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Neuropsychiatric researchers rethink what depression might be

• ada1981 4y ago
  We’ve known for over a decade there is no such thing as an imbalance. Anyone who bothered to read the primary research would find this out. It’s incredible how standard of care lags decades behind.
• deleted 4y ago
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• NickM 4y ago
  It's really bizarre to me how fixated people are on viewing depression solely through the "disease with a biological cause" lens. Even in this article, which acknowledges the serious flaws in the serotonin hypothesis, all the alternatives they explore are around other biological things like other neurotransmitters, inflammation, etc. Maybe more people are anxious and depressed than in the past because modern life really sucks for a lot of people. I'm not saying that's a simple thing to fix, and certainly there is a biological component for some people...but the idea that societal changes are increasing rates of anxiety and depression seems way more plausible than there being some sudden and mysterious shift in the biology of a significant percentage of the population that needs correcting via medication.
  • alexfromapex 4y ago
    Not disagreeing with you I think depression is a constellation of things but anhedonia in my opinion definitely has a biological cause because it comes and goes.
    • awaythrow483 4y ago
      This is really faulty logic. Your emotions moving in cycles is not in any way proof of some purely biological issue. Non biological stimuli like external stressors also come and go.
      • alexfromapex 4y ago
        It's not faulty logic at all. Scientists have known for a while that your ability to experience pleasure is a result of certain biological processes. "Recent findings in the field of neuroscience have, however, demonstrated that a single functional circuit, incorporated inside the broader dopaminergic mesocorticolimbic system, seems to be involved in the various experiences of pleasure" https://www.frontiersin.org/articles/10.3389/fnhum.2018.00359/full https://www.frontiersin.org/articles/10.3389/fnhum.2018.0035... Going back to your accusation of "faulty logic": an interruption in the ability to experience pleasure, which is established to be controlled by biological processes, having a basis in a biological process would be deductively valid logic. Anhedonia is an inability to experience pleasure. https://en.wikipedia.org/wiki/Deductive_reasoning https://en.wikipedia.org/wiki/Deductive_reasoning
        • NickM 4y ago
          It's not faulty logic at all. Scientists have known for a while that your ability to experience pleasure is a result of certain biological processes Well of course on a certain level your ability to feel anything is the result of biological processes, but that doesn't mean that the specific things you feel aren't a result of the specific experiences you've had. Nobody in this thread is arguing that feelings happen completely independently of biological processes, but there's a hugely important difference between "I had a bad experience that altered my feelings, and that's reflected in my biology" vs "my biology just did something of its own accord that had nothing to do with my life circumstances, and that change altered the way I feel". You seem to be arguing that because anhedonia correlates with certain biological changes, that it must be caused by those changes. That could be true (and probably is true in some cases) but it does not necessarily follow that it is always true, or even true the majority of the time; the causation could could flow in a different direction.
          • deleted 4y ago
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          • alexfromapex 4y ago
            Let's come back to my original argument that anhedonia, which is a core feature of depression but is not the same as depression, is caused by biological processes. Do you have evidence to say that it is not?
  • mhardcastle 4y ago
    Here is a lecture by Robert Sapolsky, an extremely well-regarded researcher, that goes over some evidence on depression being a disease: https://youtu.be/NOAgplgTxfc https://youtu.be/NOAgplgTxfc It's been a while since I've seen it, but I recall his evidence including some rather striking non-behavioral symptoms, like changes in sleep cycles. To address your specific thoughts on it, his position (paraphrased from memory) is that social stressors like you describe cause elevated cortisol, which causes depression - such that your position that "modern life really sucks" is not incompatible with a biological cause. It's extraordinarily interesting in a lot of other ways - definitely worth a watch in spite of the length.
    • NickM 4y ago
      Oh yeah, certainly, being depressed is correlated with all kinds of changes in biology. I'm not saying it's like "just in your head", but the question is, do those changes lead to being depressed or does being depressed lead to biological changes? Of course that question is an oversimplification since the answer is certainly some of both; but the prevailing wisdom seems to be that it's mostly/all biological changes leading to feeling depressed, whereas I'm not convinced the scales don't lean more in the other direction, at least on average. EDIT: but as to your point about stress leading to elevated cortisol levels, to me that's clearly not a biological cause. The cause is stress, and the elevated cortisol levels are an effect of the stress. It's not like the hormone levels just went up all by themselves due to some genetic abnormality or something; if they did, then yeah maybe that's a biological disease that warrants some kind of chemical correction, but that's not at all what we're talking about.
    • awaythrow483 4y ago
      If you had crippling anxiety because someone actually was trying to kill you, don't you think you'd have changes in your sleep cycles? Why does that have to indicate some change that is based purely on chemical imbalances that are not caused by external factors?
  • rexpop 4y ago
    It's very frustrating that you impugn the biological cause and receive comments defending the biological effect.
• jobs_throwaway 4y ago
  > Experiments in which researchers artificially lowered the serotonin levels of volunteers didn’t consistently cause depression Jesus...hard to imagine volunteering for that study
• robotburrito 4y ago
  I can't help but imagine the principal Skinner meme in this case. "Am I out of touch? Is society causing depression? No... It's the chemicals that are wrong."
• pojzon 4y ago
  I dont like myself and I have no way to change myself as the issues I face are of a genetic cause. I wont be happy till I accept myself, but I wont accept myself like Im not accepted by others. Simple as that. This is the burden Ill carry till the end of my days. Hopefully sooner than later.
• zttg 4y ago
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• ogwh 4y ago
  There is literally no useful information in this article. It could be summed up as "everything people have been told is bullshit and we don't know what isn't". What a waste of time.
• louison11 4y ago
  Any approach to mental health that doesn't involve an holistic component = understanding the more subtle dynamics of consciousness, is limited. Our understanding of health is only ever as complete as our understanding of the universe and our place within it. Which makes sense considering "health" comes from Old English hǣlth, of Germanic origin, meaning "whole." Mainstream healthcare is pretty ill-equipped when it comes to helping people with mental health because what's at stake is a lot more than atoms, it's learning how to be with one's self... Which is more the function of spiritual traditions and philosophies than it is the function of doctors. (Of course, sometimes there are extreme conditions where medication can be useful to limit harm. But most times I'd argue it simply covers up symptoms and prevents the person from actually growing from the experience.)
• devwastaken 4y ago
  Depression is a result symptom of a human body fighting the anxiety of modern existence. The DSM5 does not exist to aboriginal tribes, and those that live closer to how humans evolved. Similar to how the many issues related to obesity do not exist there. The day to day work of medicine in the 1st world is to put bandaids on problems we ourselves have created.
