Evolutionarily speaking, it seems likely that depression/anxiety are there for some purpose, and yet we treat them both like meaningless pain meant only to be banished using drugs. I believe both are signals that something in our environment is not working for us. They indicate emotional or physical needs unmet---needs for safety, autonomy, connection, etc.
Often the individual suffering is fundamentally unaware of their own circumstances. I didn't realize how messed up my family relationships were growing up until much later. There are various reasons for this unawareness, but I believe the depression/anxiety are there to force our conscious self and the people around us to acknowledge that something is wrong.
This isn't just the old nonsense about depressed people needing to cheer up, and that it will pass in a day. This is a completely different paradigm that explains depression and anxiety as meaningful signals of underlying problems rather than as inexplicable suffering to be numbed through prescription medication. I believe it will prove the more robust and also the wiser way of looking at these experiences.
> Often the individual suffering is fundamentally unaware of their own circumstances. I didn't realize how messed up my family relationships were growing up until much later. There are various reasons for this unawareness, but I believe the depression/anxiety are there to force our conscious self and the people around us to acknowledge that something is wrong.
If a situation is causing no problems outside of depression/anxiety, and you took away the depression/anxiety mechanism, there would be nothing wrong with it.
If there are other problems, then piling depression on top makes it harder to fix.
A lot of medical conditions cause chronic pain. The pain helpfully signals "something is wrong" once, and then keeps unhelpfully reminding over and over. You want to treat the pain itself in that situation. Sometimes the pain is the only thing you need to treat at all.
Being an indicator of other problems does not make chronic pain useful. Depression is similarly crippling and unhelpful.
I've often held that the most insidious part about clinical depression is its self-reinforcing nature. Deep clinical depression is throwing a person into a deep hole with thorns sticking out of the sides- every attempt to climb out of said hole results in swollen cuts and pain to the arms and body, rendering eventual escape more difficult with each struggle.
Eventually, it becomes like trying to climb out of said hole with no arms at all. It's one of my life goals to discover biochemical methods to help such people regain the use of their arms, or even essentially grow new ones.
I find articles like this one useful ONLY* insofar as they assist those who have gained use of their arms and cut away the brambles on the walls of the pit- for most others, it merely ends up encouraging more struggling, self-recriminations, and effectually a deepening of the hole. :(
Depression gives you the power to make really big decisions. Everything hurts about the same. Going to work is about as painful as staying home, meaning it's easier to quit a horrible job. It's easier to divorce an abusive partner. It's easier to pack up life and start over.
Having been through extreme depression multiple times, I can say with confidence that it makes those really big, really scary decisions a lot easier. You get thoughts like "it would all be over if I never saw that person again". "I would enjoy life if I got a divorce and moved back to my home town". "My job is abusive and it's slowly killing me, having no income is better than hating 70 hours of every waking week".
If you are depressed and having those types of thoughts, you might actually be right. Following through on those major, traumatic changes might actually be what you need to do. And depression makes it easy to do so. Normal life becomes so bad that change is welcome, because change feels like a way out.
In that model, what you need to fix is not to remove the trigger (e.g. the pollen may be safe) nor to inhibit the ability to respond (sometimes you need a big immune reaction) but instead to focus on whatever's gone awry with the fiddly logic in the middle that normally regulates frequency/severity/duration.
If that were the case, then the "depression reaction" might be a useful adaptation... but for some people it's occuring disproportionately.
The article's premise is that having one's core psychological needs go unmet is like having a broken bone.
If you take away the pain from a broken bone, you still have a broken bone. As you say, there is nothing wrong with taking the pain away. But the bone is still broken, and limits you in ways that a healthy bone would not.
Taking away the symptoms of an unwell psyche still leaves you disabled, even if it isn't as outwardly evident as a broken bone.
There are often complex psychosocial factors involved, with access to disability benefits playing a substantial role in a large proportion of cases. Long-term use of opiates can cause hyperalgesia and rebound pain due to tolerance and withdrawal. Chronic pain is not simply a spontaneous biological phenomenon.
In the relational frame theory that underpins acceptance and commitment therapy, similar mechanisms are seen as integral to chronic anxiety and depression. Experiential avoidance is a common response to unpleasant emotions, but avoiding stimuli that trigger painful emotions tends to cause a paradoxical increase in the intensity and frequency of those painful emotions. Managed exposure to these stimuli is an essential component of a wide range of behavioural therapies.
My experience with SSRI's has been that taking away that mechanism is taking away creativity, emotional range, and introspective ability. Reality distortion is reality distortion. I reject procrustean medicine that fits humans to the mold of what is best for society, which is the primary environment in which anxiety/depression originate.
There probably aren't any scenarios where, if you just removed the depression/anxiety "everything else" would be just fine.
