Depression and Real Goctors

[mrissa]

This was going to go in a comment to one of my earlier posts, but it might get lost there, and I don't want it to get lost, because it may be important to more people than just the person I was talking to. I hope not, but it might.

If you tell a doctor that you are suicidally depressed and the doctor tells you that it's normal, just deal with it, the doctor is wrong. If you have any way of seeking another doctor and/or alternate treatment means, please do so. I know depression makes it more difficult to gather the motivation to seek treatment. It's one of the most insidious things about it. But please try. It's important.

If you tell a doctor that you are suicidally depressed and the doctor tells you it's because of your stupid girly hormones and you should stop whining and leave room in the waiting room for real sick people...well. WRONG doesn't even cover how wrong. If you have a doctor treating you like that, I hereby lift the ban on kicking the doctor in the stomach and shouting "No no no not real goctor." Kick as many times as you like in as many locations as you like. Should your depression leave you without the motivation to kick, a squad of willing -- nay, eager -- kickers will be appointed for you. And if you can get the motivation together, please lodge a complaint about the doctor. This treatment of a patient is both incompetent and insensitive.

Yes, various shifts in hormones can change people's brain chemistry and overall moods. This is utterly true. Yes, women are more prone to depressions at times of major hormone shift like menarche, post-partum, perimenopause, and menopause. Suicidal depression is still a medical condition that deserves attention, respect, and treatment. Even if every single woman got suicidal the year they hit menopause, it would still be worthy of treatment and attention.

Many men who live to late middle age and beyond to old age get prostate cancer.* The older a man lives, the more likely he is to have had prostate cancer somewhere along the way. We don't tell them that it's really normal and common and they should stop whining and just deal with it and quit taking up space for real sick people. We have a range of treatments to help them get better. This is like that. It doesn't count less just because you've got ovaries, and it doesn't count less because it's about feelings.

If you think I sound angry, you're right. I am. But I'm not angry at the depressed people in this circumstance. I'm angry at the doctors who took it upon themselves to belittle and ignore a dangerous medical condition, and to probably make it worse with their behavior. Good doctors don't do that, period.

*So guys, get screened.

Comments

[aimeempayne.livejournal.com]

There is even evidence that those hormonal changes can cause decreased thyroid function, which is a very specific medical condition that requires treatment. I can also cause depression. The idea that a doctor would ignore that really, really makes me angry. At least when doctors drugged women up with laudanum for "female troubles" they were offering some sort of treatment.

[mrissa.livejournal.com]

It's a very sad situation when, "Here, have some laudanum!" looks like superior medical treatment.

[pariyal.livejournal.com]

There is even evidence that those hormonal changes can cause decreased thyroid function, which is a very specific medical condition that requires treatment.
I know. My thyroid effectively stopped working after I'd had three babies in nineteen months (two of them twins). Thyroid malfunction does run in the family, but we never thought it was that (suspected being beset with toddlers, creeping old age, not trying hard enough, etcetera) until I went to the doctor for something else entirely and he could tell from the way I looked.

I can also cause depression.
Can you? Well, please don't :-)

[jmeadows.livejournal.com]

Yes.

Thank you.

[buymeaclue.livejournal.com]

Yes. Yes. Yes. Yes. Yes.

I could keep typing 'yes' until I filled up 83490281 screens and it still wouldn't be 'yes' enough.

Yes.

[songwind.livejournal.com]

No kidding! I'm constantly amazed by some of the things doctors say to their patients. Fortunately the worst thing along these lines that has happened to me was to be told that having daily joint pain in my knees at 18 years old was "just aches and pains that we have to deal with as we get older." It's not like my knees were immediately dangerous or symptoms of a condition that would make me less likely to get treatment (like depression). I knew several people (male and female) in college who were basically told to just suck it up when suffering depression. Most of them went on to eventually consult a psychiatrist and be diagnosed with clinical depression.

[iagor.livejournal.com]

True. True in case of homicidal/suicidal/incapacitating depression.

At the same time, I have all of the respect for the doctors who:
a) suggest other treament before recommending a drug coctail
b) recognize that the problem may be connected to a temporary condition and explain it to their patients
c) teach their patients to be honest and realistic

American nation in particular is addicted to shortcuts. I think it's true of any developed nation on the planet. No, we are not suppose to be deliriously happy all the time. No, just because your child is acting up or doesn't pay attention, he does not automatically have ADD. No, just because you can't concentrate at work, doesn't automatically mean you have adult ADD.

