Self Injury and Depression

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My name is Shannon and I am 27 yrs old. I am a recovering cutter, have Bipolar and Borderline Personality Disorder.
I have been cutting since I was 14, a year after my first rape. Of all days, it happened on Valentine's Day, and I honestly have not had a nice one since. I had no idea of coping and only my very best friend knew. So my idea was if others have the ability to hurt me, I should hurt myself and relieve the pain. So I started cutting my wrists, thighs and upper arms. At first it was just scratching with keys or pins, and then it became knives. When I was 23 I had a long awaited breakdown. I used my then BF's hunter's knife and gashed a 8 inch cut into my left wrist. It took 32 stitches and a month or out-patient therapy to find out my diagnosis of Bipolar and BPD. The BF at the time was verbally, sexually, and physically abusive. After that, it took going to counselors to realize that I didn't need him anymore, if ever. I have been going to therapy fairly regularly and taking med's since.
After that incident, I vowed never to use self harm as a coping mechanism again, but I did one last time about 2 years ago. Only that time I totally regretted it. It didn't leave a scar but in my mind it did. Sometimes now I get the urge, and I even will put a cold piece of metal (keys, knives, needles) up to my skin just to FEEL it. I refuse though because of my family. It's not really ME that's not doing it, it's as if my parents and sister are holding my hand back saying "no, not again"...so I don't.
Now I lead a disability/SSI life of sitting on the computer! I wanted to do this site after I saw so many people needed help in different ways. I want to create a new avenue for imagination, poetry, art, etc so maybe others will do that instead of thinking how miserable life can be! SO not only is this for YOU, but it's secretly for me too, to occupy my time LOL I am NOT stupid, a freak...people with manic depression and social/personality disorders can definitely be absolute geniuses, and are extremely intelligent. We just don't know how to process and organize our thoughts straight all the time. Tell me if I'm wrong! Please feel free to use this site as you wish, and talk to me anytime!
Hello, I'm Shaye and am working with Shannon, on this new page.
I am now 23, and have been someone who self-injures for 9 years. I started when I was 14. I started out as cutting. I remember my first time, like it was yesterday. I had a hard time with expressing myself verbally and at first resorted to physical pain to do the expressing for me. Over the years, it progressed and still can be a way for me to keep grounded and stay with reality. I, unfortunately resort to more than just cutting. I've hurt myself significantly. I've been someone who burns themselves, bruises themselves, hits themselves and the list continues. I dissociate a lot. It has become something I do when I am happy, nervous, afraid, depressed, anxious, or just feeling okay. It, over the years developed into an addiction and am just compelled at times do it. I look at my arms, thighs, stomach, wrists, calves and see all the scars, and I just feel like I need to make more.
Since May, I have been hospitalized once, but my third time over the years. I stayed there for a week and was released to a Partial Program, and from there, back into my intensive outpatient therapy. I've been doing this IOP for a year now.
I am only sharing this, in hopes that someone might be able to relate to this, and know that they are not alone... YOU are not alone in any of this.
As far as diagnosis, over the years, there has been quite a list. I've been diagnosed with Depression, Anxiety/Panic Disorder, Bulimia, Bipolar - Rapid Cycling, PTSD, and Borderline Personality Disorder. In no way am I glorifying any of this... and let me say this now... YOU are NOT your diagnosis. You are an INDIVIDUAL.
I know this has been lengthy, and I do apologize. I go on tirades, frequently. But I do also want to say, that there is a lot of support here and in your communities. Things that I find bennificial are, peer-to-peer support groups (for me, face to face, not through the internet), therapy, family therapy and a Dialectical Behavior Therapy.
If anyone would like further information on Bipolar or Depression, there is a great website, http://www.dbsalliance.org/site/PageServer?pagename=home. This is the peer-to-peer support group that I just mentioned.
As it has been said before, please, please free to express yourself here. Get things out, vent, rant, whatever you need.
Bipolar Disorder What Is Bipolar Disorder?Bipolar disorder goes by many names: Manic depression, manic-depressive disorder, manic-depressive illness, bipolar mood disorder, and bipolar affective disorder are all medical terms for the same condition.
Bipolar disorder is classified into four different types: Bipolar I, Bipolar II, Cyclothymic Disorder, or Bipolar Disorder Not Otherwise Specified. Mental health experts separate the condition into these four types because the symptoms of bipolar disorder show up differently in different people. When doctors know what type a person has, they can tailor treatment to that person's specific needs.
