Earlier quoted context omitted.
Are you still depressed? I try to have 5 good days out of 7 in a week. I found that CBT helps especially the book Feeling Good by David Burns. He has a podcast out now about a new team base cbt approach. The podcast is great and the workbooks in his books are really helpful. He has an associated clinic in Mountain View as well. The approach is practical and specific. CBT has roots in Buddhism and stoicism as well for…
I'm not sure whether I'd actually meet the criteria for a depression diagnosis anymore. I haven't been severely depressed since starting CPAP treatment, but my emotional experience is still very flat and I still have difficulty processing social interaction. I've heard of Feeling Good and CBT in general, and without going into the gory details, it really doesn't sound like it's the right approach for me.
What I have learned from my suicidal patients
81–90 of 185 posts
Re: What I have learned from my suicidal patients
#82Earlier quoted context omitted.
Are you still depressed? I try to have 5 good days out of 7 in a week. I found that CBT helps especially the book Feeling Good by David Burns. He has a podcast out now about a new team base cbt approach. The podcast is great and the workbooks in his books are really helpful. He has an associated clinic in Mountain View as well. The approach is practical and specific. CBT has roots in Buddhism and stoicism as well for…
I'm not sure whether I'd actually meet the criteria for a depression diagnosis anymore. I haven't been severely depressed since starting CPAP treatment, but my emotional experience is still very flat and I still have difficulty processing social interaction. I've heard of Feeling Good and CBT in general, and without going into the gory details, it really doesn't sound like it's the right approach for me.
Re: What I have learned from my suicidal patients
#83Earlier quoted context omitted.
I'm not sure whether I'd actually meet the criteria for a depression diagnosis anymore. I haven't been severely depressed since starting CPAP treatment, but my emotional experience is still very flat and I still have difficulty processing social interaction. I've heard of Feeling Good and CBT in general, and without going into the gory details, it really doesn't sound like it's the right approach for me.
Are you saying sleep apnea the root cause of your depression?
Re: What I have learned from my suicidal patients
#84I tried one last time to talk to my family recently...very right wing, faux Christian, self-righteous, bigoted people who think those in need are weak, didn't try hard enough, are to blame. They have never been decent people and I avoided them my entire adult life but was forced to grovel when my health got worse and I was denied official assistance. It's been nothing but misery and makes everything worse. It's a gravity well I cannot escape, I am powerless to do anything but scream online between gurgling breaths as the riptide takes me away and they seem to enjoy that power and getting me back for all that time I did avoid them. Despite a career seeing the worst people did to each other, you never want to accept those who claim to love you are that bad as well. But people show their true selves when they have power over others, when they have an opportunity to exercise their wills, when there is someone smaller/weaker/needier in their path...people will show you who they are every time. Every time.
I am not depressed because of some temporary situation. I am not suicidal because of a chemical imbalance. I had my health stolen, my finances decimated, and my life punched down on hard by anyone who was supposed to be there for me...for whom I would have been there. I am clinging to Maslow's bottom rung and losing my grip and nobody who can do anything cares at all. Everyone I have ever known who is suicidal has some real, actionable reasons like this underlying it. But all people say is "get help"..."take pills"...."meditate". That's all putting a bandaid over a gunshot wound and ignoring the trauma underneath because dealing with that is harder and costs more. People just aren't worth that to others. I am going to die angry and alone and they all know it and do nothing but antagonize, threaten, and make it about themselves. They have important things to do like rage at "liberals" ruining the world and how unfair everyone is being to Trump. Their kids and neighbors and everyone else are tools and threats to them, nothing more, they are so incredibly ego driven it's astonishing. They say "not with MY money" to everything social for others, even as they collect their social security or use subsidized systems. That's what matters to them...their own gain and power. Not me...not others. They are legion in this country. By an accident of birth I was both ruined and abandoned. Both rooted in selfish profit driven mindsets. Had I been born in the fist world the profit driven surgery likely wouldn't have even happened, but had it I would get social assistance. Not here...here I get to go live in a ditch or die.I am too old, too broken, need too much to survive and I refuse to suffer MORE because of this backwards culture so option B it is. Thanks Murica.
No SSRI or deep breathing solves those situations...and most people who end their lives didn't have to if people would do the right thing. But the right thing isn't profitable. So they push pills, write articles, cherry pick survivor-biased tales that show someone who "got better" who didn't really have any problems at the core. They show this as some enlightenment or evidence and hold it up but the light is focused on that and ignores the piles and piles of bodies underneath who were ignored or bypassed because it was too hard and not good for business. Most people don't care about you...they don't care about society...they care about themselves.
