Below are answers to some questions that I am frequently asked. Remember, these answers are my own opinion on these matters (and I can be very opinionated).
Q.Where did the title of your page come from?
A. What inspired me was this passage from William Styron’s Darkness Visible, a recounting of his own depression:
One bright day on a walk through the woods with my dog I heard a flock of Canada geese honking high above trees ablaze with foliage; ordinarily a sight and sound that would have exhilarated me, the flight of birds caused me to stop, riveted with fear, and I stood stranded there, helpless, shivering, aware for the first time that I had been stricken by no mere pangs of withdrawal but by a serious illness whose name and actuality I was able finally to acknowledge. Going home, I couldn’t rid my mind of the line of Baudelaire’s, dredged up from the distant past, that for several days had been skittering around at the edge of my consciousness: “I have felt the wind of the wing of madness.”
I have seen other translations of the line since then, but for me this passage captured how I felt when I realized that something was wrong with me that I could not banish on my own.
Q. What medications have you been on, and what has worked for you? How long will you be on medication?
A. I started off on Norpramin, which is a tricyclic antidepressant, and was on it for nine of ten years. The other year during that decade I was on Prozac, but it didn’t work for me as well as Norpramin. I still went through bouts of low-level depression on Prozac, and it also had the side effect of making me anorgasmic (unable to achieve orgasm). The reason my doctor put me on it was that he felt it would alleviate my obsessive-compulsive tendencies, which it did. When I went back on the Norpramin, he prescribed Klonopin for my OCD (Obsessive-Compulsive Disorder). Klonopin was very effective in suppressing my OCD. I went off it a couple of years ago, but if my OCD gets particularly troublesome, I will start on it again.
I had my dosage of Norpramin raised three times, since my body seemed to become accustomed to it after a year. I also was on double the initial dosage of Prozac when I was taking it. I’m not sure if this is due to a speedy metabolism, or something else, but it illustrates the fact that everyone is different, and a dose that works great for one person may be too low for someone else. This is why it’s a good idea to try a higher dosage of an antidepressant before giving up on that particular medicine entirely.
I switched to Wellbutrin in fall of 2000, which seems to work well, and has fewer side effects.
When it became obvious that I still needed medication after a year of being on it, my doctors told me that I would probably be on antidepressants my entire life. When I go through particularly stressful periods, my dosage may be temporarily increased.
Q. What do you think of Prozac?
A. As I mentioned above, I have personal experience with Prozac (generic name is Fluoxetine). Basically, Prozac is just another antidepressant. There are three reasons why it has become a household word. One is that it is one of a family of antidepressants (SSRIs) which have more moderate side-effects than the older antidepressants. Many patients are put off by side-effects from an antidepressant (which are often temporary) and will therefore will not stay on it long enough for it to have an effect. This is one reason why doctors are often inclined to prescribe Prozac over older antidepressants.
Another reason Prozac is so well-known is simply because it was marketed extensively by the drug company that produces it. Finally, Prozac is a household name because of the stories in the news about people who apparently exhibited violent behavior while on it. The explosion of stories was primarily due to media sensationalism. While violent thoughts and behavior could be a side-effect for some people, it is very rare. Of course, a side-effect like this should be reported to your doctor.
Q. I have a low income, and no insurance. How can I get treatment?
A. This is a very tough question for me to answer, since I don’t have a complete understanding of what type of government or state assistance is available, and whether mental health treatment is covered. I have tried to find general information on the Internet to answer this question, and I have not had much luck. My suggestion is to talk to someone at a local mental health clinic, perhaps one connected to a hospital. Explain your situation, and see if they have suggestions or information that will help you.
Q. How do I find a support group in my area?
A. Call the mental health or psychiatry department of your local hospital and ask them for suggestions.
Q. I have a friend/spouse/relative who suffers from depression, and I feel helpless. What can I do to help him or her?
A. First of all, educate yourself about depression, which is presumably what you’re doing on my page. Secondly, it’s very important that you try to be understanding and supportive. I address this topic in-depth on my page When Someone You Know is Depressed.
Q. I have a friend/spouse/relative who I am sure has depression, but who refuses to get help. What can I do to make him or her go to a doctor?
A. To put it bluntly, there is nothing you can do that will be effective in making someone seek treatment. Even if you can coax/cajole/shame/scare/push someone to keep an appointment with a doctor, that person will not be a good patient. It’s unlikely that they will stick to a medication regimen or participate in psychotherapy. Your best bet is to try to find out why they are resisting getting help, and educate yourself so that you can counter their misunderstandings of this illness with good information. It’s possible that they realize they have depression, but may be scared that if the doctor can’t help them, their last chance is gone. Try to find out what is at the bottom of their resistance.
Of course, if they are a danger to themself or others, you may want to talk to a psychiatrist and an attorney about possible involuntary commitment. I have no knowledge about the legality of that move, never having been involved in it.
Q. (Well, not exactly a question) I was going to write my own page about depression, but it looks like you’ve covered everything.
A. I will never cover everything, because I’ve only told my story, not yours. I think it’s important for everyone who has experienced depression and wants to share their story to do so. It’s what other people connect to, and makes them realize they’re not alone.
Q. How do I go about finding a good psychiatrist/therapist?
A. I have had the best luck finding good psychiatrists by asking my general practitioner (family doctor) to recommend someone. Of course, this is only advisable if you trust and like your family doctor. If you don’t, then it’s easy to ask around to find yourself a GP.
A. Okay, first of all, I’ll suppress the urge to rant about treating depression yourself. I’ll assume that you have been diagnosed by a psychiatrist and had other illnesses ruled out, and that your doctor has not recommended trying antidepressants or they haven’t worked for you. Please stay away from the numerous sources on the Web which are selling herbs that they promise will banish depression. They are only looking to benefit financially from your pain. If you want to go the herb route (and I really don’t understand why people think herbal is so much better than chemicals), then go to a naturopathic doctor. Most of all, be informed. Herbal medicine has its side effects and contraindications with other medicine.
Q. I was just diagnosed with depression, and I want to talk to other people who understand what I’m going through.
A. Please visit the Wing of Madness forum. You will find that you are definitely not alone in this illness.
A. Get medical help – simple as that. Especially if you have any suicidal thoughts or feelings! Your depression could be caused by a hidden medical problem, so you should consider having a complete physical, with the doctor aware that you feel you might be suffering from depression. Talk to your family doctor about your concerns, and ask for the name of a good psychiatrist if no medical condition such as thyroid problems, etc. is found to be causing your depression. If you do not feel comfortable with your family doctor, then ask around till you find the name of a couple of recommended ones, and interview them. No one has to know why you are looking for a new family doctor. I have received my best recommendations for psychiatrists from family doctors I liked and trusted.