It Did It

February 14, 2003 8:25 PM

"It Did It" is a beautiful and haunting short flick about depression. Peter Brinson artfully uses the Scientific Method to creatively document the effects of the drug Zoloft on his mood and his brain chemistry.
posted by VelvetHellvis (71 comments total)

PROPAGANDA!

Yes, depression does not make you special. You must take crippling psychoactive drugs that may make orgasm impossible and turn you into a hunchback. Prozac may lead to suicide. Buy more Prozac now! You have no choice but to buy more. I am a doctor, and you will be sent to crazy prison if you don't buy more.
posted by son_of_minya at 8:46 PM on February 14, 2003

Son of Minya, I just found the construction of the film and the underlying story compelling. There are better things to propagandize about and I certainly know better than to do so on MeFi. Not a troll, just a link to something I felt was well done, interesting and above average.
posted by VelvetHellvis at 8:52 PM on February 14, 2003

VelvetHellvis:

I am willing to accept that your own personal motivation was not to propagandize psychoactive drugs. The short did have some merits outside that, and the site itself was worth visiting. (The Pac-Man tea cloth puzzled and intrigued me.)

Sorry for opening the comments with a negative thought, too.

This short, though, really, really angers me. "I wonder if that's a sign of depression? My alien friend Steve says I need to take Prozac." This makes me want to drown in black bile.
posted by son_of_minya at 9:00 PM on February 14, 2003

At least he named his cats Alexander and Kieth. So the guy does have an appreciation for the finer things in life :)
posted by Space Coyote at 9:03 PM on February 14, 2003

Zoloft is not a serotonin suppliment pill it is much more complex and how it affects the brain structure in the long term we don't know. I know depressed people who take it and the worst past is watching their libido die off which is normally a major shaper of personalitiy and behaviour, they become happy old people doing time.

Diet, exercise, meaning and purpose in life, steady schedules, sunlight, detox programs, etc.. it takes effort and time but the natural way is the only solution, drugs are a short term fix, as he says coming off it was difficult after only one month it may be very hard long term. It's seductive to think a pill can make us better people. As the film says, being happy with ones self is the key.
posted by stbalbach at 9:08 PM on February 14, 2003

Well, when I went nutty for a while when I was 15, Zoloft was a god send. It's nice not to cry every single hour and being in control enough to work out your problems. And the decreased sex drive was the least of my worries back then.
posted by lychee at 9:20 PM on February 14, 2003

Sorry, kid, but that's just not true for everyone. I have been on and off medication for years and have tried everything under the sun (including sunlight) to avoid drugs, to no avail. Without the massive dose of Zoloft that I take, I become a bed-ridden wreck. With it, I'm as functional and social as I have ever been able to be. And my libido did not suffer at all (ask anyone who knows me), only orgasm is a bit more elusive. I had to be frank about this because these sorts of drugs, for all their problems, save people's lives. They're not cure-alls, but they help when nothing else will. We can get all Metafilter Anti-Corporate like, and tell people that they need to be "happy with themselves" (whatever the hell that means) and fight the evil drug companies. All this is noble advice to some, but to others lying in their shaded bedrooms and having panic attacks because they feel like they are suffocating, that little pill can be the first step on the road to recovery, or at least, stability.

Thanks for the interesting post, and sorry to be so crass and forward about personal information, but I needed to say it.
posted by sir walsingham at 9:30 PM on February 14, 2003

Well, Zoloft beats suicide. After all, dead people don't have sex drives.

(stbalbach, for 90% of the population, your list of solutions -diet, exercise, steady schedules, sunlight, etc.-are excellent ways to improve one's mental outlook. I join you in recommending all of them. But please have pity on the 10% that aren't helped in these ways. Painting everyone with a broad brush can be very cruel to that subset of individuals.
posted by konolia at 9:36 PM on February 14, 2003

Props to those who find a way to manage their depression and their lives, no matter how you mange to do it. I believe the "cure" should be tailored to the individual.
posted by VelvetHellvis at 9:39 PM on February 14, 2003

>As the film says, being happy with ones self is the key.

Almost a Disney ending there eh? Depression has been linked to genetics and brain chemistry is a bit more complex than "go smell the flowers."

Hundreds of thousands of people get positive results from antidepressants, how long they stay on them and how much of their treatment is dependent on pills is their business.

I know its very hip to give a positive life affirming message and believe that drugs are nothing but placebos, but tons of medical research kind of kills that argument. Not to mention a working antidepressant actually brings back one's sex drive. Overplaying that side-effect, which only certain antidepressants cause and usually temporarily, is just building a very unconvincing straw man.
posted by skallas at 9:45 PM on February 14, 2003

sir walsingham and lychee -- you have good points and compelling storys. No offense intended sorry I do realize this is a more serious problem for some. In any case my concern is we know enough about the brain to be dangerous. We know certain chemicals can permanently alter the brains chemical balance. It would seem like a powerful drug like Zoloft over a long period of time could possibly do the same. Would it be possible to use something like Zoloft as a bridge to give the time and energy to work on more sustainable natural solutions and then slowly work off the drug. It seems like doctors prescribe it very easily these days with little discussion about an overall strategy. This film is a good example of one persons attempt at this.
posted by stbalbach at 9:50 PM on February 14, 2003

Why are people surprised when some people suffer from side effects (newsflash: this happens with nearly EVERY drug)? Antidepressants have saved many lives, and made it possible for many people with crippling depression to function normally. stbalbach, while some people with mild depression may get relief from lifestyle changes, severe clinical depression is most often caused by a chemical imbalance (too-rapid uptake of serotonin), selective serotonin reuptake inhibitors like Prozac restore the balance, I don't really see what finding "meaning in life" has to do with a physiological problem like this (it can certainly help with the long-term management of depression, but it's just plain inaccurate to state that positive thinking and getting more exercise is the cure for all depression). Medication is not the right solution for everyone, but, in conjunction with therapy, it works extremely well for many people (on a temporary or permanent basis). To imply that people with a physiological problem wouldn't feel suicidal if they just tried a bit harder to be happy is not only ignorant, but cruel.

And what skallas said.
posted by biscotti at 9:54 PM on February 14, 2003

As a film I really appreciated this. Thanks for linking to it. Whether or not you believe depression can be cured by drugs, you have to admit this was a strong personal film.

