6 ms·

I am close to somebody who has been strongly affected by depression. She has, in any material respect, a perfect life. She has food, clothes, a supportive fam

I am close to somebody who has been strongly affected by depression. She has, in any material respect, a perfect life. She has food, clothes, a supportive family, a great job, plenty of money, etc. There is nothing "wrong" with her life. But she suffers off-and-on depression. Not just "I feel bad" depression. Crippling, "can't get out of bed" depression. Periodic suicidal ideation. Occasional suicide attempts. She knows she has depression. She talks about it. And she wants to be done with it. She knows how she feels when her brain is "in balance" and how it feels when she's depressed. One of these states is much more preferable to the other. She's tried drugs, ECT, talk therapy, etc. And, yes, she's tried ketamine. Anything that will put her back to a state where she is able to get out of bed and function, and reduce the odds of her killing herself when she's depressed. I'm sure there are a lot of people who are depressed due to outside factors -- poverty, oppression, war, etc. But I can tell you quite certainly that there are people who have "perfect" lives who find themselves clinically depressed. And at least some of those people want to get back to a non-depressed state. This research helps them. TL;DR: Not all people are depressed because their life sucks, nor is depression something that all people can "cure" by thinking harder or trying harder. Some people have a brain imbalance and would like to fix it so they can have a life. Literally.