Sometimes the problems stem from chemical imbalances within the body and are inescapable without drugs. And sometimes what is really needed is a lifestyle change, a radical reversal in direction of life. A good doctor will recognize the depression for what it is and will never make light of the patient's ailment.

[mrissa.livejournal.com]

Yes, there's a difference between depression and "being down." I think antidepressants are both over- and underprescribed: that is, they're not always getting to the people who need them.

I did not mean to imply that the doctor should always prescribe an antidepressant, just that the doctor should always take the situation described seriously.

[iagor.livejournal.com]

I completely agree with you. :)

[toolittletime.livejournal.com]

It happens to us guys too - my Dr. told me everybody gets sad & I should just get over it. Took a near breakdown in his office to get a scrip for the weakest SSRI he could find. Luckily it was sufficient.

[mrissa.livejournal.com]

Yes, definitely. There's a skew towards "hormones" as a reason to ignore female patients, but male patients get ignored, too.

[redbird]

Answers like "you need to exercise regularly" or "get out of that situation" may be difficult to act on, but they do recognize that the problem is real and suggest a solution.

[iagor.livejournal.com]

"Answers like "you need to exercise regularly" or "get out of that situation" may be difficult to act on, but they do recognize that the problem is real and suggest a solution."

Eaxctly. Although a lot of times it's a little bit more complicated. A specific case comes to mind: a friend of mine who was married, had three children, and found out that he husband is cheating on her. They went to a marriege therapist who immediately suggested that she had clinical depression.

She was reffered to a specialist, who sat down with her, and in the course of treatment she realized that all of her self-worth was tied to her husband. In her case, exercize and going to college did wonders for her wellbeing and given her determination to leave her husband , who is a complete scumbag.

Puting her on drugs had a good chance of turning her into a fatter and more docile vegetable. But again, in case of suicidal depression that's a whole other story.

[laurel]

Yes, what you said.

I once had a doctor tell me how smart I was and that he was confident I could get through the down times I was having, etc. Yeah. Great.

And I wish like hell doctors had figured out what was really going on with me years ago. Instead of patting me on the head and saying "you'll be fine."

[mrissa.livejournal.com]

Using people's intelligence against them that way is one of the things that makes me most furious. It seems to happen particularly often to kids, but unfortunately it doesn't go away for adults, either.

[callunav.livejournal.com]

Where can I sign up to be appointed as a kicker? I'm good at things like this, honest.

[mrissa.livejournal.com]

I figured if anyone needed one, I'd just post to lj and see who on the f'list was free that day.

[leahbobet.livejournal.com]

I volunteer kicking services if and when required.

[mamapduck.livejournal.com]

Goctors? The first instance I wrote off as a typo but you did it twice, suggesting intent. 'Splain?

[mrissa.livejournal.com]

porphyrin's little boy Roo (see picture in icon, ordinarily Auntie Mrissa's angel-boy) was not thrilled to be taken to the clinic and shouted at his pediatrician, "NO NO NO NOT REAL GOCTOR!" This was the doctor he's seen all his life, and someone his mother (who is also a doctor) knows, likes, and works with, so she was embarrassed, and the rest of us were greatly amused that instead of "I don't wanna" the kid questioned the guy's credentials.

[fiddledragon]

The OB that delivered Kritter and Beena went the opposite way. I went on the pill after Kritter was born, but had a LOT of problems with depression - it may have been coupled with post partum depression. In any case, I had a strong feeling it was due to the pill, and I went in to see him to discuss going off of it. Though there has been research published indicating that the pill can sometimes cause mood swings and depression, he poo poo'd it, telling me that it wasn't possible, I was depressed, and he was putting me on Prozac. (I should also mention that this was in Indiana - home of Ely-Lilly corporation - producers of Prozac). I told him I was going off the pill anyway. less than 6 months later I was pregnant with Beena, and his partner and I discussed it, and he agreed I didn't need to be on Prozac.

[mrissa.livejournal.com]

As I said in another comment, I think antidepressants are both under- and overprescribed: they don't always get to the people who need them. Listening to one's patients and not belittling the things that are bothering them is important.

[fiddledragon]

*nod* *nod*

[stillnotbored.livejournal.com]

Yes, yes and yes. I know this scenario first hand.

Back in my 20's when I first started showing symptoms of lupus, and had no idea what was going on, the doctor I was seeing told me it was all in my mind. He literally patted me on the top of the head, told me that it was all hormonal, I was depressed and wanted to give me Valium until I got 'over the hump'. He went so far as to tell me that I was the perfect example of why we should never have a woman president, because one bad PMS month and she'd launch the missiles.

