14 ms·

Amen to this article. As one who myself once believed my depression "came out of nowhere" (but which, in retrospect, was an obvious symptom of my emotionally de

by pc2g4d 11y ago

Amen to this article. As one who myself once believed my depression "came out of nowhere" (but which, in retrospect, was an obvious symptom of my emotionally destructive family and school environment) and who tried for many years to smother those feelings with antidepressants, I feel strongly that this article presents a wiser path. Evolutionarily speaking, it seems likely that depression/anxiety are there for some purpose, and yet we treat them both like meaningless pain meant only to be banished using drugs. I believe both are signals that something in our environment is not working for us. They indicate emotional or physical needs unmet---needs for safety, autonomy, connection, etc. Often the individual suffering is fundamentally unaware of their own circumstances. I didn't realize how messed up my family relationships were growing up until much later. There are various reasons for this unawareness, but I believe the depression/anxiety are there to force our conscious self and the people around us to acknowledge that something is wrong. This isn't just the old nonsense about depressed people needing to cheer up, and that it will pass in a day. This is a completely different paradigm that explains depression and anxiety as meaningful signals of underlying problems rather than as inexplicable suffering to be numbed through prescription medication. I believe it will prove the more robust and also the wiser way of looking at these experiences.

jakegarelick 11y ago
I completely agree, thanks for the insight. A little disappointed to see people dismissing this article right off the bat.
true_religion 11y ago
I'm not sure why you are calling this a new paradigm. Don't most, if not all, therapists deal with depression as a symptom for necessary changes in life circumstance? Yes, every particular case is different, but in general, therapy is meant to motivate you to make a change---either in perspective, or practice or upon external sources of angst.
- pc2g4d 11y ago
  You're right, this is not new to psychology itself. It's more of a direct challenge to the culturally powerful psychiatric/biomedical approach to depression and anxiety.
- deleted 11y ago
  [deleted]
- tim333 11y ago
  My experience is no, most therapists don't deal with depression as a symptom for necessary changes in life circumstances. They'll expect you to talk about your feelings and so on. I've never heard of one saying your life sucks, change your job and make some friends. Which would often actually be helpful.
themgt 11y ago
Thanks for the perspective, and ditto. It sounds condescending, and obviously physical brain damage (e.g. CTE) can cause depression completely separately from life circumstances, but I would venture that for a majority of people who say "My life is just fine but I am depressed anyway", their life is not actually fine. It's not even that they are lying, but we humans are very good at hiding truths, even from ourselves. It can be very hard to truly admit that one is unhappy about one's life, and frankly many people have never really experienced a true sense of fulfillment, peace, belonging, purpose and happiness, and don't know what it would feel like or understand how lacking the feeling is in their lives. "My life is fine" generally means "I've checked the right boxes: 'success', 'friends', a relationship, but I still feel empty." Don't use drugs to numb that feeling. Listen to it.
- retbull 11y ago
  But drugs are awesome :D Seriously though, compared to being depressed when you can't fix it because you don't have any idea that something is wrong, drugs are fucking amazing. The shitty part is people end up trapped now as the drugs can fuel the negativity which lead to the depression in the first place.
  - themgt 11y ago
    I actually agree drugs are useful for treating mental issues, I just disagree that people need a daily drip-drip-drip of e.g. serotonin or dopamine to function. Drugs can be extremely helpful in treating acute mental issues and helping people "break through" or inoculate themselves against episodes of illness, see e.g. psilocybin, MDMA, ketamine for treatments of e.g. anxiety/depression/PTSD/psychological health in the terminally ill, cluster headaches, etc. The common thread though is that a single dose of the drug offers long-lasting protection, weeks or months or years. It's not about chemically changing the brain day after day, it's about using neurochemicals to jolt the brain out of a rut. It's about occasionally kickstarting the brain back into normal self-regulation, not using externally supplied chemicals to permanently supplement dysregulation.
    - 11y ago
xlm1717 11y ago
Definitely agree with this. The exchange the doctor describes to begin the article is also common online. I've spent a lot of time in anxiety and depression support forums and chat rooms for my own problems with anxiety. The most common view is that anxiety and depression are diseases that you need to take medicine to treat. No doubt medicine has its uses in treating anxiety and depression, a momentary reprieve can grant you the clarity to see what you do need to change to feel better. However, I see many people online who cling so strongly to the idea that anxiety and depression are chemical imbalances that you are unlucky enough to be predisposed to developing and that balance can only be restored through medication, that when you suggest that anxiety and depression are not diseases and so can be treated to the point that they are not a problem anymore, people will react violently, as if you just assaulted their identity. This line of thinking makes it extremely difficult for them to get relief. It is also beneficial to pharmaceutical companies who can make a customer for life by convincing customers that if they don't have a certain medication they will always feel miserable.
