I’m not sure I’d even call it irrational as such.
One guy’s happy all the time, loving life, has a positive outlook and things just keep getting better all the time.
Another guy is deeply miserable, bitter about life, has a negative outlook and his life is in a death spiral.
I get why one of those states is preferable to the other, but why is one more rational?
Except that many people have (yes. including me, in case I didn’t make that clear). Google (or Amazon) is your friend. Ironic that I am accused of making things more “dangerous”. The pessimism expressed in this thread is astounding to me, and that is the dangerous part. Help is precisely what I am trying to offer here, biology is NOT destiny here in the way that someone with say diabetes is (leaving it at that). If you want to continue to argue in favor of your depression and resign yourself to remaining that way for the rest of your life, then go right ahead. Meanwhile those with more determination and less learned helplessness than you will continue to find ways to help and cure themselves.
I’ll ask again. Do you think other illnesses can be cured with thoughts? Cancer? Diabetes? Schizophrenia?
If not, how come? How are those illnesses any different from clinical depression?
What bothers me is that you aren’t specific about what you’re talking about. Talk therapy is useful for some conditions–including depression. I won’t disagree with you there. But you will never be able to talk someone out of a catatonic stupor, and anyone who believes this is high on crack or profoundly stupid. As I said before, existential angst issues are the bread and butter of psychotherapists–so you haven’t discovered anything new there. There is a billion dollar industry built on convincing people that they ultimately choose to be whatever they are. And there are tons of people who eat this kind of shit up because it makes them feel superior to those who suffer. It’s one of those things that both Buddhists and Christians can get behind, for their own self-serving reasons. It eases the conscience to believe that there are no diseases or biological conditions–only character defects.
Existential angst is not the same thing as clinical depression. Not anymore than distrust is the same thing as schizophrenia or nervousness is the same thing as OCD. And situational depression is only a subset of depressive cases.
When come back, please bring specifics.
Nobody is talking about just thoughts. Fighting depression takes action. I became extremely diligent about a lot of things- immediately journaling through repetitive thoughts, using relaxation techniques even when they didn’t seem to have an immediate effect, building my personal social networks, avoiding alcohol and other negative coping methods, sleeping regularly, and keeping a certain activity level. Thoughts are only a tiny part of it.
Most important for me has been keeping a very watchful eye on any potential symptoms creeping up and nipping them in the bud. My attitude is that myself and melancholy are like whiskey to an alcoholic. I can’t allow myself even the tiniest bit, no matter how appealing it may seem, because I don’t know how to control it.
Alot of people use the word lightly to refer to just being a little down or disappointed about something ie “I’m soooo depressed, I just gained five pounds”
This is part of the reason alot of people don’t understand what true depression is. Maybe alot of what your seeing are those who some of them might fall more into the former category than the latter, of medical depression
John DiFool.
I’ll give you credit in that people should not just assume that they have a disorder and they are helpless to stop it. Clinical depression is complicated and it is dangerous to diagnose yourself, or being diagnosed as having it, when it is not in fact the case. They should explore every avenue possible before coming to the conclusion that they “clinical depression.”
It’s quite clear though that hormones play a significant role in our moods and behaviour. Certain ones in particular Serotonin, Dopamine, Epinephrine all have a profound impact on our well-being Add to that, our brain must have ample receptors to be able to handle these hormones. Regulation of these is autonomic and entirely out of our control.
People are born with defects all the time. Brain defects are not in any way excluded either.
So when these manifest, people are depressed and they just can’t help it.
That’s the evidence.
If that’s not good enough, you have people actually coming out and saying exactly what the evidence suggests. All signs point to depression as a clinical disorder that cannot be managed by mere “positive thinking.” No, positive thinking does not regulate hormones.
I’m not a doctor or scientist or anything. I just an average guy with an open mind who gives more credit to the evidence than to personal bias.
So, how is “clinical depression” somehow not linked to Biology, in the same way as say Diabetes?
