# Why is depression so prevalent in contemporary society? **URL:** \ **Category:** In My Humble Opinion\ **Created:** [February 5, 2013, 8:37pm UTC](https://boards.straightdope.com/t/why-is-depression-so-prevalent-in-contemporary-society/649418 "2013-02-05T20:37:58Z")\ **Posts on this page:** 20\ **Page:** 6
**Author:** ![phouka](https://avatars.discourse-cdn.com/v4/letter/p/c5a1d2/32.png) [@phouka](https://boards.straightdope.com/u/phouka)\ **Post date:** [February 9, 2013, 4:59pm UTC](https://boards.straightdope.com/t/why-is-depression-so-prevalent-in-contemporary-society/649418/101 "2013-02-09T16:59:47Z")
**Broomstick** , thank you. Your post was a cogent description of the different kinds of depression - from feeling blue to situational depression to full blown major depressive disorder. I agree that most of the people posting to this thread aren’t making that differentiation and are lumping MDD with exogenous, transient depression. I used to think what I had to deal with was exogenous depression - external stresses brought me down, I had a hard time coping, I felt like I’d failed and let others down, and so I was depressed. Probably the first couple of bouts were, but like you said, exogenous depression can alter brain function until it becomes endogenous, and that’s where I am now. And like **monstro** says, symptoms of depression can cause external problems. Yesterday, I was working at about 30% capacity, because I just _couldn’t_ concentrate. I’d have been better off taking a sick day, but if I took one every time my brain was that far below par, I’d be out of PTO in very short order. I very much agree with your “toolbox” approach. Right now, because of life circumstances, I’m down to just the medication and a regular sleep schedule. Trouble is, the very symptoms of depression are what make it so very difficult to open that toolbox, pull out those tools, and put them to work. ---
**Author:** ![Tethered\_Kite](https://avatars.discourse-cdn.com/v4/letter/t/a5b964/32.png) [@Tethered\_Kite](https://boards.straightdope.com/u/Tethered_Kite)\ **Post date:** [February 9, 2013, 5:26pm UTC](https://boards.straightdope.com/t/why-is-depression-so-prevalent-in-contemporary-society/649418/102 "2013-02-09T17:26:56Z")
Just skimmed the thread but if it hasn’t been mentioned - Diagnosing mental health professionals are pretty skilled at finding a diagnosis which is the least stigmatizing yet will provide the maximum amount of insurance support for patients. I think that’s part of the reason we see mental health diagnoses go in streaks. I’ve noticed a trend recently for Bipolar Disorder for people who were previously diagnosed with Depression and suspect that insurance companies have been reacting to an overload of Depression patients. Any psychiatrists here who can comment on that? While I won’t take time to find a cite, OP, it’s commonly recognized that one in four Americans will suffer a bout of serious depression during his lifetime. ---
**Author:** ![phouka](https://avatars.discourse-cdn.com/v4/letter/p/c5a1d2/32.png) [@phouka](https://boards.straightdope.com/u/phouka)\ **Post date:** [February 9, 2013, 5:39pm UTC](https://boards.straightdope.com/t/why-is-depression-so-prevalent-in-contemporary-society/649418/103 "2013-02-09T17:39:57Z")
> [@Tupac](#): > > Phouka, I’m not going to say that clinical depression is not a real diagnosis. I can respect the understanding of chemical imbalances along with other factors that can lead to this condition. I’ve struggled with depression myself. I doubt it was as severe as what you may be discussing, but I was pretty down in the dumps. > > Lately, I’ve felt a lot better than I ever have. I’m finally headed in a direction I want to take career-wise. I’ve seperated myself from a lot of negative people and surrounded myself with positive people. Now, instead of saying “I fucking suck. I hate myself. Why does life suck so bad?” I replaced it with, “I’m a kind, confident, easy going and good looking dude.” Or simply “I’m a beast.” I also have learned about a lot of the struggles others go through and when compared with mine, realize how lucky I am. I’ve changed my diet and exercise regularly (even though I did that back then too.) > > When I do all these things, I feel better. What kind of role do you feel these interventions play in combating depression? How is this more/less effective than drug therapy? > > I’d like to hear from anybody else with an opinion on the matter as well. I’ll tell you that pretty much, if separating yourself from negative people and doing some self-affirmation exercises fixed your situation, you did not have endogenous depression. You may very well have had situational depression, which can be brutal indeed, but situational depression goes away when the situation changes. Read **Broomstick’s** description up above. Like **monstro** , there are some aspects of my illness I don’t like discussing. I accept that I have an illness, and when I can I try to educate others about it. But, while I will recite symptoms - tiredness, hypersomnia, labile emotions, despair, amotivation, et cetera ad nauseum - and I will try to explain what an average day’s depression feels like, I have avoided describing just how disordered my thinking can become in the grips of severe depression. It’s frightening and