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When does Depression need medical attention?


I am quite confident that all of us have felt moments of deep sadness before. There are moments of despair, of lost hope, helplessness, uncertainty, fear and just plain old tired of everything that has and is happening. What I want to know (or discuss) is when do these feelings begin to be considered depression that needs treatment with drugs, therapy or an alternative way?

Many of the drugs we need to take can cause depression, or at the very least mood swings (like prednisone). It is quite common to feel like a different person when on these drugs, but does that mean that special attention needs to be paid to control the feelings of sadness?

I think that one is considered "depressed" or in depression if:

-Constant state of sadness and lethargic
-No desire to eat
-No desire to go through daily activities (especially ones that are usually enjoyed)
-A feeling of despair that results in a wanting to "stop fighting" the disease

These are based on what I have read and heard of the medical definition of depression. My problem is that these symptoms seem to be things that all of us can feel and go through during our combat with our diseases. There are times (when we are not on prednisone of course) where the last thing we want to think about is food. We are dead tired (from a recent flair, malabsorption/anemia or any other reason) and we have no willingness to carry on normal, daily activity. Lying in bed is all we want to do, and we may want to also do it alone.

What I feel then is that being depressed is more of a personal decision than a clinical diagnosal. I do not mean to say that being depressed is your choice and you are weak or wrong for being so, but rather you need to decide for yourself whether your state of sadness is in need of further attention or medication. I know that I went through some pretty low periods, but I would not have wanted to be medicated for depression. I think that I had all the symptoms that would classify myself as being depressed though, but I was just waiting for my surgery date to come, and was still doing my best to keep up with school and my normal activities at the time (made sure to watch my favourite television shows everyday :)).

Maybe as someone who has perhaps never been to what is the lowest of low points, I may not be able to correctly discuss this matter. I may be totally wrong in my feelings, so I would really like to hear others perspectives on this.

I hope that you all will feel comfortable discussing this matter. If not, I encourage you to post about your dealings with depression in the support forum under the anonymous account (instructions to do so are in that forum) as I really want other perspectives on this.
Remember Mike when I first joined this forum I wanted to just die. I hated my life and everything about myself. I had to put on an act in front of my friends and family. I felt like I was nothing. I think that depression is an ongoing feeling of sadness that you feel like you don't belong to the world.

I was all for of what you stated above plus a feeling of hatred towards myself because I couldn't do anything to help myself. But the only reason I was depressed was because of my mindset.

I think that I made myself depressed and that in most people it is true because you just get sad and because of that you think that you are helpless or that you are not supposed to be here or something of the sort.

I took celexa and that made me feel much better. I have been able to control my mindset and now I am not depressed and I feel good about myself.
i could say i have been depressed since i was 13, i am 26 now. but i always said it was the teenage blues. i didn't seek out celexa until this year. it felt different this time - i felt like i had no control over my life and that i was sinking deeper into a hole with no way out.
celexa helped my when i needed it most - i love myself more, except when i'm bloated lol - and i appreciate the simple pleasures in life that i seemed to not notice before. i got a coffee mug to remind me everyday of all the good things (well some of them anyways). it says:

go for long walks,
indulge in hot baths,
question your assumptions,
be kind to yourself,
live for the moment,
loosen up, scream,
curse the world,
count your blessings,
just let go,
just be. (by carol shields)

so that is what i do hehehe
I know like when I was on celexa I was literally bouncing off of the walls. I went insane in the membrane LOL. That was my only problem on celexa but it taught me to love myself.


Ive dealt with it in the past. I think I was "depressed" a lot as a teen, but for me I think at that point it was all situational sadness. I was going through some really awful things, some I had no control over.
as I got older, I started to really get down again, but this time there wasnt really any situation going on in my life that fit such really low feelings. and it got to the point I couldnt even lift my head or get out of bed. at that point I was told I had a chemical imbalance. that was the only time I took any kind of antidepressant. they helped the imblance, and eventually I was able to come off of them.
I dont want to ever go on them again. just a personal decision for myself. Ive nothing against them, or anyone who takes them. but for me, I dont like the person I was on them. I prefer the highs and lows... didnt like the numb feeling they gave me.
on the other hand Ive also refused to take any steroids ever again. they just make me way to panicky and not myself at all. drugs can suck the life right out of you.


It funny, but I had a easier time dealing emotionally with CD for the first few years after I was diagnosed. It has been lately that the emotional beast has come up and flaired its head.
I find that getting out and walking, etc helps and finally finding a place like this to express myself has started to help.
I have had no med's so far but it is not outside of the relm of possibilities, and maybe counciling also?????


Senior Member
I am not trying to hijack this thread, think it's all too important. I expressed similar feelings yesterday (post # 20 under 'I can't handle this anymore..') so you all know where I stand on the subject. However, as you're mulling over your thoughts on it, could you take a look at something I posted today under 'anything goes' . Problem as I see it is that the classic 'symptoms' of depression match the natural feelings of anyone with IBD... So either we feel angered/insulted when the topic is raised, or we accept that we have 'depression' on top of IBD.. But maybe there is more to it than that... And that because IBD can mask or mimic the typical signs of depression, no one is taking a serious look at whether there is an even more important connection. OK, for example... long before psychologists made the connection between chemical & hormonal inbalances in the brain, they often thought there was no chemical or physiological treatment for some 'mental' disorders. However, today.. knowing better, they can & do treat (with amazing results) people suffering from bi-polar or other chronic disorders chemically. What if there is an underlying neurological link to IBD that no one is looking into BECAUSE the symptoms of common, ordinary 'depression' closely match those of anyone who has IBD? What if they are similar in nature, but different in treatment? And no one sees it because they can't see past 'depression'.
i.e. You treat a person with IBD for associated depression, and the depression is modified but the IBD remains... BUT, if there is a link between the brain and IBD, you find it, treat it, and the IBD and associated depression goes away TOO!