He won’t answer you.
People misuse the word depression. Depression is not being bummed out because you couldn’t go in vacation with your friends, or gained weight, or feel bored with your job. Depression is a medical condition caused by chemical imbalances in the brain. Mental illness is really misunderstood, the roots go way back and are still ingrained to this way although our society’s making some progress and trying to educate people in it. In school not long ago I had to read a snort story called the yellow wallpaper. The woman in the story who is the main character goes into a major depression and this turns into a psychotic depression after the birth of her child. Her husband takes her to live in the country for a while, thinking some fresh air and rest can cure her. She tries to tell him she’s not well but he patronizes her and tells her she’s fine, just a little nervous. I won’t disclose the ending but its a really good story that shows mis beliefs about depression and mental illness
By saying “contemporary society”, I didn’t imply that it formerly was not prevalent, or not as prevalent. I have no basis for making such a claim.
In my case, my depression is a higher state of consciousness in which my pleasant illusions are dispelled, leading me to realize my utter irrelevance and worthlessness. Comprehension of this higher truth inevitably has led me to the only acceptable solution: Suicide
Not going to get into my personal medicat treatment (or lack thereof), but in my job I daily deal with people who claim they are “disabled” due - at least in large part - to depression. Having done this type of work for the past 25 years I have read quite a bit on the subject of depression and mental illness - medical literature as well as individual medical and personal histories. I’ve also spoken at length with thousands of such people, and discussed such things at length with medical/legal/social support personnel.
Just my nonmedical opinion, but I suspect depression is not the only condition for which people are over diagnosed/treated. There is at least one segment of the population that is very eager to have a “disability” which they can blame for various aspects of their life.
I have seen countless instances in which mental health “professionals” see fit to diagnose and prescribed for depression based solely on a single initial interview. Which I consider reprehensible. Or significant psychotropic and other medications are prescribed for years by general practicitioners based on little beyond subjective allegations.
I acknowledge that I see only a specific segment of the population in my job. But I regularly encounter a great number of people diagnosed and treated for depression/anxiety/bipolar/ADHD/fibromyalgia/etc., whose real problem (IMO) is that they have been dealt a lousy hand at the game of life, and have misplayed the cards they have been dealt.
This is a commonly held belief that, while true in part, serves to distort the place of brain chemistry changes. It is by no means certain that this is a primary symptom. The fact that drugs fail nearly 50% pf patients indicates that other factors are more likely to be the cause of the brain chemistryt changes. Of course attitudes like this do not aid drug companies in their endeavors and are thus discouraged.
I’ll try and field this one, being a person who has been diagnosed with mild/moderate clinical depression, but who isn’t someone with brain chemistry problems.
Probably the best way to describe it is to use a computer metaphor. Let’s say that people are experiencing whatever the computer symptoms of depression are- let’s say blue screens of death.
In people with brain chemistry problems, it’s analogous to having a defective motherboard or memory unit- everything else is working fine, but there’s an actual physical part of the computer that’s not functioning right.
In people without brain chemistry problems, it’s more like a software problem. They’re thinking in ways that lead them to the wrong conclusions about the world around them.
For example (and I’ve used this example plenty), if in your inner dialogue, you use the phrase “should have” a lot, you’re essentially setting yourself up in a way that will cause you to beat yourself up about it. The reason for this is thinking that you “should have” done something, is to think about that thing in a pass or fail way, and to put that item squarely in the failing category.
Examples: Thinking “I should have made a better grade” implies that you failed to make a good grade, while thinking “I’d have liked to have made a better grade” is a subtle difference, but it doesn’t paint it as a pass/fail situation that you failed.
It’s easy enough to accumulate these ways of thinking, and what happened to me is that while things were good they weren’t really a problem, but when things went to hell for me, they became a real issue, because I blamed myself, and saw myself and my responses to these issues as inadequate, and then started viewing my ability to resolve them as incompetent. Which was total bs, BTW, but in my own head, I believed it.