What has happened is this: mainstream culture claims that these scenarios are fine when they are not, and so people seek to remove the depression and/or anxiety from them without even questioning whether the scenarios themselves are very healthy.
You're unable (unwilling) to accept that these circumstances are bad. You don't want to change them, you want reality to be something other than it is so that your culture can continue as it has without changing and growing. You would prefer that people numb themselves to it rather than address these defects.
The article's example is full of these.
* People pushed into college who do not want to be there * Parents of young children divorcing * Parents of young children remarrying * Shallow friendships * Hookups
These are not problems that will be easier to fix if he's doped up on prozac, they aren't problems you probably even want to acknowledge as such.
Additionally, chronic pain conditions generally strike late in life whereas depression/anxiety come earlier. The emotional pain seems more likely to be adaptive whereas the seemingly meaningless physical pain later in life seems more like people's bodies breaking down.
Thanks for the critique.
The problem is that the connection between depression/anxiety and interpersonal relationships has been programmed into our systems by evolution. So the question remains if it is wise to alter our biochemistry to suppress mental illness.
Though it must have some function or evolution would have got rid of it. My theory is keeping your head down may be helpful if you are screwing up socially. These days if the people who know you don't like you you can just move but in the hunter gatherer days that may have been fatal.
Similar with depression. Unless it is severe, it gives a hint to try to change something. Those changes can be really small, like getting enough sleep, or going to sea once in a while, or talking to an old buddy, or joining some volunteer activity. The key is to try and recognize the feedback that is impossible under antidepressants.
It's not even that they are lying, but we humans are very good at hiding truths, even from ourselves. It can be very hard to truly admit that one is unhappy about one's life, and frankly many people have never really experienced a true sense of fulfillment, peace, belonging, purpose and happiness, and don't know what it would feel like or understand how lacking the feeling is in their lives.
"My life is fine" generally means "I've checked the right boxes: 'success', 'friends', a relationship, but I still feel empty." Don't use drugs to numb that feeling. Listen to it.
These symptoms can be caused by trauma that happened in the long ago past. Your current life situation could actually be fine but you have symptoms of past trama.
Seen too many people running around making drastic changes in their lives in an attempt to feel happy but each change just brings more depression because it doesn't work.
"Just make a change in your life" is some feel good bullshit. It's not that simple.
Seriously though, compared to being depressed when you can't fix it because you don't have any idea that something is wrong, drugs are fucking amazing. The shitty part is people end up trapped now as the drugs can fuel the negativity which lead to the depression in the first place.
No doubt medicine has its uses in treating anxiety and depression, a momentary reprieve can grant you the clarity to see what you do need to change to feel better. However, I see many people online who cling so strongly to the idea that anxiety and depression are chemical imbalances that you are unlucky enough to be predisposed to developing and that balance can only be restored through medication, that when you suggest that anxiety and depression are not diseases and so can be treated to the point that they are not a problem anymore, people will react violently, as if you just assaulted their identity.
This line of thinking makes it extremely difficult for them to get relief. It is also beneficial to pharmaceutical companies who can make a customer for life by convincing customers that if they don't have a certain medication they will always feel miserable.
What we need is to foster open discussion of both viewpoints because both are fully valid explanations of anxiety and depression. For those who truly do need[1] such medicine it is demeaning and disheartening to hear views like yours touted as the only valid point of view because it implies they are invalid, or that they're cheating because they're not managing without drugs.
I similarly take issue with the article's claim that "anxiety and depression are symptoms of psychosocial needs and threats" because it completely rejects neurological causes of anxiety and depression. There's nothing that says predisposition to neurochemical imbalances will never be more severe than what can be managed without medication. And the same can be said for environmental factors (e.g. ingested and inhaled compounds from the area around where you live, just by happening to live there).
Has anyone done a scientific study on the common root causes of anxiety and depression? Do we even know enough about the brain to be able to confidently identify the root cause?
[1] If you know there are no such people, I'd like to learn about how you know that.
It's a surprisingly cushy lifestyle, and some would do anything to keep it. And that entire structure is dependent on depression/anxiety being seen as a medical problem with no solution, only medication.
They are very vocal in it's protection.
Evolutionarily speaking, just because something has evolved does not mean it happened for a purpose, or is useful at all.
Pathological anxiety and depression may actually be purely disadvantageous mutations which nevertheless still passed evolution filters because they are not disadvantageous enough to wipe out 100% of their carriers.
Or they may have a much uglier purpose than you have assumed, for example, to force weak individuals (in)voluntarily withdraw from consuming resources useful to others, or even to kill themselves completely, which might be "wise" during foraging times but is nothing but useless breakage in civilized age.
