Why you need to be careful when talking about that pilot's depression.

[jeff47]

There's a hell of a lot of people who do not understand mental illness. Because they are using their normally-functioning brains to try and understand a brain that is not functioning normally.

As a result, people use their "normal" situation to try and "help" people who are not in a normal situation. "I felt bad the other day, but green tea just cheered me right up. You should just do that instead of taking drugs!". The last sentence is always said with a sneer.

This is the equivalent of telling someone nearly incinerated in a fire that they don't need skin grafts, because aloe helped your sunburn. And big surgery is just out to get your money.

This is the equivalent of telling a blind person that they should just take some vitamin E. And big seeing-eye-dog is just out to get your money.

This is the equivalent of telling a paraplegic that they should just eat some kimchi, because it cured your leg cramps. And big wheelchair is just out to get your money.

Clinical depression is not just "feeling down". When you are clinically depressed, you have thoughts like "I should kill myself. Eh, why bother? Too much effort". That is why suicide is a side effect of antidepressants. They can cure "Too much effort" before curing "I should kill myself".

People with clinical depression need real treatment from mental health experts. And that treatment will involve drugs, at least for a time. They do not need you talking up St. John's Wort. It will not work for clinical depression, and yet another failure will hurt them.

Falsely demonizing antidepressant drugs will make it even harder for them to get real treatment. Yes, they have side effects. Some of them even sound rather unpleasant. They're worth it. Every single awful side effect. Because with real mental health treatment, they are a temporary crutch until the depressed person is able to manage their disease on their own.

Overcoming that "Too much effort" in order to get treatment is a herculean task I hope you never face. Do not make it harder.

[Jackpine Radical]

1. On the other hand--

http://www.medicalnewstoday.com/articles/174928.php

Studies from reputable research centers report that St. John's wort is more effective than a placebo and equally effective as tricyclic antidepressant drugs in the short-term (1 to 3 months) treatment of mild-to-moderate major depression. Experts continue to debate whether St. John's wort is as effective as SSRIs (selective serotonin reuptake inhibitors).

The last sentence is rather odd since the SSRIs have not been consistently shown more effective than the tricyclics.

[jeff47]

3. :facepalm:

This isn't mild to moderate depression.

Do you trip people who are walking with a cane? No? Then stop doing the mental health equivalent.

[get the red out]

5. No offence but

I tried St. John's wort in my efforts to not be a bad person and get real help.

[DRoseDARs]

14. On WHAT other hand? That website you link actively promotes Woo. nt

[jeff47]

18. It was convenient to have a poster child for "what not to do" be the first reply. (nt)

[DRoseDARs]

19. You poor thing, that bruise on your face must sting...

Damn-near broke your nose facepalming on that, didn't you?

[MANative]

2. AND... CNN just reported (on air) that the clinic in which he was treated...

has issued a statement saying that he was NOT treated for depression, but for another ailment which they did not disclose.

Your points about the discussion around this ailment are valid and important. They just may not be directly pertinent to the pilot's situation.

[jeff47]

6. Sweet! That report just cured all clinical depression!!

Or maybe what I'm talking about still applies.

[get the red out]

4. Thank you thank you!

Did I say thank you???

I bought into the don't take drugs, big pharma is lying, they don't work, here are some vitamins....for a lot of years. When I finally gave up and got professional help, I realized I had been living half a life for a very long time.

[jeff47]

7. You're welcome, and I'm glad you got help.

My particular case started sometime in my youth - I don't remember not feeling depressed as a child.

It took a hell of a lot of work, and going through a hell of a lot of herbs, teas and other ineffective bullshit, to get real treatment in my late 20s.

[get the red out]

34. I was about 9

I finally told my parents when I was 17. To say they were really upset to have a defective child would be an understatement. I got help, but it wasn't very good. My young age made psychiatrists in the 80s think it just couldn't be that bad, even after two overdoses of prescription drugs trying to stop the pain. I am so glad young people are being seen as suffering as much as their adult counterparts. Genetics, both my Mom and both Grandmothers were obviously depression suffers.

