Help - depressed, ill or what?

Re: Help - depressed, ill or what?

listhestar — Fri, 04 Oct 2013 14:33:23 GMT

Firstly well done for coming on here and talking about it. This is a good first step. I nearly walked away from my computer and didn't offer up my thoughts and realised that was incredibly selfish of me having being helped on here many times.

Half the stress with vets sometimes is we have too much knowledge (but not always quite enough) which then means we over analyse results, problems etc. We all want to 'sort ourselves out'. I have had a bout of depression a few years ago kicked off by a bad run of migraines, medication for those, news my dad had a terminal disease and silly hours at work. I could reply Anon to you but I am fed up of people judging others with mental illness. My symptoms were extreme tiredness and I did not have energy to do anything I liked anymore, I didn't spot the problem, my husband and a friend (who are both in the health profession) noticed it. I was at times very tearful but couldn't explain why and yet I managed to continue to work. My memory was poor, appetite variable and I could sleep 12hrs and still feel tired. I was offered time off but decided to work through it as my job gave me structure. I went to my boss and advised him of my diagnosis and drugs I was on and he was brilliant. A component can be adrenal burnout (google it- seen in a lot in intern docs) or emotional burnout if you have had a lot of draining cases. I had a type of cognitive therapy (which I took up thinking 'it wouldn't help) but it did and I managed to chat ok to the therapist.

I was on citalopram which made me drop a stone in 6 weeks but during this time took up running and slowly made progress and along with the therapy came out of it about 3-4 months later. A lot of my friends had (and still don't) no idea of the issues I was facing-it's very hard to ring up someone and tell them you have depression. If you have a hubbie/wife/partner etc use them to support you. My husband was my rock through it.

Try mind or your local health authority. You are more than welcome to message me, it will be treated in confidence.

Good luck

Lisa

Re: Help - depressed, ill or what?

Mike Dale — Wed, 02 Oct 2013 21:20:07 GMT

I am sorry to hear of your plight. There are resonances of both depression and possible physical disorder although you do seem to muster the energy for off duty or "displacement" activities. You don't say whether you are male female, alone or in partnership with or without children. I can think of several physical conditions that could produce these symptoms ranging from hypothyroidism through ME, Tick borne Fever, Post viral stress syndrome, Primary Biliary Cirrhosis and a number of conditions that, for example, can cause sick mitochondria syndromes.

You clearly need a) alternative, more sympathetic and enlightened medical advice

b) a best mate to support you through seeking the right help and to get through the flat periods with talk and practical support.

We can all chip in our theories but you already show signs of making the right move when you say you really need to acknowledge the problem and I suggest you try the VBF helpline for guidance on professional help. (Vetlife). This is too important for you to rely on anecdotal suggestions. You must find positive, sympathetic professional advice. Good luck and it would be nice to hear from you when you have come out the other end. You will.

Re: Help - depressed, ill or what?

Paula Bentley — Wed, 02 Oct 2013 16:21:33 GMT

Have you had your vitamin D levels checked? I am hypothyroid and even on medication i was exhausted for years and that in itself was very depressing. My GP just said well , your t 4 is normal , nothing more i can do. Very, very disheartening. I had BUPA so went to see an endocrinologist who took more bloods, found the lo serum ferritin (mentioned here) and virtually non existent D3. She also picked up that I had IBS and probably was not absorbing very well. She openly recommended trying supplements as well as addressing the clinical issues. I find high dose B supplements d3 (also intermittent ferritin) have helped tremendously, even if it is placebo effect , I am happy with that. Also try eating more protein and more regularly, that also made a big difference. I am now like the seventies add, I go to work on an egg. Hope that helps. I remember leaving the GP in tears every time, so I think I have some understanding of your feelings. I also tried some relaxation techniques. Can't harm .. ( I also changed GP! ) Hoping some one on here has an idea which helps you .

Re: Help - depressed, ill or what?

SAB — Tue, 01 Oct 2013 14:21:36 GMT

Above is the copied and pasted article. Hope it helps

Re: Help - depressed, ill or what?

