Major Depressive Disorder

Coming Out about Depression

A newspaper has an interesting article about coming out about depression and one man’s experiences.

Logging on to my laptop, I emailed my secretary telling her I needed to work from home for a few days after coming down with another bout of flu.

The first bit was certainly true: I could barely get out of bed, never mind leave the house. But what had floored me wasn’t a bug, but another episode of the depression that had dogged my life for as long as I can remember.

Depression that left me paralysed, tearful and unable to cope with the simplest task. Depression that I lied about to myself and concealed from nearly everyone else – certain that revealing the truth would stop my successful career in its tracks.

No wonder. Perceived stigma surrounding mental health problems persists: this week, Ruby Wax, who has courageously spoken about her depression, advised against transparency with employers.

“When people say ‘Should you tell them at work?’ I say ‘Are you crazy?’ You have to lie,” she said.

“If you have someone who is physically ill, they can’t fire you. They can’t fire you for mental health problems but they’ll [find] another reason.”

It’s no coincidence that people use language like “coming out” when confessing to mental health issues. There is the fear that your true self will not be accepted, or that it could be held against you. It has taken me years to realise the opposite is true: in my case, being open about my struggles with depression with peers and seniors has liberated me.

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Are anti-depressants killing us?

As regular readers will know I suffered through almost every type of anti-depressant that there is.

Eventually I ended up on a cocktail of Venlafaxine and Zyban, plus addicted to sleeping tablets.

Though they work for a lot of people and provide relief, they caused me nothing but angst, side-effects and trouble.

Peter Gotzsche, founder of the Cochrane Collaboration, is visiting Australia to talk about dangers of prescription drugs and has written a piece in the Sydney Morning Herald.

Peter Gotzsche, a co-founder of the Cochrane Collaboration, the world’s foremost body in assessing medical evidence, arrives in Australia on Monday for a whirlwind speaking tour warning Australians about their use of prescription medications.

He estimates that 100,000 people in the United States alone die each year from the side-effects of correctly used drugs. Similar figures are not available in Australia, although the Australian Bureau of Statistics estimates that 3000 people died after complications with medical and surgical care in 2012.

“It’s remarkable that nobody raises an eyebrow when we kill so many of our own citizens with drugs,” Professor Gotzsche, who heads the Nordic Cochrane Centre, told Fairfax Media ahead of his visit.

Two of Professor Gotzsche’s biggest targets are antidepressants and the painkillers described as “non-steroidal anti-inflammatories”, such as ibuprofen, diclofenac and celecoxib. Another, sold under the brand name Vioxx, was withdrawn after it emerged it had caused up to 140,000 cases of serious heart disease in the US alone in the five years it was on the market – during which time its manufacturer, Merck was withholding information about its risks. About half the cases were thought to be fatal.

Professor Gotzsche says those deaths are only the tip of the iceberg and are representative of a system of drug regulation that simply does not protect patients.

Even the name for these drugs, “anti-inflammatory”, is not supported by evidence, he says. He has conducted a clinical trial and review of the evidence that has found there is no proof they reduce inflammation.

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A blood test for depression

Scientists have developed a blood test for depression…it will certainly be a whole lot easier than filling out forms to determine the issue.

However the reality is diagnosis of depression is the easiest part…dealing with it and living it is a far great challenge.

A blood test for a major psychiatric disorder is something that many psychiatric researchers have described as a “Holy Grail.” Especially for a disorder that effects large numbers of people. And that’s exactly what one startup, Ridge Diagnostics, believes that they have achieved.

Their test takes measurements of 9 different biomarkers. The measurements are then calculated through a set of proprietary algorithms to produce what the company calls an “MDD Score” – a number from 1 to 9 that rates how likely it is that a person is clinically depressed, and the level of that depression. The cost of the test right now is about $745.    Read more »

Understanding Depression

Regular readers know that I have had and continue to battle depression. I have also found that talking about ti honestly helps leave a breadcrumb trail for others to to follow so that they can seek help for their own battles.

I know that the trail works because I regularly get emails from people thanking me for sharing my stories about depression and sharing about how I came off anti-depressants. Each of us who has spoken publicly, people like John Kirwan and Mike King all help in their own way to assisting people with depression understand and overcome and mitigate the debilitating effects of depression.

I have been thinking over the holiday period about writing some more about the issues but i hadn’t quite worked out the shape of what i would write. As is often the way when I am researching about something a blog post elsewhere pops up and says what i want to say for me.

