A New Beginning

Hopeful man standing on stone in front of body of water looking at sunset

A Reason For Living

Life brings us so many unexpected, unfortunate and unpredictable moments at such random times, that it can sometimes cause some serious damage if unprepared for. You see, there’s no pattern to mental health prior to a mental illness developing in someone. Each individual has his or her own unique experience.

Someone’s depressive course may be completely different than another’s. They may have grown up in similar neighborhoods, have gone to similar schools, have smoked the same amount of Godfather OG and still present with a completely different type of depressive experience.

But just because you might have been genetically predisposed or environmentally affected to developing a mental illness, does not mean that you should give up all hope and future expectations. Life goes on, whether you have a mental illness or not. Look at it as a new beginning, a reason for living!

Life will present you with many moments where you will feel like giving up and even taking your life. These moments require a lot of strength to get you through the rubble; if you give into these depressive states of mind, they can take you away like a powerful tide. Therefore, don’t take the risk of wading through depressive thoughts.

Once you’re hit by them, seek help as soon as possible. This may be through talking to a good friend or family member, seeing a psychiatrist or even sharing your feelings and thoughts on The DSM Ready platform. The important point is to act! Never go through depression by yourself; you are only asking for trouble.

What have your experiences with depression and suicidal thoughts been like?

Are you Ready? (This is Defeating Stigma Mindfully)

Is It Possible To Die Of Boredom?

Young asian lady bored and staring out the window

How To Deal With Boredom

The quick answer is no! The complex answer is maybe. Boredom is a state of being weary and restless through lack of interest. When you are feeling bored, your mind is not being stimulated. Your current activities just don’t do it anymore and you find yourself losing drive to perform them.

The problem with boredom is that it can gain more and more energy over time and become a bigger problem. It’s a mentality that is very easy to get stuck into if you do not eliminate it in its infancy. Today, you may be bored for half an hour, while tomorrow you may be bored for two hours.

It’s not so much the activities that make you bored, but rather you mindset and will. It’s as if the mind is stuck in limbo and you are just waiting for a resolution. The way to deal with boredom is to jump back into your activities or new ones as soon as you start feeling boredom coming on.

Do not give boredom a breeding ground. As soon as you sense it, detach from the feeling by distracting your mind with an activity. The more you do this, the less you will experience boredom. From time to time, it’s normal to experience it but only for brief periods, like 5-10 minutes. But chronic boredom increases your risk of developing a substance use disorder or mental illness.

Allowing boredom to take over your mind like a malignant neoplasm can turn out to be very dangerous. People who aren’t stimulated for longer periods of time can start to experience depression. Long periods of boredom stir up feelings of insecurity, uncertainty and low self-esteem. And this can promote substance abuse as a way to cope with the negativity.

Over time, this can quickly progress to major depressive disorder, the leading cause of disability worldwide. When one enters depression, it is very difficult to experience remission without treatment and/or strong family support. Depression is like a virus that slowly shuts down the system; in this case, the mind, body and soul.

When depression advances far enough, suicidal ideation, intent and plan become evident in many people. As you can see, uncontrolled boredom can lead down a path of mental destruction. Therefore, always stay preoccupied and keep your mind active and stimulated!

Are you Ready? (This is Defeating Stigma Mindfully)

Ketamine For Depression

Depressed man sitting on street with hand on face

How Does Ketamine Work For Depression?

Ketamine is a street drug, anesthetic and an antidepressant for treatment-resistant depression; cases were conventional treatments such as antidepressants and psychotherapy are not effective. Ketamine can be given by nasal spray or infusion. It is not meant to be a long-term treatment due to its addictive properties; patients receive a few doses of ketamine and go on to continue with an antidepressant and/or psychotherapy.

Ketamine is an NMDA receptor antagonist but it is not exactly clear how it helps treat depression. It is believed that it increases the neurotransmitter glutamate in the synaptic clefts between neurons. Glutamate then activates AMPA receptors on other neurons, leading to the release of other molecules which help neurons communicate with each other, resulting in improved mood and cognition. It is very fast-acting and effective for depressed and suicidal patients (i.e., those walking into an emergency department after attempting to kill themselves).

Ketamine is effective for depression because it can rapidly reduce suicidality as well as depression combined with anxiety. While other conventional treatments such as antidepressants and psychotherapy take weeks or even months to work, ketamine is very fast-acting and works within hours to days.

There is racemic ketamine (IV ketamine) which is given as an infusion into the bloodstream. It was approved many years ago by the FDA as an anesthetic. Currently, it is used off-label to treat depression; some patients respond after 1-3 infusions. Esketamine or Spravato was FDA approved in March, 2019 and is given as a nasal spray.

IV ketamine may cause nausea and vomiting, high blood pressure, perceptual disturbances and out-of-body experiences. Esketamine nasal spray may cause the same side effects.

Overall, depression can be a very daunting mental illness that may take years to resolve. Besides SSRIs, ECT and ketamine, one of the best treatments is to find a close friend, family member or therapist and open up about your thoughts, feelings and emotions. Depression is often triggered by life events that can be worked through via consistent talking over time.

No matter how deep your depression takes you, never give up! There is always hope!

Are you Ready? (This is Defeating Stigma Mindfully)

What Is Depression?

A brunette female appearing depressed with a double next to her

Low Serotonin Levels

Appetite, sleep, interest, suicidal thoughts, guilt, agitation/retardation – these are the components that make or break a diagnosis of depression. There are many forms of depression: Major Depressive Disorder, Situational Depression, Major Depressive Episodes, Substance-induced Depression, Bipolar Depression, Pseudodementia, etc.

It is hypothesized that serotonin is in low quantities in the synaptic cleft of neurons, which results in depressive symptoms. Depression is not just an emotional event; actual brain chemistry is changed at the neuronal and receptor levels in the brain.

People experience depression in many ways. Some quit their jobs and lay in bed all day while others are still functional; some unfortunately commit suicide. It is not clear what the exact source of depression is.

Environmental triggers definitely contribute to it: loss of a loved one, substances of abuse, accidents, loss of a job, etc. But others may be genetically predisposed; especially if their family members have depression.

Is depression curable? Curable is a strong word. I’m not sure if anything is curable. But it is treatable and manageable. Psychotherapy and antidepressants together is a stronger therapy than either alone. Prozac, Lexapro and Wellbutrin are some of the antidepressants you may have heard of; they work great, but for some people, even that is not enough.

Some people may require ECT: electroconvulsive therapy. ECT involves 12-20 sessions of shocks delivered to the brain. Believe it or not, it works! I had a patient in Baltimore, Maryland who was doing better on it. It is time that we come together and eliminate the stigma of ECT and antidepressants; we must utilize all approaches and help each other along the way.

Are you Ready? (This is Defeating Stigma Mindfully)