So many adaptations are sledgehammers for a smaller problem. Evolution doesn't plan; it just diddles around until something (sort of) works. And our bodies are the unfortunate result!
After all, there are quacks out there trying to explain away cancer as a symptom, not a disease (see: http://www.goodreads.com/book/show/163184.Cancer_Is_Not_a_Di...).
You can accept or ignore this, and it won't change the science at all.
I think that suicide could have some evolutionary advantage in a group. Say there is a member of a group who has become sick, injured, or otherwise incapacitated and is unable to contribute to the group. The group must spend more work to take care of the member than they receive back from the individuals paltry, or nonexistent contributions to the group. If the member's ailment is temporary, then it would be advantageous for the group to bear the burden of taking care of the member, as they would benefit more in the long run.
However, if the member's condition is more permanent, then they represent a net loss to the group's well-being. It would then benefit the group as a whole if that member were to commit suicide, eliminating their burden from the group.
I think this is something that many individuals with suicidal ideation feel on some level. They think that they cannot contribute to their group (family, friends, job, community, country, etc), and that their lack of contribution will be indefinite. For example, a person with anxiety so bad that they are unable to leave the house or get a job might feel like a burden to their family, and unable to contribute. Or, a person with depression might have such a low opinion of themselves that they are unable to see the contributions they are making, or think that their contributions are meaningless and so feel like they are not contributing anything at all worthwhile.
Even though suicide could have had evolutionary advantages in the earlier days of human existence, in modern times I don't think this is the case any longer. With modern medicines and technologies, medical conditions are not as crippling as in the past, and there are more ways to contribute to a group than ever, even without being able to walk or leave the home. The difficulty would then seem to be either helping the suicidal individual to find a group and method of worthwhile contribution, or helping the individual to understand the ways they are already contributing to a group and why that contribution is worthwhile.
Of course, this is just a baseless theory of mine, and I would be very curious to see if there is any actual evidence to back this up.
That would also explain how people are able to get out of unexplainable depression after a period of time, and why people sometimes seem to seek out more sadness when they're already sad. They're looking for perspective.
Awareness is the goal of some forms of meditation. I'd like to see more studies on the effects of meditation on those who have various forms of depression.
Yes, that's all true IMO, but the problem is that many times, it simply isn't feasible to change your environment. So antidepressants are a good way to deal with the problem.
For instance, suppose you live in the ghetto and are constantly struggling to make ends meet. How do you change your environment here? Well, here in American, you don't. You just suffer. If it were that easy to get out of poverty, most people in that trap would do it. Indeed, many things in society seem to be actively designed to keep people trapped in poverty.
What if you're lonely because you're single and have never had any success dating, and the reason is that you're cursed with being extremely unattractive? There again, there's only so much you can do to change that. (Or worse, you have a serious physical disability, which really limits how many people are willing to date you.)
>but I believe the depression/anxiety are there to force our conscious self and the people around us to acknowledge that something is wrong.
Sounds like an interesting theory, but in reality, at least in this society, it seems to have the opposite effect: it makes you an outcast. No one wants to be around depressed people, so they're stuck being lonely, which feeds the depression, it's a vicious cycle. Antidepressants can really help a lot here, by giving you a short-term boost to jump-start your social life and just to help you cope with life in general.
>This is a completely different paradigm that explains depression and anxiety as meaningful signals of underlying problems rather than as inexplicable suffering to be numbed through prescription medication. I believe it will prove the more robust and also the wiser way of looking at these experiences.
I think the problem with this idea is that this seems to require some gigantic changes in our very culture and how we deal with people who are depressed.
A better example for anxiety or depression would be standing inside in a warm room, and despite everyone else in the room being comfortable, you are unable to warm up at all. When you complain, you are told that "everyone gets cold sometimes".
This article doesn't seem to have any new information, it's just repeating the old ideas that depression and anxiety are the same as temporary sadness and worry due to legitimate problems.
Frankly we have spent too long acting as if mental disorders could not possibly have anything to do with ones surroundings, upbringing and life in general, when it's beyond obvious that they have very much to do with those things, as well as genotype/phenotype/etc. We've used this idea that it shames individuals to suggest that the actual problems they deal with could contribute to mental damage in much the manner they can physical damage, which is simply dogma masquerading as science.
In fact, using purely neurochemical explanations denies people's humanity and lived experience, denies that we are sentient humans not some organic robots that need an serotonin oil change and some dopamine transmission fluid.
Is it clear? Or have we gotten better at diagnosing conditions that people have been experiencing all along? (Not to mention reducing stigma and making people more likely to admit to having these conditions.) In any case, citation needed.