Bipolar disorder affects both men and women. For many people, the first symptoms show up in their early twenties. However, research has shown that the first episode of bipolar disorder is occurring earlier: The condition often shows up in adolescence, and even children can have it.
Recent research suggests that kids and teens with bipolar disorder don't always have the same behavioral patterns that adults with the disorder do. For example, kids who have bipolar disorder may experience particularly rapid mood changes and may have some of the other mood-related symptoms listed below, such as irritability and high levels of anxiety. But they may not show other symptoms that are more commonly seen in adults.
Because brain function is involved, the ways people with bipolar disorder think, act, and feel are all affected. This can make it especially difficult for other people to understand the condition. It can be incredibly frustrating if other people act as though someone with bipolar disorder should just "snap out of it," as if a person who is sick can become well simply by wanting to. Bipolar disorder isn't a sign of weakness or a character flaw; it's a serious medical condition that requires treatment, just like any other condition.
Self-Injury
Self-injury, sometimes referred to as self-harm (SH), self-inflicted violence (SIV), self-injurious behavior (SIB) refers to a spectrum of behaviors where demonstrable injury is self-inflicted. [3] The term self-mutilation is also sometimes used, although this phrase evokes connotations that some find worrisome, inaccurate, or offensive. [3] A broader definition of self-injury might also include those who inflict harm on their bodies by means of disordered eating, as well as tattooing or body piercing that goes beyond the limits of culturally accepted body modification.
Self-injury is not associated with suicidal or para-suicidal behavior. The person who self-injures is not usually seeking to end his or her own life, but is instead using self-injury as a coping mechanism to relieve emotional pain or discomfort.[4]
A common misconception regarding self-injury is that it is an attention seeking behavior. In point of fact, people who self-injure are very self-conscious of both their wounds and scars, and go to great lengths to conceal their behavior from others. They may offer alternative explanations for their injuries, or conceal their scars with clothing.[5][6]
Methods of injury
A common form of self-injury involves making cuts in the skin of the arms, legs, abdomen, inner thighs, etc. This is colloquially referred to as "cutting"; a person who routinely does this may be colloquially called "a cutter". The number of self-injury methods are only limited to an individual's creativity. The bodily locations of self-injury often are areas that are easily hidden and concealed from the detection of others.[7]
Examples of self-injury other than cutting include:
* Punching, hitting and scratching
* Choking, constricting of the airway
* Self-biting of hands, limbs, tongue, lips, or arms
* Picking at wounds, ulceration, or sutures
* Burning, including cigarette burns, and self-incendiarism (as well as eraser burns)
* Stabbing self with wire, pins, needles, nails, staples, pens, or hair accessories
* Ingesting corrosive chemicals, batteries, or pins[8]
* Self-poisoning; for example by over-dosing on medication and/or alcohol, without suicidal intent[5]
Other definitions
Strictly speaking, self-harm is a general term for self-damaging activities (which could include such activities as alcohol abuse or bulimia). Self-injury refers more specifically to the practice of cutting, bruising, poisoning, over-dosing (without suicidal intent), burning, or otherwise directly injuring the body.[9] Many people, including health-care workers, define self-harm based around the act of damaging one's own body. It may be more accurate to define self-harm based around the intent, and the emotional distress that the person wishes to deal with. An example of this form of definition is provided by the self-injury awareness charity, LifeSIGNS.[10]
Neither the DSM-IV-TR nor the ICD-10 provide diagnostic criteria for self-injury. It is often seen as only a symptom of an underlying disorder,[4] though many people who self-injure would like this to be addressed.[6]
Self-inflicted wounds is a specific term associated with soldiers, where they inflicted harm on themselves (commonly a shot in the foot or hand) in order to obtain early dismissal from combat.[11][12]This differs from the common definition of self-injury as the damage is inflicted for a specific secondary purpose.
If you need someone to talk to, and we cannot be of service, please call:
1-800-Suicide
1-800-273-Talk
National Domestic Hotline:1-800-799-SAFE
RAINN-1-800-656-HOPE
or visit:
WWW.THEHOPELINE.COM
www.selfmutilatorsanonymous.org/
or check out:
http://www.heart7.net/self-inj.html
What is Borderline Personality Disorder?