I had a nightmare just last night about a victim I recall from early in my career...in such a horrible personal situation...who died in such a terrible way. She didn't have to. She was pushed to it and then allowed to because nobody she reached out to would help. I've seen dozens like that...and not a single one of them had to die. Every one of them was failed by their family, by their neighbors, by systems...it's shameful. But enough about silly bleeding heart things like people and the planet and whatever. There are important things to do like get those likes, those dopamine hits, shut down those losers in a political argument or downvote someone to signal how wrong they are, make those dolla dolla bills convincing someone to buy that useless to society "product" or cash out big to someone else who will because those luxury status symbols won't buy themselves. After all anyone who is suffering only has themselves to blame and didn't want it bad enough or step on enough other heads to get it. Losers.
Re: What I have learned from my suicidal patients
#85I just wanted to say, if anyone is having a dark time, make an appointment with a doctor and ask them about Prozac. Unlike most antidepressants, the side effects don’t seem very noticeable. I think there’s a sort of stigma against talking about mental health (except in the third person), but it’s one of those things that should probably change. Taking Prozac doesn’t mean you’re somehow broken. It’s like a crutch: why…
5-HT1A agonism relieves a lot of symptoms commonly associated with SSRIs, so does antagonism of 5-HT2A, 5-HT2C (Prozac does this), 5-HT3, 5-HT7 and certain adrenergic receptors. Some newer drugs target these receptors.
Re: What I have learned from my suicidal patients
#86I just wanted to say, if anyone is having a dark time, make an appointment with a doctor and ask them about Prozac. Unlike most antidepressants, the side effects don’t seem very noticeable. I think there’s a sort of stigma against talking about mental health (except in the third person), but it’s one of those things that should probably change. Taking Prozac doesn’t mean you’re somehow broken. It’s like a crutch: why…
All anti-depressants have severe or annoying side effects for some people . Most anti-depressants have almost no side effects for most people. The trick is to change prescriptions until you find one you like. (I'm on my third prescription, and have no complaints.)
This isn't true for all anti-depressants, especially when you look at dosage.
For example, if you look at clinical trial data and studies for a certain drug, 60% of people experienced weight gain. Another drug caused nausea in nearly 70% of patients.
Paroxetine has a reported sexual dysfunction rate of nearly 75%, and patients who take 20mg of vortioxetine report a similar rate of sexual dysfunction after several weeks, but nearly none at all when taking 10mg daily.
Re: What I have learned from my suicidal patients
#87A colleague of mine calls suicide 'a permanent solution to a temporary problem' - not to diminish it, but to recognize that for most people the desire to die is a temporary state. Whenever depression comes up on HN (as it does with surprising frequency), I'm both touched by people's willingness to share their own stories, and frustrated by otherwise very rational and logical people's speed to dismiss data. Initial tr…
> A colleague of mine calls suicide 'a permanent solution to a temporary problem' - not to diminish it, but to recognize that for most people the desire to die is a temporary state. I've seen that quote floating around and never much liked it. For those afflicted with long-term treatment resistant depression, it's more like "a guaranteed solution to a permanent problem".
Re: What I have learned from my suicidal patients
#88Earlier quoted context omitted.
> A colleague of mine calls suicide 'a permanent solution to a temporary problem' - not to diminish it, but to recognize that for most people the desire to die is a temporary state. I've seen that quote floating around and never much liked it. For those afflicted with long-term treatment resistant depression, it's more like "a guaranteed solution to a permanent problem".
I've always disliked it too. It seems very presumptuous. The people repeating it typically don't know what the person in question is dealing with.
Re: What I have learned from my suicidal patients
#89Earlier quoted context omitted.
STAR*D presents us with a "glass half full" problem. It's absolutely true that the majority of people will recover from depression with suitable treatment, but that leaves us with a minority who won't. I'm not sure how to communicate those facts effectively to a wide audience. It is absolutely imperative that people with depression seek treatment and keep trying even if the first or second or fifth treatment fails, o…
The term "treatment resistant depression" bothers me because, I think, a more accurate name would be "placebo resistant depression". Sorry to come off as frustrated; I'm like others in this thread with 10+ years of trying various therapies and antidepressants to end up feeling more, not less, hopeless. David Burns does a good job explaining why antidepressants and psychotherapy don't typically work in his most recent…
https://www.ncbi.nlm.nih.gov/pubmed/29477251
for moderate to severe depression, the kind most posters are talking about, they're consistently better than placebo. It is true that placebo is often effective too. But most people I talk to would rather have that extra chance of getting better.
Re: What I have learned from my suicidal patients
#90A colleague of mine calls suicide 'a permanent solution to a temporary problem' - not to diminish it, but to recognize that for most people the desire to die is a temporary state. Whenever depression comes up on HN (as it does with surprising frequency), I'm both touched by people's willingness to share their own stories, and frustrated by otherwise very rational and logical people's speed to dismiss data. Initial tr…
Is this data talking about a "cure" where people no longer would be labeled as having depression at all, or are we talking about clinically significant improvements/better than placebo results?
The closest thing to a cure (for some people) can be cognitive-behavioral therapy, or long-term antidepressant treatment when indicated.