Where does diabetes fall I to this argument? I'll concede that depression is frequently misdiagnosed, especially as a misdiagnosis for other conditions (e.g. MTHFR) and even more frequently as a self-misdiagnosis. However, this does not change the struggle of people who genuinely suffer from it.
The article is not shortcutting to a non-solution, it's pointing out that there can be overlooked root causes beyond the symptom, and this can be a very valuable thing to point out to people, leading to actionable solutions to their problem.
I was diagnosed depressed for many years, and it turned out I simply had the expected affect given I was not socializing enough, exercising enough, or sleeping well enough given an undiagnosed case of sleep apnea and a bit of a spiral from obsessing about trying to stay employed despite that affect.
Talking myself in circles, messing around with serotonin, none of this got me anywhere because it wasn't solving the actual problems. I didn't need any of that, I needed a machine that pushes air into my face at night and another one that pulls a belt below my feet in the morning, but the professionals I visited failed to prescribe these.
People have no basis of comparison when it comes to their direct subjective experience with long-lived habits so someone who exercises regularly can say "if I couch-potato too hard, I'll start to feel gross", but someone who doesn't can't as easily observe "I feel gross all the time because I never exercise enough". Likewise with hygiene, regular social exposure, sleeping properly, eating properly. It's important to think of mood as a complex function with many inputs and a good amount of feedback and delay.
Certainly it can be the case that depression is its own root cause, and one should not reject talk therapy or prescriptions to help with it, but I definitely recommend people search for something they may have overlooked.
Maybe there are good psychiatrists and therapists which will find these kinds of things, but I haven't met any. Patients should be aware they need to consider them.
What sort of therapy is that?
And here, by objectively worse, we're talking, risk their lives daily on a shoestring lifestyle that barely keeps them from not having a roof over their heads and rice or beans enough not to starve to death. Do those who risk their lives have something the comparatively wealthy depression cases lack? Are the kinds of pressure the relatively wealthy depression cases experience particularly likely to create this kind of response? What's the difference? What's the root cause?!
If we had actual, good root causes, then we'd be golden, but the problem, the HUGE PROBLEM that the paradigm espoused in the article faces, is that we DON'T have a kind of 'smoking gun' need that is not being fulfilled for people with depression. MANY, MANY people with deep depression really do have fantastic lives compared to those who suffer no depression- and moreover, admonishing people with depression to 'figure out what need is being unfulfilled in your life, and fill it' is highly toxic advice, at least in its way- based on my experience with depressed individuals, if you effectually tell depressed people to figure out what's wrong in their life and fix it- well, it's one way to obliquely encourage suicide.
Psychological diversity is a precious resource, and a society that is too inflexible to accommodate those who are particularly sensitive or have exceptionally different needs is a bad society. Depression and anxiety, and a host of other mental disorders for that matter, are an epidemic in too many countries, too many countries that are supposed to have high quality of life.
> if you effectually tell depressed people to figure out what's wrong in their life and fix it- well, it's one way to obliquely encourage suicide.
Kind of a straw man don't you think?
...and amend it to read: >'figure out (through a well-defined, detailed, objective process with the help of your psych(olog/ichiatr)ist [I'm not a medical human]) if there is a need that's being unfulfilled in your life, and make a plan to incrementally, sustainably fill it'
That changes the nature of the argument significantly. I propose that this may be a valuable line of inquiry to take before/during pharmacological treatment.
https://www.psychologytoday.com/blog/theory-knowledge/201603...
His position is that investigating the practical causes of depression and anxiety should be the first approach to diagnosis, not that it should be the only approach. It's not that cases of depression without another cause don't exist; he's just saying those cases are less common.
To compare it with physical pain, saying that most cases are symptoms of something else doesn't mean that the pain shouldn't be treated, nor that cases of unknown or genetic origin would be any less legitimate.
I am not suggesting that depression is a 'serotonin disorder', just that this class of medication does work for some with this disorder and others.
The other side of this is that exercise, MAOIs, CBT, ERP etc are effective as well.
His main argument seems to be that depression is a symptom of mucked up relationships. Googling "depression symptom relationships" his is the only article arguing that in the first 40 results. So it seems at least somewhat original.
But you have worn out doctors facing a tough choice: do the near impossible and try and help someone change their life, or take 40 second to prescribe a pill from a billion dollar drug company that is paying for him to go on a conference in the Bahamas next month.
The truth is, this PhD is not a psychiatrist, appears to have little clinical experience except whatever his "practice" has thrown his way, and, tellingly, refers to "clients" instead of "patients".
Some depression is situational, for sure, but this is not a deep observation or original thinking. The author is perhaps qualified to treat situational, temporary depression but cannot speak to clinical depression or depression that arises from mood disorders. To the extent he is in denial that these forms exist he is mistreating his "clients", and he shouldn't have the support of a bunch of smarty-pants nerds when he does it.