• awaythrow483 4y ago
  More people have https://en.wikipedia.org/wiki/Shit_life_syndrome https://en.wikipedia.org/wiki/Shit_life_syndrome than depression
• nichohel 4y ago
  Can publications please put a publication date at the top of the piece? (There is a date, at the end, with the author, which is somewhat ambiguous.)
  • nkurz 4y ago
    Agree in general, but this article seems fine for me. I think the placement might depend on screen width. With a narrow screen, the date is right at the top. Wider, it gets moved below a graphic, but still even with the end of the first paragraph. Maybe there's some other version you are seeing that puts it at the bottom? If by ambiguous you mean it's the same as today's date, yeah, but I'm not sure there's a way to avoid that ambiguity on the day of publication.
• Razengan 4y ago
  I think, to put it simply, depression is the inability to be happy. It could be chemical, but usually at its core it's a constant sadness about something you cannot, or will not, change. Whether it's for your own self, or for someone else, or just about the state of affairs you witness in the world. Money, friendship, family, a partner, security, a safety net, an optimistic future.. For most depressed people it's a lack of one or more of those things.
• xen2xen1 4y ago
  Let's see... Gut Biome comment? Check. Just diet and exercise, check. "It's really a social problem", check. Arguing about fat people? Check. Sometime I'm going to register hnbingo.com and show my clairvoyance, this is all predictable. Oh, arguments about the poor! Knew those had to be there.
  • deleted 4y ago
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  • graderjs 4y ago
    Seems there’s a lot of anger about the topic; maybe. One description I heard which sounds pretty good is: depression is anger turned inwards; rather than expressed: expressed through either being processed or turned outward, or both? I guess. Just find an outlet that does not take it out on someone else :)
  • curioussavage 4y ago
    Don’t you think that’s a little condescending. It’s predictable because those are all topics that are related and there of course differences in common opinions. So you are trying to call everybody out for earnestly bringing relevant opinions and other points and just having a good discussion on an important topic. Is this not what comments are for? this isn’t Reddit where all the comment threads have to devolve into pithy jokes.
• ImaCake 4y ago
  Depression is often, not always, a symptom of another disorder. This is especially true if your depression symptoms are acute or cyclical. Conditions like Bipolar Disorder or ADHD are often mis-diagnosed as depression or anxiety. Beyond that, Depression could be caused by any of a myriad of internal or external variables. It is no wonder that it is notoriously difficult to study Depression when it might just be a symptom of a dozen distinct conditions. My anecdote is that I thought I experienced bouts of depression for no deeper reason right through my 20s. Turns out I have ADHD and my depression is just caused by my brain getting exhausted from masking/functioning.
• nonlincoder 4y ago
  “Before you diagnose yourself with depression or low self-esteem, first make sure you are not, in fact, just surrounded by assholes.” Been depressed and unhappy for ages. But I find it gets exacerbated when people are assholes.
• cvccvroomvroom 4y ago
  I have intense TRD. Only mirtazapine could scratch it partially. On mirtazapine, buproprion, and vilazodone. Psychedelics, magnets, and if it takes protein intake or fecal transplant, sure.
• aszantu 4y ago
  Changing my diet helped me with energy levels. My Parents moved when I was 5, and divorced when I was 14, ever since I've moved about every 5 years or so - it's a restless life. I've been bullied and beaten when before I was 5, bullied by a teacher in elementary school, and when I left there my parents divorced. Depression probably has been with me since I was 6 or 7. Nothing matters, and I don't want to do anything. At the age of about 31 I got diagnosed with heavy depression and adhd (I'm female and probably authistic as well). With 35 the last thing I hadn't tried yet was ketogenic diet. Within a Week my energy levels rose dramatically, and it took another year to pull it together, but my life is normal now (at 40 years old). I haven't found a definitive answer, but my guess is that I've ruined my gut when I first moved. Can't digest plants and they ferment in the belly. It takes about 4 days to have effects. Any effect stays for a few days and then leaves when I go back to Meat and Butter. Either that or the brain/immune system just connects carbs and veggies with violence/danger (mum used to beat me over food I didn't want to eat) I've been to gastro enterologist - no diagnosis, allergy testing - no allergies, general practicioner - no diagnosis, psychologist - no diagnosis except for the depression and adhd part (which are much much lighter on a meat based diet)
  • fullmoon 4y ago
    I’ve made the same personal observations. Ketogenic diets have also been used for a century to treat epilepsy in children, so effects might not be limited to the gut. Maybe it’s ketone bodies as an alternative fuel for the brain that is doing the trick.
    • aszantu 4y ago
      it's really interesting. I wish I'd be a researcher. I'd try to science the sht out of ketones. There's anecdotal evidence that cocos fat helps with dementia and alzheimers as well. It already has MCT which can be forwarded by the liver to wherever it's needed. I actually get migraines from most plant-fats, but not from cocos!
• lazyeye 4y ago
  SSRIs are just a way for pharmaceutical companies to monetise the placebo effect. They work vey well initially but quickly taper off (just like placebos). Is there any aspect of modern life that doesnt come with a layer of bullshit attached?
• AndrewKemendo 4y ago
  Depression is social hopelessness. You don't feel like you have a community that can help you achieve your goals, or even set goals that are attainable that will put you in the social role that you think you should be filling. The interplay between your self concept and societal expectations for you individually determine your mood stability Now, certain people (me) have behavioral contributors from childhood like massive trauma that makes it easier to feel low self worth. I would argue everyone has some trauma, but those with big trauma deal with it chronically.
• endorphine 4y ago
  I was hoping to see Finasteride mentioned in the article. I've read that it was found to trigger suicidal thoughts in patients. I'm curious why that is.
  • bitL 4y ago
    Pregnenolone and DIM supplementation might help there. Though post-finasteride syndrome is likely a complex beast and very individualized.
  • deleted 4y ago
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  • rhinoceraptor 4y ago
    The most common reason I've seen speculated is the neurosteroids that 5-alpha reductase is involved in, allopregnanole and isopregnanolone.
  • deleted 4y ago
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  • asdff 4y ago
    I'm really curious what the long term effects of finasteride use will be or if there are side effects from withdrawl. So many people I know use it and this is the first I've read of this side effect, so it must be relatively understudied. I guess the silver lining with so many people testing out a drug like this is that it makes it easier to look at more rare side effects with a larger sample size. Sometimes I think if there's an actual perfectly safe cure for baldness out there, you'd at least see rich people like the British Royal Family or LeBron James using it.
