More Depression, and Not the Last

Okay, this is the day I turn on my air conditioning.  It is in the 80s outside and my bedroom has reached at least 376 degrees.  I will air condition this place or be roasted.  In just a minute.  When I finish typing.  And watching Ugly Betty, which is a new episode for the first time in forever. 


I mentioned depression yesterday and received an unexpected number of comments, both on and off the blog.  Actually, that shouldn’t surprise me, because the prevalence of this disorder is astonishingly high.  According to the World Health Organization, depression is the leading cause of disability in persons over the age of 5 worldwide.  In the United States, it is the 8th leading cause of death for men and the 16th for women (and climbing).  (2004 National Institutes of Mental Health statistics)  The NIMH estimates that 7% of U.S. adults experience an episode of major depression each year-11% if you include less severe depressive disorders and bipolar disorder.  Given those numbers, we should expect that in company where we mention depression, we will be among people who have experienced it either first-hand or in friends or relatives.  How could something that common be something we can’t discuss? 


The sad thing is, when we don’t discuss it, and let the world know that it’s an illness that affects a lot of us and it is treatable and we are dealing with it and living our lives–when we don’t convey that, more people are afraid to admit to symptoms and reluctant to seek treatment.  If the research into brain chemistry and our ever-improving understanding of the brain and how it works doesn’t convince people that depression is an illness and not a weakness of the will, the attitudes and successes of the millions of us in treatment should accomplish that. 


The worst thing about depression (after feeling lousy, losing productivity, ruining your home life, and having sleep and eating disturbances) is that it is a risk factor for suicide.  That means it is a potentially fatal illness.  The incidence of suicide in the U.S. has recently climbed sharply.  It went up 8% from 2003-2004.  It is the 8th leading cause of death in men, the 16th in women, and the 3rd in young people age 10-24.  All of those statistics are from the NIMH, which also has terrific patient information on their website (google “NIMH depression”). 


My daughter recently mentioned that she thought the roommate of a friend was depressed.  I suspect she was right.  It’s a hard diagnosis to miss in adults when you’ve lived in a family with a strong genetic tendency to depression.  As a medical student learning diagnostic techniques, I could diagnose depression by just sitting in the room with a depressed person.  You learn to feel it before you hear it.  Children are another matter-you need to know the symptoms for them, because they can look like inattention, or misbehaviour, or attention-seeking.  And it’s important to know that it occurs in children, with results that are just as ominous as in adults if it isn’t treated. 


Grey’s Anatomy is on.  It’s my favorite doctor-in-training tv series yet.  It is heavily skewed toward surgery, so the contest amongst the residents tonight involves getting points for things like numbers of sutures placed.  In internal medicine, we made our points by (1) presenting every history and physical to our team on morning rounds fully from memory, even after being up all night and admitting eight patients; (2) having an arsenal of journal articles on every relevant topic that we could quote from memory; and (3) single-handedly making complex diagnoses before anyone else on the team.  We thought surgeons were Neanderthals.  Numbers of sutures indeed!  (Not to say that I couldn’t suture.  Two of my best friends, both a year ahead of me, made me practice until I was adept at suturing, and my surgical attendings complimented me on my skills.  I could also place my full 128 pounds on a retractor and keep all the guts out of the way on an abdominal surgery.)


Okay, not the time for medical exploits.  Today I have worked some more on the prototype sock.  Those of you who want to see it will be able to, after you are sworn to secrecy.  Not that there’s much to show right now.  I’m just approaching the part with the innovation, and it’s gonna be hard to knit, so I may still just be talking about it for the next few days. 


Oh no, wisdom from Grey’s!  George just said “Great doctors-they know when to stop.”  How true and real is that?  One of the hardest things to teach to my interns and residents. 




3 Responses

  1. We haven’t turned our AC on yet – but our house does stay pretty cool – lots of trees around. I’m sure it’ll go on after this next cool spell.

    I’d love to see your socks. And I’ll be glad to swear!

  2. We are in the Air Conditioning mode too….
    We have window units though…so it is tricky getting the noise level to a comfortable roar!
    I struggled with anxiety, not depression, for a few years and the meds were not helpful to me at all. They made me sleepy and lax..but the withdrawal was horrendous, even tapering. Anyway, the thing is to take care of it as soon as it appears…and there are various ways to do it…I am glad you know what works for you…depression sucks…
    Hope to see you soon…we keep missing each other.

  3. I really can appreciate your insightful take on depression. I can’t agree with you more about the stigma that surrounds mental illness. It is critical that people speak out about their problems and let others know that it is an illness and not a choice. Afterall, who would choose to feel sad all the time? Thank you for helping to enlighten others about the problems of those who struggle with mental illness. 🙂

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