Depression

[The Hunt Doctors]

Depression

It wasn’t bad enough that between the three of us we filled only 5 of 17 tags in two weeks of wilderness hunting in BC. No, we tolerated the leaking tents, lack of equipment, terrible weather and an over abundance of horses as well. Even the horseback swimming experienced in a raging river was a shadow in the rear view mirror now. This next trip to the game rich land of the giant whitetail namely Saskatchewan was all fun and no suffering. It was redemption time.

Day three brought really, really cold temperatures, - 20F. The deer were moving and all was well. By midday a massive, heavy, tall B&C class 10 point buck snuck into the alfalfa pile. He was facing directly away. The Texas heart shot crossed into and out of mind. The waiting game was on, each breath of what seemed an eternity brought more fog to the scope. Finally a broadside angle was presented; breath, relax, slack, squeeze….CLICK.

No bang, no boom, just click, and an odd, dense, non metallic click. Another round was gently but hurriedly jacked into place and again a dense soft click. The rifle was re-cocked and click, again for a third attempt and click. The round was slowly eased out of the rifle and it was clear that the primer had not been touched. The big buck was oblivious, but for how long? My memories of a pre-hunt sight in (which had no malfunctions) were not helpful at all. One more squeeze, the same click and he walked off. Nausea set in. The mood was dark. Thoughts of hunting were distant. Dinner that evening wasn’t an option as no appetite existed.

That night dry firing resulted in a loud distinct metallic click inside the lodge. A buddy “Yankee” Jim suggested that the bolt be disassembled. Inside was some rust and a bunch of water which was the last nail in the coffin from the previous BC hunt. Spraying out the bolt upon return from BC had done nothing to undo the river submersion in the scabbard. The water remained in the bolt and simply froze, locking up the firing pin. All of the misery of the trip just two months ago came roaring back. Oh the agony.

There are none of us who hunt who haven’t experienced the agony of defeat. Whether operator error, equipment failure, weather, or just the vagaries of the hunt itself, we are engaged in a rollercoaster of a sport. In fact, life itself is often a bit of a rollercoaster and sadness is simply a normal human response to circumstance. Sometimes sadness is more than just a normal response and can linger, cause dysfunction and even mortality. Depression is a real disease and potentially fatal. As usual, let’s start with some definitions.

Essential in understanding depression is to distinguish depression from “normal” sadness. There aren’t really good blood tests or strictly objective measures to make such a distinction. There are some generalities however. These include the length of time, severity of symptoms, relationship to circumstance, and other medical and psychiatric conditions. Before getting into those specifics one must remember that depression is a real biologic illness. Recent research suggests that 5% of Americans have experienced clinical depression in the last year and the life time incidence is about 13%.

Psychiatrists define “major depression” as five or more of the following symptoms having been present during the same two week period representing a change in previous function. At least one of the five symptoms is either 1) depressed mood or 2) loss of interest or pleasure in most or all activities. The other symptoms to look for in making the diagnosis is significant changes in weight, sleep disturbance (too much or too little), fatigue or a sense of diminished energy nearly every day, feelings of worthlessness or excessive guilt, diminished concentration, motor agitation or retardation, and recurrent thoughts of death, suicidal thoughts, plan or attempt.

Please keep in mind that almost everyone will experience some of these symptoms for at least some period of time in their life. Do not fall into the pitfall of making your own diagnosis or diagnosing a loved one. By the same token, be careful not to exempt yourself or loved ones from the need for a professional evaluation. Change from normal levels of function and duration of symptoms are key indicators.

Depression tends to run in families and is more often diagnosed in women than men. Other than genetics there are multiple contributing factors that can be important in impacting mood stability. Alcohol consumption is a major cause of mood disturbance. Virtually all of the illegal drugs are known to cause depression. Some medications such as stimulants as well as some blood pressure meds can have psychiatric complications such as those listed above. Treatment for Hepatitis C is notorious for inducing a depressive state. Depression can co-exist with many medical problems such as chronic pain, cancer, thyroid disease, after a heart attack, post-partum, and a host of others. Depression can also be part of other psychiatric illnesses such as Bipolar Disorder, PTSD to name a few.

These days treatment is effective. There are many approaches and schools of thought. Basically these can be broken into traditional and non-traditional. It is with increasing interest that we note that this line is being broken down and treatments classified as non-traditional are receiving rigorous scientific investigation. For example, the Medical University of South Carolina has ongoing research entitled “Magnetic Brain Stimulation for the Treatment of Adult Depression” funded by the National Institute of Mental Health.

Because of the subjective nature of the symptoms of this disease, there will be true believers in a whole variety of “treatments” that actually do not work. Invoking Tom Cruise and Scientology is not our purpose, rather it is to suggest that when dealing with the mind, it is necessary to keep an open, albeit skeptical mind yourself. St. John’s Wort has been shown to be effective in some but not all studies and for mild to moderate symptoms. By the same token, traditional pharmaceuticals used for the treatment of depression certainly don’t work for everyone either. Both herbal and pharmaceutical approaches come with side effect baggage. Electric Convulsive Therapy is effective, yet controversial as its proper role in the pantheon of treatment options is hotly debated. Brain and mind may co-exist in the same skull but are vastly different.

Light therapy is extremely effective as treatment and preventative for many folks with depression. There is even a sub-class of depression smartly named Seasonal Affective Disorder which is particularly sensitive to the amount of light received in the eyes. If you think about it, the word sunny is often used as a synonym for happy and dark for sadness and gloom. There is a small industry of “full spectrum” light therapy lights available.

Remember that depression can kill as surely as a heart attack. The highest rates of suicide are in the >65 age group followed by 24-35 year olds. For both these age groups the western US had the highest rates with the northeast having the lowest. There were over 32,000 suicides in the US in 2005. The long and short of treatment involves a working relationship with your doctor. Open and frank conversation about what is going on can help your physician make informed recommendations about treatment options and referral to specialists if needed.

We hope that this information has been helpful to you and yours. By the way that buck never came back and I had to live with that till the following year’s hunt in which I redeemed myself.

Be safe and enjoy the outdoors.