plix (imported) wrote: Thu Feb 07, 2008 1:18 pm You were very lucky that your GP thought to check your T level. Most doctors do not do this, and instead the diagnosis of "depression" is given and SSRIs are prescribed.

I know of many cases where this has happened, and these guys have spent years or even decades on SSRIs trying to figure out why they still don't feel so great. Some have even had their marriages and other aspects of their lives ruined over the doctor's mistake. Then years later they find out it was low T all along. Once they start T therapy, they feel better than they have in years or decades. And since SSRIs are suspected to lower T, they may even make the problem worse (and goodness only knows what other long-term effects these powerful and little understood drugs have on the body and mind).

This could have easily been you if it were not for you doctor's knowledge to give your T a check first. You have a good doctor

You are right that there is no objective test for depression, and that is my biggest beef with it. This diagnosis is entirely subjective, usually given by only one person, and often it is based on one short interview. There are no objective tests to confirm any diagnosis of depression.

I have been given more psychiatric diagnoses than I can count by therapists who have seen me no more than a few sessions, sometimes as few as one. These people usually knew nothing about me or my history. And many of their diagnoses were later said by other therapists to be mistakes. So if the diagnosis of "depression" is to be given, it is one that should be given with care, only after all possible physical medical problems have been ruled out. It is a diagnosis that follows a person for the rest of his or her life.

Thanks! I really am pleased (and amazed) that I have such a good doctor. When she retires I plan to jump off a building

I've often wondered about the number of menopausal women who are prescribed SSRIs. Is this more of the same thing? I mean are they treating the "symptoms" instead of the actual cause? And again I wonder if its two different things? I can see how strong doses of mental health meds might make a person feeling lousy from hormone problems no longer "care" about them. We had a neighbor who had "vegged" out on this type of thing and her doctor left her on this junk for years. Then when she went off the stuff she was so happy to have her head removed from the "fog" that it was almost scary.

I did not respond on the second part of you question. That is a far harder one to answer. First of all it is harder to get first hand information on suicidal. I would find it unusual to a person to leave a note behind stating that they took their life because they are an eunuch. Again different groups will react differently.

The voluntary eunuch may be depressed as a result of the castration. The effects were not s desired. While this may not be enough by itself to bring on suicidal thoughts. It could be a factor along with other depression causes. The combined depression could be enough to push the person over the edge. IN general castration would not be a cause of suicidal thoughts.

The involuntary eunuch poses different potential problems. Castration can cause serious depression in some. If other personal problems are going on in their lives it can compound and be overwhelming. The inability to perform in bed with a partner can cause problems that stress relationships to the point of separation. An unhappy eunuch may have a desire to keep showing that he is still a “man” and takes wild chances to prove that he is. He may try to over compensate and become a risk taker. This may not be suicidal in the true sense but could be cry for help. Can castration contribute to thoughts of or the act of suicide? Yes it can for some. Castration may be more of a factor but many other things are going on in his life that are playing a part of the depression.

Now for the unfortunate who were talked into castration or were done against their will. Finding records for this group would be very hard. Their stories makes for some good reading but do not think that happens all that often. This group would tend to be more prone to act more irrational. Depression could be deeper and have other physiological problems. Do not have the numbers of how many females are suicidal as a result of being raped. I would think that being forced into castration would have at least the same effect if not more. If the guys castration story was on the evening news the embarrassment could be very overpowering and harmful. Harmful to the degree of being suicidal. I am not sure just how trauma and crisis centers are prepared to deal with a forced castration. Judging how the medical community treats castration in general I bet very poorly. This person will need psychology help for some time to help put the life together.

I am not going into all the possible areas. I taking a very general standpoint. Suicidal persons will most often have several areas in their life that is in trouble. All it may take is one more little thing to reach the limit and they snap.

Depression is a multifaceted and variable phenomenon, and there are many theories abounding regarding it

The largest areas of agreement suggest that depression is either of a transient type or a more chronic, long–lasting form. It can range in degree of severity from mild to very severe, including psychotic levels.

There are strong arguments that depression has a significant element of heritability (a genetic component). There is substantial evidence, though by no means conclusive, for this. It may also include a propensity toward depression, as well as that state itself. Propensity may suggest more transient types of depression as well as the full monty. Degrees of any of this are always variable, suggestive, and at this point, never completely definitive.

The more transient types are usually associated with a situation where one may feel “down” for a few days, to something significant, like a death in the family. The less transient types (more chronic) generally need and should be treated with such drugs as SSRI’s. There are other options available as well. In any case, depression is not likely something that one can just “snap out” of, especially more difficult forms or degrees.

Certainly, such things as different levels of hormones or other body chemicals, or lack thereof, can cause depression. There is substantial support for this all throughout the medical literature – including a lack of testosterone. Of course, the risk is, as has been pointed out, that an accurate causative assessment may not be made, and a physical cause that manifests depression not be discovered. The risk is furthered in that the cause may be masked by SSRI’s or similar, and go untreated. A thorough physical exam, including labs, should always precede a diagnosis of depression.

