I think I may be depressed

Bob Thowaway

Hey all - I'm going under an alt here.

I'm single, 39, no wife or kids. I live on my own in an OK apartment. I have a job that isn't spatacular, but I'm not hating myself going into the office everyday. Every spring I tend to get the blues. No biggy, I go through it and find something to occupy my time.

This year has been super-rough. I've had a few family deaths. One was a younger cousin that went from cancer diagnosis to being in a casket in under 6 months. I wasn't sad about it though... Sorta went though the motions. Since then I have been on a strange attitude where I simply quit caring. I've been eating out of a gas station for a while and gained some weight. My sleep has been erratic. I've lost any modivation to hang out with friends, work on a hobby, or even giving two shits about cleaning my apartment. For the last month or so I'm been coming home, crashing after work, geting up at wierd hours and then internet-ing till I feel like lying down and look at my ceiling for a while.

I've been sleeping through days during the weekends.

Recently I've been feeling like not going to work so I don't have to get out of bed. This has been making little red flags go off that something is going down and I need to fix it. (I only have so may days I can take off from work before things so badly there)

Hyperbole and a Half did a comic on depression and it's sounding scarily like what I'm going though. The whole "I'm not sad, I just don't care" attitude is striking a little too close to home.

I think need to go see a doctor, I have new insurance that covers me much better than my employer (Thanks, Obama!). What kind of a docter do I see? I had a primary care doc under my old plan, but I don't know if he takes my new insurance or not. Actually, don't have my new insurance card yet. (I'm up to date on my premiums since January)

Ummm. Help?

knitdan

If you think you have depression you probably want to see a psychiatrist. First thing is to see if psychiatric care is covered under your plan, and if it is, try to find one that your plan will help pay for.

Even if you aren't covered, try to see one anyway.

I don't know what sort of benefits your employer offers, but if you feel comfortable bringing it up your HR rep may be able to point you toward some mental health resources.

wrong_button

The boring paperwork/procedural advice:
You can likely check your insurer's website for a professional locator - most of the big guys have that - and since you'll probably already be on the site (because you're going to want to call and get a new card so you can fill out paperwork, riiiight? ) you can probably have them send (or you can download) a booklet detailing the coverage/co-pays/out of pocket/etc. for your plan. If you aren't feeling great anyway, no need to compound it with surprise bills. It sounds like it's a whole thing, but don't be put off by it - it will only take a few minutes.

You also might start by talking to your primary care physician if you're already comfortable with them and see if he/she has a referral for you. Like knitdan said, even if mental health isn't covered (but anymore I feel like most plans have some sort of coverage, even if it isn't super), there are usually options for mental health with billing that works on a sliding scale based on your income. If your insurer doesn't have a listing, here's a page of places to start looking.

But for real, get in and talk to someone if you think you need some help. Even if it isn't "Capital-D-Depression," talking to someone might help you out a bit.

IrrationalRobot

My wife was struggling with what she thought might be depression, and so she went and talked to her primary care physician about it. The doctor gave her a short quiz, looked at the results, and confirmed that yes, she was depressed. Then the doctor was able to point her in a smart direction- so if you've got a PCP, just set an appointment and go, and talk to them. That would be a great starting point.

ThunderSaid

Good advice from everyone so far, and I'd just like to suggest that you try your best (I know it's rough) to tend to your physical health as well. Try to stop eating from the gas station, and move around as much as you can. You don't need a host of physical ailments and general physical discomforts to add on to the emotional and mental troubles you're dealing with.

Bloodycow

Also, I'm not sure where you are located, but if you need someone to talk to who can be empathic and not sympathetic. I'm available.

I'm only 32, but have been living with depression and PTSD since 2005 that stems from a brain injury in Iraq. I ignored it for far too long and ended up trying to take my own life.

I am now a suicide counselor and have been treated for my stuff since 2009. So I have some experience with what you might encounter when seeing a doctor for the first time.

RoyceSraphim

Something I tried when families deaths, druggery, and breakups came together was to find patterns in my travels and break them for something new, going somewhere different. I know this sounds cheesy but a change in perspective, a bit of adventure, can add momentum to the immediate future and make things better.

Joe Camacho MKII

Great advice so far, as someone that has had to deal with depression before, I would like to add that you might also want to consider a psychologist. I don't know the differences between a psychiatrist and a psychologist where you live, but if you are thanking Obama for your healthcare insurance I will assume you are in the USA. I live in another country so I won't assume I know them, but you could look into them yourself.

