5 ms·

Largely because articles like this generally focus on what I think of as “layman’s depression”, or “layman’s anxiety.” That is, a mild form of the condition tha

Largely because articles like this generally focus on what I think of as “layman’s depression”, or “layman’s anxiety.” That is, a mild form of the condition that straddles the gray area between “personality” and “mild personality disorder,” that diminishes quality of life in a perceptible but not devastating way. Then you go work on a psych floor and meet people whose depression is so severe it induces catatonia; people who look and feel like zombies and who would end their lives if given the chance; people whose depression comes with a healthy side-order of delusions. Extreme things that render someone incapable of even mild functioning. Or severe anxiety - patients whose worry comes from no external stimulant, renders them incapable of anything but physically sickening levels of worry, and if you manage to somehow help them reason through the thing they are currently worried about ... find a new thing to attach their emotions to. Look at something like OCD, wherein one - for instance - May obsessively wash hands to stymie an overpowering anxiety that ones house may burn down (OCD sometimes has logical triggers between ritual and anxiety; often not.) Interpreting that as “an adaptive response” is ridiculous. An adaptive response “taken too far”, on the other hand, is the very definition of wide swaths of disease - autoimmune, cancer, etc. I find the “gosh it’s just cultural mismatch” theory to be a modern stigma against mental disease. You can break any bone or system in the body - except for neuro/behavioral, that’s just another type of person that needs some cultural adaptation. /That’s/ never really broken.

