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As true as that might be, I strongly believe depression as a disease/condition should only be diagnosed (and thus treated) if there is no real cause for the sym

As true as that might be, I strongly believe depression as a disease/condition should only be diagnosed (and thus treated) if there is no real cause for the symptoms. Being sad and unable to leave the bed because (your dog died | you are morbidly obese | you are going to die in 3 months) doesn't qualify as depression.

Broken_Hippo 9y ago
Actually, just because there is a reason for you to be depressed doesn't mean that you don't have depression. Depression can cause abnormal responses to life's events. Not to mention the fact that a life event - death of a loved one, death of yourself, or a bad situation - can cause an episode of clinical depression. The basics with mental health is that it needs to be abnormal and/or cause problems doing basic life stuff. So back to your example: Not leaving the bed because your dog died can be a red flag of depression. Or cause it in a few people (death of significant other, parent, or child is probably more likely to cause it though). This is especially true the longer the person has the symptom - none of us would blame a person for taking a couple days off, but you should be able to function at work a few days later. It doesn't matter if obesity is the cause of the depression if the state of mind keeps them from doing self-care. And I don't know why it would be bad to let some terminally sick person to take happy drugs. It seriously doens't matter at this point because they will probably be dead. Might as well enjoy what you can of the rest. This is probably a bad example all around and likely hard to diagnose properly.
- athenot 9y ago
  Yes, it's a tradeoff for quality of life. Any active medication has side-effects. But if the depression—even though it may have an unknown cause—prevents a person from functioning in life, then the medication might be worth it. But it's a judgement call to be made by the patient, with proper guidance by his/her care team. In many cases, increasing the risk of a severe disease 20 years from now is preferable than losing job/house/life. It's easy to criticize these patients or their care team as doing too little but sometimes, a baby step is the only realistic step that can be taken, and there may even be some urgency associated with it. Having said that of course, it's important to follow-up and continue to dig deeper in what can be done from a mental health perspective. An antidepressor may be the band-aid to regain sanity and some stability, and from that place, the next steps can be taken. The key is to not give up in that journey towards health, but that is easier said than done. Disclaimer: not a doctor, just a patient advocate.
- glastra 9y ago
  In my opinion, inability to cope with whatever is going on with life is still not depression. It is, however, something that can and should be addressed (possibly through therapy). In fact, I believe using antidepressants for such cases is counter-productive, making people rely on pills to feel alright instead of acquiring the adequate coping mechanisms or mental processes. Giving drugs (whatever their legal status) to terminally ill patients is acceptable, but it's still not treating any illness known as depression.
  - rsynnott 9y ago
    > In my opinion, inability to cope with whatever is going on with life is still not depression. It is, however, something that can and should be addressed (possibly through therapy). Okay, so it can be addressed, using therapy, like depression. What would you prefer to call it?
bonesss 9y ago
Respectfully: the entire mental health profession and the DSM-5 explicitly disagree with your belief. Conflating depression with "being sad" is to misunderstand what depression is, what sadness is, and how we qualify depression diagnoses. Sadness is natural and healthy. Depression is natural and unhealthy. While the word 'depression' is abused in pop culture, showing enough symptoms of major depressive disorder over a long enough timeline is the literal textbook definition of being depressed. Not getting out of bed because your dog died is arguably a natural reaction to sadness. Not getting out of bed for three months, refusing to eat because you're trying to die, cutting off lifelong friends, and undergoing severe personality changes because your dog died is really, really, something else. And, on a personal note, distinguishing between what is and isn't a "real" cause for a feeling is a pretty offensive judgment and implies a very dismissive attitude towards peoples pain... I mean, someone who is unable to function in society 15 years after their kid died doesn't get to be depressed because they have a "real" reason to feel bad? And people who kill themselves from a major cognitive imbalance don't have a "real" cause for feeling that way? Bleh. That's a half step removed from "suck it up" or "snap out of it".
- glastra 9y ago
  I haven't conflated sadness with depression. I was in fact stating the opposite. Unfortunately I am very aware of most of the symptoms of depression as I have suffered it myself in the past. And yes, I did take antidepressants. I am not against their use at all, only against misdiagnoses. 15 years of mourning the death of a loved one is of course abnormal, as I have stated already in another response around this thread, but... is it depression? Or is it lack of coping mechanisms? Maybe learning to face reality is better than depending on a daily dose?
  - samirillian 9y ago
    Not a doctor, but: it seems the real problem with your claim is that it's patently absurd to say that a symptom can only be a symptom if it has no cause. Symptoms present themselves that we might find the cause of the problem. Do you mean no cause other than a chemical imbalance? I still think that's shaky ground, but I don't really know enough to say.
rsynnott 9y ago
In the first two cases, it’s an extreme and unreasonable reaction (assuming it goes on for a while, rather than just being for a day or so), and could well be depression. On that basis, depression could only be diagnosed in people who have perfect lives, ie nobody.

