All Entries Tagged With: "illnesses"
Interesting Way of Putting It
This article found on the Psychology Today website says “depression is the leading cause of years lost due to disability.” I have never thought of the time I spend dealing with depression as actually losing years of my life. My life may not be cut short, as in I will die at age 50 instead of say, 80, but I could easily still loose 30 years moping around feeling unmotivated or as my mom likes to put it, “sleeping my life away.” When they put it that way there is a strong urge to actively work on overcoming depression in order to reclaim those years of my life.
The Major Scourge of Humankind
A milestone was reached toward the end of last year, and the press made no note of it. In October, the World Health Organization declared that now, among all the illnesses and forms of injury it measures, “depression is the leading cause of years lost due to disability.”
I have a personal stake in this announcement. In doubting reviews, I was twitted for claiming in my 2005 book, Against Depression, that “depression is the major scourge of humankind.” This criticism was based on a misreading. What I had written was that the WHO and other organizations interested in public health were making that assertion. The full paragraph goes: “Groups around the world have undertaken the same effort using different assumptions and weightings. The results of these analyses are similar. Varied assumptions lead to a single conclusion: Not AIDS, not breast cancer, but depression is the major scourge of humankind.”
I went on to explain how the WHO assesses disability. It uses a measure, called “disability-adjusted life years,” or DALYs, that gauges how far a disease or injury robs a person of good health. If you live in a country where the life expectancy is 80 but cancer kills you at age 60, you have lost 20 good years; but likewise, if a birth injury partially paralyzes you and leaves you 25% disabled, then if you live to 80 you will also be judged to have lost 20 good years. Actually, the birth injury would be rated worse, because the measure values years in young adulthood slightly more than years in old age. Because major depression is so common and so severe in its effects, and because its onset is often early in life, it tends to stand out in surveys focused on DALYs.
I should add that the panels that devised the rating systems used by the WHO included few or no psychiatrists. Surgeons, pediatricians, and internists made the assessments. When the results of the first surveys emerged, the prominent place of depression surprised everyone. But the findings have been consistent over time. What has changed is largely the WHO’s willingness to stand behind them and emphasize, as it did in its recent the press releases, depression’s awful status. Still, here it is: the claim I was criticized for (but did not quite make) is now the official position of the preeminent authority on global health and illness.
The survey available when I was writing was based on 1990 data; the new report has updates from as recently as 2004. As had been predicted, depression has moved up in the standings – that is, it appears yet more disabling, compared to other conditions.
In truth, the status of depression has changed only modestly. Because they kill children at birth and so rob them of a whole life span, “lower respiratory infections” and “diarrhoeal diseases” remain at the top of the DALYs list. But those categories represent clusters of differing illnesses. Depression comes next, and it is arguably a narrower category.
If you set aside low-income countries and look either at middle- or high-income countries, depression is now absolutely atop the list, above ischemic heart disease and cerebrovascular disease, above traffic accidents, dementia, and diabetes. If you look regionally, here in the Americas, depression is also outright the most disabling condition, above violence and heart disease. For women, depression is the leading cause of disability everywhere, even in low- and middle-income countries, outpacing HIV/AIDS.
One can debate the WHO measures. They count each episode of depression as highly disabling; but then, they omit more minor episodes altogether. Also, they ignore links between conditions. For example, maternal depression is a potent risk factor for infantile diarrhea. Self-inflicted injuries, which are very common in poor countries, are counted as separate from depression. And really, wouldn’t depression be a serious enough problem if it were judged only as disabling as cancer, heart disease, diabetes, or AIDS? Still, the WHO Global Burden of Disease study is the gold standard, and it finds depression to be, yes, the severest scourge.
Regarding science journalism, we live in strange times. When isolated academics use esoteric studies and idiosyncratic theorizing to question depression’s standing as a disease, that’s news. But when the world’s leading public health organization, using a quite strict definition of illness, announces that depression has become the leading cause of disability in our hemisphere – you can scour the pages of the press and find nary a report.
Good Start
2009- So far, So good.
Despite my delayed sleep phase syndrome being worse than ever, 2009 is proving to be significantly better than last year. Nothing extraordinary has happened, but I am definitely in better spirits.
Last month I increased my Paxil dosage to 15 mg. It takes a few weeks for your body to start noticing any changes, and so I decided to do an experiment. I had a doctors appointment on Monday and wanted to make sure to get all my prescriptions re-filled at that time. In order to know how much Paxil I should ask for I needed to know if 15 mg was effective. I left Tareak a note on Saturday that we should have the “baby talk” on Sunday night to see how the 15 mg was working. I could tell Tareak was excited to have the “baby talk” and I’m sure was hopeful that we’d be able to get through it without tears.
