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Old 01-11-2018, 12:21 PM
wonky wonky is offline
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"Depression/anxiety is not a malfunction but a symptom of unmet needs." Thoughts?

This is very interesting article on a book calling for a new approach to depression: https://www.theguardian.com/society/...st-connections

I recommend the whole article but am interested in takes particularly on two excerpts.

One excerpt:

Quote:
None of this applies, they said, if you have lost somebody you love in the past year. In that situation, all these symptoms are natural, and not a disorder. It was called “the grief exception”, and it seemed to resolve the problem.

Then, as the years and decades passed, doctors on the frontline started to come back with another question. All over the world, they were being encouraged to tell patients that depression is, in fact, just the result of a spontaneous chemical imbalance in your brain – it is produced by low serotonin, or a natural lack of some other chemical. It’s not caused by your life – it’s caused by your broken brain. Some of the doctors began to ask how this fitted with the grief exception. If you agree that the symptoms of depression are a logical and understandable response to one set of life circumstances – losing a loved one – might they not be an understandable response to other situations? What about if you lose your job? What if you are stuck in a job that you hate for the next 40 years? What about if you are alone and friendless?

And another:

Quote:
If you are depressed and anxious, you are not a machine with malfunctioning parts. You are a human being with unmet needs. The only real way out of our epidemic of despair is for all of us, together, to begin to meet those human needs – for deep connection, to the things that really matter in life.
I do not mean to stack my anecdotes up against someone else's data, but while reading this article I thought "These statements weren't true for me." Or at least I don't recognize them as true, which may be a failing of mine rather than the author's.

My only depression seemed to occur randomly. It lasted a couple of months. I don't remember anything changing to start it, and I didn't do anything to treat it. It just went away.

On the flip side, when I was widowed, I didn't become depressed. I was sad, but I didn't have the helpless/hopeless feeling I felt during my depression (not to claim that it never surfaced, but it would surface for an hour, not a week or a month or a year).

Do these quotes ring true or false for you?
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Old 01-11-2018, 12:38 PM
MichaelEmouse MichaelEmouse is offline
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Can't make blanket statements about whether or not it is. For some people, anxiety and depression are indeed symptoms, even useful signals and motivators that something is wrong and needs to be addressed. As an example, if a large dog seems angry with me and I'm within its reach, having an initial anxious reaction is perfectly fine. It would be a failure of my survival instinct if no anxiety were felt.

On the other hand, there are times when anxiety and depression are not so much symptoms of something needing to be addressed/unmet needs but more like infections from past wounds. Even after the wound is closed up, you still need to deal with the infection qua infection, not qua wound. To continue the dog analogy, if someone has panic attacks when they see a dog because a dog bit them decades ago as a kid, that's not a symptom of their current situation needing to be addressed or needs being unmet, it's the mind having a runaway reaction and needs to be addressed as an anxiety problem, not an angry dog problem.

And just like it's possible for someone to be anemic, not produce enough insulin or have some other biochemical imbalance, some people just have an imbalance of serotonin or dopamine or some other neurotransmitter. That needs to be addressed on a chemical basis.


Now, is there overreliance on meds? Probably, because it's simple for healthcare workers, insurance and people to understand, manage and apply. Delving into your social situation, your psyche or existential issues is a lot more difficult and intricate. Getting into a program of proper sleep, nutrition, exercise and meditation/yoga also requires far more dedication than taking a pill each day.

I'm reminded of Addyi, the so-called "women's Viagra" which was non-sense as for women, sexual problems typically stem not from insufficient bloodflow but unsatisfying relationships. You can't pop a pill for that.

Last edited by MichaelEmouse; 01-11-2018 at 12:43 PM.
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Old 01-11-2018, 12:40 PM
Sattua Sattua is offline
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I think it's way more complicated that either of the binary positions. I think it's likely that many cases of depression are caused by unmet needs--sometimes as simple as poor diet or too little fresh air and sunshine, but also by poverty, poor expectations, toxic people, tragedy, etc.

But sometimes depression just happens. Brain serotonin levels go wrong, and it's no one's fault and behavior therapy isn't going to help it.

Twenty years ago when I took psych 101 (crikey, I'm not young anymore) they told us that schizophrenia was really a myriad of different disorders lumped under one heading. I'm pretty sure depression is the same.
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Old 01-11-2018, 12:44 PM
Gatopescado Gatopescado is offline
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Dunno. I guess if I had everything I "needed", at least in my mind, I don't suppose I'd be depressed.
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Old 01-11-2018, 12:47 PM
wonky wonky is offline
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Quote:
Originally Posted by Sattua View Post
Twenty years ago when I took psych 101 (crikey, I'm not young anymore) they told us that schizophrenia was really a myriad of different disorders lumped under one heading. I'm pretty sure depression is the same.
That rings true for me, but of course I am very much just knee jerking from my own experiences.

It's interesting that when I was grieving my first husband, many resources made a very big point of distinguishing between sadness and depression. The article I referred to seems to bundle them back together. Should we think of them as something separate?
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Old 01-11-2018, 12:50 PM
wonky wonky is offline
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Originally Posted by Gatopescado View Post
Dunno. I guess if I had everything I "needed", at least in my mind, I don't suppose I'd be depressed.
This ends up as almost a philosophical or axiomatic point. If we have everything we need, we can't be depressed because we would also have the right chemistry, etc.

But I do know that when I had my bout of depression, one of the most frustrating things was my inability to identify anything that was actually wrong with my life. I had what felt like everything I needed.
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Old 01-11-2018, 12:54 PM
Jackmannii Jackmannii is offline
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In many ways, the linked article is a crock of hog drippings.

The business about "unmet psychological needs" being the basis of depression sounds like a hearkening back to the bad old days before we had a decent understanding about neurotransmitters and chemical dysfunction in the brain, and people's supposedly bad attitudes were held to be responsible for their depression.

I'm not impressed by bogus blanket statements like "Now, if your baby dies at 10am, your doctor can diagnose you with a mental illness at 10.01am and start drugging you straight away."

It is a gross exaggeration to claim that physicians' sole response to symptoms of depression is to start drugging patients, or that other, non-pharmacologic measures are not employed.

The answer to over-medicating the population is not to address someone's severe, life-threatening depression with advice about how they should find a more fulfilling career.
Quote:
Originally Posted by Sattua
But sometimes depression just happens. Brain serotonin levels go wrong, and it's no one's fault and behavior therapy isn't going to help it.
Yes.