disturbing, I imagine it could freak other people right the hell out, and there’s the very real possibility that by putting this out there, people will pull back from me and avoid me. But here you go. Three years ago, I was in the middle of the worst bout of depression I’ve ever experienced. Here’s what it was like inside my head: > [@phouka's broken brain](#): > > I can’t believe I forgot to mail Mom’s letter. I need to be helping, and I’m just making things worse. Mom’s so stressed out, and all I can do is fuck things up. I am a waste. I’m a burden. No wonder Dad can’t stand me. Why does anyone put up with me? God, no wonder I don’t have any friends. Nobody wants me. Why am I even here? **I should just fucking kill myself and get it over with. It’s never going to get any better. It’s never going to stop hurting. WHAT IS WRONG WITH ME?** And that’s before I started considering methods like an overdose, driving into an abutment, walking out into the ocean, cutting my wrists . . . Never mind that I could have just gotten back in the car, driven to the post office and dropped the letter in a mailbox. Never mind that the letter wasn’t _that_ important, or that my suffering was much more stressful for my mom that a stupid letter. Never mind that the reason my father couldn’t stand me had nothing to do with me and everything to do with his Alzheimer’s, or that I had and still have plenty of friends. Depression doesn’t just make a person feel “down”. It distorts and destroys normal thought processes. It causes physical pain and mental anguish. It annihilates a person’s sense of self first by making them feel helpless (“nothing I do will change anything”) and then hopeless (“nothing anyone does will ever help”). Still think your method is going to help? All the other things normally suggested either didn’t help at all (exercise, better eating, getting more sunlight) or helped only while I was doing it (crying it out, sleeping it off, or once, cutting the fleshy part of my arm so that my brain would release some endorphins (only worked for five minutes, and then I was back in that pit, AND I had a self-inflicted cut on my arm)). What worked at that moment was to take 5 mg of diazepam and a 5-500 hydrocodone. The diazepam killed the spiraling thoughts, and the hydrocodone stopped the pain. What worked longer term was getting to a public mental health clinic and getting an hour of in-depth counseling twice a week as well as a major adjustment of my anti-depressants with two follow up adjustments. That’s what depression is, **Tupac**. That’s what it does. And that’s why I and others are so offended when people recommend that we can get better by changing our internal dialogue. You might as well tell the crew of Titanic to start bailing with teaspoons. ---
**Author:** ![even\_sven](https://avatars.discourse-cdn.com/v4/letter/e/dfb087/32.png) [@even\_sven](https://boards.straightdope.com/u/even_sven)\ **Post date:** [February 9, 2013, 6:54pm UTC](https://boards.straightdope.com/t/why-is-depression-so-prevalent-in-contemporary-society/649418/104 "2013-02-09T18:54:55Z")
Different people have different experiences. I’ve told my story here before, but I was depressed from maybe middle school on. As I finished college, it got worse and worse until I had a very bad year where I was experiencing basically every symptom you’d expect from major depressions. We are talking about weeks spent in bed, crying in public, howling despair, and the whole shebang. There is no doubt in my mind that it was the “real thing.” For whatever reason, I was resistant to drugs. Maybe it was youthful idealism. Maybe it was some intuition that it wasn’t the best path for me. Maybe it was that the doctor who tried to prescribe them to me saw me for less than five minutes. Eventually, things hit a rock bottom and somehow, from some strange part of me, came the thought that maybe getting better wouldn’t be so bad. What came next was the hardest thing I’ve ever done. I had to tear my personality apart brick by brick, break away from all of my maladjusted coping devices, and face the things I was terrified to face- namely, all the responsibilities and work I’d have to if I got better. The process was brutal and terrifying, but it didn’t actually take that long. What I was doing was basically a homegrown form of CBT. Within a week, I was feeling better. By the end of the year, I’d completely turned my life around. Since then, I have been completely free of depression. There have been times when I’ve felt it edging in, but I’ve developed an arsenal of positive coping devices and it’s never stuck again. Everyone has a different path. I am glad the medication has given so many people their lives back. But I also will not believe that medication is the only way, or that it is right for everyone. I know I am grateful that I found what seems like a permanent solution. Depression is a complex disease, and as much as we wish it was as straightforward as a broken arm, it never will be. ---
