David Letterman Talks to Oprah About Depression Struggle

In the first 2013 episode of Oprah’s Next Chapter, Oprah sat down with Late Show host David Letterman.

The interview covered a variety of topics, including his sex scandal, his quintuple bypass heart surgery in 2000, and his alleged “feuds” with Jay Leno and Oprah herself.

He also spent some time talking about his struggles with depression, which he describes as a being in a “sinkhole.”

Letterman first acknowledged his diagnosis in 2010. Appearing on Live with Regis and Kelly, Letterman said the sex scandal surrounding his workplace affairs had triggered his depression.

Letterman also revealed that he sees a therapist once a week, and takes an SSRI (anti-depressive medication).

Do You Know the Signs of Depression?

Someone who is depressed has feelings of sadness or anxiety that last for weeks at a time. He or she may also experience:

  • Feelings of hopelessness and/or pessimism
  • Feelings of guilt, worthlessness, and/or helplessness
  • Irritability, restlessness
  • Loss of interest in activities or hobbies once pleasurable
  • Fatigue and decreased energy
  • Difficulty concentrating, remembering details, and making decisions
  • Insomnia, early-morning wakefulness, or excessive sleeping
  • Overeating, or appetite loss
  • Thoughts of suicide, suicide attempts
  • Persistent aches or pains, headaches, cramps, or digestive problems that do not get better, even with treatment

What are SSRI’s?

Selective Serotonin Re-uptake Inhibitors (SSRIs) are a class of compounds typically used as antidepressants in the treatment of depression, anxiety disorders, and some personality disorders. Some of the most commonly used ones include:

  • Fluoxetine (Prozac)
  • Citalopram (Celexa)
  • Sertraline (Zoloft)
  • Paroxetine (Paxil)
  • Escitalopram (Lexapro)

Neurotransmitters are chemicals that transmit signals from one nerve cell (neuron) to another across a gap called a synapse. The neurotransmitter is released from the first neuron (pre-synaptic neuron), travels across the gap and affects specific receptors on the next nerve cell thereby continuing the signal down the line. Common neurotransmitters include serotonin, dopamine, epinephrine, as well as others.

Serotonin, helps regulate sleep, appetite, and mood and inhibits pain.

After being released into a synapse, serotonin is removed from the gap by being moved back into the pre-synaptic neurons by a special serotonin transporter (a serotonin re-uptake site).

In depression, the levels of serotonin in the synapse may be low, leading to the symptoms of the disease.

SSRI’s work by blocking the re-uptake transporter. This leaves more serotonin in the gap and improves the transmission across it.

The most common side effects associated with SSRIs include:

  • Headache, which usually goes away within a few days.
  • Nausea (feeling sick to your stomach), which usually goes away within a few days.
  • Sleeplessness or drowsiness, which may happen during the first few weeks but then goes away.
  • Agitation (feeling jittery).
  • Sexual problems, which can affect both men and women and may include reduced sex drive, and problems having and enjoying sex.

 

Michele R. Berman, M.D. was Clinical Director of The Pediatric Center, a private practice on Capitol Hill in Washington, D.C. from 1988-2000, and was named Outstanding Washington Physician by Washingtonian Magazine in 1999. She was a medical internet pioneer having established one of the first medical practice websites in 1997. Dr. Berman also authored a monthly column for Washington Parent Magazine.

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