Antidepressants literally save lives. Trashing them wholesale as the author of this article does, puts lives in danger.
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Old 01-11-2018, 12:59 PM
Buck Godot Buck Godot is offline
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My impression is that there are two types of Depression. Those that are caused purely by a brain chemistry imbalance and those that are caused by events in ones life. My wife has the latter, she only suffers from depression and suicidal thoughts when her pain is particularly bad, or when she dwells on trouble with her family or her past history of abuse. Her anti-depressant takes the edge off but its clear that there is something beyond a chemical imbalance that is going on. On the other hand there are certainly some people for whom there is absolutely no reason for them to feel depressed other than their brain turning against them making it impossible to get out of bed, and who after having this corrected make miraculous improvement.

IMHO the author of this is right in his conclusion that a significant number of people whose depression may not be chemically based, but then he makes that logical fallacy of excluded middle by tilting all the way to the other extreme by claiming that no depression is chemically based. His study seems to be mostly anecdotal, and may suffer from reversed causality. Is it the lack of work satisfaction that make people depressed, or is it that a chemical imbalance that makes you think that nothing is worthwhile will extend to your opinion of your work life as well?

I have no doubt that the author is earnest in his belief and that his depression was probably not caused by a chemical imbalance, but like many self help guru's they overplay their hand from "This helped me" to "This will help everyone", and is very dangerous if it prevents those who suffer from chemical based depression from getting the help they need.

Last edited by Buck Godot; 01-11-2018 at 01:01 PM.
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Old 01-11-2018, 01:05 PM
TriPolar TriPolar is offline
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A past theory, I think largely discredited, is that chronic depression is the result of a lack of 'rose colored glasses' to view the world with. While depression is clearly not simply the result of a poor attitude there should still be consideration for the potential for the mind and body to heal itself. But that is just a generality.
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Old 01-11-2018, 02:41 PM
Sunny Daze Sunny Daze is offline
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It's true that sometimes depression and stress and anxiety are caused by circumstances, and those circumstances may resolve with time. Medication may still have a role to play in working through that. For example, work is stressful. Not everyone has the option to tell the boss to sod off, and walk out. Stress causes chemical changes. You might have to stick it out which you work out another job, or a move, or pay off some large bills. Medication might help you hold things together while you master other tools to deal with the stress, or just make it through a short patch of time when things until you can change your circumstances.

In other words, I think circumstances and/or brain imbalances can play a role in causing depression or other issues, and so a wide variety of treatments can help, potentially including medication. People aren't cookies and treatments can't be cookie cutter.
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Old 01-11-2018, 09:54 PM
Wesley Clark Wesley Clark is offline
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Both true and false.

There are many biological causes of depression and anxiety. Many. Lots of hormonal imbalances can cause these issues.

I know for me, when my blood sugar gets low I get anxiety. Low blood sugar means adrenaline is released to bring sugar levels back up.

I've also had severe anxiety from using an anti-snoring device. I'm not sure why, maybe I was choking in my sleep. But that wasn't psychological.

Basically, yes and no.
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Old 01-12-2018, 12:56 AM
Nava Nava is offline
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Quote:
Originally Posted by Sattua View Post
I think it's way more complicated that either of the binary positions. I think it's likely that many cases of depression are caused by unmet needs--sometimes as simple as poor diet or too little fresh air and sunshine, but also by poverty, poor expectations, toxic people, tragedy, etc.
Spanish psychiatrists differentiate between exogenic depression (caused by external triggers, heals by itself when the triggers are removed unless they last long enough for the depression to become encysted; encysted exogenic depression responds to non-chemical approaches) and endogenic depression (caused by a problem with internal chemistry, remember to take your pills; non-chemical approaches do not work).

Feeling bad because your cat died is normal. Feeling bad because your cat died six years ago is not. Feeling bad because your serotonin receptors have a mis-synthethized bit is, again, not.
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Last edited by Nava; 01-12-2018 at 12:57 AM.
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Old 01-12-2018, 01:18 AM
Mangetout Mangetout is offline
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Quote:
Originally Posted by Sattua View Post
I think it's way more complicated that either of the binary positions. I think it's likely that many cases of depression are caused by unmet needs--sometimes as simple as poor diet or too little fresh air and sunshine, but also by poverty, poor expectations, toxic people, tragedy, etc.

But sometimes depression just happens. Brain serotonin levels go wrong, and it's no one's fault and behavior therapy isn't going to help it.

Twenty years ago when I took psych 101 (crikey, I'm not young anymore) they told us that schizophrenia was really a myriad of different disorders lumped under one heading. I'm pretty sure depression is the same.
This seems about right to me. I think rather than depression being caused by unmet needs, it may actually be that unmet needs and the woes of modern life can produce temporary symptoms that in some ways resemble those of clinical depression.

I'm not sure I want to lump all of those different, but similar-looking things into one bucket - lest we make the grave error of assuming 'people with depression are just sad', or worse, 'they just need to snap out of it'.
  #14  
Old 01-12-2018, 01:35 AM
Voyager Voyager is offline
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Originally Posted by Gatopescado View Post
Dunno. I guess if I had everything I "needed", at least in my mind, I don't suppose I'd be depressed.
There are plenty of rich people who are depressed. Shrinks in NY don't live on treating the poor. Now depression might cause someone to never feel they get what they need, or need new things once they do get them.
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Old 01-12-2018, 01:55 AM
Voyager Voyager is offline
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It seems to me that the article uses a very loose definition of depression. Bad jobs cause stress, sure, but not everyone working a shit job is depressed. The loss of a loved one makes you sad, but some people snap out of it quickly and some, who are depressed anyway, may grieve for excessive periods.
She also accuses drug companies of violating the most basic rule of reporting a study, which is reporting on all the subjects. In a press release, maybe, but in a published paper - unlikely. It sounds like what an anti-vaxxer would accuse a drug company of.
I've seen people snap out of depressed states immediately upon taking an anti-depressant. They may be over-prescribed, sure, but they do work.
If what she says is true, levels of depression would decrease with rising incomes and power. I'd love to see evidence of this. Clearly people in similar situations have widely varying degrees of depression. And no one who is retired with a reasonable amount of money would be depressed in her model.
Sure sounds like she is trying to blame society for everything. And she over-simplifies the problem, claiming that people say depression is caused by one hormone. Seems unlikely to me - nothing about the brain is claimed to be that simple.
Lots of strawmen too. How many psychiatrists diagnose depression solely because of a loss?

