![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 3 of 3. This is the beginning of the thread.
Posted by dave_fox on July 1, 2002, at 1:46:17
A friend of mine is very sad and I am wondering how long it needs to be before she can be considered to have depression?
She is 29 and generally has a low mood. For two or so years now she has been trying to get into drama school but she can't get through the auditions. This year she tried one last drama school and failed to pass the audition.
I think she saw it as her last hope slipping away because afterwrds she became very sad. Very very sad. She took to bed for two days because she was too drained to get up. (She doesn't work on account of some other medical problem so she was not skipping work.)
Her profound sadness has lasted for about 10 days. Maybe it is more akin to grief in her situation than just sadness. But even 10 days later she seems very deeply affected by it. She complains of having no energy, of sleeping in the day, of not sleeping at night, etc. (Some elements of this bad sleep pattern was present before).
As a former depression sufferer I know that depression can last a long time and that 10 days is not really very much time at all in these matters. However I am keen that she gets any antidepressive meds as soon as possible in order to prevent her hitting a deep trough which might be much harder to get out of.
Of course, antidepressive meds take a few weeks to kick in and that might be an argument for holding off. OTOH it might be an argument to get started as soon as possible.
She is reluctant to visit her doc about this. (Yes, yes, yes, I know it's silly.) In fact she is still bewildered and sad and confused and exhausted. I don't want to encourage her to visit her doc if it is far too early to consider taking anti-depressant meds.
I might add that she suffers from OCD and has tried all the SSRIs with no success (and she attend therapy). Her next candidate med (which she does not really want to try) is Effexor. It seems to me that it might be useful to try this med for her current mood as much as for her OCD.
What do you think? Do you think she is having a normal reaction to a profound disappointment? After what period of time do you think it becomes something which could be treated with meds?
Posted by katekite on July 1, 2002, at 15:37:10
In reply to Is this sadness/grief or is it depression?, posted by dave_fox on July 1, 2002, at 1:46:17
I agree it sounds worrisome. On the other hand, almost everyone experiences some depression at some point in their lives and it has only been in the last 10 years or so that we would even think of getting someone to take meds as soon as this. Many people recover on their own.
Grief is depression. Some people take meds for grief-type depression if it's bad enough, others try to get through it without.
I'm wondering if maybe she could be convinced to see a general practitioner doctor on the off-chance that she has some actual medical problem. Thyroid or adrenal problems, I'm sure other things too, can cause or look like depression... so at least she could get those things ruled out. Also, a doctor would then know, at least, that she was depressed, maybe have a recheck appointment to see how she is doing a week later -- she would have a professional to call if it wasn't getting better. So that you aren't the only person aware of this.
Keep on trying to drag her out to do things -- try getting her to go for a walk or to a movie even if she doesn't really feel like it.
You sound concerned: you are wonderful for caring.
The DSM IV is a book that is the agreed guidelines for saying 'what is depression'. I think it is supposed to be 2 weeks, but I can't recall for sure. If you type "dsm IV and depression" into a search engine like yahoo or google you should be able to find the exact guidelines.
Hope she feels better soon.
Posted by ShelliR on July 1, 2002, at 20:14:48
In reply to Is this sadness/grief or is it depression?, posted by dave_fox on July 1, 2002, at 1:46:17
You really are a good friend, not just to care, but to care enough to do some research.
I think your friend's OCD and prior problems make this more confusing. With anyone else I'd try to let the depression run its course. Two weeks is not a long time if you feel like your professional dream has faded. For example, it takes many people much longer than that to get through the grief of a divorce, yet most do it without antidepressants.
Your friend, though, has been through so many anti-depressants; obviously her problems are severe and I would talk to her about seeing a doctor sooner, rather than later. If SSRIs all haven't worked for her, if she decides she dosen't want to go on effexor, she might also be interested in taking an MAOI. They are not as scary as they seem (diet wise) and often effective for those who are not helped by most ADs. If she's not in any danger of hurting herself, I'd give her some input, but let her make the final decision.
Shelli
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.