scary information about cognitive problems + depression ?
Q.I have always felt that it was unclear whether my cognitive problems (decrease in IQ of 15-20 pts, poor memory and concentration, poor perceptiveness and sense of being fully alive, withdrawn and inable to feel like a "normal" human) were caused by depression, or whether my depression was because of some kind of dementia. I always had the strong belief that it was the latter because after each major episode, I never fully recover my intellect, I only become undepressed after I finally accpet my new limitations.
A.Vascular changes may have important implications for clinical classification. Consistent with the current conceptualization of vascular dementia, the term "vascular depression" has been proposed (Krishnan et al, 1997; Alexopoulos et al, 1997). Just as vascular dementia is a manifestation of cognitive deficits associated with cerebrovascular pathology, vascular depression should be viewed as a manifestation of depressive symptomatology associated with such pathology. In a study investigating the prevalence of depression in patients with various dementia types, major depression was found to be more common and more severe in patients with vascular dementia than in patents with Alzheimer’s disease (Ballard et al, 1996). It has been proposed that depression, cognitive impairment, and degenerative dementia should be viewed as intersecting continua (Emery & Oxman, 1997). I don't think it is scary. It says pretty much what everyone knows. Normal depression doesn't cause cognitive problems when treated, while non-treatable depression brought on late-in-life by some kind of physical brain disease may cause cognitive problems and depression. Both of which probably go hand in hand. In my own experience, I have found ADs help my cognitive processes. However, some ADs do have side effects that make it seem that my thinking isn't right. Maybe you have to find one that works for you. It seems to me the big question is whether or not ADs cause this condition. I personally do not think so. That would have to be studied in a scientific controlled group environment of many groups but where one group of depressed people would not be allowed to take any medication, and others would have to stay on one for many years, and this will never be done because it is inhuman. So no one will really know for sure. I'm on a high dose of desipramine and not actively depressed at the moment. But as I told my neurospych, I think it's the dementia causing the depression, not the other way around. And so now it would appear that I am just an undepresssed demented guy. (Which really isn't that much better than being simply depressed)
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