And so it was that I saw on Andrew Sullivan’s blog his snip from Jenny Lawson’s blog post about her battles:

I wrote this post a month ago, but I couldn’t bring myself to post it then.  I was too weak from fighting to shout, and so instead I whispered this into the night and left it unpublished until I felt like I could speak to it with the battle-cry it deserves.  Years ago, coming out about depression and anxiety disorder was something frightening, but now people are more honest and open and so much of the shame has dissipated.  We may not have pink ribbons or telethons but we know that someone out there understands.  That is, until we’re honest about how it affects us.  I’ve never written about this because I can’t talk about it without it being a trigger but I think it’s important to be honest even when it’s scary.  Especially when it’s scary.

But Jenny said so much more and it resonates with me, and so I will share it too:

When cancer sufferers fight, recover, and go into remission we laud their bravery.  We call them survivors.  Because they are.

When depression sufferers fight, recover and go into remission we seldom even know, simply because so many suffer in the dark…ashamed to admit something they see as a personal weakness…afraid that people will worry, and more afraid that they won’t.  We find ourselves unable to do anything but cling to the couch and force ourselves to breathe.

When you come out of the grips of a depression there is an incredible relief, but not one you feel allowed to celebrate.  Instead, the feeling of victory is replaced with anxiety that it will happen again, and with shame and vulnerability when you see how your illness affected your family, your work, everything left untouched while you struggled to survive.  We come back to life thinner, paler, weaker…but as survivors.  Survivors who don’t get pats on the back from coworkers who congratulate them on making it.  Survivors who wake to more work than before because their friends and family are exhausted from helping them fight a battle they may not even understand.

Regardless, today I feel proud.  I survived.  And I celebrate every one of you reading this.  I celebrate the fact that you’ve fought your battle and continue to win.  I celebrate the fact that you may not understand the battle, but you pick up the baton dropped by someone you love until they can carry it again.  I celebrate the fact that each time we go through this, we get a little stronger.  We learn new tricks on the battlefield.  We learn them in terrible ways, but we use them.  We don’t struggle in vain.

We win.

We are alive.

It is now just over a year since I came through the roughest time of my life. The toughest time wasn’t being depressed, it was coming off the medication and all the side effects both physical and mentally that are associated with that. I have done a lot of rough and tumble things in my life. I have jumped from airplanes, out the back of Hercules, from helicopters, I have tramped, hunted, fallen off cliffs into rivers, white water rafted, kayaked, waveskiid and surfed, i nearly drowned once swimming across an estuary but none of those things were as tough coming off anti-depressants.

But as Jenny says above, I won and I am alive.

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Movember – Day 2

Today is my birthday, it is also the day that 6 years ago I went to the doctor and found out that the reason I wanted to punch every one out and was so utterly exhausted at the same time was because I suffered from depression.

That started what has been a six year battle with depression, anti-depressants, a scum insurance company called Fidelity Life and their equally scum doctors Des Gorman, Anthony Asteraidis and Ralf Schnabel (medical professionals who make their living almost exclusively from insurance companies). It is only now, after de-toxing myself from the anti-depressants that I also find out that covered up under all the medication and depression was de-personlisation disorder. Adam Duritz lead singer of the Counting Crows published an essay in which he describes his experience with suffering from depersonalization disorder. (It is the best, but also most frightening description of what it is like with depersonalisation disorder)

Now that I no longer have the anti-depressants in my system I can start to address the causes of my depression in a meaningful way instead of plastering over the cracks.

Fidelity Life thought a year ago that I was cured, this despite their own medical evidence, yet in the past year I haven’t managed to even remotely get near working. In that year I have lost my house, been in court, and removed all drugs from my system, this year has been one of the hardest of my life, it is almost as if I am starting a new life.

I realise now, even, if Fidelity Life doesn’t, that I will now live with the spectre of depression for the rest of my life. It isn’t something, now after 6 years, that will just go away. I live every day hoping I don’t slip into a DPD episode or wake up in the morning so utterly exhausted just from surviving the previous day that I can’t get out of bed.

Three things keep it all at bay, or at least help when depression and DPD strikes. The gym, music and blogging.

When I say the gym, I don’t mean some namby-pamby poofs type of gym, I mean my mate Buck‘s gym in the heart of South Auckland, where fatties, gang members, both patched and un-patched, Pasifika, Maori plus a few of us whitey go. A gym where there are no sooks, and there are no soft options. When I go to the gym it is for two hours at least and it is tough. It needs to be to reset my core being. because in living with depression for 6 years I have learned and understood the pathology of the illness so that I can try to combat it.