**Author:** ![Guinastasia](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/guinastasia/32/5751_2.png) [@Guinastasia](https://boards.straightdope.com/u/Guinastasia)\ **Post date:** [February 9, 2013, 7:05pm UTC](https://boards.straightdope.com/t/why-is-depression-so-prevalent-in-contemporary-society/649418/105 "2013-02-09T19:05:56Z")
No, meds aren’t the only solution – in fact, I think therapy should be encouraged whether you’re on meds or not. Not everyone needs the same treatment, and I think therapy should always accompany a scrip for meds. Sometimes antidepressants can be used to treat an anxiety disorder, like OCD. That’s the case with me. Anxiety disorders can trigger depression, or at least that’s what happened in my case. When I was finally diagnosed, therapy helped, but with my meds, it brought me back on balance. I could _feel_ again. I could be normal sad, not depressed sad. When I was depressed, it was like nothing brought me any pleasure. My favorite foods didn’t taste good, my favorite songs didn’t sound as good, I didn’t want to watch my favorite shows, or read, or go out and hang out with my friends. Everything was so blah. I just wanted to lie around and stare up at the ceiling. I couldn’t eat because I was always nauseous and I probably lost about fifteen pounds. I used to take extra long showers and I’d just curl up inside the tub and cry. There wasn’t anything specific bothering me, although I could say there were events that triggered it. But even happy stuff didn’t help. I don’t ever want that to happen again. If hell exists, that’s it. If anti-depressants are a crutch, so be it. ---
**Author:** ![Broomstick](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/broomstick/32/246_2.png) [@Broomstick](https://boards.straightdope.com/u/Broomstick)\ **Post date:** [February 9, 2013, 7:46pm UTC](https://boards.straightdope.com/t/why-is-depression-so-prevalent-in-contemporary-society/649418/106 "2013-02-09T19:46:38Z")
> [@even\_sven](#): > > Everyone has a different path. I am glad the medication has given so many people their lives back. But I also will not believe that medication is the only way, or that it is right for everyone. I know I am grateful that I found what seems like a permanent solution. Depression is a complex disease, and as much as we wish it was as straightforward as a broken arm, it never will be. That’s one reason people have such trouble understanding it, our society has conditioned people to want simple answers and sometimes a simple answer just doesn’t exist. That’s one reason I like the diabetes comparison. Sure, in a sense diabetes is “simple” - your body no longer processes sugar correctly and there’s too much of it floating around your bloodstream. It’s not simple, though, it has multiple causes and multiple forms, and management can be extremely difficult. Some people can control it sufficiently through behavior (diet, exercise, losing weight, etc.) and some can’t and need insulin. Some people can _usually_ control it through behavior but may need insulin if there is an added stress of some sort (illness, severe emotional stress, etc.) and it’s better if they have medication for those “episodes” than not, because leaving those “episodes” untreated can cause further damage. People who have Type I diabetes are not “weak willed” because they’re dependent on insulin. People who have horrible complications may or may not be screwing up on their medication - some people just don’t do well no matter what is tried and we don’t know why. The difference is that diabetes can be _quantified_ - you can run tests and compare numbers. It’s so _objective_. You can’t run a blood test that detects endogenous depression (at least not yet). It’s based on _subjective_ symptoms to a large extent and that means there will always be people who don’t believe it’s real. So… with depression some people can control it by behavior and some can’t and need medications. Some people only need medication occasionally and some every day for life. The disease can be well managed or mismanaged. People can be under or over medicated for either depression or diabetes. And some people, we don’t know why, don’t seem helped by _anything_ we do and have horrible complications. I’ve probably spent too much time thinking about this over the years, but since major depression does happen in my family, and we seem to have at least one suicide a generation, it does concern me. Also what concerns me is the “contagion” aspect of the stigma - the notion that if one member of a family is mentally ill they ALL must be. Most notably, I remember a woman who used to just tell me to cheer up whenever I was down, and get over it, and it’s not such a big deal… until she found out my oldest sister was a suicide, THEN it was “OMG! OMG! Are you SUICIDAL??? Do you want to HURT YOURSELF? You should see a DOCTOR and get MEDICINE or you WILL KILL YOURSELF IN THE END!!!” which is about when I stopped associating with her, because who the hell needs that when all you say is “work didn’t go that well today”? Just because my sister had a particular disease doesn’t mean we ALL do… most of us are quite normal and functional people, thank you very much, who thoroughly enjoy life, except for the occasional icky bit, which is transitory. My god, you’d expect people like this, upon hearing one sister was diagnosed with breast cancer, to get hysterical if every woman in the family isn’t immediately rolled into surgery for a double mastectomy. Because, you know, if it happened to ONE of them it MUST happen to ALL. So, sometimes, I do think people who don’t need medication