Was he depressed? I hope I am never to the point where I say: "Everyday of my life I have wanted to die." Hell yes, he was depressed.

So, if exercise, diet, etc. doesn't help...why not try a drug? As for losing his libido...I didn't hear him voice that as a concern. After all, isn't libido simply chemicals acting on tissue and vice-versa? If you were a happy, well-adjusted person who found you'd lost your desire...maybe through a chemical problem in your brain....would you take a pill to fix that? Humans have attempted to alter their body chemistry since the dawn of history. I believe that desire is as natural as sex.

The question he asked was "If I am always happy will I still be me?" He titled his film "It Did It." What did what? Zoloft made him happy?
posted by ?! at 10:03 PM on February 14, 2003

Yeah, well, you see, Zoloft works. For many people. Those who find it morally questionable to take a drug to regulate moods should, I think, try living with serious depression for a while; and I can only assume that they have never done so, because I believe that anybody who has experienced it would not judge anyone else's efforts to escape it. If your emotional life resembles a marshy bog, with quicksand and deep pits at every turn, are you to be blamed for seeking solid ground? Not to get too metaphorical, but I tire of the "it's not natural" argument against SSRIs. Very little we do in our daily lives is natural, from caffeine to mass transit to reading Mefi to talking on your cell phone. If taking Zoloft allows you to feel a bit more confident, a bit happier, then you may, in turn, be able to address the other things in your life that are causing you grief--the courage to quit your job, whatever. I could go on, but you get the point.
posted by jokeefe at 10:19 PM on February 14, 2003

I'll tell you what, stbalbach, a bullet sure as fuck " can permanently alter the brains chemical balance."

No offense to your arrogant proclamations of knowledge regarding my internal mental health, but I'll take zoloft over the bullet any day. At least, I will now that I'm not suicidally depressed.

Thanks, zoloft! You literally saved my life!

[disclaimer: it's actually a standard SSRI I owe thanks to, but the point remains the same. Assholes who've never been to those black depths should shut their pieholes: they know not of what they speak.]

[yes, I do get a little irate when it comes to the bullshit judgement calls people make on depression. It's real, it's fucking scary as all hell, and jerk-offs who tell us to 'just get over it' are a part of the problem, not the solution. If there weren't such a stigma attached to depression, a whole lot more people would be finding help a lot sooner instead of needlessly suffering for years longer than necessary. grrr.]
posted by five fresh fish at 10:29 PM on February 14, 2003

"If I am always happy will I still be me?"

This is a true and worrying concern. It's one I wrestle with myself.

The problem is that depression is who I am. I've lived with depression since, as best I can guess, puberty -- that's twenty-odd years of adapting to it, working with it, living it, and not knowing that there was a problem and that life didn't have to be like that.

This life-is-good experience is a little unnerving for me. Am I allowed to be happy? It doesn't seem... right. And a lot of my behaviours, which were good behaviours for coping with depression and not ending up dead, don't really fit this new reality.

All told, though, it's all a hell of a lot better than the alternative. I'm not who I used to be, and I'm not real familiar with who I am now, and I don't really know who I'm going to be in the future... but at least I'm not in the black and tarry pit of despair and doubt.

Words can't even begin to adequately express what depression is like. Sigh.

k, I think I'll try to shut up about it now.
posted by five fresh fish at 10:38 PM on February 14, 2003

Someone without depression telling others with it how to treat it, is analogous to someone without children of their own trying to tell a parent the proper way to raise their children.

I've had bad depression, and Prozac is a lifesaver for me. I'm now social, i feel good about myself and have a positive outlook. Trust me, I'm generally a big cynic, but I'm a lifelong believer in Prozac now. (No, I don't work for the company, I'm just a very happy client :-)
posted by milnak at 10:49 PM on February 14, 2003

Someone without depression telling others with it how to treat it, is analogous to someone without children of their own trying to tell a parent the proper way to raise their children.

While I agree with your message, I don't agree with this statement. Having depression doesn't magically endow you with knowledge of how to effectively treat it, any more than squeezing out a couple of sprogs magically endows you with good parenting skills. I agree that many people who have never suffered from depression don't understand it at all, but plenty of others understand it very well. I don't really see much relation between having depression and understanding depression, but I see a lot of relation between learning about depression and understanding depression - it's knowledge vs. ignorance, not experience vs. lack thereof.
posted by biscotti at 11:24 PM on February 14, 2003

It's not only people who've never been depressed who have issues with anti-depressants. I was in and out of mental hospitals around 14 and 15, went through about 6 or 7 shrinks in a few years, etc. I took Zoloft for two weeks before I couldn't do it anymore. Made me feel like oatmeal -- not depressed, not happy, not anything. If a rock had a consciousness, this is what it would feel like. Nowadays I'm just bitter, not depressed as such, but if I had a choice between the depression and the Zoloft I would go with the suicidal ideations in a second.

They tell me people take it recreationally. Why anyone would do that is utterly beyond me.

Regarding the film, I don't have Quicktime, but I am almost certain this is the same film I saw at the Cucalorus film festival a few years back. If I'm right, I enjoyed it and didn't see it as pro-drug propaganda. I thought it was fairly balanced (and I am about as anti-psych-drugs as they come).
posted by IshmaelGraves at 11:25 PM on February 14, 2003

IshmaelGraves: people can react in idiosyncratic ways to powerful psychoactives like SSRI's or antidepressants more generally. That's part of why there's such a large stable of antidepressants out there -- one of them won't work for someone, or has unacceptable side effects, so you try them on another, repeat until success or you work your way down to lithium and/or ECT. Or just wait to see if it passes, or bury their corpse after their suicide.

As far as a natural cure goes, well, natural isn't any guarantee of nice. Cobra venom and ricin and botulinum and Carrot Top and red-hot fucking magma are natural, but you wouldn't want to eat them. Major depression and bipolar disorder and schizophrenia and Down's syndrome and death are natural, but they're still horrors and anything we can come up with to combat their natural selves is fine in my book.
posted by ROU_Xenophobe at 12:08 AM on February 15, 2003

Made me feel like oatmeal -- not depressed, not happy, not anything.

