Dialysis and Depression

[paris]

ODAT, great to hear from you   

Peleroja - my sister gets the knee and back injections and soon to start infusions for RA.  The injections help.  I hope you can get some relief from at least one of your sources of pain!   

Bottom line for me:  If I take a med that helps with pain, why wouldn't I take something for depression?  The meds are there to help us.  Don't be afraid to talk to you Dr. if you are always sad and life is overwhelming.

[RichardMEL]

Cariad - I totally understand what you are saying. I know in other threads I've suggested to people to try and look on the positive side of things, but I certainly hope I would never say (or sound like) "look on the bright side" because that *is* lame.. and absolutely unhelpful to folks trying to deal with being depressed because of their situation. I guess I want to share something that works for me.. but I absolutely understand and agree that that kind of attitude has to come from within rather than someone telling you what you need to feel - specially someone who hasn't been in a similar situation.

[cariad]

Ack, Richard, I hope you don't think I was criticizing what you wrote - I honestly did not mean to do that. Those "cheer up" types have been the bane of my existence since I had my transplant, and I guess I was reacting to what you reported the dialysis nurse said to you, not meaning to imply that you were trying to shove sunshine down anyone's throat. I think it's a wonderful suggestion to look for the positives, but one must be careful in how the suggestion is presented - not in a way that makes it seem like ill health is the patient's fault, which is how I often felt when medical pros would start up about my attitude. They probably knew that depression and anger led to lax attention to health, but the delivery left much to be desired. I think if one more or less follows what the doctors say and doesn't do anything too outrageously stupid, then one could be the biggest defeatist known to man and still luck out.

I feel that for me anyway, what's going to happen is going to happen, and I can either be miserable going through it, or find as much joy as possible. That was what I got out of what you were saying, and why I agree with you. Sorry if there was confusion!  

[dwcrawford]

I'm going to put my two cents worth in here now.  Granted it may be worth only a penny, but be that as it may.

Has anyone thought that possibly you cannot tell if another person is depressed or not.  Many times I've been the keeper of mirth and fun and gone home alone to the depths of depression.

Never would I suggest  to take pills or not to take pills, but I will suggest the benefit of talk therapy with or without the pills.  Pills?  Do you take them forever?  Not usually!  My  doctor like to have you on meds for a year and then review.  If you are doing well, he believes it best to decrease the dosage and then see how things go for another six month (unless they take a downward spiral) and then if all is well, stop and see how it goes.  But my doctor is an individual and his theories may  vary from others.  Basically, I say follow a doctors advise and work with meds and talk therapy together.

"Perk up"'s and "look on the bright side"s are a waste of time and probably detrimental.  He or she can act the way you want them to, but that doesn't help the depression.

I once had an IHD lizard threaten to slap the depression out of me and talk about using pills as a crutch, etc.  That wouldn't work either.

Actually, I don't guess it was worth a penny even.  Take it for what it is worth or not.

[RichardMEL]

Hey Cariad all good. I had no problem with your post We're all happy and in agreement - no depression here!

Dan - you're right - sometimes it's very hard to tell if another person is depressed or just down. Some time last year at D a number of nurses came to me in a row and said stuff like "Hey what's happened? Are you OK? Something wrong?" and I asked why all the concern all of a sudden... well they said that I wasn't my usual cheery happy self so they thought I must be depressed about something and that something must have happened. Well no, nothing really.. I just pointed out that even someone like me that tries to see the positive side of things most of the time and is generally fairly happy facing to people.. well I just felt like a quiet day. I wasn't really mad or sad or unhappy.. just didn't have the energy to joke around or whatever...

Now I understand that when someone's demeanour DOES change that can be a sign that something is up - I have no problem with the concern, but I'd think it should be if it was for a few days or a week or something, rather than a one off thing.

Also sometimes people don't want to admit to others what they are really feeling - because they may feel silly, or stupid for thinking it, or that they need to be "strong" for others, or whatever (there's any number of reasons) so you wind up with this mask that isn't at all accurate.

I think to a little extent all of us do this from time to time. It's sort of like when someone asks you "How are you?" and you know they're not REALLY interested in the truth, so you just say "yep I'm OK" when you're not. I think that's kind of similar in a way.

The important thing I guess is that each person is real to *themselves* - if you feel sad, depressed, upset, angry at it all... understand that these feelings are NOT abnormal, and that many others in similar situations share them, and that it should be OK to discuss these feelings, specially if they're so strong that they're affecting every day functioning, with a professional and seek some help. There's no shame in that in my view.

[dwcrawford]

ok Kitkat, this is what I had posted and deleted.  does it make things better?  It certainly makes me feel worse to have it back.