I wonder if she is selling some sort of self-help solution in her book. It smells like it.
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Old 01-12-2018, 04:13 AM
AHunter3 AHunter3 is offline
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I agree with the overall point, that situational factors are the primary cause of why a person manifests as being in a depressive state at a specific time and place. Biological factors may play a role in why this person and not someone else in a similar situation is manifesting as depressed, but our mental states are not "caused by a chemical imbalance" or by our genetics — treating them as specifically biological diseases has not proven to be a very useful approach.
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Old 01-12-2018, 05:24 AM
HMS Irruncible HMS Irruncible is offline
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Originally Posted by wonky View Post
This is very interesting article on a book calling for a new approach to depression: https://www.theguardian.com/society/...st-connections
Both true and false. To me, he has highlighted a distinction by choice of examples. Grieving (loss of a spouse) is a case where you have a sudden loss, but given time, most people adjust and recover. Some even remarry. Other cases he quoted contain an element of being trapped: "What if you are stuck in a job that you hate for the next 40 years? What about if you are alone and friendless?" I find it hard to explain, but the latter 2 situations would obviously cause situational depression as opposed to temporary grief because they could plausibly last longer and be much harder to resolve.

On the other hand I know depression absolutely can be purely physical in some cases. Since I swore off alcohol, on the isolate occasions where I cave to temptation, an evening of heavy drinking can make me feel depressed for 10 full days afterward. So I know there are chemicals sloshing around in my brain that can make me depressed when they don't slosh like they should.
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Old 01-12-2018, 06:03 AM
JacobSwan JacobSwan is offline
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Quote:
Originally Posted by Voyager View Post
It seems to me that the article uses a very loose definition of depression. Bad jobs cause stress, sure, but not everyone working a shit job is depressed. The loss of a loved one makes you sad, but some people snap out of it quickly and some, who are depressed anyway, may grieve for excessive periods.
She also accuses drug companies of violating the most basic rule of reporting a study, which is reporting on all the subjects. In a press release, maybe, but in a published paper - unlikely. It sounds like what an anti-vaxxer would accuse a drug company of.
I've seen people snap out of depressed states immediately upon taking an anti-depressant. They may be over-prescribed, sure, but they do work.
If what she says is true, levels of depression would decrease with rising incomes and power. I'd love to see evidence of this. Clearly people in similar situations have widely varying degrees of depression. And no one who is retired with a reasonable amount of money would be depressed in her model.
Sure sounds like she is trying to blame society for everything. And she over-simplifies the problem, claiming that people say depression is caused by one hormone. Seems unlikely to me - nothing about the brain is claimed to be that simple.
Lots of strawmen too. How many psychiatrists diagnose depression solely because of a loss?

I wonder if she is selling some sort of self-help solution in her book. It smells like it.
She is a he, although the name is confusing. He was on RHLSTP this week and turned a normally comic podcast into a massive downer. He never shuts up!
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Old 01-12-2018, 07:40 AM
Dinsdale Dinsdale is offline
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IMO, the elimination of bereavement was just one of the most bothersome changes in the recent DSM revision.

As others have said, there are countless different causes of mental and emotional distress - whether depression, anxiety, PTSD, or whatever. Moreover, there are countless levels of severity for each of those conditions. And other aspects of an individual's character and personality affect how they respond to their particular stressor.

My problem with the mental health profession is the eagerness to diagnose, treat, and opine as to severity - after an initial consultation. And I perceive a great many people (CERTAINLY NOT ALL) as eager to rely upon a diagnosis as freeing them from responsibility.

Life is hard. Most people get anxious and depressed at times. Really lousy shit happens - but people get over it. And MOST people continue getting up everyday, going to work, and doing what needs to be done. Hell, I'm all for taking a pill or talking to someone if that makes you feel better. But you're not all that special. And the fact that something unpleasant happened to you once in your life does not give you a free ride forever.
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Old 01-12-2018, 09:19 AM
Leo Krupe Leo Krupe is offline
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I've suffered from depression and anxiety all my life, or at least for as long as I can remember. I'm now 56, and was formally diagnosed probably in my early 40s. I'm still struggling with definitions, causes, and all manner of thoughts about the subject.

The reason I'm writing this post is more of a release, so feel free to ignore it. It probably won't make much sense outside of my head, and that's okay with me.

Dinsdale says you're not that special. I disagree, because while everyone goes through difficulty, be it losing a job, bankruptcy, family tragedies, etc., no one goes through my experience my way, with my thoughts, emotions, reactions, etc. So yes, I am special. But so is everyone else. That's the paradox: we're all together, as the same species, but we react to and process experiences (even the same ones) differently.

However, I do agree that if something happened to you once doesn't give you a free ride forever. Depending on the circumstance(s), you do need to deal with it, and get over it. On the other hand, I, for example, am still dealing with the fallout from decades of toxic work environments (I've been describing it as "workplace PTSD," even if that's not a recognized diagnosis, it's an apt description).

You could say the treatment I received at various workplaces was my own fault; that I brought it on myself, and I'd say to a certain extent, that's true, even if it was unintentional. However, as has been pointed out to me over the years, I can't be responsible for other people. They react in ways that I can't control; so if they're bullies, I can't stop them. Sure, I can stand up to them, but given my individual temperament, that's very difficult to do. (Call me weak, a wimp, whatever, I was taught to let it roll off my back and not lower myself to the bully's level.)

So as far as I can tell, my problem (which simultaneously is and isn't mine alone) is that it's a combination of chemical imbalance (or genes, or hormones, or other natural process, since my condition runs in my family) and environment.

It's not nature vs. nurture, it's nature and nurture.

The problem I'm seeing with society as a whole is that if I were to compare the status of mental health to breast cancer, we're in the late 70s to early 80s. (Betty Ford, in the mid-70s, was among the first to talk openly about breast cancer. I remember prior, you could barely say the word "breast," unless it had to do with chicken. Mental health at the time was still stuck in the Cuckoo's Nest mentality, as far as the public were concerned. By the 80s, breast cancer was slightly more in the open. Today, of course, it's not a bit shameful. Compare that to mental health--we're just beginning to talk about it openly, but it's still stigmatized. Not as much as just a few years ago, but hopefully, it'll get better. Too bad it's taking so long.)

The bottom line is that mental health is complicated, and there's still much we don't understand. In some ways, we're all together, because we share the same brain biology, but at the same time, we are each special snowflakes.

