situational versus biochemical?

[dancesintherain]

How do you tell if depression symptoms are situational versus biochemical?  In short, I have a slew of work-related anxiety that could be triggering a low mood state and I also had a recent med change (lowering lithium) that could be causing it.  Any suggestions/thoughts for how to figure out and treat the cause?

[Iceberg]

Unfortunately, I think sometimes they are inseparable as far as what issue correlates to which problem 

[Will]

Duration of symptoms might be one factor in the determination.

[Blahblah]

I think they are both intertwined. Like, either one can lead to the other, or maybe it's caused by both at the same time. For example ,maybe stress from Covid lockdown is the initial situational trigger (or exacerbation of a mood state), and the situation itself causes biochemical changes that need to be addressed. (Especially if your brain is wired towards anxiety or depression)

At any rate, is there a way to reduce the anxiety first (changing the situation) and then if that doesn't help, address the med change? I wish it wasn't so complicated with mental health issues, but I know for me, there must be a strong biochemical element, because I can remain depressed when my situation is all good.

[Fluent In Silence]

That can be difficult, if not impossible, to work out. Certain situations can be crappy and make you feel depressed, but I sometimes wonder if I'm overreacting to circumstances due to being prone to depression. In some cases this can be obvious in hindsight - it really wasn't a big deal and not worth getting upset about - though I don't always realise that at the time. Any perspective can go out the window when I feel low, and I sometimes make mountains out of mole hills. This doesn't mean that your situation isn't a cause and that you're overreacting, I just mean that I share your confusion when I try to work out why I feel down. Maybe talking to someone about your work issues will help put them into perspective. That doubt can also lead to self-blame, but sometimes it really is the situation and your reaction is perfectly justified.

[echolocation]

my approach is to try and wait out the situation, and if the symptoms persist, change the meds.

i think Blahblah and Fluent are right on with the thought that the two are tangled and often inseparable. 

[dancesintherain]

Thanks everyone.  Good to know that I'm not overly complicating things and that they likely are intertwined.

I don't really have a good way to release the work anxiety.  It's based on the nature of my job and seems to just come with the territory.  I'll try to give it a  bit more time.  That said, my tdoc said that it's good that I have a pdoc appointment soon (Wednesday), so maybe he leans toward biochemical. 

[Will]

On 11/20/2020 at 12:13 PM, dancesintherain said:

I don't really have a good way to release the work anxiety.  It's based on the nature of my job and seems to just come with the territory.  I'll try to give it a  bit more time. 

Do you have time and any desire to try exercise?  Exercise makes a huge difference in my mood. 

[dancesintherain]

I walk about 40 minutes most days.  Sadly, I haven’t found the mood boost related to it.

 

sorry, not intending to be dismissive.  It’s just frustrating to have something that’s supposed to help not pay off.  

Edited Saturday at 11:56 PM by dancesintherain

[Will]

41 minutes ago, dancesintherain said:

I walk about 40 minutes most days.  Sadly, I haven’t found the mood boost related to it.

sorry, not intending to be dismissive.  It’s just frustrating to have something that’s supposed to help not pay off.

  I get that.  I'm glad you walk though, because you're no doubt getting physical benefits from that if not mental.   

Edited Sunday at 12:35 AM by Will

[dancesintherain]

thanks--for a while it was contributing to weight loss, but that seems to have halted.  I don't have the bandwidth to do more than what I'm currently doing though. 

Edited Sunday at 01:01 AM by dancesintherain

[Antecedent]

Like Blahblah said, I don't know how possible it is to pick them apart, what happens in one always impacts on the other, each of them has its own ignition but they'll also fire the other one up (or freeze the other one!)

[dancesintherain]

thanks @Antecedent.  If each causes/impacts the other, perhaps a treatment that is geared at biochemical (med change/alteration, sigh) will impact both. 

[Gearhead]

I think everybody is right, that the two are intertwined. It’s a bummer that you have to reduce your lithium right now.

 

[Will]

Here's a Harvard Med School article on depression ("What Causes Depression:  Onset of Depression More Complex Than a Brain Chemical Imbalance".)  One thing this thread has done for me is to realize that I have been using the term "organic depression" when I should have been saying "biological" or "biochemical."

https://www.mayoclinic.org/healthy-lifestyle/stress-management/in-depth/stress/art-20047544