Hey all
Since 1960, The Hamilton Depression Rating Scale (HDRS or "The HAM-D") has been the gold standard in identifying and evaluating depression in humans. I have always felt that it lacked some very basic and important questions. I have found that there are certain behaviors that are common in nearly all people who are at least moderately depressed. Here are 5 that I used to continually observed in depressed clients. The HAM-D doesn't even mention any of these. It is still a useful tool, but I think that it would be more effective (and could more readily cut to the heart of the matter) if it included the following. (If you find that 2 or more of these describe you, you are more than likely to be clinically depressed at this moment).
1.It feels like the clock is moving too slowly. Every time you glance at the time, you wish that it was later. Conversely, a happy person usually thinks that the clock is moving too quickly.
2.You are too depressed to seek help. You feel that you need it, but can't imagine getting yourself together and enduring the rigors of an office visit.
3.You let your personal hygiene slide a bit. Many report that it is next to impossible to get together the motivation for something like a simple shower.
4. You find it progressively more difficult to get out of bed in the morning, as you begin using sleep as escapism.
5.You have trouble staying awake in the daytime. Time feels like it is moving so slowly that you can't imagine how you will be able to endure it until your next scheduled bedtime.
Does anyone care to say if they are prisoner to any of these behaviors? We can use that as a starting point and then further develop the five of these, and ultimately provide some workarounds to these problems. Thanks!
(01-08-2018, 03:16 PM)Naomi Wrote: [ -> ]The first one is me every day all day. It doesn't matter if I'm at work or at home, I'm always watching the clock. Watching the time slowly tick away until I can "reasonably" get back into bed.
You would not believe how common that symptom is, yet it is hardly ever talked about. That is the first thing that changes for me when I am entering a depressive state. When I am not depressed, there aren't enough hours in the day for me and I want to live to be 100. Just the opposite is true when I am depressed. I look forward to reading more posts by you. I know that you are on a posting limit. Have a great day. RM
RM, without trying to hold your hand in the shower, let me just say that I find your posts to be helpful as all get out. Your experience gives you a unique perspective that's sorely needed in an environment like this, and I always find a great deal of useful information in them.
Kudos my friend. I hope you stay with us for a long time to come.
OB
(01-08-2018, 03:46 PM)Rafterman Wrote: [ -> ] (01-08-2018, 03:16 PM)Naomi Wrote: [ -> ]The first one is me every day all day. It doesn't matter if I'm at work or at home, I'm always watching the clock. Watching the time slowly tick away until I can "reasonably" get back into bed.
You would not believe how common that symptom is, yet it is hardly ever talked about. That is the first thing that changes for me when I am entering a depressive state. When I am not depressed, there aren't enough hours in the day for me and I want to live to be 100. Just the opposite is true when I am depressed. I look forward to reading more posts by you. I know that you are on a posting limit. Have a great day. RM
Wow, you described it exactly how it feels for me, too. I'm sorry to hear you're suffering, I hope you're finding help whether it's meds or therapy. I do a combination of both and that seems to help the best it can. There doesn't seem to be a magic solution, at least not that I've found.
Hey Rafterman,
You know a lot about depression and I think I speak as others have when I say I appreciate your sharing your 30-years, if I remember correctly, knowledge and experience helping others with us.
I knew about these types of questions. If a psych asked me, I would just lie. But when you are asking them of yourself, by yourself, you kind of think, yeah, I couldn't wait to leave my job, so I could go to bed. That getting out of bed and yawning was a reason to get back into bed. That just because I actually, miraculously made the bed, doesn't mean, I can't roll back those blankets after being awake a few hours.
Thanks for all the info!
(01-08-2018, 06:34 PM)OldBoy Wrote: [ -> ]RM, without trying to hold your hand in the shower, let me just say that I find your posts to be helpful as all get out. Your experience gives you a unique perspective that's sorely needed in an environment like this, and I always find a great deal of useful information in them.
Kudos my friend. I hope you stay with us for a long time to come.
OB
I can't thank you enough for that compliment. OB. You are a very kind person and that is the first thing that I noticed about you. With people like you on here, I will continue to be the posting fool that I am for as long as management will have me. I couldn't be happier here. I love the people, I love the management, and even love the way the site lays out. Its all good and that is so rare these days. Thanks again, man. RM
(01-09-2018, 01:24 AM)fishfarmer Wrote: [ -> ]Hello My Friend, 3 of the signs I most definitely have, and have been aware that I have depression as on the weekends I sleep so much, and at work minutes are hours. Nice to know as you shared with me that they can swab your cheek and find a good match. Am still hesitant after my Paxil experience. Are sexual side effects common in most AD's? Will not go into detail, but that really F-'d things up for me and I love Women and will not take that chance, any thoughts Rafterman?