SAB — Tue, 01 Oct 2013 14:20:46 GMT

One in five of us in a state of near-permanent exhaustion and it’s not a simple lack of sleep causing the problem

Do you find yourself talking too fast, unable to concentrate properly and constantly worried you may have Alzheimer’s? If so, you may be part of what doctors say is a growing epidemic of tiredness.

It’s not the kind of tiredness caused by a simple lack of sleep — more a feeling of near-permanent exhaustion that makes the brain feel as if it is constantly misfiring. Yet we also feel wired and hyper alert because of the swirl of stress hormones, so we may not even realise how deeply tired we are. Sufferers often wake up wondering if they’ve slept at all because the buzz of a constant narrative has been running through their heads (though they usually have; studies show most people who complain of constant tiredness are getting the six hours’ sleep scientists say is just about enough to get by).

One recent large-scale survey of 38,700 British employees revealed that only 15 per cent felt revived by their sleep, and even the Royal College of Psychiatrists believes one in five of us is unusually tired at any given time.

“This sense of fatigue is a pretty universal epidemic, and I see it all the time in my clinical work,” says psychologist Dr Cecilia d’Felice. “But there is nothing physically wrong, and it’s not really about sleep — it’s about a state of mind.”

What specialists think is happening is that we are bombarding our brains with too much information for too long during the day — whether it’s answering emails at 10pm or thinking up a new witticism to Tweet — and not allowing our brains sufficient recovery time. “We’re afraid to stop and do nothing because we feel this constant need to be in ‘doing mode’,” says physiologist Dr Nerina Ramlakhan, who runs a clinic for the chronically tired at a London hospital. “But we underestimate just how much mental effort is involved for the brain in processing all this information.”

We try to perk ourselves up with caffeine, which makes us feel more alert but doesn’t stop us feeling tired at a deep level. “So we get into a fatigue cycle where we feel exhausted so we run on caffeine, then we are wired so we feel we need alcohol in the evening to get to sleep, which then stops us getting deep sleep and breaking down all that adrenaline and we wake up exhausted and so the cycle continues,” she says.

The wired state that many of us live in during the day is a “hyper-arousal” caused by tiredness, stress hormones and caffeine and it has terrible effects on our ability to concentrate properly, focus and remember things. This hyper-aroused state is fine for simple, repetitive tasks, explains sleep expert Professor Jim Horne at Loughborough University. But as the task gets more complicated, we are less able to cope. “Anything involving innovation, problem-solving and higher thinking is impaired, and if it carries on for months and months it can end in burnout.”

New research has suggested the idea of “local sleep”: that if we constantly over-use parts of our brain, those circuits may actually shut down and take a “nap” while we are still awake and believe we are functioning normally. “What may be happening is that parts of the brain essentially drop out for a time, which could explain errors of judgment, mistakes and irritability experienced by people who are tired,” says Dr Chris Idzikowski, director of the Edinburgh Sleep Centre.

He agrees that this tidal wave of tiredness is not predominantly caused by a lack of sleep. “People have been worrying about a lack of sleep because of the hustle and bustle of modern life for a long time — I found an article in the British Medical Journal from 1894 saying exactly the same thing,” he says. Despite our perceptions, the amount we sleep hasn’t changed that much in 50 years — between seven and seven and a half hours a night on average, although it has dropped a little. And studies show most people manage to adapt if their sleep is cut to six from seven hours without huge knock-on effects. The major health problems (high blood pressure, a rise in inflammatory markers, cardiovascular problems and higher risk of diabetes and obesity) tend to kick in when you get below six hours.

It’s the quality of our sleep that’s the problem, according to Ramlakhan. “It’s likely to be more shallow and interrupted,” she says. “If someone is suffering an overload of information they may get ‘stuck’ in the intermediate levels of sleep when the brain is consolidating and filing, and never really get to the deeper, most rejuvenating delta sleep, which is probably why they wake up feeling unrefreshed.”