Still, the main difference between them is that a psychologist can't prescribe medication, while a psychiatrist can. I would assume that a session with a psychologist is cheaper than a psychiatrist consultation (If for some reason your medical insurance doesn't cover this situation and you need to pay out of your pocket.); psychologist are cheaper compared to psychiatrists where I live at least.

Get help, any kind of help, but speaking with someone that knows how to deal with this types of situations really does wonders, either a psychiatrist, psychologist, counselor or however you find.

RanaVex

In 2 states are psychologist psychotherapist also able to prescribe drugs, but drug-based therapy is only one part of therapy in depression. Seeking professionell help is highly recommended. Besides that, physical exercise and spending time with animals are a good way to lower the symptoms of a depression. I wish you all the best and hope that you can get help soon !

cookh4ever

Sometimes, we go through a stage of depression at one point in our life. This happens when we see no direction in life, we don't see the future with anyone else, and many other reasons. The most important thing is to be able to identify the source of your depression and deal with it. If your healthcare can give you the chance to seek professional help for free then do it. See a psychiatrist, sometimes we need the help of professional counselors just to put back "zest" and direction in our life. I hope you feel better soon.

stevemarks44

As someone who has gone through similar things and has done therapy I can't recommend it enough. Of course you should check and see what your employer covers but don't let that be the end all be all. I actually ended up going to a therapist outside of my employer's network but I could only go after work (7pm) and after a consultation with the therapist she recognized that I clearly needed some help and she offered to lower my rate to just the normal copay that I would've paid with insurance.

Don't neglect your health physically, mentally or emotionally. Hang in there, try and keep yourself as active as possible, and don't hesitate to see someone. These things pass, but sometimes its helpful to get a leg up from someone else.

Kamar

I'll agree with everyone here and add on a just-in-case tidbit. If you go to a psychiatrist and they do determine you need medicine in addition to therapy, don't freak out. It's not going to force you to be happy or anything crazy, just normalize you so you can care and enjoy things again. Also, it can take a while for a given medicine to kick in, and sometimes you'll have to do trial and error to find the right one--that's part of the normal process, just be patient.

All this assuming you need medicine to begin with, of course, but I thought it was important to say because I see way too many people bail at the first mention of medicine, or give up on medicine after the first one they try doesn't work or has gnarly side effects. Just gotta ride it out. It'll get better.

RanaVex

Another important fact about pharmacology and drugs in psychatry is the fact, that many peole stop taking the medicine after they feel better. They don't feel depressed or anxious anymore. Now many people think "great, lets stop those pills", but often we see a rebound and the people need to start over again. Taking medicine is never easy and should be well-thought, but in some cases its very important and will bring a great benefit.

darkmayo

In this case you probably need to talk it out with someone, whether that be a Psychologist, or a psychiatrist. A psychiatrist has to have an M.D. Psychologists a Phd in Physchology. (my wife is a psychiatrist) at this stage I would say Psychologist as it is guilt you are feeling from the death that is causing the depression and not a mental illness, of course both are capable of helping.

Vixx

The intent behind psychotropic medication is to enable you to engage in therapy (either in the first place or without significant disruption). The challenge of a mental health problem like depression or anxiety is that the symptoms can potentially prevent you from engaging in therapy. Medication can be viewed as a way to get a kick in the pants to actually do the stuff that will help.

The metaphor I use is that you have walked down the same road your whole life. No other road, just that one. And it's getting a bit worn. Maybe there's a pothole on that road that you can't avoid, but because you go down that road, you hit it, stumble, hurt yourself. Every day.

All medication does is kind of put a wooden plank over the pothole. So you get over it okay, but there's still a pothole beneath you.

The hard work of therapy is to actually build a new road for you to walk down (or to actually repair the pothole, whichever you want). That's harder work, but it's a more permanent fix. And because this takes time to build, and you will need to function in the meantime, the plank over the pothole is serviceable for now.

For young people, taking them off medication is easy because they react to therapy straight away - the advantage of a still-developing brain is that it's very, very flexible. It's easier to build from the ground up than renovate, as they say.

For older adults, medication is often an ongoing business, because therapy either takes much longer or they do not have the time to commit to getting the therapy they need in a timely fashion. So in that case medication and therapy is often about strengthening the plank as a priority, with repairing the pothole as a secondary objective.

So it's far more common for young people to cease medication eventually. Plenty of adults do, too, but some stay on it almost indefinitely, for a variety of reasons.

I like this metaphor because it speaks to neuroplasticity and the pathways your brain takes when processing information.

Pure Din

Vivixenne wrote: »

The intent behind psychotropic medication is to enable you to engage in therapy (either in the first place or without significant disruption). The challenge of a mental health problem like depression or anxiety is that the symptoms can potentially prevent you from engaging in therapy. Medication can be viewed as a way to get a kick in the pants to actually do the stuff that will help.

