Depression: Things I Don't Understand About It

[wishingluck]

Dear Dr. Ancill

I hope you are doing well. I wanted to ask some questions about 'depression' and after reading your bio, I decided to ask you.

I generally have always been 'dismissive' of depression, related to myself (not to others). In other words, I never believed I am 'depressed'.

Yet many times during the last 20 years, I have been prescribed various antidepressants by several doctors, which I always avoided taking, as my outlook has always been of the kind 'better to know the truth and feel tha pain if necessary, rather than try to change my moods with drugs, alcohol, etc).

I have a long history of challenges I have gone through. The harshest one, even worst than my tinnitus (which feels like a curse and makes life even much harder than it already is) was my dear mother's sudden death at only 36 years of age. This happened 24 years ago.

At the time I took it quite 'well'. I didn't understand all the things I understand now about life and death, about how permanent and fixed is the death of someone you know, someone who loved you more than anybody else. (although my whole family loved me and still do).

I am a musician and fortunately this aspect is the one thing I always felt motivated about, in life. I never particularly cared if I didn't seem to have the normal things so many other people have....girlfriend, wife, a car, etc.
I have always liked to study music theory and that one thing kept me busy for years.

Yet, a few years ago, the immense grief assaulted my soul in full force. I have never felt like that before. I have always been quite pessimistic, but since then I started to really see life for what it really is. I started to seek answers to my questions about mortality, and philosophy helped me greatly in this.

I started to notice that I get drawn in extreme sadness, and I also am quite isolated. Unfortunately, after my mother's death, my family broke up, although never completely. We still love each other but we don't live together anymore, and we are quite far from each other, etc.

I was reading about depression on wikipedia, and I just don't get many of the things about it. For example, it is classed as 'mental illness', and it was called 'melancholia'. Since I started to deal with the assault of grief (mainly because I understood many other things about life), I started to feel EXTREMELY 'malancholic', and the loneliness accentuates that as I generally always had bad social skills and always been quite introverted, although I have had several exceptional friends in the past.

What I am trying to understand is, how do I know I am really depressed? Sometimes I seem to be completely unmotivated doing ANYTHING. I just want to sit in there doing nothing, but I know it's not laziness. I generally am not lazy, and I generally always try to postpone distractions and do more useful things, such as reading useful books, learning something, other than my pursuits in music.

I am seriously starting to consider taking antidepressants. Are there ways to make 'sure' that I am depressed? Doctors generally always told me I 'am', but then again, how can you really know anybody in a sitting of 5 minutes?

Anyways, sorry about the long message and my confusion too. Please just tell me what you can, your thoughts.

Thank you and be well

WL

 

[Dr. Ancill]

I apologize if you have waited for this response. Your question did not show up normally and I stumbled across it only today.

There is a difference between feeling depressed and melancholic as a normal reaction to stress or life and the illness: Major Depression. While this may be a spectrum, Major Depression is characterized by biological symptoms - poor sleep, low energy, slow thinking, loss of enjoyment, negative thoughts (even suicidal ones), flat emotions and anxiety - which persist for some time.

Sometimes the best way of determining if you have the illness is to take an antidepressant although many GPS are not really familiar with how to properly treat depression. Sometimes, the patient will, in addition, also need psychological treatments. In my opinion and experience, psychological treatments are not effective on their own.

Contrary to the popular press (and what you read in this Forum), antidepressant medications are generally quite benign and the side-effects are transient but if you don't improve or tolerate the first or second medication, I would ask for a referral to a psychiatrist (not a psychologist).