So what’s to be done? The most vital thing is to give your brain a break from the onslaught of information. “We should ask ourselves, is it really important to check our emails at 10pm? Many of us are developing unhealthy relationships with our phones — they are amazing devices but we need to start creating healthy boundaries to protect us from ourselves, such as turning the phone to silent or leaving it in another room at some points in the day.”

“The trouble is, checking your phone is quite addictive. We produce dopamine every time we respond to an alert on our phones, which is a chemical that wakes us up and makes us feel energised. So when we are tired we reach for the phone to check messages because we are after that ‘hit’ of dopamine – it’s the next best thing to a cup of coffee.”

She advises stopping using the phone at least an hour before going to sleep. “There’s no hard and fast research on how long you can spend on your phone, tablet or laptop in the evenings before you start causing damage,” says Ramlakhan, author of Tired But Wired (Souvenir Press, £12.99). “But from my 20 years of work in this area, I recommend my patients go for an ‘electronic sundown’ 60-90 minutes before bed – so no technology in that time apart from watching TV. This allows the brain to go offline and pack away that day’s information. Their sleep is then much cleaner, more restful and deeper.”

Instead, she advises leaving the phone downstairs at night and at least an hour before going to sleep as studies show the bright light from screens may inhibit the production of the sleep hormone melatonin. Using a computer late at night is linked to stress, difficulty sleeping and depression, according to a study last year at the University of Gothenburg. Never use a smartphone as an alarm clock. And leave it in another room when talking to your children or partner, or helping with homework, to avoid giving people what psychologists call “continuous partial attention”.

True information-overload junkies may require something stronger to rest their minds, and research shows meditation and the current buzzword “mindfulness” — learning to live in the moment to quiet the mind — can help. Even ten minutes’ meditation a day can make a difference, and there are several phone apps to help. In fact, research suggests that the quality of rest your body gets from 10 minutes’ meditation first thing in the morning is better than in the final phase of sleep.

The meditation-averse can get as many benefits from spending 10 minutes “in the present” noticing the world around them, says Professor Stephen Palmer, director of the Centre for Stress Management . He says it’s the equivalent for the brain of just standing at the bus stop letting the mind wander, rather than anxiously checking your smartphone, although he admits to being one of the few people in Britain not to own a smartphone.

“Walking is what does it for me. I get off the Tube a few stops earlier and walk 20 or 30 minutes: it’s a time to switch off , listen and reflect, and an experience of being in the present. Today on the train I think I was the only one looking out of the window, contemplating the trees and thinking about how they must have evolved. Every else was texting, reading on their iPads or working. You have to take time to live in the moment. We don’t give ourselves time to reflect — no wonder we are so tired. We are human doings now not human beings.”

What’s happening in the brain when we switch off - either by meditation or just letting our minds wander - is that the beta waves produced when we are alert are replaced by slower alpha waves (signifying a relaxed state) and then by much slower theta waves. “In a theta state – that daydreamy, glazed over state - your working memory begins to shut down,” says Ramlakhan. “You are essentially going ‘offline’ and consolidating, and your creativity increases. It’s a very important state to get into several times a day. Meditation is a conscious way of achieving it, but you could also get to it by walking or just ‘tuning out’. Walking has natural rhythm and is a meditation in itself.”

A sleep is the most effective way of reaching a theta state, and although the old advice to have a daily nap during the natural energy dip between 2 and 4pm is absurd for most people, research shows you don’t actually have to sleep to get the benefits. Just sitting in a chair and closing your eyes for 5-20 minutes and taking your body to a near-sleep state of relaxation can have similar mind-resting effects and can aid concentration levels and word recall later in the afternoon, research shows. Some studies show a 15-minute nap in the afternoon dip is as good as extending the night’s sleep by an hour.

D’Felice is a big fan of learning relaxation techniques and mindfulness, and also recommends cognitive behavioural therapy for dealing with stress and other unhelpful thought processes. It’s also important, she believes, to make lifestyle changes to address the root cause of the tiredness. “Get honest with yourself about what you have invited into your life that has created this stress. How many hours of work do you really want to keep committing to when you cannot enjoy your life, for example?”

