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hi all while browsing through the british medical journal's website, http://bmj.com/ i found this page and was so impressed i wanted to share it with you all the bmj site is extraordinary for its access and cross-referencing if you hop to this page per the link below and then follow other links from it a world of information and current medical news about clinical depression will open up in front of your eyes thank you, bmj! janet ------------- BMJ 2001;323:1010 ( 27 October 2001 ) Personal views: Why am I crying? I was a competent and respected junior doctor on a popular specialist registrar rotation. I had hoped that my working conditions would improve with seniority but, as a registrar, I was still having a rough time. I was doing one in three rotas in an acute specialty where there was little chance of much sleep. I felt overworked, undervalued, and unappreciated. I spent all my time caring for others, but no one cared for me. I was existing to go to work only to return home to work because I had one last postgraduate exam to sit. I had no life. I was becoming increasingly shattered and exhausted. I felt awful but put it down to chronic sleep deprivation and stress. I was extremely unhappy and regularly drove to and from work in tears. I decided that as soon as I had done the exam I would change my job in order to protect my sanity. I managed to cover up my unhappiness by smiling and being cheerful most of the time. But, as I struggled on feeling more and more desperate, I started having thoughts about wanting to go to sleep never to wake up again and about cocktails of drugs and doses that I could use. One day, feeling shattered and distressed, I couldn't hide the tears any longer. I was found by a colleague from a different specialty, who contacted the occupational health department. I was given an appointment for that day with the doctor. He was sympathetic, but I was shocked to find myself being told that I was depressed and too unwell to work. I felt guilty about not doing on calls, but was forcefully told that I was not in a fit state to be at work. This happened a week before the final exam so I was not fit to do the exam either. Having sailed through previous exams, not being able to complete this one felt like the end of the world. I had worked hard towards what I thought was going to be a rewarding and fulfilling career, but my life had now completely fallen apart. Having been stopped from working, I collapsed into a heap and ground to a complete halt. I was absolutely burnt out. Frazzled with exhaustion, I wondered how my heart had the energy to pump blood around my body. For months I endured endless nights of insomnia. I was so tired, but my distressed brain had forgotten how to sleep. Eventually, I experienced auditory hallucinations. This frightened me so much that I agreed to try benzodiazepines, but doses escalated rapidly. With the help of a longer acting benzodiazepine, I eventually achieved some sleep, although it was dominated by numerous and vivid nightmares, during which I relived unpleasant parts of my past. I was amazed at how quickly I lost two stones (14 pounds) in weight. I felt dazed and detached, and experienced intense feelings of depersonalisation. I have often felt so strange and so flat that it is as if my brain is made of porridge. I have cried inconsolably on countless occasions and have descended into the depths of despair. I was started on antidepressants but even with dose increases they did not seem to make any difference. I experienced an extremely unpleasant and severe discontinuation reaction when changed from paroxetine to another drug. I did, however, respond to the fourth antidepressant, a sedative tricyclic, but, unfortunately, this response was not maintained. Lithium has recently been added and I am now beginning to emerge from the haze of depression. I was lucky to be registered with an excellent general practitioner, whose help, understanding, and support have been invaluable. I owe him a big thank you. I am also under the care of a consultant and his team and am grateful for their help and continuity of care. Unfortunately, it took 18 months to get this care. Before this, I suffered health care by postcode and a series of one off appointments with various consultants. The past three years of my life have been a living hell. Although I am medically qualified, I did not realise how awful and frightening clinical depression could be until I experienced it myself. The everyday use of the word depression to mean feeling fed up belittles clinical depression, which is an unpleasant, destructive, and debilitating illness. I feel that it has been quite an insult to my brain, causing both physical and mental effects. It has dramatically affected my life, which I now have to rebuild, and the road to recovery seems to be a long and stormy one. Unfortunately, many people show prejudice towards those who suffer from depression. I am reluctant to put my name to this personal view because I suspect I am seen as "a wimp who couldn't cope" by many of my colleagues who do not understand what depression is. So I welcome the campaign by the Royal College of Psychiatrists to lessen the stigma associated with mental health problems. They are real illnesses, and doctors, who are only human, do suffer from them. Clinical depression is horrible, and I never want to experience it again. An ex-junior hospital doctor BMJ 2001 http://bmj.com/cgi/content/full/323/7319/1010 janet paterson: an akinetic rigid subtype, albeit perky, parky pd: 55/41/37 cd: 55/44/43 tel: 613 256 8340 email: [log in to unmask] smail: 375 Country Street, Almonte, Ontario, Canada, K0A 1A0 a new voice: http://www.geocities.com/janet313/ ---------------------------------------------------------------------- To sign-off Parkinsn send a message to: mailto:[log in to unmask] In the body of the message put: signoff parkinsn