[uppityperson]

8. Big k&r.

And my take on it.
http://www.democraticunderground.com/10026423534

[NCTraveler]

9. K&R nt.

[LiberalEsto]

10. K&R

[Cleita]

11. I don't have a degree in psychology or any of the other academic

disciplines regarding mental health, so I have declined to comment and hope that those who do will weigh in with their expert opinions.

[F4lconF16]

12. Thank you. nt

[Ron Green]

13. Mental illnesses are real, and ought not to be trivialized. Also it's true that

we live in a more and more toxic, distracted and disconnected world, driven largely by consumer capitalism and fear. There's a moral deficit that should be acknowledged and widely discussed.

[GliderGuider]

15. Big thumbs up here.

I've used both Wellbutrin and St. John's Wort. Guess which one let me get control over my life?

If you have a touch of existential angst, take two sutras and call me in the morning.
If you have suicidal ideation, get thee to a professional, pronto.

[steve2470]

16. good post

Anti-depressant medications (yes, even those with unpleasant side effects) have helped millions, myself included. Until something can be invented that has NO side effects (even aspirin has side effects), we have to take the imperfect route. Along with counseling. And exercise.

[SheilaT]

17. While I'm certainly no expert in depression or suicide, it does seem to me

as though when a person is genuinely suicidal, they're not thinking rationally. Or not rationally the way a non-depressed, non-suicidal person would think.

My guess is that the pilot (if what he did was intended as suicide) didn't really consider that he'd be killing all those others also, or at least not care in the way most of us reading bout it care.

It's the disordered thinking that causes someone to kill their children, and then perhaps themselves.

I've been depressed on occasion, but never clinically depressed, and I am guilty of thinking that someone else should just snap out of it. It can be hard not to be judgmental, or not to understand that someone else's situation is very different.

[Ms. Toad]

20. I was with you until your next to last paragraph -

but that is way too broad a generalization. No - they are not worth every single awful side effect. They are only worth it if you have a competent psychiatrist with whom you have worked to determine the proper antidepressant and the proper dose for you, specifically, and who continues to monitor you to provide objective feedback as to whether what you are experiencing is the depression lifting - or drug-induced and dangerous emotional side effects.

The way antidepressants are way too often handled is by the family physician, without proper monitoring - and even some (perhaps many) psychiatrists have their own pet drug rather than finding what works for you or, worse yet, stop paying any attention to you.

Unfortunately, my family has experience with everything in the preceding paragraph, with the side effects my daughter experienced under the psychiatrist's care (until he abandoned her) resulted in her taking life-threatening risks (for both her and others).

So no, as a blanket statement, they are not worth each and every side effect. Specifically, they are not worth the side effects my daughter experienced (and, because of the emotionally devastating side effects & malpractice, she is currently untreated and terrified to try other pharmaceutical alternatives).

[jeff47]

21. So you just skipped over the paragraph before that.

Specifically the part where I said people needed treatment from mental health professionals.

[Ms. Toad]

22. My daughter was receiving treatment from more than one mental health professional.

Apparently you skipped over what I wrote:

Unfortunately, my family has experience with everything in the preceding paragraph, with the side effects my daughter experienced under the psychiatrist's care (until he abandoned her) resulted in her taking life-threatening risks (for both her and others).

Although I did not mention it, during the relevant time she was also seeing an LISW and a psychologist.

My spouse is also taking anti-depressants, under the care of our family physician. She has never been diagnosed as depressed, and I believe that care is inappropriate.

[KMOD]

23. Ms. Toad, may I politely ask why your physician

may have prescribed an anti-depressant for your spouse? I understand if it's none of my business.

I developed a sudden severe case of anxiety and panic disorder a few years ago. I honestly believe it is connected to perimenopause. My husband felt I could snap my fingers and force my way through it. I tried for 18 months to do just that. I increased my exercise, (which I don't regret, because I'm now in the best shape I've been in in years), changed my diet, took ashwaganda, drank tea, and tried to force my way through it.