What's the answer? I don't know, but I do know there isn't one--there may be many, but it's not just one. Discussion and a sincere attempt to understand what someone else is going through is a start. One thing I do know: we have to get away from the "snap out of it" line of thinking (something my wife of 30+ years is just now beginning to understand--so if a person I've lived with most of my life is just now starting to understand my condition, it's even more difficult to people I don't even know to understand.) But I have to keep trying to get myself to understand it, and share what I've learned. Because if I don't at least try to understand it myself, I may as well give up and give in to the self-destructive thoughts I've had over the course of my life. And I know what it would do to my family, even if I didn't care about myself. I know they care about me.
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Old 01-12-2018, 09:19 AM
HMS Irruncible HMS Irruncible is offline
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Hell, I'm all for taking a pill or talking to someone if that makes you feel better. But you're not all that special. And the fact that something unpleasant happened to you once in your life does not give you a free ride forever.
Yeah, because all depressed people go around thinking they're special and asking for a free ride on... what exactly?

But it's great to know we have your permission to seek treatment for mental health issues!
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Old 01-12-2018, 10:21 AM
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Let's accept the premise that "chemicals" aren't the ultimate cause, but situations and unmet "needs" are.

It is a lot easier said than done to revamp one's life. If you have to work 16-hour days to keep everyone in the family fed and sheltered and happy, and you can't take off from work to get counseling and even if you could, you can only afford a few sessions anyway, then why NOT take a pill? Yes, pills have side effects and they don't always work. But seeing as how we don't have a system where you get a special variance on rent/mortage/bills when life turns shitty for you, then pills will always be the first choice.

I went through several years of depression. I did talk therapy for a couple of years in the absence of medication because I was certain I could fix it all on my own. But I only got worst through that period, so it would have been stupid for me to not try meds. And while they weren't a perfect fix, they did stop my deterioration and gave me some space to develop some insight and do healthy, self-caring things. It's really hard to do healthy things when you're thinking about suicide all the time. Pain medication helps someone with a broken bone heal faster if only because it allows them to take care of themselves without the distraction of the pain. That's what psych meds did for me. And I was lucky enough to be able to stick with therapy so that I could take a multi-prong approach to my issues.

Not everyone is this lucky.

I think people who make this kind of argument think there was some idyllic yesteryear when you were allowed to be depressed/anxious without it being medicalized and people would just magically get better all on their own. Ha! What a load of SHIT. In this "yesteryear", parents could beat their children and wives in public and no one would say a damn thing. In this "yesteryear", the crazy aunt or uncle was locked in the basement or sent to an institution and no one would speak about them ever again. People have self-medicated themselves with abandon for centuries. It is a luxury to be in the position to cure oneself by addressing unmet needs. Most people can only afford crutches and band-aides.
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Old 01-12-2018, 10:25 AM
kunilou kunilou is offline
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Forty years ago when I saw a therapist after my divorce, the official diagnosis was "transient situational depression." Sure enough, as my "situation" changed I worked through it with cognitive-behavioral techniques and didn't need drugs.

Years later a different set of concerns put me back in therapy. At that point I was prescribed a mild antidepressant and have responded very well to it.

So it isn't like the professionals haven't always recognized the difference between being depressed because something bad happened and being depressed even though nothing bad happened. Anyone who claims Big Psychology doesn't know that, or doesn't try different treatments, is just lying.
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Old 01-12-2018, 10:25 AM
Dinsdale Dinsdale is offline
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Yeah, because all depressed people go around thinking they're special and asking for a free ride on... what exactly? ...
Disability benefits, for one.

Boo hoo - I'm a fragile snowflake! Where's my check?
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Old 01-12-2018, 11:07 AM
wonky wonky is offline
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Disability benefits, for one.

Boo hoo - I'm a fragile snowflake! Where's my check?
This is offensive, and I think you know that or you would not have slapped a big grinning smiley on it.
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Old 01-12-2018, 11:13 AM
Leo Krupe Leo Krupe is offline
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Disability benefits, for one.

Boo hoo - I'm a fragile snowflake! Where's my check?
Not even close. I agreed with you on the point that there are cases when the right thought is, "Life's tough, deal with it and move on."

Disability is not one of them.
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Old 01-12-2018, 11:14 AM
madsircool madsircool is offline
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It seems to me that the article uses a very loose definition of depression. Bad jobs cause stress, sure, but not everyone working a shit job is depressed. The loss of a loved one makes you sad, but some people snap out of it quickly and some, who are depressed anyway, may grieve for excessive periods.
She also accuses drug companies of violating the most basic rule of reporting a study, which is reporting on all the subjects. In a press release, maybe, but in a published paper - unlikely. It sounds like what an anti-vaxxer would accuse a drug company of.
I've seen people snap out of depressed states immediately upon taking an anti-depressant. They may be over-prescribed, sure, but they do work.
If what she says is true, levels of depression would decrease with rising incomes and power. I'd love to see evidence of this. Clearly people in similar situations have widely varying degrees of depression. And no one who is retired with a reasonable amount of money would be depressed in her model.
Sure sounds like she is trying to blame society for everything. And she over-simplifies the problem, claiming that people say depression is caused by one hormone. Seems unlikely to me - nothing about the brain is claimed to be that simple.
Lots of strawmen too. How many psychiatrists diagnose depression solely because of a loss?

I wonder if she is selling some sort of self-help solution in her book. It smells like it.
https://slate.com/health-and-science...is-broken.html

Research data was routinely manipulated in peer-reviewed scientific papers. Reforms have since been put in place.
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Old 01-12-2018, 11:23 AM
Dinsdale Dinsdale is offline
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Sorry guys, just posting from my point of view where every day I have to deal with people who are putting more effort into obtaining various disability benefits than into holding down a job.

At no point have I suggested that mental illness is not real, or that SOME people are not incapacitated by it. However, in my daily experience, there are many many people who are whiners and fuck-ups, but would prefer to attribute their situation to factors beyond their control.

And mental health is no different from any area of medicine - mostly conscientious practitioners, but a good number of quacks and whores as well. JMHO
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  #29  
Old 01-12-2018, 11:47 AM
Leo Krupe Leo Krupe is offline
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Originally Posted by Dinsdale View Post
Sorry guys, just posting from my point of view where every day I have to deal with people who are putting more effort into obtaining various disability benefits than into holding down a job.

At no point have I suggested that mental illness is not real, or that SOME people are not incapacitated by it. However, in my daily experience, there are many many people who are whiners and fuck-ups, but would prefer to attribute their situation to factors beyond their control.