For me, my form of depression is the “fight response”. That means my body thinks it is always in a battle. The closer to the edge of depression I get the shallower my breathing becomes, its all automatic, the body is designed that way to divert oxygen to the muscles for battle or for flight. It is one of the reasons why John Kirwan was able to perform so well despite his depression, literally his body was tuned to provide huge amounts of oxygen to the fast twitch muscles which enabled him to score magnificent tries like there was no-one in front of him. This is the same mechanism that causes people in high stress situations, in battle, in acidents, in trauma situation can perform huge feats of physical amazement. It is the ancient “berserker” mechanism of the Vikings. The problem is my body is set on that full time. With it come determination, hyper-vigilance, and utter, utter exhaustion. Eventually if you don’t reset you just collapse as I well know. The gym forces your body to breathe deeply and helps reset.

I encourage anyone suffering depression to start of by going for good, hard long walks or bike rides. Trust me it will help. It is what got me started on the road to recovery.

It is only now after I have purged the drugs from my body that I am finally starting to feel like I am getting on top of the “Black Dog”. But it is still a daily battle. As I mentioned music helps and in particular some songs that have a great deal of meaning for me. Here is one I listen to frequently. It helps to express out loud what is going on inside.

Of course I don’t have to tell you about my blogging, you are all my loyal and understanding fans so you know already how that helps. by reading and commenting and supporting you have all helped me immensely and for that I thank you you all.

I will continue the fight against depression and I will continue to try to educate people as to why depression isn’t just about feeling a bit sad. Unfortunately Insurance companies and Fidelity Life in particular don’t seem to grasp this issue and continue to force feed their clients and patients with cocktails of drugs that do nothing to address the core issues of depression. The pity is that Fidelity Life doesn’t want to talk so I will have have to educate them in a court room, an education that will cost them far more than a few meetings.

Movember is a cause I feel strongly about and I’m asking you to support my efforts by making a donation to me.  To help, you can either:

•    Click this link and donate online using your credit card or PayPal account
•    Write a cheque payable to ‘Movember Foundation,’ referencing my Registration Number 17568 and mailing it to: Movember Foundation, PO Box 12708, Wellington, 6144

All donations are tax deductible to the extent permitted by law.

To join my Movember team go to and follow the steps. Once registered you’ll be sent all the information you need to raise funds and start growing as part of my Movember team.

The perils of the pills

Vincent van Gogh's 1890 painting At Eternity's Gate

Vincent van Gogh's 1890 painting At Eternity's Gate

As part of my ongoing discussion about depression I am going to explain in cold facts why warm fuzzy soft focus ads do nothing in understanding depression.

Don’t get me wrong, John Kirwan is doing a great job but he still doesn’t want to scare the horses on what I believe is a fraud and mass poisoning by professionals in dosing people with depression with drugs.

The simple, plain and unadulterated fact about anti-depressants for me is that not one single one I have been experimented with has worked and some, particularly venlafaxine, have actually contributed more pain than any relief. This isn’t necessarily the doctors fault, because this is all one great experiment that unwilling participants commit themselves to without any idea as to the outcome or the consequences of pouring a chemical cocktail into your body.

When you first go down with depression, or perhaps, reach the magic threshold under the Diagnostic and Statistical Manual of Mental Disorders then your doctor will use what s/he has been trained to use which is drugs. the first lolly almost without exception is Prozac. When that doesn’t do anything, then they usually try Citalopram or Paroxetine, then after trying all those and still feeling like Vincent Van Gogh in his famous painting At Eternity’s Gate (left/above). That painting covers exactly show you feel. you can see the despair in every brush stroke.

Yet doctors, bless them, just aren’t trained in how to actually help you. If you happen to have a insurance policy for income protection, like from life leechers like Fidelity Life, thn you are really screwed. You are now trapped in a spiral of hurt you have no control over.

You see, in order to make a claim you have to be sick. You are sick, but that is not the problem, the problem is that now you have to get well, and not by your definition, or any other definition except that of the insurance company. Plus you have to get well in their time-frame or you are in for some serious poisoning at the hands of paid lackeys of the insurance company.

The problem starts because the insurance company and the doctor and indeed society in general puts the cart before the horse. You sit a test, you are depressed, you make a claim, you sit more tests and then the claim is accepted.  A course of medical experimentation treatment is agreed upon and off you go on the chemical train-wreck.