That's the thing with antidepressants: they can work, and they can work well (Paxil did a lot of good for me), but while you're taking them, there's always a piece missing: you're happier, but your personality never seems to quite add up.

Once you're far enough out of your pit, you begin to wonder why you need to take a pill to be out of it in the first place...your newfound balance, or normality, or whatever it is you're seeking when you're depressed, seems fake, oatmeal, grey, wet.
posted by andnbsp at 12:24 AM on February 15, 2003

5 yrs ago I suffered a crushing depression. The first one in my lifetime although it does run in my family. I spent the following year on antidepressant drugs among others, sitting in a darkened room. I couldn't watch television, listen to radio, read, etc. I merely existed. But existed is the key word here. It kept me from dying. No I didn't attempt suicide, but I completely lost my will to live. I lost 30 lbs from my already thin frame, because I simply could not eat. I was totally lost in despair. To me it felt like being at the bottom of a deep deep well with my former annoyingly cheerful, happy self at the top. I thought I would never be the same again. Never enjoy the things in life that gave me pleasure ever again. The antidepressant medication however somehow kept me alive through this. I was told that depression of this nature typically takes 2 years to overcome. I spent that year numb but I eventually weaned myself off of them, but spent another year battling to keep weight on, to stop crying, and generally fighting back. At the end of the second year I enrolled in school and slowly but surely I began to realize that I had begun to live again. I just wanted to say that being depressed is a horrible horrible thing, being on antidepressants can be numbing but they can also get you past an otherwise non survivable result. I too did not understand just what it was that other people I knew who were going through when depressed. In the past I would have sounded like some of the others here, get some sunshine exercise etc. There really is no way to describe it, and no way to understand it unless you have been through it. Its not just a feeling of sadness, its a feeling of hopelessness. That's just the only way I can describe it.
posted by SweetIceT at 5:53 AM on February 15, 2003

By the way, it generally takes 3 to 6 weeks for an antidepressant to work. Until then one really doesn't know how he/she will be affected.

It is true that while on zoloft nothing bothers you much. I have to say that the months I was on zoloft were some of the best of my life-and I lost 20 pounds to boot. Unfortunately for a small minority of people it poops out on them, and I was one of them.

I concur with the others on this thread-real depression is about as close to hell as you can get while still breathing. And altho drugs are not the TOTAL answer, I still get really annoyed at the chirpy people who insist that positive thinking snaps you out of it, and that you have a moral failing if it doesn't. My personal "favorite" is the people who tell you depression is sin. What a load of bull hockey.

But I still do get out in the sunshine when I can. It's all part of a "complete breakfast".
posted by konolia at 7:19 AM on February 15, 2003

About the film: It's good. This subject is almost designed for the self-reflecting and self-aware structure (you can see that by how fast people in this thread starting getting personal). I don't think he's really anti or pro drug treatment. "No one has all the answers" was the line that stuck with me the most.

What I can't appreciate is the total one-sidedness of so many of these posts. Did you not watch the film all the way to the end? If someone says they don't think anti-depressants work that well or not at all, you can't just explain based on your own personal experience. Well, you can, but you're not convincing at all since you can't prove thoughts or state of mind to someone else. Plus, it sounds like a bad game of Who Suffered More.

Of course, my main problem is that few people who kneel down before SSRI's and other anti-depressants rarely mention that it is possible to overcome depression without drug treatment. It's not likely or probable or expected or should be attempted, but it is possible.
posted by dogwalker at 8:11 AM on February 15, 2003

The movie jammed before the end, but it seemed a pretty accurate representation of what it's like when someone decides to start taking anti-depressants. I wonder if it makes much sense to those lucky people who are not, by nature, inclined towards depression?

Anti-depressants have helped many, but they are no substutute for the basics in life: medical treatment that keeps you from suffering constant physical pain, regular nutritious meals instead of low blood sugar, having a job or daily routine that doesn't work you to the point of exhaustion, experiencing a bit of physical affection on a regular basis, and coming into regular social contact with people who are not only supportive, but who also share some common ground.

Giving someone else a backrub, cutting other people some slack instead of trying to squeeze maximum money and advantage from them every chance you get, and being generally supportive of other humans ... this is what helps keep people happy, healthy, and out of the depressive state. It is possible to overcome depression without drugs, but as others are pointing out, the natural cures tend to be more work than simply handing people a prescription.
posted by sheauga at 8:30 AM on February 15, 2003

At the end of the day, I'm functional and unhappy with my meds and dysfunctional and unhappy without them. I'll settle.
posted by alumshubby at 9:45 AM on February 15, 2003

sheauga: It is possible to overcome depression without drugs, but as others are pointing out, the natural cures tend to be more work than simply handing people a prescription.

This implies that what depressed people really need is to work at their recovery, and that people are copping out by taking medication. I can't begin to tell you how wrong and flat-out offensive this is. There is no "natural cure" for clinical depression aside from suicide, and as long as you perpetuate the myth that antidepressants are only for the lazy, you continue to stigmatize depression and make sufferers less likely to seek help.
posted by swerve at 10:14 AM on February 15, 2003

dogwalker, my reaction when someone says that antidepressants don't work is that all that they mean is that antidepressants (or just some given antidepressant) didn't work for them, or for someone they care about. Any given antidepressant won't work for a significant percentage of the population -- ISTR 15--20% but could be wrong. This is a serious problem with antidepressants and a good reason why there are so many different ones, that act in different ways (SSRI's versus, say, wellbutrin, which at least a few years ago they weren't sure *what* it was doing but they were pretty sure it wasn't monkeying with serotonin reuptake).

Of course, my main problem is that few people who kneel down before SSRI's and other anti-depressants rarely mention that it is possible to overcome depression without drug treatment. It's not likely or probable or expected or should be attempted, but it is possible.

Hey, it's a big world, lots of things are possible. It's almost certainly possible for someone to get 100% cured of depression by being chased by a loose bear, or by playing Battleship with Mr. T (or at least to have a cure right after experiencing either). Not likely or probable or expected or to be attempted, but they are possible.
posted by ROU_Xenophobe at 10:42 AM on February 15, 2003

sheauga, I assure you that there are a very large number of people suffering through major depression that is not a result of grinding physical pain, and who are not hypoglycemic, and who are not overworked, who have a schnooky who gives them physical affection, and whose social circle is supportive.

