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rooster wrote:However, I am sure there is some permanent damage that will never be totally overcome.

Like your tendency to post stirring political threads

Uncle_Bob wrote:

rooster wrote:However, I am sure there is some permanent damage that will never be totally overcome.

Like your tendency to post stirring political threads

As long as they stir, everything's OK.

Should I get back into that health bill stuff? Maybe threw in something about Canadian health care?

Or maybe this stupid body scanning deal?

secret agent girl wrote:

Judy R wrote:Everyone is different and has to do what's right for them.

YES!

Also, a book that may interest some: Depression Is Contagious: How the Most Common Mood Disorder Is Spreading Around the World and How to Stop It by Michael Yapko
http://www.amazon.com/Depression-Contag ... 1416590749

Thanks for the link, I'll go and check it out. I'm sure it's packed full of useful tips.

I can only speak from my own experience. I dealt with depression long before I had apnea. My problems began in my early to mid teens but I lingered almost 25 years before seeking treatment. I was functional but lived with indescribable, unexplained sadness at times (I can only equate the sadness to the death of a loved one). I tried talk therapy for a good while before my counselor determined I needed the medication. He and I both wanted to avoid meds but it became obvious it was a physical issue as well. My family has a history of depression and he took that into account.

I too believe these meds are overprescribed, ironically I also firmly believe I need them to function well. I am very successful in my career and I am one class from completing my PhD. I have raised two wonderful, well adjusted children. I could not have come this far without the meds...I am convinced of that. The only thing that has sidelined me in recent years is the apnea yet in spite of that I completed my PhD residency while working a full-time job with overtime. All in all I have been fortunate.

As with apnea we can see people require different treatments and varying levels of therapy so we shouldn't be quick to generalize.

I saw a pretty in-depth report that stated the patients were given questionnaires that when scored would rate depression severity. Those with severe depression (scoring 14+) were helped significantly, while the rest scored about equal with placebos.

I am very doubtful that this study on its own is representative. There are lots of reasons why people with moderate to mild depression might not answer questionnaires relating a significant improvement. I think this study is a good starting point to focus on the <14 group to better define them.

Finally, I am concerned that the treatment of patients is becoming a game of numbers that can be gamed either way and treatment provided or withheld. The recent rash of releasing "studies" showing women don't need mammograms, one I can't remember, and now this sure looks like future cuts in medical coverage. I absolutely expect coverage changes extending the frequency of CPAP supplies and perhaps even dropping the requirement of Rx for masks and cushions so they in effect become over-the counter to us so we get to pay for them without reimbursement.

OldLincoln wrote: Finally, I am concerned that the treatment of patients is becoming a game of numbers that can be gamed either way and treatment provided or withheld.

Good point. Treatment should be between the patient and his doctors.

Antidepressants, like many other treatments, can be helpful in fighting depression. Depression is often multifactorial, and can be contributed to by many different causes, including personal and intrapersonal stress, financial issues (especially since the recent recession), hereditary factors, lack of sun exposure (seasonal affective disorder), obesity, hormonal issues and fluctuations,and yes, OSA etc., etc.... The list is not complete. Sometimes there is no obvious cause, it just is!.. What works for one may not work for another.

After over thirty years as a family doc / ER doc / nursing home doc, having treated people ranging from young children to the developmentally delayed to the frail elderly, from mild depression to suicidal despair, I am still as baffled by the whole spectrum as when I started. I have learned to respect everyone as an individual, and have learned that in the whole area of mental health treatment flexibility is a must. I've seen depression improve by talk therapy, with medications, a combination of the two, as well as light therapy, natural medications, CPAP, vacations, ....this list is not complete either.....

My suggestions for this forum is to listen to and learn from each other and not to judge too quickly....
More to the point on this site, if CPAP has helped your depression, tell us your story.....

thomzeyl wrote: More to the point on this site, if CPAP has helped your depression, tell us your story.....

And here is a good thread in which to post your story -> viewtopic.php?f=1&t=47183&st=0&sk=t&sd= ... depression

thomzeyl wrote: ....
After over thirty years as a family doc / ER doc / nursing home doc, having treated people ranging from young children to the developmentally delayed to the frail elderly, from mild depression to suicidal despair, I am still as baffled by the whole spectrum as when I started. .....

I was prescribed three different SSRIs, sleeping pills and sedatives. Then I found out about my sleep apnea, started CPAP and threw all the capsules away (They were a totally wrong treatment).

In the meantime, I found many people who went through the same thing I did before they were finally diagnosed with sleep apnea. The medical profession in the U.S. has really missed out big on the prevalence and widespread effects of SDB. They have started to catch on but many doctors are still well behind. How is it in Canada?

rooster wrote:

"I was prescribed three different SSRIs, sleeping pills and sedatives. Then I found out about my sleep apnea, started CPAP and threw all the capsules away (They were a totally wrong treatment).

