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Paul3eb wrote:another thing, depression is an overdiagnosed "disease" in the country today. you might be depressed.. but are you suffering from a clinical disease known as depression? have it looked into and think about seriously on your own. do you have absolutely no control over whether or not you're happy? what sort of thoughts and actions do you have? are you or are you not in control? this rush to diagnose everyone as victims of depression, the "depressed" i think detracts from people taking responsibility for their feelings and actions. people get sad.. people get sad for a long time. it happens. but that doesn't make you a victim of the clinical disease of depression.

Sorry Paul, but I'm going to have take major offense to this one. For anyone who doesn't want to read a lecture/flame, I suggest you skip this post. This has obviously struck a nerve in me and I'd like to take a minute to put some accurate information out there for people to see.

Depression is a major disease in this country right now. (I don't know about the rest of the world, but I suspect it may be there also.) It is not diagnosed nearly as often as it probably should be. There are two reasons for this. 1. People don't realize they're depressed. 2. People are afraid to get help for the very reasons you're talking about. You might think, "wow, it's really obvious that they're depressed" but to the person who lives in that state all the time, they're not depressed, it's their "normal" state. Do you know what it's like to be short, black or bald? It's something that you've lived with for a long time and you come to think of it as normal. This is similar to kids needing to be educated that sexual and physical abuse are not "normal" even though it may seem so to them since they may have been around it for so long.

Furthermore, people often think depression=being sad all the time. That's not the case at all for most cases. Depression is a state where not only your mood, but also your cognitive functions are functioning at a lower level than they should. It affects many different parts of the brain.

Criteria for Major Depressive Episode Based on DSM-IV
A) Five or more of the following symptoms have been present during the same 2-week period and represent a change from previous functioning; at least one of the symptoms is either 1) depressed mood or 2) loss of interest or pleasure.
1) Depressed mood most of the day, nearly every day as self-reported or observed by others.
2) Diminished interest or pleasure in all or almost all activities most of the day, nearly every day.
3) Significant weight loss when not dieting, or weight gain; or decrease or increase in appetite nearly every day.
4) Insomnia or hypersomnia nearly every day.
5) Psychomotor agitation or retardation nearly every day
6) Fatigue or loss of energy nearly every day.
7) Feelings of worthlessness or excessive or inappropriate guilt nearly every day.
8 ) Diminished ability to think or concentrate nearly every day.
9) Recurrent thoughts of death, recurrent suicidal ideation without a specific plan.
B) The symptoms do not meet criteria for a mixed episode
C) The symptoms cause clinically significant distress or impairment in social, occupational, or other areas of functioning.
D) The symptoms are not due to the direct physiological effects of a substance (drug or medication) or a general medical condition (hypothyroidism).
E) The symptoms are not better accounted for by bereavement, i.e., after the loss of a loved one, the symptoms persist for longer than 2 months or are characterized by marked functional impairment, morbid preoccupation with worthlessness, suicidal ideation, psychotic symptoms, or psychomotor retardation.

Although they aren't diagnostic criteria, anxiety and decreased labido are also often seen with depression.

Someone can be diagnosed as being having depression instead of just being depressed after only two weeks, but most clinicians would hesitate to make that diagnosis until it has been going on for several months. This isn't to say that they just wait and see, but by the time the vast majority of people seek treatment they've had symptoms for months if not years.

The causes are threefold, genetics, developmental and psychosocial.

I don't want to imply that tons of people should be on antidepressants, but depression is greatly underdiagnosed and undertreated. Some of the studies coming out right now say that therapy is just as effective if not better than meds for a lot of people. Meds are a last resort. The ultimate goal is just to get people to feel better. The diagnosis is irrelevant as long as people get the treatment they need. There is usually no reason to suffer.

There are two reasons that depression is so prevalent now. First is that we're doing a much better job recognizing it. Second, and this is a personal belief, our society sets people up for depression so that many more people are clinically depressed than might be in a different society. We're a nation of couch potatoes with exceedingly poor nutrition that define a considerable portion of our reality by watching television. When you learn your definition of beauty by watching these shows on television, it's no wonder people don't see beauty around themselves and in their own lives. Whether consciously or not, they're comparing themselves and their lives to what they see on TV. Obviously they know they shouldn't be like guests on Springer, but we want to be popular and beautiful and we see those things defined in Baywatch, Melrose Place, America's Next Top Model, etc, etc, etc. We spend time numbing our brains instead of stimulating them and this also keeps us from socializing. Our bodies and minds developed to be physically active, eat a low-fat/high-carbohydrate diet, live in social groups, and sleep at night. Instead we sit around all day, eat a high-protein/high-fat diet, spend time staring at TV so that there can be no interaction in a room full of people, and then don't get enough sleep. Is it any wonder our bodies and minds aren't working properly?