It took my wife to convince me to go to therapy, and then once there, the therapist started CBT therapy with me, and here I am 4 years later, having had some arguably worse things happen than what brought on the depression, and I haven’t had a reoccurrence.
That’s how it may roll with non-brain chemistry type depression. Based on one of my closest friend’s experience, when there are brain chemistry issues, it’s truly an irrational thing- your thoughts are distorted, and you have no idea why, and no amount of CBT is going to change that.
Oh, and Tollhouse, there is a big difference between being down in the dumps or a bit low, and being really depressed. It’s a real difference in the way you perceive the world, and my personal suspicion is that it works like this- something distorts your normal thoughts, and then those distorted thoughts start negatively changing how you perceive the world and your place in it. When you’re down in the dumps. have the ‘blues’ or whatever, you’re temporarily just sad/upset or whatever, and you snap out of it. Depression is something altogether different and more intense.
This is a commonly held belief that, while true in part, serves to distort the place of brain chemistry changes. It is by no means certain that this is a primary symptom. The fact that drugs fail nearly 50% pf patients indicates that other factors are more likely to be the cause of the brain chemistryt changes. Of course attitudes like this do not aid drug companies in their endeavors and are thus discouraged.
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Actually, there’s no evidence supporting this hypothesis (that any mental illness is “caused by chemical imbalances in the brain”) and what exists instead is a pretty clear track record of how the claim evolved historically.
PSYCHIATRIC MEDICATIONS change brain electrochemistry. In historical order, these medications were found to muffle or reduce psychiatric symptoms; studies were then done to see how the medications were accomplishing that (since, in many cases, the medications were originally developed for other purposes) and were found to be reducing or enhancing uptake of this or that neurotransmitter; from this, it was hypothesized that, aha!, the mental illnesses in question were basically the opposite of whatever the medications were doing; research was performed over the decades that followed to nail down, once and for all, that yes this was the etiology of the mental illness; and those decades went by and no such corroboration was found.
So psych meds appear to address psychiatric symptoms*; psych meds work by modifying brain chemistry; but that does not mean that mental illnesses are caused by or are accompanied by any chemical imbalance in the brain. Or (for that matter) by oversensitivity or insensitivity to normal levels of neurotransmitters.
See I read the OP as defining “depression” as a more general
, as opposed to the specific clinical definition.
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I acknowledge that I see only a specific segment of the population in my job. But I regularly encounter a great number of people diagnosed and treated for depression/anxiety/bipolar/ADHD/fibromyalgia/etc., whose real problem (IMO) is that they have been dealt a lousy hand at the game of life, and have misplayed the cards they have been dealt.
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I see a lot of people who have been dealt a decent hand, played them well but still are depressed about life. It’s like they got a 4 of a kind but are frustrated that they didn’t get a straight flush. Or they got a royal flush and are frustrated that there isn’t anything higher. Or maybe they think everyone else has a monster hand and they are stuck with a pair of jacks when in reality everyone is bluffing.
In less metaphorical terms, they did everything they were supposed to, but still feel disatisfied for one reason or another and may not know why.
I like this analogy! 
Yes, at a minimum, I expect people to retain in their heads the concept that there might exist reasons other than “you’ve got hardware problems in your brain” as the explanation for the symptoms.
If I come across as polemical, it’s because the psychiatric profession (along with the alliance for the mentally ill and the pharmaceutical industry) has been so insistent that hardware problems in the brain is THE cause, and that furthermore they’ve got a solid handle on it.
Okay, fine, that worked. But what works for one person may not work for everyone.
And making the kinds of comments you do only does more to imply that people who are depressed are faking, or just wimps. It’s fucking insulting to those who genuinely suffer, and CANNOT simply “cure themselves”. You simply don’t understand how insensitive that is. I don’t wallow in depression. I sought help. But I couldn’t cure myself. And you know what? That’s nothing to be ashamed of. NO ONE SHOULD BE ASHAMED OF SEEKING HELP FOR DEPRESSION. But people like you only continue the stigma that they should.