- brador 11y ago
  There are also some forums where people discuss abusing a depression/anxiety diagnosis to claim disability welfare. This is much more widespread than most people realise since the rates are higher and the requirements much lower than regular welfare. It's a surprisingly cushy lifestyle, and some would do anything to keep it. And that entire structure is dependent on depression/anxiety being seen as a medical problem with no solution, only medication. They are very vocal in it's protection.
  - jacalata 11y ago
    > the rates are higher could you explain this? I've never heard about it.
    - brador 11y ago
      The simplest example would be welfare per month from (disability + unemployed) > unemployed only.
stantona 11y ago
..or that for some individuals, those who suffer bipolar (such as myself) or clinical depression, there's a biological factor that has little relation to past circumstances.
fucking_tragedy 11y ago
How are suicidal ideation/attempts and 'successful' suicides explained by this hypothesis?
- wonderlust 11y ago
  As I read this, its not a hypothesis, nor is it a theory. Its just a long value statement about how to think about what's going on. You can accept or ignore this, and it won't change the science at all.
  - spangry 11y ago
    Fantastic comment. Medical history is replete with quack-theories and charlatans offering various cures. Blood-letting to balance the body's "humours" for example. The wonderful thing about scientific progress is that it shrinks the space quacks and charlatans have to peddle their pet theories and cures.
  - tim333 11y ago
    As I read it "Depression and anxiety are, for the large majority of cases, emotional signals that one’s psychological health is not ideal and that one’s psychosocial/relational needs are not being met." looks like a theory and and experimentally testable and falsifiable one at that. Take a bunch of depressed people, try to fix their relationship needs along the lines mentioned in the article, survey the people who now have friends, get on with their family and so on and see if they are still depressed and compare to a control group. Simples.
    - wonderlust 11y ago
      Depression and anxiety are by definition not ideal physcological health. And almost no ones social needs are ever truly completely met. we also know already that social support helps anxiety and depression regardless of whether it is a root cause. So your test wouldn't falsify if it returned a negative value, nor support with a positive correlation.
  - deleted 11y ago
    [deleted]
Dylan16807 11y ago
> Evolutionarily speaking, it seems likely that depression/anxiety are there for some purpose, and yet we treat them both like meaningless pain meant only to be banished using drugs. I believe both are signals that something in our environment is not working for us. They indicate emotional or physical needs unmet---needs for safety, autonomy, connection, etc. > Often the individual suffering is fundamentally unaware of their own circumstances. I didn't realize how messed up my family relationships were growing up until much later. There are various reasons for this unawareness, but I believe the depression/anxiety are there to force our conscious self and the people around us to acknowledge that something is wrong. If a situation is causing no problems outside of depression/anxiety, and you took away the depression/anxiety mechanism, there would be nothing wrong with it. If there are other problems, then piling depression on top makes it harder to fix. A lot of medical conditions cause chronic pain. The pain helpfully signals "something is wrong" once, and then keeps unhelpfully reminding over and over. You want to treat the pain itself in that situation. Sometimes the pain is the only thing you need to treat at all. Being an indicator of other problems does not make chronic pain useful. Depression is similarly crippling and unhelpful.
- danharaj 11y ago
  > If a situation is causing no problems outside of depression/anxiety, and you took away the depression/anxiety mechanism, there would be nothing wrong with it. My experience with SSRI's has been that taking away that mechanism is taking away creativity, emotional range, and introspective ability. Reality distortion is reality distortion. I reject procrustean medicine that fits humans to the mold of what is best for society, which is the primary environment in which anxiety/depression originate.
  - Dylan16807 11y ago
    > My experience with SSRI's has been that taking away that mechanism is taking away creativity, emotional range, and introspective ability. I'm not talking about SSRI's, I mean a theoretical way of removing only depression and the similar kinds of chronic anxiety. You can be very creative and introspective without being actively depressed. > Reality distortion is reality distortion. It's depression that distorts reality, even to the point of making you feel negative emotions that you know aren't true but can't stop. > I reject procrustean medicine that fits humans to the mold of what is best for society, which is the primary environment in which anxiety/depression originate. That's great. Me too. But that's really a different issue. You could fix that entirely, and you'd still have people hurt by depression.