Howdy FF, my Brother, Genetic testing for the best AD is really exciting. Insurance companies are starting to cover it, more primary docs are starting to administer it. It will save so much time, money and suffering. As the word gets out, doctors will scramble to include it as part of their services. As for your question about the sexual side effects of AD's, it is said that around 60% of patients taking SSRI's or SNRI's will be adversely affected in that way. Judging my the client's whom I have seen, I would say that figure is probably correct. It also varies from AD to AD. In most cases, its a problem with decreased libido. This affects both men and women. We wouldn't often try lowering the dose or switching up AD's. If nothing else worked, we would prescribe a vacuum device, or ED drug. Mind you, these people were already suffering from depression. The appetite for sexual gratification is a major daily motivating force for most people (similar to how an appetite for food is a primary daily motivator). Take it away and you are looking at someone who will probably sink deeper into depression. That is why we treated it aggressively. On the other side of the coin, there was the side effect of priapism caused by AD's. (A prolonged erection without sexual arousal). More common than you might think and sometimes requiring surgery (or the most embarrassing ER visit of your entire life). These potential side effects are one of the reasons that we didn't rush someone onto AD's, particularly if they were male. No drug is perfect, AD's included. The glossy ad campaigns make it sound like they are all completely benign. I am not saying that they aren't useful and needed in many cases, but I think that the future of depression treatment lies in u-opioid receptor agonists. That's just my opinion, though. With the huge money behind conventional AD's, I don't think that they are going anywhere anytime soon. RM
I think that both alcohol and benzos can provide short-term relief and if used with discipline can really help and unwind. But if abused Unfortunately they will just add to your suffering. I also noticed being depressed I become antisocial I don't want to go out much or visit friends I like to just stay home more. I believe 3 things in your life affect your mood and attitude. That is where you live, who you live with, and what you do for a living. But sometimes it's just in our DNA to deal with depression and although it's gotten a lot better these days a lot of people who don't have it or I've never experienced it will never understand it, and some believe since they have never dealt with it it does not exist.
(01-09-2018, 01:58 PM)FirePlaces Wrote: [ -> ]Hi RM,
Genetic testing for the best AD sounds like a huge step forward for depression treatment. I googled it but could find no information. Could you elaborate?
Thanks,
Fire
Hey Fire,
You have an in-office cheek swab at your doctors to get a sample of your DNA, which they then send off to a lab to be mixed with different AD's. The lab reports on how each med metabolized. It can also be done with PK meds for people who suffer with pain. The old way to find the right med for a patient was a long PET session with IV introduction of different medications. This new way is exciting because it relies on DNA and is also so easy to participate in. When I had MDD, it was torture to accomplish the simplest thing. A trip for a PET scan would have been like climbing Mt Everest.
GeneSight is the largest company of the few that are springing up. Insurance companies are beginning to cover gene testing. Medicare and Medicaid both cover it, 100%. Other insurance companies usually require a co-pay. GeneSight claims that the cost is usually a couple of hundred dollars. The fact that Medicare and Medicaid cover it is a very good sign. In my experience, they usually only cover tried and true procedures, not snake oil. It also bodes well for the future coverage by private insurance companies. RM
(01-10-2018, 01:22 AM)fishfarmer Wrote: [ -> ]Thanks for the advice My Friend! I over-use, OK abuse Alcohol. I know it is a depressant. Does Benzo use over time because of it's sedative effects worsen or contribute to Depression? I think a lot of folks would be curious to know. Thanks-FF
Hey FF,
Benzo's do have a slight depressant effect. That effect is more pronounced in some people than in others. What combats that is the relief from stress that they give. In other words, they would work best for someone whose depression is primarily stress-based. Remove the stress and much of the depression lifts. A person in this situation would hardly notice the depressant effect of the benzo. Other who suffer from a more conventional form of depression (a depletion of the biochemicals in the brain that control feelings of satiation, comfort, safety, motivation--and/or a problem with the receptors which activate those biochemicals) may be made worse by benzo (or alcohol) use. C-pam use, for instance, is associated with increased levels of frustration and anger. Each benzo has slightly different properties. I would think that every person is also a little bit different. Over all, I would still think that it was prudent for a doctor to prescribe a benzo to any patient, depressed or not, who suffered from chronic or severe anxiety. Just my opinion, though. Take care, my friend. RM
(01-08-2018, 10:46 PM)Blockhead59 Wrote: [ -> ]Hey Rafterman,
You know a lot about depression and I think I speak as others have when I say I appreciate your sharing your 30-years, if I remember correctly, knowledge and experience helping others with us.
I knew about these types of questions. If a psych asked me, I would just lie. But when you are asking them of yourself, by yourself, you kind of think, yeah, I couldn't wait to leave my job, so I could go to bed. That getting out of bed and yawning was a reason to get back into bed. That just because I actually, miraculously made the bed, doesn't mean, I can't roll back those blankets after being awake a few hours.
Thanks for all the info!
Very much my pleasure, BH. Thank YOU.
I always thought having Benzos would make it so much harder to stop drinking because they would basically erase any hangover. Not taking them anymore really kinda amplified the hang-overs and eventually got me to quit drinking with Naltrexone. It was quite the process and some days still kinda have the suck but I'm glad it finally worked.
(01-11-2018, 03:45 AM)coffeedude22 Wrote: [ -> ]I always thought having Benzos would make it so much harder to stop drinking because they would basically erase any hangover. Not taking them anymore really kinda amplified the hang-overs and eventually got me to quit drinking with Naltrexone. It was quite the process and some days still kinda have the suck but I'm glad it finally worked.
Hang in there, my friend. People talk about how hard it is to kick all kinds of substances but, truth be known, alcohol is as hard to put aside as any of them. Even harder than most. It's been a long time now, but I do know from personal experience, as well as counseling. Stay strong. RM
(01-11-2018, 02:14 AM)fishfarmer Wrote: [ -> ]Great Post Naomi, I to, years ago would always have a couple beers as my anti-anxiety med and it gradually grew to 15 or so every night after work. Still an alcoholic but down to 6-8 a day, it's a start anyway! Med's are much kinder to a person than alcohol, but it is a hard habit to break, and Hat's Off to you for doing so! Best Wishes-FF
Way to go, my good friend, FF. I think that you have a tremendous amount of resolve. The most amazing thing is how you continually put aside the problems you have in your own life and come on here and encourage others. It is really inspirational. My best to you. RM