depression

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Teency children, starting at about four months, laugh about 400 times a day. Adults seem to laugh only about five times a day. This has got to have at least something to do with why growing up often stinks. The authors of this article start by reporting about a case of a woman with a mood disorder that was difficult to control. But she was more easily controlled with medication once she started doing “laughter yoga.”

Now “laughter yoga” sounds like my idea of a crashing bore.  I think that this discipline — invented by an Indian Doctor in the 1990’s — is intended to make people laugh without using words.  From what little I can find it seems to depend more on the “contagious” nature of laughter than on any humorous content. I suppose laughter can exist, as a neurophysiological entity, apart from content. A bunch of neurophysiological imaging studies, which I have actually attempted to read, implicate practically every part of the brain I can think of. Tickling initiates laughter in a baby (and on several occasions, in my husband as well). Read more on The Good Stuff…

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I just did one of those continuing medical education courses — in psychiatry, my very own field no less. It says that people who get a bout of depression are twice as likely to get a bout of back pain. What I read is a meta-analysis.  That means some clever person who probably needed the publication on his (or her) resume did a statistical (and critical) analysis of research other people did. This a noble attempt to asymptotically approach “the Truth and the Light” on a subject. It is also a delightfully erudite way to do research and get a publication without using a lot of time and money that the author had to scrape up.

Look, the relationship between depression and low back pain is something I have seen from every imaginable angle. As a neurosurgeon, it did not take me terribly long to figure out that surgery was not a very good solution for back pain. Of course, we rigorously restricted ourselves to operating focalized sciatica.  Cases where we could reasonably infer that an intervertebral disc seemed to be compressing a distinct (lumbar) nerve root that formed part of the sciatic nerve (plexus) that descended from the spinal cord to the leg and foot. There was the physical examination.  If someone were lying flat on his (more rarely, her) back and their straight leg was raised toward the ceiling, pain would appear on a trajectory anatomically consistent with one of those nerves. This was the sign of Laseque.  And we took it to be as solid as money in the bank. Read more on Depression and Low Back Pain…

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I was about three years old when I enjoyed tending our backyard with her.  I had been a marvel to her, since she was a little girl, earning her keep as an agricultural worker in the Ukraine, it what was then known as Russia.

Read more on What You Eat Makes You Who You Are (Smart!)…

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“I don’t like other women.  They gossip.  I hate gossip.  I think they should all go pound sand.” No, it is not a patient who said this. It was my (Great-) aunt Etta, who wore her hair like “Bride of Frankenstein.” She had been militant about her disdain for “gossip,” and certainly wore a bitter expression on her face most of the time.  But she would not tell the little girl I was then any more of her story.

Read more on Gossip Can Drive Some People Crazy…

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I had a really depressed patient.  She had just had one leg amputated below the knee because of advanced diabetes. Of course, I prescribed some antidepressants, and made sure the medical stuff (medical causes of diabetes) had been eliminated. I asked her why she couldn’t dance. “I can’t walk and you want me to dance?”  she asked, as if holding back tears.

Read more on Never say “Never” — Especially to dancing!…

Filed under depression, News by on . Comment#

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I think I was in my teens when I heard the playwright Edward Albee interviewed.  It was one of those interviews that sears your soul and that you remember over 40 years later. He said something about people who get older, like when their children who are adults and start having families of their own.  They all ask themselves the same question, which is “Did I do it right?” — meaning “Life” definitely with a capital “L.”

Read more on Don’t Live A Life Of Regrets…

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Fifteen years after.  That means there are sentient, living teenagers who are (I hope) somewhere in school learning about this devastating event in some kind of secondary school curriculum, or perhaps witnessing public patriotic events. — But they don’t remember it, because they weren’t born yet.

Read more on 9-11 15th Anniversary…

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He was just 18. He had been followed by child psychiatry with a diagnosis of depression. He had long refused to take any pills.  As far as this poor, agricultural county was concerned, I was just seeing him so I could bill MediCal and fatten up the county coffers. The previous psychiatrists had simply noted he was depressed, was not suicidal, and refused any participation in his own treatment.

He was a young man of few words, with a common Hispanic name.  He sat there and twirled one of his lush curls. It became pretty obvious he wasn’t going to give me a complete history.  He said he would never take pills, not ever. To his credit, he did say I could talk to his mother, if I wanted to, but he had to be in the room and hear what she said. Someone brought her to me, from the waiting room.  She spoke only Spanish; fine with me. I learned my Spanish mostly from my patients, who in that time and place could rarely communicate well in either Spanish or English. His mother was charming, really grateful that I wanted to talk to her. She kept complimenting my clothes and elegance. I told her it was all thrift shop.  I doubt she believed me. Read more on Diagnosis From The Guts…

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My telephone was cradled between my left ear and my shoulder, as I pounded the keyboard of the sluggish rural county computer with one of the requisite patient visit fill-in-the-blanks atrocities — er, I mean “reports.” Finally, I heard the person I was waiting for pick up the other end.
“Hello,” I said. “Is this doctor A…….(name unpronounceable to native speakers of English)?”
-“Yes,” he answered, “I am the only doctor here.”
“This is Doctor Goldstein. I am one of the psychiatrists at the county mental health clinic.”
-“Really? And you call me?” Read more on The County Mental Health Clinic’s Referral…

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It gets pretty evident pretty fast, to any psychiatrist who deals with the general public, that depression is daily bread.  I mean, with current estimates at 19 million patients per year coming down with a depression — even with less than one half of them seeking treatment — it is a pretty sure bet that depressed people are common.

This in no way diminishes the anguish I have seen in patients having that disease. The anguish is real and dramatic.

I remember one of my earlier newspaper columns written for the Wichita Eagle-Beacon — the largest daily newspaper in Kansas — asking this simple question:

Why — when someone broke their leg — a salt-of-the-earth next-door neighbor would never fail to bake a pie.  But when someone had a depression, nobody would bake anything.

The depressed person was basically treated like someone with a contagious disease. Read more on Why Some Get Depressed And Some Do Not…