deleted 11y ago
[deleted]
copperx 11y ago
While I agree with you on some points, one has to be careful with anything that tries to explain away a complex phenomenon. After all, there are quacks out there trying to explain away cancer as a symptom, not a disease (see: http://www.goodreads.com/book/show/163184.Cancer_Is_Not_a_Disease_It_s_a_Survival_Mechanism http://www.goodreads.com/book/show/163184.Cancer_Is_Not_a_Di...).
venomsnake 11y ago
My favorite pet theory is that depression is the equivalent of autoimmune reaction for the brain. The same way we need some exposure to dirt to calibrate our immune system to not go berserk with some food allergies or lupus, probably we need something in our life to calibrate our brains' loopback feeds.
- studentrob 11y ago
  So, people who've led relatively normal, successful lives with good relationships and have depression might be experiencing it so deeply because they haven't had much exposure to sadness? Sounds like a reasonable theory to me. That would also explain how people are able to get out of unexplainable depression after a period of time, and why people sometimes seem to seek out more sadness when they're already sad. They're looking for perspective. Awareness is the goal of some forms of meditation. I'd like to see more studies on the effects of meditation on those who have various forms of depression.
papapra 11y ago
At the same time some people are just more neurotic(and genetics has a big role), it's not so simple
hamstergene 11y ago
I often notice people assume evolution to be "wise" and "nice" when searching for evolutionary explanations, which it is neither. Evolutionarily speaking, just because something has evolved does not mean it happened for a purpose, or is useful at all. Pathological anxiety and depression may actually be purely disadvantageous mutations which nevertheless still passed evolution filters because they are not disadvantageous enough to wipe out 100% of their carriers. Or they may have a much uglier purpose than you have assumed, for example, to force weak individuals (in)voluntarily withdraw from consuming resources useful to others, or even to kill themselves completely, which might be "wise" during foraging times but is nothing but useless breakage in civilized age.
- JoeAltmaier 11y ago
  But most human variations are recent! We've changed more in the last 50,000 years than the previous 1M years. I'd say, instead of a real purpose, any 'breakages' are likely coincidental to some other, more advantageous adaptation. Getting smaller and more calorie-efficient (to suit the village/town/city/urban environment) may mean biochemical changes that change our mental state. Not because we 'need' that mental state, but because its better for the clan if more of us fit closer together. So many adaptations are sledgehammers for a smaller problem. Evolution doesn't plan; it just diddles around until something (sort of) works. And our bodies are the unfortunate result!
hipsterrific 11y ago
The author addresses social structures and we seem to live in an age of increasing isolatedness amongst people. I thought it would have been a hard read (I suffer from depression) but it's also liberating to see it in a different light.
Grishnakh 11y ago
>Evolutionarily speaking, it seems likely that depression/anxiety are there for some purpose, and yet we treat them both like meaningless pain meant only to be banished using drugs. I believe both are signals that something in our environment is not working for us. They indicate emotional or physical needs unmet---needs for safety, autonomy, connection, etc. Yes, that's all true IMO, but the problem is that many times, it simply isn't feasible to change your environment. So antidepressants are a good way to deal with the problem. For instance, suppose you live in the ghetto and are constantly struggling to make ends meet. How do you change your environment here? Well, here in American, you don't. You just suffer. If it were that easy to get out of poverty, most people in that trap would do it. Indeed, many things in society seem to be actively designed to keep people trapped in poverty. What if you're lonely because you're single and have never had any success dating, and the reason is that you're cursed with being extremely unattractive? There again, there's only so much you can do to change that. (Or worse, you have a serious physical disability, which really limits how many people are willing to date you.) >but I believe the depression/anxiety are there to force our conscious self and the people around us to acknowledge that something is wrong. Sounds like an interesting theory, but in reality, at least in this society, it seems to have the opposite effect: it makes you an outcast. No one wants to be around depressed people, so they're stuck being lonely, which feeds the depression, it's a vicious cycle. Antidepressants can really help a lot here, by giving you a short-term boost to jump-start your social life and just to help you cope with life in general. >This is a completely different paradigm that explains depression and anxiety as meaningful signals of underlying problems rather than as inexplicable suffering to be numbed through prescription medication. I believe it will prove the more robust and also the wiser way of looking at these experiences. I think the problem with this idea is that this seems to require some gigantic changes in our very culture and how we deal with people who are depressed.