No, biology is not always destiny*, but it does play a part. Sometimes, we need to admit we need help. I still don’t see why people are so resistant to the idea that our brains sometimes have a chemical problem – just like the rest of our bodies. The brain is an organ, just like the heart, or the lungs, or the kidneys.
Taking an anti-depressant is not just “popping a happy pill”. It’s getting your mind back to it’s normal state, so it can function like it’s supposed to.
*Genetics, and family history do play a part in our health, like it or not.
Now we’re getting to it.
You’re special, because you saw the truth and thought yourself better. People like you are stronger, more clear-eyed, have better character, and are morally superior to those who don’t think themselves better.
It doesn’t really matter that you just make shit up because it sounds good. You won’t be bothered with the facts, and hell, empathy is for the weak, which you certainly aren’t. You know more about depression than the people who study, research, or suffer from depression. All those facts are pessimistic and just really get you down.
It’s good that you’ve made this clear. Now I know exactly how valuable your input in this discussion is.
Fascinating discussion we have going here.
If I may, there seems to be a lot of conflict between the biological model of depression and the environmental/social model. I think the human brain is a lot more complex than that, and that both things happen, or could be happening, at the same time.
When I first started seeking treatment for depression at age 18, my therapists assumed that it was the result of my unstable childhood. After all, I did have PTSD and a slew of other anxiety disorders. I went through 12-13 completely useless medications and a bunch of psychodynamic therapy until I finally came to the conclusion that if I could find better ways of thinking and behaving, my depression would go away. I had unhealthy relationships and behaviors that were literally killing me.
I can relate so much to even sven’s description of dismantling herself completely. I feel like I built myself from scratch. Some things, like eating and bathing and getting dressed in the morning, I had to re-teach myself. Other things, like dealing effectively with my emotions, I had to learn for the first time. My life for the last ten years has consisted of slow, continuous behavioral change and cognitive restructuring. I got really into evidence-based practices and all of that living and learning really did radically change the way I coped with depression. I learned to live a full and engaged life.
My depression did not go away.
In 2010, I finally got an appropriate treatment for my PTSD - prolonged exposure therapy - which is one of the most difficult but rewarding things I have ever done. It helped tremendously with my PTSD symptoms and associated anxiety issues. I could sleep at night. I made peace with my past. My psychologist told me that the depression would most likely dissipate along with the PTSD.
My depression did not go away.
I started cognitive therapy and made some headway on my social anxiety issues.
My depression did not go away.
I went back to a psychiatrist (after years of no medication), who gave me some more medications to try.
The depression did not go away.
Because I had ‘‘treatment-resistant’’ depression, my psychiatrist recommended a promising treatment called transcranial magnetic stimulation (TMS.) I forked over $10,000 to have someone zap my left prefrontal cortex with a magnetic pulse for an hour a day, three months straight. It kind of hurt.
My depression did not go away.
Are we noticing a trend here? Well, apparently I wasn’t. I still believed, if I could just work hard enough, change enough, learn enough, eventually I would be free from this horrible disease. I had, as John DiFool so innocently calls it, ‘‘hope.’’
I started a new evidence-based treatment called Acceptance and Commitment Therapy (ACT.) This is when my psychologist looked at all I had done, my history, the ways I had changed my thinking and behavior, and said, ‘‘Your depression isn’t going to go away.’’
At first, I grieved. Deeply. Then, I rejoiced. Because my life was no longer burdened with this herculean task of ‘‘getting better.’’ I don’t have to shell out any more money, or spend any more painful hours trying desperately to become a thing I cannot be. I have chronic depression. I will probably have it for the rest of my life. Full stop. ACT was about learning to accept my condition and learn to live a meaningful life anyway.