I further assure you that, for the vast majority of people suffering through a major depressive episode, after you're done rubbing their back you have a depressed person with a backrub, not a cured person. Nor is any amount of backrubs really likely to alter their balance of neurotransmitters.

You seem to be thinking of people who are, because of their objective, verifiable circumstances, very sad. That is not the same thing as depression.
posted by ROU_Xenophobe at 10:51 AM on February 15, 2003

Until four years ago, I was firmly entrenched in the camp that did not for a second believe that drugs were necessary to combat depression. Why couldn't people just "pull themselves up by their bootstraps?" But after about 8 months of a deep, deep malaise that I could not "pull myself out of," my wife finally forced me to see a psychiatrist. I was diagnosed with major (aka clinical) depression -- I hit all of the classic symptoms except inability to get out of bed. I was prescribed celexa, then a brand new drug. I was highly skeptical at first, then sorely disappointed after about a month when it didn't seem to be helping. Then right around that magical six-week period, everything changed for the better. I've come off celexa once, to fairly predictable results. So I take it to this day.

Here's one misconception people have: SSRIs do not "make you happy." The better way to put it is that they "make you not be so unhappy" (the feeling of reducing the valleys but also shortening the peaks is a common one).

Anyway, put me in the camp of those who know that these medications can save lives -- figuratively and literally.
posted by pardonyou? at 10:58 AM on February 15, 2003

stbalbach:As the film says, being happy with ones self is the key.

Somewhat easier said than done. Can't I just, like, develop a unified field theory or something simple like that?

sheauga:but they are no substutute for the basics in life: ... experiencing a bit of physical affection on a regular basis, and coming into regular social contact with people who are not only supportive, but who also share some common ground.

Well, that's me totally screwed, then.

I don't suppose someone saying "*hugs*" over IRC counts? No? Damn.

Ah well, guess it's back to the Venlafaxine for me.
posted by Freaky at 11:00 AM on February 15, 2003

Drugs certainly have their place. For many people they are the only option, but not for everyone. For those who want to (and are able to) avoid drugs, I recommend reading the book A Guide to Rational Living by Melvin Powers. It's based in rational emotive behavior therapy which is now widely used by therapists. I can't say it will work for everyone, but at risk of sounding like an infomercial, it certainly helped me.
posted by Xkot at 11:23 AM on February 15, 2003

Here is the answer!
posted by homunculus at 11:44 AM on February 15, 2003

Well, if someone can explain to me how a person can overcome a brain defect with positive thinking, please enlighten me. That is just about the same as curing epilepsy with a backrub.

Oh, and homunculus, if that book's premise were true, there would be no depressed people on Metafilter-or at least Metatalk. *smile*
posted by konolia at 12:57 PM on February 15, 2003

I get frustrated and disgusted with the arrogant attitudes so many creeps have about depression.

Do you asshats go around telling diabetics that if they'd "think positive" they'd be able to eat candy?

For over twenty years my brain has not regulated its chemistry appropriately. All the "think happy" work in the world is NOT going to fix that.

I have a fucked-up brain that, given half a chance, would throw me into that black, tarry pit of despair which makes me feel like dying.

Like the diabetic who takes insulin to counteract his screwed-up pancreas, I take Celexa to counteract my brain's screwed-up chemical regulatory system.

It's not a cure, just like insulin isn't a cure. But neither are happy thoughts.

I just wish you jerks with the arrogant views on depression could begin to comprehend what it's all about.

I guess it's like childbirth, orgasms, or salmonella poisoning: you can't really appreciate or understand what they're all about until you've experienced them.

hint: I'd recommend the orgasms, but strongly suggest you avoid salmonella and depression.
posted by five fresh fish at 2:17 PM on February 15, 2003

five fresh fish (and possibly others), don't worry that you are no longer yourself. You are still yourself, just with the obscuring factors of depressive behaviours and feelings cleared away (to a greater or lesser extent). Meeting one's non-depressed self can be a bit of a shock, particularly when you have organized your self image around the fact of your depression, which is also pretty common for those of us who experienced the onset of depression in childhood; but then there's the astonishment of finding out how "normal" people manage to get so much done--they don't have all that static clouding their minds. And I'd like to add, with all due respect and in the nicest possible way, that all those who think that depression can be cured by "rational thinking" and hugs can get bent. Me, I'm a 100-milligrams-of-Zoloft-a-day gal, and probably will be for the rest of my life. I have no qualms about this whatsoever. That little orange capsule is the difference between riding a bike uphill with and without gears.
posted by jokeefe at 2:18 PM on February 15, 2003

ROU_Xenophobe: I think you may be misinterpreting my comment. I didn't say that I personally thought that drugs won't help treat depression. I just want that to be clear. I believe drugs can (and do) help many people overcome problems with depression.

That being said, I still maintain that drug treatment is not always necessary.

And here's the thing: People think that when someone says "drug treatment is not always necessary" it implies that anyone could have overcome their depression without drugs, if only they had tried harder. What it really means is that depression is an individualized disease, with many different forms of treatment.
posted by dogwalker at 3:07 PM on February 15, 2003

dogwalker, the way your worded your comment "my main problem is that few people who kneel down before SSRI's and other anti-depressants rarely mention that it is possible to overcome depression without drug treatment." is pretty unpleasant (it's also not true in my experience). The words you used imply that those who think drug therapy works are somehow cultie drug worshippers instead of rational people. I agree with you, drugs aren't always necessary, and I know from personal experience that drugs are sometimes only necessary for a limited period, but those who've experienced the kind of ignorance the general public has of depression ("what are you sad about?" "why don't you think positively?" that sort of shit) get understandably touchy when people imply that there's something wrong with taking medication, which your post did, intentionally or not.
posted by biscotti at 3:37 PM on February 15, 2003

swerve: Apologies, it's tough to be unambiguous in these brief comments. Your point is well taken, that it's not a matter of depressed people working harder or thinking positive so they feel OK. What I'm trying to get at is that sometimes it is a cop out to hand somebody a bottle of pills, instead of taking the time and effort to help them get through the very real obstacles and problems they may face. I'm also making the point that it's important to nurture other people to help them stay happy, healthy, and prevent depression from taking hold.

