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Can you have depression without feeling sad or suicidal?


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Prior to having my schizophrenia episode I had the following symptoms:

Lack of concentration.

Feeling hopeless.

Paranoia that people didn't like me.

Overly sensivity to critism

Anxiety

Pessimism

Loss of appitite and weight loss despite having PCOS.

Irritable

Racing thoughts

Jumping from one idea to the next

Crying spells

Fear

Guilt.

But I didn't have thoughts of suicide and I didn't feel very down. And the symptoms went away on antipsychotics. I guess depression cannot go away on antipsychotics alone? Are these just negative symptoms? Or signs of depression? I posted this here because people are more familiar with the signs of depression.

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Some of those are symptoms of depression, some are more negative symptoms of something like schizophrenia, some are more manic symptoms. Fear and guilt are emotions, not symptoms. Anti psychotics can have a mood stabilising effect, working on the agitation and the anxiety and also regulating mood, which may help with depressive type symptoms. Ultimately if your medication works, your diagnosis is moot, so long as you have relief from symptoms it's fairly immaterial what class of medication you're taking, IMHO.

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You don't need to have thoughts of suicide to be depressed. How did you feel when you were having the crying spells?

Anti-psychotics can help withe depression.

Some of the symptoms you describe could go along with mania: racing thoughts, flight of ideas.

others sound more like depression. You are right that negative symptoms and depression can be similar.

Sometimes i just feel blah with no motivation and nothing sounds good. I asked my pdoc and he says they aren't negative symptoms. That I show emotions/laughter is one reason he gave.

Did the symptoms go away before the episode or were they part of it?

Can you ask your pdoc about it?

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Some of those are symptoms of depression, some are more negative symptoms of something like schizophrenia, some are more manic symptoms. Fear and guilt are emotions, not symptoms. Anti psychotics can have a mood stabilising effect, working on the agitation and the anxiety and also regulating mood, which may help with depressive type symptoms. Ultimately if your medication works, your diagnosis is moot, so long as you have relief from symptoms it's fairly immaterial what class of medication you're taking, IMHO.

You don't need to have thoughts of suicide to be depressed. How did you feel when you were having the crying spells?

Anti-psychotics can help withe depression.

Some of the symptoms you describe could go along with mania: racing thoughts, flight of ideas.

others sound more like depression. You are right that negative symptoms and depression can be similar.

Sometimes i just feel blah with no motivation and nothing sounds good. I asked my pdoc and he says they aren't negative symptoms. That I show emotions/laughter is one reason he gave.

Did the symptoms go away before the episode or were they part of it?

Can you ask your pdoc about it?

I show emotions like laughter and crying too, yet I do have blunted affect apparently. And the flight of ideas and racing thoughts can be part of schizophrenia too. Of course when I had crying spells I felt upset and hopeless. But I wasn't always crying. It just happened to be because I was feeling socially rejected at work. When I left the work place and got on the meds, the depression seemed to lift. Which is why I am wondering if it was depression to do with schizophrenia at all.

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Guest Vapourware

If I were to hazard a guess, I would say that your symptoms are more closely aligned with negative symptoms than depression. Both negative symptoms and depression share a lot of commonalities, but the main way of differentiating the two is the mood component. While you can have depression without the suicidal thoughts, depression does require a depressed mood - or otherwise, it wouldn't be called "depression" in the first place.

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While you can have depression without the suicidal thoughts, depression does require a depressed mood - or otherwise, it wouldn't be called "depression" in the first place.

Actually, as far as the DSM-IV criteria are concerned, you don't need to have a depressed mood to have a depressive episode. You must have either a depressed mood or lack of interest in doing things. According to a book I read (I think it was Thomas Joiner's Why People Die By Suicide), about 5% of people who are in a depressive episode don't have a depressed mood. They have a very good prognosis. I'm not sure if depressed is really the right term for these people, but they do qualify according to current criteria.

Ishy, some of your symptoms do sound like depression (hopelessness, pessimism, guilt, crying spells) rather than negative symptoms. But since you mentioned feeling rejected at work, maybe it was more like situational depression, hence why it lifted when you left the workplace? Although AAPs can have a mood-lifting effect as well, so they may have helped.

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Hmm, just my two cents, for what it's worth. When I read your list I was puzzled as to why you think these might be symptoms of depression (some of them are yes). I've had major depression in the past and currently have dysthymia, which is a milder but longer lasting type of depression. Major depression is very debilitating, and if you have it you will have no doubts or questions whether you have it or not.

If you didn't feel very down (as you say) then I really doubt it's depression. But that's my opinion, I'm no doctor, I just know from experience what major depression really feels like.

Are you able to feel any happiness at all? And what is the cause of your crying spells?

