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What you're describing is "exogenous depression", which occurs due to environmental causes. Its existence doesn't change the fact that a lot of people suffer f

What you're describing is "exogenous depression", which occurs due to environmental causes. Its existence doesn't change the fact that a lot of people suffer from endogenous depression, which requires no external circumstances or stimuli. A lot of mental illness can be summarised as people reacting to things with the wrong emotions or the wrong intensity of emotion, and some forms of depression fall under this category.

tomhoward 11y ago
I understand your position, as it's one I held very strongly for a long time. I also agree with your point about "people reacting to things with the wrong emotions or the wrong intensity of emotion"; understanding and addressing this has been fundamental to my own recovery. What I'm disputing is the notion that there is a clear-cut distinction between "exogenous" and "endogenous" depression, and that one is "totally unrelated" to the other. Nothing in biology - or in and truly complex system - works like that. That said, I'm not presuming to be able to change your mind, but more pointing out that the premise your position relies on - that one's environment and one's emotional response to their environment are completely independent - is neither an undisputed scientific fact nor true in my own experience or anyone else I've observed.
- rl3 11y ago
  >What I'm disputing is the notion that there is a clear-cut distinction between "exogenous" and "endogenous" depression, and that one is "totally unrelated" to the other. While I agree that neither exist in complete isolation, it still doesn't preclude one from being the dominant cause. Moreover, not many people would advance the same argument in regards to conditions such as schizophrenia or bipolar disorder—how clinical depression is somehow special and not deserving of the same [endogenous] understanding is beyond me.
  - cpncrunch 11y ago
    There certainly does seem to be a difference between depression vs bipolar/schizophrenia. Major depression is a lot more prevalent than the others, and stress seems to be a much greater part of the etiology. Having seen various family members with clinical depression and schizophrenia, life events were always associated with the depression, but not for the schizophrenia. My own view is that depression is an evolved response to negative stresses and situations, and that clinical depression is the far end of this scale. Depression is therefore your brain's way of telling you that you need get out of a bad situation. Schizophrenia seems to be akin to a flaw resulting from some evolutionary aspect of the brain's operation, perhaps due to creativity/intelligence.
    - rl3 11y ago
      >My own view is that depression is an evolved response to negative stresses and situations, and that clinical depression is the far end of this scale. How do you reconcile this with cases of clinical depression where the person's life is otherwise fantastic, and yet they suffer from crippling depression anyways—absent any negative stresses or situations?
      - tomhoward 11y ago
        I would question the definition of a "fantastic" life. Appearance and reality are very different things.
        cpncrunch 11y ago
        Yes, my experience agrees with this. I'm also interested in knowing exactly how "fantastic" the life of this person actually is. Stress levels? Relationships? Negative emotions? I was in similar denial at the beginning, until I realised that these factors are important. I'm certainly open to the possibility that depression might be possible for someone with a fantastic life, but from what I've seen that doesn't correspond with the experiences of myself and friends/family who have experienced it.
        rl3 11y ago