by pc2g4d 11y ago

jakegarelick 11y ago

I completely agree, thanks for the insight. A little disappointed to see people dismissing this article right off the bat.

true_religion 11y ago

I'm not sure why you are calling this a new paradigm. Don't most, if not all, therapists deal with depression as a symptom for necessary changes in life circumstance? Yes, every particular case is different, but in general, therapy is meant to motivate you to make a change---either in perspective, or practice or upon external sources of angst.

pc2g4d 11y ago
You're right, this is not new to psychology itself. It's more of a direct challenge to the culturally powerful psychiatric/biomedical approach to depression and anxiety.
deleted 11y ago
[deleted]
tim333 11y ago
My experience is no, most therapists don't deal with depression as a symptom for necessary changes in life circumstances. They'll expect you to talk about your feelings and so on. I've never heard of one saying your life sucks, change your job and make some friends. Which would often actually be helpful.

themgt 11y ago

Thanks for the perspective, and ditto. It sounds condescending, and obviously physical brain damage (e.g. CTE) can cause depression completely separately from life circumstances, but I would venture that for a majority of people who say "My life is just fine but I am depressed anyway", their life is not actually fine. It's not even that they are lying, but we humans are very good at hiding truths, even from ourselves. It can be very hard to truly admit that one is unhappy about one's life, and frankly many people have never really experienced a true sense of fulfillment, peace, belonging, purpose and happiness, and don't know what it would feel like or understand how lacking the feeling is in their lives. "My life is fine" generally means "I've checked the right boxes: 'success', 'friends', a relationship, but I still feel empty." Don't use drugs to numb that feeling. Listen to it.

retbull 11y ago
But drugs are awesome :D Seriously though, compared to being depressed when you can't fix it because you don't have any idea that something is wrong, drugs are fucking amazing. The shitty part is people end up trapped now as the drugs can fuel the negativity which lead to the depression in the first place.
- themgt 11y ago
  I actually agree drugs are useful for treating mental issues, I just disagree that people need a daily drip-drip-drip of e.g. serotonin or dopamine to function. Drugs can be extremely helpful in treating acute mental issues and helping people "break through" or inoculate themselves against episodes of illness, see e.g. psilocybin, MDMA, ketamine for treatments of e.g. anxiety/depression/PTSD/psychological health in the terminally ill, cluster headaches, etc. The common thread though is that a single dose of the drug offers long-lasting protection, weeks or months or years. It's not about chemically changing the brain day after day, it's about using neurochemicals to jolt the brain out of a rut. It's about occasionally kickstarting the brain back into normal self-regulation, not using externally supplied chemicals to permanently supplement dysregulation.
  - 11y ago