Six months later and your doctor will be pretty sure by now that the first course of drugs hasn’t done a thing. The insurance company knows for sure that you aren’t yet well because they are still paying and that is the worst thing ever in their minds. They don’t give a flying fuck bout you or your health and it is about now that they write you a letter demanding a review by “their” psychologists and psychiatrists. I say “their” because that is exactly what I mean. Almost their entire practices are funded by insurance companies. In Auckland the insurance company favourites are Dr. Anthony Asteraidis and Ralf Schnabel, one is South African and has a handshake like a wet tissue from a peep show and the other is a German and all the medical experimentation nightmares that conjures up. they sit you down for a 40 min session. It should be 60 minutes, but they need 20 minutes of the hour they are billing the insurance company to write a report that is more about covering their arse than helping you. Dr Anthony Asteraidis, at this point for me, recommended I go onto Lithium, for no reason whatsoever other than it couldn’t really hurt could it. this despite me showing none of the symptoms for which Lithium is a treatment. Of course I resisted. But this is all part of the trap from the insurance company. You see they will now say that you aren’t trying hard enough to get well, so demand a change of medication.

Now you have to go through withdrawal from one and substitute that poison for another. then gradually increase dosage until it too becomes apparent that this drug doesn’t work either. Now repeat this several times. By now you will have realised that your life has become a chemically imposed treadmill, slowly but surely wearing you down. Just to increase your stress levels though, you will discover that the insurance company has put a private investigator on your tail. he isn’t that smart because he gets caught, then they write a letter and say it is all part of the process. that’s about the only true thing, the process, that is the insurance companies process to get you off claim, well or not. And you have to do what they say or like Pavlov’s Dogs you cop a flogging from them. This will include cutting your claim off, just to see how you react, interviews private investigators and the like. Not once will they offer to pay for a psychologist. Not once did they ever.

I sought the extra help because I realised that the drugs weren’t going to work. I paid for it, I went every week, then dropped to a fortnight because I couldn’t afford it, then monthly because my claim was delayed, postponed, lost or simply cut off.

After a while though the insurance company insists that you start taking more serious drugs. They don’t say it openly, but when they send you letters, lots of letters, with the implied threat of cessation underlined and in bold then  you get the picture. The doctors all concur that you have a Major Depressive Disorder, and you do. What they fail to tell you is that all their treatment, plus the tickle ups from the insurance company is why you still have it. but their answer is more powerful drugs. Even better, not for you, but for someone, is that these more powerful drugs aren’t funded by Pharmac, welcome to real wealth distribution by chemical torture.

When I was left to my own devices and with good work from my psychologist I was getting well. The long hours in the gym have helped me way more than any drug but psychology and gym doesn’t count to an insurance company. For them trying means trying more chemicals. Along comes a drug regime change, a tickle up, a cessation of  claim and right back down into the painting you go. This where the combination of chemical torture and mathematics starts to bite you. you see what no-one tells you is that depression is cumulative. the maths gets you in the end. the insurance company knows this, and this is why they try like hell to get you off claim well before a year is out. Once you go past a year, the maths mounts, once you go past two or three serious depressive episodes the maths mounts, for them financially, and for you mentally. For them only the money matters, your health is of no consequence to them.

So because you have now had two or three depressive episodes they define you as having a major depressive illness. You do. they put you there. Basically the maths goes like this. If you have one major depressive episode (longer than the median of 23 weeks) then you have a 50% chance of having another in your lifetime. If you do have another episode then you now have a 75% chance of having still another major depressive episode, and after the third the maths is 99%. Got that. Three major depressive episodes and get used to life with major depression. The maths and the research says you will never be rid of the black dog as long as you shall live.

Once you work out the math, you also work out that drugs aren’t going to work, but by this time you are on Venlafaxine or something similar.

These are the side effects of Venlafaxine (The ones I have I’ll note for you. This is highly personal but I think people really should know what these drugs do without the soft soaping. This is real, this is my life, has been my life for 6 years. I’m not hiding it, I’m using it for your education, and I’m not excusing anything either, this is just what it is.)

NOTE: The percentage of occurrences for each side effect listed comes from clinical trial data provided by Wyeth Pharmaceuticals Inc. The percentages indicate the percentage of people that experienced the side effect in clinical trials.

  • Headache (34%) YES
  • Nausea (21-35%) YES
  • Insomnia (15-23%) YES
  • Sexual dysfunction (14-34%) YES
  • Dry mouth (12-16%) YES
  • Dizziness (11-20%) YES
  • Sweating (10-14%) YES
  • Decreased appetite (8-20%)
  • Abnormal ejaculation (8-16%) YES
  • Hypertension (4-5%)
  • Vivid/abnormal dreams (3-7%) YES
  • Akathisia (agitation) (3-4%) YES
  • Decreased libido (3-9%) YES
  • Increased yawning (3-5%) YES
  • Apathy YES
  • Constipation
  • Ongoing irritable bowel syndrome
  • Fatigue YES
  • Vertigo YES
  • Orthostatic hypotension (postural drop in blood pressure)
  • Impulsive actions YES
  • Electric shock-like sensations also called “brain zapsYES
  • Increased anxiety at the start of treatment
  • Memory loss YES
  • Restless legs syndrome YES

Less common to rare side effects

Note ‘Rare’ adverse effects occur in fewer than 1 in 1000 patients.

