if you are
not careful about how you use your mind. Unfortunately, most
people don't know how to use their minds to best effect.
Looking at it that way, the most common cause of depression
is ignorance - that is, lack of knowledge about how to manage
one's emotions. For more information about this, please read
the section on depression at my site and also the Question
and Answer forum for depression questions. Thanks again and
hope this helped.
Q. How do I approach my employer and let
him know about my struggle with depression? Should I? What do
I risk? I am a school teacher and have serious difficulties
getting along with my colleagues; I am neither very
productive lately, which at the same time makes me even more
depressive. At times I feel I Should die to end with my
struggle, but I have a couple of adorable kid whom I love
dearly and would not leave for anything in this world.
Recently, I began to see a psychiatrist, who prescribed me
light therapy along with Wellbutrin (75 mg, 3 times a day). I
don't see any improvement in these past 2 months. I already
skiped an appointment. Is there any hope for me? I feel I'm
doomed. Any recomendations?
A. Sorry about your depression, but
there is certainly hope. Depression often lifts by itself,
but there are many things you can do to speed it along. You
might want to ask your psychiatrist about a referral for
cognitive-behavioral therapy, or check out the section on my
site about finding a therapist. Do also mention your thoughts
about wanting to die to your psychiatrist, if you haven't
already. You may also want to read the material on depression
at my site, including the questions and answers regarding
depression, as well as getting David Burns' book, "Feeling
Good: The New Mood Therapy". Depression is a "false grief",
in my view. The more you realize it is a false feeling
(although it seems legitimate), the more you can fight it. As
for telling your employer, it may be wise not to reveal any
more than is necessary. There is no shame in being depressed
- many millions of people suffer from depression - but you
still have your right to privacy. If your work is suffering
or if it comes up, you may want to mention that you are
having some difficulty that you are getting help with, but it
would probably be best not to go into the details. Hope this
helped and take care.
Q. 47y/o male on 600mg lithobid trying
serzone and effexor to offset increasing depression. any
reported problems with these two concurrent antidepressants?
considering remeron...what about agranulocytosis? i'm still
working a forty hour week but its getting more difficult.
A. Sorry, but your question is out
of my area of expertise, as I am a psychologist, not a
psychiatrist. The one thing I can say is that you might want
to consider getting psychotherapy in addition to the meds you
are taking. Cognitive behavioral therapy is often quite
effective with depression and may help you reduce or maybe
even get off meds. The lower the dose, the less likely to get
side effects. Please check out the depression section of my
site, the section on finding a therapist and the question and
answer forum on depression for more information. On the
suggested readings, check out David Burn's "Feeling Good: The
New Mood Therapy". Good luck and let me know how you are
doing. --
Q. I have named myself, life has been a
real tough game lots of pain but still a smile is within that
keeps me going on. lived my life backward as an adult now
feel at peace each day as a child 90% of the day..... bye bye
A. I think finding or keeping our
childlike innocence is important. It is easy to become cold,
uncaring or overly guarded as a way of trying to protect
ourselves from pain. The price of indifference is lack of joy
and intimacy. The solution, as I see it, is to learn how to
not let anything or anyone needlessly upset us. If the pain
isn't so bad, it is worth being vulnerable, like a child.
Hope you have checked out some of the specific self-help
tools at my site. Thanks for writing and take care! -
Q. Last March I was hospitalized three
times in a month and a half. For suicidial ideation. Since
then I am on my third med. I have tried Zoloft, Paxil and now
Effexor. Nothing seems to help. I'm not back to where I
should be. I have't been back in the hospital though because
I can't. Also I feel counseling is pointless. I't not helping
and I'm NOT a novice to it. Any suggestions would be
appreciated.
A. Thanks for writing. I'm sorry to
hear of your difficulties. It can be very frustrating to work
so hard and still not get much in the way of results. I have
a couple of comments or suggestions. First, you might want to
keep "shopping" for counseling. There are lots of different
kinds of counselors with different methods and personalities.
I encourage people not to give up on counseling just because
it hasn't worked before. If you haven't yet, you might want
to try a cognitive-behavioral counselor (see the picking a
counselor section of my site). The second comment is that
people vary in the amount of time and effort it takes to make
progress. It may just mean it will require more time and
effort for you than for some others. That's unfortunate if it
is true, but not hopeless and not the end of the world. There
are many others who have much more difficult burdens to bear,
like being quadreplegic or having multiple sclerosis or
whatever. I don't mean your's is not difficult, but just that
if it exists, it exists. Your choice is to feel bad about it
or to do everything you can to get around it. The most
important thing is to keep fighting. The more tools you can
acquire, the better. Check out the sections at my site about
depression and suicidal thinking. Also, check out the reading
list, especially the books by David Burns (Feeling Good) or
any by Albert Ellis. A third point, by the way, is to get a
second or third opinion about the medications. That is out of
my area of expertise, but I have had many clients who had
difficulty working on self-management skills until they got
on the right medication for them. However, there has been
research showing that cognitive-behavioral therapy can be as
effective by itself as with medication or medication alone.
