6 ms·

Influential descriptions of depression are often misleading

49 points by wjb3 2y ago

stonethrowaway 2y ago
We had a thread on this a few days ago but this goes hand in hand with people not knowing what introversion really is. Pop culture and media have significantly distorted things for the purposes of whimsical storytelling and product sales.
- HPsquared 2y ago
  I think there are a lot of frustrated extraverts out there who don't have "compatible" people to talk to so think they're introverts.
  - deleted 2y ago
    [deleted]
  - hirvi74 2y ago
    I think the reality is that most people are more ambiverts or closer to the middle than they think they are. I am super social and basically talk perpetually. I talk so much that it's often been problematic in my primary schooling, occupation, social situations, etc.. However, people do not think I am introverted based on those personality traits, and surprised that I basically never leave the house unless I have to. I find more pleasure in being at home alone doing my own thing vs. "going out" and whatnot. Bring me around others though? I won't stop talking nor stop being a "life of the party" type.
- interludead 2y ago
  Oversimplifying leads to misunderstandings
  - hirvi74 2y ago
    The whole concept of introversion vs. extroversion is oversimplified.
mock-possum 2y ago
> the team argues that the understanding of depression conveyed on many sites is often "based on circular logic," which could leave those aiming to understand their low mood worse off. They reference recent research that found that emotional regulation is more successful when people were aware of the causes of their suffering – if educational material bills depression as causative, however, some of those with the condition may not look further to identify potentially-addressable causative factors. I have been under the impression that the deal with ‘clinical depression’ is that there is no reasonable cause - you feel depressed because of your brain chemistry, not because of your circumstances. You would feel depressed regardless of whether your life was good or bad, because it’s not a response to your life, it’s an aberrant behavior by the part of your brain that makes you feel feelings. And to that end, to the contrary of what’s written in the article, trying to find a reason for your depression is a trap - one of your brain’s favorite things to do is to feel an emotion and then find a cause to pin it on. But if the cause is really just weird brain stuff - you risk false accusations or false positives when searching for the source of your depression. I must feel depressed because of my relationship. I must feel depressed because of climate change. I must feel depressed because my kid is away at college, because my car needs work, because I haven’t had sex for a while, etc. All of those things may very well be problems in your life worth addressing - but are they actually the cause of your feelings of depression? Or is that just your brain doing stuff you don’t want it to do?
- ghostly_s 2y ago
  That is one theory of depression-but it is very much not the only one, and is not how it is defined in the DSM, which generally relies in purely symptomatic definitions of mental illness.
- rexpop 2y ago
  > you feel depressed because of your brain chemistry, not because of your circumstances. Would that it were so simple. Circumstances can, of course, impact brain chemistry and, over time, neural architecture. Classic example is the learned helplessness of rats[0]. In this context, we know the cause of the depression, because it's the independent variable of our experiment! Is it irrational to project the his framing to learned helplessness or "psychomotor retardation" in the wild? > the cause is really just weird brain stuff Is it weird or is it evolutionarily selected for? > it’s an aberrant behavior Is it abberant or is it consequent? You may benefit from the perspective of Sapolsky's (now 14 year old) lecture on the basics of depression[1] in which he asserts that it's a response to repeated trauma. 0. https://www.sciencedirect.com/science/article/pii/S0376635710002901 https://www.sciencedirect.com/science/article/pii/S037663571... 1. https://youtu.be/NOAgplgTxfc https://youtu.be/NOAgplgTxfc
taeric 2y ago
This is endemic to language, sadly. Descriptive can read the same as explanatory. Or justification. Or causative, as is most applicable to this story. You can see this easily with how hard it is to describe crime as high in some places without sounding like you are explaining that crime is high because of the area. And, no doubt, often this is purposely blurred by people that are bad actors and do have bad intentions. It doesn't help the underlying difficulties to push them as hard as they have been pushed recently.
- interludead 2y ago
  This underscoring the need for careful and responsible communication in this field
  - taeric 2y ago