Sunday night rolled around and we set up a “picnic” on our bedroom floor and started chatting. The 10 mg Leslie could only get through about 2 minutes of conversation before crying so much that there wasn’t any point in talking further. I am happy to report that I was able to get through about 2 hours of conversation (much of it was off topic) before the tears came. This is a significant improvement in any one’s book! The big issue is still my lack of desire for a baby. Since I do realize that I eventually want to have older children I am starting to come to terms with the fact that they have to be babies first. This doesn’t make me feel any more confident in my ability to manage my illnesses and raise a child/children simultaneously, but it is a step in the right direction.
At my doctors appointment on Monday we asked the doctor about the danger of being on 15 mg of Paxil while pregnant since it is such a low dosage. Apparently Paxil is a “class C” drug which means it shouldn’t be taken during the 3rd trimester, but I could be on Paxil during the beginning of my pregnancy. There are other drugs that manage depression, but not ocd, anxiety or trichotillomania that are safe to be on during the entire pregnancy, but I don’t know if my body chemistry is compatible with those drugs. Tareak is also to the point where he realizes that it might not be realistic for me to breast-feed our babies since I may need to be on medication. Earlier in our marriage he was very adamant about our children being breastfed for at least 6 months, but he has now resigned to saying, “If it comes down to not having a baby, or having a baby that drinks formula, I’ll take the baby with formula.” I wish there wasn’t a need for such compromises.
I’m hopeful that I’ll continue to feel in good spirits this year and for Tareak’s sake hope that my desire for children gets stronger sooner rather than later!
Depression Myths- Part 2
Here are the final 4 depression myths that I have encountered most often:
5- MYTH: You can choose to be happy if you wanted to- OR- You can will depression away. If you can’t, then you’re weak
This is like a slap in the face to someone with depression. Though our thoughts do create our lives, most people do not know HOW to stop their negative thoughts or know how to reverse the resulting physiological conditions. Suggesting to someone with depression that they can just choose to be happy ignores and invalidates their current reality. Since negative thoughts and emotions, over time, cause biochemical changes that disrupt the brain’s chemistry it’s not quite that simple to just choose happiness. Depression is not cured by willpower. It goes much deeper. Depression cannot be willed away any more than heart disease or diabetes can. It’s caused by chemical changes in the body, which cannot be overcome simply by positive thinking and grim determination.
-Leslie’s Comments: This is one of the myths that I’m most sensitive to. I don’t like the idea that uneducated people out there think I am weak or don’t want to be happy.
6-MYTH: People who think they have depression are just feeling sorry for themselves.
Depression affects about 19 million people annually in the U.S. alone. Some of the most prominent and well-known individuals who have suffered from a depressive disorder include Alexander the Great, Napoleon Bonaparte, Abraham Lincoln, Theodore Roosevelt, Winston Churchill, George Patton, abolitionist John Brown, Robert E. Lee, Florence Nightingale, Sir Isaac Newton, Stephen Hawking, Charles Darwin, J.P. Morgan, Barbara Bush, Ludwig von Beethoven and Michelangelo. Not exactly people who just sit around feeling sorry for themselves.
-Leslie’s Comments: I can see how it would be easy to look at someone with depression as being lazy, self absorbed or just plain feeling sorry for themselves, but this simply isn’t the case. See my blog entry, “I’m not lazy, I’m depressed” for more of my thoughts on this myth.
7- MYTH: Talking about depression only makes it worse.
While it is easy to understand why someone might be worried about discussing their depression, being alone with your thoughts is even more harmful when facing this disorder. A lot of people with mental health problems are stigmatized in our society, so the best thing you can do to help a friend is be a good, supportive, and non-judgmental listener if they choose to talk with you. If you are hesitant to discuss difficulties you might be facing with a close family member or friend, think about other people in your life, like spiritual leaders or faculty members who would be willing to discuss your struggles. If at any point, you feel so overwhelmed by feelings of sadness and hopelessness that you are considering hurting yourself, call 1-800-273-TALK for help.
-Leslie’s Comments: I’ve always maintained the attitude that honesty is the best policy. If you are depressed start out being honest with yourself and accepting the condition. Then work on feeling comfortable talking to others about your condition. Not only can you help others learn more about depression, it can be insightful to talk with people who’s minds aren’t in a depressed state.
8-Myth: Depression is not a real medical illness.