Even if you are not on the verge of jacking in your job and becoming a monk or sheep farmer, there are other, more modest, lifestyle changes that can make a surprisingly big difference.

On her 21-day programme for those who feel permanently tired, Ramlakhan insists on a change in diet. Research shows a direct correlation between weight gain and persistent tiredness: a study in Colorado earlier in the year showed that those who lost a few hours sleep over several nights put on two pounds. Another showed sleep-deprived people ate up to 500 extra calories a day.

A study last month at the University of California, Berkeley showed sleep deprived people not only craved more junk food (even if they weren’t hungry) but they had even less power than normal to resist it. MRI scans of their brains showed decreased activity in the area which makes reasoned, thoughtful decisions.

This unfortunate double whammy could largely be avoided if we just ate a decent breakfast, says Ramlakhan. “If you eat within half an hour of getting up, research shows you will produce more melatonin in the day, you will sleep better and will have less reliance on caffeine. It’s very important to include protein as the amino acids help make the hormones that will send you to sleep later in the day.”

She also advises strategic snacking — one mid-morning and one in the afternoon, but not chocolate bars. A perfect snack would be something small of 100-200 calories that contained all the major food groups. Her favourite is eight almonds and two dates. “Or you could have a small handful of raisins and rice cakes with hoummus, the kind of things you would put in your child’s lunchbox.”

Exercise is also important, agree the experts — but it is vital to get the what and when right. Ten to 15 minutes of exercise when you come in from work can shake off the mental fatigue and clear the mind, but exercising too late (within three hours of going to bed) will delay sleep because it keeps your body temperature too high. Ramlakhan advocates an evening routine of three simple yoga poses: the child’s pose, legs up the wall and corpse pose to calm the nervous system.

Exercise has a dramatically positive effect on the brain: it increases the flow of oxygen, glucose and water and also stimulates the body’s production of endorphin chemicals, which are similar in structure to cocaine and morphine, and have analgesic, sedative and mood-enhancing effects. The long-term effects on concentration and cognitive abilities could also be profound; a study of 6,000 women in California found that those who walked regularly (up to 2.4 miles a day) showed improvements to higher mental processes (planning, organising and juggling tasks) compared with those who walked less than half a mile a week, whose cognitive abilities declined over the eight-year period.

What you do in the 60-90 minutes before bed is still crucial, even if the old advice to have a warm bath isn’t, says Horne. The aim is to wind down the mind, which means doing something properly distracting using both your eyes and hands (he swears by jigsaws “you can’t worry and find pieces at the same time”). Experts agree that the very worst thing is to worry about being tired.

“People who always feel tired will worry about their health — they’ve read that if they don’t get eight hours’ sleep they will be obese, get diabetes, hypertension and heart disease. Then they worry even more about getting to sleep and are less able to sleep and so the cycle continues,” he says. “But tired people are not always sleepy and don’t necessarily need more sleep — what they really want is more time out for themselves; the trick is to work out how to do that.”

Re: Help - depressed, ill or what?

KMurphy — Tue, 01 Oct 2013 12:09:41 GMT

[quote user="emma_j"]did they let you know what the actual numbers were or just reported 'normal'? I've had several friends not had a great experience with their GPs not diagnosing hypothyroidism properly. [/quote]

This is a huge problem with GPs - they seem to be very much treat the numbers and not the patient. NHS recommends not treating hypothyroidism until TSH >10. You can feel pretty crummy at a TSH of 9 but you'll still technically be subclinical. Did they check freeT4 as well as TSH?

+2 for getting your actual results.

Re: Help - depressed, ill or what?

Kate Richardson — Tue, 01 Oct 2013 08:42:30 GMT

[quote user="An On MRCVS"]I've been checked for thyroid, pernicious anaemia & coeliac disease, all negative.[/quote]

Negative coeliac test doesn't rule out a dietary intolerance. My friend was negative for coeliacs but responded to a gluten free diet.

Good luck with GP visit today

Re: Help - depressed, ill or what?