• super256 4y ago
  Maybe it's different across cultures, but to me it was communicated that more serotonin makes you more risk-taking and removes anxiety from you. The anti-depressant effect is coming from the rewards of taking risk (e.g. asking someone out, applying for a new job, asking for extra ketchup on your fries). There was a funny study about crayfish changing behaviour when exposed to SSRI, where they became bolder to the point of endangering their life. https://www.theguardian.com/environment/2021/jun/15/crayfish-behave-more-boldly-after-exposure-to-antidepressants-study https://www.theguardian.com/environment/2021/jun/15/crayfish...
• untech 4y ago
  …because literally nobody really knows what causes the depression.
  • cpncrunch 4y ago
    We do actually have a lot of research into factors that can cause depression, which the article mentions: "Different genetic variations can affect whether individuals respond to certain types of stress, such as sleep deprivation, physical or emotional abuse, and lack of social contact, by becoming depressed."
    • untech 4y ago
      Yes, I agree that we know many correlating factors. We don’t now, however, how depression works on a biochemical level, and whether it is a process that could be described on such a level.
  • deleted 4y ago
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• LatteLazy 4y ago
  We really have no idea what "the" cause is. It maybe have one cause or many (it almost certainly has many...). We don't even really know what depression is. Is it a disease or a symptom or both? Is it actually multiple different diseases all presenting similarly? One look at how regularly professionals change the name/definition/diagnostic criteria for this shows you we are still in very early days for mental health...
  • zeroonetwothree 4y ago
    Right, depression isn't just one thing. It's a general term we give for a family of related symptoms. Sometimes it can be caused by obvious external factors (your loved one dies or you lose your job), in which case it's not considered a "disorder", just a normal response of your brain. Other times there is no obvious external cause and you just have those symptoms for no apparent reason. In such cases we call it "depressive disorder" and treat it with therapy or drugs (which are at best only moderately effective). Of course there are many things in medicine that have no known cause so it's not exactly unique to depression or even mental illness. For example some large % of chronic pain is idiopathic (no known cause), and there are a host of physical conditions that we similarly have no idea about (fibromyalgia, IBS, etc.).
    • LatteLazy 4y ago
      Of course, before it was called "depressive disorder" it was called clinical depression and defined slightly differently. Before that it was just (unipolar) depression. Before that it was Melancholy. I think it is actually now called something else but I cannot for the life of me remember what... It's like in the dark ages when people just had "fever" and died.
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• MuffinFlavored 4y ago
  What are some good ways to get a bunch of serotonin when seemingly nothing really excites you/brings you joy and you view almost everything in the form of “pros/cons” (aka everything is not without its downsides)?
  • rcarr 4y ago
    “If exercise could be packaged in a pill, it would be the single most widely prescribed and beneficial medicine in the nation.” Robert Butler
    • bitL 4y ago
      Tell that to exercise-intolerant people next...
    • MuffinFlavored 4y ago
      I go for a 3 mile walk every now and then. Doesn't really do much to be honest. I guess you could be referring to the kind of exercise where you need to at least get sweaty.
      • zeroonetwothree 4y ago
        Yes, unfortunately walking isn't really sufficient. You need to get your heart rate up sufficiently, so something like running, biking, weightlifting, dance, etc. work. I've long suffered from depression, and while I find it very hard to exercise regularly, when I do I definitely feels significant improvement to my mood. It's unfortunate that it's so hard to do it consistently.
        • rcarr 4y ago
          For what it’s worth, try bringing the exercise to you. If you like cycling, set up a turbo trainer or exercise bike in your house. If you like weightlifting, get some dumbbells or a sandbag or a squat rack. Reduce the friction and set yourself a goal of doing 1 repetition or 1 minute of exercise a day. It’s such a trivial amount and you’ve reduced the friction of doing the task to such an amount that it makes it much easier to get a consistent habit going.
• tjpnz 4y ago
  I wonder to what degree medicine would be "solved" if in the future chronic inflammation could be removed from the equation. Based on my own consumption of pop-medical articles it's the biggest recurring villain.
• david_draco 4y ago
  "The Cause of Depression" assumes there is a single cause, which may not be the case.
  • mettamage 4y ago
    I agree with this idea. I personally think there isn't. There are more parts of the system that can be attacked in order to cause depression
    • cpncrunch 4y ago
      I wouldn't say attack is the right word. Depression seems to be an evolved mechanism that has developed in the brain, as a way to change the organism's behaviour, e.g. resting while sick (sickness behaviour depression), getting more sleep, getting out of a stressful situation, etc. The problem is, it's more like a generic "check engine" light, but without having access to an OBD, so you kinda have to look at your lifestyle and try to figure out what's causing the depression, which isn't always easy.
• debacle 4y ago
  HN has seen a steep rise in mental health related posts in the last year. Am I the only one who has noticed?
  • digitalsankhara 4y ago
    No. I see an increase in mental health awareness in general across most media. Which is a good thing.
    • debacle 4y ago
      Unless it's symptomatic of a sharp increase in mental health difficulties. Most MH folks I know are completely booked months out at this point.
      • harvey9 4y ago
        Those bookings could be increased willingness to seek treatment rather than increased difficulties.
      • DenisM 4y ago
        Booked? What do you mean?
    • trgn 4y ago
      Is that increased exposure making us healthier (ie. mindful, tolerant, understanding, patient, ...) or more neurotic (ie. ruminative, paranoid, self-absorbed, defensive, ...)?
      • fahadkhan 4y ago
        No doubt the correct answer is "it requires research." But I guess the answer is going to be "it depends, on the individual and the circumstances"
      • digitalsankhara 4y ago
        This is a good question and one that must vex most mental health practitioners. You list both states of mind and some potential mitigations. I'm a bit uncomfortable with the term neurotic myself as it can have dismissive connotations.
• syntaxfree 4y ago
  This is a little unfair to _Listening to Prozac_, which was raising speculation about SSRIs effect on trophic and atrophic factors back in the 90s. In fact it’s unclear whether anyone ever believed in the catecholamine hypothesis (excepting simplified accounts for marketing or doctor-patient communication), and it’s been for decades now a cottage industry to disprove it in favor of something ele. It’s on the other hand disturbing that there’s talk of broadening the term “depression”, when it really needs narrowing. There’s such a thing as a medical condition “depression” that one might as well define as “responds to antidepressants” and then there’s everything else — the invisible boundary accounting for how little effectiveness antidepressants have at large. It’s a damn shame that we don’t have the means of diagnosing it (whereasw Kraepelin developed the bipolar/schizophrenia differential diagnosis before Freud even arrived on the scene). Overall this article does nothing to inform or educate.
