Analysis of "Depression: Out of the Shadows"


The show is essentially Depression 101 – for those new to learning
about the illness.
As someone who struggles with depression (within
bipolar disorder), I found a lot of the two hours pretty boring (90
minutes on personal stories and about 22 minutes for "candid
conversation"). The "a lot" comes from the stuff that I've either heard before or flies over my head, eg, how depression affects the brain, prefrontal cortex, neurotransmitters, synapses, etc. The personal stories were powerful: depressingly heartwarming. (Yes, I mean that.)

My heart sank as I heard the stories of Emma and Hart, teenagers who were diagnosed with depression and bipolar disorder, respectively. Both were such extreme cases that they needed to be sent away for special psychiatric care. They are on medications for their disorders; the specific drugs are never mentioned.

While watching Deana's story of treatment-resistant depression, I instantly thought of Herb of VNSDepression.com whose wife suffers from the same malady.

I tried to listen attentively for the antidepressant that Ellie, who suffered from PPD after the birth of her first child, would be taking during her next pregnancy. It was never mentioned.

My jaw nearly dropped to the carpet as Andrew Solomon, carefully plucked brightly colored pills from his pillbox that he takes every morning for his unipolar depression: Remeron, Zoloft, Zyprexa, Wellbutrin, Namenda, Ranitidine, and two kinds of fish oil. He might have even mentioned Prozac. He takes Namenda, an Alzheimer's drug to combat the effects of an adverse interaction between Wellbutrin and one of the other drugs that I can't remember. Solomon says he's happy. I'm happy for him and I'm happy that his drug cocktail works for him but I couldn't help but sit there and wonder, "Isn't there a better way?"

While I thought the stories covered the gamut, in retrospect, I'm surprised they didn't interview a veteran or U.S. soldier to discuss PTSD. If the producers were able to fit in dysthymia, I'm sure they might have been able to throw in a story about a soldier who struggles with depression and suicidal thoughts stemming out of PTSD. Considering all the stories coming out of the VA, it's rather relevant. It would have been more interesting than the Jane Pauley segment. But I'll get to that in a minute.

As I listened to the narrator, I couldn't help but wonder what alternate perspectives could have popped up. For what it was, I fear none. This was a Depression 101 show — a program designed to either get people to fight against fear and stigma and get help or to open the eyes of loved ones to this debilitating disorder. I'm not sure how to slip in an opposing view on medication from a doctor without confusing or scaring people away. What would Healy or Breggin say that would encourage people to seek appropriate care?

Holistic or natural treatment was not mentioned. It's not mainstream and it's not recommended by most doctors as first-line therapy. I would have been surprised had something been said about it.

The depression portion of bipolar disorder was briefly discussed in Hart's story then Pauley added commentary about her personal experience in the remaining 22 minutes of the program.

Pauley appears at the end of the show promising a "candid conversation" on the topic. The three experts: Drs. Charney, Duckworth, and Primm sit and smile politely as Pauley rattles on occasionally about herself. Some people might find her exchange endearing and personal. After the first 3 minutes, I found it annoying. As a journalist, I wish she would have taken the impartial observer approach rather than the "intimate discussion" approach. In my opinion, she seemed to have dominated the "discussion."

It ended up being a Q&A with each doctor. Her questions were focused and direct. I expected a little bit of an exchange between doctors, talking not only about the pros of medication and treatment like ECT and VNS but also the cons. (Should I apologize for being optimistic?) Charney interjected into the conversation maybe once or twice but was only to offer an assenting opinion. Primm spoke least of everyone on the panel. I think she was placed on the show solely to represent diversity.

There were no "a recent study said…" or "critics say such-and-such, how do you address that?" It was a straightforward emphasis on encouraging people to get help or for those suffering to get treatment. Pauley's segment didn't discuss any negatives (not with the medical director of NAMI there!). The closest the entire 2 hours gets to any cons is with ECT shock treatment and giving medication to growing children. The childhood medication thing isn't dwelt on. The basic gist is: Doctors don't understand how medication works in children but are working on trying to understand it and improve its efficacy.