And mental health is no different from any area of medicine - mostly conscientious practitioners, but a good number of quacks and whores as well. JMHO
And that's part of the problem (not accusing you personally, I don't know you). It's not your job personally, but as a society, we need to find out why these people are whiners and fuckups. It's easy to label them that way, because I certainly was (there were reasons other than I mentioned above -- immaturity among them, but I've grown and learned since then--not everyone does, even those my age and older).

The thing is, is if people don't want to do a job, there's usually a reason (or reasons). One is our culture goads us into thinking it's all right to have that mentality. It's as if laziness is rewarded. That's cultural, and as such, we all are responsible.

But we also have a responsibility to try to understand mental illness, even if it doesn't touch us directly. Just like we understand cancer, or broken bones, or paralysis.

Obviously, I can't speak to the people that Dinsdale works with, but I do know people are more complex than we usually give them credit for. And if they're behaving in some detrimental way, there's usually a reason.

That isn't to say they need to be comforted and hugged, while you say, "Awwwwwwww....it's all right, shhhhh," because ytou don't. But you shouldn't go too far the other way either, and just label someone who doesn't want to do a job just because they're lazy. Maybe, as in my case, management is the problem.

For one example, I was "promoted" at a company (it was a sales job, and I was given higher dollar accounts), and the paperwork was different than I'd been used to. I asked my boss for advice and instruction. He threw me out of his office, saying, "Figure it out for yourself. I don't have time to train you!" Some will take the boss's stance, but to me, that's wrong.

Also, when you see (joke) signs in workplaces that say, "Beatings will continue until morale improves," or "I don't have the time or crayons to explain it to you," what the hell kind of message is that sending to employees?

In the job I just mentioned, I was told, in no uncertain terms, that I wasn't important, because I had Mom and Pop accounts, and not big box stores. Guess what? My customers thought I was important. When I was transitioned out, one of my customers said, "What's wrong with those idiots?!" because he would then have to deal with customer service, either on the phone or through the website.

My upshot is people behave the way they do because of reasons. Those reasons may not be obvious, or even make sense to you, but to them they do. And if you want the best out of people, you should begin understanding them. As individual people.

Now, having said all that, not everything is for everybody. Not everyone is suited to work in a factory, or to pick up trash, or to be a mortician, or be an executive, or work in a restaurant. If people are fucking up in a particular job, they may not be right for that job. In that case, it's management's responsibility to determine that, and either train the employee properly, or get someone better suited. It's also the employee's responsibility to do the job to the best of their ability, or get out.

Working is a dance between the employer and employee.
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Old 01-12-2018, 12:16 PM
Spice Weasel Spice Weasel is offline
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Originally Posted by Dinsdale View Post
Disability benefits, for one.

Boo hoo - I'm a fragile snowflake! Where's my check?
All right, I see you've qualified your statement, but let's try to be mindful that a number of people on this message board are directly impacted by mental illness, and this statement definitely qualifies as ''being a jerk.'' You're welcome to share your opinions about this subject, even if they are unpopular, but let's knock it down a notch.
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Old 01-12-2018, 12:25 PM
Dinsdale Dinsdale is offline
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Originally Posted by Leo Krupe View Post
And that's part of the problem (not accusing you personally, I don't know you). It's not your job personally, but as a society, we need to find out why these people are whiners and fuckups. It's easy to label them that way, because I certainly was (there were reasons other than I mentioned above -- immaturity among them, but I've grown and learned since then--not everyone does, even those my age and older).

The thing is, is if people don't want to do a job, there's usually a reason (or reasons). One is our culture goads us into thinking it's all right to have that mentality. It's as if laziness is rewarded. That's cultural, and as such, we all are responsible.

But we also have a responsibility to try to understand mental illness, even if it doesn't touch us directly. Just like we understand cancer, or broken bones, or paralysis. ...
Thanks for your thoughtful response.

My entirely nonprofessional opinion is that today's society makes it a lot harder to be a whiner or a fuck up. Or unintelligent. Some people simply consistently draw short straws. Below average all around. There simply aren't enough unskilled decently paying jobs to go around. You drop out of high school, get a drug conviction or 2 on your record, and you are fucked.

American society does a HORRIBLE job working with such people. There definitely should be increased education and training available. Hell, I'm a big fan of CCC-type workfare programs. And I'm a strong supporter of universal health care (with some measure of rationing.)

I am not willing to accept "mental illness" as a catchall term to cover (excuse) everyone who had poor role models, never learned of the need to mature and act responsibly, made various poor choices, or have undesirable personality traits.

On edit - notice received, Spice. I thought someone suggested that NO ONE alleges mental illness seeking a free ride, when my daily experience for 30+ years has been to the contrary.
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  #32  
Old 01-12-2018, 12:54 PM
Spice Weasel Spice Weasel is offline
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Do these quotes ring true or false for you?
To me, the differing viewpoints on this matter present a false choice. In my case, there's a strong argument that I have a biologically based mental illness (recurrent major depressive disorder), but it's complicated by the fact that I have PTSD and that trauma in my family is generational. Did I inherit depression from my mother? Or did she teach me how to be depressed the way she learned how to be depressed? Particularly in the case of children, early experiences permanently shape neurology. Children exposed to repeated trauma are left with permanently hyperactive amygdalae. The more times you are depressed, the more likely you are to be depressed in the future. It's not just the behavior that is learned, it's the brain's response too. The brain learns depression and anxiety, and sometimes it learns it forever.

So what ''causes'' mental illness? There's no way to answer this definitively. My general view of mental health disorders, particularly anxiety and depression, is that they are rooted in learned behaviors that protect from short-term harm but do more damage in the long run. Depression, whether ''chemical'' or induced by a sudden loss, leads to self-isolation, sitting around doing nothing, and heaps of negative cognition, all of which contribute to and perpetuate the depression. I find behavioral approaches most effective in combating it, as well as something called ''opposite action'' in Dialectical Behavioral Therapy circles. If I feel like a worthless piece of shit, I go do something worthwhile.

I read an excellent article about ''self-care'' once that asserted, against the grain, ''Self-care is not always about spending the day in bed and drawing a bubble bath. More often it's about cleaning the pile of shit off your kitchen counter, doing the dishes and applying for a job.'' This really hit home for me, because so much of mental illness pathology is constructed around avoidance of distress. You can't be happy if your entire life is built around trying to avoid pain. Most of what I get depressed about is not having accomplished something important to me that day. (This idea is reinforced by Acceptance of Commitment Therapy, which is partly about accepting chronic illness but also about recognizing our mental pain often comes from not prioritizing the things that we value.)