In the meantime, I found many people who went through the same thing I did before they were finally diagnosed with sleep apnea. The medical profession in the U.S. has really missed out big on the prevalence and widespread effects of SDB. They have started to catch on but many doctors are still well behind. How is it in Canada?[/quote]"


Probably the same in Canada as anywhere.... I was taught in medical school that history is 70% of the diagnosis, exam is 20% and testing is 10%- done to confirm what you already know. If a doc is too speedy in the history, OSA symptoms won't be asked about, and the diagnosis will be missed. I always critique my medical students and residents for not asking about and considering OSA when dealing with fatigue, depression, etc.... Considering OSA as a diagnosis dates from the 1960's and CPAP from 1981 (after I graduated from medical school!), we are making progress..... slow, agonizingly slow progress.

thomzeyl wrote: I always critique my medical students and residents for not asking about and considering OSA when dealing with fatigue, depression, etc....

Thank you.

Mary Z wrote:BlackSpinner, if you're not an accredited Psychiatrist I suggest you not give psychiatic med advice to people whose lives depend on it. .

I don't see where I gave any advice. I gave an anecdote and agreed with someone about bipolar needing different meds from someone with depression. That is not giving advice that is commenting on what is happening.

Perhaps a reading comprehension course might be in order.

BlackSpinner wrote:

Mary Z wrote:BlackSpinner, if you're not an accredited Psychiatrist I suggest you not give psychiatic med advice to people whose lives depend on it. .

I don't see where I gave any advice. I gave an anecdote and agreed with someone about bipolar needing different meds from someone with depression. That is not giving advice that is commenting on what is happening.

Perhaps a reading comprehension course might be in order.

I think I figured out what BlackSpinner was referring to. It was when you mentioned that antidepressants aren't effective for bipolar people. When I first read that I was thinking like BlackSpinner. But you went on to speak anecdotally and it came together.

Meanwhile... my mom has bipolar. It's been quite the saga. She has been on anti-depressants for a while and when the doc first gave them to her I thought he was nuts! (pun totally intended.) She seemed totally manic to my father and me. But it turns out that she needed it to stabilize her mood. At other times she needs the mega-mood stabilizers to keep her from going manic. And always she needs some kind of sleep med to keep her from going days and weeks without sleep. It's a very complex disorder.

When my dr first wanted to put me on anti-depressants I told him I'd check with a psychiatrist first. (Because of my experience with my mom I have a strong belief that only psychiatrists should prescribe these sorts of meds.) I've been on them for years. I recently changed psychiatrists and that's the dr that ordered my sleep study. If all goes as she thinks I'll be off the anti-depressants by the end of the month!!!! I think the other dr's came to conclusions based on my family history. And of course, they never asked questions that would've shown OSA. I used to see a dr that blamed my fatigue solely on my weight. He told me that heavy people need more sleep to refresh their additional amounts of fat! That just never made sense to me. I know plenty of super heavy people that are never tired and get a ton of stuff done. Now... I may still really have depression. But I'm very hopeful that all my symptoms fall under this one dx.

BlackSpinner wrote:...But you are not supposed to take antidepressants for bipolar!...

One of my closest friends is bipolar and cannot take any antidepressant, even the ones supposedly safe for bipolars. Several doses of one of those sent him into mania for which he spent several wks hospitalized trying to get back to his version of 'normal,' antidepressants are to prescribed with great caution for those who are bipolar that's for sure.

There is more than one type of Bipolar Disorder. Depressive symptoms differ between the types likely resulting in benefits or risks of using antidepressant medications. Maybe the below information can help with clarity and understanding of thoughts presented. Opposing opinions may be correct in this discussion.
Bipolar I
A person affected by bipolar I disorder has had at least one manic episode in his or her life. A manic episode is a period of abnormally elevated mood, accompanied by abnormal behavior that disrupts life.

Bipolar II
Bipolar II is similar to bipolar I disorder, with moods cycling between high and low over time. However, in bipolar II disorder, the "up" moods never reach full-on mania.

Rapid Cycling
In rapid cycling, a person with bipolar disorder experiences four or more episodes of mania or depression in one year. About 10% to 20% of people with bipolar disorder have rapid cycling.

Mixed Bipolar
In most forms of bipolar disorder, moods alternate between elevated and depressed over time. But with mixed bipolar disorder, a person experiences both mania and depression simultaneously or in rapid sequence.

Cyclothymia
Cyclothymia (cyclothymic disorder) is a relatively mild mood disorder. People with cyclothymic disorder have milder symptoms than in full-blown bipolar disorder.

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