Talk to me about depression

For the better part of 2 years, I’ve been living with a woman who I believe has suffered Borderline Personality Disorder since she was an adolescent. If you ask her, she’s depressed, has ADD/ADHD, she “needs” uppers (OTC or otherwise) to regulate her sleeping patterns, has been maxed out on Wellbutrin since she was 18 (now 31), that she doesn’t think it matters if she drinks on her meds, and she may or may not bring up that some doctor might have mentioned the possibility of a borderline diagnosis once when she was younger.

Her family breathed a sigh of relief and then fell off the radar when I came along. Our romantic relationship didn’t survive the first 6 months intact, but has been steadily degrading to our current state of a drama-filled supporter/dependent situation.

Virtually every day is a struggle to help her through even the most basic situations expected of a functional adult. She’s had at least 7 jobs in the 2 something years I’ve known her. She’s a social worker, and intimately knows what resources are available to her, and the importance of getting quality and consistent help from competent people…but that doesn’t mean she’s capable of reaching out for that help herself. She can give excellent mental health advice to a client in the afternoon, and then promptly go home and do just the opposite for herself that evening.

The few instances of positive reinforcement that come along are dwarfed in comparison to the mountains of pain and hurt and doubt that her skewed perceptions surround her with.

She holds the key to her own improvement, but her imbalance(s) and past failures sadly result in a constant quest for some external source of salvation. The next latest and greatest meds, a self-help book that really seems like it will do the trick this time, for our relationship to get back on track so that we can get married and have kids so she’ll finally be happy.

I’ve gotten her to actually sit with a therapist only once since I’ve known her, and aside from attending all of her therapy sessions with her, I highly doubt that she would be honest with them, let alone be honest on her own on a consistent and regular basis. Not without a sense of focus and resolve that she has yet to kindle within herself. If we can just keep her at her current job with the health benefits, I do want to figure out a way to attend therapy with her, even though we don’t have the same insurance. It is the one area of treatment that she has avoided the most, and I think that is partially due to the potential of it being the most effective. It will force her to confront many things that she does not want to face. Here’s hoping.

Here’s something I’ve always wondered. Assuming it is not caused by a chemical imbalance, does a person’s circumstances make them depressed or does depression make a persons circumstances seem much worse than they really are?

For example, a job or relationship that makes you miserable, death of someone close to you, losing your job, etc. It is perfectly reasonible that any of these things can make a person miserable. At what point does it become “depression”?

This just seemed to make my girlfriend very aggressive.

It actually could make her more depressed and irritable. Not that it necessarily will, but it does for some people.

I have depression and eat a sort-of low-carb diet during Passover (kosher-for-Passover rules forbidding most of my favorite carb-type foods), and you do NOT want to be around me on the last couple of days of Passover. It’s somewhat better now that I’m on medication for the depression, but I still get very irritable if I go on a low-carb diet.

Here’s a cite for how low-carb diets can make someone irritable and depressed.

In addition to what others have already said, depression and its evil cousin anxiety can sometimes become so much a part of a person that it’s difficult to break away. I know a person who was clinically depressed for years. Finally, he got treatment and felt like a whole person for the first time in his adult life. Shortly thereafter, his marriage broke up. The dynamic between himself and his wife had now changed so much that he was literally not the man she married. Both have subsequently re-wed and are much happier now.

I know when I got medical treatment for my depression and anxiety, it was just amazing how my world changed. All of the various coping techniques I’d been trying now actually worked. There was a brief time, though, when I felt like there was something oddly “missing.” As soon as I realized that what was “missing” was that grey fog over everything beautiful, it was o.k. I also felt for a little while afraid to be happy, dreading the plunge that I had been used to coming after the lift. Again, once I realized what was going on, I was able for the first time in many a year to simply enjoy life and to deal with the inevitable things that will go wrong without collapsing.

Bottom line: Your friend should be getting help. It’s out there and can do her a world of good.

Excellent description phouka…it took me back for a moment.

I have had one episode of depression and I remember feeling closed off, like I could see my life happening all around me but I was not an active participant. Unfortunately what happens in depression and not in other diseases like diabetes is all of your coping mechanisms are, at best, blunted. And like phouka said so eloquently…you can see out but nothing touches you. That is a bigger statement than it appears on first blush. Your friend can see out and see that her life is good but to her the joy of it it may feel distant, unattainable.

Sharon may need for you or someone to step in and actually physically assist her in finding the professional help she needs. She sounds almost immobilized. Offer to sit with her and check her insurance plan, help her find a therapist’s number, be with her while she calls, even offer to go with her…some of the things you may be able to do to help her take the hardest step…the first one. Then someone can offer the professional help she needs.