You're right that he isn't a psychiatrist, but he is a clinical psychologist. My educated layman's understanding is that this informs the more behaviorally/environmentally-driven view in his article, but because psychiatrists are trained from a traditional medicine/biology-focus, they are just as likely to be shifted towards the (also valid) biochemical explanations of depression (and the pharmaceutical treatments).
Everyone brings out their anecdotes about how their aunt 'just got better through positive thinking, and you can too!' Or people just throw in whatever pop-psychology is currently in fashion. If we were having this conversation in the 1950s, all the smarty-pants would be talking about how depression is simply one of the many materialisations of conflicts between the concious and unconscious mind a la Freudian psychoanalytic theory.
Thankfully our methods of scientific inquiry (if you could categorise past efforts as such) have advanced significantly, and continue to do so. Our understanding of genomics suggests that mood disorders like unipolar and bipolar depression, and even psychotic disorders like schizophrenia, represent a spectrum of possibly thousands of different 'diseases', rather than the few 'categories' arbitrarily delineated in the DSM.
Advances in neuroscience and medical imaging allow us to directly observe how different symptoms are associated with inefficient information processing in different topographically localised brain regions. As we gather more data and the verisimilitude of our observations increases (as tends to occur with rigorous scientific study), we will be able to develop new treatments; be they psycho pharmacological (e.g. drugs) or physical (e.g. trans-cranial magnetic stimulation).
Yes, psychological therapy has its use, and has proven effective in certain situations. But it is just one tool in our ever-growing toolbox. To just blithely deem the rest of the tools to be useless and throw them out is to condemn people like me to a (short) life filled with suffering.
There are a number of comments in here from people who say they were depressed for years and found some solution. People share their personal stories on the internet. It's an anonymous outlet. It is what we do. Readers can make up their own minds who to listen to. I don't hold any power over you with the words I write and nor do you over me.
"For clinical depression, you must have five or more of the following symptoms over a two-week period, most of the day, nearly every day" [1]
[1] http://www.mayoclinic.org/diseases-conditions/depression/exp...
Perhaps he should have clarified that the cause of the symptom might be situational, or it might be the result of another medical problem, e.g. brain malfunction/chemicals, genetics, nervous system disorder, cortisol issues, thyroid, hormone disorders etc., all shown to correlate with high levels of depression.
Most people who I've talked to who say it's a disease seem to believe so because they haven't identified the cause, and that brings them comfort.
But the meds, while necessary in some cases, should be avoided when possible, or weaned off quickly. They're bad news pushed by an industry that's making so much money from them, and the side effects are worse than what's being disclosed.
Gregg and his ideas run parallel to a line of thought associated with The Citizens Commission on Human Rights, a group hell bent on denouncing mental illness as a disease. CCHR are/were a nonprofit organization established in 1969 by the Church of Scientology and psychiatrist Thomas Szasz.
I can't believe people are still pushing these ideas, but this thread is rife with them. Please review your position, and make an effort to update yourself to the state of the art.
But every man and his dog has claimed they've had depression. It's like listening to a student who had to survive on ramen noodles for a few years, claim they know what starvation and poverty is like. Unbelievable.
> There are days that I feel like I am the luckiest man in the world, technically speaking
The reality is that each person's needs are different, and just because you are the luckiest man in the world based off society's values doesn't mean your individual needs are being met.
I sympathize with the fact that you have depression but I don't really see how the article is dangerous. If anything I would think that it's good to try and find/fix any underlying issues which cause the depression if possible rather than just hoping medication will make everything go away.
We still don't have a good understanding of the brain and psychological disorders..
Sudden pain isn't itself a disease, but a symptom of some other underlying issue. Why can't depression be the same way? No one here is discounting the discomfort of the depressive experience.
I'd be pretty damn depressed if I were thinking in terms of how satisfied I should be with the status quo. A person needs more than having his/her needs taken care of -- what is it? That search is part of the whole life, and you won't find any answers at all for yourself unless you're harnessing the power of depression. Labelling it as a disease will not get you anywhere but just leaves you as a bystander who unfairly got sick.
Seems more like a failing of our society to recognize the importance of relationships. I'd argue this is especially true in the US where we obsess over careers and monetary wealth much more than we emphasize the importance of friendships, family, and romance.
Considering how little we understand about the brain and psychological disorders, it seems premature to dismiss the article so easily, especially when the author is a practicing psychologist and presumably has had some level of success with his methods.
{{ citation needed }}
It's all down to personal responsibility. You have to find the drive inside to constantly push. To forget the victim mentality that society encourages. To fix one problem at a time. To fight the hellish mode that your mind has enabled.
