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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

by 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.
- rcarr 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. This seems analogous to Stockholm Syndrome. The “kidnappers aren’t that bad, if they were really bad they would have taped our mouths shut rather than just tying us up and locking us in this room”. > 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. So if the people there are that happy, why are some of them risking their lives to flee? > 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, This argument doesn’t make sense. You seem to be saying: - autocracies and democracies are societies - some poor people in autocracies are happy - some people in well regarded democracies kill themselves - therefore societal factors do not play a leading role in 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. not sure on this. PTSD correlates pretty strongly with both anxiety and 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. I agree with the apathy part. But I think it has varying levels of severity, and at its most severe is when it leads to a catatonic state. I agree that these people are the most likely to need medical treatment. I think this illustrates the first point I’m making though which is that we need to either do away with “depression” as a term or that people need to get more specific with it. Also just because drugs are the cure for the disease, doesn’t rule out the fact that the social triggers may have been responsible for causing the biological issues. > Depression is a disease, and we don't know the cause. Well if this thread is anything to go by, people can’t even agree on what the term ‘depression’ is meant to represent. You’re making a bold claim here stating it is a disease, which implies that the cause is purely biological. Most medical definitions state it is a mood disorder. > 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". Quoting https://www.science.org/doi/10.1126/science.aay0214 https://www.science.org/doi/10.1126/science.aay0214 > Rates of depression, anxiety, and suicide correlate negatively with income (4–7) and employment (5, 8). Those with the lowest incomes in a community suffer 1.5 to 3 times more frequently from depression, anxiety, and other common mental illnesses than those with the highest incomes. It would seem that actually yes, as a society we do know what to do to alleviate depression. We can help these people out of poverty. > As for what society can do to promote healthy habits, this is really a complex thing. Well yes but also no. We seem to have reduced smoking very effectively. Sugar taxes work well. It seems that in general, if you tax unhealthy things and subsidise healthy things, it tends to have the intended effect. > 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. You seem to be trying to make the point that any societal attempts aimed at boosting physical and mental wellbeing should be avoided because Hitler also ran societal programs so any such initiatives are destined to lead to fascist societies. This does not appear to be the case. > 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. No, it is not the “ultimate solution” (ironic choice of words given the contents of the last paragraph) to depression but it is a giant leap in the right direction.
jaywalk 4y ago
So only poor people suffer from depression?
- Buttons840 4y ago
  You really missed the point. He's saying "depression" means a lot of different things[0], and that many people are unhappy simply because their societal (economic and social) situation sucks and thus their life sucks. [0]: It would be interesting to have a discussion about "depression" without actually using the word, since it's so overloaded.
  - DrThunder 4y ago
    I think OP is referring to the 2nd paragraph.
- re-actor 4y ago
  Poor not in wealth but in quality of life, which is almost everyone.
- rcarr 4y ago
  No not at all. Rich people who benefit from the system can also be victim to it in other ways. Not all managers are sociopaths and I’m sure a lot of them feel shit about some of the things they have to do in order to maintain their jobs. And everyone, regardless of wealth and status, is subject to the “slings and arrows of outrageous fortune” and whatever personal tragedies they may bring. As I said we need finer grained diagnoses. You might have for example: - Catatonic depression, likely physical in nature - Shit Life Syndrome [1], likely societal cause, possibly other issues are play - Privilege Pathos, likely caused by past trauma, loss or existential issues These are obviously exaggerated groupings to make the point. At the end of the day, at the receiving end of every diagnosis is an individual with a unique biology and backstory that lead to their depression. But if you want to have the most impact on reducing the ever skyrocketing amount of depression cases, you would be best to focus on the societal issues and that, in my opinion, is what is causing the most symptoms in the most amount of people. The people in the other two categories (the catatonic and the rich) are the people most likely to be currently receiving treatment anyway, the first because they can no longer look after themselves and so wind up in the system and the second because they have the means to access therapies. [1] - https://en.wikipedia.org/wiki/Shit_life_syndrome?wprov=sfti1 https://en.wikipedia.org/wiki/Shit_life_syndrome?wprov=sfti1
DrThunder 4y ago
