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.
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.
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.
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.
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
Oh, right, the OP. Yeah, it didn’t really ring true for me either.
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.
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.
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.
“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.
. I think before we can determine that a person has a physiological problem preventing them from having a proper balance of all the chemicals we need to maintain a sense of well being on this planet it would be necessary for them to accept a long list pf premises that are known to be conducive to good emotional health. The first one is. Do you really want to get better? Are you willing to go to any length to get better? From that point on they could simply start following instructions. Obviously what they have done in the past hasn’t worked, if they can admit that maybe they would be willing to try something new. Life is difficult for nearly all creatures on this planet, humans have it easier than most, start off with gratitude.
Are you under the impression that recovery from mental illness is as straightforward as following a list of instructions and that it’s simply a matter of being willing to work hard at it?
You are mistaken.
I’m not grateful for depression. Not even a little. There is a lot of evidence that the expectation for people to think positively about genuine suffering causes greater psychological harm. People are allowed to be angry about their suffering.
I think for some it is just a matter of getting some new tools and for others it is not. I think it can be very difficult to distinguish between the two. I also think that a person suffering from depression might be about the worst judge there is of what she or he might need to fix it.
That’s fair.
I’m speaking as someone who has done psychodynamic therapy, group psychodrama, group therapy, DBT, CBT, cognitive therapy, EMDR, prolonged exposure, behavioral activation and ACT in an attempt to treat my problems. Most of them gave me some tools that help, but none of them disappeared the problem.
I’m addition to therapy I’ve also done TMS to the tune of $10,000 and tried somewhere in the neighborhood of 15 different medications, one of which worked fantastically, but lowered my seizure threshold and resulted in a three day hospital stay for a grand mal seizure cluster.
I’m unusually proactive about mental health. Nobody could tell me with a straight face I haven’t been trying hard enough.
As mentioned upthread, I keep it under management through a combination of things, including mood stabilizers, behavioral activation, exercise, proper nutrition, meditation, monophasic birth control, regular socialization, and internet restriction. It would be difficult for a mentally healthy person to do all that. For me, it’s impossible. I’m always spinning some plates and dropping others.
I’ve made peace with it. I am no longer on a fruitless search for a cure. I’m always on the lookout for new tools and ideas, but life is more about managing crises when they come up less than trying to fix myself.
I don’t know why I am this way. I don’t know what percentage is genetics or my mother or any number of things. Trying to figure that out is rather pointless, because knowing why, we still wouldn’t know how to treat it. Mental illness treatment is still a trial and error thing. There are some treatments known to work the best for most people, but mine falls into a category called “treatment-resistant” and that’s the case for many. That’s why Acceptance and Commitment Therapy (ACT) helped me so much. It taught me how to live with chronic depression.
Threads like this one remind me that all too often, people fail to differentiate between feeling down/sad a large proportion of the time, but coping with it to allow one to keep a job and interact socially - as opposed to severe depression, where the black cloud covers your life and makes normal functioning impossible.
The latter is a serious, life-threatening illness. Blathering about “unmet needs” in such a circumstance makes no sense. Those people need active intervention, generally including antidepressants with close monitoring. Later on, you can analyze their “needs”.
Singled out and bolded for TRUTH.
Too many people think it’s all solved and you just need to go to a doctor who will give you the right drugs and you’ll be fine.
Not even remotely true. It’s all guesswork and all too much of modern medicinal pharmaceuticals is “well it appears to work this way in some people even though we originally thought of this drug for something completely different”. Far too many of them have dangerous or unhelpful side effects (and lucky me, I seem to be the guy who always hits the “less than 1% will experience this” side effects). Or they may work fine for some people and have deleterious effects for others.
There is no cure-all. There’s very little “exact science”. We’re still in the age of “hey, here’s a new chemical compound, let’s see how it affects the human body!”.
Disclaimer: I’ve read part of this thread and just skimmed the rest.
Here’s a detail I’m not seeing discussed about the “unmet needs” hypothesis, or maybe I’ve just missed it:
Some people may be depressed about “unmet needs”, and some on those people may just simply be plain flat-out unable to ever get those needs met – for whatever reason. The people who are pushing the “unmet needs” theory, AFAICT, aren’t offering much of a constructive solution beyond advising that people with “unmet needs” should get their needs met. And perhaps with the corollary that the therapist’s job is to help them get their unmet needs met?
Hey, if you’re horribly poverty-stricken and your family has been for generations, there are probably a lot of things you’d like to have happen in your life that just aren’t going to happen. What solution does the “unmet needs” therapist offer for this? Lottery tickets?
Hey, if it’s your life’s ambition to be a star Major League baseball hero but you just aren’t (see: Damn Yankees), and you’re depressed about that, what’s the solution? How ya going to go out and get that need met (especially if you’re a middle-age has-been wallowing in your fantasy might-have-beens).
Are the therapists of the “unmet needs” school just peddling fantasies?
I don’t have any reason to buy into the unmet needs camp, but I think being right and having a constructive solution aren’t necessarily related. The old joke about the man looking for his lost watch under a lamppost because that’s where the light is springs to mind.
[emphasis mine]
Thank you. Depression is not just being depressed about something.
Depression frequently has ‘triggers’, but they are more likely to be a week of bad diet and no exercise as a sad event or circumstance.
And there is nothing wrong with it being both.
I’m a victim of a chemical imbalance. But that triggers when my environment gets out of control, then feeds itself like a hurricane. My needs are security and stability - and life is not going to be 100% secure and stable, so once in a while I’m going to spin out of control. Medication helps, but I also need the stable and secure environment. Both my environment and my brain chemistry need to keep steady for me to remain mentally healthy - when either goes out of whack, so does my mental health until both can get back into balance.