![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 36. This is the beginning of the thread.
Posted by TherapyGirl on February 11, 2009, at 16:28:05
This could potentially trigger people who are in the midst of depression right now, so please feel free to bypass.
I just had a conversation with a long-time friend who I've had this conversation with before, but she is clearly upset with me about it. I mostly want to know if anyone else thinks of it this way.
I consider my depression to be a terminal illness, much like cancer. It will eventually go into remission, but at some point I will make the decision not to seek treatment for it because I just won't have anything left to throw at it. (Much like those with cancer who choose not to treat it when it comes back several times). My position on this does not change depending on whether or not I am depressed. My T actually does not argue with me about this because I've been completely consistent about this for 20 or more years.
I'm curious how any of the rest of you think of it.
Posted by Dinah on February 11, 2009, at 17:29:39
In reply to Anyone else think about it this way? *may trigger*, posted by TherapyGirl on February 11, 2009, at 16:28:05
I think of my problems more as like diabetes. It'll never be something I put behind me, because it has a strong biological component. But with medication, and therapy, and hopefully lifestyle changes, I muddle along as best I can.
It's hard to say what the future holds. We don't know how our lives will turn out. Even people with terminal illnesses often die of something else. Diabetes might eventually cause my death. But I could die in an accident or by violence or by some other illness that actually isn't related.
Depression, like diabetes, can be terminal. Either directly or indirectly. But with any chronic long term illness, there's no way to say if it will be in your case.
My mother's family is chock full of absolutely ancient diabetics. Even a long time ago without the current drugs. I'm not saying it didn't affect or harm their lives, because of course it did. But diagnosis isn't destiny.
Saying it could be terminal is respecting the reality. Treating seriously something that is serious. Saying it will be terminal isn't respecting the other realities of life. Depression isn't all of your life, or even all of your biology. Any number of forces both positive and negative exert influence on your fate at any given time.
Posted by Sharon7 on February 11, 2009, at 20:49:39
In reply to Anyone else think about it this way? *may trigger*, posted by TherapyGirl on February 11, 2009, at 16:28:05
Hi TG. Okay. Here's my take on your post.
I absolutely agree with what Dinah said. Sure, depression can be terminal, but so can countless other conditions. I don't think it does us any good to consider the possibilities of what may or may not kill us. Something's going to.
I agree with you that depression is terminal in that, depending on its severity, may require life long treatment, whether that means meds, meds and therapy, or whatever we find that is helpful to us. Like Dinah said, just like any other condition like diabetes. Sure, it can be a fatal condition, but it can also be managed quite well in most cases. You just have to take care of it.
I think a lot of people probably don't take mental illness seriously. You can't see it under a microscope, but it's as real a medical condition as anything else. It is serious. Sure, we'll likely have the condition for the rest of our lives, but we don't need to dwell on that. We just have to take care of it, the very best we can.
What I hear in your post is wanting to give up the fight and just succumb to it. I can understand that. The battle grows wearisome, I know. I know this is way easier said than done, but try to not dwell on such a negative thought as that. I don't want you to embrace the thought of death in any way shape or form. I go there quite often myself, so I'm speaking to myself, too.
Stay in the fight and don't waste your breath or emotional energy trying to educate your friend or anyone else on the grim realities of depression. It is tough. No doubt. But honestly, I don't believe it is any more likely to take me out than anything else.
Take care. Thanks for throwing that out there.
Sharon (o:
Posted by Dinah on February 11, 2009, at 21:13:58
In reply to Anyone else think about it this way? *may trigger*, posted by TherapyGirl on February 11, 2009, at 16:28:05
I also think about my own ideas about suicide. I have to think that suicide is always a possibility or I would find life too terrifying to bear. It's strangely comforting to me.
My therapist understands this, though he doesn't particularly like it. My husband would never understand it.
Is it possible that the thought of giving up helps you keep going on?
Posted by TherapyGirl on February 11, 2009, at 21:30:21
In reply to Re: Anyone else think about it this way? *may trigger*, posted by Dinah on February 11, 2009, at 21:13:58
Exactly, Dinah. The only part of this I can control is how long I have to live with it. And I get what you and Sharon are both saying, I just see it differently in my case. There is not much to be done in the way of treatment because antidepressants are out for me (I'm one of the people for whom the Black Box warning was written.) And with the way it presented this time, I was completely out of options.