emmelaich 11y ago
I agree mostly, but how do you know for sure that there is some stress or thought there which is perhaps unacknowledged? I think that someone can be affected by somethings in their earlier life that can affect them forever. I'm not talk about repressed memories, I'm talking about the lack of positively formative experiences at critical moments of their life. Example - what happens when say someone starts school or is a teenager at the same time their mother is undergoing menopause and their father has lost their job and they're both starting to drink? The child will feel a lack of something but not sure what. If they do think of it all, they'll think of it as partly their fault.
- kstenerud 11y ago
  How do you know for sure that it's not something in the water? How can you be sure it's not WiFi radio waves messing with her brain? Can you really rule out space aliens trying to stop her from reaching her potential? There's a reason we use the scientific method.
  - emmelaich 11y ago
    How do you control for those things? Do you believe those things are equally likely? Part of the scientific method is attempting to be aware of you don't know.
tachyonbeam 11y ago
I fully agree. I dated for 5 years a woman in the same situation as what you describe. She has money, friends, family, a roof over her head. She hasn't suffered childhood trauma or anything abnormal, but she's consistently depressed and lethargic. I'm bipolar myself. I've been through some difficult things, but my condition makes me acutely aware of how subjective human emotions are. How much of our thinking is influenced my neurochemistry rather than rational thoughts or memories. I'm pretty stable these days, but I've had times where I would just wake up in the morning and feel happy to be alive. Energized, stress-free, and confident in my abilities. The next day, I wake up depressed and I feel like my life is shit, not worth living. A few days later I feel fine again. No major life events, no major causes of stress, just my neurochemistry being unpredictable. I think that the overinsistence in some circles on past trauma causing mental illness is harmful. There is definitely such a thing as genetic predispositions. Some depression and mental illness just does not have a cause you can point to. It's not all about overcoming negative experiences and willing yourself out of it. Genetic defects can cause all sorts of physical problems, just think of psoriasis, asthma, acne and peanut allergies. I'm not sure why people think that the brain can't have such issues. Believe me, people with peanut allergies won't overcome that through psychotherapy and confronting their mommy issues.
tomhoward 11y ago
I empathise with your friend's plight, and her exasperating struggle to get well. I've been similar in terms of having a life that others would consider pretty darn good but where you find yourself depressed to the point of being largely unable to function, no matter what treatment you try. I get it, it's profoundly awful, and the world needs to to better at dealing with it, and that has become somewhat of a calling for me now that my own mental health is improving. But all my research and experiences support the notion that both one's experiences and one's emotional reactions to those experiences are crucial. This is why you can have some people living seemingly perfect lives and winding up depressed, and others living through war and oppression and coming out fine. In your friend's case, the environmental factors could be: (1) pressure from outsiders to "keep up appearances", (2) the negative messages and images that proliferate through the media of war, poverty, murder, terrorism, climate change etc, (3) a world that offers so many options of how to live but little consistent guidance about what is best, (4) living in a society that can still be very difficult for women, due to career challenges, threat of abuse, paternalistic attitudes etc. These are just hypothetical of course, given that I don't know her. And for her to be crippled by depression in response to these or other stimuli would be as much to do with a difference in the way she responds to such things vs the "average" person. But it may not even be unhealthy. Maybe her true calling is to work as a humanitarian helping the needy rather than doing what she's been trying to do, and her depression is her mind's way of making her realise she needs to make that kind of change. Having gone through this process in myself and with others, when you dig deep enough, something like this always turns out to be there. But my main point is that the mind does not and cannot function independently of a person's environment, and paths to mental wellness that really work (and they do exist), involve addressing both one's inner reactions to things and one'e outer environment.
spangry 11y ago
I'm very much in this category of depression. I have what is unfortunately termed 'melancholic depression'. I should note that I'm very sceptical of the DSM 'disease model' of mental illness, and am glad to see psychiatry and neuroscience beginning to converge. 'Discrete disease' is a poor abstraction for most mental illnesses. A better term for my kind of depression would be 'endogenous depression' (i.e. depression that comes from within). I have an objectively good life: I have a family that loves me, friends that care about me, and a job that I enjoy with colleagues I respect. Yet I still have episodes where I sometimes can't get out of bed, or can't bring myself to leave the house. A couple of months ago I spent three days just sitting (and occasionally sleeping) in a chair, not even getting up to eat or shower. I just simply couldn't do it. While it's true that people can experience temporary depressive episodes due to 'exogenous' factors (e.g. the death of a loved one), it is very different to 'endogenous' depression, and requires different types of treatment. While talk therapy and time can be very helpful for people to work through difficult and temporary 'adverse circumstances', it is of little help for endogenous/biological depression. No amount of 'talk therapy' can convince my pre-frontal cortex to operate within 'normal' parameters or to get my brain to produce appropriate quantities of neurotransmitters like serotonin, dopamine and noradrenaline. I'm reasonably sure this is a chronic illness that I will never be rid of (as I've learned from 15 years of failed treatment attempts). On the upside, there's a good chance that there is some treatment out there, coupled with sustained lifestyle changes, that will allow me to stave off the symptoms so that I can live a relatively 'normal' life. In some ways it's similar to how type 1 diabetics can survive and live normal lives with regular injections of insulin.
- cpncrunch 11y ago
  If you don't mind me asking, is there anything you can identify in the days/weeks before you become depressed, such as working long hours for a long period, boring work, excessive negative emotions, etc. It's not that I don't believe your depression is endogenous, I'm just curious. I was in a similar position to you until I looked closely at my life and identified the factors that were causing my depression/CFS.
- Abraln 11y ago
  It does get pretty tiring explaining the difference between them. Mine is definitely biologically based, although stress exacerbates it like it does many other things like acne. My "eureka" moment came in high school (when brain chemistry changes from puberty can cause such issues). I was at home playing video games online with friends when I noticed my vision was blurry. I went to the bathroom and saw tears streaming down my face, which baffled me as my conscious thoughts were in no way sad/negative at the time. There was just an underlying feeling of heartache. Over the next 4-5 years I worked with a professional and finally managed to find a drug combo that balances me out. I still get sad, but only for logical reasons, and only as much as I used to before my symptoms developed. It has been a full year for me now without any "episodes", something I had not thought possible previously. I just figured I would share this in case someone else might benefit from reading it.
tedks 11y ago
> She has, in any material respect, a perfect life. She has food, clothes, a supportive family, a great job, plenty of money, etc. There is nothing "wrong" with her life. Could it possibly be that there is more to life than these things?
- TeMPOraL 11y ago
  Could be, but those things are the basics; lack of them is a cause of misery for people in today's society. Depression is something that makes you miserable even if all objective factors about your life are stable and comfortable.
  - tedks 11y ago
    >Depression is something that makes you miserable even if all objective factors about your life are stable and comfortable. ...could it be that there is more to life than these "objective factors"?
    - TeMPOraL 11y ago
      Could be, but if you can figure out what exactly it is and how to package it nicely, then you'll become a billionaire overnight.
      - tedks 11y ago
        Could it perhaps be that there are things people need that can't be bought? Hacker news is pretty depressing.

