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Depression : Real Life Struggle with the Disease
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From: Rene  (Original Message)Sent: 3/29/2005 3:36 PM

Sopranos Psychiatrist Gets Tough on Depression


Lorraine Bracco describes her real-life struggle with the disease
By E.J. Mundell, HealthDay Reporter

THURSDAY, March 17/05 (HealthDay News) -- "The irony isn't lost on me," actress Lorraine Bracco said with a smile over her morning coffee.

Even though she plays smart, savvy psychiatrist Dr. Jennifer Melfi in the HBO hit series The Sopranos, Bracco admits she suffered through a full year of what she calls "joylessness" before seeing her own doctor for help against depression.

"It was the late 1990s, I was already with The Sopranos," the Brooklyn-born actress recalled. After a divorce and custody battle, "my whole life seemed to be finally pulling itself together."

"But it was as if I was living my life without any joy," said Bracco, 50, an Emmy- and Golden Globe-nominated actress who was also nominated for an Academy Award for her work in Goodfellas.

"I was doing what I was supposed to be doing, but I wasn't experiencing it. Whatever I had to do -- whether it was being interviewed, or a movie premiere, or making oatmeal for the kids in the morning -- I did it, but without any sense of fun."

Finally, a friend noticed the mood change, and suggested Bracco seek professional help.

"Even then I thought, 'What? My life is on the upswing!' I thought I'd exercise and yoga my way out of this -- I was going to beat it," she said. "But of course, we know now that that's impossible. Depression gets a hold on you, and the longer you wait, the harder it is to get out."

That type of denial and procrastination is typical of many depressed individuals, said psychiatrist Dr. Patrice Harris, who is working with Bracco and drugmaker Pfizer Inc. on a campaign and Web site (DepressionHelp.com) that urges people to spot depressive symptoms early and seek out care.

"There are lots of people out there that are saying, like Lorraine did, 'I'll just exercise this away, or think it away, or it'll just go away,'" Harris said. "There's also this misperception that depression is a moral weakness, a failing. People don't understand that it's a serious medical illness with a biological basis."

As far as researchers can tell, much of the biology of depression relies on an imbalance in amounts of a specific brain chemical called serotonin. While psychotherapy can help fight depression, medications called selective serotonin reuptake inhibitors (SSRIs) try to re-balance serotonin levels, and thus correct the problem. SSRIs include drugs such as Celexa, Paxil, Prozac and Zoloft. (Beginning this spring, antidepressants are to begin carrying a "black box" label warning of the potential suicide risk among children and teens.)

A year into her depression, Bracco made the decision to see her doctor and underwent a combination of talk therapy and Zoloft.

"The talk therapy I wasn't worried about, but I had some serious misconceptions about the medication," she recalled. "I thought, 'Oh, I'm never going to feel anything anymore' -- not just as an actress, but in my everyday life."

She also worried that she'd become hooked on Zoloft for life.

Neither fear was realized.

Like other SSRIs, Zoloft "doesn't void or dull you," she said. And about 18 months into therapy, Bracco said, she felt she could slowly wean herself off the drug. She hasn't felt the need to use it since, she said, although she said she's thankful effective medications exist.

"For me, it was one of the most important decisions I made, I just regret not going for help earlier," she said. "I suffered for a year -- why?"

According to Harris, specific events, such as a death in the family, divorce or trauma, can help trigger depression.

"But we also don't want to lose sight of the fact that there doesn't have to be a stressor," said Harris, a practicing psychiatrist who also teaches at Emory University in Atlanta. "In fact, that's even more problematic, because I have people come into my office and say, 'I'm sad, but I don't know why.'"

She said depression is distinct from just intermittent bouts of the blues. "Symptoms have to occur all day, every day, for at least two weeks," she said. Typical symptoms include an inability to sleep or sleeping too much, a loss of appetite or compulsive eating, poor concentration, frequent crying and suicidal thoughts.

According to Harris, more than 34 million Americans will be diagnosed with depression at some point in their lives, "but only half of them will go get treatment."

"Depression is scary to people, they're afraid and I really want to help lift that taboo," Bracco said, stressing that Zoloft is just one of many SSRIs with proven effectiveness. "If one doesn't work for you, there are others."

While women often find it tough to seek help, studies show that men are even more reluctant to see a doctor about their feelings, and often turn to 'self-medicating' with alcohol or drugs, creating what Bracco called a "vicious cycle."

That's why she's especially proud of her role in The Sopranos, which hinges, in part, on Dr. Melfi's psychotherapy sessions with tough-guy mob boss Tony Soprano.

"He originally came in because he was having fainting spells," Bracco said. "Then we kind of broke down the walls, and I put him on medication. But we know that story has absolutely helped take away some of the stigma [about depression] for men."

"A lot of psychiatrists from all over the country have told me, 'I now have a lot more men coming to see me,' " she said.

In the meantime, Sopranos fans across the country may be feeling a little blue missing their weekly dose of Tony, Carmella, Paulie, Silvio and the gang.

Unlike her alter ego on the show, Bracco wasn't able to give immediate relief for those symptoms, however.

"We go back to work shooting the end of April," she said, "and the new episodes won't be out till the winter of '06."