Okay, this has gone on for way to long, but we all need to rant a bit now and then. Thanks.

I've had many close contacts with suicide and attempts and they often strike me as being one of the most intense forms of personal violence possible. That being said, I think it can be a good thing in some situations. I've heard of physicians prescribing morphine as pain control in terminal patients and then telling them that taking X number of pills would be fatal. Often the pills are not used for that and are found after the person dies, but it can be very empowering to know that you have that option available to control one thing in your life when everything else is being taken from you one piece at a time.

Marathonmedic - that was one of the most well written responses I have seen on this board - albiet lengthy . You put a lot of thought into that and I took in every word. Thanks. KD

I always like to hear your side MM. So what are the real suicide numbers? This thread has me wondering. Logic tells me that climbers are no more predisposed to suicide than anyone else.

eek.. reading that again, you're right about one thing: i shouldn't say it's "overdiagnosed" because that'd imply that a doctor actually made the diagnoses. and you're right, too many people are afraid to go in and actually have it "looked at". i still say, however, people cry victim too often before they really think about what's going on.

it's just too often that i've seen people slump and says they're depressed (myself included) as though they're a victim of some debilitating disease. then they run off to the first doctor who'll give them prozac so that they won't feel as bad (prozac doesn't make you feel happy).

you're right, it is much better diagnosed as a disease today than in the past. and that is great. and there's a lot more to do with it in regards to removing stigmas about it. people don't look down on people who go have mammiograms.. yet if you tell someone you have a mental illness, people run screaming.

my problem is the dr. phil's out there who make everyone think they should be happy all the time and bastardize the idea of depression. i might not get to climb this weekend. i'm depressed. but i don't suffer from depression the disease. people mix the two up too often and marginalize what depression really is.

[yet if you tell someone you have a mental illness, people run screaming.]
Good choice. Crazy people are a pain in the ass. At first I was sympathetic,but enough is enough.

my guess is that there are an equivalent percentage of derpressed climbers as there are in society at large, but that perhaps the suicide rates are higher because climbers are bolder and therefore more likely to go through with suicide or perhaps use methods that are more likely to result in death...

Sandy, I would say the opposite but can't back it up. I think climbers tend to be more social, active, and (some) eat healthier. The healthier lifestyle can go a long way.

Paul, now you're getting it. Being depressed and having depression are two different things.

For my man ynot, this comes from the Merck Manual 17ed. It's my bible and one of the best medical references out there.

Incidence
Statistics on suicidal behavior are based mainly on death certificates and inquest reports, and they underestimate the true incidence. Even so, suicide is one of the top 10 causes of death among adults in urban communities. In Europe, the urban rate is higher than the rural; in the USA, they are about the same. In the USA, about 75 persons commit suicide every day. Suicide accounts for 10% of deaths among those aged 25 to 34 yr and for 30% of deaths among university students. It is the second leading cause of death among adolescents (see Ch. 274). The steady rise in adolescent suicides during the last decade is due mainly to an increase in male suicides, which has more than doubled. More than 70% of persons who complete suicide are > 40 yr old, and the incidence rises sharply among those > 60 yr old, particularly men. About 65% of those who attempt suicide are < 40 yr old.
Of about 200,000 suicide attempts in the USA each year, 10% are completed. Attempted suicides account for about 20% of emergency medical admissions and for 10% of all medical admissions. Women attempt suicide 2 to 3 times more often than men, but men are generally more apt to die in their attempts. Several studies have found a higher incidence of suicide among family members of patients who have attempted suicide.

Several studies have found a higher incidence of suicide among family members of patients who have attempted suicide.

something to think about next time you're considering suicide..

Well Shit, I have all of the symptoms marathonmedic describes. They usually start when I wake and end at around 4:30pm on the weekdays.