commented on SLLOTD: Judgment Day
I think TOAD was asking for insight, not permission or advice. I don’t know why Dan suggested the option of a second chance: we already know she isn’t interested, she just doesn’t understand why not.
I suspect it’s partly because she *does* do these things that she knows that they are realistic and is thinking about what it would be like to do them with him. She knows she doesn’t want to do them with this guy because he doesn’t make her feel safe. The way TOAD quoted him, it sounds like he didn’t even make her feel as though he were willing to work for the privilege of treating her this way.
Short answer: nothing about his answer was seductive. At this stage there should be some seduction games going on.
commented on SLLLOTD: Tenure Track
I don’t know why Dan is so sure they wouldn’t tell eachother. Assume they will. Be upfront.
It’s not hard to do. One of your topics of conversation is going to be online dating, how you came to it and what your experiences have been. One of the common experiences of OKC is that you discover that you’re already friends with all your best matches. Being well-matched with two women in the same university department is an indication of how well-targeted OKC matching is. “Yeah, OKC matching is kind of freaky. It matched me with one of your colleagues too.” If asked, reveal that the matching resulted in a date. No more is required.
commented on Savage Love
Who said anything about not being able to build skills being a criterion for being depressed? Most people can build skills and many people learn lessons from clinical depression. I learned compassion for suffering. I learned a huge amount from the aftermath of my ex-from-hell though the price of the lessons was too high. Still, I paid and I learned.
I was in a workshop for people “at risk for depression” meaning people who’d been depressed on and off for years but who were able to interact and participate and weren’t actively suicidal. It was a great workshop. One of the reasons it was so great was that I got to meet other depressed people and they were really cool. Black humour. Able to look suffering in the face. Compassionate and thoughtful. I thought, if these folks are so obviously cool maybe I have something to contribute too.
Pills don’t necessarily prevent people developing this depth. You don’t start taking pills until you’ve been suffering for a while, for one thing.
Taking pills is in itself a learning experience. It gives you a sort of standard to compare your state of mind to even when you aren’t taking them. “Oh, this is how I think when I’m depressed. Not good. How would I have responded when I was taking Zoloft and feeling resilient? Ok, let’s work towards that then.”
In my experience, no, doctors do not prescribe them wantonly at all. I had real trouble getting them.
RE the doctor caring for your grandfather. 1) Are you sure that what he was proposing was that your entire family line up for medication? Could he have had some other type of support or therapy in mind? There are various grief support groups that families may be referred to through hospitals. 2) The doctor may make general grief-support recommendations to everyone, or he may have had some thoughts about the abilities of some of your family members to manage their emotions appropriately. Even if he had not met you in person he reviewed your grandfather’s file in detail every day and I am quite sure he would have been aware of any dramas.
commented on Savage Love
Again, it’s not either-or. Let’s say your mother dies and you end up with a lot of family responsiblities you don’t know how to handle. You become overwhelmed and are less effective at work. There are layoffs and you’re on the list. You lie around the house watching television, drinking too much and being critical of yourself and everyone else. Your partner leaves you. You stay like this for a year and a half before you gradually pull out of your funk, get regular work and find a new partner.
This is clinical depression because 1) it’s not your usual state; 2) it interferes with your life; and 3) (as Crinoline says) it lasts longer than two to six weeks.
A common pattern is for each subsequent episode to be triggered by less and less disruption. Perhaps the next depressive episode is triggered by an asshole boss. The next one by the double-whammy of plantar fasciitis and a root canal. The following one by your toaster and your fridge breaking the same week. (You get the picture.) Also, subsequent episodes may be more severe. Maybe the first episode lasts six months but the last one lasts three years. Maybe the first time you didn’t really notice you were depressed until after you started pulling out of it, but the last time you’re actively suicidal.
While it’s easy to understand how someone could be crushed by a combination of major losses, it’s less easy to point to minor losses as a cause. But clinicians don’t really want to put themselves in the position of rating someone else’s life experiences as “legitimate” and “illegitimate” causes of their state of mind. What interests them is whether that state of mind is helpful.
First episode, mild to moderate symptoms, less than three months duration? Lifestyle modification and CBT are probably the first-line treatments of choice whether or not there’s a clear precipitating event.
Second episode, moderate to severe symptoms, has been dragging on for more than six months? I don’t care what the precipitating event is, you’re in trouble. Lifestyle modification and CBT will go a lot further if you have the support of first-line antidepressant medication.
Twelfth episode, severe symptoms, has been decades since you felt really well? You might or might not need hospitalization to keep you safe, but we’ll definitely be keeping a close eye on you while we try various drug cocktails to get you stabilized so you can go out and deal with your life.
Another way to look at it: compare to having a bum knee. Most of the time you are fine and function the same as everyone else without a bum knee. It only gives you problems when you’re carrying something heavy, you gain weight or go skiing. So you wear a knee brace, join weight watchers, do stretching exercises and you can do all those things. Maybe you also take painkillers and get knee surgery. Maybe you eventually stop skiing.
Saying, “I don’t really have a bum knee because it’s only a problem when I put extra pressure on it” is not useful when trying to get the most out of life. Can you do what you need to do? No? That’s the problem.