Scientists have discovered that, not only do depression and anxiety have a measurable effect upon the sense of taste, it is even possible to determine which chemicals are most out of balance by how taste has been diminished. This is exciting for a couple of reasons.
This is the first research I have seen that shows physical evidence of anhedonia, the inability to experience pleasure. Anything that reinforces the physical nature of depression is very important. Research that demonstrates the physical symptoms of this disease go a long way towards dispelling the myth that it is "in your head." That phrase makes it sound like depression victims make a decision to suffer, which is not true. Ironically, the very nature of the disease does cause those selfsame victims to make a decision to continue suffering, but this doesn't occur until the will is compromised. Scientific research can demonstrate the physical nature of this disease, although I am of the belief that it will never discover a physical organism, a "depression virus," if you will. The root is not in the body, although much of the damage ends up there.
Diagnosis by taste-test is really just a fancy way of suggesting that we should listen to what our bodies are telling us. We are given a plethora of clues about our health, day in and day out, and either we ignore them or we just don't understand what they mean. Now we have an additional level of understanding, and another tool to use in the evaluation of our health. Another piece of the puzzle is slipped into place as diminished taste is coupled with diminished appetite in some people. We have been given one more solid tool to use to to sweep away the miasma; something corporeal with which to document a disease that prides itself on being as vaporous and insubstantial as a hunting vampire.
Sunday, December 10, 2006
Thursday, December 7, 2006
Medical Reinforcement (sort of)
Dr. Neubauer has located some studies that support what I have stated previously, namely that there are steps you can take to improve your mood and your sense of accomplishment, including caring for pets and exercise. I understand that his training is scientific and so he will only support any treatment option so far as the scientific method can document its success, but I take exception of his downplaying the value of these treatments, as well as herbal remedies like St. John's Wort, which I will discuss more in detail in a future post. For now, suffice it to say that there have been studies that demonstrate this herb's efficacy, just not, apparently, published in any journal the doctor respects.
I'm also not surprised that he does not include such vehicles as prayer and self-affirmation, as these are exceedingly difficult to document in a laboratory. Being unverifiable is not the same is being unsuccessful, however. Expectation is often half the battle.
I'm also not surprised that he does not include such vehicles as prayer and self-affirmation, as these are exceedingly difficult to document in a laboratory. Being unverifiable is not the same is being unsuccessful, however. Expectation is often half the battle.
Will Employers Actually Help?
This is an interesting study - careful tracking of employees through screening and treatment, even accounting for various levels of quality of treatment, to see how much productivity could be improved by working to overcome the depression. I'm more amazed with the process than with the results. The keys to such an enhanced depression screening program working would be twofold:
First, the employers must recognize that the cost of replacing an employee with another, which would not include the cost of depression treatment, would still be higher. Training and development, even for a relatively low-challenge job like fast food, can amount to thousands of dollars. The investment would be a crap shoot if you consider that a lack of depression screening could land another underperforming individual on the payroll.
Second, it must be mandatory, or it will be a failure. Nobody submits themselves for depression screening, or nearly nobody. Half of the depression victims don't realize they have a problem and the other half are too ashamed to admit it. Most of the people with a need would never be identified, so the cost would have no offset in value.
Employers are very results-oriented, so hard data such as these are promising. It is still likely only to be implemented by employers that are independent enough not to have to answer to stakeholders that are so shortsighted that they resist anything without an immediate benefit, and only in industries where employees are likely to stay more than the five years projected by the study as the point at which savings develop.
First, the employers must recognize that the cost of replacing an employee with another, which would not include the cost of depression treatment, would still be higher. Training and development, even for a relatively low-challenge job like fast food, can amount to thousands of dollars. The investment would be a crap shoot if you consider that a lack of depression screening could land another underperforming individual on the payroll.
Second, it must be mandatory, or it will be a failure. Nobody submits themselves for depression screening, or nearly nobody. Half of the depression victims don't realize they have a problem and the other half are too ashamed to admit it. Most of the people with a need would never be identified, so the cost would have no offset in value.
Employers are very results-oriented, so hard data such as these are promising. It is still likely only to be implemented by employers that are independent enough not to have to answer to stakeholders that are so shortsighted that they resist anything without an immediate benefit, and only in industries where employees are likely to stay more than the five years projected by the study as the point at which savings develop.
