Feelings of sadness after children leave home - how long does this go on before being classified as depression?
Jane It depends on how sad you are and how much your sad feelings interfere with your daily life. Depression has many other symptoms. What is entirely normal is to experience a period of grief after a separation of this kind. Generally speaking if a pervasive sadness and grief reaction goes on beyond six months, it may well be worth seeing your doctor about it.
Dr Isaac
Depression or personality disorder? I'm perplexed by the labels given to people suffering such illnesses - what is the difference?
Julia Clinical depression is an illness. Personality disorder is not. Personality disorder is an accumulation of personality traits that we all have, but which in most people do not dominate the picture or cause significant impairment. Depression is common in personality disorder, but the vast majority of people with clinical depression do not have a personality disorder.
Dr Isaac
I have suffered from depression for many years. One of the most helpful therapies, Creativity, through writing and painting, was set up in our area and was largely instrumental in several sufferers being able to resume their normal lives and return to work or college. Why does the NHS not give more priority and help to these therapies and help with organising and financing them? It would help cut down bills for treatment and medication.
Janet I totally agree. Through contact with others who have found such support helpful I would encourage you to campaign for the same. One of the key issues is current service needs for evidence based treatments and the lack of formal research and evidence regarding the treatment you mention. The government has however, expressed a commitment to listening to service users and I feel there are opportunities to use this policy to try to make changes. Perhaps yourself and peers would be able to write something about your experiences and seek support from supportive professionals to publish the same?
Lorna Jellicoe Jones
I am thinking of joining a self help group for depression but don't know where to find one. Do you have any suggestions?
Jan There are several ways to do this. The Depression Alliance in the UK has a good name, and has many local branches. You can also try your local branch of the Mental Health charity MIND.
Dr Isaac
I have suffered severe depression following 15 years of domestic violence. It's being treated (so far unsuccessfully) with anti-depressants and counselling. Should I also be supported in confronting my ex-husband?
Anon Firstly, given the length of time you have suffered violence, give yourself time in therapy to address the issues it has raised for you. In future if you continue to feel you are not making progress, it would be important to discuss this with your therapist and consider whether other possibly more intensive psychological treatment is required. With regard to confronting your husband again I would suggest the need to explore this with your therapist. It will be important to consider for example; what you would hope or want to achieve by this and or whether other ways of continuing to move forward in your life will be more productive for you. You may find opportunities to confront perpetrators through any contact with women's pressure groups as an alternative.
Lorna Jellicoe Jones
I am a smoker, around twenty a day. Is there any scientific evidence to indicate that smoking exacerbates depression, makes it worse, as with other substances?
Joan The direct link between smoking and depression is difficult to make. Smoking has a number of health consequences, such as heart disease and diabetes, that predispose to depression. And nicotine, as well as being highly addictive, can interact with medication of all kinds, including indepressants.
Dr Isaac
What do you think would be the most effective way to reduce the stigma STILL surrounding mental illness even though statistics demonstrate that - especially for women - it is extremely common. Currently, coping with the stigma can be almost as bad as the illness itself.
Lucy I think a key need is to start education at an earlier age, for example in schools. With information focused on normalising emotional distress and reducing stigma. I also think it is important for services users to be consistently involved in the training of professionals in an equal collaborative way. In addition it is important for professionals to recognise coping with stigma as an essential part of treatment. I have undertaken research, which highlighted the need for this.
Lorna Jellicoe Jones
I have read that Obsessive Compulsive Disorder is the second most common mental health problem after depression (and is frequently accompanied by depression). Is this high incidence actually now matched by a corresponding high diagnosis rate, or does it still tend to be a hidden and ignored disorder?
Stephen OCD is commonly missed, especially if there is depression as well. One consolation may be that some of the anti depressants seem to help the specific symptoms of OCD as well. But OCD is a common and often very disabling disorder.
Dr Isaac
I don't know how to explain to my boyfriend that it's not his fault that I have scars on my wrist, can you help?
