The anti-depressent market is making millions off of healthy people. I had a hard time watching the news after Hurricane Katrina and the war in Iraq. I know I'm not "depressed" I just wanted to understand ways to cope with those feelings. Before my doctor even heard my entire situation, he attempted to perscribe anti-depressants. I declined the offer and just cut away from the news for a month, I feel much better now... It's just too easy to be labeled depressed.

Sent by Tierra Montgomery | 2:17 PM ET | 04-04-2007

Recent studies indicate that social isolation in USA is rapidly increasing and is accompanied by social depression.
How is this diagnosed and treated by the medical profession?.
baz gray
Naperville IL

Sent by baz gray | 2:20 PM ET | 04-04-2007

My wife is bipolar and my son is bipolar. We have an insane life. My son called a few minutes ago wanting me to get rid of my wife. My wife is in the background yelling uncontrollably at my son. It is a viscous cycle. I do not see how psychotherapy can be of any help. It has not been of any help for us! We are not newbies to this diease either. The medication controls it; but, there are still huge mood swings. We chart our son's moods daily. The swings are from 1 to 9.

Sent by Charles Smith Kalamazoo | 2:23 PM ET | 04-04-2007

I was diagnosed bipolar 10 years ago and put on a depakote/wellbutrin regimen for depression because Paxil made me hypomanic and my brother takes lithium. I do not believe my diagnosis was considered terribly severe. I stopped taking both medications seven months ago and since stopping I really have felt okay. (I did notify my psychiatrist and have seen him in the duration).

Does bipolar go into remission and/or might I have been misdiagnosed?

Sent by Nancy Hertz | 2:23 PM ET | 04-04-2007

The conversation brings up the subject of primary care physicians diagnosing depression based on the DSM IV guidelines. In fact, there are subtleties among types of depression and individual responses to different medications. I spent a year suffering from "depression" being treated only with Prozac until I reached out to a medical school for diagnosis and found I had bipolar disorder.

There are also subtypes of bipolar disorder, and those that are more often depression than mania may need antidepressants in addition to stabilizers. It's a long process of tuning for some people with these illnesses.

Sent by Karen Wilhelm | 2:27 PM ET | 04-04-2007

My wife and my son were both treated for dipression each was bipolar. The results were unreal. They both went through rapid cycling suicidal episodes. We are struggling everyday without adequate help or understanding.

"The Bipolar Child" a book has been great for our understanding.

Sent by Charles Smith | 2:27 PM ET | 04-04-2007

As someone living with chronic clinical depression, my concern is that we risk discounting people who do have life-threatening, chronic mental illnesses by swinging back toward the "just sad" or "shake it off" mentality. Even people with chronic mental illness experience "circumstantial" depressive episodes. We need to be cautious, as a society, about devaluing the experiences of those living with mental illness.

Sent by J. Adams | 2:34 PM ET | 04-04-2007

Did the study ask how many of the cases of people getting divorced, losing a job, etc.. were caused by the depression? It is all well and good to say 15% of people "suffering from major depressive disorder were suffering from normal grief". In day to day life major depressive disorder causes many of the things individuals "grieve" over.

Sent by Mike Moran | 2:35 PM ET | 04-04-2007

I do agree that a combination of meds and talk therapy can be best. However, getting into a therapist in a timely manner is next to impossible. I called for an appointment in October, was supposed to be seen for the first available in January but that was postponed to April.

It's easier to get the meds than to get into talk therapy.

Sent by Carol | 2:35 PM ET | 04-04-2007

We were surprised to find out how deadly bipolar disease is. Can you tell us what the life expectancy is of someone with bipolar disease, and discuss exactly how death usually comes to such a person? Such information might have spared this family a life.

Sent by John Fairfield | 2:37 PM ET | 04-04-2007

Why are we focusing on Medication as the assumed "best" treatment for depression (or any illness for that matter)? We have far and away enough support for the value of exercise as a more effective and certainly safer way to help people achieve a more stable and improved mental/physical state. The average person is exercising far less than healthy standards dictate. The fact that NPR is having this discussion without this point being mentioned makes me wonder.