But I agree with you in general that depression that can be treated (and not just waited out) is not necessarily terminal.
Posted by Dinah on February 11, 2009, at 21:49:12
In reply to Re: Anyone else think about it this way? *may trigger* » Dinah, posted by TherapyGirl on February 11, 2009, at 21:30:21
Well, I know how important it is to keep some way to maintain control. And I know how scary an open ended commitment to endure can be.
Would it be possible to think of it as a possibility without thinking of it as an inevitability? It wouldn't really decrease your control, but it might allow for other options?
You never know what medications might be helpful. I find Risperdal, for example, really helpful for intense dysphoria and suicidal thinking. It's not an AD, but it is helpful. And even if no current medication is helpful for you, there's no saying what advances in medication might come.
But also, medication isn't the only option. You haven't found relief yet, but that doesn't mean it's not possible. Just that you haven't found it.
I understand if you think of it differently than I do, and don't find what to me is a slight difference in viewpoint acceptable. I'm just offering it to you.
I think your friend is worried. Either that you have decided that this is the time that you will give up, or that she'll be worrying about when that time may be. If your therapist understands, then that's good.
TherapyGirl, you know I would never ever say you can replace your therapist. It would be like replacing a child or a parent. It can't be done. But if this is an ongoing physical condition that you find is helped by your therapeutic relationship, it might be a good idea to consider establishing another therapeutic relationship? It won't be the same of course. Believe me, I understand that. But maybe you could find one that would be helpful in a completely different way?
In any case, for the time being, while it's difficult for you, try not to think of the long term. It's like trying to carry an armload of heavy stuff. If you just think of one step in front of the other, it's more possible to carry that load. While if you look down the hallway to how far away the door seems, you might feel overwhelmed. Just one step in front of another, and lean on your support systems.
Posted by Tabitha on February 12, 2009, at 0:05:17
In reply to Anyone else think about it this way? *may trigger*, posted by TherapyGirl on February 11, 2009, at 16:28:05
I think of it as a chronic condition. It ain't gonna be terminal for me! It's an enemy that may be strong, but I'm stronger.
Posted by SLS on February 12, 2009, at 8:03:03
In reply to Re: Anyone else think about it this way? *may trigger*, posted by Tabitha on February 12, 2009, at 0:05:17
I know it is trite to say, but life is a terminal condition.
It is a matter of choice, I believe, as to which condition to romance - life or death.
I have gone through the hell of bipolar depression for each moment of every day over a span of decades. The main thing that kept me going is that I had hope that I would eventually be well, and I chose to make it a lifetime war to conquer depression. I was smart enough to look around and see what my life could be without depression - something to look forward to. Fierceness helps. I feel like a warrior. Even so, a warrior, like anyone who has ever lived, has his breaking point, beyond which there is nothing left to fight with. But this is usually only a temporary state with depression, and it can pass, almost by itself.
Depression is a liar. It distorts your perceptions and conclusions regarding the world around you. Impusle actions - that is what the depression is counting on. For the moment, you might not FEEL that there is anything to live for. But somewhere deep inside, you probably KNOW that there are things worth living for.
The human drive for survival is strong. Listen to it. It will give you the strength to get through this aweful time. Rest when you must. Remove yourself from the battle, but don't give up the war.
I hope I never reach the point of resignation that depression is all that there is for me, and that all that I am is depression, even though this is what it often feels like. The human spirit is bigger than depression, especially when it is supported by other human spirits.
- Scott
Posted by SLS on February 12, 2009, at 8:22:58
In reply to Re: Anyone else think about it this way? *may trigger* » Dinah, posted by TherapyGirl on February 11, 2009, at 21:30:21
> Exactly, Dinah. The only part of this I can control is how long I have to live with it.
Many years ago, I gave myself permission to take my own life. It was freeing. It took away the awful nightmare of having to be trapped inside myself and doomed to pain and misery for decades to come. I believe that there is such a thing as a rational suicide - autoeuthanasia. I resist any attempts by others to convince me otherwise. The thing is, depression can take out of the equation the word "rational". Depression distorts judgment so much as to change one's outlook for what the rest of their life will look like. But is this one of depression's lies, or is it a certitude? Tough call. I like to err on the side of continuing with life - just in case. I can always reverse my decision and go with autoeuthanasia. That, of course, is final. I'm not into final.