Anyway, thanks for the question. Hope this helped and take
care. I would like to hear how you are doing. --
Q. Dear Doctor, This has been a rough
time for me. I was diagnosed with type 1 diabetes last year
and I am on the verge of anxiety attacks all day long.
Sometimes i even think of suicide. I am takink Zoloft for
depression and Ativan for Panic Attacks. I like my therapist,
but I still feel trapped in my own body. I thought group
therapy might help. I hav'nt found on yet. What should I do?
Any advice, I've been on 100mg of Zoloft for 2wks now. I've
tried other drugs as well, they had side effects. I feel so
depressed.
A. Sorry to hear about the problems
you are having. The first thing I would suggest is talking to
your therapist about your feelings of depression and
especially about the suicidal thoughts. Also check out the
section at my site on "When Life doesn't seem worth it",
which has some specific suggestions about how to handle such
thoughts. You may want to look into some cognitive-behavioral
approaches to depression and anxiety, like the methods at my
site. More information about these methods can be found in
the suggested readings. "Feeling Good", by David Burns is an
excellent book on depression. Any of the books by Albert
Ellis provide a variety of specific techniques for combating
depression and anxiety. The most important idea in all this
is that you can learn how to manage your emotions and reduce
or eliminate your depression and anxiety. It takes work and
practice over a period of time, but it is a skill well worth
developing. You may be stuck with diabetes, which is
unfortunate. However, there are ways of treating it that will
allow you to have a normal life. Albert Ellis, the founder of
Rational-Emotive Behavior Therapy has suffered from diabetes
for many years and he is a famous man who is now in his 80's
and still quite active professionally. He has also written a
book on how to live with chronic illness. I don't remember
the exact title, but you can get a catalog from the Albert
Ellis Institute at 800 323-IRET that will list it. Thanks for
writing and take care. --
Q. Hi. I'm a manic depressive & take
Zoloft to help. I need '97 to be better than '96. I need to
know how I can make it better. I lost my job of 9 years in
August. I'm unemployed, I have no medical benefits, so I
can't continue therapy and I can't afford to refill my
prescription which ran out in September. I'm amazed that I'm
still breathing. I sleep about 2 hours every 4 or 5 hours,
day & night. I eat constantly and I can't get motivated to
exercise even though I know you have to look good to be loved
and I want that so bad. I'm 28 & I've never had someone.
You'd think I'd be used to being alone. Please give me some
tips, advice for that hour-to-hour basis. I want to win not
just survive. I want to say I CAN & believe it and DO IT!
I've run out of hope. It's do or die. Thank You,
A. Sorry to hear of your
difficulties, but don't give up hope. Hope is a very powerful
belief! I know in Houston, there is a public psychiatric
hospital and I'm sure there is something like that where you
live. The first thing you might want to do is check with your
local mental health association or public hospital or crisis
hotline service. Any of these can direct you to where you can
get your prescription filled even if you can't afford it
right now. They can also suggest low cost or no cost therapy.
Check out the Finding a Therapist section of my site, by the
way. It is important for you to keep your medical condition
managed, but beyond that, there may be many things you can do
to help yourself. Try some of the techniques at my site, like
the Reality Check or Exchange Vocabulary. Then check out some
of the books in the Suggested Readings section. Sounds like
you might also benefit from exploring the career section of
my site, as well as the section on relationships. There are
no magical answers for your problems, but with reasonable
diligence and effort, you have every hope of improving your
life situation substantially. It is unfortunate that you have
manic-depressive illness, but the good news is that it can be
managed medically. That's why it is so important to keep up
with the medical treatment. The rest of it is just the same
kind of problems that we all face, so improving your
self-management and coping skills will probably be quite
helpful. Take care and let me know how you are doing. Thanks
for your question.
Q. My problem is fairly simple I always
feel depressed and I have no drive. I 'm always tired. I find
it extremely difficult to complete any task that will take
longer than now.
A. What you seem to be describing is
the behavioral manifestations of depression - loss of energy
and enthusiasm. The other element of depression you mention
is low frustration tolerance or impatience. Please read the
section on depression at my site, if you haven't already, and
try some of the self-help tools to fight depression. You
might also want to read the "finding a therapist" section.