Anthony Todd — Mon, 30 Sep 2013 22:50:22 GMT

[quote user="emma_j"]did they let you know what the actual numbers were or just reported 'normal'?[/quote]

+1 Results are reported as normal if they are just above the normal lower limit [one example 43 where the "normal" lower limit is 40]

Lab results are not like a bank statement......

My guess is that people who feel fine will have a value of,say, 60 or over and it's probably not until values get to say 20 that you'll see overt signs of hypothyroidism; you may feel "tired" at the lower end of the scale though??

Re: Help - depressed, ill or what?

emma_j — Mon, 30 Sep 2013 18:55:08 GMT

It might be worth asking to double, trip check the thyroid results - did they let you know what the actual numbers were or just reported 'normal'? I've had several friends not had a great experience with their GPs not diagnosing hypothyroidism properly. http://www.thyroiduk.org.uk/tuk/about_the_thyroid/hypothyroidism.html is worth a read.

Re: Help - depressed, ill or what?

An On MRCVS — Mon, 30 Sep 2013 18:41:21 GMT

Original poster here. Thanks for all your comments. I've been checked for thyroid, pernicious anaemia & coeliac disease, all negative. They've checked folate combined with B12 - not sure on that one, I got told results were all normal then got letters saying please call the docs but the receptionist wont tell me anything so left confused.

Unless magically turning 40 has a physical effect on you I'm not doing anything different now than I was last yr. Yes, diet & sleep aren't great but not sure how much that is cause or effect.

Off to see a GP tomorrow in the hopes of getting a bit more of a plan to go forwards. Fingers crossed!

Re: Help - depressed, ill or what?

Joyce Whitehead — Mon, 30 Sep 2013 18:36:52 GMT

Black cohosh is apparently good for flushes, I have a few friends who swear by it. It is herbal and available from health food shops. Beware though, over dosage I think can lead to liver problems. She has my sympathies...

Re: Help - depressed, ill or what?

patrick murphy — Mon, 30 Sep 2013 16:33:37 GMT

my wife is very similar, but it is being put down to her being weary fanning herself for flushes, and waking at night in a sweat. does anyone have any advice for symptons?

Re: Help - depressed, ill or what?

Pippa de Chassart — Sun, 29 Sep 2013 04:59:47 GMT

Have your thyroid checked, often low Vit B12 is in conjunction with low T4 and high TSH.

Easy to treat and you will feel a thousand times better once your hormones are sorted out.

Don't stress about it, focus on finding a good GP & a proper diagnosis.

Good luck.

Re: Help - depressed, ill or what?

Pippa de Chassart — Sun, 29 Sep 2013 04:59:43 GMT

Have your thyroid checked, often low Vit B12 is in conjunction with low T4 and high TSH.

Easy to treat and you will feel a thousand times better once your hormones are sorted out.

Don't stress about it, focus on finding a good GP & a proper diagnosis.

Good luck.

Re: Help - depressed, ill or what?

An On MRCVS — Sat, 28 Sep 2013 21:13:06 GMT

Can you summarise? Or it it possible to view elsewhere without subscription?

Re: Help - depressed, ill or what?

An On MRCVS — Sat, 28 Sep 2013 21:11:55 GMT

I really want to read that....but I don't subscribe to The Times :(

Re: Help - depressed, ill or what?

SAB — Sat, 28 Sep 2013 20:34:56 GMT

http://www.thetimes.co.uk/tto/health/article3880963.ece

What you're describing sounds just like this article in todays Times.

Re: Help - depressed, ill or what?

Hanna Bennett — Sat, 28 Sep 2013 20:15:21 GMT

i'm with the others, this sounds physical not mental - I have Crohns which causes chronic fatigue and I often have days like this - not saying that's what you've got but there are lots of underlying disease that cause this level of tiredness. +1 for the dietary intolerances as this can be a big problem for me - try cutting out gluten and dairy (tho probably not at the same time - it's a killer!) and from my reading on the subject the chronic malabsorption/digestion that results from this is a big cause of fatigue - and the B12 jabs are great too for any number of reasons... Folate/B12 worth getting checked too (you'd do it in a dog...)

