Virginia NPP

Funny about that, I did the same thing. I said I would let myself smoke at 65 (this was when I was 35) well I am now 63 but doubt I will start again at 65. (To tell you the truth I am sure I would be addicted again with one cigarette ) I think this idea is worth a try.

It just amazes me that this continues to be a question or concern. It must have something to do with stigma. Is it because of this false idea that depression is a character flaw or weakness that one can get over if they are strong enough or try hard enough??? REAL (clinical) depression does NOT work this way! Will someone PLEASE help me understand what the concern is here???? I will say again: ANTIDEPRESSANTS (NOT Benzo's or alot of other drugs people mistakenly think are antidepressants) do not effect skills except to make them BETTER in depressed persons. They help with concentration, decision making, motivation etc etc etc. Sadly, many people do not take them due to this attitude / stigma especially medical people.(see the previous video on doctors and depression). They end up hurting themselves and not helping others. I sincerely hope that a care provider with depression is medicated when taking care of me.

Sounds like you did a great job, and I agree with the take care of yourself advice. These questions of course have no answers, and the parent is just speaking his agony out loud. Silence or a touch is a good response, or just a simple "This is a terrible tragedy, I'm so sorry". Sometimes parents need to see their children after they have died and should be offered the opportunity, even if it is extremely difficult. Virginia

My 2 Cents. Propranolol will slow your heart rate down regardless of the cause. It blocks the effects of epinephrine. It has been used for stage fright and by public speakers for many years. What happens is if you are anxious, your heart rate goes up and then you become even more anxious in response. It becomes a vicious cycle. The propanolol seems to break the cycle by slowing the heart rate. This research is so very early, it really can't tell us much at this point. It needs to contiue, and hopefully will because of all the soldiers returning from wars who are suffering. I personally agree PTSD is over diagnosed for the same reason I mentioned in an earlier post. Clinicians make the diagnosis based on there own ideas, and do not use the specific criteria in DSM. PTSD is a very real problem, over-diagnosing it just makes it less reliable, and leads to questioning of its' validity. This is what seems to be happening with Bipolar disorder also. PTSD is really a syndrome, so medication is prescribed for the particular symptoms that a client has. There is no medication for PTSD per se.

The research shows it takes four attempts before someone actually quits smoking! So if you don't make it, don't think of it as a failure, but rather as a step in the process! (Really ) Virginia

Hi All, Lots of my clients are doing well on Chantix in terms of quitting smoking. The way it is said to work is by both stimulating and blocking specific nicotinic receptors in the brain; it is thought that the stimulation of these receptors mimics the effects of nicotine and reduces cravings. A number of reports have indicated that Chantix induces suicidal feelings and aggressive and erratic behaviour. I haven't seen any of that, but lots of people feel irritable. Its hard to know if this is from the chantix or withdrawal from nicotine. Insomnia can be a problem with Chantix. Remember no drug is without side effects, nicotine however is a real killer. If you do use the Chantix don't ignore the support they offer along with it, it can help. Virginia

Superfly is correct MAOIs are RARELY used today. Tricyclic antidepressants are not used often either (lots of side effects and VERY lethal in overdose. I think we are again mixing up Clinical Depression (most often genetic, "chemical imbalance") with "run of the mill depression" which is really mood changes due to circumstances, grief, sadness loss, anger (other things) and is mainly psychologically/ emotionally based. This type of "depression" usually responds to time and counselling. (Now personality disorder is another entire subject that often is misdiagnosed as depression, especially by non-psych professionals) Virginia NPP

Melatonin seems to work well for many people. The long acting or time release is the better choice for a full nights sleep. Can someone please tell me how you can tell the date and time of posts, I just can't get it. :oops:

Wow lots of big words here (I had to look up anaclitic had not heard it in years For others not in the know it refers to emotional dependence) and Orthomolecular (Ortho Molecular Science, which prevents and treats disease by optimizing the body's natural substances)! Any way as you very well know we don't have the answers to many questions about depression. Actually the latest theory (and much of medicine is theory, not just psych) is that clinical depression is a combination of chemical imbalance ( most often caused by genetics, heredity) and a stressor which sets it off somehow. I never quite get why some people need to protest so hard about a physical basis for depression, do you think is something to do with a need to feel in control issue?? Virginia

Hi, Glad you found it helpful. For all, I try to answer Psych questions, I can't keep up on posts on the site so feel free to PM me if there is a question you think I may be able to help with. Virginia