Gift For a Depressed Person
Holidays can be a very difficult time for the victim of depression. As I've discussed in the last post, it is very easy for well-intentioned holiday activities to completely overwhelm the depressed person. If you know someone who's depressed (some warning signs can be found here if you're not sure), you might want to prepare a gift that takes their disease into consideration. Here are some ideas:
Presence, not presents: present them with an invitation or a certificate that requests that they spend the holiday or a specific time with you. Make it quite clear that no gifts will be exchanged, no food is to be prepared, and nothing special is required. If they tell you, "I'm afraid I won't be very good company," tell them, "That may be true, but I will be." If you sincerely care about this person and are willing to see who dwells beneath the cloud of gloom that their disease has helped them make for themselves, this may be the best gift you could give. If you and they are lucky, they will be able to tell you it made them happy. If not, trust that it did.
Focus on the positive: Put together a photo album, a slide show on a CD, or a letter or scrapbook that centers on positive things you have shared. A well-depressed person doesn't see themselves as having any value, and this kind of effort serves to remind them of things they've almost certainly forgotten. Depression can cause memory loss, and you can bet that the good ones go first. This is a gift that will be cherished.
Ask for help: This may or may not work, depending on the level of the depression. My mother has suffered from depression on and off for most of my life. The holidays have always been important to her, and I knew that being at a loss for things to suggest to her for gift ideas wouldn't sit well with her. Since I didn't have any wants particularly, I requested that she create a needlework piece for me. Mom has always been an avid needlework artist, ranging from knitting to crewel to embroidery to counted cross stitch. Her hands knew what to do even though her mind didn't see the point, so the act of creation served as a reminder of the value she held to me.
Bright Blessings: If you share a religious belief with the victim, or at the very least he or she isn't a diehard atheist, offering a tangible blessing may be helpful. Depressed people have very often lost their faith, and cannot pray for themselves, even if they know that prayer is a very important part of their ability to overcome the disease. Give them a promise, one you intend to keep, that you will pray for them daily or weekly for a set amount of time. Put it in writing. As an alternative, find an appropriate candle and either bless it yourself or have it blessed by someone who has taken religious orders or their equivalent. Specifically focus the blessing on light, be it the Light of Jesus or the return of the sun or the oil that burned for eight days, or whatever makes sense in your tradition. Tell them to burn the candle at their lowest point in the day.
Presence, not presents: present them with an invitation or a certificate that requests that they spend the holiday or a specific time with you. Make it quite clear that no gifts will be exchanged, no food is to be prepared, and nothing special is required. If they tell you, "I'm afraid I won't be very good company," tell them, "That may be true, but I will be." If you sincerely care about this person and are willing to see who dwells beneath the cloud of gloom that their disease has helped them make for themselves, this may be the best gift you could give. If you and they are lucky, they will be able to tell you it made them happy. If not, trust that it did.
Focus on the positive: Put together a photo album, a slide show on a CD, or a letter or scrapbook that centers on positive things you have shared. A well-depressed person doesn't see themselves as having any value, and this kind of effort serves to remind them of things they've almost certainly forgotten. Depression can cause memory loss, and you can bet that the good ones go first. This is a gift that will be cherished.
Ask for help: This may or may not work, depending on the level of the depression. My mother has suffered from depression on and off for most of my life. The holidays have always been important to her, and I knew that being at a loss for things to suggest to her for gift ideas wouldn't sit well with her. Since I didn't have any wants particularly, I requested that she create a needlework piece for me. Mom has always been an avid needlework artist, ranging from knitting to crewel to embroidery to counted cross stitch. Her hands knew what to do even though her mind didn't see the point, so the act of creation served as a reminder of the value she held to me.
Bright Blessings: If you share a religious belief with the victim, or at the very least he or she isn't a diehard atheist, offering a tangible blessing may be helpful. Depressed people have very often lost their faith, and cannot pray for themselves, even if they know that prayer is a very important part of their ability to overcome the disease. Give them a promise, one you intend to keep, that you will pray for them daily or weekly for a set amount of time. Put it in writing. As an alternative, find an appropriate candle and either bless it yourself or have it blessed by someone who has taken religious orders or their equivalent. Specifically focus the blessing on light, be it the Light of Jesus or the return of the sun or the oil that burned for eight days, or whatever makes sense in your tradition. Tell them to burn the candle at their lowest point in the day.