are pushed into it by other, well-meaning folk unable to notice the difference between one form of “depression” and another. Or who want an easy answer to a complex problem. A big difference between me and someone who has had a major depressive disorder? Even at my absolute _worst_ I never had any notion of killing myself. Never (and I’ve had some people express disbelief at that - what? You _never_ thought of killing yourself? No, actually not… I _always_ want to know what happens next, what happens tomorrow, next year…but it does make me wonder just how many people have had a serious depressive episode who now appear normal). On the other hand, judging by the conduct of those in my family with actual major depression, it is a thought that occurs fairly often to them, and not just as a thought but they _think_ it, _plan_ it, they figure out a process of doing it and sometimes succeed quite well at it. Not a “cry for help” at all but a serious opt-out action. The other side is that have a doctor write you a prescription for something seems to legitimize it in some peoples’ eyes. You’re seeing a therapist and just _talking_ about being depressed? Why, you’re a self-absorbed first-world twit! But if a doctor gives you a _drug_ for it - that must be a _real disease!_ Or, in the case of my unemployment misery, I several times received the suggestion “talk to a professional! Talk to a therapist!” _Why?_ What would that have given me that I didn’t already have, other than yet another bill? I _knew_ what the problem was: I was so poor I didn’t have the money to put a roof over my head or food on my table. I _knew_ what the solution was: get a job! And until you get a job swallow your pride, apply for food stamps and whatever else you might qualify for, and yes, go to the family and ask for financial help. Which is what I did and eventually it worked. Yay, me. But I was lucky in that the problem and solution(s) were so clear - for _many_ people the source of their unhappiness is not so clear or easily remedied. My spouse is depressed because he’s disabled and suffers chronic pain. That sucks, you know? The source is clear _but there is nothing that can fix it_. Medicine has no way to make him undisabled and chronic pain control is difficult at best. So he takes Prozac and it helps him a great deal. Better yet, it allows him to deal with his chronic pain without needing constant and ever-increasing doses of pain killer. He’s an example of depression with a clear cause that isn’t brain chemistry but can’t really be fixed either so in that particular case life-long treatment of symptoms is about all we can do. And it works and he enjoys life. It’s still not the sort of depression my sister had, which really didn’t have any external cause. No matter how well things were going for her, no matter how much she accomplished, it never killed that dark cloud that surrounded her. What killed her, in the end, was getting hit by multiple stressors even people with normal brain chemistry would have trouble handling well. For her, it was just too much, even if those triggering events were transitory. Or, as I’ve occasionally explained it, she ran out of “cope”. She just couldn’t cope with it any more. I’m still angry as hell about the horrific pain she dealt to the rest of us, but yeah, I think I understand why she took her own life. I don’t _agree_ with her action, but at least I’m pretty sure why she took it. I suppose that will have to be enough. In a way, what got her was piling situational depression on top of endogenous depression which is a double-dose of hell. Having seen what my sister (and my mother, and one of my nephews now) dealt with, though, comparing intrinsic depression with what the rest of us mean when we use that term… no, it’s not the same thing at all. That’s why I wish people could/would distinguish more between types of depression (while recognizing that there are forms of it that are a mix of types - you can have a really bad day while being in a suck situation AND while having bad brain chemistry, which I shudder to think about!) ---
**Author:** ![panaccione](https://avatars.discourse-cdn.com/v4/letter/p/94ad74/32.png) [@panaccione](https://boards.straightdope.com/u/panaccione)\ **Post date:** [February 9, 2013, 9:16pm UTC](https://boards.straightdope.com/t/why-is-depression-so-prevalent-in-contemporary-society/649418/107 "2013-02-09T21:16:43Z")
How do they distinguish someone with clinical depression who may need medication from somebody who’s just going through a tough time and maybe needs to make some better decisions? ---
**Author:** ![Boyo\_Jim](https://avatars.discourse-cdn.com/v4/letter/b/87869e/32.png) [@Boyo\_Jim](https://boards.straightdope.com/u/Boyo_Jim)\ **Post date:** [February 9, 2013, 9:22pm UTC](https://boards.straightdope.com/t/why-is-depression-so-prevalent-in-contemporary-society/649418/108 "2013-02-09T21:22:04Z")
There’s a difference? ---
