Depression destroys lives. Healing is possible.
TMS: hope in the treatment of resistant depression
When I first heard of Transcranial Magnetic Stimulation, I must admit, I was a bit sceptical. I struggled to believe that a giant magnet held to your head could help patients struggling with Treatment Resistant Depression. But, as study after study came in, with extremely positive results in traditionally hard to treat patients, I became increasingly frustrated. Why wasn’t TMS treatment available to my patients, here in Cape Town? Depression is a horrible illness that robs people of their joy, their ability to connect, their ability to function. Antidepressants came out in the 50’s and have saved millions of lives.…
Anxiety myths busted
Anxiety is a cluster of psychological and physical symptoms. The psychological symptoms include feelings of dread, fear and being overwhelmed. Patients having a panic attack tell me it feels like they are going to die or go insane. Physical symptoms manifest all over the body: racing pulse, sweating, blushing, irritable bowel, irritable bladder, shaking and muscle tension. Anxiety is normal. It makes us look both ways when crossing the street. It becomes abnormal when the sufferer starts worrying and dreading everyday situations.It can start making it difficult to work, attend school or socialise. When it starts making someone’s world small, stops…
What if depression was not an illness of the brain?
At med school, I learnt that depression is an illness of the brain. When we properly treat it with the correct medication, we restore imbalances and patients get better. Depression as a brain illness is a useful model. Many of my patients come seeking help, deeply ashamed of their depression, as if it is a character flaw. When I say that the brain is an organ and can get sick like any other organ in the body, it often helps to get past all the judgemental, self-critical chatter. The longer I am in this game, the more I realise that…
How to love someone with serious mental illness
My gut still churns when I see that look in family members’ eyes. The one of desperate confusion and frustration. The fatigue and anger, especially if the symptoms their loved one suffers from has been ongoing for some time or involved aggression. If your loved one has a serious mental illness like schizophrenia, profound depression, bipolar mood disorder, addictions or eating disorders, it is awful. They aren’t the only ones suffering. You are too. The good news is that improvements for mental illnesses are as good, or even better than, chronic physical illnesses like diabetes or cardiovascular disease. But there is…
The lowdown of living with Borderline Personality Disorder
Historically, the border of Borderline Personality Disorder (BPD) refers to the edge of neurosis and psychosis. That unstable area which is always hysterical or mad. It is classified as a personality disorder. Personality disorders are considered fixed throughout life and not amenable to treatment. Unlike psychiatric illnesses such as schizophrenia or bipolar mood disorders, which are considered chronic but responsive to treatment. It is a very bleak view of BPD. Because of this, when I was doing my specialist degree, many psychiatrists felt that it was pointless telling a patient of their BPD diagnosis, that it would just add to…
Are you moody, bipolar or misdiagnosed?
To suffer from bipolar mood disorder is rough. It is often difficult to treat, with two mood stabilisers and an antipsychotic being needed, before even a bit of control is achieved. This hand full of pills can come with serious side effects like weight gain, sedation, hormonal imbalances and movement disorders. As if that’s not enough, as soon as you get a diagnosis of bipolar mood disorder, you get exposed to the stigma of such a label. People with serious mental illnesses have employment difficulties, get excluded from certain benefits and get labeled “mad” by loved ones. Despite all these problems, untreated…
Due to an unexpected medical emergency (aren’t they all unexpected?), I have not been able to write a new blog. Here is a relaunch of an old one.
The Public’s guide to dealing with psychosis
I was speaking to a friend recently. She said that she was accosted by someone while walking on the greenbelt. He was delusional and feverishly trying to engage her in a grand scheme. She felt uncomfortable and was unsure of how to deal with him. A patient of mine works in a bank. She dreads when a particular client comes in because he always demands to speak to her outside, “where the cameras aren’t watching”. She too feels uncomfortable and is unsure how to respond. One of my medical colleagues was giving a talk at a restaurant which opened onto…
The rawness of panic attacks
My patients tell me that panic attacks are not pleasant. They describe it more as sheer terror. They fear dying, losing control or going insane. Panic attacks come on hard, peak fast and usually pass within the hour. They create such a fracture in the sufferer’s psyche that the hangover feeling of having been overwhelmed and the fear of another attack can put a dampener on life plans. Panic attacks can happen to anyone. It does happen to about 10% of us. If they recur and the sufferer starts making their life smaller to avoid situations which might trigger an…
Why can’t I shake this recurrent depression?
By the time patients come to me for the treatment of their depression, they have often been sick for some time. When we go into the history of the illness, it becomes clear that most have been depressed before. If you have had two episodes, more than likely, you will have a third one. If you have had three episodes, there’s a 90 percent chance you will have a 4th. It seems that a single episode of depression is more the exception than the rule. The greatest predictor of a relapse of depression is stopping antidepressant treatment. More and more evidence…