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After 47 years, I finally have depression.

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    After 47 years, I finally have depression.

    I just started taking Lexapro today. It might take effect in 14 days. That's 47 years of quadness.

    #2
    Doctors say spinal cord injured folks have residual depression by definition. I've always taken that to mean our conditions leave us with this residual/partial baseline type of depression, regardless of how we feel.

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      #3
      Originally posted by Patton57 View Post
      Doctors say spinal cord injured folks have residual depression by definition. I've always taken that to mean our conditions leave us with this residual/partial baseline type of depression, regardless of how we feel.
      Sounds more like the human condition.
      stephen@bike-on.com

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        #4
        Hey Peter
        I think it's a big step to seek medical help for depression really regardless of the level. Be patient it might take a while to get the right mix for you. Best of luck and congrats on 47 years!




        Originally posted by Uncle Peter View Post
        I just started taking Lexapro today. It might take effect in 14 days. That's 47 years of quadness.

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          #5
          Originally posted by Uncle Peter View Post
          I just started taking Lexapro today. It might take effect in 14 days. That's 47 years of quadness.
          Wondering if you have someone, professional or friend to talk to about things, in addition to your medication. Getting older can be a massive challenge for someone with paralysis. Are you getting help/equipment that would help you lessen any load? 2019 will be my 70th year of Polio, and my husband's 48th year of SCI. I grew up with my paralysis so didn't really experience a major life change like my husband did at age 25. Most non-disabled folks have no clue what is faced on a day to day basis. Give yourself a pat on the back for coping all these years.
          I have long felt that many who appear 'non-disabled' may have worse issues than I have - loss of a child, disease, etc. Somehow this helps me put things into perspective.
          Hoping 2019 will be a great year for you.

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            #6
            Originally posted by Patton57 View Post
            Doctors say spinal cord injured folks have residual depression by definition. I've always taken that to mean our conditions leave us with this residual/partial baseline type of depression, regardless of how we feel.
            I am not a fan of generalizations. My innate personality is cheerful and sociable. Abuse in my teens left me morose and quiet until I got out on my own. The SCI accident left me with brief bout of crying every day, but then I go back to work on rehab. I'm C5-6 incomplete. Normally cheerful again in these years despite a problematic marriage, I've found myself flirting with depression over the past month. I did some research and stopped using weed as a sleep aid. Miracle of wonders, I'm waking up cheerful again.

            Of course we react to life events and I hope Uncle Pete finds success with the medication, but I think the above generalization is wrong.

            Steven212- Definitely! The human condition. We react to life and "getting old" is a tough one for any disabled or ill person. "Getting old" is a poor label for losing capabilities. The term lends itself to a sense that we cannot fix problems.

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              #7
              Originally posted by Patton57 View Post
              Doctors say spinal cord injured folks have residual depression by definition. I've always taken that to mean our conditions leave us with this residual/partial baseline type of depression, regardless of how we feel.
              Not sure which doctors are saying this, but I?m fairly sure the above statement is not scientifically based and has no evidence to support it other than someone feeling like SCIers are always gonna be depressed cuz we?re so damn disabled.

              but in the interest of providing further unverifiable and unscientific opini?n to the conversation, I will give my opinion.

              Spinal cord injury predisposes to depression because it is a chronic, annoying, disabling and painful injury. It doesn?t cause depression and very many people with spinal cord injuries are not the least bit depressed. There is no such thing as any disease (even ones that directly cause depression such as hypothyroidism) that presents so consistently that it universally causes ?residual/partial baseline? depression. If you?re not feeling depressed, guess what? You?re not depressed.

              So now i have thoroughly refuted whichever doctors opinion you are quoting above. Since i am a doctor my opinion should hold just as much weight as theirs. And since I?m a psychiatrist I probably know a bit more about depression than they do (unless of course they are psychiatrists as well, you don?t mention their specialty). And since I also have a spinal cord injury I?m pretty sure I outrank them in terms of experience, expertise and knowledge on this particular subject.

              Edit: of course my opinion above is still just my opinion. I?m not aware of any research that refutes or confirms the hypothesis that all SCI people are a little depressed. That may well be true, I just think it is very unlikely to be true.

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                #8
                I was told our Serotonin uptake is affected after SCI. This can cause mood swings. I could map it everymonth on my upswings and downswings. Bupropion helps to regulate the Serotonin and lessons the depression.

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                  #9
                  Originally posted by Patrick Madsen View Post
                  I was told our Serotonin uptake is affected after SCI. This can cause mood swings. I could map it everymonth on my upswings and downswings. Bupropion helps to regulate the Serotonin and lessons the depression.
                  Interesting... bupropion is one of the few antidepressants that doesn't really affect serotonin. It works mostly on dopamine and norepinephrine (and has some activity at the nicotinic receptor). It's great that it helps you, I'm glad you found something that works for you (bupropion is a great antidepressant that avoids the weight gain, sedation and GI side effects of most of the serotonergic drugs), perhaps attributing this improvement purely to serotonin is a bit overly simplistic.

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                    #10
                    Originally posted by Patton57 View Post
                    Doctors say spinal cord injured folks have residual depression by definition. I've always taken that to mean our conditions leave us with this residual/partial baseline type of depression, regardless of how we feel.
                    I've been told that about MS, too...yet I have never been depressed until this year, when a lot of other things (unrelated to MS) clobbered me, and those are situational issues that I'll have to address on their own terms.

                    I take funklab's word as authoritative in this matter...to do otherwise would be to accept a form of what Andrew Weil, MD calls "medical hexing": saddling a patient with a grim prognosis from the get-go. We all have to deal with what's in front of us, using appropriate tools and/or therapies, no matter what the starting conditions are.
                    MS with cervical and thoracic cord lesions

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                      #11
                      Some people adapt better. Severe depression can be a chemical imbalance and more serotonin needed. Hope the Le April helps! Thanks for sharing! 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.

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                        #12
                        I meant no slights to the disabled population by saying SCIs have residual depression. I've thought long and hard about it for 8 years since having it described to me by a neuro-psychologist, who has done SCI rotations and gives expert testimony around the country on the impact a disability has on one's ability to work. This guy has no dog in the fight except for his professional reputation.

                        By definition, he is saying SCIs have residual depression.

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                          #13
                          Uncle Peter, were you and I at IRM at the same time? I was on 4th floor from 9/70 to 2/71 back in the days when rehab was determined by actual needs. Remember Ed Sullivan hosting the Christmas show with Steve and Edie Gormet and other celebrities. I hope you benefit from the new meds, we all are facing difficult stuff and have been for decades but we are tough enough to go the distance. Wishing you the best.

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                            #14
                            I was never at IRM. I live in Connecticut, about 40 miles from Ground Zero in NYC.

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                              #15
                              Originally posted by Patton57 View Post
                              I meant no slights to the disabled population by saying SCIs have residual depression. I've thought long and hard about it for 8 years since having it described to me by a neuro-psychologist, who has done SCI rotations and gives expert testimony around the country on the impact a disability has on one's ability to work. This guy has no dog in the fight except for his professional reputation.

                              By definition, he is saying SCIs have residual depression.
                              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.

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