I agree with your first paragraph. However, I don't think your 2nd paragraph is a fix that'll help very many people at all. This idea that just throwing free things at people will give them any amount of deeper happiness is typically proven false. I also don't find therapists all that useful but I guess that's a personal subjective take... maybe for the right people they can be. The healthy food thing is a cultural issue and no amount of subsidizing it to make it cheaper will get people to eat healthier. The percentage of obese people is too high to place all the obesity blame on food pricing. The issue is simply that modern day life is typically TOO easy for most people and gives back very little deep meaning. We've created a culture that gives zero meaning to anyone and promotes nihilism. You will not fix that with welfare. Some of the most depressed mentally ill people you find will be very well off financially.
- juve1996 4y ago
  > Some of the most depressed mentally ill people you find will be very well off financially. Is this statistically true? otherwise this is worthless. See: Study Finds Strong Relation Between Income and Happiness, Does Not Max Out at $75k. Turns out that famous study that everyone loved to quote isn't exactly truth. https://www.nysscpa.org/news/publications/nextgen/nextgen-article/study-finds-strong-relation-between-income-and-happiness-does-not-max-out-at-75k https://www.nysscpa.org/news/publications/nextgen/nextgen-ar...
  - DrThunder 4y ago
    Happiness has nothing to do with clinical mental illness.
- idontpost 4y ago
  [dead]
- landemva 4y ago
  > modern day life is typically TOO easy for most people and gives back very little deep meaning. That is about accurate for USA. People can start a garden or put a pepper plant under a CFL bulb. Grow some food to get some appreciation for how life has become easier.
starkd 4y ago
Way to completely ignore the point. It is also addressing a spiritual problem with material concerns. Just throw more money at it and the problem goes away? It is also founded on the premise that the government is in a position to remove any and all risk from people's lives. Indeed, it would be obligated to do this. It is extending a guarantee it has no way of fulfilling.
davidn20 4y ago
I would argue we live in an era with the most access to everything you listed out ever. There are more programs to help the poor than any other period in history. The internet and YouTube give you access to the world's knowledge. You can get a membership to Planet Fitness for $10/month. Also, I realize all of this is great, but the opposite side is true too. We also live in an era with the most amount of obstacles and vices people can fall into. Yes, there are amazing lectures on YouTube, but there are also millions of addicting cute cat videos. I state all this to say depression and improving people lives is not as easy as providing them access. They need to want to put in the work themselves.
- rcarr 4y ago
  I agree that people do need to put the effort in themselves. I just think that they put the effort in when they have breathing space and hope. If people can’t see a way out of their situation then they won’t put any effort in, they’ve become hopeless and therefore depressed. You could argue that the disease in that case may be one of perception, and that you need to enrich the person’s life by opening up to new possibilities and ways of perceiving the world. But you can also build more visible progression paths into the system so people never feel that way in the first place and can always see a route out if they choose to take it. I’d also argue that there are some social programs but: - we’re drowning in information overload so people don’t necessarily know how to access them. For example, a lot of the poorest households in the Uk did not claim the money they were entitled to from the government for energy payments this winter. - We don’t really have policies that are addressing the root causes of poverty which are unaffordable housing, unaffordable and/or poor quality education and low wages.
landemva 4y ago
> political failures If politics is being blamed for depression, it is because people voluntarily consume media about politics. Just say no. Refuse to be sucked in to that pattern.
- rcarr 4y ago
  Second and third order effects. If the main cause of poverty is unaffordable housing and low wages and poverty is one of the leading causes of depression then the people who have the ability to tackle the housing crisis and low wages but instead choose to do nothing are also responsible for the causation of a lot of depression. The people who are able to do something about the housing crisis are politicians. I do agree with you though if you think political media is pretty toxic.
s1artibartfast 4y ago
I would argue that most depression is something more philosophical and behavioral then simple material conditions. It is a state of disconnect from one's own life and the World At Large. This is symptomatic of a loss of individual agency and ability to interact with their environment in a personally meaningful way. All the free gym memberships and free food in the world is useless if individuals don't want to go to the gym or cook the food. In reality, there are opportunities for free recreation and cheap healthy food readily available, but that isn't the bottleneck. Bottleneck is trained helplessness which leads people to self medicate and watch an average of 40 plus hours of Television a week instead of doing something that actually Sparks Joy.