Kate Have you thought of contacting National or Local Self Injury Support Groups? They offer support and advice on such issues, including to partners or carers. The Bristol crisis centre may be helpful or they maybe aware of local groups. If your boyfriend is aware you self injure, perhaps some of the point raised today about how we all self injure in different ways maybe useful, alternatively discussion of some of the different roles and functions it has may help.
Lorna Jellicoe Jones
Is there ever complete recovery from depression or is it always there?
G Depression is a long term relapsing illness. It is very treatable, and remission (that is complete abolition of symptoms) is entirely possible. In this sense, it is similar to many other medical conditions such as asthma and diabetes, which are also treatable but not in the end curable.
Dr Isaac
During the programme one of the women said that when she showed any emotion her medication was increased. My experience of being in mental hospital was that if I complained about the conditions my medication was also increased and I was put on 24 hour watch. What can be done to stop this happening to people in hospitals? Are there any patient's groups campaigning for better treatment of mental patients?
Penguin Women in special hospitals campaigns for improvements in the secure services and has specifically highlighted issues regarding medication. In local services advocacy or user groups should be contacted.
Lorna Jellicoe Jones
My GP says I would benefit from seeing a psychologist but said that the only way to do this was to see a psychiatrist first, why is this so?
Nora This may reflect local referral procedures and protocols, in some areas GP's can refer directly to psychology, so you could question this. You obviously have the right to further explanation as to why this is the case. Again it may be useful to raise some of the points discussed on this programme!
Lorna Jellicoe Jones
Is depression hereditary? I have had depression, on and off, over the last 33 years since I was 15. I'm concerned about the possibility of having passed on a predisposition to depression to my teenage daughter.
From a regular listener Depression is so common that it is not surprising that it occurs several times in families of any size. This means that is very difficult to find out exactly how much it can be inherited. The chances are that there is no predisposition to inherit that explains the onset of depression.
Dr Isaac
My 32 year old daughter has been suffering from bi-polar affective disorder for some years. Having been sectioned in Aug 2003 during a manic phase she has been suffering from extreme depression since Sept '03 and has been on very high doses of anti-depressants. I'm concerned that she isn't getting any 'talking therapy' treatment, the local cognitive behavioural psychologist having deferred any treatment until she's 'better.' Any suggestions?
Katy A key issue for me would be your daughter's wishes and ability to make choices about her treatment. Advocacy services and user groups maybe useful sources of support to peruse this issue. Equally it may be worth looking on the internet regarding evidence for the efficacy of different treatment approaches at different times, to enable you to argue from an informed perspective.
Lorna Jellicoe Jones
Our 17 yr old daughter has been ill for the last 4 yrs. She was admitted to Eating Disorder Unit with Anorexia and Bulimia at 7 stone. After 18 months she was transferred to the secure unit. In all of her treatment, her father and I have persistently noted and commented on the correlation between her deepest depressions and her menstrual cycle. This has been completely ignored by the "professional" involved in her case. Is there any link?
Maureen The hard evidence of a link between hormonal changes and depression is difficult to find. The most important point is that dips in mood should be related to the identical phase in your daughter's menstrual cycle every time. If the dips differ between months so that one month the dip will occur just before the period, while in another month during or just after, the chances are very small that there is a real link. Perhaps if she or you kept a simple diary, you might a clearer pattern. But the notion should not simply be dismissed out of hand.
Dr Isaac
Why is there a lack of resources for adolescent girls between ages of 16 and 21. Our daughter is suffering from Anorexia and she is being held in an adult psychiatric ward dealing with a wide range of mental health problems where the next oldest is 25.
Peter Services for 15-25 year olds are perhaps one of the greatest gaps in mental health services. The voluntary sector in some areas has attempted to address this, for example; in Manchester there are young people's mental health projects, which cater specifically for this age group, in a non stigmatising way. With regard to your daughters needs I am not sure whether you have contact with the Eating Disorders Association, which attempts to provide support for women with Eating Disorders and families. They also campaign to improve services. Young Mind is an alternative possible source of pressure on services. It would be important to note, how much the gender issues raised today are incorporated into your daughters care and treatment.