**Author:** ![solosam](https://avatars.discourse-cdn.com/v4/letter/s/9d8465/32.png) [@solosam](https://boards.straightdope.com/u/solosam)\ **Post date:** [February 9, 2013, 9:34pm UTC](https://boards.straightdope.com/t/why-is-depression-so-prevalent-in-contemporary-society/649418/109 "2013-02-09T21:34:15Z")
> [@](#): > > Depression is one of the easiest things to convince a person they have, then you get them to take this marvelous “medication” to make it “all better.” > > It is total bullshit. It’s good to know that low brain cell production of serotonin, a lack of receptor sites able to receive the serotonin that is made, inability of serotonin to reach the receptor sites, or a shortage in tryptophan, the chemical from which serotonin is made, is all bunch of bullshit and has never been subject to peer-reviewed scholarship. Depression, then is just the fantasy of a loser seeking drugs, and _not_ the result of demonstrated imbalances in brain function and chemistry that can be corrected by modern medicine. Thank you for clearing that up. \ ---
**Author:** ![solosam](https://avatars.discourse-cdn.com/v4/letter/s/9d8465/32.png) [@solosam](https://boards.straightdope.com/u/solosam)\ **Post date:** [February 9, 2013, 9:35pm UTC](https://boards.straightdope.com/t/why-is-depression-so-prevalent-in-contemporary-society/649418/110 "2013-02-09T21:35:59Z")
> [@](#): > > How do they distinguish someone with clinical depression who may need medication from somebody who’s just going through a tough time and maybe needs to make some better decisions? > [@Boyo\_Jim](#): > > There’s a difference? It deals with recurrence of symptoms. Someone having a hard time will go through depressive episodes, but when the episodes are repeated or sustained for months on end it becomes pathological rather than an obvious response to unpleasant stimuli. ---
**Author:** ![panaccione](https://avatars.discourse-cdn.com/v4/letter/p/94ad74/32.png) [@panaccione](https://boards.straightdope.com/u/panaccione)\ **Post date:** [February 9, 2013, 9:39pm UTC](https://boards.straightdope.com/t/why-is-depression-so-prevalent-in-contemporary-society/649418/111 "2013-02-09T21:39:33Z")
Disregard my last post. I didn’t see the new ones that Phouka and Broomstick had put up. It seems like it would be very stressful and scary to have those extreme thoughts raging through your head. You’re right, I haven’t gone through something like that. I’ve had suicidal ideation, but I can’t say I’ve ever actually planned it out to any real extent. I don’t think I fully understand though, and I’m not sure if I’m capable of it. I’ve had periods in my life where I’ve been frustrated like that, but after a cooling down period I’m able to think more clearly. So when I find myself in that situation, I just tell myself to “calm down” and that “I can handle this”, and that usually works. I’m not saying though that it would work for you, or someone with your condition. I can respect that this type of disorder is more complicated than that. But why doesn’t that work? I’m not trying to be snarky at all either. Honest question. Regardless, thank you for sharing. I’ve learned a lot already. ---
**Author:** ![solosam](https://avatars.discourse-cdn.com/v4/letter/s/9d8465/32.png) [@solosam](https://boards.straightdope.com/u/solosam)\ **Post date:** [February 9, 2013, 10:12pm UTC](https://boards.straightdope.com/t/why-is-depression-so-prevalent-in-contemporary-society/649418/112 "2013-02-09T22:12:10Z")
> [@Tupac](#): > > I don’t think I fully understand though, and I’m not sure if I’m capable of it. I’ve had periods in my life where I’ve been frustrated like that, but after a cooling down period I’m able to think more clearly. So when I find myself in that situation, I just tell myself to “calm down” and that “I can handle this”, and that usually works. > > I’m not saying though that it would work for you, or someone with your condition. I can respect that this type of disorder is more complicated than that. > > But why doesn’t that work? A few points: A pathological mental disorder, almost by definition, implies the patient does not understand the unreality of their own perceptions. A depressed patient has a hard time admitting their perceptions are unreasonable, the same way a schizophrenic has difficulty identifying their hallucinations. If you can bring the depressive episode under control that easily, you probably don’t have clinical depression. Cognitive therapy spends a great deal of time and effort trying to instill these skills in the patient. The goal is to allow the patient to identify cognitive biases and misperceptions so that they can combat the symptoms with reason. This is not always sufficient, but any decent doctor will at least try cognitive therapy before moving on to medication. My last point (that some people on this board appear to struggle with) is that clinical depression is often rooted in biological factors and imbalanced brain chemistry. Thinking happy thoughts does not bring my serotonin levels back into balance. Looking at the psychiatric history of my family, it is quite clear that my depression is an inherited condition and therefore largely unrelated to the circumstances in which I find myself. By an objective measure, I should be a happy person, but my brain chemistry does not permit me to feel happiness as much as a normal human being. (Although its worth pointing out that SRIs don’t necessarily promote happiness, either… they just balance the moods so you feel neutral rather than awful) So in my case, cognitive therapy is only mildly effective. ---