Hi BVESBC, All the things you suggest will help with many problems. However Clinical Depression is hereditary ( think like a physical illness) and truly a chemical imbalance (I hate that phrase its so over used). It will not really respond to these lifestyle changes. I know I did psychotherapy for years with some of these patients, so frustrating for me and them. Another comment, when someone is truly having a major clinical depression they literally cannot do these things, they cannot force them selves to make changes or "pull themselves up by their bootstraps". It is not a matter of weakness of character or lack of trying. It is a DISEASE with a biochemical cause (may be worsened by many factors) But there are true brain changes in persons with depression. Major depression can and does result in psychosis (really !!!) and suicide. It is a horrible disease, worse then many physical illnesses. Again the real problem is misdiagnoses and overuse of SSRIs. They do not work with sadness, personality disorder (another whole story) anger, and lots of other things they are prescribed for. One of the reasons I think it is difficult for so many to accepting clinical depression as a disease is that we all like to believe we can use our mind to control our mood, other wise we feel out of control ! Oh Well, sorry but this can be true. Ok enough already, hope I have convinced some. Virginia Virginia Duffy PhD Psychiatric NP PM me for details on my website...changed by AK

Hello All, I have been in the mental health field for 30 years. I have been exclusively prescribing meds for the last 15 as a psych NP. Can I put my two cents in in relation to many previous comments? "Benzos" are benzodiazpines such as Ativan (lorazepam), Xanax (alprazalom), Klonopin (Clonozepam) Valium ( diazepam ) THESE ARE NOT ANTIDEPRESSANTS. These DO have significant effects on your ability to respond and should not be used by anyone in a position of decision making, heavy machinery or even driving. These are addictive and are routinely screened for in "Tox" screens. In my opinion they are way overused. Persons with clinical depression (serious depression with physical symptoms) are much more at risk for making poor decisions, irritability and generally poorer functioning then those with a well treated depression. Depression is NOT, the blues, grief, "tough times" or burnout!! Antidepressants will NOT help these life problems; persons with clinical depression have more difficulty with these stressors and sometimes these situations will reveal the underlying depression. The side effects of the SSRIs are minimal (sexual dysfunction can be a problem). They do not make you "spaced out" like the benzos can. The TCA have more side effects and are used pretty sparingly these days. These are helpful in LOW doses (much less then antidepressant dose) for neuropathy, headaches and some other pains. These drugs are not found in general "tox screens" . A specific test must be done for them. I can't tell you how many years I did Psychotherapy trying to help patients with a true clinical depression. It was supportive but didn't help in most cases for more then a brief time. When they were put on an antidepressant they were like new people in 4 weeks. I am not exaggerating here! The problem is that antidepressants (like so many other drugs) are overused on the wrong patients. They seem to be given to everyone with a complaint of "stress". On the other hand significant clinical depression is often MISSED ( these are often not the people going to the PCP complaining of depression) and these people are suffering. Medication will make them better at their job of being a paramedic, ems, nurse, doctor,etc. It is important that we all try to understand the difference between clinical depression and other syndromes. Don't let anybody kid you, sometimes this is not easy, ever for experienced people. The problem is that everybody thinks they can do it. Feel free to comment or ask questions. Best and thanks for all your good work. ( I had a heart attack last year the the EMS were terrific) Virginia

I think you are referring to Sigmund Freud's theory of reaction formation . This is when anxiety-producing or unacceptable emotions are replaced by their direct opposites. Actually, bad jokes" and "sick humor" are very good examples of this. They also are effective in relieving tension. This type of coping only becomes a problem when it is used most/all of the time. Flexible coping skills are the key to managing stress. Hope you don't mind the plug, but I just wrote something in my blog about coping mechanisms that might be of interest. Check it out. http://www.behavioralfirstaid.com/wordp Virginia

FFMedic 1911, I know it is hard to really see the good you are doing when you spend so much time on illogical rules and paperwork, politics and incompetence. I get pretty tired of this sometime to. Then I have a great experience with a client whom I am able to help and who is so thankful. Those are the times you need to try to focus on. I also have become very good at filling out form with the BS they want. I also sometimes battle the system (pick your battles) and occasionally actually win. Stand up for what you believe. Put the drink down, (ice cream works for Me) Virginia

There is lots of research supporting women as being more empathic then men. Of course you can challange the research (as some do) and we all know women who have very little empathy. Yes , I agree guilt is a common feeling in rescuers who have poor outcomes, however it is not the only response. Sometimes its the most obvious, and the easiest to admit to (because it is a universal feeling). However there are often more personal issues that get triggered by certain experiences. The healing takes place in recognition of how/why the incident effected you personally. (Sorry if this sounds like psychobabble) Stay well and practice self-empathy ( also took me years to learn) Virginia