Donna Speaks: How is your Cognition?

I thank Jan for her blog post on clinical depression. It was very informative and helpful.  I hope anyone who recognizes the symptoms does value themselves enough to get thee to a therapist.

I have some additional information to share that I also think will be informative and helpful to you.

Clinical Depression (CD) takes a toll on us from at least four different fronts.

The first front, Jan described: Clinical depression caused by situations we find ourselves in that are beyond our control.  A relationship break-up, the loss of a job, or retirement from your life long job, losing possessions and/or your home as a result of a natural disaster can cause depression.

Jan also alluded to the second front: physiological. Depression can adversely affect all bodily systems. 

For example, we know that serotonin, that feel-good chemical healthy bodies produce, is well known as a brain neurotransmitter.  However, it is estimated that 90 percent of the body's serotonin is made in the digestive tract. In fact, altered levels of this peripheral serotonin have been linked to diseases such as irritable bowel syndrome, cardiovascular disease, and osteoporosis. CD and osteoporosis linked?  You betcha.

Your immune system is also compromised by depression.  When depressed, you are more likely to catch that bug everyone else has.  Pain receptors become more sensitive: pain is more painful.  And, your heart really does hurt.

On the third, family and friends front, there is also no doubt that depression makes developing and maintaining relationships much more difficult. Depressed people often isolate, become social hermits.  This is not a conscious choice.  You can rightfully blame that on Big Ole Aunt Anhedonia who usually comes to visit.  When you are depressed, there ain't much you do that gives you pleasure.  So you are pretty much likely to curl up on your couch in a fetal position and suck your thumb.

The fourth front, the cognitive front, is often not discussed as much as it needs to be.  It is way-way-way important when doing therapy with CD folks.

Yes, when afflicted with CD, your mood is way, way down.  And you feel Yuckie-Yuckie-Yuckie.  But, your thoughts are, your thought process is, also really fucked up.  What didn't piss you off last week, does now.  The people you loved yesterday - especially your lover, husband, wife, partner, etc. - you cannot stand today.  Your job was OK; now it isn't.  What changed?  You did.  Your thoughts did. 

Your thinking did. When your body declines to produce enough of the feel-good chemicals, your thinking goes in the toilet.

For a great percentage of the time, the things that upset us do so not because they are by their nature upsetting, but because of the way we think about them.  This is why research has demonstrated that the most effective therapy for CD is Cognitive-Behavioral Therapy (CBT).

Our actions are a result of our feelings.  Feelings are based on the way we think about life, love, people, places, and things. So, in therapy, we examine your Belief System (BS), help you find the flaws in it, the unhealthy beliefs, the stinkin 'thinkin', and assist you in re-thinking your BS, so you do not think BullShit anymore.

The drugs used to treat CD treat mood and cognition.  They will elevate your mood and help correct your toilet-bowl thoughts.  It is essential, in the long run, that you are able to think critically about the way you think, and change your flawed thinking in order to have long term success.

More thoughts about depression in my next blog.

Miss Althea, have a great day.

Therapy for Clinical Depression

How do we separate having a bad day from clinical depression?  Sometimes that's difficult to do.  If a loved one dies, we understandably have bad days, often many weeks of bad days. Or if we are out of work, go through a divorce, even retirement can spark clinical depression.

Any traumatic events can lead to bad days.  Suddenly, or not so suddenly, a string of bad days get so bad, we cannot function in day to day living.  We feel awful. We feel like dying could not be nearly as bad as living. We have a real problem just getting out of bed in the morning or sleeping at night.  And it never seems to end.  We may begin self medicating with alcohol or drugs, but they only make us feel better for hours and then the sad feelings are back.

 Our friends, family and colleagues ask us if we are OK.  We may well be suffering from clinical depression. It's time to look for a therapist who can help us get back to our life loving self.  She will begin depression therapy with us.

Depression therapy is often treated with the short term help of anti depressant drugs like Zoloft or Celexa. There are dozens of them and only an MD can prescribe them. So your therapy may begin with a visit to a psychiatrist or other medical doctor to get a prescription before you can begin talk therapy.  Sometimes the medication is enough and your depression will begin to lift in a couple of weeks.  One important thing medications can do is help lift your depression so you can concentrate on working with your therapist.

Talk therapy done by a Licensed Clinical Social Worker may often accompany your prescription drug therapy.  Choose one you can work with, one you were referred to by your psychiatrist or MD. A friend can also be a good referral source.

You will have an initial intake interview, often lasting 1.5 - 2 hours getting your history.  Don't hold back. Tell her everything. She will not judge you, nor can you tell her something she has not heard before.  The work to heal your depression starts here, so be honest.  It's important.

Depression therapy is done by both of you, often with your family as well.  All are important in your life and want you to return to the person you were before you got sick.  Ask them to become involved with the therapist if it can help you.

Getting better is not easy. It's hard work done by you and the therapist, often for 6 months.  Sometimes more.  Your insurance usually covers  your visits.  

Check with your insurance company and ask your potential therapist if she is a provider for your insurance company. Of course, any therapist will take cash. This is your health we are talking about and you can feel fine again.