NYTimes: It’s Not Always Depression

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I would love to hear your views on this interesting piece by a therapist: It’s Not Always Depression

What if we’re sometimes treating, diagnosing the wrong problem?

20 comments

  1. This is an excellent article, unfortunately more kids are raised in a home that is emotionless, loveless, kids tolerated, that do not suffer to the extreme as this patient of Hilary Hendel. I guess they grow up and realize they were raised in error. What is a bigger disgrace is being ordered to see a psychologist, and him “holding it against you” for showing emotion. Using his hand and snorting noises to mimic , ridicule someone having an emotional reaction to digging up past issues that were buried. So the statement Hilary makes , is this is core emotions , anger , sadness, joy, and ‘when experienced viscerally lead to a sense of relief and clarity”. Contradicts the quacks opinion, A psychologist who was basically a hired gun , should not be around people. It makes a person never ever want to associate with anyone in the profession ever again. It is like a shame in itself. thanks for sharing the article.

    Liked by 1 person

  2. That is the problem with going to psychologist is they must give you a diagnosis when you may not need a diagnosis, and so you are labeled.
    That is not right, too many quacks out there willing to put a label on a patient to help a government agency.

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    1. Insurance demands often seriously distort the diagnostic process. There are perfectly sound diagnoses that get avoided like the plague in inusred patients as they nearly promise denied coverage. I’ve even been told of nurses required to seek assessment with a Board-approved psychiatrist, apparently to trigger this effect and justify termination of licensure. If you pay cash, no diagnosis is required. Thanks for your feedback – Greg

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  3. Well, I have the luxury of having received several different labels. Labels are for cans. They do not belong on people.

    I have also had the luxury of being prescribed and using just about every different type of SSRI, SNRI, Tricyclic, and MAOI Inhibitors to combat depression. I have also had many types of polypharmacy and Lithium. I know longer use any of this shit. My thought process is that drugs should be the last resort and not the first.

    My ending thought is that the story is where the healing is. Peer to peer in a supportive environment works. Writing works. Well anyway.

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    1. I work mostly with the last resort crowd, myself. I myself would be dead, more than likely, without medicine that has few if any adverse effects, for me, other than the need for a prescriber and remembering to take it. Lots of people seem to skip right to meds for much less dire circumstances, doing themselves a disservice perhaps; I see many others who err the other way, avoiding meds and suffering over and over and over, ignoring obvious and painful lessons. I counsel against either error.

      Liked by 1 person

      1. Frankly, we probably both agree that what is right for one may not be right for the other. My opinion about the usage of SSRI’s and other psychotropic drugs is somewhat corrupted by the pharmaceutical industry that has gone amok. It is not what we know that is evident; but what we do not know.

        Liked by 1 person

  4. I have PTSD, I was sexually abused at the age of two. Things went downhill from there.
    In comes psychiatry, you have major depression and PTSD. They give me Prozac. It doesn’t work. Amped it up to full dosage. Bingo I’m bi-polar. I constantly have hard to live with side effects. Finally the medication went toxic and I almost died.
    I quit medication, went in a healthy vegan diet after consulting a nutritionist. No more depression.
    I still have PTSD. I need help with sleep and anxiety.
    I take wellbutron, buspar , clonazapam and ambien. I don’t take the ambien or clonazapam all the time.
    I’m still on a good diet. I will have bi-polar stamped on my forehead because Doctors don’t retract a diagnosis. I haven’t been depressed in four years. Not bad for a bi-polar-I rapid cycler.

    Liked by 1 person

    1. Regardless of diagnosis, one can safely assume there are many causes potentially involved, many posssible avenues of recovery: only some of them medications, and meds offer many risks to be respected. I often see patients benefit from discontinuation of certain meds, especially when a treater somewhere had made a bad bet. Bipolar and other illnesses are often episodic, so it becomes hard to determine sometimes what helps, versus what you tried at a fortunate time when things would soon get better regardless. No easy answers! Plus, people are so different, their illnesses so different even with the same label, that what works for one offers little useful information for others. Each must find their own way, sad but true. It helps to fing a trustworthy guide for the journey, a project in of itself. Thanks for taking the effort to provide your story! – Greg

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  5. Reblogged this on After Midnight: A Christian Bipolar and commented:
    These were my comments after reading the article. What do you think?

    “I don’t know, I get the impression that shame and guilt partly manifest themselves AS depression. And in PTSD which it sounds like is an aspect of this person’s illness – one of the symptoms of that being depression. It IS complicated. I don’t know that shame/guilt should be separated out. I do think of course that part of this person’s treatment plan would be as described in the article.

    I have a HUGE component of shame and guilt as part of my depression. Most of that shame and guilt due to having a mental illness (I am bipolar and have general anxiety disorder as well) My depression HAS been intractable 😦 Of course, some of it incurred as a child; I related so much to the client’s issues with that, part of the fallout of being one of 8 kids. My therapist sadly says that, were it not for my lack of acceptance and guilt for having my illnesses, I would not struggle so much, and I think he’s right.”

    Liked by 1 person

  6. I don’t know, I get the impression that shame and guilt partly manifest themselves AS depression. And in PTSD which it sounds like is an aspect of this person’s illness – one of the symptoms of that being depression. It IS complicated. I don’t know that shame/guilt should be separated out. I do think of course that part of this person’s treatment plan would be as described in the article.

    I have a HUGE component of shame and guilt as part of my depression. Most of that shame and guilt due to having a mental illness (I am bipolar and have general anxiety disorder as well) My depression HAS been intractable 😦 Of course, some of it incurred as a child; I related so much to the client’s issues with that, part of the fallout of being one of 8 kids. My therapist sadly says that, were it not for my unacceptance and guilt for having my illnesses, I would not struggle so much, and I think he’s right

    Liked by 3 people

    1. Clearly, increased guilt and/or shame is a common and often prominent symptom of depression and other mental illnesses. THis article described people for whom treatment aimed at depression had been unsuccessful despite multiple treatment trials. This happens more often than anyone involved would like. Often enough further trials lead to relief, but the longer one approach has failed, the more interesting alternative theories become. Despite one word, “Depression,” the group of people to whihc this label might apply are a quite diverse group, likely reflecting multiple underlying etiologies. Hopefully we’ll see more diagnostic clarity soon. Good luck with your recovery, and thanks for your thoughtful comment and reblog – Greg

      Liked by 1 person

  7. It is encouraging that the mental health analysts are learning that not every mental issue can be treated by drugs. Drugs are not the be all and end all or quick-fix that is often promoted. “Relationships’ or emotional connection that we as humans crave, cannot be underestimated or trivialized otherwise the repercussions can be endless as in Brian’s case.
    Seeing the therapist twice a week for four years must have been an expensive exercise, as pointed out by someone. It is an indisputable fact but he had been living with his issue practically all of his life and in the grand scheme of things, 4 years to try to undo the damage is minuscule in comparison and more importantly, it appears to have been effective and dare I say it, successful in restoring his peace of mind.

    I iterate that I’m no psychoanalyst but i do use common sense and the above is my humble opinion.

    Liked by 2 people

    1. Well put! Medications remain first line and likely overused for multiple reasons. As expensive as they usually are, they remain cheaper than intensive therapy, far more widely available, and far more often covered by insurance. Many people also expect treaters to “fix” them more quickly and easily than therapy allows, akin to expecting a healthy weight, blood pressure, cholesterol, etc. without changing diet or exercise habits. THanks, Wendy, for your thoughts – Greg

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