If anti-depressants work for you, maybe giving your testimonial here will help someone else get up the nerve to try them too.

However, I'd like to put it out there that we aren't all alike, we aren't all willing to take drugs, and when anti-depressants don't seem to work, there are other possibilities that might. One of the reasons humans persist at sex, music, literature, and art is that the creative spirit can bring inspiration in even the darkest hours, and nobody knows exactly when this will happen or why.

Virtual *hugs* to anyone reading this who is feeling depressed. I can't give you the backrub you deserve over the MetaFilter, but we can all share some ideas here that prove there are more ways to connect with other people besides cheap tabloid passion! Hopefully, every so often, somebody posts a link that reminds you that you have a few kindred spirits in the world. I've found it a great source of comfort over the past year to have this blue screen of intelligent conversation with all of you on it.
posted by sheauga at 3:47 PM on February 15, 2003

It's not all that difficult to be unambiguous. Try this:

Depression is a multi-faceted problem that is not well-understood. Its cause may result from a number of problems, ranging from "the power of negative thinking" to out-and-out biochemical cockups in its structure.

Curing or controlling depression can be as varied as its causes.

For some, cognitive therapy may provide a true cure. Perhaps these people don't suffer a chemical imbalance, or perhaps there are cases where the brain can indeed heal itself. We really don't know. All we can do is congratulate these lucky folk on having truly beat their depression.

Others, however, are not so fortunate: their brains are indeed broken, and there is no cure to be had at this time: they, instead, must rely on a pill to regulate their brain chemistry. There's no alternative for these people: take them off the meds and, no matter how well their life was going, they fall back into depression.

For most people, the best solution appears to lie in combination therapy: between the use of a pill to bring the brain's chemistry back into normalcy and the use of one or another form of psychotherapy, they find a more or less permanent solution. Between the pill restoring normal thinking, and learning new patterns of thinking that support healthy thinking, they can come to eliminate or reduce the need for medication.

The brain is our least-understood organ, and may never be completely understood. There is no one-size-fits-all cure for any mental disorder or disease, and all that we can do as individuals is seek a solution that works for us, and support others as they do the same.

jo: I'm comfortable with the new me now, and don't miss the old one. It's unlearning the old behaviours that's the real kicker at this point...
posted by five fresh fish at 4:06 PM on February 15, 2003

anyways, that was a cool flick.
posted by mcsweetie at 4:08 PM on February 15, 2003

That's part of why there's such a large stable of antidepressants out there -- one of them won't work for someone, or has unacceptable side effects, so you try them on another, repeat until success or you work your way down to lithium and/or ECT. Or just wait to see if it passes, or bury their corpse after their suicide.

Funny thing is, though, nobody tried me on another, and I haven't offed myself yet.

Are there biochemical disorders that result in depression that can only be cured chemically? Probably. How many of the people who get prescriptions for SSRIs actually have these disorders, as opposed to depression that is based on their situation or external factors? Maybe — maybe — ten percent. These are drugs that are highly overprescribed.
posted by IshmaelGraves at 4:25 PM on February 15, 2003

I'm so happy to see this film getting recognition. I went to film school with Peter, and I was in his workshop while he was working on this film. I've probably seen it 50 times, but it was great to see it again today. I think it's a smart, thoughtful, great film.
posted by faustessa at 4:47 PM on February 15, 2003

What I'm trying to get at is that sometimes it is a cop out to hand somebody a bottle of pills, instead of taking the time and effort to help them get through the very real obstacles and problems they may face.

No disagreement there. HMOs and health plans in general like people to hand out Prozac like candy because it's cheaper than talking-therapy or cognitive therapy, but *good* care would make use of both.
posted by ROU_Xenophobe at 5:31 PM on February 15, 2003

How many of the people who get prescriptions for SSRIs actually have these disorders, as opposed to depression that is based on their situation or external factors? Maybe — maybe — ten percent. These are drugs that are highly overprescribed.

IshmaelGraves, sadness, no matter how profound, with identifiable, situational causes is not clinical depression. Depression is a mental illness, it is not caused by external factors any more than schizophrenia is caused by external factors. I agree that drugs are over-prescribed in many cases, and I agree with sheauga that more needs to be done than handing over a scrip (drugs alone have been shown to be far less effective than drugs combined with therapy), but I'd like to know where your ten percent figure comes from. Given than you seem to have a clear misunderstanding of what depression is, I find this assertion extremely questionable.
posted by biscotti at 5:35 PM on February 15, 2003

Funny thing is, though, nobody tried me on another

Then either you received shockingly substandard psychiatric care, or you refused further care yourself.

and I haven't offed myself yet

Then you were either moderately lucky, or not actually suffering from clinical depression. It is entirely possible for someone to be miserable and unhappy and very sad because the circumstances in their life are legitimately horrible, and not because they suffer from clinical depression.

Yeah, the drugs are probably overprescribed. They're still very useful drugs that are overprescribed, though, not bullshit that's overprescribed.
posted by ROU_Xenophobe at 5:35 PM on February 15, 2003

By my experience of depression, it's unlikely those who claim the drugs are unnecessary have actually experienced clinical depression.

During my worst bouts I spent days curled up in a dark bedroom with soaring anxiety about nothing in particular, afraid to go outside and into the public, and contemplating my mortality, the act of suicide, and whether the pain I'd cause others by committing suicide would be less harmful than performing the act.

And during these bouts, I did not understand that this was unhealthy, that my suffering was unnecessary, that there was help available, or that this wasn't all perfectly normal.

Most shockingly of all, my wife didn't kick my ass into the doctor's. She knew there was something wrong, but didn't realize how bad it was. I seemed moody and sometimes irrational; I seemed unhappy and unenergetic, but without seeing into my head, she couldn't see how much an effort I was making to...well, not disguise things so much as be her companion instead of a wimping sack of unhappy.

Somehow or other I eventually came to realize that I'd better talk about how awful my days were, and as I started to reveal my inner self, we understood that this was far beyond the normal range of mood and thinking, and got me into the doctor's.