all of high school i was on the verge of a nervous breakdown and then one day in college i took the dive...i tried to get help from the university clinic but that turned out to be a joke...but finally i found a good therapist and she helps me get through life...having battled with depression and bad coping mechanisms myself i say would say that depression needs professional attention once the sufferer can't see a way out...the moment you feel trapped in your head, thoughts, body or however the feeling manifests itself, is the moment you need outside help...i also think that even tough drugs helped me they are not the answer...talk therapy is important...often we need to change something in our lives when are depressed but usually what needs changing is not obvious...talk therapy helps us as patients to evolve past our problems...those of us with chronic diseases especially need to pay attention to our emotional and spiritual need
Yeah I think you are completely right. I had the feeling of being trapped in my own head and every one else was just along for the ride.

I just never thought of it that way


Senior Member
I'd agree with 'that girl'.. counselling is as vital, and in the long run probably more,
than any little 'blue' pill (or whatever).. I think they work well hand in hand. Meds can be an immediate part of the solution, but only a part if it isn't combined with a form of counselling/therapy. The counselling/therapy is the route to a longterm fix
I have to agree with all of the posts regarding counseling. I am personally on Wellbutrin right now ~ a very low dose (150mg per day) and it has made a slight difference. I fought for months to not take another pill but finally my GI and my reg dr spoke and decided that it was best. I have also been referred to a therapist that has experience with Crohn's and IBD, the only problem is that she is so busy I cannot get in for my first appt for three more weeks.

Hang in there and try to find something that does make you feel a little better ~ it may sound stupid but for me when I am depressed then I get down on the floor and color with my two year old. He puts life into a fresh perspective.



wow 150 mg is a bit isnt it? of the welbutrin? I took it in the past and believe it waas only 75mg maybe my memory is wrong

I'd just like to add that I know mos of you arently newly diagnosed, but 80% of newly diagnosed Crohns patients experiene some 'form' of depression. Prety interesting to me if I might add...alslo considering MOST GI's and docs agree Crohns isnt caused by stress anymore, I'm soory but you cano not tell me this and me beleive this.


Senior Member
Some of you have heard this before (my apologies for the repitition) but I was Dxd with depression BEFORE I was Dxd with IBD... Found it insulting at the time, like they were saying all my physical problems were just in my head.. prescribed a drug to alleviate my 'depression' (to me, I was just sick N tired of being sick N tired).. However, like a good lil patient, I took all of my meds. Didn't make a bit of difference in the progression of my IBD, or any of the related physical symptoms. I was just more relaxed about it all, so I just really didn't give a crap (pun intended) anymore... Now that I'm Dxd with IBD, do I still feel/get depressed at times? You bet... Am I still taking those lil pills? NOT! I'd rather face the depression, note if it coincides with upturns YET more importantly down turns in the progress of my IBD, than have it control my emotions to such a point that I really don't care 1 way or the other. I fight my depression when it occurs by facing it, challenging it, and modifying my behaviour. Rather do that than just skim over it with drugs. My view is like if you break your leg, you use a cane for a while, then you turf it and learn to walk without... As for doctors and their accepted consensus of whether depression is/isn't associated with IBD, I recall all to vividly what their consensus USED to be regarding another intestinal disorder. Ulcers. They commonly thought that anxiety, depression, stress... etc., were the cause behind whether a person developed ulcers. My dad had them, and he was a worrier. They operated on him and removed 2/3 of his stomach... Meanwhile, Australian docs had learned & published that ulcers were commonly caused by a type of intestinal bacteria, and that it was curable without surgery, etc., by anti-biotics... North American doctors didn't pay attention/accept this for decades... Now, whether a persons mind set had any effect on how hospitable/inhospitable their gastric tract was for the type of bacteria that caused it... dunno if anyone really researched this.. I do know that the mind is a powerful thing... I've been involved in any number of bar fights where I'd got seriously injured, yet the good old adrenalin my brain was pumping kept me from feeling the associated pain for hours... I think thats just the tip of the iceberg... I've seen 1st hand some people w bipolar disorder have meltdowns after they stopped their meds... If a chemical or hormonal imbalance in our heads can cause these drastic changes in our behaviour, then I feel that psyhical change in our bodies can/does affect how we fight illnesses, how our bodies respond to an infection, how our bodies just cope with day to day living, regardless of any IBD

To try and short phrase it... OK, not everyone with depression has a form of IBD, but can anyone with IBD state convincingly that they aren't sick N tired of having it
(and does that constitute a real form of depression, or is it just common sense OR is it a possible link.. Did IBD make you depressed, or did being depressed give you IBD... OR is it something the dr's haven't clued in or accepted yet, like ulcers, that causes depression like symptoms and results in the body turning on itself?)


Very interesting thread.. I think our state of mind plays a big role in our illness. I can only speak for myself, and can say that I have actually been under alot of stress continuisly since childhood and depressed on and off the past 7 years. So yes.. I think stress and depression have alot to do with it...