Now there is certainly a strain of ignorance and lack of understanding about mental illness. It's not just about what you do. And you could do everything right, every day, and still feel like shit, because your brain decided that's how it's gonna feel. There is an element that is completely beyond your control. I know some people hate the physical illness comparison, but I think it can be like diabetes in that way. As a diabetic, there are things you can do to make your condition worse and things you can do to mitigate the damage, but it's never going away. The best many can do is ''manage it.'' It's the best I can do. I've had severe depression since I was 13, and the first time I felt anything close to relief was at 27, when my ACT therapist told me, "Oh, are you under the impression your depression can be cured? No, I'm sorry. This is not likely to ever go away." I had been in search of a cure up to that point. And not having to chase a cure gave me a lot of freedom to think about what I wanted to make out of my life.

But when you're facing the reality of chronic, lifelong mental illness, and you mention that you're depressed, and someone blithely says, ''Oh, you just need a bit of fresh air,'' it's rage-inducing. It's tone-deaf, it's minimizing, and so much so that we are less inclined to want to admit fresh air will probably help. Management of depression for me doesn't look like pills and therapy. It looks like pills, therapy, good sleep hygiene, vitamins, light therapy, time spent outdoors, regular exercise, deliberate social interaction even when I don't feel like it, etc. etc. And it's exhausting. And most people don't have to do all that just to make their lives bearable. But there is a lot to be said for a holistic approach.

But I do see, as Dinsdale has seen, a refusal, in some, to even try to manage their symptoms. They are the proverbial diabetic stuffing cake down their gullet (or whatever makes diabetes worse... I'm not educated) and then claiming they are helpless victims of their own biology. My husband of course also sees these people on a regular basis, and as a psychologist, he finds it very frustrating. It's nice though because he always comes home and showers me with praise for being so proactive.

Quote:
Originally Posted by Dinsdale
I am not willing to accept "mental illness" as a catchall term to cover (excuse) everyone who had poor role models, never learned of the need to mature and act responsibly, made various poor choices, or have undesirable personality traits.
I think a common disconnect is that having a mental illness doesn't mean you are free of responsibility for your choices. Some people seem to think it does. (cough *mother* cough.) The difficulty is in parsing out what portion is dodging responsibility and what portion is a real limitation, and I honestly couldn't even answer that for myself. Sometimes I think I give it too much power, and other times I think I'm too hard on myself. With depression in particular, part of the illness is a blindness to elements within our control to change and a feeling of hopelessless that anything will ever change. It's a hard thing to combat a brain that is always trying to talk you out of success. It's kind of remarkable to get anything done at all when you do not give a shit whether you live or die. Anxiety actually makes way more sense to me, evolutionarily speaking, than depression. Anxiety is an exaggerated version of the natural fear response intended to avoid death. It's hard to understand any biological being suffering with a malady that compels it toward death.

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  #33  
Old 01-12-2018, 01:16 PM
Leo Krupe Leo Krupe is offline
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Thanks for your thoughtful response.

My entirely nonprofessional opinion is that today's society makes it a lot harder to be a whiner or a fuck up. Or unintelligent. Some people simply consistently draw short straws. Below average all around. There simply aren't enough unskilled decently paying jobs to go around. You drop out of high school, get a drug conviction or 2 on your record, and you are fucked.
Very true, especially the last sentence. It's all too common to get pigeonholed in society. For instance, I've been in sales/customer service, and I'm working on reinventing myself as an SOP writer (I've done a bit of that in various jobs, and one full-time), but companies say, "Customer service? Sales? Pshaw, you don't know anything about what we do." When it's the reverse. I have skills that can translate to any number of jobs and industries, but they don't realize that.

I've never had a drug conviction, and am not a HS dropout, but the point's the same: you get typed as one sort of worker, and (in my experience, which covers decades) that's all you got. Sure, people can reinvent themselves -- it happens, but it sure ain't easy.
Quote:
American society does a HORRIBLE job working with such people. There definitely should be increased education and training available. Hell, I'm a big fan of CCC-type workfare programs. And I'm a strong supporter of universal health care (with some measure of rationing.)
Agreed again. Maybe not on the rationing, but certainly on the fact that American society does a horrible job with mental illness in particular. But as I mentioned before, the situation is slowly changing. In my lifetime, we've gone from the Cuckoo's Nest type of treatment to actually discussing it openly, which is a great step forward. But it's not enough. (It wasn't until the mid 80s that it was discovered children could suffer from depression -- before that, it was thought their brains weren't developed enough. Think of that--just 30 years ago. In some contexts, that's a long time, but in medicine, it's yesterday.)

Quote:
I am not willing to accept "mental illness" as a catchall term to cover (excuse) everyone who had poor role models, never learned of the need to mature and act responsibly, made various poor choices, or have undesirable personality traits.
I don't think you should. And I'm not saying mental illness covers all those actions and behaviors. What I am saying is that if someone acts badly because they didn't have a good role model, or made poor choices, doesn't mean they should necessarily be punished. Nor should they be rewarded, because it's not a binary choice. Actions have consequences, but sometimes, just sometimes, it can be worth it to take a person aside and try to understand their point of view, and try to teach them. Maybe they'll listen. Most people won't, but that doesn't mean no one will. (I was a manager, and had 2 separate underperforming employees. One didn't give a shit, the other tried, but still failed. I had to fire them both, but I was able to give the one who at least tried more room, because the first had just given up entirely. There's nothing you can do with someone like that, unless you're a health professional, and even then you can't force someone to be better.)
Quote:
On edit - notice received, Spice. I thought someone suggested that NO ONE alleges mental illness seeking a free ride, when my daily experience for 30+ years has been to the contrary.
No comment from me, as this isn't my business.
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Old 01-12-2018, 01:45 PM
Spice Weasel Spice Weasel is offline
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I'm sure there are people who allege mental illness seeking a free ride, but what I'm saying is that a lot of people with mental illness underestimate their abilities as a direct result of their mental illness. It is the nature of depression to assume failure. Learned helplessness is a real phenomenon. So it's not necessarily that those people aren't actually mentally ill, it's that their mental illness is more treatable than they think, that they are in fact capable of more than they realize.

My mother filed for disability based on a back injury, and I don't believe that she's incapable of working. But I believe that she believes she's incapable of working. The problem is not trying to hoodwink the system, it's distorted perception caused by her mental illness.