1_player 6y ago
How common is that extreme form of depression? Sounds like we need two different names for two very different diseases (or perhaps only one is actually a disease)
- podgaj 6y ago
  There are no diseases, only symptoms. We can name diseases forever but that gets us nowhere. They just have more depression, or are more depressed. By the way, why don't people get SSRI's when they are depressed with a flu? I mean that is caused my lower serotonin as well. So for some reason we accept that depression because we have a reason for it? https://www.inverse.com/article/40843-what-f-lu-do-es-t-o-you-r-brain https://www.inverse.com/article/40843-what-f-lu-do-es-t-o-yo... You see, depression is fundamentally and immune disorder. We react negatively to something in the environment, like a bad job or marriage.
  - _jal 6y ago
    > By the way, why don't people get SSRI's when they are depressed with a flu? One reason is SSRIs typically require a a few weeks to reach effective levels in your system; about how long it takes to recover from the flu. > depression is fundamentally and immune disorder You appear to be playing a free association game with words, not describing reality.
    - podgaj 6y ago
      The idea that it take weeks for antidepressants to reach 'effective levels" is a misunderstanding of the science. It is is true for MOST people that, for example, fluoxetine and its metabolite, norfluoxetine will be at a certain level in the serum before they have resolution of symptoms, but this is not the case for all people. It takes a very small dose to inhibit serotonin reuptake and this will happen with the first dose. https://www.nature.com/articles/1395757 https://www.nature.com/articles/1395757 "The single dose caused only a slight increase in drug plasma concentrations but relatively clear changes in sleep structure." And I was hoping you would all chime in and say it is useless for the flu. Because it might be very helpful https://www.sciencedaily.com/releases/2012/07/120727171919.htm https://www.sciencedaily.com/releases/2012/07/120727171919.h...
  - SketchySeaBeast 6y ago
    > You see, depression is fundamentally and immune disorder. That's a lot of certainty for something that is still very much uncertain. > By the way, why don't people get SSRI's when they are depressed with a flu? Because that's a short term, acute condition that will get better on its own? That's the same as saying "People in the hospital who can't breath are given oxygen, so why aren't runners who are breathing hard?" Because long term major depressive disorder is totally different than having a down couple of days.
    - podgaj 6y ago
      More certain than ever actually: https://www.sciencedirect.com/science/article/pii/S2666354620300739 https://www.sciencedirect.com/science/article/pii/S266635462... Regarding oxygen use during running, it is already something: https://trainright.com/hyperoxic-training-little-know-training-technique-olympic-athletes-using/ https://trainright.com/hyperoxic-training-little-know-traini...
tremon 6y ago
Interpreting that as “an adaptive response” is ridiculous. An adaptive response “taken too far”, on the other hand, is the very definition of wide swaths of disease - autoimmune, cancer, etc. These two statements don't add up for me. If you do accept that various autoimmune disorders and cancers are essentially adaptive responses taken too far, then why can't depression similarly be considered the same? Or is your point that depression is simply an adaptive response, and it's not "taken too far" until people are at the catatonic state?
- wittyreference 6y ago
  Sorry, your question is fair -- let me elaborate: I feel the OP puts forward two statements, categorizing depression as "adaptive", or "adaptive response taken too far." I wish to address each of these separately. Having seen what these maladies do, I believe that categorizing them as "adaptive" is a position that can only be borne from "have never seen these diseases in their full spectrum, largely responding to mild, layman's-presented versions of them." Separately, addressing the concept of them being "adaptive responses being taken too far," I find essentially tautological. Give me a little leeway to oversimplify when I say that there are two broad categories of disease: exogenous (trauma, infection - things done to us by the external environment) and endogenous (things that occur from dysregulation of human physiology). ((Aside: the above is, like all models, wrong. There are interactions and predispositions between biology, exposure, etc. I aim to use the above to illustrate a point about "adaptive response gone too far", not to overlook the full biopsychosocial model of disease.)) Calling a non-exogenous disease "an adaptive response taken too far" is a tautology. All human physiology arises from homeostasis - it's all "adaptive" in purpose, if not in effect. So all endogenous disease can be described as "adaptive response that is acting maladaptively."
- novok 6y ago
  You don't have depression if you really hate your job / university degree / sad your mom died, you just hate your job / sad your mom died.
vmchale 6y ago
> I find the “gosh it’s just cultural mismatch” theory to be a modern stigma against mental disease. You can break any bone or system in the body - except for neuro/behavioral, that’s just another type of person that needs some cultural adaptation. Also ties into minimization of mental illness, which is a form of stigma!
LatNax 6y ago
The examples you have given seem to be outliers where the system "human" broke out of its basic parameters, causing multiple other subsystems to fire out of control.
filleduchaos 6y ago
> That is, a mild form of the condition that straddles the gray area between “personality” and “mild personality disorder,” that diminishes quality of life in a perceptible but not devastating way. I otherwise agree with your comment, but depression and anxiety aren't personality disorders or personality related at all. Depression is an affective disorder. Anxiety is its own class of disorder.
- wittyreference 6y ago
  You’re quite right. That was a typo/brain fart, and by the time I noticed it my comment was past editing.

1_player 6y ago

How common is that extreme form of depression? Sounds like we need two different names for two very different diseases (or perhaps only one is actually a disease)