  • opportune 4y ago
    Depression and anxiety may as well be the cough and fever of the mental health world. We can certainly treat cough and fever symptoms but that is quite different from treating the underlying condition. I think the big problem is we probably have a lot of recent societal/cultural changes which at least contribute to depression and anxiety, but are very hard to detect because of near universal adoption + too many confounding variables when examining holdout populations. Thinking of things like diet (and trace chemicals, pesticides), sleep habits, screen usage (internet, social media, porn, passive media, games), caffeine, etc. Somewhere in those areas, IMO, likely lie very large causal contributors to all of the reportedly increasing mental health problems we are seeing. I can also speak from personal experience that I had very debilitating depression/anxiety as an adolescent which has since greatly leveled off but not quite cleared. While I could likely still be diagnosed with depression now, to me the two states comparing now vs then are so wildly, qualitatively different that I am convinced they represent different underlying pathologies. What I have now feels more like the same thing that most other malcontents seem to have.
• bannedbybros 4y ago
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• likeabbas 4y ago
  There's no single cause and no single cure which is why it's so hard. I moved cities at 10 years old, and was bullied and isolated during the entirety of Middle School. Ever since then, I've always had negative and depressive thoughts lurking around. It's just my normal. A psychiatrist helped me understand that those formative years are when your cortex is developing. The cortex learns through repetition, and during those years I was having constant sadness and suffering events. So, my emotional intelligence learned to be that way and that's why I've suffered ever since. If I'm not pro active in thinking about being happy or doing active things, I default to being depressed. After almost 20 years, I'm still suffering. A side effect of being isolated during those years is my social skills have taken longer to develop. I didn't have a true batch of friends until college, but now I've lost all of them.
  • kodah 4y ago
    Same thing, ish, here. I don't know if my experience is anecdotal but this gets easier with age. I can hypothesize that I did a lot of unpacking and that my experiences today are much more net positive, thus drifting my "default state" farther from a depressive mindset. Mushrooms helped, but I'd recommend anyone looking into mushrooms, or psychedelics in general, to be cognizant that dealing with trauma in a trip can either be really great or really terrifying. You also are largely not in the driver's seat when dealing with trauma in a trip and fighting it will make things worse. The latter being a lesson I've learned many times over at this point.
  • UncleOxidant 4y ago
    Bullying is such a detrimental thing to experience. It has lifelong consequences. It's good to see that schools in the US are taking it more seriously than they used to. In the past the attitude from adults seemed to be that experiencing bullying would make you tougher. Now we know better. I know that I personally still suffer the effects of bullying some 40 to 50 years later - for example, I tend to withdraw from any conflict/confrontation in the work setting misinterpreting even constructive conflict/criticism as being directed at me personally. When I was a kid playing with other kids I tended to withdraw and disappear even in situations where there was no bullying because I came to expect it would happen. And I see that I withdraw similarly in the workplace. In that sense the bullying from many years ago has negatively impacted my career and mental health (anxiety, panic attacks and a bit of paranoia as I'm always expecting the worst from other people).
• tifik 4y ago
  I made it a principle to never click a title (or a thumbnail in case of e.g. youtube) that is intentionally this click-baity. If it's a topic I genuinely am interested in, I just look the information up somewhere else.
  • spacemadness 4y ago
    Or titles in the form of a question that ultimately is either answered “no” or “we have no idea. keep clicking each week to find out more!”
    • tifik 4y ago
      Just for the record, the original title was 'The real cause of depression is not what you think it is', or sth very close to that. I am happy to see it was changed.
• samsquire 4y ago
  When you cannot find something inside something you can try looking outside where you were looking for answers. In my experience, my spiritual health, acceptances, lack of rejecting bad (and source of) things is the direct cause of all negative thoughts, feelings. Reject the bad, false, negativity, darkness and move toward the love, true, light and goodness. When I was depressed, only spiritual teachings, love and God moved me nearer good feelings and comfort.
  • rpastuszak 4y ago
    For the love of God and all that is holy, please stop.
    • NateEag 4y ago
      What did you find objectionable or offensive in the grandparent post?
      • rpastuszak 4y ago
        > When I was depressed, only spiritual teachings, love and God moved me nearer good feelings and comfort. This is a potentially dangerous statement. Many of the people reading this thread are probably struggling which makes them more vulnerable to snake oil. Talk to a priest if you like, but seek help from a trained specialist.
        • NateEag 4y ago
          I strongly agree that spiritual-sounding platitudes can be a dangerous stand-in for actual mental health assistance. I grew up in conservative evangelical Christianity and saw that happen far too often. I don't see how the OP describing his own experience is telling other people they should do that. He offered spirituality as an option, and said it was the only one he'd found helpful. I think that's an unusual experience, and I understand your concerns about it potentially misleading others into thinking it's the only legitimate path, but I don't think saying "Stop sharing your personal experience!" is actually going to help anyone. Explaining your concerns, like you did for me above, seems much more likely to. Thanks for doing that.
• alienalp 4y ago
  Chronic inflammation is also result of many other health problem. Depression is ultimately a natural process. It is known that depression caused by health issues probably big portion of cases. Nothing new. I realized that bluntly interfering with a mechanism built-in in our body is ridicules. People should be focusing in root causes. However i doubt that SSRIs really interfere with depression anyway. https://www.youtube.com/watch?v=TTDPV1XOIPY https://www.youtube.com/watch?v=TTDPV1XOIPY I think what happens is SSRIs make recovery faster for people who are at the stage of recovery by giving false hope. There are ones that really interfere with depression and result is drastically increased mortality. Which is really what should happen if you surpress a natural mechanism solely exists to increase survival.
