experiences needed - depression in the family

[Catbrian]

 +-_I can only imagine how sad and worrying it must be to have so much mental health issues in your family.   AS I said before, I'm not so sure on the hereditary side of things.  If it is all about learned behaviour, then hopefully your wisdom and knowledge will keep you, wife and future child safe from such debilitating mental illness.

I've suffered depression since teenage years.  I started using many different anti-depressant over the last 13years, but my depression never seemed to lift.  The GP would always say that without the AD, perhaps I'd feel worse.  Cut long story short, my psychiatrist started me on Quetiapine in May of this year.  In low doses, up to 400mg, it is used as a mood-stabilizer; higher doses, it's considered an anti-psychotic.  My depression has been a little Psychotic at times, so this drug seemed the best option.  I'm also taking Mirtazapine, an AD.

Within days, the change in my mood was quite remarkable.  I've since been diagnosed with Bi-Polar and have been struggling with the highs; sometimes they feel worse than the lows.  Whether this means, once again, my meds are not doing the job they should be, I dunno.  Lately I have been encouraged by a member of the Forum who lives through Bi-Polar without any Meds.  Maybe one day I'll give it a go.

I hope your time on meds are not too long, but try not feel so downhearted.

How are you doing now?  Are things going ok with the pregnancy?

[bookletters]

Cat think you have a point about learnt behaviour. Studies on identical twins separated at birth shows depression is hereditary at 34% I think so really it is not at all a case of "it is guaranteed you will get it!!"

[Catbrian]

I didn't know that book, my opinion is just down to observation.  That's very interesting about twins 'thing'

[bookletters]

Yes, that's how scientists are best able to predict if an illness is hereditary or not, identical twins separated at birth!!!
Bipolar is a lot more hereditary than depression from what I have read...
In any case, it's a combination of factors anyway: you may have the gene susceptibility but your environment, way of seeing the world etc won't necessarily make you depressed...

[bookletters]

This article sums it best I think;
"While there is usually a genetic or hereditary element - meaning, some people are more susceptible to a certain disease because of their genetic disposition, it is usually the case that environmental factors play a greater role. In other words, the influence of "nurture" is as great as, and most likely greater than, "nature".

For example, hypothetically, say a hundred people have the exact same genetic disposition. If they all embark on very different dietary and lifestyle habits, for example smoking versus not smoking; alcohol drinking versus being alcohol-free; a diet of processed foods versus a diet of clean, fresh organic foods; regular exercise versus a sedentary lifestyle; a stressful life versus a relaxed life; many traumatic emotional experiences versus a relatively smooth-sailing life; fresh air versus polluted air; eating moderately versus frequent overeating; etc, the health and disease outcomes will be very different."

[Catbrian]

Very interesting, Book and totally makes sense. 

[bookletters]

It does doesn't it?

[nickemj]

Hi

This is really interesting.  I agree there is mos likely a mix of nature and nurture

I think one thing that worries me, which I've read about recently, is the 'kindling hypothesis' ie that whilst it often takes a lot of stressful events to triggger the first episode of severe depression, you become more and more sensitive to stress as a trigger over time - as the brain becomes increasingly sensitised.  This certainly seems the case with me, and with my mother.  I am much more susceptible to stress now than I was ten years ago (and have had 4 bouts of severe depression over that time).  For my job I have to be able to work well under pressure and respond confidently to criticism, yet I often fold under the slightest criticism of my work and find pressure increasingly difficult to manage.  This is such a change from when I was younger and I feel like I am slowly losing who I am and my ability to maintain my career.  Yet, I will need to stay strong and maintain a job/income to support my new child.

On the upside, 'mindfulness cognitive therapy' sounds a promising approach for maintining/extending the well periods and dealing with stress.  Might look into this.

Take care, N

[bookletters]

Mindfulness reduces the chances of further episodes in people with recurrent depression by 55%!
As for kindling, well, I am sure this can be managed with good therapy / CBT, meds etc. It's probably a case of "left untreated", kindling can occur.... Again, it's probably not the case with absolutely everyone you know...

[bookletters]

"feeling like you are loosing who you were and the ability to maintain a career" ... I had a mood gym session online last night and I believe it you think like this it is going to make you worse!!
Remember that with age, we loose some of our abilities too! I certainly wouldn't go clubbing until 5am like I did when I was 17 etc

[Catbrian]

Nick, I think you have a point about becoming sensitised to depression.  However, I also think, as the years tick by, our experience affords us the ability to manage it better.

Most of us do tend to fold under criticism and pressure.  We are normally dealing with such a heavy burden, it doesn't take much to tip us over the edge 

[bookletters]

Yes, experience helps. When I was first diagnosed aged 17 1/2 I was absolutely terrified and didn't know how to cope or what to do!! No-one is my family gets depression apart from my cousin who had one episode 25 years ago and I think a great uncle somewhere had it too. My mum has anxiety but she's never had depression so it was tough as no-one really was able to reassure me or tell me I was going to be able to recover!

I find now, I know how to deal with things a lot better and I respond to antidepressant a lot quicker than I used to, especially if I am getting a "top up". GPs never seem to believe me but if I have a top up of the right medication I am able to go back to work after 3-6 weeks. The docs keep saying "but in 6 weeks most ADs wouldn't have kicked in fully you know!" but, not sure why, it often does the trick for me! I am sure it's chemical too as when I was left on citalopram for months I was in a really bad state.... but give me venlafaxin or mianserin and I feel better every day (well okay some days are still low, but nowhere as bad as they used to be!).

I think science has a lot to offer us in the future too Nick. I keep going on and on about GLYX-13 but in december, we'll be able to find out whether it is bringing us the news we are all expecting (AD that works in a few hours!!!!). My friend who was born profoundly deaf is now able to hear after an operation. I have good faith that in 10 years time or less, science will be able to give us fast acting AD that mean we don't have to suffer unnecessarily.

Likewise, TMS is still very expensive at the moment but I am sure in the near future it will become more and more accessible.

So, will our brain become sensitized to depression? Maybe. But does it mean we will be suffering more as a result? Not necessarily...