Tuesday, December 5, 2006
Use Holidays Properly
Why are there so many holidays in December and January? We have Hanukkah, Christmas, Yule, Kwanzaa, New Year's Eve, St. Lucia's Day, and all manner of variations on those, as will as ancillary celebrations (such as Advent). In one form or another, these celebrations focus on happiness or light. Celebrations of light, all clustered around the longest night of the year? Surely this is not a random occurrence. Obviously the human spirit craves light and the life it brings, and the dark times of less activity and more eating are being offset by singing, candles, parties (okay, that's also a handy excuse for eating), and opportunities to spend time with other people: cultural and religious offsets to the physiological reactions to winter. We understand that times of cold and darkness can wear away at our resolve, and we fight back by creating a flurry of activities aimed, purportedly, at joyfulness at this darkest time. Hopefully it's enough to carry us through the remaining ice and snow as the days grow longer.
Enter depression, subtle twister of goodness.
Looking at the world through the unwholesome filter of depression can make a good thing into a painful experience. Holidays are designed to bring people together; you just want to be left alone. They encourage you to give; you're overwhelmed by the idea of shopping, or terrified that you'll choose the wrong item. Indoor creative crafts flourish; your mind is a pile of mush and you're sure you can create or decorate anything.
If you've read this blog for any amount of time you know that it's my firm belief that depression has physiological, psychological, and spiritual components, and gleefully will attack you on all those fronts. This is a time of year when it can use the forces of nature (less sunlight and warmth) as its strength, overwhelming the forces of culture (social activities, giving and happiness). Well if it will use the momentum of the year, you can too.
Go to the parties, even if you sit by yourself. Joy is also an infectious disease, and if you expose yourself to it you may find that you catch it. Surround yourself with people that won't judge you for your failings - there is no better time of year to find the goodness in your fellow man than right now. Sing and don't care how you sound. If buying gifts is too expensive or you hate the crowds, try making your own and (here's the trick) stop caring if they're perfect. Spend some time volunteering as a Santa or Salvation Army bell-ringer. Force yourself to be in situations where you will be exposed to the goodness of humanity.
All the drugs in the world will not get you out of bed. Your therapist and your gods cannot do this for you either. Depression is working very, very hard to convince you that you have no power, no worth, no purpose. Set yourself a schedule of things to do, things that intellectually you know are good at this time of year, and stick to it no matter what. You will find many, many excuses to avoid positive, social activities, because the more of them you engage in the more the depression will fight back and try to suck you back in. That's why I suggest literally writing down (or getting a friend to, if you must) your holiday activities and going through the motions. Sooner or later the habit will find its way in deeper, helping out whatever treatments you might have going for you.
And then you'll discover the most amazing gift of all - that you can.
Enter depression, subtle twister of goodness.
Looking at the world through the unwholesome filter of depression can make a good thing into a painful experience. Holidays are designed to bring people together; you just want to be left alone. They encourage you to give; you're overwhelmed by the idea of shopping, or terrified that you'll choose the wrong item. Indoor creative crafts flourish; your mind is a pile of mush and you're sure you can create or decorate anything.
If you've read this blog for any amount of time you know that it's my firm belief that depression has physiological, psychological, and spiritual components, and gleefully will attack you on all those fronts. This is a time of year when it can use the forces of nature (less sunlight and warmth) as its strength, overwhelming the forces of culture (social activities, giving and happiness). Well if it will use the momentum of the year, you can too.
Go to the parties, even if you sit by yourself. Joy is also an infectious disease, and if you expose yourself to it you may find that you catch it. Surround yourself with people that won't judge you for your failings - there is no better time of year to find the goodness in your fellow man than right now. Sing and don't care how you sound. If buying gifts is too expensive or you hate the crowds, try making your own and (here's the trick) stop caring if they're perfect. Spend some time volunteering as a Santa or Salvation Army bell-ringer. Force yourself to be in situations where you will be exposed to the goodness of humanity.
All the drugs in the world will not get you out of bed. Your therapist and your gods cannot do this for you either. Depression is working very, very hard to convince you that you have no power, no worth, no purpose. Set yourself a schedule of things to do, things that intellectually you know are good at this time of year, and stick to it no matter what. You will find many, many excuses to avoid positive, social activities, because the more of them you engage in the more the depression will fight back and try to suck you back in. That's why I suggest literally writing down (or getting a friend to, if you must) your holiday activities and going through the motions. Sooner or later the habit will find its way in deeper, helping out whatever treatments you might have going for you.
And then you'll discover the most amazing gift of all - that you can.
Monday, December 4, 2006
Wellbutrin and SAD
I think the most promising thing about this discussion of Wellbutrin is that it's only recommended to be taken during the dark months. It's very easy to get into a maintenance program with depression, and it's often not necessary. Long-term medication creates a dependence in a way that isn't defined by the scientific community; it's a belief that develops that one cannot be well without a drug, which becomes a self-fulfilling prophecy. If you're depressed you're already extremely susceptible to the belief that you are simply not a strong person, and drugs can easily reinforce that by becoming a security blanket. Properly used, a medication for most depression victims should be a trainer, showing their minds what health looks like so that they can reproduce it in themselves.