Sent by matthew smith | 2:39 PM ET | 04-04-2007

I am 21 year old male and have suffered from manic depression and adhd for the better part of 17 years..every day i thank the great people who produce the medicines that have kept me on my feet for so many years! if it was not for the day to day research on mental illness. people like me and many many others would have a great difficulty having a day to day life! only two years ago i was near rock bottom with my depression and went through a suicide attempt. i managed to bounce back from that and as of this friday i will be settleing in my first apartment! much thanks to you great folks who keep this subject on the front line.

Zack

Sent by Zack | 2:40 PM ET | 04-04-2007

I was diagnosed with bipolar disorder 5 years ago and after my therapist passed away shortly after the diagnosis, I was simply treated by a prescription pad by a psychiatrist for the next several years. It got to the point where I was so heavily medicated on Lithium, Welbutrin, Xanax, and Ativan, that I reached a suicidal state. Now, Im in intensive outpatient therapy and on a mild anti-depressent and mood stabelizer and I'm the best Ive ever been in my life. I truly believe that the key to living with this disorder is to learn everything about it that you can. You must take control of the disorder by learning and fully understanding all of the symptoms. Medication will not help alone and I view my therapist as my coach, who is guding me along.

Sent by Shannon Acles | 2:41 PM ET | 04-04-2007

I have been taking lithium orotate for a couple of years for my Bipolar II. It works well for me, and costs a fraction of the pharmaceutical with NO side effects -- no tremor, very little dry mouth or salty taste.

Has anyone else had experience with it? It's far superior to any of the anti-convulsants or other alternative prescriptions, and as a person with no health insurance, it's way more affordable.

Sent by vb | 2:41 PM ET | 04-04-2007

How often does the patient him/herself participate in the misdiagnosis??? I recently had a friend say to me, "I'm depressed, should I start the meds they give me when I get suicidal?". After some deep thought, I a) recommended she see her therapist, and b) offered back, "No, you're not, you're experiencing a serious life change - you've had an injury, you can't work, and you can't do most of your hobbies, you're just having trouble ADJUSTING."

Sent by Inge | 2:42 PM ET | 04-04-2007

In my experience, the meds can get you to a point where talk therapy can begin to work. When you're really depressed, you don't even want to talk to anyone, and opening up enough to get therapy is nearly impossible.

Sent by Virginia Bruce | 2:44 PM ET | 04-04-2007

I am a medical nutritionist and have observed 1st hand the tendency of the medical profession to prescribe drugs without considering other factors such as diet that can contribute to depression. A significant cause of depression for some people is iron deficiency particulary among young women. They lose iron each month with menstruation and often have little or no iron in their diets. Multivitamins often don't help much as they contain calcium that binds up iron from absorption. Often when doctors look for iron deficiencty they test for anemia. A person can, however, have low iron stores and be depressed with very low energy for years without ever developing anemia. The result is that a common and easily fixed cause of some depression is missed. Ferritin level is the blood test that gives a more accurate reflection of iron status. In addition one of the artifial sweeteners has been linked to depression in a study published in a peer reviewed scientific journal. Diet should always be considered as an underlying cause before medications are presribed in all but emergency situations.

Sent by Jan Kaplan, MS,RD | 2:49 PM ET | 04-04-2007

Talk therapy may be beneficial; limited coverage if you have medical insurance. No help if you don't have health insurance. "Mental health" does not seem to garner the support that physical health does. My experience is there is a stigma to acknowledging not being mentally healthy.
For the past four months i wake up thinking how i will end my life today, where will i do it. That is how my morninig starts. Hey it can only get better from there, right? Haven't had a "normal" sleep for months.
I haven't said anything to any on because I don't want to risk being locked up. My problem i know. i believe that i am the only one who feels this way. Health care for all is important. i think you have just touched the surface of an important issue.