emmelaich 11y ago

I agree mostly, but how do you know for sure that there is some stress or thought there which is perhaps unacknowledged? I think that someone can be affected by somethings in their earlier life that can affect them forever. I'm not talk about repressed memories, I'm talking about the lack of positively formative experiences at critical moments of their life. Example - what happens when say someone starts school or is a teenager at the same time their mother is undergoing menopause and their father has lost their job and they're both starting to drink? The child will feel a lack of something but not sure what. If they do think of it all, they'll think of it as partly their fault.

kstenerud 11y ago
How do you know for sure that it's not something in the water? How can you be sure it's not WiFi radio waves messing with her brain? Can you really rule out space aliens trying to stop her from reaching her potential? There's a reason we use the scientific method.
- emmelaich 11y ago
  How do you control for those things? Do you believe those things are equally likely? Part of the scientific method is attempting to be aware of you don't know.

tachyonbeam 11y ago

I fully agree. I dated for 5 years a woman in the same situation as what you describe. She has money, friends, family, a roof over her head. She hasn't suffered childhood trauma or anything abnormal, but she's consistently depressed and lethargic. I'm bipolar myself. I've been through some difficult things, but my condition makes me acutely aware of how subjective human emotions are. How much of our thinking is influenced my neurochemistry rather than rational thoughts or memories. I'm pretty stable these days, but I've had times where I would just wake up in the morning and feel happy to be alive. Energized, stress-free, and confident in my abilities. The next day, I wake up depressed and I feel like my life is shit, not worth living. A few days later I feel fine again. No major life events, no major causes of stress, just my neurochemistry being unpredictable. I think that the overinsistence in some circles on past trauma causing mental illness is harmful. There is definitely such a thing as genetic predispositions. Some depression and mental illness just does not have a cause you can point to. It's not all about overcoming negative experiences and willing yourself out of it. Genetic defects can cause all sorts of physical problems, just think of psoriasis, asthma, acne and peanut allergies. I'm not sure why people think that the brain can't have such issues. Believe me, people with peanut allergies won't overcome that through psychotherapy and confronting their mommy issues.

tomhoward 11y ago

I empathise with your friend's plight, and her exasperating struggle to get well. I've been similar in terms of having a life that others would consider pretty darn good but where you find yourself depressed to the point of being largely unable to function, no matter what treatment you try. I get it, it's profoundly awful, and the world needs to to better at dealing with it, and that has become somewhat of a calling for me now that my own mental health is improving. But all my research and experiences support the notion that both one's experiences and one's emotional reactions to those experiences are crucial. This is why you can have some people living seemingly perfect lives and winding up depressed, and others living through war and oppression and coming out fine. In your friend's case, the environmental factors could be: (1) pressure from outsiders to "keep up appearances", (2) the negative messages and images that proliferate through the media of war, poverty, murder, terrorism, climate change etc, (3) a world that offers so many options of how to live but little consistent guidance about what is best, (4) living in a society that can still be very difficult for women, due to career challenges, threat of abuse, paternalistic attitudes etc. These are just hypothetical of course, given that I don't know her. And for her to be crippled by depression in response to these or other stimuli would be as much to do with a difference in the way she responds to such things vs the "average" person. But it may not even be unhealthy. Maybe her true calling is to work as a humanitarian helping the needy rather than doing what she's been trying to do, and her depression is her mind's way of making her realise she needs to make that kind of change. Having gone through this process in myself and with others, when you dig deep enough, something like this always turns out to be there. But my main point is that the mind does not and cannot function independently of a person's environment, and paths to mental wellness that really work (and they do exist), involve addressing both one's inner reactions to things and one'e outer environment.