That being said, I'm glad that Wellbutrin might be useful for SAD sufferers. If it gets you through the darkest times, and allows you enough energy and motivation to modify your behavior for health (exercising, exposing yourself to more sunlight), then it could be a godsend for many. Only for a very small percentage of depression victims is a permanent drug solution logical. And I know how you think if you're depressed, so let me make this clear: you're not one of that small percentage. Don't believe it. The light is inside you, and the drug is only a tool that can bring you back to the level where you can find and use what you've had all along.
That being said, I'm glad that Wellbutrin might be useful for SAD sufferers. If it gets you through the darkest times, and allows you enough energy and motivation to modify your behavior for health (exercising, exposing yourself to more sunlight), then it could be a godsend for many. Only for a very small percentage of depression victims is a permanent drug solution logical. And I know how you think if you're depressed, so let me make this clear: you're not one of that small percentage. Don't believe it. The light is inside you, and the drug is only a tool that can bring you back to the level where you can find and use what you've had all along.
Sunday, December 3, 2006
Dark Times Ahead
Seasonal Affective Disorder is really only the beginning. You don't have to be crippled badly enough by the season alone to have it really affect you negatively. "Winter blues" leads to a lack of energy and a desire to eat more in all of us to some extent, and if you're otherwise depressed this can compound your symptoms.
The metaphor of darkness and light works well with depression because darkness and light have very significant physiological effects upon us. Diurnal is the standard behavior cycle for most living things, and even though we humans can act against type, we are generally responsive to having light in our lives. Darkness is a time of hibernation, introspection, preparing for the light to return. Sunlight encourages us to think, to act, to experience outwardly rather than inwardly. Both are perfectly normal and healthy and we need a balance between focusing on within versus focusing on without. With depression, though, darkness takes precedence, and the darkness that is created within magnifies the darkness in the world until it's unbearable.
You might be eating more and feel guilt over the weight you're gaining, or think you're gaining. Or you're less motivated to exercise. Or when the sun sets at 4:30 in the afternoon it feels like all the light in your life is vanishing with it.
The light box described in the link is probably not necessary for someone who is depressed but not specifically prone to SAD. However, daily walks in the daylight will get your blood flowing, expose you to sunlight, and get you the exercise you need anyway. You don't want to exercise if you're depressed (since depression discourages you from doing anything that might benefit you), and this is just compounded by the time of year.
The sunlight is going to be diminishing for a few more weeks. Make an extra effort to get outside, even if it's cold out. Buy a full-spectrum bulb or two if you can. Set your alarm for the same time every day and get up, no matter how much you don't want to. It's going to turn around soon, and before long you'll see that the light creeps in a little earlier and lingers a bit longer than it had been. Don't be afraid to make a note of the time so you recognize the increased light more quickly. The light always returns. That's a promise.
The metaphor of darkness and light works well with depression because darkness and light have very significant physiological effects upon us. Diurnal is the standard behavior cycle for most living things, and even though we humans can act against type, we are generally responsive to having light in our lives. Darkness is a time of hibernation, introspection, preparing for the light to return. Sunlight encourages us to think, to act, to experience outwardly rather than inwardly. Both are perfectly normal and healthy and we need a balance between focusing on within versus focusing on without. With depression, though, darkness takes precedence, and the darkness that is created within magnifies the darkness in the world until it's unbearable.
You might be eating more and feel guilt over the weight you're gaining, or think you're gaining. Or you're less motivated to exercise. Or when the sun sets at 4:30 in the afternoon it feels like all the light in your life is vanishing with it.
The light box described in the link is probably not necessary for someone who is depressed but not specifically prone to SAD. However, daily walks in the daylight will get your blood flowing, expose you to sunlight, and get you the exercise you need anyway. You don't want to exercise if you're depressed (since depression discourages you from doing anything that might benefit you), and this is just compounded by the time of year.
The sunlight is going to be diminishing for a few more weeks. Make an extra effort to get outside, even if it's cold out. Buy a full-spectrum bulb or two if you can. Set your alarm for the same time every day and get up, no matter how much you don't want to. It's going to turn around soon, and before long you'll see that the light creeps in a little earlier and lingers a bit longer than it had been. Don't be afraid to make a note of the time so you recognize the increased light more quickly. The light always returns. That's a promise.
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