Please don’t think, though, that you can hold yourself responsible for Sharon getting help. You can support her and help her get there but the work will be hers to do.

Good luck…to you and Sharon.

MarcoPolo12, can I recommend a book to you? Check out The Noonday Demon by Andrew Solomon. It’s an autobiography/sociological and scientific survey of depression. It won the National Book Award a couple years ago. I do not, fortunately, suffer from depression, but this book gave me great insight on those who do.

:frowning: Oh, this all sounds all too familiar, and everyoen else has been explaining better than I possibly could. (I’m sort of butting in mainly so that I can “subscribe to thread”.)

One thing, though, as others have said, it sounds to me as though the OP has been trying very hard to be of help and really now needs a bit of a break, before the strain and frustrtion of it jsut put him off friendship with Sharon for ever. (Yeah, I know, easy to tell others what to do. :frowning: I’m serious, though. OK, righ now I am the useless one who seems detached from everything, hating even to go outdors unless essential, but there have been times when I have spent tons of energy on trying to support others - really , if you go on like that, the friendship might break entirely. It might not, but… Do think of giving yourself more time away from your friend’s trouble for a little while, MarcoPolo - good foro you,a nd probably lets you to be of hel to her after a bit of a “rest” (can’t think of a better word right now, sorry.

Best wishes for the whoel situation - I admire that you are trying to be such a very good and genuine friend.

You are making a very common mistake that people on the outside make. They assume that depression is just a long period of the type of sadness that everyone experiences from time to time.

Depression does not equal the sadness that you are familar with. It is as much physical as it is mental. Sleeping patterns get all screwed up, energy gets sucked out of you, and weight may go up or down. Other people have covered the mental mental shifts that occur such as anhedonia and poor concentration.

A sad or traumatic life event can trigger a depressive episode but the initial sadness is not the same thing as the depressive episode that follows.

To answer your question directly, depression makes a persons circumstances seem much worse than they really are and has many other mental and physical consequences.

Also, I firmly believe that depression is almost always caused by a “chemical imbalance” typically in seretonin and norepinephrine receptors in the brain. Most people can find some relief from antidepressants assuming they are given the right one. Unfortunately, many general practitioners and even psychiatrists, in my experience, do not know how to treat depression adequately. Many just write a perscription for the “drug of the day” for anyone that claims that they have depressive symptoms.

Of course that drug (usually Prozac, Paxil, or Zoloft) doesn’t work for everyone so the patient gets frustrated and gives up on the medication. There are many, many more antidepressant drugs available, including some very powerful new ones, but it takes time to cycle through them and find out which one works best. The doctor and the patient are often not willing to go through that process because it can take a long time and many office visits.

People that are severely depressed are sometimes given electroshock therapy (yes they still do it). Most times, the improvement is dramatic but the major side effect is memory loss.

If I can give you one concrete piece of advise MarcoPolo12 it is the following:

You have to somehow to get her to agree to go to one appointment with a psychiatrist with expertise in mood disorders. The quality of psychiatrists varies wildly in my experience (I have seen dozens) so you will probably need to get a referral from another depressed person, friend, or family member. The psychiatrist will need to be someone that does an intensive psychological accessment, has a firm grasp of the drugs available to treat it, and will do follow-up work on a regular schedule (you don’t have to tell her that last part just now). Finding the psychiatrist is something you can do behind the scenes. Just make sure they take her type of insurance.

Now getting her to agree to actually go to the appointment can be a little tricky. Depressed people don’t think rationally and often deny that there is anything wrong with them. You know your relationship better than I do so you will have to figure out how to talk her into it. I would recommend only positive talk and absolutely no blaming or implying how pitiful some of her behaviors are. Just tell her that you have noticed that she has been feeling down for a while and you have someone that might be able to help if she can spare an hour.

You can even set the appointment up for her and drive her there if that works. Maybe tell her that the psychiatrist is a friend of a family member and wanted to take a look at her after you mentioned it. Whatever works.

My wife had to fight with me to go to a psychiatrist for over six weeks before I agreed to go and I have a severe form of Bipolar Disorder that was destroying everything I had right before my eyes. I didn’t really care because there was nothing wrong with me. :wink:

I’ve suffered from chronic depression my whole life, and the thing that other people just don’t understand is that we’re not necessarily depressed **about **anything in particular. Sure, we get more depressed when losing a friend or a job or getting sick, just like anyone else. But we’re also depressed even when things are going well. There’s a constant undercurrent of depression, regardless of what’s going on in our lives.