This is what doesn't work. This approach is wrong - we already know you can't rely on peoples' willpower in normal tasks, what makes people think it will work with issues that by definition kill whatever willpower reserves you have? Talking about personal responsibility didn't cure obeseity, didn't cure alcoholism, didn't cure drug abuse - so it sure as hell isn't going to cure depression.
Now I'm not saying this is equal to putting all hope in drugs. Maybe there are other "social" approaches, but it won't help to tell people that depression is their choice.
By all accounts I have a great life, I have friends that have been with me for over 20 years, have a wife who by all my accounts is the greatest person in the world, have an amazing job that I completely love going to every day. I'm truly blessed with what I have, and could never argue otherwise.
I am a diagnosed manic depressive and I treat it like alcoholism. You're not going to see an alcoholic stand up in an AA meeting 20 years later and say "I'm not an alcoholic anymore". I treat depression the same way, you have to confront it head on each day and admit what is happening to you mentally. 10 years from now, 20 years from now, whenever. The great irony of that is that alcoholism is recognized as a disease where this article is arguing that depression isn't the same.
You can have the best life, the best people in it and still want to top yourself. To "fight the hellish mode" is such a radical oversimplification it's comical. I seriously have some of the best and most longstanding relationships with my friends that makes it most people jealous. Most people don't understand how a group of people could still be with each other after 20+ years. Yet I'm still depressed every day. It's never going away, it will always be there no matter what I do. To characterize that as victimization or lack of effort is exactly what leads people to kill themselves, because whats the point after honestly? You are literally saying their inability to foster positive relationships is what is the problem. Having nothing but positive relationships in my life I can tell you that's bullshit.
It's not interaction that fosters the problem, it's fucking depression, the disease. Get off you high horse or were going to have more Aaron Swartz's on our hands. The stigma is a 100% real, and garbage like this just makes people with depression feel more alienated.
Talking to people, making sure that they're healthy, connected, secure, and that they feel like they can express themselves is more expensive than drugging them and/or warehousing them, so I don't think that avoiding the depression diagnosis should reduce public spending or concern with the same sufferers, but raise it. I also assume that when the people who are now lumped together in depression diagnoses are dealt with with more precise approaches, there will always be places among those approaches where drugging and warehousing will be the best option.
Treating sadness with drugs is like how we try to cure poverty with teachers.
So if someone lives in germany and can give me a hint to find someone, or anyone else in any way I'd appreciate it.
You want help, right? If so, then pick up the phone, and keep searching until you find a fit.
To me this article is akin to saying that the various forms of heart disease are not actually diseases. Instead, they are symptoms of a poor diet and lack of exercise.
- Clinical depression. The disease type that for many "comes out of nowhere" and paralyzes people to the point where they can't leave bed any more. I'd venture to say it's the minority of cases but the author may be wrong in putting them in the same group as the...
- Symptom depression. That's what I think the author is talking about and what I think is the majority of cases. People who work a lot call it "burn-out". Those affected can still function in daily live but quality of life is still pretty poor.
It's probably a mistake to put the first kind in the same class as the second kind. However I think it is a far bigger mistake to treat the second kind like the first kind and that's I think what the author was trying to say (and I would very much agree with it).
>it's not a pathology
is that the medical establishment ought to respond to those who approach it in immense pain by saying, "this is working as expected, go away."
To use your analogy, if a patient presents with a problematic degree of weight loss, the appropriate response is not "yeah, that's what happens when you don't eat, bye." It's to figure out why they aren't eating, and how to get them to eat. Loss of appetite is a symptom of all sorts of pathologies, from an obsession with mass-media standards of beauty to all sorts of fun physical disorders, and a doctor would investigate these avenues and resolve whatever is responsible so that the patient starts eating again.
For more, there is
David V. Sheehan, M.D., The Anxiety Disease.
where he argues that, even after controlling on various obvious candidate variables, anxiety disease is four times more common in human females than human males. He conjectures that the difference is so great that at some time the disease must have had some reproductive advantage.
Or, some people come from just horrible backgrounds and still do not suffer from anxiety disease, while other people come from apparently ideal backgrounds and do suffer.
Of course, a child gets from their parents both nature and nurture, so we have to suspect that can be difficult to separate the two.
Still, IMHO, on this quite serious subject, the OP is a bit too simplistic.
That's an interesting bit of advice. English NICE recommends psychotherapy for front line treatment of anxiety. https://www.nice.org.uk/guidance/qs53
To make mice depressed they will do a forced swimming test (poor mice). So this is another way to induce depression: physical+psychological stress.
If there were good science with good funding it's feasible to come up with a lab test for depression--and anxiety--that's very, very accurate.
