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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by Poppy on May 14, 2001, at 8:23:18
I was just wondering whether or not people thought that depression can be purely a chemical inbalance not brought on by any pre emotional upset ect.
My doc keeps trying to relate my depression to problems or problems in my past. I have been on effexor for 2 years now (but in process of changing med) and I would like to know what people thnk. Is it mostly emotions, trouble, ect driven, or chemical inbalance unassisted by these problems???
Posted by JahL on May 14, 2001, at 12:18:04
In reply to What do you think??? Is it chemical?, posted by Poppy on May 14, 2001, at 8:23:18
> > I was just wondering whether or not people thought that depression can be purely a chemical inbalance not brought on by any pre emotional upset ect.
I think current thinking is moving towards a more biological model of depression. It has been posited that everyone has a given level of predisposition to a given disorder, which may (or may not) be triggered by enviromental/psychosocial stimulus.
However the level of predisposition is so low in some people as to become irrelavent. Sneezing could set the ball rolling. This is so in my case; mental illness was inevitable in my case. If you like, I irrefutably have 'endogenous chemical imbalance'.
That said it is reasonable to suggest that some depressions are *almost* entirely entirely enviromental in nature. I know a couple of child-abuse victims & this would seem to be the case here.
> > My doc keeps trying to relate my depression to problems or problems in my past.
Sounds like my worst nightmare; I have had the same trouble (only I have no 'problems'!!). Maybe yr pdoc looks @ things only from a psychological perspective. Maybe a 2nd opinion would be in order (it took me 4 goes-I now see a specialist *psychopharmacologist*)? Maybe it comes down to how serious yr problems were.
> >I have been on effexor for 2 years now (but in process of changing med) and I would like to know what people think. Is it mostly emotions, trouble, ect driven, or chemical inbalance unassisted by these problems???
I guess it's a rehash of the old nature/nurture debate (& one of great interest to me). I fall pretty firmly on the nature side of things, based on the experiences of a no. of mentally ill people I know (some of whom are close family), & what I read on this board. That said there is definitely a 'nurture' side to things but I think the significance of this is often overplayed (IMHO). Endless reliving of a past event won't necessarily resolve any biological dysfunction possibly caused by this. I'm not talking about the sort of counselling say, abuse victims generally seem to require.
It's also a question of causality. Many wld have it that 'problems lead to all depression', whereas I would argue that by physically treating, & resolving yr deprssion in the first instance, most of yr 'problems' will soon resolve themselves.
Hope this gives you something to ponder,
Jah.
Posted by loosmrbls on May 14, 2001, at 12:42:59
In reply to What do you think??? Is it chemical?, posted by Poppy on May 14, 2001, at 8:23:18
This is an extremely difficult question.
In my own experience, I would have told you earlier that there were no "predisposing factors" and I have no history of known abuse or neglect.
But now looking back I think I denied or minimized stressors in my life -- especially trying to balance a busy stressful career and a wife and family not adapting well to it. We tend to just accept this as "the norm" and when people ask us how things are going we say "fine." I was leading one stressful life for several years. I think even minimal stressors such as poor interpersonal skills, social withdrawal, and poor self-esteem are damaging because they make our external environment stressful even if it appears quite mild from the outside.
That being said, some people lead lives twice as stressful as mine without developing depression, so what gives?
I have to agree that I think we all have a genetic presdisposition to how much stress (in any form) or what duration of stress we can take before there are detrimental neurochemical changes and we become depressed, or develop a mood disorder. There are many studies showing that physical changes take place in the brain in response to stress and the hormones released in stressful situations -- short term they are adaptive, long term they are toxic.
Therefore, I think lifestyle changes (sometimes quite radical) and medications are both important in healing. There is no magic pill out there that will make everything better. (I wish there was!!!!!!!)
OK, after that long speech, I hope no one fell asleep!!!!
Posted by JahL on May 14, 2001, at 14:41:24
In reply to Re: What do you think??? Is it chemical? » Poppy, posted by JahL on May 14, 2001, at 12:18:04
> However the level of predisposition is so "low" in some people as to become irrelavent.This should say :
"However the level of predisposition is so HIGH in some people so as to make the nature (or even existence) of the stressor irrelevant."Or something like that.
Darned ADD.
J.
Posted by Poppy on May 15, 2001, at 8:45:02
In reply to erratum. » JahL, posted by JahL on May 14, 2001, at 14:41:24
Thanks for your feedback.
I sometimes find myself hoping that its something that i cant help or control, that way it is not my fault. I think this is more because of the stigma attatched to "depression" and the drugs associated with it.
however, i do think what I have is something that my environment cannot control. Maybe it triggered something. My dad was bipolar, unfortunately he was treated unsuccessfully, well he wasnt really treated at all. So maybe I got something from him.
And I think that the psychologists I have seen have helped me with daily stressors adn really given me someone to talk to. But as far as my depression is concerned there has been no difference for the two years now.
:)
Posted by JahL on May 15, 2001, at 16:13:23
In reply to thanks, interesting, posted by Poppy on May 15, 2001, at 8:45:02
> Thanks for your feedback.
> I sometimes find myself hoping that its something that i cant help or control, that way it is not my fault. I think this is more because of the stigma attatched to "depression" and the drugs associated with it.Of course you know it *isn't*
> however, i do think what I have is something that my environment cannot control. Maybe it triggered something. My dad was bipolar, unfortunately he was treated unsuccessfully, well he wasnt really treated at all. So maybe I got something from him.
Bipolar is *highly* hereditary. I think maybe I am 'soft' BP III. *All* my immediate family, & many relatives, have some form of my disorder. Situational? I think not.
> And I think that the psychologists I have seen have helped me with daily stressors adn really given me someone to talk to. But as far as my depression is concerned there has been no difference for the two years now.
Exactly my experience. I have tried (@ length) every form of 'therapy' going, to zero effect (tho' maybe I 'understand myself better', fwiw). I agree that therapy can be 'comforting', & at times even thought-provoking, but what does this count for if yr depression isn't improving (the end game after all)?
I sincerely hope you consider getting a 2nd opinion from a psychopharmacologist or at the very least, a 'proper' psychiatrist. If you feel you'd still like to talk then no problem, but meds offer you the hope of relief (or even complete remission!) in the *here-and-now*, especially if, as you suggest, enviromental factors play little or no part in yr illness.
Rgds,
J.
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