DR PHIL: I'm glad you're here talking about it, because so often
people feel ashamed, right? I mean, you're confused and
you're ashamed about depression and
mistakenly believe that, 'Look, I've just gotta gut it up here,
I've gotta overcome it using willpower alone.
DR FREDA: It is so true, the stigma around depression is so great.
There are so many treatment options that are available.
There are many medications that are available -- different types --
there is psychotherapy that is available --
there are many forms of that. And you mentioned one,
which is a brain stimulating therapy, electroconvulsive therapy, or ECT.
These things can being used by themselves or
in combination, and it sounds as though
you've done what many people must do, and that is
go through a number of these therapies, alone or in combination,
to find just the right one for you. DR PHIL: You ...
Would you say, in your general course of things, you're doing better or you're doing worse
than you were,
say, two years ago? NOEL: I've definitely come a long way.
You know, I've gone from around 17 medications down to about four, which is
great progress.
DR PHIL: We often think -- sometimes, people think -- depressed people, like I said, are just lazy
Just like, 'Look, get over it. You know, just come on, quit whining.
Get over it.' But depression is a real disorder
with very real consequences. DR FREDA: Depressive
illnesses are brain disorders and now, luckily,
with advances in brain imaging and other technologies,
really have a chance to see that
what happens in people with depression are changes in their brains.
DR PHIL: Let me show you, cause, Don, I want you to really think about this.
If you guys were out hiking and she broke her leg, you wouldn't just leave her
behind.
DON: No, never. DR PHIL: Say, 'Well, you can't walk, bye.'
You wouldn't do that, and when you think about the brain, you've got
depression, you've gotta think about it the same way. You can't see it just looking at her,
but if you look at the normal brain
versus the depressed brain, they're very different.
In the normal brain,
you know, this frontal lobe area here
is where you have kind of a higher order thinking and
reasoning and processing. And you can see how different it is in the depressed
brain.
And then, you've got the temporal lobes here, and this is where
you have emotions are centered in here
and some of the aspects that have to do
with your feeling. And you and you can see over here,
concomitantly, is in a depressed brain,
it's much darker. And then.
this is thalamus in the middle of the brain, and you see over here,
again, it's shut down. So, it's kinda like
you talk about depression -- you don't feel the lightness, you don't feel the energy,
you don't feel the activity.
That's what you'd see if there was a broken leg and you look at an x-ray.
We now have that ability to do the same thing with the brain.
DR FREDA: I do wanna say, though, that we've got a ways to go with this. As exciting
as these
advances are, these brain imaging technologies can't do a couple of things.
First of all, they can't tell us why depression occurs.
And second, is that they're not typically used yet
to diagnose depression or to help guide treatment.
DR PHIL: So, how do you distinguish just regular sadness from depression? Talk about that at a little bit.
DR FREDA: You know, that is so important, because some people say, 'You, know,
I should be sad, right? And it's OK, but there's some really important
diagnostic criteria -- things that your doctor would use,
signs and symptoms that you would share with them that would help differentiate
from,
from the normal sadness from a major depression.
What needs to happen is you would have five of these
or more that would occur
for a two-week period or more, in order for the depression
diagnosis. So, the first one is feeling sad
or empty or tearful most of the day,
every day. So, this is a profound sadness. The second is loss of interest in
things that used to bring you pleasure.
Being outside, doing things don't bring pleasure anymore.
A significant change in appetite, and that can either be
up or down -- and usually has some weight loss that goes along with it, or weight
gain if your appetite's up.
The other thing is trouble sleeping. Some people have trouble sleeping,
others sleep far too much -- like all day, can't get themselves
up and moving. Fatigue and lack of energy is also
really an important key. And feelings of hopelessness, helplessness,
worthlessness, guilt -- those things plague you
during the day. Reduced ability to concentrate,
to think, to make decisions -- just, you know, can't quite
focus. And agitation, restlessness or irritability,
these things also occur. And last, but absolutely not least,
are recurrent thoughts -- these thoughts that won't go away
around death and suicide. DR PHIL: And if you see, on the graphic, that we have up here, we've
checked off all but one for you.
Your weight's been pretty stable. NOEL: Yeah, thank goodness. DR PHIL: Yeah. But
other than that, we've checked almost every one off for those, which
means you're dealing with a major depressive episode.
But that doesn't mean that it tells the whole story.
Listen, everybody we have on here
is, in a away, a teaching tool, and I hope this has
given you guys some insight, at home and in the audience today. If you suspect a loved
one
is battling depression, the most important thing you can do
is help they'll get the diagnosis and treatment.
Don't just feel like, 'Come on, I've gotta be tough.' You offer emotional support and
understanding.
Never ignore comments about suicide. This old adage that
people that talk about it don't do it is not true.
That is a myth, do not believe that. And if you are depressed and suicidal call the
24-hour
National Suicide Prevention Lifeline at 1 800
273 TALK. That's 1 800
273 8255.
DR FREDA: And this is so true. There's so much help that is available,
and the good news for you, Noel, and for others who suffer from depression is
that there are many options
that are available. And I have to applaud you for
raising your hand, asking for help, inspiring others
to do that, and also for sticking with it
and really working hard, both of you, to get your depression treated so
that you can feel better.
Lots of information to know about depression and, for more information,
you can go to get healthy stay healthy dot com.
There's information there on both depression and other illnesses.