by rcarr 4y ago

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.

rcarr 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. This seems analogous to Stockholm Syndrome. The “kidnappers aren’t that bad, if they were really bad they would have taped our mouths shut rather than just tying us up and locking us in this room”. > 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. So if the people there are that happy, why are some of them risking their lives to flee? > 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, This argument doesn’t make sense. You seem to be saying: - autocracies and democracies are societies - some poor people in autocracies are happy - some people in well regarded democracies kill themselves - therefore societal factors do not play a leading role in 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. not sure on this. PTSD correlates pretty strongly with both anxiety and 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. I agree with the apathy part. But I think it has varying levels of severity, and at its most severe is when it leads to a catatonic state. I agree that these people are the most likely to need medical treatment. I think this illustrates the first point I’m making though which is that we need to either do away with “depression” as a term or that people need to get more specific with it. Also just because drugs are the cure for the disease, doesn’t rule out the fact that the social triggers may have been responsible for causing the biological issues. > Depression is a disease, and we don't know the cause. Well if this thread is anything to go by, people can’t even agree on what the term ‘depression’ is meant to represent. You’re making a bold claim here stating it is a disease, which implies that the cause is purely biological. Most medical definitions state it is a mood disorder. > 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". Quoting https://www.science.org/doi/10.1126/science.aay0214 https://www.science.org/doi/10.1126/science.aay0214 > Rates of depression, anxiety, and suicide correlate negatively with income (4–7) and employment (5, 8). Those with the lowest incomes in a community suffer 1.5 to 3 times more frequently from depression, anxiety, and other common mental illnesses than those with the highest incomes. It would seem that actually yes, as a society we do know what to do to alleviate depression. We can help these people out of poverty. > As for what society can do to promote healthy habits, this is really a complex thing. Well yes but also no. We seem to have reduced smoking very effectively. Sugar taxes work well. It seems that in general, if you tax unhealthy things and subsidise healthy things, it tends to have the intended effect. > 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. You seem to be trying to make the point that any societal attempts aimed at boosting physical and mental wellbeing should be avoided because Hitler also ran societal programs so any such initiatives are destined to lead to fascist societies. This does not appear to be the case. > 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. No, it is not the “ultimate solution” (ironic choice of words given the contents of the last paragraph) to depression but it is a giant leap in the right direction.

jaywalk 4y ago

So only poor people suffer from depression?

Buttons840 4y ago
You really missed the point. He's saying "depression" means a lot of different things[0], and that many people are unhappy simply because their societal (economic and social) situation sucks and thus their life sucks. [0]: It would be interesting to have a discussion about "depression" without actually using the word, since it's so overloaded.
- DrThunder 4y ago
  I think OP is referring to the 2nd paragraph.
re-actor 4y ago
Poor not in wealth but in quality of life, which is almost everyone.
rcarr 4y ago
No not at all. Rich people who benefit from the system can also be victim to it in other ways. Not all managers are sociopaths and I’m sure a lot of them feel shit about some of the things they have to do in order to maintain their jobs. And everyone, regardless of wealth and status, is subject to the “slings and arrows of outrageous fortune” and whatever personal tragedies they may bring. As I said we need finer grained diagnoses. You might have for example: - Catatonic depression, likely physical in nature - Shit Life Syndrome [1], likely societal cause, possibly other issues are play - Privilege Pathos, likely caused by past trauma, loss or existential issues These are obviously exaggerated groupings to make the point. At the end of the day, at the receiving end of every diagnosis is an individual with a unique biology and backstory that lead to their depression. But if you want to have the most impact on reducing the ever skyrocketing amount of depression cases, you would be best to focus on the societal issues and that, in my opinion, is what is causing the most symptoms in the most amount of people. The people in the other two categories (the catatonic and the rich) are the people most likely to be currently receiving treatment anyway, the first because they can no longer look after themselves and so wind up in the system and the second because they have the means to access therapies. [1] - https://en.wikipedia.org/wiki/Shit_life_syndrome?wprov=sfti1 https://en.wikipedia.org/wiki/Shit_life_syndrome?wprov=sfti1