**Author:** ![Broomstick](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/broomstick/32/246_2.png) [@Broomstick](https://boards.straightdope.com/u/Broomstick)\ **Post date:** [February 9, 2013, 10:25pm UTC](https://boards.straightdope.com/t/why-is-depression-so-prevalent-in-contemporary-society/649418/113 "2013-02-09T22:25:28Z")
> [@Tupac](#): > > How do they distinguish someone with clinical depression who may need medication from somebody who’s just going through a tough time and maybe needs to make some better decisions? > [@Tupac](#): > > Disregard my last post. I didn’t see the new ones that Phouka and Broomstick had put up. Actually… I’m not going to disregard it because it is a valid question. One necessity is looking at a medical history: have there been prior depressive episodes or other evidence of mental illness? You also need to examine their lives: have there been recent events that, even in normal people, generate negative emotions? A death in the family, loss of a job, divorce, severe illness or accident, and various other things can trigger a “depressive episode” even in people with normal brain chemistry. Having _multiple_ such events makes for even more stress and more likelihood of serious depression. How is the environment in which they live? Is their home clean and secure with adequate heat/cooling and working plumbing, or is it a rat-infested hellhole with no heat, a leaking roof, and everyone has to shit in a bucket because the toilet hasn’t worked in six months? Do they even _have_ a home? (Homelessness can be hugely traumatic and unsettling). If someone has been humming along happy for, say, 50 years and suddenly, without any obvious triggering event, becomes horrifically depressed then doctors might even start looking for things like brain tumors or some other sort of physical illness sort of cause. A comprehensive look at the patient and his/her circumstances is soooo important… and that’s why the 15 minute consult with an overworked doctor who then writes a script for X, Y, or Z without any counseling unnerves some of us, because that’s not good medicine for this condition. Back in the days when anti-depressives had much worse side effects than the current popular ones “talk therapy” and behavior modification was usually tried first and if that didn’t work the conclusion was usually it’s a brain problem. Now, drugs might be tried _first_, and sometimes only, even though they probably won’t do much or anything if the problem is situational rather than chemical. It’s a process of deduction and sometimes elimination. > [@](#): > > I don’t think I fully understand though, and I’m not sure if I’m capable of it. I’m not sure I’d _want_ to fully understand that mindset, even though I acknowledge it exists. It’s just so foreign to my own way of thinking. But, you know, you don’t need to break your own leg to recognize that someone else’s broken leg hurts really, really badly. > [@](#): > > I’ve had periods in my life where I’ve been frustrated like that, but after a cooling down period I’m able to think more clearly. So when I find myself in that situation, I just tell myself to “calm down” and that “I can handle this”, and that usually works. > > I’m not saying though that it would work for you, or someone with your condition. I can respect that this type of disorder is more complicated than that. > > But why doesn’t that work? Because their brain functions differently than yours does. Those of us without diabetes might talk about “low blood sugar” or a “sugar rush” but it’s nothing like what they mean by the term. For us normal folk we just have to wait it out, we don’t really have to _do_ anything (your “cooling down period”, so to speak). A diabetic’s body doesn’t do that automatically, it requires either behavior modification (to eat properly, the right foods, and at regular intervals) or medication (from oral ones up to the various formulations of insulin) or both to keep things within normal range. Likewise, someone with abnormal brain chemistry will _not_ always return to baseline after being knocked by a stressor and may need either specific behavior or medication or both to restore something like normality. Your brain might be knocked away from a normal balance by something - job loss, death of a loved one, whatever - but given some time it will go back to where it should be _by itself_. A brain with clinical depression won’t. It might not even with behavior modification or medication, either, which is why, in very extreme cases, electroshock therapy is still used on occasion. And sometimes that doesn’t work either. I’d also like to point out that there are some instances where thoughts of suicide are considered _normal_ in the sense of “it’s a common reaction” rather than “this is a desirable state”. For example, people who have an accident that makes them suddenly quadriplegic _often_ go through a period of severe depression and thoughts of suicide. It’s not a desired reaction but it’s a normal, that is, common reaction to such a disabling injury. Often, through rehab and adaption, quadriplegics come to terms with their condition and decide they want to live and may even go on to live happy and fulfilling lives. (Although not all of them do - not everyone can make that adaption) Someone in that situation who _doesn’t_ go through some sort of depressive episode may lead to medical people worrying that perhaps