> There is not much to be done in the way of treatment because antidepressants are out for me (I'm one of the people for whom the Black Box warning was written.) And with the way it presented this time, I was completely out of options.
What happened when you combined Parnate with desipramine? Any Black Box stuff happening there?
Sorry, it was the logical thing to ask. This is the treatment that is currently bringing me into remission. Well, that is not exactly true. I had to add to those two drugs two more - Lamictal and Abilify. If you have not tried EVERY CONCEIVABLE SAFE COMBINATION, then I am not sure you should give up on biological treatments just yet.
I say all of this out of ignorance, of course. I don't know very much about you. Perhaps your experience with drugs is such that I don't fully appreciate.
- Scott
Posted by muffled on February 12, 2009, at 8:51:42
In reply to Re: Anyone else think about it this way? *may trigger*, posted by SLS on February 12, 2009, at 8:03:03
> I know it is trite to say, but life is a terminal condition.
>
> It is a matter of choice, I believe, as to which condition to romance - life or death.
>
> I have gone through the hell of bipolar depression for each moment of every day over a span of decades. The main thing that kept me going is that I had hope that I would eventually be well, and I chose to make it a lifetime war to conquer depression. I was smart enough to look around and see what my life could be without depression - something to look forward to. Fierceness helps. I feel like a warrior. Even so, a warrior, like anyone who has ever lived, has his breaking point, beyond which there is nothing left to fight with. But this is usually only a temporary state with depression, and it can pass, almost by itself.
>
> Depression is a liar. It distorts your perceptions and conclusions regarding the world around you. Impusle actions - that is what the depression is counting on. For the moment, you might not FEEL that there is anything to live for. But somewhere deep inside, you probably KNOW that there are things worth living for.
>
> The human drive for survival is strong. Listen to it. It will give you the strength to get through this aweful time. Rest when you must. Remove yourself from the battle, but don't give up the war.
>
> I hope I never reach the point of resignation that depression is all that there is for me, and that all that I am is depression, even though this is what it often feels like. The human spirit is bigger than depression, especially when it is supported by other human spirits.
>
>
> - Scott
>((((((((((((((therapy girl))))))))))))))))
(((((((((((((scott)))))))))))))))
((((((((((((((babblers))))))))))))))
Posted by antigua3 on February 12, 2009, at 9:02:12
In reply to Anyone else think about it this way? *may trigger*, posted by TherapyGirl on February 11, 2009, at 16:28:05
I can hear the pain in your post and understand why you feel this way.
I don't view depression as terminal, in a sense that I don't think it's going to kill me. I will probably suffer with it my whole life and know that I may get to that place you're describing, but I think knowing what actions I take would devastate my kids, I wouldn't give up. I can't.
Two other things:
1. New drugs come out on the market all the time, and new treatment options, and one day one might arise that could really help you. So don't discount that option.
2. You have been going through an incredibly difficult time, both emotionally and physically, so please take that into consideration. Be kinder to yourself, if you can.We love you and will do anything we can to suppport you here at babble, and I admire that you were honest in your post. You verbalized what so many of us feel at times.
antigua
Posted by lucie lu on February 12, 2009, at 9:24:23
In reply to Anyone else think about it this way? *may trigger*, posted by TherapyGirl on February 11, 2009, at 16:28:05
Therapy Girl,
There have been some wonderful posts on this thread, and I don't think I can come close to adding anything to their intelligence and eloquence.
I do want to concur about the new treatments that are in the pipeline. When I was a child and depressed, there were virtually no treatments available, especially for children who were considered not to suffer from depression. We know and can offer so much more now.
Keep in mind how thyroid and other medical conditions can influence mood, particularly symptoms of depression. While these medical conditions can have their own treatment difficulties (as you know! A good endo would work wonders in your case and I hope you can find one), they do offer yet another route through which your mood problems might be corrected. Another point where the brain biochemistry might be tweakable to reduce your depression symptoms.
Also TG, you are grieving so that is another component. That is not a lifelong condition, though it certainly adds to the weight of what you are feeling. It will not always be so.