My first doctor was pill-happy, and put me on Effexor. It was a trip. Lots of side-effects, especially with distorted time and space -- kind of like being on acid, I'm told. But it flattened my emotions and brought me back into the world of the living. I was living oatmeal, but it was such a tremendous relief from depression that I was perfectly content to accept it. It was a nice vacation from hell.

About a year later I took myself off the prescription. Things went pretty darn well for a couple of years. I dipped down toward depression a few times, but recognized it enough to fight back. At one point I ended back up on the meds, but took myself back off long before running out of pills. I thought I was 'cured.'

But it didn't last. I slipped back into the black tar, not realizing that it was happening. I once again found myself obsessing on hurting myself, found myself angry and confused and lost.

And I didn't even know I was depressed again. It just seems so... normal. Familiar. Comfortable. I mean, it's terrifying and painful, but it's what I know. It's very difficult for me to realize that this isn't the way things should be.

But at least I got clueful a bit quicker this time, suffering for only the better part of a year instead of a lifetime. Found myself a new doctor, got new meds.

So I'm currently on Celexa. It hasn't had any of the weird, wonderful, and disturbing side-effects of Effexor (which is an SNRI, not an SSRI). My doctor has recommended me for some group therapy, and has repeatedly offered opportunities for talk-therapy.

I checked out the group therapy and decided against it. I've attended LGAT courses and while they were certainly quite the experience, they do not appear to have had lasting power in changing the life behaviours of any of the people I attended with: some became more themselves, but none have actually changed to become who they wanted to be during the course.

At this point, I've made a few changes in my working and social life that I hope will prove adequate in allowing me to make the behavioural changes that will help me attain or retain healthy thinking patterns. If they aren't adequate, then I will attend talk therapy in one-on-one sessions.

Too, I've also shared my experiences with my wife now, and between the two of us I am hopeful that should I begin the downward slide, we'll recognize it and put a stop to it long before I hit bottom again.

I don't expect to hit bottom again. I've had my three strikes, and I want out: I am never, ever going to stop taking my meds. It doesn't matter that I feel I'm okay now, it just isn't worth the risk.

And now for my turn at arrogance: based on my experience with depression, I am confident that anyone who claims that depression -- clinical depression -- can be cured without either medication or intensive therapy (institutionalization, I should think) has never dealt with depression.

This isn't a case of being sad, folks. It's a case of being inutterably fucked-up beyond all recognition. It is a living hell. It is beyond your imagination. It can not be described in any way that could possibly get it across to anyone who hasn't been there themselves.
posted by five fresh fish at 7:07 PM on February 15, 2003

I'd also like to say that I find sharing my experience with others -- even complete strangers who will likely never, ever know who I am in real life, beyond the pseudonym -- feels like jumping off a cliff. It's real scary.
posted by five fresh fish at 7:09 PM on February 15, 2003

It's all crucible.

Everyone is artificially flavored. The silliest reason to stay in the pit is fear of 'unnatural' mutation - our brains have been marinating in mutative runoff - natural, unnatural, and supernatural - since before we were decanted. So, if you're brittle and scared and utterly gray, soak up an appropriate drug and see if you glisten - if you like it, its you, dahling - no strings attached.

Been off Prozac for three years (was on it for two)...I visit the pit regularly, of course, but they're business trips - I'm its interior decorator...
posted by Opus Dark at 7:39 PM on February 15, 2003

It's real scary.

Amen. And as a total aside, anyone who is on Prozac or another of the older-model SSRIs, or who is thinking of talking to a psychiatrist, should consider requesting a prescription of Celexa, which has the lowest side-effect profile. One potential downside of all of these meds, however (and I don't know whether you've had the "pleasure" of experiencing this, fff) -- weaning off of them is very delicate business. If it's done too fast, it can cause some ugly byproducts. In my case, that included these weird shock-like sensations. These bother some people so much that they appear on shows like Dateline or 20/20 claiming they never would have taken the meds if they'd known what it would be like to come off of them. When I hear that I wonder whether those people experienced the same degree of depression I did, because for me it's not even a close call.
posted by pardonyou? at 7:39 PM on February 15, 2003

depressionfilter
posted by sgt.serenity at 8:10 PM on February 15, 2003

I think maybe this is my talk therapy. :-) I must be getting something out of this. I've never writ so much on MeFi!

PardonYou: I won't be weaning off. I've had it with depression. I see absolutely no need to ever, ever, ever! suffer again. I truly believe it would kill me.
posted by five fresh fish at 8:14 PM on February 15, 2003

Fivefreshfish, you are a brave soul. And one of these days those of us who have to slog thru these things will be treated with the same respect as those with other illnesses.
posted by konolia at 8:24 PM on February 15, 2003

It's important to be aware of multiple levels here. On one level there's your physical body that has to go to work and takes pills to make it easier. I don't have any problem with that; am taking St. John's Wort and Valerian Root myself every night.

There's also the level of your mind not being able to fit into whatever social construct you've gotten yourself involved in. It's a big tangled mess between friends, work, acquaintances. How do you fit into all this? Depression is just the feeling of being overwhelmed.

My fear is that the pill would make you fit in. Of course, I have taken some of these medications and I know that they maybe don't work. What if they do work, though? Some magic pill that tweaks your settings just right for some social pursuit (career, class advancement, family, etc.). I don't know; I don't think I've ever had clinical depression. I look to the "feeling" apparatus when I think about my feelings... How my arms feel, and whatnot. It's a troubling thought that one can take a pill and feel good without feeling any sensation.

Don't really have much to say, but I wonder if Prozac is covered under Canada's socialized medicine system.
posted by son_of_minya at 8:30 PM on February 15, 2003

fff: all I have to say is *hug*. Not to get all touchy-feely, but thanks for sharing, sincerely, I've been there.

son_of_minya: your misconceptions about what antidepressants are and how they work are very common - antidepressants don't "make you fit in", and they don't make you "feel good", all they do is bring your brain chemistry into some semblance of "normal", to get you to a level where you can actually look at the world rationally. They work in a manner similar to the way insulin works for diabetics - just as the body cannot function properly with its chemistry too far outside certain limits, the brain cannot function properly with its chemistry too far outside certain limits. This is why I find it odd that some people take SSRI's for recreational purposes - they're not happy pills, and they take weeks of daily dosages to build up to therapeutic levels. A bit of research should clear things up for you. And Prozac is covered exactly the same way most other prescription drugs are covered in Ontario (as far as I know, there is no "Canadian" socialized health care, it's all provincially-run) - unless you're on social assistance, you or your private health plan pays for it.
posted by biscotti at 9:04 PM on February 15, 2003

"Depression is just the feeling of being overwhelmed."