there was some sort of brain damage that occurred along with the spinal damage, or something else amiss although sometimes it’s just that a person is so congenitally upbeat they weather such tragedy better than the average person. Isn’t that interesting? There ARE people who just never seem to get depressed no matter how awful their circumstances. You’ve probably encountered some inspirational story about someone who overcame a harsh background and incredibly awful experiences with a smile on their face. We don’t normally see that sort of resilience as abnormal because we view it as a positive, but someone who _never_ went through an unhappy phase when horrible things happen is just as odd as someone who is _never_ happy no matter how wonderful things are, but why shouldn’t the opposite “wrongness” occur as well? And while that sort of “chemical” happiness might be good in one sense I wonder if there are negative effects that aren’t obvious but come to light if you really look into such a person’s life? ---
**Author:** ![panaccione](https://avatars.discourse-cdn.com/v4/letter/p/94ad74/32.png) [@panaccione](https://boards.straightdope.com/u/panaccione)\ **Post date:** [February 9, 2013, 11:00pm UTC](https://boards.straightdope.com/t/why-is-depression-so-prevalent-in-contemporary-society/649418/114 "2013-02-09T23:00:04Z")
That is some interesting shit. The diabetes example makes it very clear too. ---
**Author:** ![monstro](https://avatars.discourse-cdn.com/v4/letter/m/ba9def/32.png) [@monstro](https://boards.straightdope.com/u/monstro)\ **Post date:** [February 9, 2013, 11:30pm UTC](https://boards.straightdope.com/t/why-is-depression-so-prevalent-in-contemporary-society/649418/115 "2013-02-09T23:30:44Z")
> [@Tupac](#): > > So when I find myself in that situation, I just tell myself to “calm down” and that “I can handle this”, and that usually works. > … > > But why doesn’t that work? It works when you aren’t delusional. When you aren’t delusional, you can see that you are facing a minor stress that will eventually abate. You can also easily see the negative feelings about yourself are not based on rational thoughts. When you aren’t delusional, you can remember the times when you weren’t stupid/ugly/horrible. When you are delusionally depressed, a simple mistake becomes the epitome of your non-worthiness. It makes you think of everything you’ve ever done wrong in your entire life. It makes you forget everything good that you’ve ever done. It becomes Exhibit Eleventy-Billion for why You Suck Mightily and Must Die. The kind of self-talking that you do DOES work for some people. It’s the basis of cognitive behavior therapy. But for some people, it just isn’t enough. It’s like how someone who has hallucinations can talk themselves out of reacting to them, but they will still see and hear things that aren’t there. ---
**Author:** ![John\_DiFool](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/john_difool/32/19543_2.png) [@John\_DiFool](https://boards.straightdope.com/u/John_DiFool)\ **Post date:** [February 9, 2013, 11:42pm UTC](https://boards.straightdope.com/t/why-is-depression-so-prevalent-in-contemporary-society/649418/116 "2013-02-09T23:42:36Z")
> [@phouka](#): > > That’s what depression is, **Tupac**. That’s what it does. And that’s why I and others are so offended when people recommend that we can get better by changing our internal dialogue. You might as well tell the crew of Titanic to start bailing with teaspoons. If that is being addressed partially at me (busy last two days), then I apologize. My main points can be summed up as, first, I dislike inventing dichotomies where none are necessarily warranted. Chicken-egg dilemma-even the pros aren’t in agreement as to whether it is the dysfunctional thoughts that cause the depression, or that the depression causes the dysfunctional thoughts. I just dislike it when people conclude that they have the latter “kind”, since that can engender a sort of learned helplessness, biology is destiny, oh well I’m fucked no matter what I do. Second, on that note, I simply believe (due to my innate optimism when even back in my dark days still flickered away deep down) in no fate, that there must be a way out for every person on earth who has this terrible mental dysfunction. But in today’s society many of these ways/methods/practices are often unthinkable, as in not only they often exist beyond where most people imagine them, but beyond where most people can imagine them. Sorry if that offends you, but I am firmly convinced that the thoughts you choose are ultimately capable of radically changing your brain chemistry and transforming your life into one of boundless joy, somehow someway someday. Hope, what a concept, eh? ---
**Author:** ![solosam](https://avatars.discourse-cdn.com/v4/letter/s/9d8465/32.png) [@solosam](https://boards.straightdope.com/u/solosam)\ **Post date:** [February 9, 2013, 11:54pm UTC](https://boards.straightdope.com/t/why-is-depression-so-prevalent-in-contemporary-society/649418/117 "2013-02-09T23:54:18Z")
> [@](#): > > Sorry if that offends you, but I am firmly convinced that the thoughts you choose are ultimately capable of radically changing your brain chemistry and transforming your life into one of boundless joy, somehow someway someday. Hope, what a concept, eh? When this theory gets past peer review, I’ll look into it. ---