Clinical depression is a serious medical condition that affects not only an individual’s mood and thoughts, but also the individual’s body. Individuals coping with depression have a higher level of stress hormones present in their bodies, and the brain scans of depression patients show decreased activity in some areas of the brain. Depression is a real and serious condition. It is no different than diabetes or heart disease in its ability to impact someone’s life. It can have both emotional and physical symptoms and make life very difficult for those who have it. The medical community has acknowledged the seriousness of depression and recognizes it as a disease. While no one is completely certain what causes depression, we know that genetic and biological factors play a significant role in development of this disease.
-Leslie’s Comments: Like most mental illnesses, it has taken people a long time to recognize such conditions as “medical”. I look at my depression, trichotillomania, and other mental illnesses the same way as I look at my severe allergies. You learn to live with the illnesses and treat the symptoms with medication or whatever methods work best for you.
Hopefully after reading these myths you are a little more educated and will be a little more understanding of those who suffer from depression.
Sources:
http://www.ldsmag.com/familyconnections/040524depression2.html
http://www.healthcentral.com/depression/just-diagnosed-822-143.html
Depression Myths- Part 1
Since “coming out” about my depression I have had varying responses to my blog. Most people have been very supportive and understanding. Many people have been able to relate. But there is a small group who have a harder time with my blog for some of the following reasons: 1- they have never experienced depression, or known anyone who was depressed therefore never had any real reason to educate themselves about depression, 2- they think depression is something bad or something to keep hidden and deal with on your own, or 3- they don’t acknowledge or recognize that depression is an actual medical condition, not just a fleeting bad day. I have found some common “Depression Myths” online from several sources (all cited at the end of this article). I have gone through and chosen some that I feel are the most common or at least the ones I’ve encountered in discussing depression with others.
1- MYTH: If you have depression you are depressed all the time.
Depression is most often something that comes and goes not something you feel 24/7. This misunderstanding about depression makes it deceptively easy for many with mild depression to believe they don’t really have a problem to address, but are just having “occasional bad days.” This is particularly concerning because the quicker you start taking care of yourself and get the help you need, the quicker depression can end and the easier it will be to heal.
-Leslie’s comments: Another side to this myth is to help others recognize that even though you are laughing and smiling you can still be depressed. See blog entry “Not always as it seems” for more on this subject”
2-MYTH: Depression does not affect children or teenagers – their problems are just a part of growing up.
We’d like to believe that all children experience a happy, carefree childhood, but that’s simply not the case. According to the National Institute of Mental Health, studies show that 1 in 33 children and 1 in 8 adolescents are depressed in any given year. Children are not as practiced at articulating their feelings as adults, so adults must take the initiative to look for and notice symptoms of depression in children.
-Leslie’s Comments: My first major bouts of depression occurred when I was in High School. My parents didn’t recognize my symptoms as depression and instead would continually ask me if I was using drugs (as in illegal drugs). Anyone who knows me well, knows how funny their suspicions were because they were so far from the truth.
3-MYTH: Depression only happens when something bad happens in your life, such as a breakup, the death of a loved one, or failing an exam.
Depression is more than just having occasional sad thoughts. While everyone experiences ups and downs in life, and often will feel sad for some time after a serious loss or disappointment, developing depression does not require a specific negative event. Prolonged periods of hopelessness, sadness, and lack of interest in things someone usually enjoys are symptoms of depression. Depression can arise suddenly, even when things in life seem to be going well.
-Leslie’s Comments: This myth seems to be particularly common. People always seem to want to know “Why” you are depressed, implying that something bad must have happened to make you feel down. While you can feel depressed and down for short periods of time after something bad happens, this is not classified as the medical version of depression.
4- MYTH: Serving others will cure depression.
Contrary to popular belief, service does not cure depression. Serving from an empty bucket is akin to squeezing water from a stone and will merely drain your already low reserves and make it less likely that you will have time to address your own needs and your own healing. We would never tell someone with a broken leg to just fast and pray to get better, neither will temple attendance or scripture study or service heal the imbalance that has occurred in the brain from accumulated stressors.
-Leslie’s Comments: From a religious point of view depression can sometimes be seen as simply allowing Satan into our lives and giving in to his negative influence. While service is always a good thing to do and can many times make you forget your own problems and worries you would never tell someone with cancer to just forget themselves and go serve someone else in order to fix their illness.
I will address an addtional 4 common myths in my next post.
Sources:
http://www.nmha.org/go/backtocampus/depression
http://www.healthcentral.com/depression/just-diagnosed-822-143.html
http://www.ldsmag.com/familyconnections/040524depression2.html