Sigh. I'm clearly not communicating well with some people here.

Oh well... guess I'll take to heart some good advice I once was told: some will, some won't, so what.

If any of you wish support or conversation regarding depression, please contact me via fffish_throwaway, at operamail dot com. Please note that I do not frequently check that mailbox, so it may take a week for a response; we'll work out a better arrangement after that.

Peace, friends.
posted by five fresh fish at 9:38 PM on February 15, 2003

Well this thread made me think about it again so I decided to take the depression test just to see where I am these days, 5 yrs since my very first episode and I discovered that I am still experiencing mild symptoms. Maybe that's always been normal for me, hard to say. I don't have access to insurance at this time so I won't be seeking treatment. I better start trying to take better care of myself and hope that I don't slip any farther until I am in better financial standings. Thanks you all for getting me to pay attention to how I am feeling. I do not ever want to return to the hell that I experienced then.
posted by SweetIceT at 9:46 PM on February 15, 2003

"...so that happy thoughts are more likely..."
"If I'm happy all the time, will I still be me?"
-from the film.

This perpetuates the idea that antidepressants put the user in a state of perpetual happiness. The fact is, an SSRI or other med is (hopefully) correcting the user's brain chemistry so he is capable of feeling happy, and not constantly depressed/hopeless/overwhelmed/despairing. The med is not making him feel happy.

The brain is, in very simplified terms, a battery. A battery does not conduct electrical activity without an electrolyte. Your brain does not conduct the electrical impulses that accompany thought and emotion without seratonin, dopamine, etc. Most antidepressants (especially SSRIs) just keep the seratonin in place.

But the idea that antidepressants are "happy drugs" is ridiculous and simply perpetuates stereotypes about clinical depression.

Wow. Sad.
posted by Shane at 10:10 PM on February 15, 2003

it generally takes 3 to 6 weeks for an antidepressant to work

Unless it's Paxil. (This is also what causes Paxil withdrawal symptoms to be more intense than other antiedpressants -- the drug's a lot more metabolically active.)

I took Paxil for a few months a couple years ago. I had been running my own business for five years. I knew I was in bad financial shape but the more I thought about how bad it was, the less I wanted to think about it, so the worse it got. Eventually I confided to a doctor friend of mine that I was having trouble motivating myself to do anything at all, and he asked me a few questions and prescribed Paxil.

The day I went on Paxil, I found myself with some work to do, but I was getting itchy to go out for a walk. This was unusual enough (I was very sedentary at the time) but what was even more amazing was that I said to myself, "Well, I'll finish this work, then I'll go for a walk as a reward." And proceeded to do exactly that. The idea of using physical activity as a reward was so foreign to my inert then-self that I practically boggled.

Over the couple of weeks, as the Paxil well and truly kicked in, I noticed that places I had been hundreds of times suddenly seemed new and interesting. A lot of things were unexpectedly beautiful. The corn they serve at Boston Market -- man, that stuff was, without warning, a startlingly vivid yellow. The corn hadn't changed, of course; my perception had. Before I went on Paxil, just leaving the house was difficult because it involved a long series of tasks that just seemed so exhausting (take shower, find presentable clothes, locate car keys, etc.). With the Paxil, this to-do list "collapsed" so that going to the store was one thing, rather than ten, and thus easily accomplished.

One weekend I gathered all my bills, added them up, and nearly had a heart attack at the debt I had got myself into without really knowing it. Had it not been for the Paxil, I might well have considered suicide, but of course, without the Paxil I hadn't been able to add up the numbers anyway. So I avoided panicking, did some research, found a credit counselor, set a budget, and began paying off my debt. With a budget in hand I was able to determine how much income I needed to make each month, and I started hitting that number. Still, it was tough, and though I wanted to continue working for myself, I began considering seeking full-time employment again.

By the time I went off the Paxil I had basically decided to look for a "real job" and when the opportunity came up to take a job in Seattle, I eventually decided to make the move. Three and a half years later, I'm nearly out of debt. I did have some seasonal depression last year for which I took Paxil for a couple months -- once you've lived with depression for a while, you learn to recognize the knot of dread in your stomach that says you need treatment -- but other than that, I've been doing fine without the drugs for the last couple years.

Sexual side effects? Sure, I had the "delayed orgasm" thing. My girlfriend at the time liked that a good bit, it actually put my timing more in tune with hers. Of course if you're a woman to begin with, delaying your orgasm might make it basically impossible to have one, which would suck.

A weird side-effect that a friend of mine who's on Paxil right now confirms: it really diminished my enjoyment of music. Music became merely pretty sound that I could take or leave, rather than the deeply emotionally resonant artform it was when I wasn't on the drug. Very weird.

Meeting one's non-depressed self can be a bit of a shock

I found this to be unequivocably the case. The "real me" is much more aggressive than I thought. One time my bank had done something that really pissed me off and I was in the process of insisting that it be fixed when I looked into the eyes of the poor teller girl (who was about half my size) and saw fear. She was literally afraid I was going to hurt her. I hadn't raised my voice that much, but it was clear that I had raised it quite enough. I had to learn to rein myself in. I also drove more aggressively and had to work at that as well.

I've not been as depressed as a lot of people here, but the taste I've had has been quite enough to know that for some people, modern antidepressants can be miraculous. Certainly Paxil allowed me to make changes to my life that needed making and that I was having trouble making without the drug.

Sure, a drug is a crutch. So? Nobody expects a person with a broken leg to walk without a crutch, and nobody should expect a person with a depressed mind to think clearly without treatment.
posted by kindall at 10:46 PM on February 15, 2003

And now for my turn at arrogance: based on my experience with depression, I am confident that anyone who claims that depression -- clinical depression -- can be cured without either medication or intensive therapy (institutionalization, I should think) has never dealt with depression.