I kid you not, those were his exact words. Took me two more doctors and almost two years to find out what was wrong with me.

Women much more than men still get dismissed in our health care system. That is one of the huge reasons I seek out younger, female doctors and have for years. Most of them will take me seriously and don't treat me like a brain dead three-year-old.

Available for kicking detail when ever needed.

[nycshelly.livejournal.com]

There are some great male doctors out there. I wouldn't trade mine for anything. I worry what I'll do when he retires. He's a couple of years older than me, I think. He looks a bit like John Lithgow. All my other doctors are men except my gyn. And not one of my doctors has ever dismissed my symptoms or complaints.

But I agree that women are more likely to be dismissed than men and that has to stop.

[mrissa.livejournal.com]

That is un-freakin'-believable. (Which doesn't mean I don't believe you. Just--GAH.)

I think women do get dismissed more often. I also think that men have a cultural disadvantage as well: they're taught not to mention things that really might be relevant. But that doesn't mean we can't work on both problems.

[nycshelly.livejournal.com]

It's not just depression that gets treated that way, and it's usually women whose complaints get dismissed by doctors. I know someone who had a grapefruit-sized benign brain tumor removed about 8 or so years ago months after her doctor dismissed her complaints about numbness in her feet as nothing more than hypochondria. She was in her 30s and by the time she got a brain CAT and MRI, the numbness was up to her knees.

Depression is also a symptom of a number of medical conditions. It's a symptom of thyroid problems. I know. I got depressed when I developed hyperthyroidism (it's not just hypothyroid that can be accompanied by depression; I had symptoms from both conditions). While my depression was mild, it was enough to concern my best friend. I was already being monitored for an overactive thryoid and when I looked up the symptoms of thyroid problems, there was depression. And I developed the thryoid condition in my mid-40s, well before I started perimenopause. In fact, my thryoid problems affected my cycle and led my doctor and me to wonder if perimenopause was starting, only for that to be a false alarm. Things went back to normal there once my thryoid was zapped.

First thing any doctor should do, IMO, for a complaint of depression or anything similar is to do a complete physical, including a regular workup of blood tests, including TSH (thryoid stimulating hormone) and blood sugars (I know someone who suffers bouts of depression when his sugar levels drop -- he's mildly diabetic).

Along with making sure there's no physical underlying cause, the patient should receive some sort of treatment for the depression. Even if it's simply perimenopause, that doesn't mean the depression isn't real. And look at post-partum depression and what it has led some women to do.

Any doctor who dismisses a patient's complaints or symptoms is simply not doing his or her job. No ifs, ands, or buts about it. My doctor has assured me for various things that my symptoms are probably nothing, but he's run tests anyway, to be sure. That's how it's supposed to be.

And if someone feels suicidal, that should be checked immediately. There is no margin for error. The solution might be drug therapy or maybe something else, but without further examination, there's no way to know what's going on.

[mrissa.livejournal.com]

One of the things that has been good about my experiences lately with health problems is that none of the specialists I've seen have attempted to tell me I don't experience what I experience. They'll say things like, "Wow, that's really weird," but it's never in that dubious tone that bodes no good. They can't come up with what it might be, but they're perfectly willing to stipulate that it is something.

[nycshelly.livejournal.com]

That's good. My co-author has had dismissive doctors, but her current ones accept her as a challenge. They want to get to the bottom of things. She's a mystery they want to solve. You'd think all doctors would be that way. Isn't that why they went into medicine? To help people?

[mrissa.livejournal.com]

Our medical training system is set up so hideously, it's amazing anyone gets through it with any empathy intact. All the good doctors I know get double doses of respect from me, because it looks to me like they've had to struggle against the system on more than one occasion, rather than having it help them to be better doctors.

[dreadmouse.livejournal.com]

Abso-freaking-lutely. I couldn't agree more. I volunteer for the kicking squad.

