Challenging My Depression (3)

What if even the most severe depression were just a state of mind?
OK I have written a couple of posts on this now, and there are some questions to be answered. The first is whether I really do know anything about depression. The second would be whether I have really felt that utter despair that goes with ideas that life is not really worth living. I guess if the answer to either or both of those is 'No', then what I have to say is not really authentic - that is I am talking out the back of my neck! So here goes...
I have been a doctor since 1967, started training in psychiatry in London 1968-69, did 5 years as a general medical practitioner in the community, completed the Australian formal training program in psychiatry (RANZCP) in 1975-79, and was in private practice as a clinical psychiatrist from 1982-86, seeing 600 new referrals over 4 years. I moved back into public clinical services in 1986, and have been a clinician and academic ever since. I keep up with the literature, but do not believe everything I read. So, can I recognise the most serious despair, and diagnose depressive illness? You bet! Have I treated and managed people over the longterm and seen them reach remission? You bet; the longest clinical processes I have managed were 15 and 16 years respectively. Both are still alive and flourishing. Do I know about suicidality? Well its a long story for another day, but I believe I do.
Do I prescribe for depression? Not in every case, and I tend to be old fashioned and use drugs I know rather than all the new variants that really don't seem to be any advance on stuff I originally used in the 70s. I am cautious and careful. In addition I have a strong belief that even serious depression is driven by our life experience, day to day problems, and our interactions with those around us. Even if you prescribe as a psychiatrist, I believe you are duty bound to ALSO do all the work to assist change for all those things driving the problem.
Now the other side of the problem. Have I ever been depressed or despairing? Of course. There were several times in my early youth when I felt isolated and under pressure and despairing, and then again later in married life there were times when I got to the point of asking if life was worth living. Of course, the last two years since being paralysed have been at times challenging in the extreme - and you can read about some of this in my serialised chapters of the book 'Taking Charge' (see earlier posts 2009-10). To begin with, lying flat on your back with no movement below the waist, no control over waterworks and bowels, and nobody appearing to know what had happened was not fun.
Was it clinical depression - that is genuine dinky-dy with all the bells and whistles depression? I certainly was utterly miserable, felt totally under the control of others, could think of no solutions to my predicament, lost my appetite (very rare for me), could not get to sleep, woke early in the morning with reality pressing in, wondered whether it was my fault that I had been paralysed, had no energy, lost interest in all sorts of bits of my complex life, and at times just wanted to die to solve the problem. Was it clinical depression? You judge for yourself? Did I admit to it? No. Did I seek help? No. Is that stupid? You bet. Did I think antidepressants would help? No. Can you believe that? I would not necessarily advise you to do things my way. In the first place I would seek some sort of help.
Seeking Help Saves Lives
So what began the change in me? See Challenging My Depression (1), where I had acupuncture and the next day saw a glimmer of hope. And then I began to write every day - just little bits or odd notes. Then I began to see all sorts of odd things as funny. Hysteria? Hypomanic defence against depression? No just bureaucracy and the way it treats human beings so poorly. So I alternated between laughing at lots of stupidities, and then getting angry, and then being determined to write down the story in the form of a book. I called that getting even - not for the paralysis, but for all the petty things that happen when you are a patient or in a wheel chair. So, do I know about depression; you be the judge.
Oh, and if you are reading this, and do suffer from depression SEEK HELP, and MAKE SURE YOU GET TREATED RIGHT.
More next time...