Lorna Jellicoe Jones
Why can't more resources be targeted at helping sufferers understand what they can do to help themselves? I do not mean pulling yourself together - rather understanding what actions exacerbate the situation (ie drinking) and what will help (ie exercise, diet etc). Drug treatment has an important role, but as part of a wider treatment solution. With resources stretched for counselling services, individuals need to take actions to 'manage' their health without waiting for the drugs to magically solve the problem.
Lynsay I couldn't agree more! If we recognise that there are many conditions that fall short of clinical despression, there are many things that you can do. You quite rightly mention diet and exercise; alcohol is a depressant, and caffeine can make you anxious. Social networks are extremely important.
Dr Isaac
I have been suffering from "mild", low-level depression for most of my adult life, though thinking back I can recognize symptoms of anxiety, severe lack of self-confidence and even a tendency to self-harm in my teenage years. I have been on prescribed anti-depressants at various times and have had access to short-term and some long-term counselling, always privately, which have helped to some extent. Is there an alternative to more antidepressants and more counselling, as I do feel that I have explored all there was to explore and I can see no way out of my general dissatisfaction with my life?
Anna There are different psychological models and treatment approaches, which may be worth considering as counselling may not have covered these. Equally it may be worth considering alternatives to traditional psychological and psychiatric approaches for example: services provided by women's groups in the voluntary sector. It would probably also be useful to review what has helped and what has been missing from what you have received already, given some of the specific issues which have been raised for women today.
Lorna Jellicoe Jones
My daughter last night told me she has been self harming. I have made an appointment with the GP. What else do I do? Where do I seek help?
Lesley Not all self harming is the same. Has your daughter been cutting herself or doing something else? No one self harms who is coping well with their life and many people harm themselves because they feel that their distress has not been heard or taken seriously, so they increase the stakes. The problem is that self harming behaviour, especially cutting, can become a habit that is difficult to break. You should also, as I'm sure you have done, talk to your daughter about her feelings and what made her feel so desperate that she began to harm herself. It is an extremely good sign that she has been able to trust you enough to tell you about this and you can build on this in the future. However hard it may be, please don't judge her, as this is likely to make things worse.
Dr Isaac
Why are there not women only psychiatric wards available? Having been in mixed acute psychiatric wards on 3 occasions I can honestly say they are the most terrifying places. Men and their needs are dominant; women are forced to take second place. The only way women got attention was to self-harm or to be violent. The nurses (whilst doing their best) were forced to act as virtual prison guards, the wards were all desperately under-staffed and women's need to talk and discuss their feelings was never considered.
Mandy There is increasing access to women only wards. However, there remains a lack of awareness of the need for safe women only spaces. Trusts now are being required to consider this as a priority, but as we discussed there is still lack of funding and a lack of prioritising of women's needs in government targets. I agree that women frequently learn the only way to get input, is by injuring self or others. However, this input is often punitive and does little to address underlying distress.
Lorna Jellicoe Jones
What are the current treatment guidelines for dealing with Prozac (fluoxitine)"poop out". This is when the antidepressant just stops working. I have had a long term problem with depression and have tried venlafaxine, seroxat and mirtazapine. The side effects of these were unacceptable to me and so I am back on fluoxitine. I honestly don't feel able to cope without antidepressants but feel terrible failure.
Katharine There are no specific treatment guidelines for this. Sometimes a small increase of the dose can help, but most doctors would probably prescribe a drug from a different class rather as happened to you and it is a pity that the side effects were too great. But the failure, if you can call it a failure, is the treatment's not yours. Have you discussed the possibility of having psychological treatment as well? Also, some psychiatrists specialise in mood disorders and may be able to offer some solutions to this difficulty.
Dr Mike Isaac
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