Broken_Hippo 9y ago

Actually, just because there is a reason for you to be depressed doesn't mean that you don't have depression. Depression can cause abnormal responses to life's events. Not to mention the fact that a life event - death of a loved one, death of yourself, or a bad situation - can cause an episode of clinical depression. The basics with mental health is that it needs to be abnormal and/or cause problems doing basic life stuff. So back to your example: Not leaving the bed because your dog died can be a red flag of depression. Or cause it in a few people (death of significant other, parent, or child is probably more likely to cause it though). This is especially true the longer the person has the symptom - none of us would blame a person for taking a couple days off, but you should be able to function at work a few days later. It doesn't matter if obesity is the cause of the depression if the state of mind keeps them from doing self-care. And I don't know why it would be bad to let some terminally sick person to take happy drugs. It seriously doens't matter at this point because they will probably be dead. Might as well enjoy what you can of the rest. This is probably a bad example all around and likely hard to diagnose properly.

athenot 9y ago
Yes, it's a tradeoff for quality of life. Any active medication has side-effects. But if the depression—even though it may have an unknown cause—prevents a person from functioning in life, then the medication might be worth it. But it's a judgement call to be made by the patient, with proper guidance by his/her care team. In many cases, increasing the risk of a severe disease 20 years from now is preferable than losing job/house/life. It's easy to criticize these patients or their care team as doing too little but sometimes, a baby step is the only realistic step that can be taken, and there may even be some urgency associated with it. Having said that of course, it's important to follow-up and continue to dig deeper in what can be done from a mental health perspective. An antidepressor may be the band-aid to regain sanity and some stability, and from that place, the next steps can be taken. The key is to not give up in that journey towards health, but that is easier said than done. Disclaimer: not a doctor, just a patient advocate.
glastra 9y ago
In my opinion, inability to cope with whatever is going on with life is still not depression. It is, however, something that can and should be addressed (possibly through therapy). In fact, I believe using antidepressants for such cases is counter-productive, making people rely on pills to feel alright instead of acquiring the adequate coping mechanisms or mental processes. Giving drugs (whatever their legal status) to terminally ill patients is acceptable, but it's still not treating any illness known as depression.
- rsynnott 9y ago
  > In my opinion, inability to cope with whatever is going on with life is still not depression. It is, however, something that can and should be addressed (possibly through therapy). Okay, so it can be addressed, using therapy, like depression. What would you prefer to call it?

bonesss 9y ago

Respectfully: the entire mental health profession and the DSM-5 explicitly disagree with your belief. Conflating depression with "being sad" is to misunderstand what depression is, what sadness is, and how we qualify depression diagnoses. Sadness is natural and healthy. Depression is natural and unhealthy. While the word 'depression' is abused in pop culture, showing enough symptoms of major depressive disorder over a long enough timeline is the literal textbook definition of being depressed. Not getting out of bed because your dog died is arguably a natural reaction to sadness. Not getting out of bed for three months, refusing to eat because you're trying to die, cutting off lifelong friends, and undergoing severe personality changes because your dog died is really, really, something else. And, on a personal note, distinguishing between what is and isn't a "real" cause for a feeling is a pretty offensive judgment and implies a very dismissive attitude towards peoples pain... I mean, someone who is unable to function in society 15 years after their kid died doesn't get to be depressed because they have a "real" reason to feel bad? And people who kill themselves from a major cognitive imbalance don't have a "real" cause for feeling that way? Bleh. That's a half step removed from "suck it up" or "snap out of it".

glastra 9y ago
I haven't conflated sadness with depression. I was in fact stating the opposite. Unfortunately I am very aware of most of the symptoms of depression as I have suffered it myself in the past. And yes, I did take antidepressants. I am not against their use at all, only against misdiagnoses. 15 years of mourning the death of a loved one is of course abnormal, as I have stated already in another response around this thread, but... is it depression? Or is it lack of coping mechanisms? Maybe learning to face reality is better than depending on a daily dose?
- samirillian 9y ago
  Not a doctor, but: it seems the real problem with your claim is that it's patently absurd to say that a symptom can only be a symptom if it has no cause. Symptoms present themselves that we might find the cause of the problem. Do you mean no cause other than a chemical imbalance? I still think that's shaky ground, but I don't really know enough to say.

rsynnott 9y ago

In the first two cases, it’s an extreme and unreasonable reaction (assuming it goes on for a while, rather than just being for a day or so), and could well be depression. On that basis, depression could only be diagnosed in people who have perfect lives, ie nobody.