Now that is quite a list, and I’m not making it up. This is my life. Doesn’t sound like a wonder drug to you now does it. Well think about how it is from my point of view. Now those are the side effects of being on it, I am now 8 days into being off the evil chemical and the withdrawal side effects are even worse. the worst thing is this scary paragraph:

Venlafaxine may be particularly hazardous to those individuals who are susceptible to both venlafaxine-induced serotonin toxicity (also known as serotonin syndrome) and SSRI discontinuation syndrome. In such cases, individuals who have developed the potentially fatal serotonin toxicity and/or may be at risk of doing so, may find cessation or dose reduction unachievable, placing them at continuing risk. As it is not possible to determine which patients are likely to develop the most severe symptoms of the discontinuation syndrome before cessation or dose reduction is attempted, this dual risk requires that all patients are closely monitored during any increase in dosage (when the patient is most at risk of developing serotonin toxicity) and that such increases are carried out in the smallest incremental steps possible. Additionally, patients who recommence venlafaxine or revert to a higher dosage following a failed attempt to discontinue the drug or reduce dosage are another group with an increased risk of developing serotonin toxicity.

Fantastic drug huh? F*cked if you are on it, or doubly f*cked if you try to come off it.

I am writing this today after having spent 4 hours this afternoon “in the painting”. I have had a full blown DPD episode, complete with hallucinations. This post came about right in the middle of the episode and it wasn’t till I could get up again that I started writing. I am writing this because it lessens the pain. Every word I write takes a little bit away as I type it out. (At this point I have written 1781 words and the pain is still there. I’m sorry but I think people need to know.

For me the drugs don’t work, I suspect that they don’t work for many others, I suspect that their lives are ruined and papered over by the cocktail of drugs. Right now I feel that my live as I knew has been destroyed. The devastation is pretty complete. The money is all gone, and I had a fair bit. The houses are gone, the friendships are gone, the relationships are gone. I find it utterly confusing that despite all of that I can actually still do this, that unfortunately doesn’t pay the bills. Working and suffering through the above are unfortunately unable to intersect. the insurance company, Fidelity Life, however thinks I am “cured”, they think that I am “well”. What they really mean is that they arbitrarily decided I cost them too much and despite all medical evidence to the contrary moved me “off claim”. they can do this knowing that my life and stability is utterly destroyed and that to pursue them will cost me my sanity and any remaining resources I have.

Unfortunately for them they picked the wrong person to screw over. I never give in, I never surrender and I can write and surprisingly lots of people like what I write. they refuse to talk, they ignore letters, well they can play like that, but after wrecking my life they will pay and it will be loss of reputation and ongoing posts like this that they will pay through. If they won’t talk, then I will.

I will fight this illness for as long as it takes, I will not give in, and I will tell the truth so that others may learn. If I had known then what i know now about these evil drugs I would never have taken them, I would have fought harder at the start to run my plan for wellness, based around physical fitness and I for sure would be well now. Drugs, Doctors and Fidelity Life have taken me from one “painting” and put me in another. I sure as hell won’t be solving this like Van Gogh did though.

That said, my GP and my psychologist in conjunction with my psychiatrist have been brilliant, they have always agreed with my plan, but when in the grip of an insurance company that can see only one solution then it is impossible to move ahead. In one sense having Fidelity Life cut me off in contravention of our contract has allowed me to be free to pursue my own path toward wellness. It has taken me 6 months to wean myself down to zero on the drugs, I am now in the home stretch for being drug free. Now I can concentrate on trying to pick up the pieces of the wreckage of the last six years.

Blame is the wrong word, but I can think of no other. State funded, doctor prescribed drugs supposed to heal are the “blame” for my hell of a life. In actual fact the blame is a lack of education that there are other ways.

If you suffer depression, or think you do then seek help, but make sure you explore the alternatives to the chemical cocktails. In the absence of anything else listen to John Kirwan, even if the message is soft-focused and massaged so as not to scare you.

As a postscript….If you notice me posting all sorts of videos to my Facebook wall, that is another of my release mechanisms. I play really sad songs about depression until I’m sick of hearing about it, every video I post leaches the depression away. Don’t despair of me, I’m not going to top myself, and I really, really appreciate the messages of support I get even if it is a “Like” of the post.