You're entitled to that opinion, and I don't want to go into too many details here, but the brain has a tremendous capability to rewire itself. Drugs can do the job, but there are numerous cases where meditation, religion, and so forth, have relieved depression (and even resolved schizophrenia) in mild to medium cases.
posted by wackybrit at 3:43 AM on February 16, 2003

Wackybrit, you do realise that depression also affects motivation, right?

Also, many of you may not be aware that if clinical depression is caught and treated early, one only has to use the antidepressants for a year or so. The longer you tough it out, the more likely that you will have to be on antidepressants permanently.

Oh, for the few that feel TOO good on antidepressants, email me -as you may be looking at another diagnosis entirely, which I will not discuss here.
posted by konolia at 3:55 AM on February 16, 2003

I forgot to add that some of the confusion on this thread stems from the confusion between the two main kinds of depression. Situational depression is the type that is pretty much caused by outside events-the loss of a job, a marital breakup, so on and so forth.

Clinical depression is the type that hits out of nowhere. You can win an Academy award, inherit a million dollars, and be married to the perfect man (or woman) and still be depressed-that is one thing that makes this so hard as people wonder why on earth you can't be happy.

Yes this is a simplistic explanation, but I did feel it necessary to underscore that we are talking apples/oranges here.
posted by konolia at 3:59 AM on February 16, 2003

I've enjoyed reading this thread , i find that medication is helpful but dont want to be on it forever.
i do the meditation and religion thing as well wackybrit and can confirm sometimes god just tells you to go to the doctor and take the pills, sometimes it does get cured though.
Also , i am not talking about my opinion on depression , i am talking about about my experience.
posted by sgt.serenity at 5:43 AM on February 16, 2003

For those of you who took the brave step to start SSRIs or similar drugs, a question:

I have someone in my life who clearly is suffering from serious depression and has been diagnosed as so. However, she refuses to enter real therapy or start on chemical therapy, for many of the reasons brought up in the film: how would this change who she is?

What would you all recommend? How did you make these decisions?

If this is a way too personal question, I apologize...its just that I feel strongly about this person.
posted by pjgulliver at 8:32 AM on February 16, 2003

kindall: Cool story. Thanks.

pjgulliver: In situations where a person is unable to make healthy choices, I believe it is the responsibility of those around them to step in and take control. This is why we raise our children instead of abandoning them. I do not see a dysfunctional adult as being much more capable of rational decision-making than a child is.

That said, it isn't practical to force an adult to do something they don't want to do, especially if there are repercussions that could permanently destroy your relationship with them. This means that in real-life terms, the risk of self-destruction (suicide) must pose a greater threat than having them resent you.

Which means that probably the best you can do is support her and encourage her. Strongly encourage her, perhaps.

If she's at the extreme, ie.) has hurt herself physically, or is spending all day in the dark, etc, then you may want to consider gaining legal control, and having her institutionalized. It might destroy your relationship but save her life. I dunno... haven't been in that situation myself, not sure how I'd have felt about it if I were. On the whole, I think I wanted someone to do it for me.
posted by five fresh fish at 11:11 AM on February 16, 2003

Fishie, i don't think it's very easy to get someone into the hospital unless you can prove he or she is a danger to themselves or to others...such as threatening suicide.

By the way, some folks have this religious believe that meds are always a copout. I am a Christian and have had to deal with that-thankfully, not much, altho others have really been hurt terribly. So let me state categorically for the record- meds are not anti-Christian in the least. You scientologists are on your own tho.
posted by konolia at 11:21 AM on February 16, 2003

What would you all recommend? How did you make these decisions?

Knowledge is the enemy of ignorance - do some research yourself, get her to read this thread, supply her with knowledge so that she can make an informed decision rather than one based on half-truths and misconceptions. The reasons for not entering therapy brought up in the film aren't really valid, IMO. Yes, depression gets comfortable in a weird way, and yes, you start feeling that it's just part of who you are, but in the long run, there are ways to be yourself which don't feel like that - if she's hanging onto her depression because she feels it's one of the things which defines her, you could try explaining to her that it's probably already defined her, she doesn't need to keep experiencing it, that's just overkill. For the vast majority of people, there is a medication/therapy combination which will work, and NOT leave them feeling like oatmeal, it's just a matter of seeking them out (something a depressed person may not be motivated to do). I believe konolia's point about catching it early is an important one - many people can learn to cope with their depression without medication, but it often requires that they take medication for long enough to give themselves an opportunity to learn coping skills. All I can suggest is that you do your best to provide her with enough information to make an informed decision, ultimately, however, she has to make the decision herself - you can't force a cure on someone, they have to want to change.
posted by biscotti at 11:46 AM on February 16, 2003

Anyone else find the "latest trend" of treating Bipolar and Depression with epileptic drugs a little... strange? Lamictal I'm thinking of, and recently others.

Good luck, PJG. Meds are nothing to be afraid of, and a good book might break down some of the stereotypes that have no doubt affected your friend's mind. Meds are neither "happy pills" nor zombie-makers, when used right. Maybe send some emails around here and get a few opinions?
posted by Shane at 7:17 PM on February 16, 2003

pjg: Regarding meds and identity: I am more myself on Celexa than I am off it. It's partly because the noise and chaos have been turned down to a dull roar, giving me a chance to think, and partly the personal understanding I've gained since the noise was turned down. I've learned that my default mood doesn't have to be despair or anger and that it's okay to wake up happy. Meds + therapy have been life-changing for me.

I'm among those who will probably remain on meds for life. Something is wrong with my wiring. Something was wrong with my sister's wiring, too, only much worse, and she took her own life last June after twenty years of mental illness. But she was a complicated case.

Meds are worth trying. They're not permanent; your friend can always taper back off them. Good luck.
posted by swerve at 8:01 PM on February 16, 2003

I'd like to apologize for calling people "asshats" here. It wasn't the best way to help them understand the reality of depression.
posted by five fresh fish at 10:12 AM on February 17, 2003

I'd like to apologize for calling people "asshats" here. It wasn't the best way to help them understand the reality of depression.

hahaha!!
posted by sgt.serenity at 7:14 AM on February 18, 2003