Am I going to get fired?  Does today, tomorrow or yesterday matter?

Last week this pushy technician from my unit changed my goal for fluid removal.  I had gained weight.  My nurse said it was actual weight gain and I could stand only 1.5 to 2 liters of removal so she set it for 1.8.  (The dietician just tells me to EAT.  Anything but eat.  I try.  So I did gain weight.)  The tech comes by and says this is ridiculous and moved the goal up to 3.  Midsession  I started the cramps, etc. and as usual,  at that time the techs were all gossiping or on a break or just not there.  I hurt all weekend.     

Then Thanh, the nurse, turns the machine the next time so that I can see what is going on.  I want to learn and I want to see.  This tech asked what that was about.  I told her and she said I wouldn’t understand it anyway so she turned it back.  Pissed me off yet I said nothing.

The nurse can’t spend a lot of time with an individual.  After all, she has 11 other patients at any given time.  I never see the tech except when she puts me on and four hours later when she takes me off – unless she is pissing me off.

I carry lots of junk with me (computer, etc.) so the nurse will sometimes wave me to come in once the chair is ready.  On this particular day, the tech referenced above said if I kept coming in early and rushing here she’d see to it I was the last person put on the machines and taken off.   Pissed me off.

Well, last Friday the nurse (who is unfortunately a friend – unfortunate in that being a NONO.)  Told me to talk to the scheduling nurse and request another tech.  She said this one was rude to her too and she didn’t like how she’d been talking to me.  The nurse made a call to the scheduler who was supposed to come by with her boss (but never did).

My doctor comes early in my session every Monday.  Somehow the tech had reported beforehand that I was unhappy with what was going on.  The doctor comes by and immediately starts on possible alternative treatments for me.  Have I thought about Home Hemo (yes I had but I don’t have the required support at home)?  How about PD?  It isn’t for me for various reasons.  Did we stop pursuing the transplant option?     (I haven’t filled out the papers yet and I’m too old for other than cadaver and I don’t really think I want to go through it – being alone and without family, etc.).  Shouldn’t he be considering how I’d fair the best rather than what makes technicians happy?  He’d already at an earlier date said either this or a transplant.

Then I told of some of my complaints.  Choking and not being able to get water from my techs.  Being promised button holes for ages and self training.

My thought?  Is he getting ready to “fire” me because I am confrontational?  Once before they’d asked me to come in the morning.  I got there and was told there was no chair so I had to wait an hour.  I was pissed and raised a little stink.  They got me a chair.  Another time I was sitting by Roy (rest his soul) and his screaming, etc. was getting to me.  I asked to have another chair.  I got it.  I guess that is all confrontational.  Maybe it is my personality.  On this site even, I’m accused to starting things when I had not such intention at all.  And of saying things that never came out of mouth (or off my keyboard).  Is it my fault?

Thanh did tell me yesterday that I was to start Buttonholes immediately and she was going to do it.  Wonderful except she is going to Tanzania next week for two weeks to meet her in-laws.  I suggested we wait until she returns.   Where did that edict come from anyway?     

Anyone who has read anything I’ve written about Davita Med Center Houston knows how I’ve praised the unit all these months.  Do I leave it?  I’d have to change doctors.  He is the best in the city.  But it sounds like he may be getting ready to “fire” me anyway.   Do I just hang in and live with it, as any other center could have those issues?  Do I just give up on dialysis all the way?  Does today, tomorrow or yesterday really make a difference?       

[willowtreewren]

Dan,
I really understand. I think that part of why I had such a hard week this week was because I had come to this thread only half able to ward off depression. Then reading about it and thinking about it pushed me over the edge and down into the depths.

I only returned here because I saw that you had posted here.

And neither of us, nor any of the rest of the souls battling the shadows should do so alone. So I am here, my friend. Braving the darkness to reach out a hand to you. No smileys. I don't feel up to that.

Just a hug.

Aleta

[kitkatz]

Dan,
I hope you have read other threads that read very similar to yours.  There are complaints about centers everywhere.  Epoman started IHD.com so these kinds of posts can be seen and answered by dialysis patients all over the world. Your thread is going to help other patients.

I have had bad experiences at centers, too. I hate it when the techs disappear never to be seen again until time to come off.  I swear the last center I was at was out to kill me off.

[Bub]

Thank you all for contributing and writing about things that just a few years ago were strictly private.  I feel better knowing that I am not the only one, although of course I knew this already.  I have shared my feelings with some of my friends in the dialysis center and got much the same feedback and alot of support.

[paris]

Good to see your post, Bub.  It does help to know we aren't in this boat alone and someone else understands.   We just need to keep paddling along.