The metaphor I use is that you have walked down the same road your whole life. No other road, just that one. And it's getting a bit worn. Maybe there's a pothole on that road that you can't avoid, but because you go down that road, you hit it, stumble, hurt yourself. Every day.

All medication does is kind of put a wooden plank over the pothole. So you get over it okay, but there's still a pothole beneath you.

The hard work of therapy is to actually build a new road for you to walk down (or to actually repair the pothole, whichever you want). That's harder work, but it's a more permanent fix. And because this takes time to build, and you will need to function in the meantime, the plank over the pothole is serviceable for now.

For young people, taking them off medication is easy because they react to therapy straight away - the advantage of a still-developing brain is that it's very, very flexible. It's easier to build from the ground up than renovate, as they say.

For older adults, medication is often an ongoing business, because therapy either takes much longer or they do not have the time to commit to getting the therapy they need in a timely fashion. So in that case medication and therapy is often about strengthening the plank as a priority, with repairing the pothole as a secondary objective.

So it's far more common for young people to cease medication eventually. Plenty of adults do, too, but some stay on it almost indefinitely, for a variety of reasons.

I like this metaphor because it speaks to neuroplasticity and the pathways your brain takes when processing information.

I get what you're saying here, but I disagree with the statement that taking medication doesn't deal with the underlying problem, because everyone is different and for many people the chemistry of their brain is the underlying problem to fix.

I know in my case, therapy was like putting the plank over the pothole, diet and exercize were like fixing the potholes, and medication was like moving to a warmer town where potholes don't form in the first place.

Vixx

Neuroplasticity is a concept that neural pathways (and by extension brain chemistry) can be altered via experience. Including therapy. "Fixing" brain chemistry with medication is one thing, sure, I see what you're saying. I am not saying this to invalidate your experience. But it's been backed by research that the main benefit of therapy is that it leverages that flexibility in your brain to actually alter the way your brain works, which also means the way it accesses the neurotransmitters it needs.

Essentially medication does in the short-term what therapy can do, and that without effective therapy, you will continue to need medication. The problem is that not everyone gets the same kinds of therapy, respond to the same kinds of therapy, or receive the same quality of therapy. And because it's such an organic variable, our job as therapists isn't necessarily to figure out what the underlying problem is, but what the eventual solutions may be, regardless of whether or not you use medication to get there.

The underlying cause of your difficulties (rather than the "underlying problem") is neurobiological every bit as much as it is psychosocial, because both impact the other continually. It's both, and inextricably both. That's why the solutions should also be intertwined. You cannot disconnect the two.

You could argue that neuroplasticity changes over time, in that your brain becomes less flexible, and as an older adult that's why medication works better than therapy does. The pathways don't adjust or shift as easily as they do in a younger person. In that regard, I'd agree with you.

Bob Thowaway

Hey, just want to give you guys an update....

Went to the doctor, and he suggested a full physical, since I was 40 now, he wanted to rule out if there wasn't something physically wrong with me that was causing me to be depressed. Turns out... There was...

I have a HUGE Vitamin D deficiency. They gave me some numbers and it's supped be be somewhere between a level of 20 nanograms/milliliter to 50 ng/mL... and I was rocking 4! (12 is severe)

He said "If you were a kid with that number, you would actually have rickets" also he was surprised that I didn't have bone or joint issues, because when it gets that low the body starts trying to suck Vitamin D from bones. You want to know what else is one of the symptoms are of low Vitamin D?

You guessed it! It's depression!

So I'm on a D supplement right now and I have been put on a special diet from the doctor. I'm already feeling worlds better, so thanks for the advice to go see my GP. That is just to show, if your brain is acting funny, it might actually be something wrong with your body.

Echo

That's good to hear. I tend to have a very strong seasonal affective disorder (with the appropriate acronym SAD), and I take vitamin D supplements as soon as the sun starts setting earlier.

The thing with vitamin D is that the body has a hard time absorbing it unless you combine it with calcium supplements - that's also why the body starts chewing on the bones to get to the vitamin D. You can usually get supplements that have both vitamin D3 and calcium in the same pill, but I'm guessing your doc already told you stuff about this.

TabooPhantasy

Just make sure if you get a calcium supplement it is plant-based calcium. Most of the supplements on the market are mineral-based and our bodies have trouble absorbing that properly. It can get deposited in arteries and cause them to harden (where the term "calcification" comes from).

ceres

Talk to your doctor about what kind of calcium you should have. That's not really a discussion for here.