Fortunately, you can probably get back your drive and
interest with some work at developing emotional management
skills. Good luck and take care.
Q. I am looking for information about
seratonin. Years ago I remember reading that other things
(laughter???, and certain foods, provide seratonin or
increase the seratonin production in the brain). I know that
seratonin is available in minimal quantities in food but
cannot find anything on it. What I would like to know is
where can I find more information re what foods provide even
trace amounts of seratonin and what if any other means other
than medication would increase production of seratonin in the
brain, does laughter? or I am confusing this with something
else??
I thought you might be able to lead me
to some information on this as I know Prozac is being used as
a medication which is supposed to have same effect as
Seratonin or increase seratonin production (answer
unimportant).....and know that Prozac a drug prescribed by
psychiatrists, so thought info. re seratonin might be
available more from a psychiatric point of view. Would really
appreciate any info.
A. Good question. I am a
psychologist, however, not a psychiatrist, so this is
somewhat out of my area of expertist. However, I believe you
are correct that some antidepressants increase serotonin in
the brain. I don't believe ingesting serotonin will do much
good, due to the "blood/brain barrier". In other words, most
of what we eat does not get directly into the brain. What I
can address, though, is other ways of increasing serotonin,
particularly psychological means. As you suggest, laughter is
one of those. One way of thinking about this is that the
serotonin and other chemical/physiological aspects of the
brain are the "hardware", while laughter, emotions, thoughts
and so on are the "software". The fact that serotonin is
lower in depressed people's brains may be a result rather
than a cause. Anyway, for most people, it is quite possible
to learn how to "manage your emotions", including depression.
The depression section of my site explains all this in more
detail and offers a number of self-help tools to assist
people in learning how to overcome depression. Now there may
well be situations in which there is a chemical imbalance in
which medications would be very helpful. But things like
laugher, not taking things or ourselves too seriously and
acknowledging reality do change the serotonin levels in the
brain. They can certainly help people overcome depression, as
well as stress, anger, frustration, guilt, shame and other
upset feelings. Thanks for the question. --
Q. Hi - I am interested in your thoughts
on depression and St. John's Wort and general vitamin/mineral
supplementation (like B-complex, Pantothenic acid, Zinc, and
Selenium). I have been getting some information on the net
regarding St. John's Wort. Not so much on vitamin/mineral
supplementation. I am a 50 yr old gay man. I have been on
Paxil, Prozac, and most recently Luvox (over the last 1 1/2
years) for depression in conjunction with bulimia. I have
been in therapy for the bulimia for about 1 1/2 years and
doing well. I have not liked the side effects of the above
antidepressants at all. I have recently been off the drugs
per the psychiatrist's okay, due to the side effects. I have
started taking St. John's Wort, 500 mg every 12 hours.
Probably now a month, as well as the above vitamin/mineral
supplementations. I take a time-released B-complex, 2000 mg
Vitamin C, and 250 mg Pantothenic acid every 12 hours as well
as 50 mg each of Zinc and Selenium in the morning. No side
effects at all. Feeling better and definitely sleeping
better. As I look back over the years, I realize I have
probably had a mild, pervasive, dsyrhythmic type of
depression. That's why I decided I wanted something to take
the place of the "drugs". I'd appreciate your comments.
Thanks.
A. Thanks for writing. I have a client who
has tried St. John's Wort and it seemed to help. Certainly
there has been a lot of discussion about the role of vitamins
in both physical and mental health. As a psychologist, I
don't get directly involved in the "hardware" aspect of
mental conditions, so I am not in a position to evaluate such
treatments. I do think general physical well being, including
good nutrition, exercise and so on is important to emotional
well being (and vice versa - they appear synergistic) and as
long as there are no side effects, there is nothing to lose.
Of course, if you are in treatment with a psychiatrist, it
would be a good idea to check with your doctor about this.
The other general comment I would have is that any kind of
physical treatment, whether drugs, vitamins or herbs, may not
be sufficient. As you know if you have read the section on
depression at my site, I think it is important to address
both the "hardware" and "software" aspects of depression. In
other words, it is a good idea for most people to make the
effort to learn how to manage their feelings. Medications
alone without making changes in your thinking and approach to
life may not be desirable. With cognitive changes, many
people can reduce the dosage of meds or possibly get off them
altogether. So if nutritional approaches help you, that's
great, but you might also want to learn some psychological
methods for managing depression. Check out some of the
techniques at my site and try some of the suggested readings,
especially by David Burns and Albert Ellis. Take care.
Q. A friend of mine suffers from Manic
Depression. I have been lead to believe that someone trying
to help him, gave him Anti-depressants. He has been acting
totally irrational since then. He has not slept in 3 weeks,
and his mind is racing about crazy things. I am extremely
concerned about him and I don't know what to do. He is also
very paranoid.
