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Suicide Prevention/Do some people never get better?

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Question
I`ve been in treatment for years and I`m still severely depressed. Are there some cases of depression where people just never get any better?

Answer
Hi Mary,

You have raised a very interesting question, for which there is no easy one-size-fits-all answer. Please forgive my delay in responding.. I confess I had not a clue how to answer, so I decided to educate myself before attempting to help you! Due to the enormous volume of information 'out there' on the subject of depression, and the many, varying opinions as to the causes, the treatments, the cures.. what helps, what doesn't,  who gets it.. is it nature or nurture? etc, I felt it might be useful to break your answer down into three digestible parts:

1.  Depression: General information outlining the main aspects of this debilitating illness.


2.  Depression termed 'Chronic', such as that which you have described.


3.  Resources. There are many good websites with some very useful links to websites providing further information mental illnesses including depression, treatment options, medications, social support networks, and forums wherein individuals can interact with others to share information and advice in a friendly environment. Try BeyondBlue.com; Reachout.com, or simply google keywords mental health websites, or 'depression online forums' for other great links in your area.

'While the exact cause of depression isn't known, a number of things can be associated with its development. Generally, depression does not result from a single event, but from a combination of recent events and other longer-term or personal factors.

Life events

Research suggests that continuing difficulties – long-term unemployment, living in an abusive or uncaring relationship, long-term isolation or loneliness, prolonged exposure to stress at work – are more likely to cause depression than recent life stresses. However, recent events (such as losing a job) or a combination of events can ‘trigger' depression in people who are already at risk because of past bad experiences or personal factors.

Personal factors

Family history – Depression can run in families and some people will be at an increased genetic risk. However, this doesn't mean that a person will automatically experience depression if a parent or close relative has had the illness. Life circumstances and other personal factors are still likely to have an important influence.
Personality – Some people may be more at risk of depression because of their personality, particularly if they have a tendency to worry a lot, have low self-esteem, are perfectionists, are sensitive to personal criticism, or are self-critical and negative.
Serious medical illness – Having a medical illness can trigger depression in two ways. Serious illnesses can bring about depression directly, or can contribute to depression through associated stress and worry, especially if it involves long-term management of the illness and/or chronic pain.
Drug and alcohol use – Drug and alcohol use can both lead to and result from depression. Many people with depression also have drug and alcohol problems. Over 500,000 Australians will experience depression and a substance use disorder at the same time, at some point in their lives.
Changes in the brain

Although there has been a lot of research in this complex area, there is still much that we do not know. Depression is not simply the result of a ‘chemical imbalance’, for example because you have too much or not enough of a particular brain chemical. There are in fact many and multiple causes of major depression. Factors such as genetic vulnerability, severe life stressors, substances you may take (some medications, drugs and alcohol) and medical conditions can lead to faulty mood regulation in the brain.

Most modern antidepressants have an effect on your brain’s chemical transmitters (serotonin and noradrenaline), which relay messages between brain cells – this is thought to be how medications work for more severe depression. Psychological treatments can also help you to regulate your moods.

Effective treatments can stimulate new growth of nerve cells in circuits that regulate mood, which is thought to play a critical part in recovery from the most severe episodes of depression.

Everyone is different and it's often a combination of factors that can contribute to a person developing depression. It's important to note that you can't always identify the cause of depression or change difficult circumstances. The most important thing is to recognise the signs and symptoms and seek help.'
(www.beyondblue.com.au)  

Suicide Prevention

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Rachel Hurst

Expertise

All questions sent to me will receive a warm and caring response. I'll do my utmost to address a persons particular problem, but in most cases will also attempt to supply that individual with additional resources which might be of further benefit. There are many helpful online support groups where readers can benefit from the ongoing support of others who have suffered similar problems. These groups offer invaluable peer support from others who have 'been there'. As well as responding to your initial letter, I'll attempt to provide ongoing encouragement when this is needed. Advice will be focused on addressing the writers individual needs, and providing related information and resources. I would try to ensure that any person seeking advice has accurate and up-to-date information on the signs and symptoms of depression, and importantly, is made aware that help is available through many different avenues. Where I feel that it's relative and helpful I would mention my own life experiences with depression and coping with a loved one's suicide (however, only in context.) I would be on the lookout for warning signs that the person is in crisis and may require immediate intervention. As such I would arm myself with as much information as possible in order to refer them to the help they need. In cases where I believed the persons life to be in imminent danger I would contact authorities in their area, or if unknown, I would call the emergency services in my area in order for the person to be located through tracking.

Experience

I am by no means a trained professional. My knowledge comes mainly through life experience, having endured the devastating loss of my best friend through suicide, as well as my own subsequent battle with depression following his death. I found that my own experience of losing a loved one to suicide put me in a strong position to help others, due to my ability to empathize (as opposed to sympathizing). I became knowledgeable on the topic of grief, and the extensive repertoire of depressive illnesses, signs, symptoms, and treatment options available to people in crisis.

Organizations
S.O.L.O.S. Survivors of Loved Ones Suicide - Active member since 2003.

Publications
'Marie Claire' Australian, 'Cleo' (Australian), Online discussion forums (in which my submissions have stimulated discussion and generated much feedback).

Education/Credentials
I am a professional writer. I was trained in journalism. Please see my profile in Linked In. http://au.linkedin.com/pub/rachel-hurst/41/178/165 I have studied related subjects during training as a registered nurse. Both of my parents are mental health professionals. However most of reading widely and life experience has been my greatest teacher.

Past/Present Clients
I have helped a number of individuals who have sought my take on a particular problem, or whom I have felt concern for, for various reasons.

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