So I got curious -

[kyburg]

Last weekend, I had the opportunity to observe a "true" case of ADHD, diagnosed and being managed with medication. She's 10, and about 3:00 PM, her parents provided her with a dose of Focalin. Since I didn't know what that was, I Googled it. Streamlined Ritalin. Okay.

But like just about everything out there, it had a MAOI contra-indication. Everything has a MAOI contra-indication.

So I got curious. WTF is a MAOI and why would anyone submit to it?

Found a lovely website that explains that class of antidepressants. Go check it.

"I call it the 'St. Jude' drug," says psychiatrist Andy Myerson. "It's the drug I use when nothing else works and someone is willing to give up anything in the hope that something will help their depression."

...

"I've seen a few miracle cures with these drugs," one psychiatrist noted. "And they're particularly good if people suffer from panic attacks in addition to depression."

How does it work?

Once the brain's three neurotransmitters, known as monoamines (serotonin, norepinephrine, and dopamine), have played their part in sending messages in the brain, they get burned up by a protein in the brain called monoamine oxidase, a liver and brain enzyme.

Antidepressants known as monoamine oxidase inhibitors work by blocking this cleanup activity. When the excess neurotransmitters don't get destroyed, they start piling up in the brain. And since depression is associated with low levels of these monoamines, it's not surprising that increasing the monoamines ease depressive symptoms.

Unfortunately, monoamine oxidase doesn't just destroy those neurotransmitters; it's also responsible for mopping up another amine called tyramine, a molecule that affects blood pressure. So when monoamine oxidase gets blocked, levels of tyramine begin to rise, too. And that's when the trouble starts.

While a hike in neurotransmitters is beneficial, an increase in tyramine is disastrous. Excess tyramine can cause a sudden, sometimes fatal increase in blood pressure so severe that it can burst blood vessels in the brain.

Ah. Got it.

Then I checked the sidebar. I've had a very good response to Dr. David Burns' "Feeling Good" book - I recommend it often. It doesn't do the job by itself - reading that book is not going to change your life overnight or by itself. It does provide some very useful tools and perspective, however. And once you're out of the depression hole, it does a VERY good job of keeping you out. *raises hand* 16 years and counting. But this site mentions a book called "Good Mood" - here's the Amazon reference - and low and behold, the "Feeling Good" book is recommended along with some others.

It's nice to see Dr. Burns isn't by himself on the shelf anymore. Looks like I might need to read some more on the subject - as there is more to read!

Dr. Burns' book appears to be cheapest, still - but. Cognitive work isn't pop psych anymore? Contemporaries exist - and I like the way that man thought (sadly, he passed in 1998). For some reason, perhaps because many intellectuals suffer from and write about it, depression has become a trendy psychological affliction among people who by objective criteria have little to complain about.

Then why?

It pays to be curious, at times.

Random acts of intellectualism. Yahoo.

Comments

[bigbigtruck.livejournal.com]

There's also the myth that depression makes one a better artist/writer/musician... which is bollocks in my experience.

[kyburg.livejournal.com]

*hisses* I was useless when depressed. What a joke.

[zeles.livejournal.com]

Well odd as it seems, for some, thats the case. But it really is a person to person thing *shrugs*.
Personally, back when I was younger and depressed most of the time was about the only time I ever found myself in a creative mood. If I was "on a high", I usually found better things to do to enjoy myself, but they were rarely creative. It was only when I was down that I sat around doing nothing long enough to get in a mood to write a poem, work on some piece of art or play some music, and would actually dedicate the time to think and do it right. Of course, as one might imagine everything I did work on tended to reflect my mood at the time, so in otherwords, dark and dreary works of "art". I use to try at times to be creative when I wasn't depressed, but well it just never seemed to work.
But that said, I definitely wouldn't recommend to anyone to go around being depressed to help the creative juices flow. Just doesn't pay off, unless you really have better luck making money off it than I did.