podgaj 6y ago
There are no diseases, only symptoms. We can name diseases forever but that gets us nowhere. They just have more depression, or are more depressed. By the way, why don't people get SSRI's when they are depressed with a flu? I mean that is caused my lower serotonin as well. So for some reason we accept that depression because we have a reason for it? https://www.inverse.com/article/40843-what-f-lu-do-es-t-o-you-r-brain https://www.inverse.com/article/40843-what-f-lu-do-es-t-o-yo... You see, depression is fundamentally and immune disorder. We react negatively to something in the environment, like a bad job or marriage.
- _jal 6y ago
  > By the way, why don't people get SSRI's when they are depressed with a flu? One reason is SSRIs typically require a a few weeks to reach effective levels in your system; about how long it takes to recover from the flu. > depression is fundamentally and immune disorder You appear to be playing a free association game with words, not describing reality.
  - podgaj 6y ago
    The idea that it take weeks for antidepressants to reach 'effective levels" is a misunderstanding of the science. It is is true for MOST people that, for example, fluoxetine and its metabolite, norfluoxetine will be at a certain level in the serum before they have resolution of symptoms, but this is not the case for all people. It takes a very small dose to inhibit serotonin reuptake and this will happen with the first dose. https://www.nature.com/articles/1395757 https://www.nature.com/articles/1395757 "The single dose caused only a slight increase in drug plasma concentrations but relatively clear changes in sleep structure." And I was hoping you would all chime in and say it is useless for the flu. Because it might be very helpful https://www.sciencedaily.com/releases/2012/07/120727171919.htm https://www.sciencedaily.com/releases/2012/07/120727171919.h...
- SketchySeaBeast 6y ago
  > You see, depression is fundamentally and immune disorder. That's a lot of certainty for something that is still very much uncertain. > By the way, why don't people get SSRI's when they are depressed with a flu? Because that's a short term, acute condition that will get better on its own? That's the same as saying "People in the hospital who can't breath are given oxygen, so why aren't runners who are breathing hard?" Because long term major depressive disorder is totally different than having a down couple of days.
  - podgaj 6y ago
    More certain than ever actually: https://www.sciencedirect.com/science/article/pii/S2666354620300739 https://www.sciencedirect.com/science/article/pii/S266635462... Regarding oxygen use during running, it is already something: https://trainright.com/hyperoxic-training-little-know-training-technique-olympic-athletes-using/ https://trainright.com/hyperoxic-training-little-know-traini...

tremon 6y ago

Interpreting that as “an adaptive response” is ridiculous. An adaptive response “taken too far”, on the other hand, is the very definition of wide swaths of disease - autoimmune, cancer, etc. These two statements don't add up for me. If you do accept that various autoimmune disorders and cancers are essentially adaptive responses taken too far, then why can't depression similarly be considered the same? Or is your point that depression is simply an adaptive response, and it's not "taken too far" until people are at the catatonic state?

wittyreference 6y ago
Sorry, your question is fair -- let me elaborate: I feel the OP puts forward two statements, categorizing depression as "adaptive", or "adaptive response taken too far." I wish to address each of these separately. Having seen what these maladies do, I believe that categorizing them as "adaptive" is a position that can only be borne from "have never seen these diseases in their full spectrum, largely responding to mild, layman's-presented versions of them." Separately, addressing the concept of them being "adaptive responses being taken too far," I find essentially tautological. Give me a little leeway to oversimplify when I say that there are two broad categories of disease: exogenous (trauma, infection - things done to us by the external environment) and endogenous (things that occur from dysregulation of human physiology). ((Aside: the above is, like all models, wrong. There are interactions and predispositions between biology, exposure, etc. I aim to use the above to illustrate a point about "adaptive response gone too far", not to overlook the full biopsychosocial model of disease.)) Calling a non-exogenous disease "an adaptive response taken too far" is a tautology. All human physiology arises from homeostasis - it's all "adaptive" in purpose, if not in effect. So all endogenous disease can be described as "adaptive response that is acting maladaptively."
novok 6y ago
You don't have depression if you really hate your job / university degree / sad your mom died, you just hate your job / sad your mom died.

vmchale 6y ago

> I find the “gosh it’s just cultural mismatch” theory to be a modern stigma against mental disease. You can break any bone or system in the body - except for neuro/behavioral, that’s just another type of person that needs some cultural adaptation. Also ties into minimization of mental illness, which is a form of stigma!

LatNax 6y ago

The examples you have given seem to be outliers where the system "human" broke out of its basic parameters, causing multiple other subsystems to fire out of control.

filleduchaos 6y ago

> That is, a mild form of the condition that straddles the gray area between “personality” and “mild personality disorder,” that diminishes quality of life in a perceptible but not devastating way. I otherwise agree with your comment, but depression and anxiety aren't personality disorders or personality related at all. Depression is an affective disorder. Anxiety is its own class of disorder.

wittyreference 6y ago
You’re quite right. That was a typo/brain fart, and by the time I noticed it my comment was past editing.