xlm1717 11y ago

Definitely agree with this. The exchange the doctor describes to begin the article is also common online. I've spent a lot of time in anxiety and depression support forums and chat rooms for my own problems with anxiety. The most common view is that anxiety and depression are diseases that you need to take medicine to treat. No doubt medicine has its uses in treating anxiety and depression, a momentary reprieve can grant you the clarity to see what you do need to change to feel better. However, I see many people online who cling so strongly to the idea that anxiety and depression are chemical imbalances that you are unlucky enough to be predisposed to developing and that balance can only be restored through medication, that when you suggest that anxiety and depression are not diseases and so can be treated to the point that they are not a problem anymore, people will react violently, as if you just assaulted their identity. This line of thinking makes it extremely difficult for them to get relief. It is also beneficial to pharmaceutical companies who can make a customer for life by convincing customers that if they don't have a certain medication they will always feel miserable.

brador 11y ago
There are also some forums where people discuss abusing a depression/anxiety diagnosis to claim disability welfare. This is much more widespread than most people realise since the rates are higher and the requirements much lower than regular welfare. It's a surprisingly cushy lifestyle, and some would do anything to keep it. And that entire structure is dependent on depression/anxiety being seen as a medical problem with no solution, only medication. They are very vocal in it's protection.
- jacalata 11y ago
  > the rates are higher could you explain this? I've never heard about it.
  - brador 11y ago
    The simplest example would be welfare per month from (disability + unemployed) > unemployed only.

stantona 11y ago

..or that for some individuals, those who suffer bipolar (such as myself) or clinical depression, there's a biological factor that has little relation to past circumstances.

fucking_tragedy 11y ago

How are suicidal ideation/attempts and 'successful' suicides explained by this hypothesis?

wonderlust 11y ago
As I read this, its not a hypothesis, nor is it a theory. Its just a long value statement about how to think about what's going on. You can accept or ignore this, and it won't change the science at all.
- spangry 11y ago
  Fantastic comment. Medical history is replete with quack-theories and charlatans offering various cures. Blood-letting to balance the body's "humours" for example. The wonderful thing about scientific progress is that it shrinks the space quacks and charlatans have to peddle their pet theories and cures.
- tim333 11y ago
  As I read it "Depression and anxiety are, for the large majority of cases, emotional signals that one’s psychological health is not ideal and that one’s psychosocial/relational needs are not being met." looks like a theory and and experimentally testable and falsifiable one at that. Take a bunch of depressed people, try to fix their relationship needs along the lines mentioned in the article, survey the people who now have friends, get on with their family and so on and see if they are still depressed and compare to a control group. Simples.
  - wonderlust 11y ago
    Depression and anxiety are by definition not ideal physcological health. And almost no ones social needs are ever truly completely met. we also know already that social support helps anxiety and depression regardless of whether it is a root cause. So your test wouldn't falsify if it returned a negative value, nor support with a positive correlation.
- deleted 11y ago
  [deleted]

Dylan16807 11y ago

danharaj 11y ago
> If a situation is causing no problems outside of depression/anxiety, and you took away the depression/anxiety mechanism, there would be nothing wrong with it. My experience with SSRI's has been that taking away that mechanism is taking away creativity, emotional range, and introspective ability. Reality distortion is reality distortion. I reject procrustean medicine that fits humans to the mold of what is best for society, which is the primary environment in which anxiety/depression originate.
- Dylan16807 11y ago
  > My experience with SSRI's has been that taking away that mechanism is taking away creativity, emotional range, and introspective ability. I'm not talking about SSRI's, I mean a theoretical way of removing only depression and the similar kinds of chronic anxiety. You can be very creative and introspective without being actively depressed. > Reality distortion is reality distortion. It's depression that distorts reality, even to the point of making you feel negative emotions that you know aren't true but can't stop. > I reject procrustean medicine that fits humans to the mold of what is best for society, which is the primary environment in which anxiety/depression originate. That's great. Me too. But that's really a different issue. You could fix that entirely, and you'd still have people hurt by depression.

deleted 11y ago

[deleted]

copperx 11y ago

While I agree with you on some points, one has to be careful with anything that tries to explain away a complex phenomenon. After all, there are quacks out there trying to explain away cancer as a symptom, not a disease (see: http://www.goodreads.com/book/show/163184.Cancer_Is_Not_a_Disease_It_s_a_Survival_Mechanism http://www.goodreads.com/book/show/163184.Cancer_Is_Not_a_Di...).