Re: Help - depressed, ill or what?

Kate Richardson — Sat, 28 Sep 2013 12:35:03 GMT

Hi Anon,

This sounds more like a physical problem rather than depression per se IMO, although you may well be feeling a bit depressed because of it, but having suffered from depression myself previously, it is more common to feel a lack of motivation to do anything, yes you can feel tired as well, but your description sounds more like your body is physically tired. I used to struggle to get the motivation to get out of bed and do normal everyday things, but not because I was physically tired. Hassle your doctor, find a new one if you need to, follow up the B12 and as others have said, get thyroid checked if not already, although they usually screen that with symptoms like yours. The other thing to consider is a dietary intolerance, other half has a friend who had similar symptoms and after lots of tests including seeking a private opinion and blood tests, discovered he was gluten intolerant and hasn't looked back since changing his diet. So you could try a wheat/dairy free diet for a while as well. I don't know how old you are but he was early 40's. Oh and if you feel you need some time off, ask the doctors to sign you off for a while?

Hope you start to feel better soon

Re: Help - depressed, ill or what?

Michael Woodhouse — Sat, 28 Sep 2013 12:13:12 GMT

My wife has pernicious anaemia and had similar symptoms to yours. She does DIY monthly B12 injections (the docs don't even provide syringes and needles!) - has made the world of difference to her.

http://en.wikipedia.org/wiki/Pernicious_anemia

Re: Help - depressed, ill or what?

Gillian Mostyn — Sat, 28 Sep 2013 11:20:18 GMT

I'd second the thyroid tests - testing for both under and over active. I had an overactive thyroid due to subacute thyroiditis a few years ago and was somewhat similar to you - charging around during the day (I had 2 children under 3) - I even took up running because I felt full of energy - but then as soon as I sat down I passed out! I also didn't sleep well (even when the kids weren't the cause) which increased the fatigue.

Re: Help - depressed, ill or what?

Bob Russell — Sat, 28 Sep 2013 11:03:03 GMT

May not apply to you for various reasons but glandular fever would fit the bill as well.

I had it as a student and by 5pm was washed out and drained. Fortunately it was in the 'quietest' of the years of the course so I just about coped. Not sure I ever completely made up the lost ground but passed exams.

Checking wiki it seems 90% have acquired immunity by 40 yrs old. Presumably that means 10% have not!

One danger of referral is that the specialist may favour his or her own speciality without getting the bigger picture.

Back to the GP would be my advice. Knowing our profession you are probably a bit depressed, a bit ill and a bit what? (sympathy smiley if we had one).

Daily Marmite sandwiches would put me into deep depression I am afraid!

Re: Help - depressed, ill or what?

Hannah Wynne Richards — Sat, 28 Sep 2013 09:55:33 GMT

I think an old-fashioned doctor would have put you on b12 injections. I'd say a b12 deficiency is the cause of your tiredness-so no wonder anti-depressants don't work. Depression is currently a fashionable diagnosis-and vit deficiency isn't!

Hope you like marmite! I do-but I realise it's a loveit or loathe it thing.

Seriously-you need to go back to your GP-but marmite sandwiches every day can't do any harm

Wynne

Re: Help - depressed, ill or what?

Gareth C. — Sat, 28 Sep 2013 09:54:03 GMT

i get days or occasionally a week like that, but usually put it down to being a vet, nearly 40 and 3 kids. I find it usually passes. Holiday can help. Also decent physical exercise and getting over the end of day blues where you havent got the energy to go for a run / swim / bike /whatever takes your fancy, but making yourself do it. Everything seems better after a run, the longer the better! But agree, keep badgering your doctor and also there are some decent NHS pyschologists out there who do private consults for very reasonable fees.

Re: Help - depressed, ill or what?

Tanya Fielding — Sat, 28 Sep 2013 09:44:34 GMT

If you get a diagnosis do let us know, I have been like that for years and put it down to having 2 kids and getting old!