There are also people in the world who lack even the most basic skills necessary for holding down a job. Case in point, I was recently screamed at by a woman in the parking lot because I tried to help her get directions to a place she ''absolutely had to get to on time.'' She left five minutes before the time she needed to be there, with no clue where she was going, and when I told her she probably wasn't going to make it on time, she flipped her shit.

Is she a victim? Definitively yes. She was staying at a domestic violence shelter, which means she had been assessed as being at a high risk of death or serious harm if she continued to live at home. She was under extraordinary amounts of stress. She was homeless. She was probably mentally ill.

This woman, while physically able-bodied, is probably not capable of holding down a job, at least not with her current skillset (or absence thereof.) Is she responsible for her problems? Well, yes, she has to be or else society would collapse. But the necessary work she will have to do to learn a better way to be is staggering. Is it her fault she still has all that work to do? Probably not entirely. I don't know her history. Things like ''leave with enough time to make it to your appointments'' are really taught in childhood. She clearly has a number of unmet needs.

The system is unequipped to help these people, but I'm not sure how to fix the problem. You can offer all the help in the world and it's useless if someone chooses not to take it.

Last edited by Spice Weasel; 01-12-2018 at 01:46 PM.
  #35  
Old 01-12-2018, 02:19 PM
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Menial jobs used to be available for people with low-level personality and emotional flaws.

But now you're expected to pass a personality test. You're expected to have good social skills and be able to work well with others. Had a long unemployment gap because of illness? Well, now you look like a loser.

I was able to come through my depression largely because I had a job that afforded me flexible hours and that didn't require me to put on a happy face all the time. If I had been working behind someone's register for minimum wage with no sick leave during that time period, I have no doubt that would have lost my mind.

Sometimes we think that because we made it through, then other people who are struggling must be lazy whiners. When really, a lot of "other people" don't have the social supports that enable them to make it through. And people can also lack cognitive resources. It takes a certain amount of intelligence to formulate a plan and stick with it.
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Old 01-12-2018, 03:24 PM
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Have you ever known someone with an untreated medical condition like a thyroid problem (either hyper or hypo)? Their mental mood is definitely off. Get them the right treatment and the change in mood can be amazing.

Do such people have "unmet needs" (other than treatment)? Of course not.

And there are hundreds of conditions that affect mood. Including ... messed up neurotransmitters that can be helped with the right meds!

Are all depressed/anxious people that way just because of neurotransmitters? Nope. But a whole lot are.

Trying to put all people with mental issues in one box is itself a sign of a person with a mental issue.
  #37  
Old 01-12-2018, 03:28 PM
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Originally Posted by JacobSwan View Post
She is a he, although the name is confusing. He was on RHLSTP this week and turned a normally comic podcast into a massive downer. He never shuts up!
And I was happy that I had checked the name and not assumed that he was a he!

*Now I'm depressed *
  #38  
Old 01-12-2018, 03:34 PM
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https://slate.com/health-and-science...is-broken.html

Research data was routinely manipulated in peer-reviewed scientific papers. Reforms have since been put in place.
I'm confused. The replication issue is well understood, and has nothing to do with pruning data. The rest of the article is on someone who was trying to prove ESP, hardly the mainstream. I've listened to Honorton talk - I was not impressed.

But what has this to do with the contention that papers on depression and drugs to treat depression routinely purge data not supporting the hypothesis?
  #39  
Old 01-12-2018, 03:58 PM
Busy Scissors Busy Scissors is offline
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She is a he, although the name is confusing. He was on RHLSTP this week and turned a normally comic podcast into a massive downer. He never shuts up!
He is a good journalistic writer (IMHO), but a colossal tit (in everyone's HO), and his career was basically finished a few years ago when he was found to be plagiarising material / mis-attributing quotes. He's dropped out of view to write this book, but it's not clear to me what his message is [admittedly just going on that Guardian piece]. I mean, it sounds like something from 1998 - Hold up lads, perhaps these pills don't cure depression after all. That doesn't seem especially insightful, as I thought it was well known that depression was tackled from a number of therapeutic angles, with pharmaceutical intervention just one of the tools.

Him being who he is, he's already getting stretchered on twitter over the accuracy of his source material - e.g. his claim that 65-80% of people relapse on the pills in a year has apparently been pulled from his rectum.

https://twitter.com/StuartJRitchie/s...10391908114438

Bottom line is that it's a deep area and I doubt he's equipped to make a serious contribution [although I am certain he could talk about it all day]. Add in his track record of self-promotion and unethical journalism and I doubt we're looking at a book that will add anything new.
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Old 01-12-2018, 06:05 PM
Guinastasia Guinastasia is offline
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Disability benefits, for one.

Boo hoo - I'm a fragile snowflake! Where's my check?
Do you tell that to people with diabetes? Cerebral palsy? Hey, your blood pressure's out of wack? Suck it up you big baby, we've all got problems!

Why is it so weird to think that our brain chemistry can be messed up as well? The brain is just another organ, isn't it? What makes it somehow immune?
I'm not saying people should just fall all over and whine, "oh woe is me!" but "snap out of it!" or "get over it!" is NOT going to work for people with depression, and is one of the most offensive and disgusting attitudes a person can have.

Depression is not merely "whining and fucking up". A lot of the time it's lack of caring -- you don't care period. You're numb, no matter if things are going good or bad. It's a hell of a lot more complex than you seem to think. Yeah, you definitely have people who want to use it as an excuse -- but you have that with any illness. But there's always been a stigma against mental illness, and we're only now starting to attack that.
I don't pretend to have all the answers, and trust me, I loathe people who go around saying, "you can't pick on me, I'm SICK!", but trust me, if I could just "snap out of it", I would. I wish it were that easy.
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  #41  
Old 01-12-2018, 06:22 PM
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I'm pretty sure desire and unmet needs have fuck-all to do with my brain suddenly bringing up something that happened when I was 8 years old and making me feel shitty, or making me spend a day feeling completely empty and hollow.

But it sounds like a great way to treat people as infants and ignore their real disease, along with their thoughts and feelings.