        I realize that. My point was that when the source of the depression is primarily biochemical/physiological in nature, that no matter how good the person's life is, or how well they apply emotional techniques, it can still cripple them.
        cpncrunch 11y ago
        How do you tell the difference?
        rl3 11y ago
        https://news.ycombinator.com/item?id=10762457 https://news.ycombinator.com/item?id=10762457 https://news.ycombinator.com/item?id=10761938 https://news.ycombinator.com/item?id=10761938 Perhaps they can provide some insight as to how.
  - tomhoward 11y ago
    While I agree that neither exist in complete isolation, it still doesn't preclude one from being the dominant cause. Well the argument I was responding to was that the two are completely unrelated, so if you accept that they're not, we're mostly on the same page. The question then is how common it is for one to be overwhelmingly dominant. From my experiences and research, I'd suggest that like most other biological phenomena, it fits a Gaussian distribution, in which for the majority of people it would be within 75/25 in either direction. Moreover, not many people would advance the same argument in regards to conditions such as schizophrenia or bipolar disorder This may be where I lose you completely, but I would make the same argument for those conditions. It's common for the manifestations of those illnesses to be triggered by an acute trauma or prolonged exposure to abuse. But of course the innate propensity to develop that condition had to be there too. In my own experience, I exhibited bipolar tendencies years ago (as strongly as others I know who were formally diagnosed with it). Since changing both my environment and my emotional tendencies, I no longer do. Others with schizophrenia report becoming symptom-free by following a similar approach. I'd contend that the whole reason mainstream medicine continues to be so hit-and-miss when it comes to treating mental "illness" is that it continues to resist viewing it in this way.
    - rl3 11y ago
      >This may be where I lose you completely, but I would make the same argument for those conditions. While I'm not disputing that emotional techniques can be beneficial, my main point was that in certain cases, the cause of the condition is probably the result of overwhelmingly dominant biochemical or physiological factors.
      - drharvey 11y ago
        I'm going to jump in here. Meta-analysis has shown that approximately 80% of all cases of depression are initially caused by a major life stress (1). So "exogenous" factors seem to play a large role in triggering most depression. That said, not everyone develops depression following a major life stress - people have different levels of "endogenous" stress resilience/susceptibility. "Endogenous" stress resilience can be modulated, however, by "exogenous" interventions. For example, resilience can be increased by behavioral stress inoculation or even exercise, and it can be decreased by things like sleep deprivation or illness. It can also be partially inherited (i.e., if someone's parents were "exogenously" stressed, the offspring can inherit lower levels of stress resilience through "endogenous" epigenetic changes) (2). And though 80% of initial depressive episodes may be triggered by stress, this tight correlation between stress and depression does not persist as strongly after the first depressive episode. Essentially, once someone has been depressed a first time, they are then "endogenously" more susceptible to subsequent episodes of depression. So, is it exogenous or endogenous? Long story short, in most cases, it's both. Even if it doesn't start as both, it becomes both. And both "exogenous" and "endogenous" contributing factors interact in an on-going dynamic process. 1. http://hammenlab.psych.ucla.edu/pubs/05stressand.pdf http://hammenlab.psych.ucla.edu/pubs/05stressand.pdf 2. http://www.ncbi.nlm.nih.gov/pubmed/26410355 http://www.ncbi.nlm.nih.gov/pubmed/26410355