More information

To learn more about the causes, symptoms and treatment of depression, visit the National Institute of Mental Health.

content by:
Healthday

SOURCES: Lorraine Bracco, actress; Patrice Harris; M.D., M.A, psychiatrist, private practice, and clinical associate professor, psychiatry and behavioral sciences, Emory University, Atlanta

Copyright © 2004 ScoutNews, LLC.
 


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Reply
 Message 2 of 2 in Discussion 
From: ReneSent: 4/12/2005 12:18 AM
 

Listening To Depression: Getting Out From Under Depression, Part Two
�?by Robin Rice

| page 1 | page 2 |

This is the second of a three-part series. To read Part One and Three, go to www.magicalblend.com and click on “Artiles" in "Library.�?/A>

“If you listen carefully, Robin,�?Grandma Pearl said to me, “you can hear the rain sing.�?/P>

I cuddled down under the afghan on top of her bed, grateful for the warmth, for my grandmother’s presence, and for the first time in my short five years, the rain. I found that when I listened carefully, I could indeed hear it singing as it hit the roof and poured out the downspout. No longer was rain only a spoil-sport to sunny days. There was something more to it. Something worthy of listening to. Little did I know, lying there with Grandma Pearl 35 years ago, that this metaphor would carry me though a thousand lonely days—some raining outside, some raining from a place deep within—as I faced the daunting task of getting out from under an inherited form of cyclical depression. It was an illness that began at puberty, continued on for 17 years before being diagnosed and medicated, and lasted another 8 years before I was able to live medication free.

Often people, not the least of whom are dumbfounded psychologists and psychiatrists, ask me how I did it. How did I recover from a severe inherited illness that was supposed to leave me biologically in need of medication for the rest of my life? And more important, did I have any tips I could pass on to others who suffer? Though I am not a medical professional and can only speak for my path, I do believe that there are natural ways to move ourselves toward a happy, healthy life. It is my delight to share them with anyone who asks.

As it turns out, listening to the rain of depression was key from the start. This listening—truly listening—began when none of the general doctors I’d seen could diagnose me. My moods were cyclical, but were not in tune with my menstrual cycle, so it did not fit with PMS. It was a combination of a few highs and a lot of lows, but it didn’t match the traditional bipolar structure. I knew there was something wrong with me, yet over and over I was dismissed because the details of my condition hadn’t yet made it into the general medical texts.There was only one thing to do. I devised a way to prove my moods had a medical basis.

It was simple. I took a piece of graph paper, wrote down the days of the month along the bottom, and the numbers one to ten (one starting on the bottom) on the left-hand side. Every day, I took my “emotional pulse.�?I didn’t tune into what was going on that day, because that was connected to other people and events. I just went into the pit of my stomach at about the same time every day, and asked myself how well, on a scale of one to ten, I could cope with whatever was going on. One was so bad I would have already killed myself. Ten was so high I would have died of heart failure. As a result, I never went below a three or higher than an eight-and-a-half.

At the end of three months, I hung the charts next to each other. There was a pattern of moods so detailed, I became able to predict the onset of a depressed mood (which always lasted fourteen days), an especially good mood (which always lasted three days), or a full-blown suicidal mood (which always lasted two days) down to within a few hours.

With this information, I was able to receive an accurate diagnosis. Having listened to myself so well, it was easy to get a specialist (I went all the way to the National Institutes of Mental Health to find him) to listen to me. As a result, I was able to start planning my life around the illness that, at the time, seemed to be planning my life for me.

Using the chart, I was able to give myself a break on the bad days, not feeling so guilty for all that did not get accomplished, and not going into fear that I’d never accomplish anything in my life. After all, I knew the good days would come. And when they did come, I was able to push myself past my usual limitations and get a lot accomplished. The “two steps forward, three steps back�?that had been my life for as long as I could remember was finally beginning to shift.

Once I began to realize that depression had a powerful control over the patterns in my life, I began listening in a new way. I learned to listen for what I came to call Depression’s Voice.

Anyone who has suffered from depression knows this voice, though they may mistake it for their own. It’s the one that says: “You idiot! You never do it right. You’re a loser. Always have been, always will be. You’re never going to amount to anything. With a mother like you, how are your kids ever going to grow up healthy?�?It is, to say the least, a depressing voice.

Yet when I really listened, over and over, I came to realize this voice didn’t have a large vocabulary. It was a broken record that just kept spouting the same old thing. Even more amazing, I had a brilliant idea: If depression had a voice, might it not also have ears? It was then that I took what I believe is the most critical and empowering step there is in getting out from under depression: I began to talk back to that voice.

That’s right, I began to have conversations with my own Depression.

“So, you say I’m an idiot,�?I would say when that particular slam came in. “Why do you suppose that is?�?Or I’d say, “It may be true that I’m never going to amount to anything, but I’ll consider that on a day when I’m not depressed.�?And if Depression’s Voice was being particularly obnoxious, I’d simply plug my ears with my fingers and scream, “I’m not listening!!!�?/P>

I knew I looked stupid. I didn’t care. (Nonetheless, I didn’t do it out when anyone else was in the room—looking stupid and being stupid are two very different things.) Over time, the more I talked back, the less depression spoke to me in such a degrading and manipulative way. In fact, the less depression spoke to me at all. Amazingly, I was winning the war with whatever dark part of me wasn’t working right, just by refusing it its say.

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