Borderline personality disorder (BPD) is a serious mental illness characterized by pervasive instability in moods, interpersonal relationships, self-image, and behavior. This instability often disrupts family and work life, long-term planning, and the individual's sense of self-identity. Originally thought to be at the "borderline" of psychosis, people with BPD suffer from a disorder of emotion regulation. While less well known than schizophrenia or bipolar disorder (manic-depressive illness), BPD is more common, affecting 2 percent of adults, mostly young women.1 There is a high rate of self-injury without suicide intent, as well as a significant rate of suicide attempts and completed suicide in severe cases.2,3 Patients often need extensive mental health services, and account for 20 percent of psychiatric hospitalizations.4 Yet, with help, many improve over time and are eventually able to lead productive lives. SymptomsWhile a person with depression or bipolar disorder typically endures the same mood for weeks, a person with BPD may experience intense bouts of anger, depression, and anxiety that may last only hours, or at most a day.5 These may be associated with episodes of impulsive aggression, self-injury, and drug or alcohol abuse. Distortions in cognition and sense of self can lead to frequent changes in long-term goals, career plans, jobs, friendships, gender identity, and values. Sometimes people with BPD view themselves as fundamentally bad, or unworthy. They may feel unfairly misunderstood or mistreated, bored, empty, and have little idea who they are. Such symptoms are most acute when people with BPD feel isolated and lacking in social support, and may result in frantic efforts to avoid being alone.
People with BPD often have highly unstable patterns of social relationships. While they can develop intense but stormy attachments, their attitudes towards family, friends, and loved ones may suddenly shift from idealization (great admiration and love) to devaluation (intense anger and dislike). Thus, they may form an immediate attachment and idealize the other person, but when a slight separation or conflict occurs, they switch unexpectedly to the other extreme and angrily accuse the other person of not caring for them at all. Even with family members, individuals with BPD are highly sensitive to rejection, reacting with anger and distress to such mild separations as a vacation, a business trip, or a sudden change in plans. These fears of abandonment seem to be related to difficulties feeling emotionally connected to important persons when they are physically absent, leaving the individual with BPD feeling lost and perhaps worthless. Suicide threats and attempts may occur along with anger at perceived abandonment and disappointments.
People with BPD exhibit other impulsive behaviors, such as excessive spending, binge eating and risky sex. BPD often occurs together with other psychiatric problems, particularly bipolar disorder, depression, anxiety disorders, substance abuse, and other personality disorders.
Treatment
Treatments for BPD have improved in recent years. Group and individual psychotherapy are at least partially effective for many patients. Within the past 15 years, a new psychosocial treatment termed dialectical behavior therapy (DBT) was developed specifically to treat BPD, and this technique has looked promising in treatment studies.6 Pharmacological treatments are often prescribed based on specific target symptoms shown by the individual patient. Antidepressant drugs and mood stabilizers may be helpful for depressed and/or labile mood. Antipsychotic drugs may also be used when there are distortions in thinking.
Recent Research Findings
Although the cause of BPD is unknown, both environmental and genetic factors are thought to play a role in predisposing patients to BPD symptoms and traits. Studies show that many, but not all individuals with BPD report a history of abuse, neglect, or separation as young children.8 Forty to 71 percent of BPD patients report having been sexually abused, usually by a non-caregiver.9 Researchers believe that BPD results from a combination of individual vulnerability to environmental stress, neglect or abuse as young children, and a series of events that trigger the onset of the disorder as young adults. Adults with BPD are also considerably more likely to be the victim of violence, including rape and other crimes. This may result from both harmful environments as well as impulsivity and poor judgement in choosing partners and lifestyles.
NIMH-funded neuroscience research is revealing brain mechanisms underlying the impulsivity, mood instability, aggression, anger, and negative emotion seen in BPD. Studies suggest that people predisposed to impulsive aggression have impaired regulation of the neural circuits that modulate emotion.10 The amygdala, a small almond-shaped structure deep inside the brain, is an important component of the circuit that regulates negative emotion. In response to signals from other brain centers indicating a perceived threat, it marshals fear and arousal. This might be more pronounced under the influence of drugs like alcohol, or stress. Areas in the front of the brain (pre-frontal area) act to dampen the activity of this circuit. Recent brain imaging studies show that individual differences in the ability to activate regions of the prefrontal cerebral cortex thought to be involved in inhibitory activity predict the ability to suppress negative emotion.