I'd also happily give all this to Dinsdale, since he doesn't think it to be much of a problem.
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  #42  
Old 01-12-2018, 06:45 PM
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Comparing the "grief exception" to life problems such as long term job dissatisfaction or loneliness as a way of weakening the disparate nature of situational vs chronic depression is flawed if for no other reason than you never get back the person that you lost in the 'grief exception', yet the depression somehow resolves itself.
  #43  
Old 01-12-2018, 08:09 PM
Dinsdale Dinsdale is offline
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Do you tell that to people with diabetes? Cerebral palsy? Hey, your blood pressure's out of wack? Suck it up you big baby, we've all got problems!
...
Most definitely! If your diabetes, or CP, or HTN isn't so severe that you can't do any appropriate work, get off your fucking ass and toil like the rest of us poor slobs.
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  #44  
Old 01-12-2018, 08:57 PM
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I have unmet needs. I have depressive episodes. The unmet needs have been known to trigger depressive episodes. Deaths frequently trigger depressive episodes.

However, deaths of loved ones, and the anniversaries, make me very sad, sometimes for days. Deaths of strangers are more likely to trigger depressive episodes.

The phrase "broken brain" is deliberately inflammatory. My brain isn't broke; it just foes into a weird physiological downward spiral with a positive feedback loop in response to certain triggers, some of which are emotional.
  #45  
Old 01-12-2018, 09:00 PM
Merneith Merneith is online now
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Why are we talking about people holding jobs? Why, in this thread about mental illness and it's possible causes, are we haranguing people about getting a job? Why is the fear that someone, somewhere, might be receiving disability when maybe they could manage a simple job, a bigger problem then the fact that America's health system does such a shitty job of providing care for the mentally ill?

Why, when faced with a question about what causes depression, do some people immediately insist that depression is just an excuse to get out of holding a job.

Why do we fetishize work? Why is holding a job the only way to contribute to society? Why are people who don't work assumed to be faking it? Why can't appreciate the other contributions people make to society?

Is that all there is? Are we just the sum of our paychecks? If we care for our elderly parents, or do lawncare for the neighborhood, or teach a child to read - does it matter at all if we're not getting paid for it?

Does it only count if you hate it?

Are we just animals - hairless squirrels burying nuts for winter? Christ is there any greater reason to kill oneself than the endless tedious bullshit about getting food - cooking food - eating food - shitting food. Gotta work! Gotta get those nuts! Gotta eat those nuts! Gotta shit those nuts! Gotta get a job - gotta get more nuts. Gotta get a house to store my nuts - gotta eat those nuts - gotta shit! Gotta get a bigger house - gotta shit bigger nuts - gotta get a bigger job - get more nuts - gotta eat - gotta shit gotta eat gotta shit gotta eat gotta shit gotta eat gotta shit. Gotta Work! Gotta work for those nuts! OH NO!! THAT ANIMAL OVER THERE IS LOOKING AT MY
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Old 01-12-2018, 09:03 PM
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Oh, right, the OP. Yeah, it didn't really ring true for me either.
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Old 01-12-2018, 11:33 PM
Spice Weasel Spice Weasel is offline
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Originally Posted by j666 View Post
I have unmet needs. I have depressive episodes. The unmet needs have been known to trigger depressive episodes. Deaths frequently trigger depressive episodes.

However, deaths of loved ones, and the anniversaries, make me very sad, sometimes for days. Deaths of strangers are more likely to trigger depressive episodes.

The phrase "broken brain" is deliberately inflammatory. My brain isn't broke; it just foes into a weird physiological downward spiral with a positive feedback loop in response to certain triggers, some of which are emotional.
Some people find the word "crazy" offensive, too. I guess it just depends. I call myself crazy and have no problem with the notion that my brain is broken. For me it's just part of acceptance of my lot in life.
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Old 01-12-2018, 11:49 PM
Spice Weasel Spice Weasel is offline
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Originally Posted by Merneith View Post
Why are we talking about people holding jobs? Why, in this thread about mental illness and it's possible causes, are we haranguing people about getting a job? Why is the fear that someone, somewhere, might be receiving disability when maybe they could manage a simple job, a bigger problem then the fact that America's health system does such a shitty job of providing care for the mentally ill?

Why, when faced with a question about what causes depression, do some people immediately insist that depression is just an excuse to get out of holding a job.

Why do we fetishize work? Why is holding a job the only way to contribute to society? Why are people who don't work assumed to be faking it? Why can't appreciate the other contributions people make to society?

Is that all there is? Are we just the sum of our paychecks? If we care for our elderly parents, or do lawncare for the neighborhood, or teach a child to read - does it matter at all if we're not getting paid for it?

Does it only count if you hate it?

Are we just animals - hairless squirrels burying nuts for winter? Christ is there any greater reason to kill oneself than the endless tedious bullshit about getting food - cooking food - eating food - shitting food. Gotta work! Gotta get those nuts! Gotta eat those nuts! Gotta shit those nuts! Gotta get a job - gotta get more nuts. Gotta get a house to store my nuts - gotta eat those nuts - gotta shit! Gotta get a bigger house - gotta shit bigger nuts - gotta get a bigger job - get more nuts - gotta eat - gotta shit gotta eat gotta shit gotta eat gotta shit gotta eat gotta shit. Gotta Work! Gotta work for those nuts! OH NO!! THAT ANIMAL OVER THERE IS LOOKING AT MY
The endless demand for productivity reminds me of my standard metaphor for living with mental illness. In Stephen King's novel The Long Walk, the protag is part of an endurance competition where anyone who walks below a certain speed is shot and killed. The last one standing wins all sorts of glorious prizes.

Of course, the last one standing is permanently traumatized and winning means nothing. In my metaphor, "winning" is death in old age. All paths lead to death.

Not only does life with depression feel like The Long Walk, I'm often envious of the ones taken out early in the competition. What a sweet fucking relief death will be. I think about that even on the good days. I'm exhausted. And I don't mean now, in this minute, I mean permanently, until the day I drop dead, so fucking tired.
  #49  
Old 01-13-2018, 12:00 AM
Spice Weasel Spice Weasel is offline
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That was kinda bleak, so I want to be clear it's not suicidal ideation. It's just a feeling of wanting a chance to rest in the endless marathon of life.
  #50  
Old 01-13-2018, 12:47 AM
SeniorCitizen007 SeniorCitizen007 is offline
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"This place is driving me mad" (Mixed anxiety depression, MAD). That's what I thought back in 2012 as I stood in my flat in London trying to plan an organised escape from the intolerable pressures being placed on me by certain individuals who had "influence and authority" over my life ... who could appear at my door at any moment. Everytime I moved a burst of intense confusion messed with my mind and body. I had no option but to walk out the door and never come back. Once I'd made up my mind what I needed to do my mind became clear and my body became fully-functional.
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