[kyburg.livejournal.com]

I think it has more to do with the types of thinking you allow yourself - and if you are willing to "try on" various types of POV, you're likely to keep a lively imagination alive.

That also opens you up to trying on some pretty bleak stuff.

Some of the most "creative" stuff I ever saw were in the punk and goth arenas I skirted over the years - it took a LOT of work to get that look just so - but we also butted heads a lot of times because I was such a "optimist." BAH.

[starcat-jewel.livejournal.com]

Well... I wrote some pretty decent fanfic during a bout of severe depression. But I was writing it as an escape from reality -- when I was living in that world, I didn't have to worry about where my next mortgage payment was coming from. This is not what I'd call a healthy approach, although it did produce good creative work. (It still looks good to me now, 5 years later and well out of that situation.) What's more, I knew at the time what I was doing, but I couldn't make myself care... which is pretty much the working definition of depression.

[kyburg.livejournal.com]

Escapism isn't depression - life is sucking, and you're finding a way out. When life IS depressing, you know it, you're spending your life online or writing your way out of it, that's not what I would consider depression, in the clinical sense.

Clinical depression is more than hard times; when it has a chemical basis in the brain, it can be intractable. This is when you don't write, don't create, don't do much of anything - there seems no point. Or you're so worked up about doing something "wrong," you can't function.

Is it possible you did such good work because there were no diversions? Nothing else seemed to be as enjoyable? You might have even had people waiting to give you strokes for it - which you likely didn't get for anything else at the time. (BTW, hooray for getting out of a bad spot - so many people just stay there their entire lives and turn into very bitter people.)

One of these old days, I'm going to unpack my doll collection and post pictures of the ones I made from rags when the house burned down when I was 13/14. Was supposed to be "over" that whole thing of playing with dolls - but it was the best therapy in the world to have these things. They had the most wonderful adventures, I recall -

Wow, that was 30 years ago this past May. Yah.

[starcat-jewel.livejournal.com]

Oh, my depression was real enough -- but it was situational, not medical. I was depressed because my life sucked; there were days on end when I couldn't come up with any good reason to get out of bed until it was lunchtime and I got hungry. And once my life got less sucky, the depression went away. It was nothing like the kind of thing faced by someone with medical depression.

[feyandstrange.livejournal.com]

Yes, cognitive has come a looong way lately, and is being used and recommended all over the place. I'm glad to see it. Although I am inclined to cringe at that 'trendy' statement. It seems like a disease is either under- and mis-diagnosed, or once it gets enough publicity that people have heard of it, it becomes over-diagnosed and 'trendy'.

[kyburg.livejournal.com]

I kind of think it's the book publishing lobby against the pharmaceutical lobby - who do you think will win?

And you only buy a book once.

[feyandstrange.livejournal.com]

It takes a lot longer to get a book out thatn it does for thepharmaceutical companies to get ads out. (I'm extremely against letting the phamrm companies advertise directly to us.) And ads and the press info they put out means newspaper, magazine and TV articles about it. By the time the book comes out...

[keken.livejournal.com]

do me a favor, any parent you see with a hyperactive kid on meds...send them to feingold.org. It's a scary idea at first, but once I got my head around it, the possibility that diet really could contribute to my own mental heath
opened up a world I had no chance at before....

[kyburg.livejournal.com]

Anything is worth consideration, as long as you keep your wits about you.

I've known this family for three generations - unfortunately, I don't think her ADHD is anything but based in a bad set of genetics. She has a grandfather, uncles with it - her father has a touch of it himself. There's a ton of "special education" that went on there, lemme tellya.

And her response to that one dose of Focalin was scary. It did exactly as advertised - not dopey - not drugged. Normal.

When I talk to them again, I'll mention it. I'm sure they've heard about it, as well-connected to their community as they are. And the mother has gotten an MS diagnosis as well - I'm sure they're ready to believe in curses on some days.