The way it generally affects me is by immobilizing me, making me “stuck.” Imagine going through life tied into a wheelchair. You know you’re able-bodied and perfectly able to walk, but you just can’t untie yourself and get up. So you go through life as well as you can in a wheelchair, taking forever to get to places that are easy for other people. And there are no ramps.

There is so much that I want to add to this thread, but it all seems like it all has been said better by others.

I’ve been fighting with depression for the better part of my life. I’m not sad, or blue, or anything of the sort. Most days I’m nothing. I live in a place where feeling sad is something which I actually enjoy, just for the fact that I’m feeling something. Actually feeling happy is very rare occurrence, and then a very short term thing.

Others have described it as being in a grey world. That rings true. It also feels like being wrapped in a soaking wet blanket all of the time. Or like being in a movie that’s stuck on fast forward, and you’re moving in real time. Everything goes so fast, and you go so slow.

The thing about depression is when I’m in a good mood, read, not depressed, I honestly see that there is nothing wrong with my life. I am actually where I want to be at this stage. and I’m happy. When I’m depressed though, every thing is wrong. I can never pin it down to something specific, just everything is wrong. Nothing you can say will mean much of anything. Even the greatest of praise will be casually dismissed, or even taken as a criticism. When I’m good, I can’t imagine why I would feel that way I normally do. When I’m down it all makes perfect sense.

I’ve tried medications, and they didn’t work for a damn (Both wellibutrin and celexa). For a bit all was good, then my moods would disappear and I would just stop caring. I wasn’t depressed, and I wasn’t sad. I was a zombie. Stopped going to class, stopped doing much of anything. It sounds like depression, but it wasn’t. I felt no anxiety or guilt. I just had no measure of what was important anymore. I failed a test? Oh well, no biggie. Haven’t been to class in a month? Doesn’t matter. I’ve lived with depression and anxiety for so long, I don’t know how to function with out them, really. The only thing that ever seemed to help with my depression was self medicating with booze. A very dangerous road to walk down, but one I did go down for a spell (and still do). I wasn’t a heavy drinker, but I was a extended drinker. I didn’t get black out drunk. I just drank to maintain a faint background buzz, just because at that point, the world seemed all right.

So what am I getting at with all of this? I don’t know really. Perhaps just more insight into a damaged mind. Maybe it will help, probably it won’t. Anyone who has been where I am will know of what I speak, and those that haven’t won’t grasp the crux of what I am saying. Hell, I’m not sure I even get it, and I wrote it. I think until you’ve truly walked down this road, you can’t really fathom what it’s like. You may feel that you have a good idea, and you most likely do, but you just can’t grasp how all pervasive it really is. All you have in as idea. For myself, it’s like listening to somebody play guitar. I can tell a crappy player from good, and I can tell what I like and don’t like, but my understanding and appreciation is only superficial. I can’t tell a good player from an excellent player. It all sounds that same to me. Stevie Ray Vaughn? Tom Morello? James Hetfeld? You could switch them around, and I couldn’t tell them apart. I all hear is a guy making pretty sounds. Just trying to learn how to play, I gained some small insight into how complex guitar is, and how differing levels of skill sound, but in the end, as long as they don’t hit and sour notes, it’s all just pretty music to me.

I understand that. The problem is that depression is quite different from most illnesses. A person with cancer can choose to fight the disease with everything it takes, see every doctor, try every treatment. When you have depression, the “giving up” is part of the illness. Choosing to deal with depression is kind of like choosing not to have tumours.

That’s why you need to get Sharon to a psychiatrist, no matter what she says about it. Get her there. Force her.

Abbie Carmichael, I’m going to try to be gentle here, believe it or not. Your suggestion about cutting out carbs is about as ridiculous and unfounded a suggestion as a cure for depression to me as my suggesting you walk out on your kids would be as a way to lose weight.

As some of you know, I run an on-line support group for Dopers who battle depression, Cecil’s Place. While membership is strictly confidential, I will say we’ve got people there with all kinds of diet, and depression is no respecter of diet.

Marco Polo, I do sympathize with you. Many years ago, two friends of mine ended our friendship because I simply wasn’t recovering fast enough for them. I will also be the last person to tell you that “being depressed mitigates the person from any personal responsibility”. That’s an attitude I absolutely refute. Here’s the problem. I was in my late twenties before I sought treatment for clinical depression, even though I’d suffered from it since I was a teenager. When I did get treatment, it wasn’t exactly voluntary – I was close to catatonic and almost completely nonresponsive at the time. I also had a reasonably good life at the time. I was engaged to a man I was madly in love with and who was also madly in love with me; I was living in Hawaii, working in my chosen field, and making enough to pay the bills, although it was close. I also had extremely low self esteem due to some abusive stuff in my past which had never been dealt with.