Serotonin, norepinephrine and acetylcholine are among the chemical messengers in these circuits that play a role in the regulation of emotions, including sadness, anger, anxiety, and irritability. Drugs that enhance brain serotonin function may improve emotional symptoms in BPD. Likewise, mood-stabilizing drugs that are known to enhance the activity of GABA, the brain's major inhibitory neurotransmitter, may help people who experience BPD-like mood swings. Such brain-based vulnerabilities can be managed with help from behavioral interventions and medications, much like people manage susceptibility to diabetes or high blood pressure.
Future Progress
Studies that translate basic findings about the neural basis of temperament, mood regulation, and cognition into clinically relevant insights�which bear directly on BPD�represent a growing area of NIMH-supported research. Research is also underway to test the efficacy of combining medications with behavioral treatments like DBT, and gauging the effect of childhood abuse and other stress in BPD on brain hormones. Data from the first prospective, longitudinal study of BPD, which began in the early 1990s, is expected to reveal how treatment affects the course of the illness. It will also pinpoint specific environmental factors and personality traits that predict a more favorable outcome. The Institute is also collaborating with a private foundation to help attract new researchers to develop a better understanding and better treatment for BPD.
Depression
What is Depression?
The word 'depression' causes much confusion. It is often used to describe when someone is feeling 'low', 'miserable', 'in a mood', or having 'got out of bed on the wrong side'. However, doctors use the word in two different ways. They can use it to describe the symptom of a 'low mood', or to refer to a specific illness, ie a 'depressive illness'. This factsheet, relates to depression - the illness.
This confusion is made all the worse because it is often difficult to tell the difference between feeling gloomy and having a depressive illness. Doctors make a diagnosis of depression after assessing the severity of the low mood, other associated symptoms and the duration of the problem.
Depression is very common. Almost anybody can develop the illness; it is certainly NOT a sign of weakness. Depression is also treatable. You may need to see a doctor, but there are things you can do yourself or things you can do to help somebody suffering from the illness. What you cannot do is 'PULL YOURSELF TOGETHER' - no matter whether this is what you think you should be able to do, or what other people tell you to do.
People who have experienced an episode of depression are at risk of developing another in the future. A small proportion may experience an episode of depression as part of a bipolar affective disorder (manic depression) that is characterised by episodes of both low and high moods.
Who gets depressed?
* Depression is very common.
* Between 5 and 10 per cent of the population are suffering from the illness to some extent at any one time.
* Over a lifetime you have a 20 per cent, or one in five, chance of having an episode of depression.
* Women are twice as likely to get depression as men.
* Bipolar affective disorder is less common than depressive illness with a life-time risk of around 1-2 per cent. Men and women are equally affected.
Getting depression is not a sign of weakness. There are no particular 'personality types' that are more at risk than others. However, some risk factors have been identified, these include inherited (genetic) factors, such as having parents or grandparents who have suffered from depression and non-genetic factors such as the death of a parent when you were young.
What causes depression?
* We do not fully understand the causes of depression.
* Genes or early life experiences may make some people vulnerable.
* Stressful life events, such as losing a job or a relationship ending, may trigger an episode of depression.
* Depression can be triggered by some physical illnesses, drug treatments and recreational drugs.
It is often impossible to identify a 'cause' in many people and this can be distressing for people who want to understand the reasons why they are ill. However depression, like any illness, can strike for no apparent reason.
It is clear that there are definite changes in the way the brain works when a person is depressed:
* Modern brain scans that can look at how 'hard' the brain is working have shown that some areas of the brain (such as at the front) are not working as well as normal.
* Depressed patients have higher than normal levels of stress hormones.
* Various chemical systems in the brain may not be working correctly including one known as the serotonin or 5-HT system.
* Antidepressants may help to reverse these changes.
Symptoms of depression
*Stress can lead to you to feeling 'down' and 'miserable'. What is different about a depressive illness is that these feelings last for weeks or months, rather than days. In addition to feeling low most or all of the time, many other symptoms can occur in depressive illness (though not everybody has every one).
* Being unable to gain pleasure from activities that normally would be pleasurable.
* Losing interest in normal activities, hobbies and everyday life.
* Feeling tired all of the time and having no energy.
* Difficulty sleeping or waking early in the morning (though some feel that they can't get out of bed and 'face the world').
* Having a poor appetite, no interest in food and losing weight (though some people overeat and put on weight - 'comfort eating').
* Losing interest in sex.
* Finding it difficult to concentrate and think straight.