Can thoughts cure depression, Mr. DiFool? I successfully changed my thinking. For example, I very rarely indulge in the ‘‘I’m a horrible person’’ line of thought. I’ve learned all the CBT techniques and apply them pretty regularly. It helps things from spinning out of control. But it doesn’t cure my depression. I still feel depressed regardless of my thoughts, because depression is a physical thing that takes over my body and makes me feel bad.
I’m now on a medication (Wellbutrin la la la!) that helps a lot. But… what is this… Oh, look, I still have depression! I’m depressed today. I’m not sure which came first, the depression or the behavior, but I called in a personal day because I was too anxious about an event I was supposed to attend tonight. Not my shining moment. Not the end of the world, either - a past me would be crucifying myself for being so irresponsible and unreliable etc. and then getting more depressed and missing more days… I’ve gotten past that. I’ll just get back to work tomorrow and try to learn from it and do better next time. It’s just my life. I now think of myself as a basically happy person, even though I’m depressed pretty much every day.
Now, I will say, I don’t think most people have gone to the same lengths as I have in trying to address their issues. That’s not a judgment against them, I just know I happen to be unusually compliant and aggressive when it comes to my mental health (and also blessed with the financial resources to pursue high-quality treatment.) So it really is quite insulting to hear that there is a miracle cure out there, and that the answer lies within me or some other bullshit.
I also think I had plenty of genuine issues related to my childhood, lived in depression-inducing circumstances of my own design, and have a biologically based mental illness. These three things can all be true at once. Because of my proactivity, things are a million times better than they were ten years ago. But I know, and I wish other people would understand and accept, there is no cure.
Olives, thank you for your well thought out and very informative post.
You obviously have a lot of knowledge on this subject. What would you say about the link between depression and biology?
I’m not very knowledgeable about the neuroscience of depression, but I have my opinions. A common approach to mental illness in psychology today is the diathesis stress model that posits some kind of biological vulnerability to depression (or any mental illness) that is triggered by a highly stressful experience. I don’t know if you’re familiar with epigenetics, the idea that some genes are ‘‘switched on’’ by some kind of trigger or experience, but I guess it’d be similar to that. Many psychologists today use the ‘‘bio-psycho-social’’ model of mental illness which basically acknowledges that all three of these things are working together to create a person’s mental state, and tries to address all of them. Research indicates that the best shot a person has for depression recovery is medication in conjunction with some evidence-based intervention like CBT.
I believe depression can be heritable; most of the women in my family have it, and their symptoms are very similar to mine. Most of the women in my family also have PMDD, endometriosis and serious reproductive issues that seem to be tied into mental health, so I believe hormones have a lot to do with it as well. One of the most effective things I did for my depression was switch to a continuous monophasic BC.
I know for a fact that there are certain behaviors that can cause physical changes in the brain. Both exercise and meditation have been shown to cause neurogenesis, the growth of new brain cells. Meditation has also been indicated to raise a person’s baseline mood. These activities must be repeated a lot for a long time to have the full effect. I believe part of treating depression effectively is identifying the thoughts and behaviors which cause these changes (or imbalances, or whatever you want to call them) in the brain. For some people, cognitive restructuring and regular exercise really is enough. I don’t want to imply that all depression is a permanent, biologically-based chronic condition. Depression is actually one of the most easily treatable illnesses we have. Some of us are just… unlucky.
Do thoughts create chemical changes in the brain, or do thoughts lead to behaviors which create chemical changes in the brain? Nobody is really sure. I have to admit I’m biased toward behavioral psychology; it seems that certain behaviors automatically change one’s thinking patterns. It’s also true that a major cause of depression is avoidance behavior. Note in the example I gave in my previous post, my avoidance behavior today led to greater depression. (Full disclosure: my husband is a behavioral therapist and a lot of this stuff I picked up from him. If you talked to someone who used a different therapeutic model you’d probably get a different answer. And the truth is, there are many different kinds of therapy that have been shown to help.)