No, the article is incorrect. It does not have citations either. Explore pubmed for plenty of information. (Keep in mind the sad reality is that even good science is wrong lots of the time--I'm hedging, okay most of the time.)
The risks of not properly treating depression and anxiety is very, very high. So the article is very irresponsible in my opinion.
That doesn't really have any bearing on the accuracy of the article. PTSD is also associated with reduced hippocampal volume, which reverses with successful treatment. It isn't as if the hippocampus suddenly shrinks for no apparent reason...
>So this is another way to induce depression: physical+psychological stress.
The article is talking about psychological stress, so you're really just discussing the same underlying cause.
>No, the article is incorrect. It does not have citations either. Explore pubmed for plenty of information.
I don't see how it is incorrect. It is just discussing the problem at a systems level rather than a biochemical level. Both explanations can be correct.
>The risks of not properly treating depression and anxiety is very, very high. So the article is very irresponsible in my opinion.
On the contrary, I think it's very irresponsible to dismiss articles like this out of hand, as that will likely prevent people from seeking the correct treatment.
Similarly, keep in mind the uplifting reality that it's usually a little bit less wrong than what came before it.
The article wasn't talking about bipolar.
Haha! How true.
A analogy which would make more sense, albeit still horrible would be: you feel pain in your arm, and decide to wait, until it gets so unbearable, that you see the doctor. The doctor asks you to try and think what could be the cause, and after some time and much thinking, you finally remember that you broke your arm that one time in the 3rd grade, but didn't go to the doctor, because it healed up itself.
Hence, you have a improperly resolved (cured) childhood trauma, that manifested itself after many years, without my immediate recollection of the root cause. In this case, I would only go to the doctor with the symptom. And, while there is one primary root cause, I'd need some pain relief to at least start thinking straight.
Obviously, this is not exclusive to the tech industry, but I don't think that's any reason to shy away from like-minded people having discussions on the topic (by using HN).
On the topic of mental health, I have recently had more pleasant and/or constructive conversations on HN than I have in years on other social media sites (reddit, facebook, twitter, tumblr). I also enjoy reading the comments and discussion on the subject quite a bit from the HN community.
FWIW, I did also discover devpressed.com recently thanks to another mental health related thread and I'm grateful for that as well. Wouldn't have found that resource without HN.
- SysEng with mental illness.
If we compared this to injure and clotting, it would be weird to describe a clotting disorder as a symptom of injuries. Preventing more injuries is likely going to help and is a good step forward, but it do nothing to address the issue on why the recovery process is impaired.
It isn't a clotting disorder if your foot keeps bleeding because you haven't taken the tack out of your shoe.
I don't know how accurate the author's characterisation of depression is, but I don't think a useful analysis will result from applying that definition of the word depression so literally in this particular case.
Example: I was with my extended family members in mountains of coffee plantations enjoying a vacation. There was no internet connection and thus nothing to disturb me. We were all (over 20 of us) having a great time. We were playing a game of cricket, where during the game I had a depression attack and almost collapsed on the ground. There was nothing there to upset me at all.
This is just one example. I have faced many more in a similar manner.
There is one thing for sure. Community support helps you fight depression very well. I am a member of a Buddhist group and their encouragement and support has really help me fight it.
Yet I felt happy and energized by just being with these people and being mindful at the same time. Any racing thought quickly identified and dismissed. Never experienced anything like this before. I now truly think anxiety can be blown to shreds by applying what you learn in meditation in your daily life.
For those with an hour to kill, Robert Sapolsky has a wonderful, accessible lecture on the topic[1].
Also: psychomotor retardation: Physical difficulty performing activities which normally would require little thought or effort such as walking up a flight of stairs, getting out of bed, preparing meals and clearing dishes from the table, household chores or returning phone calls. https://en.m.wikipedia.org/wiki/Psychomotor_retardation
e.g. http://www.nature.com/nri/journal/v16/n1/full/nri.2015.5.htm...
Gregg and his ideas run parallel to a line of thought associated with The Citizens Commission on Human Rights, a group hell bent on denouncing mental illness as a disease. CCHR are/were a nonprofit organization established in 1969 by the Church of Scientology and psychiatrist Thomas Szasz.
I can't believe people are still pushing these ideas, but this thread is rife with them. Please would ya'll make an effort to update yourselves to the state of the art.
Depression and anxiety are usually symptoms of needs not being met, or embracing a worldview in which one is not living up to things they believe are essential. Often the worldview makes a big difference, including and especially religion and philosophy -- as these affect what the person values the most. That and the interpersonal relationships with people and how they are affected by the person's goals.
