shereads
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- Jun 6, 2003
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Strange coincidence, since we've been posting our thoughts and experiences with depression - I just heard a discussion about it on NPR. A psychiatrist was urging patients and their physicians to consider possible PHYSICAL causes:
1) car accident - even a minor one, like being struck from behind by another vehicle going 35mph - might have resulted in an undiagnosed brain injury/bruising/swelling that changed behavior and mood
2) medications that the patient has been taking for other, unrelated conditions - including "self-medication" with alcohol, pain killers, marijuana, occasional use of coke or amphetimines or sleeping pills or tranquilizers; drug interactions/incompatible combinations of prescribed and over-the-counter drugs.
3) heart disease (I had read about this before, and in fact I had a mild heart murmur diagnosed at about the same time I was diagnosed with depression. This didn't alter the need for an antidepressant, but along with a genetic predispotion to depression and/or alcoholism, it might have aggravated my condition. The cardiologist knew I had just started treatment for depression, and told me that there is a statistical connection between even mild heart problems and chronic depression - the link might be the consistent, although mild, shortage of oxygen and lack of energy. Undiagnosed, and without any serious heart symptoms like chest pains or frequent shortness of breath, the patient is simply aware that their energy level isn't the same as other people's, and they blame "laziness" or a lack of motivation. This perception of themselves aggravates the mood disorder. It might also explain why - in some depressives - exercise helps alleviate the condition.
This NPR doc's point was that many patients and psychiatrists go directly to the psychic causes of depression and/or treatment with psychotropic drugs without first ruling out injury, disease, drinking or drug use or the effects of having ended a program of medication.
He suggests that a complete physical and neurological checkup should be a first step when someone seeks treatment for depression. He was part of a multi-year study that took brain scans of depression patients, and found a significant percentage showed evidence of bruising or other conditions that may have resulted from head injuries that had been considered minor at the time they occurred.
Now all we need is a health care system that gives all of us access to brain scans, blood workups, electrocardiograms and complete physical workups in conjunction with the care of a psychiatrist we can afford to see more than two or thee times a year because - as in my case - my insurance covers hospitalization but not outpatient care. Then we might find out that depression isn't nearly as mysterious and difficult to treat as it seems to be. It just isn't taken seriously yet by insurers.
btw: until recently, many health insurers considered Alzheimers Disease to be a "mental illness" and didn't cover treatment or patient care. Studies like the ones outlined in "Listening To Prozac" are beginning to convince the medical and psychiatric worlds that brain function and body function are not separate, and that there may be no such thing as a "mental" illness that has no chemical or physical cause.
1) car accident - even a minor one, like being struck from behind by another vehicle going 35mph - might have resulted in an undiagnosed brain injury/bruising/swelling that changed behavior and mood
2) medications that the patient has been taking for other, unrelated conditions - including "self-medication" with alcohol, pain killers, marijuana, occasional use of coke or amphetimines or sleeping pills or tranquilizers; drug interactions/incompatible combinations of prescribed and over-the-counter drugs.
3) heart disease (I had read about this before, and in fact I had a mild heart murmur diagnosed at about the same time I was diagnosed with depression. This didn't alter the need for an antidepressant, but along with a genetic predispotion to depression and/or alcoholism, it might have aggravated my condition. The cardiologist knew I had just started treatment for depression, and told me that there is a statistical connection between even mild heart problems and chronic depression - the link might be the consistent, although mild, shortage of oxygen and lack of energy. Undiagnosed, and without any serious heart symptoms like chest pains or frequent shortness of breath, the patient is simply aware that their energy level isn't the same as other people's, and they blame "laziness" or a lack of motivation. This perception of themselves aggravates the mood disorder. It might also explain why - in some depressives - exercise helps alleviate the condition.
This NPR doc's point was that many patients and psychiatrists go directly to the psychic causes of depression and/or treatment with psychotropic drugs without first ruling out injury, disease, drinking or drug use or the effects of having ended a program of medication.
He suggests that a complete physical and neurological checkup should be a first step when someone seeks treatment for depression. He was part of a multi-year study that took brain scans of depression patients, and found a significant percentage showed evidence of bruising or other conditions that may have resulted from head injuries that had been considered minor at the time they occurred.
Now all we need is a health care system that gives all of us access to brain scans, blood workups, electrocardiograms and complete physical workups in conjunction with the care of a psychiatrist we can afford to see more than two or thee times a year because - as in my case - my insurance covers hospitalization but not outpatient care. Then we might find out that depression isn't nearly as mysterious and difficult to treat as it seems to be. It just isn't taken seriously yet by insurers.
btw: until recently, many health insurers considered Alzheimers Disease to be a "mental illness" and didn't cover treatment or patient care. Studies like the ones outlined in "Listening To Prozac" are beginning to convince the medical and psychiatric worlds that brain function and body function are not separate, and that there may be no such thing as a "mental" illness that has no chemical or physical cause.
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