But it just kept getting worse, to the point that I missed my daughters graduation ceremony for her Master's degree. That broke my heart. Thankfully my daughter is a very intelligent and kind sweetheart. She had my back when I told my husband I needed help, that I sincerely tried everything I could, and it is not just in my head.

My primary care physician was wonderful. "Hey, shit happens." is what he told me, lol. He gave me an SSRI prescription, and although I hated the side-effects at first, within two weeks I felt better than I had in 20 years. My anxiety and panic are gone. I am myself again. He did monitor me, and had me come back for a 4 week checkup, an 8 week checkup and a three month checkup. I know that many people don't have as much luck with the first prescription and dose right off the bat, that it sometimes takes trial and error. Had I not had success, I would have kept trying. It certainly beats doing nothing.

SSRI's have been around for many years, and are relatively harmless. I have no side-effects at all, except for being thrilled at feeling whole again.

[smirkymonkey]

24. I am glad it worked for you!

It can be a lifesaver for some of us. Contrary to what some here might think, it is not some mind-altering, psychotropic drug. It is as simple as restoring a serotonin balance to our brains. We don't feel high, we dont have mood swings, we are just restored to a level of relative normalcy.

I am not sure what other drugs people are talking about but most SSRIs do not have harmful side effects.

[KMOD]

25. Thanks, and I completely agree.

My only regret is not seeking help sooner. I was tormented for 18 months and I didn't have to be. On my first check-up with my doctor, I told him "thank you" and "I wish I could hug you", as I smiled and shook his hand.

I have no shame that I am taking an SSRI to help myself. I was shamed when I suffered, and made excuses for not being able to go events and places.

[smirkymonkey]

33. Good to hear!

[Ms. Toad]

26. Initially she was given a below therapeutic dose as a sleep aid

because of fibromyalgia-related sleep disruption.

A few years after that, I started to notice changes in her memory and cognition (which she was unaware of). I mentioned it to a neurologist she saw briefly for an unrelated condition. His take on my observations was, "She's in a PhD program and has 4 other degrees - you can't be serious." She had then recently been terminated from her job (which should have been a clue that I certainly was serious), and had other things going on which might have caused or exacerbated depression - so he suggested increasing her dose to the therapeutic level to rule out depression as a cause of her symptoms, since depression can cause memory and cognition deficits.

The anti-depressants changed nothing, and she has since flunked out of the PhD program and has been diagnosed with mild cognitive impairment consistent with the early stages of Alzheimers.

Typical of what I had already been noticing about her memory, she has completely blocked out the middle step - that she was on the theraputic dosage to rule out depression, and continues to tell her family physician (the neurologist is out of the picture now) that she is on antidepressants for fibromyalgia related sleep disruption - and he continues to just refill the prescription. For her, they appear harmless aside from the typical relatively harmless side effects, so getting a medically appropriate evaluation and care on this matter is a battle not worth fighting.

SSRIs are relatively harmless (and quite helpful) for many people. That is not true for everyone, and when they go wrong, they can go very dangerously wrong for the same reason they are helpful - they alter what is going on in your mind in ways that you may not recognize until it is too late.

SSRIs are not innocuous medications which should be prescribed without a proper diagnosis by a competent mental health professional who is committed to very close monitoring for a long enough period to make sure the patient is stabilized on particular SSRI and dosage is appropriate. My daughter was on the same SSRI as my spouse, and the side-effects were anything but harmless. The uncommon (but well known) side effects she experienced caused her to take life-threatening risks and engage in behavior she now hates herself for. Neither her psychiatrist (nor the LISW or psychologist she was seeing during the relevant period) asked the relevant questions that should have been asked, quesitons that would have identified the dnagerous emotional path the SSRIs put her on - and to compound things, her psychiatrist abandoned her while she was still on a dose that was at least 50% higher than the maximum dose currently recommended.

You, and many others who are put on SSRIs without incident by their family physicians are lucky - because for most people they are relatively harmless (and can be very helpful). But make no mistake, it is purely luck that you did not experience the same (or other serious) side effects like my daughter did - and had you experienced them, your family physician is less likely to be able to spot them than the psychiatrist and two counselors who missed them in my daughter, even with specialized training.