If you are close to someone who is depressed, ask them about:
Their worldview
What is important
Their values and goals
Why must they achieve those goals
How have they been achieving them
Their interpersonal relationships
What is wrong is often systemic - it is seen over and over in various people in various ways. The underlying worldview usually is the first factor, followed by interpersonal relationships that are colored by the worldview and goals. Often one's early relationship with the parents sets unconcious goals (eg must get married to someone within the faith, must get good grades etc.) that cause people to expend a lot of effort pursuing while not fulfilling their physical and emotional needs. They end up depressed or anxious as a result.
In the article, there was a quote: Many people with severe anxiety and/or depression are also anti-authoritarians. Often a major pain of their lives that fuels their anxiety and/or depression is fear that their contempt for illegitimate authorities will cause them to be financially and socially marginalized; but they fear that compliance with such illegitimate authorities will cause them existential death.
It seems to me, sometimes, being a member of society (having these societal needs met) can be quite tricky.
Now I realise that anger is a self defense mechanism because when my system is overloaded with people's emotions, it's a desperate but sane manuever of my subconscious in order to cut off the situation completely.
Of course it's just a temporary solution and it has many consequences but if you're loading too much of others on you, your body has to issue an irrevokable state of mind.
I think it's similar to other "negative" symptoms. So when i started to meditation (in order to create an interface to talk with the hidden drive in my subsconscious), i regarded them as little wicked monsters, but not anymore, now i regard them as the only company i have in my breakdown episode. Because when you're depressed, you don't believe in whatever your loved ones say anymore. there's only you and the battle.
> Some people have a legitimate reason to feel depressed, but not me. I just woke up one day feeling sad and helpless for absolutely no reason.
http://hyperboleandahalf.blogspot.com/2011/10/adventures-in-...
http://hyperboleandahalf.blogspot.com/2013/05/depression-par...
If this article is true, the Allie just hadn't figured out what the underlying issue was yet. Or what she went through was something else entirely.
Haven't been depressed or suicidal in the slightest since I came out here to SF and started living an autonomous life on my own trajectory half a decade ago. Was 100% circumstantial and situational for me, took zero drugs and professional therapy didn't do anything. Changing my life circumstances did everything.
Long-term depression is a way of thinking and feeling that some people fall into easier than others and that is also cultivated over time.
If you had a rough childhood and coped with it by getting sad and finally dissociating from your emotions in an early age, and you proceed to do that for a long time, then you are likely to get what's called a major depression.
I don't know if I would call that a symptom or a disorder and I frankly think that most of the time it doesn't matter for the treatment.
So is Asperger's by the way. Mild forms of autism, it seems, is an adaptation of a brain to cope with overwhelming cognitive overload of certain types, usually related to other people and unfamiliar places, which could be compared to too loud noise or an attacks of height-sickness.
And there is no single cause, of course. The symptoms are results of some genetic predisposition (slight differences in brain structure, perhaps, or higher levels of some neurotransmitters) and environmental and social factors, which conditioned the resulting habits and behavioral patterns.
One of the simplest and less wrong theories about mild forms of autism is that of so-called mind blindness. The children who have difficulty with maintaining eye contact and are looking to a mouth area instead of eyes area, could not learn to properly read accompanying emotions form faces of other people, so they constantly confused about interpreting the intentions and behavior of others and easily fooled by fake "Pan Am" smiles, so they learn to avoid confusing society and develop what we call introvert or nerdy mentality, with typical social awkwardness and eventually lack of interest in all these clowns, which clowns label sociopaths.)
> Depression is a way the emotional system signals that things are not working and that one is not getting one’s relational needs met. If you are low on relational value in the key domains of family, friends, lovers, group and self, feeling depressed in this context is EXACTLY like feeling pain from a broken arm, feeling cold being outside in the cold, and feeling hungry after going 24 hours without food.
Exactly, it's a signal, not a disease. A signal a lot more people I know are having as they grow into their desk jobs with bleak outlooks for advancement and fulfillment. Anecdotally, when I talk to depressed men I know, lack of romantic prospects is by far the biggest factor. We've never had more single men: http://cnsnews.com/news/article/barbara-hollingsworth/bachel... I'm sure women are much happier either with these circumstances. Somehow modern society has us further apart in this regard.
I've written before about being prescribed SSRIs after a 45 minute meeting with a college psychiatrist. Absolute rubish. The real solution was to cut out a failing romantic relationship, stop living with this person, and start cultivating new, healthier relationships. I've never been depressed since, but I got a great experience dealing with SSRI withdrawal symptoms in a foreign country.
If anyone reading this is depressed, I strongly recommend thinking about it as a signal that something is off in your life. For most people (though certainly not all), the meds will only help you cope with whatever the underlying problems are. Get some exercise: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3674785/ and also start being more social. Practical tip for hitting two birds with one stone: join a running club.