spangry 11y ago

I'm very much in this category of depression. I have what is unfortunately termed 'melancholic depression'. I should note that I'm very sceptical of the DSM 'disease model' of mental illness, and am glad to see psychiatry and neuroscience beginning to converge. 'Discrete disease' is a poor abstraction for most mental illnesses. A better term for my kind of depression would be 'endogenous depression' (i.e. depression that comes from within). I have an objectively good life: I have a family that loves me, friends that care about me, and a job that I enjoy with colleagues I respect. Yet I still have episodes where I sometimes can't get out of bed, or can't bring myself to leave the house. A couple of months ago I spent three days just sitting (and occasionally sleeping) in a chair, not even getting up to eat or shower. I just simply couldn't do it. While it's true that people can experience temporary depressive episodes due to 'exogenous' factors (e.g. the death of a loved one), it is very different to 'endogenous' depression, and requires different types of treatment. While talk therapy and time can be very helpful for people to work through difficult and temporary 'adverse circumstances', it is of little help for endogenous/biological depression. No amount of 'talk therapy' can convince my pre-frontal cortex to operate within 'normal' parameters or to get my brain to produce appropriate quantities of neurotransmitters like serotonin, dopamine and noradrenaline. I'm reasonably sure this is a chronic illness that I will never be rid of (as I've learned from 15 years of failed treatment attempts). On the upside, there's a good chance that there is some treatment out there, coupled with sustained lifestyle changes, that will allow me to stave off the symptoms so that I can live a relatively 'normal' life. In some ways it's similar to how type 1 diabetics can survive and live normal lives with regular injections of insulin.

cpncrunch 11y ago
If you don't mind me asking, is there anything you can identify in the days/weeks before you become depressed, such as working long hours for a long period, boring work, excessive negative emotions, etc. It's not that I don't believe your depression is endogenous, I'm just curious. I was in a similar position to you until I looked closely at my life and identified the factors that were causing my depression/CFS.
Abraln 11y ago
It does get pretty tiring explaining the difference between them. Mine is definitely biologically based, although stress exacerbates it like it does many other things like acne. My "eureka" moment came in high school (when brain chemistry changes from puberty can cause such issues). I was at home playing video games online with friends when I noticed my vision was blurry. I went to the bathroom and saw tears streaming down my face, which baffled me as my conscious thoughts were in no way sad/negative at the time. There was just an underlying feeling of heartache. Over the next 4-5 years I worked with a professional and finally managed to find a drug combo that balances me out. I still get sad, but only for logical reasons, and only as much as I used to before my symptoms developed. It has been a full year for me now without any "episodes", something I had not thought possible previously. I just figured I would share this in case someone else might benefit from reading it.

tedks 11y ago

> She has, in any material respect, a perfect life. She has food, clothes, a supportive family, a great job, plenty of money, etc. There is nothing "wrong" with her life. Could it possibly be that there is more to life than these things?

TeMPOraL 11y ago
Could be, but those things are the basics; lack of them is a cause of misery for people in today's society. Depression is something that makes you miserable even if all objective factors about your life are stable and comfortable.
- tedks 11y ago
  >Depression is something that makes you miserable even if all objective factors about your life are stable and comfortable. ...could it be that there is more to life than these "objective factors"?
  - TeMPOraL 11y ago
    Could be, but if you can figure out what exactly it is and how to package it nicely, then you'll become a billionaire overnight.
    - tedks 11y ago
      Could it perhaps be that there are things people need that can't be bought? Hacker news is pretty depressing.