Posted by Don_Bristol on April 12, 2006, at 19:05:52
In reply to Re: HELP: How often how deeply do you get depress, posted by SLS on April 10, 2006, at 6:01:08
This is a long posting
> You asked some very constructive questions. I am
> not a good example to represent the course of
> the average affective disorder (mood illness). I
> have an uncommon type of bipolar disorder. I
> stay deeply depressed all of the time year after
> year. I meet the DSM criteria for major depressive
> disorder (MDD).Scott, can I ask you something about yourself? If you are deeply depressed all the time then how can you be bipolar? The BI refers to two states and the other would be mania. Are you saying you are majorly depressed during your manic states?
It sounds strange to me because I thought that, by definition, mania was the opposite of depression.
> You might have something known as "double depression".
> This condition presents as a chronic dysthymia (minor
> depression) with intermittent episodes of MDD. It is possible
> that you have not known what it feels like to be mentally
> healthy and free of depression for many years. The MDD
> is usually as treatable as any other case would be. However
> , the dysthymia can be more stubborn. I don't think there is
> any consensus among doctors how best to treat it, but
> generally it is treated as if it were MDD.I am trying to understand what MDD feels like. It a quest to understand the definitions. I am certain I have had it and I am certain I have dysthymia. The bit I don't know is at what point does the depression get so much worse that it can be called a MDD.
I recently hit an unusually low depressive state. The thing which prompted me to post my questions here in the first place (HOW OFTEN AND HOW LONG DO YOU HAVE MDD?) is that the state I went through was so awful that I can't imagine anyone having it for long. This is what I am referring to at that time of deep depression. In this description I have tried to keep my experiences accurate but it ihard to do.
----------- MY DEPRESSION -------------
It was Hell on Earth. It was no dream, no fantasy. You were there.I learnt the limit of just how low the human soul can go and what it feels like when ets to that pint of ultimate lowness.
And then I experience what it felt like to go even lower still.
How it feels after you have had your very soul removed. Your soul could not survive to be with you at this geat depth.
Your soul is gone, your self-identity is gone, your very sense of self is gone. Your place in the world has gone. The world – well – that hasn't gone. There's a lot of the world that seems to still be there. You care only about your immediate world.
Consciousness itself becomes a torment. And consciousness makes you weary. In the past you have travelled far and always had the energy to carry on just a little bit further in the the hope that maybe, just maybe things will get better but now the weariness starts to overwhelm you.
And all around you it is so totally devoid of light that the word "black" barely does this landscape, roomscape, worldscape true justice. It is black beyong black. The ground is flat - who knows why. There you are passing, stumbling, wandering, lost in a great blackness.
Cognitive processes ceased long ago during this descent. There is no thinking. You just feel painful "streaks" of emotion. Guilt: ("what have I done to deserve this?). Denial that your very self is nearly extinguished because it is simply too amazing for you to be able to accept it. Free floating fear - fear of of anything and everything because all that "is" out there has created this situation for you and so you cannot let anything near you. The thought that these things may come physically close to you is frightening.
You cower. Literally. You curl up. You don't know why or what this leads to next. You close your eyes; you open your eyes - it seems to make no difference.
There is no way out. You have tried everything to prevent this. You are surrounded on all sides by this hell. There is no tactic to employ. You are now well beyond coping tactics. And anyway you can't watch because you are too much a participant.
----------- END -------------I had several days of this. And it is completely out of character for me. It is not my usual experience.
I cannot see how anyone can experience this for very long. And so this is my question: HOW LONG and HOW OFTEN?
Maybe I am describing an acute period within a much larger and much longer period of what could be called MDD.
At what point on the journey from dysthymia to that state I describe above do I hit MDD? The DSM doesn't really convery the intensity of the criteria it describes.
> Psychotherapy might be very helpful. I would
> definitely consider it as a treatment for the dysthymia,
> with the hope that it might break a cycle of depressive
> thinking driving or making worse the dysthymia. At the
> very least, it would be very supportive and teach
> you how to experience life more fully.I am going through the options at the moment. I am familiar with some forms of cognitive type therapies.
> Can you describe how you experience life during
> the time in between MDD episodes?
> What makes you think that you might be
> experiencing a chronic dysthymia?
I have only has two such episodes in the last 10 years although it is qite possible I had some more many years ago – I am 50.Life seems very ordinary. There is a lot to do and that is probably from my obsessiveness (which is not really related OCD but of an OC personality). Things seems generally unsatisfactory and there are few moments of real happiness. But I do have some of the ATYPICAL traits such as mood responsiveness so my mood will improve quite markedly when I encounter something I feel is good.
See http://www.allaboutdepression.com/dia_specifiers.html
REJECTION SENSITVITY is very marked in me. However I do not sleep too much and my body may feel heavy but not massivel, so I can not tick those two.
My moods seems episodic and I entertained that I may have had a soft-bipolar. Then I felt that my mood may have been influenced a great deal by a chronic bacterial infection of my abdomen which is hard to remove and which makes me feel physically exhausted.
Ther are times when I have energy but it is all devoted into nonproductive things like researchng on the PC, or home repairs of the weirdest things (the actuator brushes on the electric motor of a $1 coffee whisker), complaining when I feel someone has cheated me (oh my and how I can chase this up the compony to senior managers or higher for what are small amounts of money but which seem "unfair" to me).>
> What has been your treatment history?
>At least a dozen shrinks. Rather fewer psychotherapists.
Many meds (a dozen or more different trials). But so many still to try!
All SSRIs are no good.
Reboxetine (and SNRI) was good but side effects were a problem.
Moclobemide may have shown the beginnings of usefulness but dose was an issue. Nardil was not bad but the side effects were weird (slow movement and slow talking).
Parnate has been best and I take it now at 50mg. Current idea is to augment it with olanzapine (start at 2.5mg and then see where to go). Well that *was* the current idea.
I now have a new doc and he is musing that it may be worth checking out alternatives such as lithium.
What are your (or anyone else's) thoughts on the above?
Don B
poster:Don_Bristol
thread:630873
URL: http://www.dr-bob.org/babble/20060412/msgs/632312.html