Forgive me for being negative. The point of the program was designed to give hope to those suffering. Instead, it just made me feel even worse. Thoughts raced through my head: "Well, if this doesn't work, then it's on to that. And if that medication doesn't work then I'll probably be prescribed this therapy, and if that doesn't work, then I'm treatment-resistant at which point, I'll have to do…"

I hope the program does what it's designed to do and that's to get those suffering with depression to seek appropriate care. The one upside is that talk therapy was stressed. I'm a huge proponent of talk therapy myself. Let me know what you thought of the show if you were able to catch it.

In the meantime, this depressed girl is going to cure herself for the night by going to bed.

P.S. Is it really fact that depression is a disease?

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Loose Screws Mental Health News

VNSCyberonics has its vagus nerve stimulator (VNS) while Neurontics is attempting to promote its Neurostar. The Food and Drug Administration will consider whether Neurontics’ device will be able to compete with Cyberonics’ device on Jan. 26. The VNS, according to FDA standards, is the only device that has been proven to show efficacy in depression treatment for those who do not respond to drug treatment. While the VNS is surgically implanted in the chest and stimulates nerves in the neck to alleviate depression, Neurontics claims that Neurostar is not surgically implanted and uses magnetic pulses over the course of three to six weeks to stimulate a patient’s brain.

In the most shocking news ever, the Australian Mental Health Council has found that marijuana can induce mental illness. [sarcasm] Former Federal Police commissioner Mick Palmer has noted three significant conclusions from the MHC report: Cannabis use can:

  • increase the risk of mental illness in young adults, namely with those who have a family history of psychosis
  • make any current mental illness worse
  • induce poor education and employment outcomes

This report once again reminds us, kids, that we must always say no to drugs. Especially if you’re mentally ill.

Girl, InterruptedAn article from the UK Guardian points out that Hollywood’s depiction of mental illness is NOT what people experience on a normal basis. Tim Lott states the reality of mental illness quite well:

“Genuinely accurate depictions of mental illness are still rare in all the art forms. Why? For the very good reason that real mental illness is boring. Depressives are toxic and dull. Manic depressives are irritating. People with schizophrenia or autism are largely indecipherable.”

Just in case you didn’t know, depression can be a problem during the holidays. Oh and p.s. from the article: those who abuse anti-depressants are more likely to commit suicide. You know… just in case you were wondering. Amy Alkon at the Advice Goddess Blog rightly shoots down the holiday-suicide increase myth.

NBC5 in Chicago has reported that “brain music” can help fight depression. Brain waves are recorded through an EEG (electroencephalogram) and then the recordings are turned into a music CD containing two files. According to Dr. Galina Mindlin, who introduced the therapy to the U.S. from Russia, says one file helps a patient relax and the other file helps increase “concentration, performance and productivity.” Mindlin adds that the “relax” music helps decrease anxiety levels in a patient and helps the patient fall asleep and stay asleep. The treatment, according to NBC5, has been used in Europe for the past 15 years, but is not widely available in the U.S. BUT if you’re itching to try it, you’d better have some dough in your pocket: it’s not covered by insurance and costs $550.

Nerves and New Orleans

I promised myself I wouldn't write entries on the past but I'd already had the following typed up and I can't just let it sit and rot:

I haven’t heard much about it but a device called the vagus nerve stimulator was approved by the FDA in 2005 for “chronic or recurrent treatment-resistant depression and bipolar disorder.” It was previously approved for epilepsy treatment only. The VNS generator is implanted under the skin from the chest to the neck, around the vagus nerve that connects the brain with major organs. VNS is only recommended for people who cannot use medications due to side effects or receive no relief from mental illness.

The New York Times has a stunning piece on Katrina’s latest legacy in New Orleans: unprecedented post-traumatic stress disorder (PTSD), depression and suicide in the city. The article is a grim reminder that while the world has moved past Katrina, New Orleans has not. I’m sure the same could be said for Mississippi, which gets considerably less attention.