* Feeling restless, tense and anxious.
* Being irritable.
* Losing self-confidence.
* Avoiding other people.
* Finding it harder than usual to make decisions.
* Feeling useless and inadequate - 'a waste of space'.
* Feeling guilty about who you are and what you have done.
* Feeling hopeless - that nothing will make things better.
* Thinking about suicide - this is very common. If you feel this way, talk to somebody about it. If you think somebody else might be thinking this way, ask them about it - IT WILL NOT MAKE THEM MORE LIKELY TO COMMIT SUICIDE.
How is depression diagnosed?
Unfortunately there is no brain scan or blood test that can be used to diagnose when a person has a depressive illness. The diagnosis can only be made from the symptoms. Generally speaking a diagnosis of depression will be made if a person has a persistently low mood that significantly influences their everyday life and has been present for two weeks or more, and there are also three or four or more other symptoms of depression.
Eating Disorders
What is an eating disorder?
An eating disorder is a complex compulsion to eat, or not eat, in a way which disturbs physical and mental health. The eating may be excessive (compulsive over-eating); too limited (restricting); may include normal eating punctuated with episodes of purging; may include cycles of binging and purging; or may encompass the ingesting of non-foods. The most heard about eating disorders are Anorexia nervosa and Bulimia nervosa. The most widely and rapidly spreading eating disorder is compulsive overeating or Binge eating disorder. These are also the three most common eating disorders. All three have severe consequences to a person's immediate and long-term health and can cause death. There are numerous theories as to the causes and mechanisms leading to eating disorders. Contents
* 1 Types
o 1.1 Anorexia Nervosa
o 1.2 Bulimia Nervosa
o 1.3 Binge-Eating Disorder
* 2 Causes and mechanisms
o 2.1 Environmental factors
o 2.2 Family Relationships
o 2.3 Biological/Genetic factors
o 2.4 Addiction
o 2.5 Developmental etiology
* 3 External links
* 4 References
o 4.1 Journal references
o 4.2 Book references
o 4.3 Online references
Types
* Anorexia nervosa
* Starvation diet
* Binge eating disorder
* Bulimia nervosa
* Diabulimia
* Eating disorder not otherwise specified
* Orthorexia
* Hyperphagia
* Rumination
* Pica
* Night eating syndrome
Eating disorders are characterized by an abnormal obsession with food and weight. Eating disorders are much more noticed in women than in men. This can be attributed to the fact that society is seen to put an emphasis on women to be thin, and men to be 'bulked up'. This can lead to pressure on women to be 'picture perfect', and an eating disorder prevails as a result of stress of not being able to reach unattainable goals related to this 'picture perfect' ideal. Researchers who study eating-disordered thoughts and behaviors suggest that the media, women’s magazines in particular, may play a role in triggering these practices.
Anorexia Nervosa
The American Psychiatric Association [2] defines anorexia nervosa as the presence of an abnormally low body weight (15% below normal body weight for age and height), the intense fear of gaining weight or becoming fat, disturbance and preoccupation with body weight and shape, and amenorrhoea (the absence of three consecutive menstrual cycles). Anorexia can be life-threatening as victims commonly refuse to eat and drastically lose weight. Anorexics are commonly perfectionists, driven to succeed; yet they set unattainable standards of performance for themselves. When they fail to meet these standards, they look for a part of their lives they can control; food and weight become that “control” for them. Low self-esteem and constant self-criticism cause anorexics to constantly fear losing control, and even consuming a small amount of food could be considered a loss of control [3]. One thousand women die of anorexia nervosa each year, and millions more suffer from the destructive physical compications [4].
Bulimia Nervosa
Bulimia nervosa is characterized by the recurrent episodes of bingeing (eating large quantities of food over short periods of time) followed by attempts to compensate for the excessive caloric intake by such purging behaviors as self-induced vomiting, laxative abuse, severe restrictive dieting or fasting, or excessive exercise [2]. Bulimics often have "binge food," which is the food they typically consume during binges (high-carb, high fat, foods). Some have described their binge episodes as a physical high they feel, numbing out, going into auto-pilot, losing all control, immediate comfort, etc. The reasoning or triggers behind a binge may serve different purposes for different people. This binge episode leads the individual to feel guilt, shame, embarrassment, and complete failure. Bulimics try to regain control of themselves and the situation by purging the food – making up for their mistake. This leads to feeling famished and empty again, and therefore, another uncontrollable binge, followed by feeling powerless, and the vicious binge/purge cycle continues. Bulimics have extreme eating and exercising habits, instead of demonstrating moderation. This compulsive behavior is often echoed in similar destructive behavior such as sexual promiscuity, pathological lying, and shoplifting. Some bulimics not only struggle with the eating disorder, but these other harmful behaviors as well.
