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Thread: After 47 years, I finally have depression.

  1. #21
    I think each individual is different. And depression doesn't mean you are suicidal. Here are the symptoms that can be seen-



        • *Little interest or pleasure in doing things
        • Feeling down, depressed, or hopeless
        • *Trouble falling or staying asleep, or sleeping too much

      • Feeling tired or having little energy
      • Poor appetite, overeating, or considerable weight changes
      • Feeling bad about yourself – that you are a failure or having a lot of guilt

    • Difficulty concentrating on things or making decisions
    • Moving or speaking slowly, so that other people have noticed, or being so restless that you’ve been moving around a lot


    (This is just one of the possible signs/ symptoms, the most obvious)-Thoughts that you would be better off dead, or of hurting yourself in some way.

    I will ask my patients if they are depressed. A lot of times they say no- just down a little bit. When I ask-about the enjoying things they did before- that seems to be the real eye opener. I just don't feel like doing it or I do it but don't have the enjoyment I used to.

    Everyone has some of the signs/symptoms occasionally but continued or consistent for a length of time is the "depression".
    And no one should be ashamed or embarrassed to admit their feelings.

    CWO
    The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

  2. #22
    Quote Originally Posted by funklab View Post
    I don't think his statement is a slight to the disabled community, but I do think it is incorrect (at least the way you have worded it here, which may be close to but not exactly what he said, memory is a tricky thing especially memory from years in the past). My main point of saying he was wrong was to point out that expert opinion (which seems to be all he has provided) can be contradicted and to provide that contradiction (and I still assert that I have as much psychologic training as your expert and in addition I went to medical school for 4 years which he did not). Using the wording as you have provided his argument it seems impossible to prove and easy to refute. Psychologists use the same diagnostic manual (DSM-5) that we psychiatrists put out every few years, and there is no recognized diagnosis for "residual depression", I am going to be a little long winded and nitpicky below, but I think words are important here and I think the overall point is important. To say "by definition" SCIs have depression would mean that if one was not depressed, not a single symptom of depression one would not have a spinal cord injury, despite their paralysis and loss of sensation... that's what "by definition" means.

    But I don't think that's what you meant. I think you were conveying his assertion that SCI causes residual depression and that it is inevitable and happens to all people with SCI. In addition to being an unhelpful conclusion, this is extraordinarily difficult to prove scientifically and easy to refute (and I will disprove it momentarily). If one were to attempt to prove it, he would have to prove within an acceptable margin of error that 100% of people with SCI were "residually depressed" by whatever way he chose to define that (perhaps a zero on the full 29 question Hamilton Rating Scale for Depression, which is probably the most studied rating scale), this would require getting at least several hundred if not several thousand SCIers, none of whom score a zero. But if you gave the rating scale to all SCIers (globally there must be at least a few tens of millions of us) and even one person scored a zero this theory would instantly be disproven. My point being it is extremely difficult to prove such an absolute statement as "all" or "never" or "always" with any scientific certainty. This is the main reason why I felt the need to make my original comment (apologies to the OP for going so widely off topic here) and why I'm so certain the statement as provided to us here, is not true.

    So allow me to disprove your statement. Just for fun I performed a Hamilton Depression Rating Scale on myself right now, admittedly it is supposed to be clinician administered, and not taken by the patient, but I am a clinician after all. I scored a 3. You have to have at least a 7 to qualify for "mild" depression. This study is obviously an N = 1 study that wasn't blinded (and I probably invented a whole new category of bias since I am the only participant and the only investigator), but that is entirely sufficient to disprove your psychologist's statement because it was so absolute. Therefore, by a very reasonable and widely accepted metric I do not have depression (even "mild" depression, though as I pointed out I don't know what "residual depression" is because that is not a defined term in our field). Therefore I conclude that your psychologist's assertion has been thoroughly disproved (or if we want to get technical with your word choice quoted above, this means I no longer have an SCI, hooray!)