It should be noted that there is no published literature that says the SSRI’s lower testosterone levels, at least that I can find (and I have looked a lot) (maybe someone else may find something contrary). There are, however, many reports that they can impair sexual function, but not by reducing testosterone. The “how“of the impairment is not known.

In terms of differentiating “real” or “mental” depression from some or any other sort, I would suggest there is no difference between them in any form, save degree. Pain, after all, is pain, no matter the cause. The only questions in my mind would be how much and how long is the pain, and why the pain – if discernible –to determine transience.

Relative to tests for depression, I know of no blood or other physical test the detects depression. In many respects, it is a subjective judgement that needs to be tempered by experience and care. There are, however, questionnaires and inventories (not these 10 or 20 question Reader’s Digest things) that are reasonably to quite accurate for assessment. I favor those developed by Cattell and the successors to them, as very highly accurate.

Regarding some of the manifestations of depression, I won’t go into any great discussion. There is a LOT of very good information all over the net on the topic. But, specifically, to equate castration with a certainty of depression is not in the least valid. Broad generalities do no one any good, and usually only tend to stoke fear.

I will say that there is some evidence in this regard in the recent EA survey. I am not sure of the numbers off hand, but as I recall, about 50% of voluntary eunuchs experienced some level of significant depression. It is very substantial among cancer patients (testicular certainly, and much more reported evidence with prostate cancer patients). Of course, there is a significant body of anecdotal evidence scattered throughout this Archive, suggesting a high RISK (not certainty) of experiencing depression. Voluntaries seem to report significantly less depressive experience than involuntaries. Where voluntaries do experience significant depression, reports suggest that it is most often an exacerbation of pre-existing depressive states or conditions.

Sister K:

So what your saying is depression is depression but you need to do labs etc so as to see how best to treat it? Hoo hoo for my GP! She got it right.

So for example a healthy person who takes a long series of tests like say an MMPI? or whatever and talks to a doctor is diagnosed with Depression but has good labs for hormones etc would be best treated with therapy and maybe SSRIs.

A person with low to no hormones of some type (Including Thyroid) would first be treated with HRT then if they were still having depression problems go to therapy and or SSRIs?

And I guess a third thing to check is if the patient is having some tragedy that they have to deal with like death in the family disease etc. And how to treat that? Therapy I suppose or a short run of drug therapy?

That makes sense to me!? wow....

Yoli here, nervously awaiting the predicted storms (high winds, rain, "large" hail, and maybe a tornado or two...EEEEK!)

Most of the membership here are aware that I know three eunuchs on a personal basis, including one (Barry) on an up-close-and-very personal basis. Of the three, there is one who evidences resentment, thinly-veiled anger, etc, over his condition. I've described him in some previous post. If there is one among the three that I can envision in a suicide scenario, it's him.

Whereas the other two, Barry and Mr.X, were very voluntarily castrated, this guy, without revealing specifics, hints darkly that he was forced into it, or castrated by force. This, if course, has caused me to wonder and even fantasize as to "why, where, how, by whom?". Even before this thread was initiated I had him pegged as someone who might commit suicide. Worse yet, I can't shake the feeling that he might not go out solo; That he might take someone with him, perhaps whomever he feels is the "culprit" in his castration.

As to the "why"; I suspect that he was castrated in some "either/or" scheme, perhaps being confronted with the choice of castration or being exposed for some sexual misdeed (rape? pedophilia?). I know that such things are not unheard of, the Story Section notwithstanding. Whether or not force was involved I cannot say but can imagine.

"Where"? That seems to be a tossup between Mexico or somewhere in the Houston area. I've thought in past that I'd discovered which, but can't be certain

"How"? Whoever did it must have known what they were doing or got very lucky...incision in his baggie, balls gone, neat stitching.

"Whom"? This is the greatest mystery. Beside the person doing the actual cutting, who "ordained" the castration? Who was present? Was there a struggle? Did he resist? The stuff of wonder and fantasy, to be certain, but he is most evasive re all four questions and/or changes the skimpy responses he does offer.

In my opinion, this man is a time bomb. That's why he is seldom invited to our little gatherings. Stranger still; He can be charming, helpful with domestic chores, is a good cook and good bartender, and generous to a fault when the pizza boy needs payment. He can also be silent, sullen, weepy, and a dark cloud over the proceedings.

So, suicidal? I give it a 60/40 likelihood. I just hope he goes it alone unless whomever he takes with him richly deserves it.

That's all.

Now I'm all gloomy!

Yoli

Brighten up, Yoli. Focus on the new recruit Marlene is working on and give us a report on those two. Actually, you have perfectly described some people no matter what their testicular state may be. Some people are just toxic and I usually feel best only being around them peripherally. For his own good, I do hope he has good friends, but probably not and, if not, he and he alone needs to change.

There are all types of people everywhere in all walks of life that aren't eunuchs who are totally depressed and suicidal in all kinds of places. In fact the whole entire planet is just one extremely depressed and suicidal area of the universe and may be due for some outside intervention already. Anytime now those extraterrestials should be swooping in and pulling us out of our complete misery.

Time to put the planet on Intergalactic Prozac? Actually, considering the state of the place, perhaps high doses of some potent antipsychotic might be more in order.

Or, a little home made beer! --FLO--

or a small gin....