Binge-Eating Disorder
This is often referred to as Compulsive Overeating. Binge-eating disorder is similar to bulimia in the recurrent episodes of bingeing; however, binge-eaters do not engage in any purging behavior or attempt to rid themselves of the food in any way [3]. Binges often take place in secret, when the person is alone, since feelings of shame and disgust often accompany the binge. Binge eaters typically eat very rapidly, hide food, and stuff themselves to the point of feeling sick. Some binge eaters may eat to fill an emotional void or spiritual emptiness they feel, in a desperate effort to be satisfied. This is called emotional eating, which is a coping mechanism for stress, depression, anxiety, anger, and many other negative emotions.
Patients with eating disorders may also have a comorbid diagnosis of, mood disorder, severe mental depression,[4] Obsessive compulsive disorder, Body dysmorphic disorder, Bipolar disorder, self-harm[5] personality disorders and substance abuse disorders. Sexual abuse is also frequently reported among those with eating disorders. Women with eating disorders show poorer eating self-efficacy, psychological distress, disinhibition, low self-esteem, less helpful coping strategies, more frequent sensations of hunger, and less cognitive restraint when compared to control groups.
Some psychologists also classify a syndrome called orthorexia as an eating disorder, or, more properly, "disordered eating" - the person is overly obsessed with the consumption of what they see as the 'right' foods for them, to the point that their nutrition and quality of life suffers (although due to cultural and political factors which influence food choices, this idea is considered controversial by some). In addition, some individuals have food phobias about what they can and cannot eat, which can be characterized as an eating disorder. The UK broadcaster BBC Three have shown a series called Freaky Eaters that deals with such topics.
Somewhat qualitatively different from those conditions previously mentioned is pica, or the habitual ingestion of inedibles, such as dirt, wood, hair, etc.
The American Psychiatric Association recognizes eating disorders.

Self-Medication Often Coexists With Depression
According to About Alcoholism Guide, BuddyT, nearly half of all alcoholics have an overlapping mental illness. Further, at least 50 percent of the 2 million Americans with severe mental illness abuse illicit drugs or alcohol, compared to 15 percent of the general population. Clearly alcohol and drug abuse are often a complication to mental illness.
When depression or other mental illness is coexistent with alcohol or drug abuse this is known as "dual diagnosis". If the abuse is a result of the mental illness, it may also be referred to as "self-medication", meaning that the person is using the drug as a means of coping with the symptoms of their illness.
Because it is easy to obtain and socially acceptable, alcohol is one of the most popular drugs chosen for self-medication. Rather ironically, alcohol is classified as a depressant and can accentuate many of the symptoms of depression. It can also interfere with a person's ability to successfully resolve the very situations that may have originally caused their depression.
In addition, alcohol is incompatible with many of the drugs used to treat depression. It can intensify the sedative effects of tricyclic antidepressants, such a Elavil. (1) Chronic alcohol consumption can increase the availability of some antidepressants while decreasing the availability of others. (2,3) Tyramine, a substance found in beer and wine, can interact with MAOIs potentially causing a dangerous in blood pressure. (4) Consult your physician or pharmacist for specific precautions regarding your own medications.
There is much debate as to whether one drug of abuse, marijuana, might actually help depression. Participants in a 1997 pilot study (5) reported that one of the reasons they continued to smoke marijuana was that they felt it relieved their symptoms of depression and anxiety. Another study (6) found that marijuana did not seem to exacerbate depression, but rather was another symptom of the condition. Although there is preliminary evidence that marijuana may have antidepressant properties, many argue there are also some important drawbacks to it's usage. There is a well-known phenomenon called "amotivational syndrome" in which chronic cannabis users become apathetic, socially withdrawn, and perform at a level of everyday functioning well below their capacity prior to their marijuana use. Although the depressed person may feel relief from their symptoms, this may be an illusion of well-being if the person loses motivation and productivity. Furthermore, if the drug is smoked, it can be far more harmful to the respiratory system that tobacco use because of the fact that it is not filtered.