(((((((((((((((TG)))))))))))))))
Lucie
Posted by seldomseen on February 12, 2009, at 16:25:10
In reply to Anyone else think about it this way? *may trigger*, posted by TherapyGirl on February 11, 2009, at 16:28:05
I do understand where your coming from. Knowing that there is at least one absolute out is very freeing.
I will not, for a lot of reasons, give myself permission to kill myself. What I have done, however, is give myself permission to just surrender to the sad and go into hospital.
The burden of "being normal" on top of the grief is what gets me, not the actual grief I think. It's the desire to be and act "well". The necessity of all the trappings of living can be so heavy.
As much as it scares me to think about it, if I went into the hospital, then I just wouldn't have to pretend anymore. I can just let it all go and "live" what's in my head. I could be the moribund mess that I feel like sometimes inside.I'm not there yet, but, realistic or not, it is my out.
Seldom.
Posted by TherapyGirl on February 13, 2009, at 19:43:07
In reply to Re: Anyone else think about it this way? *may trigger* » TherapyGirl, posted by Dinah on February 11, 2009, at 21:49:12
I appreciate the thought and support you put in this post, Dinah, and I agree with parts of it. I agree with all of it if we're talking about someone else -- I just don't think it applies to me.
As far as my friend being worried, I know she is. But like I told my T last night the dangerous time is when I lie about it. As long as I'm honest, I'm okay, at least temporarily.
And I hear what you're saying about reconsidering my decision to not continue therapy when my T retires. I still haven't changed my position on that because I don't think it's the therapy that actually helps me -- it's the relationship with and connection to her. That can't be replicated.
There are just a few people in this world who feel like family to me -- my T, my two best friends, my ex (still to some extent) and my ex's son. That's it. I can't transfer that to other people. That's one of the reasons I've been so devastated that my best friend isn't speaking to me, for all intents and purposes. It triggers so many things from my childhood on top of all the thyroid junk that's going on.
It's not that I don't believe that I'll ever feel better than this even. It's that that's not good enough. It's not enough to be non-suicidal. I want a different life than it looks like I'm ever going to have -- I want JOY and despite all the work, despite 24 years of therapy, despite a T who has stuck by me no matter what, I can't seem to find it for more than a few moments at a time. That's the part I find intolerable. And it's just not enough.
I really do appreciate your support, though. I'll keep thinking about it, but that's where I am right now.
Posted by TherapyGirl on February 13, 2009, at 19:44:12
In reply to Re: Anyone else think about it this way? *may trigger*, posted by Tabitha on February 12, 2009, at 0:05:17
And I fully support you in that, Tabitha. Really I do. I can see your spirit come shining through in that post and I have no doubt that what you've written is true for you.
Thank you for your support. You are obviously a strong, kick-a** woman.
Posted by TherapyGirl on February 13, 2009, at 19:46:11
In reply to Re: Anyone else think about it this way? *may trigger*, posted by SLS on February 12, 2009, at 8:03:03
Thank you, Scott. Your words bring tears to my eyes.
And you know what? I don't think it will happen when I'm depressed. It will happen afterwards, when I want to make sure I never visit this hell again.
But I admire and respect your attitude. I even think it's a better, healthier attitude than mine. I just can't get there again after all these years.
Posted by TherapyGirl on February 13, 2009, at 19:59:05
In reply to Re: Anyone else think about it this way? *may trigger* » TherapyGirl, posted by SLS on February 12, 2009, at 8:22:58
Again, Scott, your words blow me away. And I will think about it.
The problem with drugs is that it's not just that they don't work -- it's that they have the exact opposite effect on my brain chemistry of what they're supposed to have. So it's very, very risky to even try new combinations. My T and I have talked about it, of course, but we're trying to get through this without adding anything else to the mix.
It may be that my life changes once my thyroid is under control (I'm not sure if you know that part -- I had radioactive iodine treatment in Dec. to destroy my thyroid because I have warring autoimmune disorders -- Graves and Hashimoto's. It appears to everyone right now that I'm cycling fairly rapidly between hypo and hyper. My bipolar thyroid gland. And it just won't die.). But I think it still won't be good enough. I'm so tired of this journey and of having to rebuild my life after one of these episodes. I'm just not sure I have it in me to do this anymore.