Can you picture what it is to be completely without hope? To feel your soul being slowly peeled from your body, centimeter by painful centimeter, like skin being ripped from flesh? To look at your life honestly and objectively (or so you think) and see no logical reason to continue it? That’s what depression does. When I’ve been suicidal, I’ve honestly believed I’d be doing my friends a favor by killing myself and sparing them the pain of putting up with me. No, it’s not rational. That’s why it’s a mental illness.

Look, as it happens, I’ve got a journal next to me which I kept during my recovery. I’m going to share a couple of entries from it with you so you can see firsthand what’s going on in the mind of someone battling depression. Keep in mind that what you’re reading is from someone actively fighting it and being treated for it.


[ul][li]I am beautiful.[/li][li]I am intelligent.[/li][li]I have mastered a wide variety of skills.[/li][li]My opinions are as valid as anyone’s.[/li][li]My accomplishments have merit.[/ul][/li][/quote]

To explain, at the time, these were things I was struggling very hard to believe might just possibly be true. I didn’t believe them of myself at the time (OK, I’ve still got doubts about the first one).
The second entry I’m going to quote is an exchange between the negative thoughts I was thinking and what I was using to try to counter those thoughts. At the time, I’d been laid off, and, about a week earlier, had come out of the hospital for just over a week after having been hospitalized for a week after a near suicide. I’m putting the negative thoughts in bold face, and the counters in italic (in my journal, they’re side by side).

Marco Polo, please try to understand that for someone with depression, even perfect won’t be good enough, just as for an anorexic, there is no such thing as thin enough. I’ve been able to get good help, both years ago in Hawaii, and more recently here. Even so, there have been times when I’ve been lying in bed with my hand 6 inches from the phone, the number of a friend who’s willing and able to help running through my head, yet been unable to summon the will to move my hand the short distance I need to to get help. I’m as stubborn, strong-willed a person as you’re likely to meet, and I’ve been a fighter almost all my life, but depression can and has sapped me of my ability to fight and defeated my will.

I’m lucky. My depression seems to owe as much to damage done to me when I was young as to a chemical imbalance. I’ve also, as I said, found very good therapy and even better friends. Even so, the only reason I’m here writing to you is because of a miracle which occurred during that first hospitalization and a bit of luck since then. Over the years, I’ve studied several languages, written haiku in Japanese, written clean, elegantly coded progams, sung 8-part counterpoint harmony a capella, and learned to keep track of basic call changes. Even so, learning to get help, learning that I could be helped, and that I might have some merit has been the hardest thing for me to learn.

Please do encourage Sharon to get treatment, and send her my e-mail address, if you like. I’ll second cognitive therapy as an effective treatment, or at least it was for me. Eighteen months ago, when I was laid off and severly depressed, it helped when my therapist pointed out to me that, since I don’t call for the execution of the unemployed, I was being far harder on myself than I would be on any other human being when I wanted to kill myself because I couldn’t find a job. It may sound ridiculous to you, but that was honestly what I was thinking and, ironically, maybe, I thought I was taking responsibility for myself by considering killing myself when I was unable to support myself.

I hope this helps,

Thank you guys for all of the responses. Despite my frustration level being through the roof right now, I really do want to understand what it is she’s going through.

I should clarify the situation a bit further: while it would be nice if I could drag her to therapy, given the fact that she’s in a committed relationship with someone else (also a friend of mine), it’s really not my place, you know? They’re common-law, for all intents and purposes, so I would really be grossly overstepping my bounds by taking that degree of action.

I think that the suggestions to back off from her for a while are sound. I just don’t think I’m capable of unconditional friendship.

I did find a couple of interesting passages from the McWilliams book, which I am looking forward to reading in greater depth:

and also

Yes, it would be really cool if she could seek a more productive route to deal with the illness. Unfortunately, when you suffer from a mood disorder, it tends to really affect your objectivity.

Unlike an injury or a physically manifested disease where you can objectively recognize “oh, intense pain, this is an injury/condition that must be addressed!” Mood disorders are subjectively much messier. For the one suffering, the path to addressing the problem effectively may not be clear. Your judgement on the matter is affected by your emotional satet and motivation to get help can be wonky too.

First you have to have enough self awareness to realize that your moods are wonky and not legitimately produced by responding external stimulus. That’s NOT easily done.