**Author:** ![monstro](https://avatars.discourse-cdn.com/v4/letter/m/ba9def/32.png) [@monstro](https://boards.straightdope.com/u/monstro)\ **Post date:** [February 10, 2013, 12:18am UTC](https://boards.straightdope.com/t/why-is-depression-so-prevalent-in-contemporary-society/649418/118 "2013-02-10T00:18:00Z")
> [@John\_DiFool](#): > > Second, on that note, I simply believe (due to my innate optimism when even back in my dark days still flickered away deep down) in no fate, that there must be a way out for every person on earth who has this terrible mental dysfunction. Do you have this amount of optimism for everyone who has dysfunction of some type? Do you think that people can will themselves out of every mental dysfunction? Or is your philosophy just limited to depression? And maybe even not major depression, which is way more than having low self-esteem, but just the existential angst stuff that provides the meat and potatoes for a good number of psychotherapists and Dr. Phil-wannabes? Personally, I think some problems have to be accepted, including a brain that is affectively abnormal. If a person cannot feel boundless joy, then they can work on feeling contentment and satisfaction. And if these are too lofty, then can just try not to have suicidal thoughts. I see no reason to presume that we’re all capable of joy. We aren’t all capable of walking, breathing, eating, shitting, sleeping, reading, talking, or even living. We’re capable of whatever it is we have in us at any point in time. ---
**Author:** ![phouka](https://avatars.discourse-cdn.com/v4/letter/p/c5a1d2/32.png) [@phouka](https://boards.straightdope.com/u/phouka)\ **Post date:** [February 10, 2013, 4:34am UTC](https://boards.straightdope.com/t/why-is-depression-so-prevalent-in-contemporary-society/649418/119 "2013-02-10T04:34:12Z")
> [@John\_DiFool](#): > > Second, on that note, I simply believe (due to my innate optimism when even back in my dark days still flickered away deep down) in no fate, that there must be a way out for every person on earth who has this terrible mental dysfunction. But in today’s society many of these ways/methods/practices are often unthinkable, as in not only they often exist beyond where most people imagine them, but beyond where most people can imagine them. Sorry if that offends you, but I am firmly convinced that the thoughts you choose are ultimately capable of radically changing your brain chemistry and transforming your life into one of boundless joy, somehow someway someday. Hope, what a concept, eh? Oh, so you have the ability to keep your neurons from uptaking serotonin at too fast a pace? With a mere thought, you’ve found a way to dampen the levels of Tumor Necrotic Factor-alpha and Interleukin-6 in your brain? You have - through the power of _thought alone_ - adjusted the delicate timbre of the hypothalamic-pituitary-adrenal axis? BY CHANGING YOUR THINKING, you have decreased the size of your adrenal gland and lateral ventricals WHILE AT THE SAME TIME jump-started neurogenesis within the hippocampus, basal ganglia, frontal lobes, and thalamus. You have no fucking idea what you’re talking about, and your childish insistence that a severe, life-threatening illness can be cured by “better thinking” because it makes you _sad_ that it might be otherwise would be disappointing if you kept it to yourself. Evangelizing others is a sick and misguided cruelty which could get someone killed. Do the rest of us a favor - take our word for it and stop spouting fuzzy-wuzzy woo at people who need acceptance, support, and help. Our hope lies with medical science and advancements made through research, not being blamed for having wrong thoughts. ---
**Author:** ![Guinastasia](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/guinastasia/32/5751_2.png) [@Guinastasia](https://boards.straightdope.com/u/Guinastasia)\ **Post date:** [February 10, 2013, 5:46am UTC](https://boards.straightdope.com/t/why-is-depression-so-prevalent-in-contemporary-society/649418/120 "2013-02-10T05:46:39Z")
If people could reason themselves out of depression, they would. It’s like telling someone with OCD NOT to follow any rituals they have. You KNOW your fears are irrational. But you still can’t stop doing them. You know you turned off the stove. But you still have to check. I know I don’t have to arrange the dishes by color when I put them away – but it bothers me if I don’t. (To the point that if I see that if they’re NOT in that order, I’ll change them) OCD can cause some of the stupidest fears and obsessions around. But you cannot reason yourself out of them – that only makes it worse. The more you try to rationalize, the more you obsess. Trust me, it’s like being posessed. (Fortunately I never had the hand washing problem. I mean, I wash my hands, but not obsessively.) Why is it so hard to believe there might be a chemical problem with peoples’ brains? Seriously, we HAVE seen people change after brain injuries, or taking drugs, of course. So why can’t it be there to begin with? [Previous page](https://boards.straightdope.com/t/why-is-depression-so-prevalent-in-contemporary-society/649418.md?page=5) [Next page](https://boards.straightdope.com/t/why-is-depression-so-prevalent-in-contemporary-society/649418.md?page=7)