tomhoward 11y ago

I understand your position, as it's one I held very strongly for a long time. I also agree with your point about "people reacting to things with the wrong emotions or the wrong intensity of emotion"; understanding and addressing this has been fundamental to my own recovery. What I'm disputing is the notion that there is a clear-cut distinction between "exogenous" and "endogenous" depression, and that one is "totally unrelated" to the other. Nothing in biology - or in and truly complex system - works like that. That said, I'm not presuming to be able to change your mind, but more pointing out that the premise your position relies on - that one's environment and one's emotional response to their environment are completely independent - is neither an undisputed scientific fact nor true in my own experience or anyone else I've observed.

rl3 11y ago
>What I'm disputing is the notion that there is a clear-cut distinction between "exogenous" and "endogenous" depression, and that one is "totally unrelated" to the other. While I agree that neither exist in complete isolation, it still doesn't preclude one from being the dominant cause. Moreover, not many people would advance the same argument in regards to conditions such as schizophrenia or bipolar disorder—how clinical depression is somehow special and not deserving of the same [endogenous] understanding is beyond me.
- cpncrunch 11y ago
  There certainly does seem to be a difference between depression vs bipolar/schizophrenia. Major depression is a lot more prevalent than the others, and stress seems to be a much greater part of the etiology. Having seen various family members with clinical depression and schizophrenia, life events were always associated with the depression, but not for the schizophrenia. My own view is that depression is an evolved response to negative stresses and situations, and that clinical depression is the far end of this scale. Depression is therefore your brain's way of telling you that you need get out of a bad situation. Schizophrenia seems to be akin to a flaw resulting from some evolutionary aspect of the brain's operation, perhaps due to creativity/intelligence.
  - rl3 11y ago
    >My own view is that depression is an evolved response to negative stresses and situations, and that clinical depression is the far end of this scale. How do you reconcile this with cases of clinical depression where the person's life is otherwise fantastic, and yet they suffer from crippling depression anyways—absent any negative stresses or situations?
    - tomhoward 11y ago
      I would question the definition of a "fantastic" life. Appearance and reality are very different things.
      - cpncrunch 11y ago
        Yes, my experience agrees with this. I'm also interested in knowing exactly how "fantastic" the life of this person actually is. Stress levels? Relationships? Negative emotions? I was in similar denial at the beginning, until I realised that these factors are important. I'm certainly open to the possibility that depression might be possible for someone with a fantastic life, but from what I've seen that doesn't correspond with the experiences of myself and friends/family who have experienced it.
      - rl3 11y ago
        I realize that. My point was that when the source of the depression is primarily biochemical/physiological in nature, that no matter how good the person's life is, or how well they apply emotional techniques, it can still cripple them.
        cpncrunch 11y ago
        How do you tell the difference?
        rl3 11y ago
        https://news.ycombinator.com/item?id=10762457 https://news.ycombinator.com/item?id=10762457 https://news.ycombinator.com/item?id=10761938 https://news.ycombinator.com/item?id=10761938 Perhaps they can provide some insight as to how.
- tomhoward 11y ago
  While I agree that neither exist in complete isolation, it still doesn't preclude one from being the dominant cause. Well the argument I was responding to was that the two are completely unrelated, so if you accept that they're not, we're mostly on the same page. The question then is how common it is for one to be overwhelmingly dominant. From my experiences and research, I'd suggest that like most other biological phenomena, it fits a Gaussian distribution, in which for the majority of people it would be within 75/25 in either direction. Moreover, not many people would advance the same argument in regards to conditions such as schizophrenia or bipolar disorder This may be where I lose you completely, but I would make the same argument for those conditions. It's common for the manifestations of those illnesses to be triggered by an acute trauma or prolonged exposure to abuse. But of course the innate propensity to develop that condition had to be there too. In my own experience, I exhibited bipolar tendencies years ago (as strongly as others I know who were formally diagnosed with it). Since changing both my environment and my emotional tendencies, I no longer do. Others with schizophrenia report becoming symptom-free by following a similar approach. I'd contend that the whole reason mainstream medicine continues to be so hit-and-miss when it comes to treating mental "illness" is that it continues to resist viewing it in this way.
  - rl3 11y ago
    >This may be where I lose you completely, but I would make the same argument for those conditions. While I'm not disputing that emotional techniques can be beneficial, my main point was that in certain cases, the cause of the condition is probably the result of overwhelmingly dominant biochemical or physiological factors.
    - drharvey 11y ago
      I'm going to jump in here. Meta-analysis has shown that approximately 80% of all cases of depression are initially caused by a major life stress (1). So "exogenous" factors seem to play a large role in triggering most depression. That said, not everyone develops depression following a major life stress - people have different levels of "endogenous" stress resilience/susceptibility. "Endogenous" stress resilience can be modulated, however, by "exogenous" interventions. For example, resilience can be increased by behavioral stress inoculation or even exercise, and it can be decreased by things like sleep deprivation or illness. It can also be partially inherited (i.e., if someone's parents were "exogenously" stressed, the offspring can inherit lower levels of stress resilience through "endogenous" epigenetic changes) (2). And though 80% of initial depressive episodes may be triggered by stress, this tight correlation between stress and depression does not persist as strongly after the first depressive episode. Essentially, once someone has been depressed a first time, they are then "endogenously" more susceptible to subsequent episodes of depression. So, is it exogenous or endogenous? Long story short, in most cases, it's both. Even if it doesn't start as both, it becomes both. And both "exogenous" and "endogenous" contributing factors interact in an on-going dynamic process. 1. http://hammenlab.psych.ucla.edu/pubs/05stressand.pdf http://hammenlab.psych.ucla.edu/pubs/05stressand.pdf 2. http://www.ncbi.nlm.nih.gov/pubmed/26410355 http://www.ncbi.nlm.nih.gov/pubmed/26410355