That’s one of the reasons why she tends to “dwell” on things. If you feel like shit for no reason you think “I’m horrendously sad. Why am I sad? There must be a reason!” But there’s no reason, it’s biochemical. You are suffering from very intense moods with no external stimulus to cause it. The mood is just happening and happening BIG. So then you look for a reason. You think “oh, it must be because Auntie died. Right? That would explain it. Right?.. Right??”

Your objectivity is compromised so you can’t quite realize that you’re not reacting to Auntie’s death, you’re simply in the throes of a biochemical mix-up in your brain.

I’m mildly bipolar. It took a lot of therapy to develop strategies for recognizing the difference between a genuine emotion (e.g./ “I was dumped, I feel like shit.”) and an intense emotion that has no causal foundation (e.g/ “I feel so bad, I want to die… But everything in my life seems to be going right. How odd!”)

But when you’re feeling emotions intensely, again, objectivity goes out the window. I can be manic for weeks before I clue in and think “Waitaminute… Happiness is not a recurrent condition. This can’t be right…” Other times it’s other people who clue me in by saying “Crayons, you’re behaving a little strangely. Is everything… you know… okay?”

Unfortunately, a mood disorder can affect your judgment with respect to recognizing the problem and seeking an appropriate course of action. In order to choose a healthier approach to dealing with it, you first need to develop the skills to recognize the symptoms so you can try to regain some objectivity on the matter. Hard to do.

MarcoPolo12, the first passage that you quote is right on. That sums up my basic opinion of the treatment approach that should be used for anyone first diagnosed with mild or moderate clinical depression.

Eleanor Roosevelt’s quote, on the other hand, is a crock of shit and in no way accurate. You can tell that she has no personnel experience with depression or any experience with any one that she was close to. Why the fuck is she writing again about it then? Either was being an arrogant bitch or she was using the term “depressed” to mean a reactive sadness than true clinical depression. Given the state of psychiatry at the time that she wrote that, I am willing to give her the benefit of the doubt. It shouldn’t be included in a book on clinical depression in that case because it is highly misleading.

Um, Shag, Eleanor Roosevelt didn’t say anything about depression. That’s just a famous quote from her, “No one can make you feel inferior without your consent.” She wasn’t talking about clinical depression.

Well, she did use the word “depressed” more than once. Ok, she was a smart lady and during her time they didn’t have a good understanding of clinical depression so I can forgive her.

On the other hand, the book that quotes it is much more recent and titled HOW TO HEAL DEPRESSION. I just looked the book up on and it is a trite self-help book that costs less than $7 new. I guess I am really mad at the author for using the word “depression” in the title and lead someone like the OP to read it and think that it applies to clinical depression, take it to heart, and then quote it to us. Books like that are one of the reasons that so many people get warped and inaccurate views of what clinical depresion really is and how it should be handled. According to author, all you have to do is read the book and listen to the audio tapes and you should be just fine. :rolleyes:

You know, I’ve got a lot of respect for Eleanor Roosevelt. She’s probably the first lady I admire most. On the other hand, when most people in your medium-sized high school are treating you like walking pond scum and your own family’s giving you the impression you’ll never amount to anything, it’s kind of hard not to feel inferior, whether you want to give your consent or not. :rolleyes:

Actually, it’s my understanding that a combination of anti-depressants and therapy is most likely to be effective in treating clinical depression. That also fits my experience. When I was first treated for depression, I was on an anti-depressant and getting therapy. As far as I can make out, the anti-depressant levelled out my mood enough for the things my therapist was saying to penetrate. When I was being treated for depression last year, I was only seeing a therapist, and my experience with anti-depressants wound up in MPSIMS and only narrowly avoided the Pit (Zoloft is not right for me!).

MarcoPolo12, one thing you can do, if you like, is, well, fight ignorance. I used to think that depression was an untreatable life sentence, and that I’d be seen as a lunatic and on psychiatric drugs for the rest of my life. While I’m sure there are some people who might think less of me because of what I’ve gone through, no one of any importance to me does, and if they do so, it’s of no greater importance than people who think less of me because I’m a liberal Christian or because I’m into fencing. I’ve found not only is there treatment out there, it works. I’ve also worked out that I do deserve it and it’s ok to want it. Simply knowing that I’m not alone, that there are other people who’ve gone through this and survived it has been a tremendous help. I won’t presume to speak for my fellow Dopers, but please feel free to share anything I’ve told you with Sharon.

Good luck,

I suffer from depression and i believe the pessimism, the fatalism and the negativity are more results of the depression rather than causes. However i have read about using CBT or thought stopping to try to control the negative thoughts. Its helps, but only slightly. and only if you try really hard.