Sent by jay ach | 2:56 PM ET | 04-04-2007

It is apparent to me that the goal of many psychiatrist is suppression of the disease rather that treatment, or what would be much more appropriate management. Having struggled from bipolar illness I have experienced that there are un-realistic expectations placed on medications, which sadly inevitably ends in the prescribing of more medications. For instance, often I was given the expectation that the medications I was prescribed would eliminate or even heal my illness. Counseling and psychotherapy should always be included in treatment, even if only to answer questions and provide perspective. After years of struggle I was given electroconvulsive therapy, and though I don't know if counseling would have prevented the "need" for this, I do know that the end result of this treatment was an ultimate "suppression of the illness." For me, the success of this treatment was not due to the treatment itself but due to the fear and devastating side effects, causing me to manage my illness through sleep, diet and exercise (yoga in my case). Soon, health took on a different perspective as I began to understand my body, and I have been able to reduce my mood swings.

Sent by Brad | 3:11 PM ET | 04-04-2007

It scares me when the value of anti-depressants are questioned. As woman 57 years old, I have been on Prozac for the last 10 years. Before that I believe I had been depressed since the age of about 8. Even though I had taken the questionaires describing depression...it never seems to discribe my feelings and yet it is pretty obvious that I suffered from depression and that Prozac helped me immensely.
I also completed 4 years of therapy, but until I began the anti-depressants I could not shake the deep depression.

Sent by Donna, Sacramento, CA | 3:24 PM ET | 04-04-2007

One point I thought was not emphasized enough in this story is that there are many good antidepressant medicines and it may take trying several over several months to find one that really helps. Also, some people need unusually low or high doses to benefit. Educate yourself on the illnesses and treatments and ask your doctor questions.

Sent by dj | 3:29 PM ET | 04-04-2007

I heard your program "in the car" today and was very interested in the subject. I am a NAMI Family to Family teacher (have taught the course four times - and took the course once while my family member (sister with schizophrenia) was alive and took the course once after her death with an enlarged heart (probably due to the STRONG medications she was on). Since then I have taught the course (after an extensive training session) four times.

Regarding the bipolar depression, most patients present with the depression first because they are not willing to GIVE UP the mania (highs) of the illness. However, we teach that once it is determined (probably by observation and journaling by family members)that the family member has bipolar illness, the anti-depressant should be stopped. In an ideal world the psychiatrist, family doctor, psychologist and family members are all on the same page, but we all know we do not live in an ideal world.

I especially appreciated the call from the mother of the teenage daughter who was "too quickly" prescribed prosac (sp?) and became zombied out. Family input and journaling of the facts is crucial when a family member is experiencing mental illness of any kind, whether it is depression or one of the other serious mental illness (NAMI calls them "brain disorders"). The brain is a part of our body after all.

Thank you for your wonderful informative programs.

A supporter of public broadcasting.

Sent by Shirley Farley | 6:07 PM ET | 04-04-2007

What most people who are unfamiliar with mental illness don't know is that mental illness is a brain disease - just like heart disease, liver disease, etc., there is a malfunction in the body that needs to be corrected. That's why medication is so important. My boyfriend was diagnosed with bipolar close to 10 years ago; while the side effects of the medications can be very hard to deal with, he knows that his meds are keeping him healthy and allowing him to function and have real relationships with other people. Finding the right combination of meds is hard work, but it's so important in a patient's recovery.

Also, misdiagnosing biloar as depression is very dangerous because it can send someone into a manic state, which can spur someone who was thinking about suicide into actually acting on it - when being evaluated for depression, make sure your doctor considers bipolar as well!

Sent by Lisa | 6:11 PM ET | 04-04-2007

I did not get the names of the organizations offering help with bi-polar disorder. One was Mental Health America. Have you posted these groups?

Sent by Helen | 7:46 AM ET | 04-05-2007

I'm an undergrad in psychology who has been working with elderly patients with dementia. From my experience, every client should be seen as an individual based on their level of dementia, background and personal preferences. One of my elderly clients has been diagnosed with depression because she feels her mind is deteriorating from Alzheimers. She has no desire to get out of her chair, she eats very little, and is tired of living. How would a psychologist treat a depressed elderly person who feels there is nothing left to live for? Would they see this as simply symptomatic sadness of old age?

Sent by Rebecca Flynn | 6:28 PM ET | 04-05-2007