    But that's just a bunch of technicality and nitpicking... I feel like the grammar police with the last couple paragraphs. However, the reason why I think it is important to dispute your statement is that seems very fatalistic. Like, "oh I have SCI, I'm bound to be depressed, there's certainly no way I will ever be completely free of depression because 'by definition' I will have some residual depression". If one were to believe your statement and take it to heart it would be expected to lead their thinking toward more depressed thoughts. If a new SCI were to read that statement and believe that they are now predestined to be depressed, I bet that would have good odds of being a self fulfilling prophecy and increase their odds of getting depressed. And that would be a shame because it is absolutely untrue. You can definitely be not depressed... even happy, and have a SCI.

    If you have depression, treat it, whether or not you have SCI. You CAN get better and there is no reason to think you are fated to be depressed just because your spinal cord doesn't work. There are dozens of effective drugs to treat depression (again, they work whether or not you are SCI and there are many, many studies proving this). The drugs generally work about as well as seeing a good therapist weekly for a few months, and the antidepressants and therapy together work better than either alone. There's also electroconvulsive therapy which is the one most effective and fastest treatment for depression and transcranial magnetic stimulation along with a bunch of other things you can do for yourself to improve your depression (exercise - lifting weights works slightly better than aerobic exercise the studies suggest, bright light therapy or just getting out in the sun more, eating regularly and healthy even if you don't feel like it, etc).

    I feel like I've been pretty oppositional on this thread, especially towards you, Patton, my apologies, but I think your psychologist's theory is wrong and has the potential to cause unnecessary harm, therefore it's important to point out how and why it is wrong. Yes, you are more likely to get depressed if you have SCI... how well we all know the reasons for that! But it is absolutely wrong to suggest that you are inevitably going to be a little bit depressed if you have a spinal cord injury. I'm very open to being proved wrong, but I think it highly unlikely there is real scientific evidence to disprove my assertion, and I have conducted my own study of myself to disprove it quite easily.
    No worries funklab... I appreciate your thoughtfulness and convictions. I myself have questioned the doctor's position.

    I'm no authority on depression but my own rules for the road are:
    - Visiting that SCI place of things you can't do, for too long, increases the chances of getting stuck
    - If going on an anti-depressant consider an end game of coming off it at some point (1, 2, 3 years, ...) or a reason for staying on it
    - The SCI way of life is not easy no matter the circumstances

  3. #23
    I felt depressed before, but this is the first time I had to seek treatment for it. I have taken Lexapro for 16 days. It might be working. At least my appetite returned.

  4. #24
    I have been an incomplete c5-6 quad for 46 years and just celebrated my 30th anniversary to a wonderful man but I too are starting to feel the need for an antidepressant but not for coping with being disabled but the chronic pain that comes with it. I do not want to take percocets 3 times then you just sit all day so you live with the pain but now living that way is getting hard and I use to smile all the time but thats gone so my doctor suggested cymbalta has anyone tried it for pain and depression?

  5. #25
    Quote Originally Posted by cydnight View Post
    I have been an incomplete c5-6 quad for 46 years and just celebrated my 30th anniversary to a wonderful man but I too are starting to feel the need for an antidepressant but not for coping with being disabled but the chronic pain that comes with it. I do not want to take percocets 3 times then you just sit all day so you live with the pain but now living that way is getting hard and I use to smile all the time but thats gone so my doctor suggested cymbalta has anyone tried it for pain and depression?
    Every antidepressant works differently from person to person.Therefore, it is probably irrelevant how Cymbalta works for others.
    My experiences with Cymbalta:
    I'm doing much better. I feel more balanced and can enjoy small things again. My pain is not less (not a bit), but I can handle it better.
    It may give you some relief.

  6. #26
    Uncle Peter - sucks to hear of your depression. Rooting for you to get better with that medicine you are on.

  7. #27
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    So sorry Uncle Peter. Sending you a hug.

  8. #28
    bottom line sci isnt easy for anyone, its a bitch, plain and simple. seems to get trickier as the years go on for sure...... stay strong peter, you got this.
    Bike-on.com rep
    John@bike-on.com
    c4/5 inc funtioning c6. 28 yrs post.
    sponsored handcycle racer

  9. #29
    I have been on Lexapro for 3 weeks. A little improvement has come. But I need to regain a lot more strength and endurance before I can drive again.

  10. #30
    Good to hear of the progress!

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