• dbg31415 4y ago
  Not that I've had extensive conversations with licensed professionals about this topic for the last 25+ years... but oh, wait. It's a tripod, and you need all 3 to be aligned or else you can be susceptible to falling back into the shit. You don't have to have problems with all 3, problems with just 1 will do it. But you do need to aware that sometimes you do need to fix all 3. Circumstances. Biology. Behavior. And it's complicated. Circumstances. If you have a ton of shit going on that isn't making you happy, you can be depressed. You'll need to work to avoid circumstances that get you down. But... we're seldom able to control our lives. Biology. There can be unbalances. Lack of exercise, for me, is the most common way to feel shitty. If I didn't have my health, I'd feel shitty. Brain health, body health, just health. Also just physical comfort. You have to make sure you're physically OK. Behavior. You have to want to be happy. You have to be open to it. You have to strive for it. You have to respond and interact with people in a way that doesn't make them feel shitty, or else you'll drive them away. And... you have to avoid people looking to just be shitty and drag others down. If a friend tells me that they're depressed, my go to is to take them for a hike. Get them out of their surroundings, get some sunshine, fresh air, and get them moving. I like small tasks, small goals that can build into bigger ones. "We don't have to climb the mountain, let's just go a mile and see how we feel." And it's nice to just have someone there, in the moment with you, doing the same thing. And when I'm down, and I know I'm doing the same thing someone else is, and they're able to enjoy it, I am reminded to let myself enjoy it too. For me personally... it's hard. We all live our own mistakes. Finding a way to forgive myself, while still learning how to improve. Finding ways to keep my step count up. Finding ways to cross off to-dos at work. I have a little consequence / reward system in my head... if I am late to a meeting, I have to do 10 pushups. If I do my chores (stuff like cleaning up, doing the dishes, and yard, and laundry), I get to play a video game at the end of the day... and not beat myself up for being lazy. You get to set your own. It's important to reflect on why you do things. I get down when I feel like I'm just floating between things that are expected of me. Anyway I don't know, if there were cures, if this shit were simple, it wouldn't just constantly be in the background. Routines, friendships, and small goals... staying active, try not to eat pure garbage, try to be thankful and show appreciation to others. I don't know, no real punchline here. Just that life is a struggle to keep decay at bay.
• rcarr 4y ago
  What is currently called “depression” needs splitting up into finer grained categories because it’s become a useless catch all term at this point. I would argue that the people who are really truly rendered catatonic (and so likely have something seriously wrong in the brain that needs addressing with drugs) should be in one category and I would argue this is quite a small minority. I personally believe that the “depression” the majority are experiencing is more akin to what Johan Hari talks about in Lost Connections and it’s root causes are absurd societal structures and political failures which are deeply harming people. If someone feels trapped in a hopeless situation and this drags on for years because society is not providing any means to help them escape and improve their lives then depresssion is a pretty inevitable outcome. In a modern day society it really isn’t acceptable. Give people access to low cost housing. Reduce the cost of education so no one is priced out of it or forced into massive debts. Subsidise healthy food and tax junk. Subsidise gym memberships and sports clubs for the poorest. Increase the amount of therapists being trained and make them more accessible. Pay people proper wages. Watch depression plummet. The solutions are there - why is there no political will to enact them? Edit: I have no idea why but people are reading “subsidise” and seeing “free”. That is not what I said. Subsidise the things you want to encourage so it is cheaper for the consumer at the point of sale and do the opposite for the things you want to discourage. The cost you pay as a society ends up being less in the long run. Less people ill and ending up in hospital means more people working and paying taxes etc.
  • GuB-42 4y ago
    I tend to disagree. Our society is seriously not that bad, the fact we can talk freely about how bad it is show that is better than many other societies. While I didn't experience it first hand, a common thing I see when people visit really shitty places is how happy people are, from North Korean farmers to women of Saudi Arabia. On the other hand, Scandinavian countries are often a model when it comes to a "good" society, topping all the "happiness" charts, and yet, they are in the worst quartile when it comes to suicide rate. So, I won't blame society for depression, it looks like mentally healthy people are pretty resilient, and if put in extreme situations (ex: torture) to beyond breaking point, the result is usually more anxiety than depression. I know a few people with depression, treated and followed by psychiatrists. And while the trigger can be some hardship, which can be related to society, or can be a simple breakup, it is just that, a trigger, most people would have just moved on. And one trait I notice the most is apathy, not sadness. And it is really unsettling. At least, when people are sad, they react to your sollicitations, they may cry, get angry, complain, attempts to get them out will be warmly welcome or they will oppose resistance. For the depressive people I know, there is no reaction, it is not catatonia, their intelligence is unaffected, but it looks like they can't have emotions of their own. They may get good support from friends, family, and even society, but it all seem to go down in a black hole, I really think it helps, but it doesn't show. Drugs seem to be the most effective treatment, unfortunately, because these things induce tolerance and are addictive. Depression is a disease, and we don't know the cause. We know heredity is important, being healthy and well supported is certainly better than sick and alone, but we are not sure about the details, and therefore what society can do. Quoting scientists favorite phrase: "more research is needed". As for what society can do to promote healthy habits, this is really a complex thing. You may not realize but that's what Hitler tried to do (for their own people), in fact Hitler could have seriously tackled depression, though eugenics, healthy labor and campaigning against unhealthy habits like smoking. And yet, it would be an absolutely terrible society to live in. So, I don't think a better, more equal society, as good as it is, is the ultimate solution to depression. Still nice to have though.
• deleted 4y ago
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• petesergeant 4y ago
  Very anecdotal, but I've noticed on HN that people taking the SSRI Lexapro for GAD seem to think it's incredible, and people taking it for depression seem to be underwhelmed
  • tylermac1 4y ago
    Also anecdotal, but everyone metabolizes these classes of drugs differently. I'm an "ultra-rapid metabolizer" of a slew of SSRIs, so they're next to worthless for me compared to other medications.
    • lhuser123 4y ago
      Also anecdotal. And some people are ultra-slow metabolizers, which can cause the drugs to stay in the body longer than anyone could have anticipated. So the effects of 1 pill daily can feel like twice that amount since previous day dosis is still in the blood.
    • edgyquant 4y ago
      SSRIs affect me strangely. I feel mentally like I’m not depressed but then I have all of the symptoms of depression amplified. Oversleep, no motivation etc but hey I feel like I’m not sad internally.
• anonreeeeplor 4y ago
  I hate articles like this. They are part of an entire genre of pseudo intellectual nonsense that seems to be this genius insight but directly ignores obvious causes. They treat depression like it is some mystery of science when it is directly caused by…everything about modern society, institutions and lifestyles. People in Africa living in villages don’t get depressed. People living in suburbs eating shitty food with no hope due to capitalism and crappy prison schools do. The cause of depression is so obvious only a PHD would be able to write and publish a BS article like this, and it is total horse shit, and pretend it’s a mystery. It’s not a mystery, they just want to try to solve it with crappy drugs that you don’t actually need rather than target the root problems, which they can’t target. I hate these articles and think they are promoting an intellectual culture of pretending not to understand the obvious by drenching it in overly intellectualized nonsense. This is a media coverup. We know what causes it.
