5) Depression is fueled by an inner critic. We all have an inner critic, what my father, psychologist Dr. Robert Firestone , refers to as your " critical inner voice ." For people who are depressed, this critical inner voice can have a powerful and destructive influence on their state of mind. It may be feeding them a distorted commentary on their lives: You are too fat to leave the house. You are so stupid. No one will ever love you. You aren't capable of being happy. You will never succeed at anything . The critical inner voice may then persuade you to act in destructive ways: Just be by yourself; no one wants to see you. Have another piece of cake; it will make you feel better. You shouldn't even try for that job; you'll never get it. Finally, once you've listened to its directives, the critical inner voice will attack you for your actions: You are such a loser, staying home alone on a Saturday. You messed up your diet again. What is wrong with you? You'll never get a decent job. You're so lazy .
In many cases, it's the spouse or children who has detected a change in personality over the past several years -- "He/She is more cranky than he/she used to be; he/she has a shorter fuse and is quicker to anger than he/she used to be". In some cases, its ONLY the spouse who notices a big difference in the patient with the parathyroid problem, while the person with the parathyroid problem will claim they don't see much difference in their personality. After the parathyroid operation, spouses typically comment that their husband or wife sleeps better, can remember things better, and is easier to get along with -- "After the operation, he/she quickly returned to his/her old self again!". As Dr Norman says: "A good parathyroid surgeon can save a lot of marriages!"
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