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This is EXACTLY what I've felt like ever since I was put on prozac. Every single symptom. I've since gone off of it (as of two weeks ago) but I have the exact same symptoms. I also have a constant jittery, wired feeling, am very irritable, and I cannot sleep. It's absolutely miserable.

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This is EXACTLY what I've felt like ever since I was put on prozac. Every single symptom. I've since gone off of it (as of two weeks ago) but I have the exact same symptoms. I also have a constant jittery, wired feeling, am very irritable, and I cannot sleep. It's absolutely miserable.

It sounds like you might have Prozac withdrawals going on. Hopefully, they pass soon. It also sounds like your Prozac was not working, not that it was the cause of your symptoms.

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While you can have depression without the suicidal thoughts, depression does require a depressed mood - or otherwise, it wouldn't be called "depression" in the first place.

Actually, as far as the DSM-IV criteria are concerned, you don't need to have a depressed mood to have a depressive episode. You must have either a depressed mood or lack of interest in doing things.

This is true. One version is anhedonia, the inability to find pleasure in anything. Lack of interest is a natural outflow. I get this including before my depression worsens. Saying a deep sense of dispair or sorrow is required for a depression diagnosis is false. Also saying that sorrow or dispair is worse is an eroneous relative statement since anhedonia can be a pretty miserable place to be.

edit for left out words

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It could be either negative symptoms or depression, and either one can be improved with an AAP, so it's hard to say for sure.

That said, the DSM does not require depressed mood or suicidality for a depression dx. One might be more likely to assume given the dx that it's negative symptoms, but that's not necessarily a given, one can be comorbid.

in either case, I'd keep taking what works for you.

Anna

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Guest Vapourware

Oops, guess I needed a quick refresher on the depression criteria. I think I let my personal experience of depression cloud my memory of the criteria as well.

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This is EXACTLY what I've felt like ever since I was put on prozac. Every single symptom. I've since gone off of it (as of two weeks ago) but I have the exact same symptoms. I also have a constant jittery, wired feeling, am very irritable, and I cannot sleep. It's absolutely miserable.

It sounds like you might have Prozac withdrawals going on. Hopefully, they pass soon. It also sounds like your Prozac was not working, not that it was the cause of your symptoms.

I was on a high dose and went manic on it. It's been pretty bad ever since. Nice at the beginning, though.

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A. Five (or more) of the following symptoms have been present during the same 2-week period and represent a change from previous functioning; at least one of the symptoms is either (1) depressed mood or (2) loss of interest or pleasure.

Note: Do note include symptoms that are clearly due to a general medical condition, or mood-incongruent delusions or hallucinations.

(1) depressed mood most of the day, nearly every day, as indicated by either subjective report (e.g., feels sad or empty) or observation made by others (e.g., appears tearful). Note: In children and adolescents, can be irritable mood.

(2) markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day (as indicated by either subjective account or observation made by others)

(3) significant weight loss when not dieting or weight gain (e.g., a change of more than 5% of body weight in a month), or decrease or increase in appetite nearly every day. Note: In children, consider failure to make expected weight gains.

(4) insomnia or hypersomnia nearly every day

(5) psychomotor agitation or retardation nearly every day (observable by others, not merely subjective feelings of restlessness or being slowed down)

(6) fatigue or loss of energy nearly every day

(7) feelings of worthlessness or excessive or inappropriate guilt (which may be delusional) nearly every day (not merely self-reproach or guilt about being sick)

(8) diminished ability to think or concentrate, or indecisiveness, nearly every day (either by subjective account or as observed by others)

(9) recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide

I do have loss of interest in activities. But I've always had that.... for years. I lost interest in things when I was a teenager. I'm now 26. so I guess that doesn't count as depression because I've not had any recent loss of interest?

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  • 4 weeks later...

ishy -

Two things to bear in mind:

1. We cannot, of course, diagnose you here, as we are not mental health professionals, just folks on the same crazy-go-round, though there is a lot of good anecdotal experience. Likewise, we often refer to the Diagnostic and Statistical Manual IV as a guide, but the application of the Manual to real diagnosis relies upon professional knowledge and expertise. It is not intended as a tool for self-diagnosis, and if you are concerned that your condition may be worsening or that you may be experiencing new or unfamiliar symptoms, you should by all means address it with your pdoc or tdoc.

2. Symptoms of depression can vary over time, and can go back and forth. I've had periods where suicidal ideation and sadness were very pronounced, and periods where I felt nothing - absolutely nothing, crushing anhedonia - but I was equally depressed in both cases. If you're experiencing a depression that is comorbid with another condition, it can be tricky to be certain. It may be useful to keep a journal of the feelings you have that you associate with depression for your next pdoc appointment.

Cerberus

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