How can I get him help? What type of
help should I seek?(Hospital, Therapist, etc.) What do think
is wrong with him?
Please give me some advice. I am going
out to see him tonight and I don't know what approach to take
with him. I am afraid he might be suicidal.
A. From what you have said, it sounds as
though your friend has bipolar or manic-depressive illness.
This is a serious condition that will require medical
treatment and possibly hospitalization, if that's what he
has. I would strongly encourage him to see a psychiatrist. It
may even be necessary to take stronger action, like having
him committed, especially if he is suicidal and unwilling to
get help. You might want to get in touch with his family
about him. Bipolar illness involves episodes of extreme highs
and extreme lows. Your friend may be suffering from other
conditions, from various medical problems that can cause
behavioral symptoms to drug or alcohol abuse or other mental
disorders. In any event, it certainly sounds as though he
needs help. I get the impression from your e-mail that
whoever gave him medications was not a physician. That is not
only illegal, but extremely dangerous, if that is the case.
If it was a physician, he needs to let the doctor know how he
is reacting or get another opinion.
Q. I would like to know what are the
main facts in the education of a man that give him
self-confidence.
A. I think the main thing is learning
emotional management and self-management skills. This may
take some explaining. What robs people of self-confidence is
unhealthy feelings like insecurity, anxiety, shyness,
depression, guilt, shame and so on. Overcoming these feelings
leads to "unconditional self-acceptance" or USA. That doesn't
mean feeling good about yourself, but rather acknowledging
the simple reality that you are what and who you are, that
is, a human being. Human beings tend to be human. We all have
faults and shortcomings. You don't have to like these or
passively accept them, but you also don't have to put
yourself down for them. For further elaboration of these
ideas, see my CyberPsychologist site and also order my
"Official Human Being License" book. Also, check out the
suggested readings list. Unconditional self-acceptance is a
key concept in emotional well being. Thanks for the question.
Q. My wife and I have two young children
and have been married eight years, our only one for both of
us. She has been quite unhappy for several years and has had
three affairs, for which she feels quite guilty. She thinks
she had children too young. I am very successful in my work,
which seems to add to her feelings of depression. I try to
encourage her to get involved in something, but she feels she
has wasted her life. Many of her friends have divorced, so
she thinks this may work for her. Any advice would be
helpful.
A. Sorry to hear of your wife's depression
and how it is affecting the marriage. You both have a lot
invested in the marriage, not the least of which is two
children, so I think it is well worth trying to work things
out. First, your wife would benefit from learning how to not
depress herself about these problems. I suspect she feels
stuck in an unsatisfying situation, trapped by her own guilt.
There are several sections of the CyberPsychologist that
might help her, including Reality Check, Unrealistic Beliefs,
Coping Statements and Exchange Vocabulary. I suggest she read
the book "Feeling Good, The New Mood Therapy", by David Burns
or any of the books by Albert Ellis in the Suggested
Readings. I also strongly urge both of you to get counseling.
I recommend seeing someone with a cognitive/behavioral
orientation (see Therapy for People Who Don't Believe in
Therapy). Let me know how you are doing.
Q. I thought that a chemical imbalance
in the brain caused depression, not what you believe. Isn't
it mostly heredity and biochemistry? Do you mean that
thoughts can trigger the chemical imbalance?
A. Good question. In a sense, everything
psychological has correlates or parallels in physiology. One
way of thinking about it is to distinguish between software
and hardware. When I type these words, there are electrons
flowing in the chips in my computer, just as when I think the
thoughts, there are physiological processes happening in my
brain. Using that analogy or metaphor, your question can be
restated to, "Is depression a hardware problem or software
problem". Despite some conventional wisdom (mainly medical),
I am suggesting that most depression is mainly a software
problem. However, there are some depressions that are
hardware problems. It may also be that software problems
(i.e. unrealistic beliefs) may over time cause hardware
problems. One way of clarifying this is to consider how do
you treat depression. One conservative approach is to try
cognitive-behavioral methods first. If the person responds
well, that is, shows measurable or marked improvement within
a few weeks, then that pretty much proves it is a software
problem. If they are having a lot of trouble with applying
the methods and not progressing much, that usually indicates
a hardware problem that requires medication. Even so, it is
still important to also work at changing the underlying
irrational beliefs so you can eventually reduce or get off
the medication. The way I think about it is that medications
change the trigger sensitivity of certain emotional systems
in the brain, making it less likely that these systems will
be erroneously activated by irrational beliefs. Hope this
clarifies my position.
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