  • ako 4y ago
    > People in Africa living in villages don’t get depressed. Any data or studies on this?
  • fragmede 4y ago
    > People in Africa living in villages don’t get depresse Holy shit yes they do, I don't know where this myth comes from! https://www.sciencedirect.com/science/article/pii/S2667242122000173 https://www.sciencedirect.com/science/article/pii/S266724212...
    • rgbrenner 4y ago
      It's an old myth... like here's an article in American Anthropologist from 1934 talking about it: https://anthrosource.onlinelibrary.wiley.com/doi/pdf/10.1525/aa.1934.36.2.02a00090 https://anthrosource.onlinelibrary.wiley.com/doi/pdf/10.1525... There's a lot of data showing it isn't true, but it’s one of those “facts” that feels true because there’s a lot of stressors and unhealthy things about modern life.
  • gverrilla 4y ago
    Agreed. I had an introduction to this perspective long ago by reading what Karl Marx wrote about suicide [0]. 0: https://www.amazon.com/Marx-Suicide-Psychosocial-Issues-Karl/dp/0810116383 https://www.amazon.com/Marx-Suicide-Psychosocial-Issues-Karl...
• joescharf 4y ago
  Everyone wants a pill as a quick effortless fix, but IMO it seems a lot of our modern afflictions come down to an gross imbalance of exercise, diet, sleep, and social connection. Most likely the way society (see disclaimer) currently functions - how we work, how we consume our limited leisure time is sort of an occupational hazard to peak health. Not to mention, exercise is "too hard" for most, the food supply is weaponized with sugar and FUD, everyone is so tired at the end of their "BS job" workday, so hit the couch and stream the streams. And now you have a vicious flywheel that quickly turns people into candidates for the latest big-pharma "cure" HN Disclaimer: I'm in the US and making generalizations based on my observations. Not saying that there aren't needs for pharma / pills / afflictions that aren't solvable by the above, etc...
  • kerpotgh 4y ago
    [dead]
  • elric 4y ago
    > gross imbalance of exercise, diet, sleep, and social connection Indeed. What's worse is that we, as individuals, know this. But we, as in the western society at large, seem to be utterly unwilling or incapable of addressing this. Long working hours to make ends meet. The shittiest food is the most convenient option. There's a metric fuckton of light- and sound pollution which messes with our sleep. 10% of folks suffer from sleep apnea for a variety of reasons. So many things are messing with us. At some point, we're going to have to start dealing with these things.
  • jasonhansel 4y ago
    > Everyone wants a pill as a quick effortless fix Isn't a quick, effortless fix the ideal goal? Wouldn't that be better than a slow, difficult one? Lifestyle changes are a lot harder and more time-consuming than taking a pill; if the latter were equally effective and low-risk for all people, it would obviously be the better choice.
  • polished85 4y ago
    I've subscribed to this line of thinking my whole life, and mostly still do, but I've had to reassess after watching/listening to the case of Andres Iniesta, a professional footballer who sought professional help in the Summer of 2009. A starter for FC Barcelona and the Spanish national team, having just won the 2009 European Champions league with FC Barcelona and the 2008 European Championship with Spain. Multimillionaire and in peak physical condition, yet fell into a deep depression during the peak of his life. Definitely caused me to reassess my assumptions on clinical depression.
• ThinkBeat 4y ago
  We dont understand the brain nearly enough to form a cohesive understaning of depression. (or many other brain related things). Now, some are saying that gut flora might also be involved. And possible genetic markers. This would create a gigantic number of permutations. I doubt we can ever "fix" depression with just drugs / chemical imbalance. We may help it along. Current treatment for depression, in so far as drugs are concerned, is a doctor throwing an "anti depression" pill at you and askinf you to try it for a while and see how you feel. If you feel worse, or no better, you get to try another. The loop repeats until something works better or until you are out of alternatives. In which case, if you have severe depression, options like electrocution of the brain (forget proper English term) becomes an option. It is often successful, but usually must be repeated and it is not a good thing for the brains other functionality.
  • graderjs 4y ago
    This! Riffing on your comment I think probably what a lot of going on is, what’s called and labeled as depression is really a highly diverse, multi faceted multitude of different things for different people. So people come with a certain affect, certain behavior, and it gets labeled as depression, but actually what’s going on, is probably a whole range of distinctly (and likely because it’s complex: overlapping), pathologies, conditions, or whatever you wanna call them with different causes and different effective treatments and it’s all just getting lumped together. And one reason is because we just don’t know enough exactly as you say. Maybe one reason electroshock “works” (if it does and I’m speculating here and I feel like it sounds like a barbaric torturous medieval treatment) but maybe one reason is because it throws enough entropy into the brain to allow it to reset out of the local “optima” that it had settled into. And obviously there’s multiple you know assumptions going into that statement and I’m just speculating. Riffing on that comment I think it’s interesting to consider that the depressive response may actually be an adaptive evolutionarily response of the brain, the nervous system, the body, the endocrine system, whatever and I think it’s interesting to consider what that adaptation might be trying to achieve. Maybe depression is not the cause of unhappiness, but its result. The collection of symptoms is the result of unhappiness and a response by the body to try to slow somebody down when they’re sort of in a situation that the body brain system whatever has judged is dangerous or not good for them. And that danger may be to mental health or some thing so it’s basically a way to try to take somebody out of circulation to protect them. It’s the self trying to protect itself from a dangerous environment, whatever the parameters of that environment may be: social, environmental, work whatever. I was going to add my personal experience. I might be a bit of an anomaly. I have the full range of emotions, intensely experienced, and all kinds of crazy deep experiences in my life so far but I’ve never been depressed. And I always felt it was some thing I wasn’t gonna let happened to me: I was gonna Always find a way through and to keep moving through whatever situation. So I think in my case I mean riffing on what I previously said the depression response never came up because I always kept moving through whatever I was in and my body didn’t have to take me out of circulation, because I was always finding a way like actively to just keep going and doing what I want.
• ErikVandeWater 4y ago
  > Our knowledge of the genetics, however, is incomplete. Krystal noted that studies of twins suggest that genetics may account for 40% of the risk of depression. Yet the currently identified genes seem to explain only about 5%. I see the value in analyzing genetics for depressive genes, but I also consider that how the genes interact with our environment that play a role. For example, if the state of women's rights around the world returned to where it was 200 years ago, it would likely appear a genetic cause of depression is related to having two X chromosomes. To wit - is the issue with the genes themselves, or is it that those with the genes are somehow repressed by the way society works?