DrThunder 4y ago

I agree with your first paragraph. However, I don't think your 2nd paragraph is a fix that'll help very many people at all. This idea that just throwing free things at people will give them any amount of deeper happiness is typically proven false. I also don't find therapists all that useful but I guess that's a personal subjective take... maybe for the right people they can be. The healthy food thing is a cultural issue and no amount of subsidizing it to make it cheaper will get people to eat healthier. The percentage of obese people is too high to place all the obesity blame on food pricing. The issue is simply that modern day life is typically TOO easy for most people and gives back very little deep meaning. We've created a culture that gives zero meaning to anyone and promotes nihilism. You will not fix that with welfare. Some of the most depressed mentally ill people you find will be very well off financially.

juve1996 4y ago
> Some of the most depressed mentally ill people you find will be very well off financially. Is this statistically true? otherwise this is worthless. See: Study Finds Strong Relation Between Income and Happiness, Does Not Max Out at $75k. Turns out that famous study that everyone loved to quote isn't exactly truth. https://www.nysscpa.org/news/publications/nextgen/nextgen-article/study-finds-strong-relation-between-income-and-happiness-does-not-max-out-at-75k https://www.nysscpa.org/news/publications/nextgen/nextgen-ar...
- DrThunder 4y ago
  Happiness has nothing to do with clinical mental illness.
idontpost 4y ago
[dead]
landemva 4y ago
> modern day life is typically TOO easy for most people and gives back very little deep meaning. That is about accurate for USA. People can start a garden or put a pepper plant under a CFL bulb. Grow some food to get some appreciation for how life has become easier.

starkd 4y ago

Way to completely ignore the point. It is also addressing a spiritual problem with material concerns. Just throw more money at it and the problem goes away? It is also founded on the premise that the government is in a position to remove any and all risk from people's lives. Indeed, it would be obligated to do this. It is extending a guarantee it has no way of fulfilling.

davidn20 4y ago

I would argue we live in an era with the most access to everything you listed out ever. There are more programs to help the poor than any other period in history. The internet and YouTube give you access to the world's knowledge. You can get a membership to Planet Fitness for $10/month. Also, I realize all of this is great, but the opposite side is true too. We also live in an era with the most amount of obstacles and vices people can fall into. Yes, there are amazing lectures on YouTube, but there are also millions of addicting cute cat videos. I state all this to say depression and improving people lives is not as easy as providing them access. They need to want to put in the work themselves.

rcarr 4y ago
I agree that people do need to put the effort in themselves. I just think that they put the effort in when they have breathing space and hope. If people can’t see a way out of their situation then they won’t put any effort in, they’ve become hopeless and therefore depressed. You could argue that the disease in that case may be one of perception, and that you need to enrich the person’s life by opening up to new possibilities and ways of perceiving the world. But you can also build more visible progression paths into the system so people never feel that way in the first place and can always see a route out if they choose to take it. I’d also argue that there are some social programs but: - we’re drowning in information overload so people don’t necessarily know how to access them. For example, a lot of the poorest households in the Uk did not claim the money they were entitled to from the government for energy payments this winter. - We don’t really have policies that are addressing the root causes of poverty which are unaffordable housing, unaffordable and/or poor quality education and low wages.

landemva 4y ago

> political failures If politics is being blamed for depression, it is because people voluntarily consume media about politics. Just say no. Refuse to be sucked in to that pattern.

rcarr 4y ago
Second and third order effects. If the main cause of poverty is unaffordable housing and low wages and poverty is one of the leading causes of depression then the people who have the ability to tackle the housing crisis and low wages but instead choose to do nothing are also responsible for the causation of a lot of depression. The people who are able to do something about the housing crisis are politicians. I do agree with you though if you think political media is pretty toxic.

s1artibartfast 4y ago

I would argue that most depression is something more philosophical and behavioral then simple material conditions. It is a state of disconnect from one's own life and the World At Large. This is symptomatic of a loss of individual agency and ability to interact with their environment in a personally meaningful way. All the free gym memberships and free food in the world is useless if individuals don't want to go to the gym or cook the food. In reality, there are opportunities for free recreation and cheap healthy food readily available, but that isn't the bottleneck. Bottleneck is trained helplessness which leads people to self medicate and watch an average of 40 plus hours of Television a week instead of doing something that actually Sparks Joy.