Posted by TherapyGirl on February 13, 2009, at 19:59:40
In reply to amazing post, posted by muffled on February 12, 2009, at 8:51:42
Thanks, Muffly. You know I love you, no matter what else is going on, right?
Posted by TherapyGirl on February 13, 2009, at 20:01:25
In reply to Re: Anyone else think about it this way? *may trigger* » TherapyGirl, posted by antigua3 on February 12, 2009, at 9:02:12
Thank you, Antigua. Your posts are always so kind and supportive. And honestly I wouldn't have made it this far without you and the other Babblers. This is an amazing place and incredible resource.
I am trying to take care of myself, in spite of the fact that I despise myself right now.
Posted by TherapyGirl on February 13, 2009, at 20:03:57
In reply to Re: Anyone else think about it this way? *may trigger*, posted by lucie lu on February 12, 2009, at 9:24:23
Thanks, Lucie. You have been incredibly supportive and I always find your posts intelligent as well.
I'm trying to hang in there and see what my thyroid does. But I'm still stuck in this life after that, you know?
I'm really so very sick of myself right now. A few days ago, when I had to leave yet another voice mail for my T asking her to call me, I said, "I know it sucks being my T right now. Trust me, it sucks being me, too."
I don't know why any of you would respond to me or be as supportive as you are, but I do appreciate it more than my words can express.
Posted by TherapyGirl on February 13, 2009, at 20:05:11
In reply to Re: Anyone else think about it this way? *may trigger* » TherapyGirl, posted by seldomseen on February 12, 2009, at 16:25:10
You are so right about the burden of being normal. It's almost more than I can bear. It is all I can do to make it from one end of my day to the other right now.
Thank you, Seldom.
Posted by TherapyGirl on February 13, 2009, at 20:13:40
In reply to Anyone else think about it this way? *may trigger*, posted by TherapyGirl on February 11, 2009, at 16:28:05
On top of everything else, I had an extremely inappropriate sexual dream three nights ago. It is hard to express how disgusted I was when I woke up. I called and left a voice mail for my T right away, telling her enough so that we would be able to talk about it in therapy. I knew I would talk myself out of it the further away from the dream I got. But honestly, I was so afraid that there is some part of my brain that can dream something like that, that I had no choice but to confess.
My T is not all that alarmed -- she believes that the dream is parts of myself (and therefore not all that inappropriate, although I still can't see it) and that given the physical and emotional stress I'm under and given what we've always suspected is true about my childhood, this dream is not exactly a surprise. I told her it was a shock to me and that I've never had a dream like that before. She said something about it was because I was healthier than ever and dealing with this depression better than ever. I raised my voice and said, "WHAT PART OF THIS AM I DOING WELL????? I CAN'T FUNCTION, MY COGNITIVE ABILITY IS GONE, I'M SUICIDAL AND NOW I'M HAVING INAPPROPRIATE DREAMS ABOUT CHILDREN. WHAT THE F*CK PART OF THIS AM I DOING WELL?" She said I was going to work, that I was functioning more than I felt like I was, that I was feeling my feelings (which she always gets very excited about because of the whole I spent four years in therapy in total silence thing), blah, blah, blah. My own personal cheerleader. But I'm still in hell.
At the end of the session, she hugged me and, of course, I cried. Because that's what I do now. I cry all the time. I never cry and now I can't stop. I really am in hell. She was holding me and I said, "I don't want to be this person." She assures me that I'm not. I tell her I don't recognize myself and that everytime this happens, I lose part of my soul and eventually there will be nothing of me left. She says I'm still there. I said, "HOW DO YOU KNOW?" She said, "Because I've known you for over 20 years. I know you're there."
It's really never been like this before. I don't know why I'm telling all of you this. I need to just shut the f*ck up. But it feels like I'm vomiting feelings. I wish they made phernagan for that.
Posted by raisinb on February 13, 2009, at 20:35:25
In reply to Anyone else think about it this way? *may trigger*, posted by TherapyGirl on February 11, 2009, at 16:28:05
I know I'm late to this thread, but I wanted to respond anyway.
I think how you think about it is absolutely healthy. Depression IS an illness, and though we know so little about its causes, still, the fact that people respond to treatment tells us that's the way to go.