[KMOD]

28. I hope you can find a competent doctor to help

your daughter. I'm so very sorry that her experience has frightened her from seeking care. I don't know why they gave her such a high dose. I started on the minimum dose, and just took half for two weeks to see how I'd react. The only side effect I experienced was with sleep. Easily corrected by taking my dose in the morning as opposed to the evening. It has not altered my mind in anyway.

I'm also very sorry to hear about your spouse. Alzheimer's sucks. I know that my father-in-laws doctor wanted to prescribe an SSRI for him, in mid-to-late Alzheimer's for his agitation, but his family chose not to.

Hugs to you. Thank you for sharing your story. I really do hope you find help for your daughter, somehow. I also wish you peace and comfort in your spouse's journey with Alzheimer's.

[Ms. Toad]

31. Her psychiatrist started out appropriately -

She started on a very low dose, which he was raising very slowly (at least two weeks between steps up, and there were about 6 steps between the lowest dose and the dose she ultimately reached). At some point he failed to ask the appropriate questions to distinguish between feeling alive for the first time in years, and drug induced manic behavior. When she initially reached the peak dosage, it was considered the upper limit of appropriate dosing - but that ceiling dose was cut (in half, as I recall) while she was still at the peak dose, and he did not lower it.

She's going along one step at a time - very slow baby steps, and it is a daily struggle. She's got a weekly group support session that helps, and she's found a church that specializes in latching on to lost souls. The latter makes her happy, and she has a closer circle of friends than she has ever had. But it also scares me to death because it is one of those churches which believe the earth was created 6000 years ago - and that my marriage is a sin. Finding a new psychiatrist or other counselor will be a while off - too much energy to sort out one that would be compatible. She's been through 3 (plus two psychiatrists), only one of which was helpful - but she ultimately shut that one out when she wasn't saying what my daughter wanted to hear.

As for my spouse - I wouldn't have gone along with putting her on SSRIs to manage agitation. It took several years of trying to convince her to be tested (her particular executive reasoning losses mean she is incapable of being aware she is losing it - something I didn't know at the time - so she was sure I was making it up). The SSRI was a baby step toward checking out one alternative to dementia (depression) before I convinced her to get tested. If she had responded, it would have ruled out dementia. She's relatively stable on two Alzheimer's meds - and given her age and slow progression I'm still not convinced we have the right diagnosis, but convincing her to be tested in the first place was such a battle I haven't had the energy to suggest a re-evaluation with a different team of specialists.

Thanks.

[KMOD]

32. You have a lot on your plate.

I wish you strength and comfort.

[ismnotwasm]

27. K&R

[davidpdx]

29. I have a couple of thoughts

First, we would have to be mind-readers to know exactly what was going through the guys head before he crashed the plane. We will never know. So anyone who is trying to imply they know what was going through his head is bs'ing.

Second on treatments for depression, I agree medication is often the most commonly used method to manage depression. For those who have never gone through it, it requires working close with a doctor monitoring and sometimes changing medications to find the right one that works. It can be frustrating at times because there is no right answer, instead it is trial and error.

For those who have dealt with depression be careful about over medicating. My doctor has added some medication over time when I have problems. Although I trust him, I always try to push back a little to make sure I'm on only what I need. One of my medications causes my hands to shake from time to time which is scary. As Jeff said, we have to deal with the side-effects as they come and that can be part of the process of changing medications

[Ilsa]

30. I'm disturbed by judgment being passed when

The crash is still being investigated. We don't know the whole story yet. I'd rather not think about the cause until the facts are put together.

[Surya Gayatri]

35. Sorry, but examining the co-pilot's mental health issues

and investigating the motivations for his heinous act does NOT equate to:

'making it harder for depressed people to overcome their reticence in order to get treatment'

(Overcoming that "Too much effort" in order to get treatment is a herculean task I hope you never face. Do not make it harder.)

Wow, the false equivalency around here in discussions of this event is just astonishing.

And, I speak as a sufferer of mental health issues myself.