Quote:
Originally Posted by Stellatum
I'd like to distinguish two completely different points here. The first is that some people with an undiagnosed illness are told that their symptoms are being caused by depression, and their doctors give them anti-depressants instead of trying to figure out what's wrong with them. You were in that situation, and your response makes a lot of sense to me. I hope that in your situation, I would have done the same thing.
The second point, the one I've quoted above, that feelings of sadness etc. are a normal, healthy response to a very sad situation, is different. GrannyJo4 is diagnosed. She is being treated for depression in addition to receiving medical treatment for her MS and MG, and not instead of it. I want to think about your point in this situation, too, as well as in the first.
I once talked to someone whose husband had left her, and she'd been thrown into a state of despair. She was taking anti-depressants to help her function at all. I suggested (this sounds really tactless, but she took it well and I learned something) that her emotions were normal and not pathological, and thus shouldn't be treated. She said, "Well, if your hand got cut off you'd be in terrible pain. Pain is there for a reason. It's a healthy response of your body to a trauma. But you'd still take pain medicine."
Depression is not the same as grief, sadness, anger or anxiety. Depression is when some central part of your personality, what makes you you, isn't able to function properly. Depression can be triggered by things happening in your body (like chemical imbalances) or by things happening in your emotions (like being discouraged about the way your illness is affecting your life). But in either case, the depression is something distinct from its trigger, and it is good to explore ways to address the depression itself as well as (not instead of!) its underlying cause.
So: does it make sense to take anti-depressants when the cause of the depression is healthy, appropriate, normal emotional reactions to something tragic? Maybe not, as you say, if the point is only to suppress these emotions. The emotions themselves aren't the problem. But if the point is to suppress the depression that is a secondary effect of these emotions--then yes, if it works, it makes a lot of sense.
I hope this is coherent. I'm sort of thinking out loud here--I'm always trying to figure this one out myself.
Abby
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Abby,
You raise two important questions: one is that of diagnosed (vs. undiagnosed) illness. and the other is pharmacological treatment (vs. no such treatment) for painful (and even at times debilitating) normal emotional responses.
First: You say that GrannyJo is diagnosed and treated for MG and MS, but according to what she says her major current symptom is neither diagnosed nor properly treated.
Also, she didn't say-I feel that I need to be on an antidepressant because of debilitating emotions, but "my doctor is suggesting that I need to be on one"
The point I was trying to make is that (according to my personal opinion) she doesn't need to be on one just because her doctor thinks so (most likely because he doesn't understand or know how to properly manage her physical symptoms).
The answer to the other question you have raised is much more complex and controversial.
Reactive depression is normal sadness, which means that the vast majority of people would have a similar response under similar circumstances. (such as the loss of a loved one or the diagnosis of a serious illness) Pathological depression is a psychiatric illness (just like schizophernia) in which overwhelming and debilitating emotions occur out of any reasonable context. The severity, pain and debilitation can be similar.
There are two major approaches in psychiatry to this-one approach is that which you cite-it doesn't matter if the depression is pathological or reactive, one has to treat those symptoms. ( Interestingly, even those that take this approach would not treat the normal grief of losing a loved one, unless it is beyond a reasonable period of time). The only distinction they make is among depression and normal grief over the loss of a loved one.
If you are interested in this topic there is an excellent book
http://www.amazon.com/Loss-Sadness-P.../dp/0195313046
The other approach is that reactive/normal depression has a role. Which is personal and social. It stems from a very complex cognitive and behavioral process, with social ramifications. This process, if uninterrupted should gradually help you and those around you come to terms with your loss. It also leads to finding constructive ways to deal with it. There is a reason why it is manifested in ways that can be seen by others (such as tears, facial expression etc.), as it makes those around you understand your vulnerability and need for support.
There are studies that show that labeling normal grief as depression and intervening , only lead to a much longer healing process.
The need to suppress those emotions is not always because of unbearable pain to the individual but a social need in a society that constantly advocates being happy and having positive thoughts (and therefore intolerant to unpleasant emotions) .
My opinion on the matter, based on my experience, is that more times than not, reactive depression does not require any medical intervention, if given proper place and support. Just like any other reactive process it is self-limited. And just like I would not treat an enlarged reactive lymph-node with chemotherapy, I wouldn't treat reactive depression (which I prefer to call normal grief) as depression.
But, as I have said there are others who think differently.
The psychiatrist I consulted thinks differently. But, she respected my approach, just like I respect a patient who wants to take anti-depressants. She has been enormous support to me, mostly by encouraging me not to accept the unreasonable explanations and non-substantiated psychiatric diagnoses of some of those who were supposed to take care of me over those years. Even though we differ in our opinion regarding the optimal management of reactive depression, she and I share the opinion that people are free to make their own decision, as long as they are well-informed and understand what it is based on.
Bottom line-In my opinion, If GranyJo feels that taking anti-depressants would be helpful to her, she should definitely take them. But, if she is given anti-depressants by her physician (as was my impression) because it is the "easy way out" then she has the right to refuse them.