venomsnake 11y ago

My favorite pet theory is that depression is the equivalent of autoimmune reaction for the brain. The same way we need some exposure to dirt to calibrate our immune system to not go berserk with some food allergies or lupus, probably we need something in our life to calibrate our brains' loopback feeds.

studentrob 11y ago
So, people who've led relatively normal, successful lives with good relationships and have depression might be experiencing it so deeply because they haven't had much exposure to sadness? Sounds like a reasonable theory to me. That would also explain how people are able to get out of unexplainable depression after a period of time, and why people sometimes seem to seek out more sadness when they're already sad. They're looking for perspective. Awareness is the goal of some forms of meditation. I'd like to see more studies on the effects of meditation on those who have various forms of depression.

papapra 11y ago

At the same time some people are just more neurotic(and genetics has a big role), it's not so simple

hamstergene 11y ago

I often notice people assume evolution to be "wise" and "nice" when searching for evolutionary explanations, which it is neither. Evolutionarily speaking, just because something has evolved does not mean it happened for a purpose, or is useful at all. Pathological anxiety and depression may actually be purely disadvantageous mutations which nevertheless still passed evolution filters because they are not disadvantageous enough to wipe out 100% of their carriers. Or they may have a much uglier purpose than you have assumed, for example, to force weak individuals (in)voluntarily withdraw from consuming resources useful to others, or even to kill themselves completely, which might be "wise" during foraging times but is nothing but useless breakage in civilized age.

JoeAltmaier 11y ago
But most human variations are recent! We've changed more in the last 50,000 years than the previous 1M years. I'd say, instead of a real purpose, any 'breakages' are likely coincidental to some other, more advantageous adaptation. Getting smaller and more calorie-efficient (to suit the village/town/city/urban environment) may mean biochemical changes that change our mental state. Not because we 'need' that mental state, but because its better for the clan if more of us fit closer together. So many adaptations are sledgehammers for a smaller problem. Evolution doesn't plan; it just diddles around until something (sort of) works. And our bodies are the unfortunate result!

hipsterrific 11y ago

The author addresses social structures and we seem to live in an age of increasing isolatedness amongst people. I thought it would have been a hard read (I suffer from depression) but it's also liberating to see it in a different light.

Grishnakh 11y ago

>Evolutionarily speaking, it seems likely that depression/anxiety are there for some purpose, and yet we treat them both like meaningless pain meant only to be banished using drugs. I believe both are signals that something in our environment is not working for us. They indicate emotional or physical needs unmet---needs for safety, autonomy, connection, etc. Yes, that's all true IMO, but the problem is that many times, it simply isn't feasible to change your environment. So antidepressants are a good way to deal with the problem. For instance, suppose you live in the ghetto and are constantly struggling to make ends meet. How do you change your environment here? Well, here in American, you don't. You just suffer. If it were that easy to get out of poverty, most people in that trap would do it. Indeed, many things in society seem to be actively designed to keep people trapped in poverty. What if you're lonely because you're single and have never had any success dating, and the reason is that you're cursed with being extremely unattractive? There again, there's only so much you can do to change that. (Or worse, you have a serious physical disability, which really limits how many people are willing to date you.) >but I believe the depression/anxiety are there to force our conscious self and the people around us to acknowledge that something is wrong. Sounds like an interesting theory, but in reality, at least in this society, it seems to have the opposite effect: it makes you an outcast. No one wants to be around depressed people, so they're stuck being lonely, which feeds the depression, it's a vicious cycle. Antidepressants can really help a lot here, by giving you a short-term boost to jump-start your social life and just to help you cope with life in general. >This is a completely different paradigm that explains depression and anxiety as meaningful signals of underlying problems rather than as inexplicable suffering to be numbed through prescription medication. I believe it will prove the more robust and also the wiser way of looking at these experiences. I think the problem with this idea is that this seems to require some gigantic changes in our very culture and how we deal with people who are depressed.