  • zeroonetwothree 4y ago
    Women have 2x the rates of depression as men. But is there any reason to think that 200 years ago it was even more so? I think we overestimate the impact of external factors on our internal mental states. That's why the typical treatment for depression is CBT (literally changing your thoughts and behaviors) and not "improve your external situation".
    • ErikVandeWater 4y ago
      > Women have 2x the rates of depression as men. But is there any reason to think that 200 years ago it was even more so? That's interesting. I would have thought men would have it more since it's an abnormality, and with only 1 X chromosome, men are much more frequently abnormal. When I said "If the state of women's rights around the world returned to where it was 200 years ago," I meant if women who currently had normal human rights lost them. In that case we would see a major increase in depression among women, the point being that depression would be explained much more clearly by genetic factors, even though the genes didn't change; the interaction between the genes and the world changed. > I think we overestimate the impact of external factors on our internal mental states. We definitely do. And the external factors that affect our happiness the most are often the least controllable.
      • asdff 4y ago
• thenerdhead 4y ago
  I’ve always thought depression to be a symptom to a larger cause. There’s many books that talk about why such as everyday stress, childhood trauma, genetics, spirituality/meaning, and even lack of quality human basics(foods, sleep, air, etc). So many factors and even all those can be wrong. This article is promising that it seems science is rethinking this challenge one small step at a time. I’ve always been fascinated with stories where previously depressed people found the right combination of change to turn their lives around. Sometimes it feels like it is cyclical in life. Being able to treat it with a kitchen sink of tools could really help outside of a single drug solution.
• marosgrego 4y ago
  They seem to look for causes on the hardware level, but maybe it's a software issue many times.
• avgcorrection 4y ago
  Oh, so what is it? > To treat depression effectively, medical researchers may therefore need to develop a nuanced understanding of the ways it can arise. […] > That prediction may frustrate some physicians and drug developers, since it’s much easier to prescribe a one-size-fits-all solution. But it will not frustrate headline writers.
• johnthealy3 4y ago
  Correct me if I'm wrong, but this could be the first real acknowledgement in science that RA, lupus, and autoimmune disease in general could be CAUSED by mental health issues? FTA: "It’s also unclear whether simply treating inflammation could be enough to alleviate depression. Clinicians are still trying to parse whether depression causes inflammation or inflammation leads to depression. “It’s a sort of chicken-and-egg phenomenon,” Nemeroff said."
• sys32768 4y ago
  If I drink to a very buzzed state three nights in a row, I become palpably depressed, irritable, and anxious. If something bad happens during this time, it cuts deep and feels overwhelming. All of the negative things in my life become tormenting devils. It takes about 24 hours of sobriety for me to begin to feel normal again, and at least 48 to feel I am at my normal baseline. I always assumed the alcohol was depleting my serotonin. Beyond that, most of my depression seems to be due to my heroic and idealistic self raging and wallowing in the chasm between my ideals and hard realities that I cannot defeat.
  • bitL 4y ago
    Try activated charcoal first when the depression hits (your gut might have produced too much bad stuff leaking to your bloodstream, messing up your brain in the process), then get some probiotics for long-term maintenance. You might consider taking vitamin B1 and electrolytes while drinking as well.
• PaulHoule 4y ago
  "Serotonin" is itself a complex entity. There are 14 known serotonin receptors in 7 families https://en.wikipedia.org/wiki/5-HT_receptor https://en.wikipedia.org/wiki/5-HT_receptor not to mention other targets such as the serotonin transporter which is a target of many antidepressants. Serotonin pharmacology includes antidepressant and antianxiety medication, psychedelic drugs such as LSD and mescaline, the nearly unique drug MDMA (aka Ecstacy), drugs to suppress vomiting, part of the action of some antipsychotic drugs, anti-migraine, and drugs that increase gastric and intestinal motility. Platelets, your gut, and heart valves are just a few tissues that are full of serotonin receptors: some serotonin-active drugs can seriously damage your heart valves, see https://en.wikipedia.org/wiki/Fenfluramine/phentermine https://en.wikipedia.org/wiki/Fenfluramine/phentermine ---- The conclusions that people made about free serotonin in spinal taps of psychiatric patients in the 1960s have been long used in a facile manner in psych med marketing and the chickens seem to finally be coming home to roost on that one. I'd almost call the SSRIs "antineurotic" drugs in that they are helpful for both anxiety and depression in many people. There has been a lot of negativity about them in the news in the last months or so, particularly reports of bad efficacy which I think draw the wrong conclusion. Basically if you try "X mg of fluoxetine vs a placebo" you are going to have poor response and a lot of side effects. In good clinical practice you see your doc, fill a script, talk to your doc in three weeks, maybe increase the dose, maybe try a different med if you don't get a response or if you are bothered by side effects. If you do that you get much better results that the average clinical trial of a single antidepressant but you are going to talk to your doc (maybe sometimes to the nurse over the phone) several times over 6 months or so.
• ex3xu 4y ago
  I am a subscriber to the microbiome inflammasome hypothesis for major depression [0], so I wouldn't be surprised if a treatment course for depression in many people could be as simple as better dental hygiene + magnesium orotate + probiotic supplements. I've had my eye on studies linking schizophrenia with inflammatory cytokine markers, and it follows that other psychological conditions could have similar etiology and pathogenesis. Research on the influence of gut bacteria and intestinal dysbiosis on anxiety and depression has been coming out since at least 2013 [1]. After reading Robert Whitaker's 2010 Anatomy of an Epidemic [2], I'm convinced that future generations will look back on this era of psychiatric treatment with the same critical eye that our generation points at Moliere's 17th-century leeches or George Washington's personal doctor treating his strep throat with several blood-letting phlebotomies -- an absolute iatrogenic travesty. The overprescription of potentially mania-inducing antidepressants in children and teenagers is especially egregious to me. Add in the perverse incentives of profit-driven pharmaceutical companies, and you get issues like Zyprexa's 2009 class action lawsuit, for example [3]. For those looking for a readable introduction to the potential link between chronic inflammation and depression, there is The Inflamed Mind by Edward Bullmore from 2018 which did some rounds on talk shows and the like. [0] https://sci-hub.st/https://pubmed.ncbi.nlm.nih.gov/30004130/ https://sci-hub.st/https://pubmed.ncbi.nlm.nih.gov/30004130/ [1] https://sci-hub.st/https://www.sciencedirect.com/science/article/abs/pii/S0166223613000088 https://sci-hub.st/https://www.sciencedirect.com/science/art... [2] https://en.wikipedia.org/wiki/Anatomy_of_an_Epidemic https://en.wikipedia.org/wiki/Anatomy_of_an_Epidemic [3] https://www.justice.gov/archive/opa/pr/2009/January/09-civ-038.html https://www.justice.gov/archive/opa/pr/2009/January/09-civ-0...