Posted by muffled on February 13, 2009, at 23:37:03
In reply to Therapy last night ******CSA Trigger*********, posted by TherapyGirl on February 13, 2009, at 20:13:40
Sorry its so bad right now (((((((TG))))))))))
I dunno of course, but what I suspect your T is happy about, is that dream. Cuz its kinda may explain stuff some.
And ya, it may well be stuff is comming up and thats part of the stress, cuz it wants to come out. So maybe T is glad you might finally let go of something inside that is hurting you.
This is pure speculation on my part.
Also, I would not worry too much about your dream. Most people have weird dreams/thots at times, just they block them out, ir you never hear about it anyways even if they remember cuz like its not general conversation right?
I was just reading a thread on another website where a poster was upset bout her dreams/thots and another replied that she had (it was related to sex/pain etc) dreams/thots too, but she had been thru this with her T, and she was quite assured that they were just thots stemming from her prior history. She was rational and would never act on them. So its just kinda reenacting remnents that come out now and again.
Again, I dunno what your situ is. Just trying examples to show you you not alone so much.
Good for you for phoning T B4 you buried it. I am glad she was able to maybe reassure you even a bit.
Feelings completely suck.
But I guess they can feel good too I s'pose. But when they are intense its surely hard to take.
So I dunno wassup for you TG. I just dunno. I am glad you are still working thru this.
You have so much in you that is good and kind.
I hope you can make it thru and see the other side cuz I hear its an OK place, and that there's good things ahead.
I am so sorry you hurting so bad.
Wished I had the right words.
Wished I was magic.
Do you think you got little ones inside you that are maybe causing this sadness?
Maybe not.
I dunno.
I am rambling.
I am gonna go to an accupunturist next week....ack!
(((((((((TG)))))))))
I be thinking and praying for you.
Muffled
Posted by lucie lu on February 14, 2009, at 12:22:23
In reply to Therapy last night ******CSA Trigger*********, posted by TherapyGirl on February 13, 2009, at 20:13:40
Boy, when it rains it pours, doesn't it?Actually your T is right about the dreams, at least from what I am learning these days about brain circuitry. It seems like your brain during sleep is connecting dots. The dots may not have been meant to go together in the first place. So if you dream that (a) you are a child; and (b) in a particular situation; and (c) had certain feelings about that, it may not have ever happened that all three ever occurred together IRL. That's why most of our dreaming is not in the form of actual events or accurate memories. So in the dream, the three may not have even been connected IRL and so may represent something else entirely. For instance (and I am just making this up as an example) a "child" in the dream may represent unrealized growth potential, a "trigger situation" may represent something that there may be inner prohibitions against; and there may be feelings of "doing something wrong." However, what such a dream might be reflecting is that a dreamer is trying to look at what things have been holding him/her back from a level of something (happiness? success? peace?) that they have been led to think is not possible for them to attain. See what I mean? So maybe for you, you needn't worry so much about the "language" of the dream (i.e. its imagery), because it was not really meant in the literal sense.
Two other thoughts, more physiological, about the difficulty you've had w/ AD treatment. The first is that thyroid dysfunction can have a significant effect on how drugs are metabolized. For instance (and over-simplifying, to be sure), any given drug will stick around (i.e. have a longer half-life) longer in hypothyroid individual than a normal one, and the half-life will be shorter still in a hyperthyroid person. Side effects can also be affected. So getting the thyroid dysfunction under long-term control (which you are trying to do, and that IMO is a very good thing for you to keep on working toward) may very well open up possibilities for decent A/D control of your mood symptoms.
The other thing is that someone on this board a few months ago was raising the subject of a non-drug treatment (involving magnetic imaging?) that has shown promise for depression that has not responded well to meds. It is not anything like electroshock, in fact sounded quite benign and non-invasive. From what I remember, they were looking at cases like yours that have not be refractory to A/D meds. Can someone on Babble help me out here?
Just try to remember, TG (and I know how hard it is at times like these!), that everything you are thinking and feeling right now is going right through a depression filter. If you remove that filter, things will look and feel very different. Depression is a mind-bender, it changes the way everything really is to suit itself. Things really do return to normal and the birds really do start to chirp again when the Big D lifts. That's because they always were chirping, the Big D just hid it from you.
(((((((((((((TG))))))))))))))
Lucie
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