Yes, about doctors and stuff

[markiv1111.livejournal.com]

Mrissa, this is *very* important stuff. I know. In May or June 1978, in the aftermath of a painful breakup, I tried to kill myself with 300 Bufferin tablets. My roommate at the time absolutely insisted that I go down to a facility I remember vaguely as Hennepin County Mental Health and talk to a psychiatrist. The one I saw absolutely insisted that there was flatly and absolutely nothing wrong with me except the breakup (a breakup that had in part been caused by my depression) and absolutely refused to give me anything for it, raising his voice over mine several times to tell me that I was perfectly okay. About three years later, despite my being in the "crisis" level on six scales out of ten on the MMPI, the same psychiatrist tried very hard to convince me to go cold turkey on the meds a different psychiatrist had prescribed for me. I never saw him again. This is dangerous stuff and yes, it *is* a freaking big deal. This doesn't mean that everybody else out there is "clinically depressed" and I'm not trying to undervalue the thyroid problems many of you have discussed, but it means that sometimes the only thing you can do is walk away from the doctor. And maybe there had been someplace I could go to file a formal complaint -- I don't know.

Nate

Re: Yes, about doctors and stuff

[mrissa.livejournal.com]

And the hell of it is, the people who most need to file formal complaints are going to have the most difficulty in this case. Depression does that.

I'm glad you were able to walk away and find some other solution between then and now.

[leahbobet.livejournal.com]

Yeah. This is why my current doctor and my last doctor have been younger women.

[mrissa.livejournal.com]

My current doctor is matociquala's good twin.

[madwriter.livejournal.com]

This is the next generation of the group of doctors who spent ten years telling my grandmother that her headaches were "all in her head" (they never recognized the pun), before surgeons removed a brain tumor the size of my fist.

[flewellyn.livejournal.com]

Y'know, I bet if the patients were male, they wouldn't be dismissed so quickly.

[mrissa.livejournal.com]

In many circumstances I think this is true, and it's an important thing to address.

I also think men have some cultural disadvantages when it comes to dealing with the medical system. The focus on male stoicism can be extremely damaging both with the health professionals immediately on hand and in terms of sharing information etc. When my grandpa had his prostate cancer surgery, some of my (male) high school friends dropped by, and what he had to say to them was, "Don't do this if you can avoid it." If it had been my grandma with breast cancer and girl friends of mine, she'd have been giving lessons in breast self-exams from her hospital bed.

I'm not convinced that it "evens out," or that it's good to have problems for both sexes (and let's not even get into all the problems people whose sex is not definitively binary get into with the medical community, oof). But I also don't think that it's entirely that women get a bad cultural deal. We do more in some ways, and less in others.

[flewellyn.livejournal.com]

Hmm...yes, I can see that.

But what's worse? "Take it like a man"? Or "Oh, you women make stuff up all the time"?

I'm sure I don't want either, but...

[mrissa.livejournal.com]

That's just it: I don't want either, and I don't want a society that endorses either.

[timprov.livejournal.com]

Um, it's not really practical to do prostate cancer self-exams, dear.

[mrissa.livejournal.com]

No, but there are other useful pieces of information that can get passed on.

[flewellyn.livejournal.com]

The goatse guy probably could.

...and now I need to scrub my brain out with bleach and a wire brush.

[mrissa.livejournal.com]

Your brain and my livejournal, thanks. I think "goatse" is a word that doesn't need to appear here again.

[flewellyn.livejournal.com]

But you just said it again!

*scrub scrub*

[telophase.livejournal.com]

During my first stint in grad shcool, I told the school doctor I thought I was expereincing symptoms of depression, and she referred me to the campus counseling unit*. Who gave what I think must have been a new or trainee counselor - her big piece of advice was "Well, everbody feels down sometimes." I JUST TOLD YOU I HAVE BEEN HOLDING A KNIFE TO MY WRIST DO NOT TELL ME EVERYONE FEELS DOWN SOMETIMES.** Oh, and she really wanted me to tell her why it was so important that I was diagnosed with depression. BECAUSE I AM DEPRESSED YOU NIMROD.

I didn't go back, and struggled trhough a few more years with what, looking back on it, was clinical depression. I managed to get out of it somehow. No idea how.


* We did a poll of the people in my depertment and 3/4 of us admitted going to counseling during our stint there - the department had a very poisonous atmosphere.

** No suicidal intent, actually. I was just in some sort of fog most of the time and the knife was the only thing I could feel - thin cold metal cut through the haze of my perceptions.

[mrissa.livejournal.com]

While I have not experienced either, the distinction between suicidal intent and sharp sensation has been described to me enough that it's clear. I still think, with you, though, that it is a clear enough indication to set off warning bells in competent counseling services.

I hear tell that when grad school is good, it's very very good, but I have more of the when it's bad, it's horrid side of experiences, myself.

[blzblack.livejournal.com]

Amen.