  • standardly 4y ago
    The fact that healthy people still get depression makes me skeptical of hypotheses like this. If it were as simple as taking probiotics, x and y supplements, and eating healthier, (and brushing teeth more), I think a lot more people would have beaten major depression by now. Someone else in the thread suggested it's just exercise, sleep, and diet. Yet there are plenty of folks who do these things perfectly and still get depression.
    • 4y ago
• theGnuMe 4y ago
  I think it is the gut microbiome and chemicals. Basically drink too much alcohol, get depressed or inferred from the hangover. It's a negative feedback look b/c usually drinking relieves depression at first. Then fail to eat properly for what you and your microbiome need, you get depressed. Tryptophan depletion for example. Take a serious course of antibiotics get depressed since your microbiome is out of whack. There's probably genetics involved as well. Sun light exposure modulates hormones and Vit D. I wonder if there's a correlation with caesarean section births and depression as well. The hypothesis would be that the infant is born into a sterile environment and does not get populated by the moms microbiome. Exercise probably plays a role as well since it boosts resilence.
• hot_gril 4y ago
  I like how the website puts a progress bar at the top to compensate for browsers increasingly hiding the regular scroll bar on the right.
• ding_dang 4y ago
  I’ve yet to see someone qualified on HN discussing this. It’s all vapid anecdotes and unfounded/untested beliefs and subscriptions to various pet theories.
  • ninjagoo 4y ago
    Do actual scientists hang out here on HN in strength? It seems to be mostly a mix of technologists, startup-types and adjacents/aspirants.
  • rpastuszak 4y ago
    > Reject the bad, false, negativity, darkness and move toward the love, true, light and goodness. When I was depressed, only spiritual teachings, love and God moved me nearer good feelings and comfort. I have no idea what you're talking about.
    • jasonhansel 4y ago
      Is there a randomized controlled trial of rejecting the darkness?
• benibela 4y ago
  Pet theory: It is a protection from negative emotions Someone experiences too much sadness and other negative emotions, so the brain tries to stop the negative emotions by shutting down all emotion processing. Then you do not feel so many negative emotions anymore, but also no more positive emotions. You just do not feel anything. Since motivation comes from emotions, you also lose all motivation to do stuff
  • elil17 4y ago
    Sounds like psychodynamics. A core part of that theory is that unbearable emotions/thoughts are relegated to the "unconscious mind."
• deleted 4y ago
  [deleted]
• tus666 4y ago
  Move psychology and psychiatry into the Astrology department please. It ain't science.
  • elil17 4y ago
    I'd tend to agree that psychology can be unscientific at times. Certainly a lot in that field is derived from very abstract theories (e.g. psychodynamics) that are not as falsifiable as one might hope. Yet, the comparison to astrology is also unfair. Scientific studies have repeatedly shown that many psychological treatments (e.g. CBT, DBT, interpersonal therapy) are effective. A lot of early medicine worked this way: we knew a treatment was useful before we understood the fundamental biology of how it worked (e.g., rudimentary vaccines came before germ theory).
    • tus666 4y ago
      You are making a false equivalence between clearly identifiable physical disease (e.g. shingles), and this questionable concept called "mental illness" or "depression", and this false equivalence is at the root of the problem. This is one of the problems of how the scientific revolution has been carried out in western society. The scientific method which was so successful in application to certain problems (mainly in the physical realm), has been assumed to be just as effective in other areas as well. Then we see false inferences being drawn and faulty conclusions being reached based on philosophically questionable assumptions being drawn - "hey, it looks like we are applying the scientific method, therefore we must be right!". Badly applied science is just as bad a non-science like astrology. Guess what - if you lock a chimpanzee in a cage it will become "depressed". Maybe just let it out and return it to the jungle? That ain't science, it's just common sense.
      • elil17 4y ago
        If you run a bunch of people who are unhappy through a standardized psychology program (e.g. CBT), they get happier compared to the people who didn't get that program. That's just a fact. Maybe that's not the scientific method by your definition, but I'm not sure it matters. And yes, I get that a lot of mental health problems are caused by problems in society. To extend your analogy, we're not the zookeepers, we're other chimpanzees. We're a lot smarter than monkeys so we even perhaps have a shot of escaping. But it is absolutely reasonable to try to help each other make the most of our lot. So who care's what you call it, therapy is a way to help people have more fulfilling lives. Medications can be too.
• beedeebeedee 4y ago
  Really surprised no one here has made the connection between depression and the fight-flight-freeze response. Depression is just the freeze response, just like we see in our animal relatives. Only difference is we can be triggered by thoughts and not only the presence of danger. Freezing is when you are so powerless, you cannot fight and you cannot fly away. You freeze. That response can be reinforced, and sadly, reinforced by thought alone.
• golemotron 4y ago
  It's amazing how far we go to avoid seeing depression in the context of a person's social interactions.
• _xnmw 4y ago
  Depression, and almost all mental disorders, can't even be defined or reliably identified by any diagnosis test, leave alone finding a biological cause. Found a book recently on the topic, "Cracked: The Unhappy Truth about Psychiatry" by James Davies, an expert who worked as a clinical psychiatrist, and was himself present at meetings when organizations like the NHS worked on standardizing definitions for mental disorders (DSM and ICD). My notes: * Naming mental disorders is like naming constellations in the sky: the phenomena are real, but finding a pattern is completely subjective and arbitrary. * There is a growing movement of professional psychiatrists calling for the abandonment of the DSM and ICD and other newly created terms for mental disorders. * There is no scientific evidence whatsoever for the existence of ANY of the "mental disorders" described in the DSM or ICD, yet these mental health manuals are taken as bibles in the West. The authors of the manuals themselves are publicly quoted to have said that these manuals are simply subjective guidelines, with absolutely no biologically-identified cause for these "diseases". * Most of these "disorders" are simply describing normal variations in personality found among people at different periods of life. Identifying behavioural patterns and assigning a name to it is a purely subjective matter.
  • quonn 4y ago
    > Most of these "disorders" are simply describing normal variations in personality found What you call normal variations are obviously not very normal. This is almost a definition of disease: Something that deviates significantly from what is normal _and_ causes suffering for those affected (or perhaps for others).