    I've tried arguing for this in near all fields. My personal view is that most misunderstandings out there fall into traps that can be described this way. It sucks, as motivated reasoning can often be a huge culprit where you interpret a sentence in whichever of those forms fits your reasoning the best. This is also why "charity" in conversation is generally a good thing. People can literally hear the same thing, but come away with different meanings. I'd love if education focused more on this. I'm hoping it does, and I just don't remember it?
alsetmusic 2y ago
> While differences here may seem purely semantic, the team argues that the understanding of depression conveyed on many sites is often "based on circular logic," which could leave those aiming to understand their low mood worse off. They reference recent research that found that emotional regulation is more successful when people were aware of the causes of their suffering – if educational material bills depression as causative, however, some of those with the condition may not look further to identify potentially-addressable causative factors. This makes sense to me. I’d like to see more discussion and research in this area. As someone who has experienced massive depression at different times in my life, I’m reasonably well equipped to manage it. But putting myself in the shoes of someone going through it for the first time, I want people to have the best tools to address it.
- __rito__ 2y ago
  How do you identify when you are going through depression, and not a temporary down-trending mood for some situation? What are your tools for dealing with it? Any book/therapy came in handy?
  - deleted 2y ago
    [deleted]
  - hirvi74 2y ago
    > How do you identify when you are going through depression, and not a temporary down-trending mood for some situation? I'm not entirely convinced those are different states of mind. However, that is not really a satisfying answer. In my lived experience, the easiest way for me to tell the difference is mainly by answering these two questions: 1. Am I capable of making and sustaining meaningful changes in order to better my situation? 2. How long have I felt this way? So, I am in a depressed state currently, and I have been in one on/off for about 3 years now. This ain't my first rodeo, and it won't be my last, sadly. I know it because I am seemingly incapable of sustaining necessary changes to better my situations. The low-energy, low stress tolerance, and anhedonia are a PITA to overcome. As for the length of time, I have noticed with something more situational, the issues tend to get an incrementally better with time. With depression, the pattern seems to be more random. I might feel fine for a few days, down for a few, etc.. At least for me, depression has never been a 24/7 kind of issue. Often times, depressive states just seem to spontaneously resolve themselves. Research also somewhat supports this conclusion as well. I think like around half of cases of depression spontaneously resolve within a year.
interludead 2y ago
As someone who struggles with depression, it's frustrating to see so much misleading information online. When trusted sources oversimplify the condition, it can make it harder to understand what's really going on with my mental health and leave me feeling even more confused and isolated.
hirvi74 2y ago
> ...some of those with the condition may not look further to identify potentially-addressable causative factors. I believe in the hypothesis that depression is [more often] a symptom rather than some sort of organic disease. I would also lump anxiety into the same category for what it is worth. Before people get up in arms, I want to clarify that I am talking about the majority of cases of depression, but not all. I am not disputing the idea that in some cases depression could be caused by something more intrinsic, but I am inclined to think those cases are rarer than many claim. A common motif amongst quite a handful of depressed people is that there is some internal belief that they have no reason to be depressed because everything in their life is going well, and they have no reason to be depressed. However, when one peels back that onion -- layer by layer -- I find that, often times, those people might actually have a legitimate and underestimated factor which might be a major contributing factor. My completely pseudoscientific hypothesis is that anxiety and depression are signals. Much like pain, when the signals are firing, then body is trying to alert one that something has gone awry.
ThinkBeat 2y ago
"Determining the cause for negative motions" Sounds simple, but it aint. That requires careful study over along period of time and getting to know the subject well, plus the history, and an understanding of the environment. What a person who is depressed is focusing on, can be unrelated to the deeper reason. If there ever is "a" truly deeper reason. More likely it is a set of / mesh of things that have built up. Lastly nobody can describe depression. Those who have lived and are living with severe clinical depression know what it feels like, (like myself), the rest, the doctors and scientists are guessing.
afpx 2y ago
I used to have debilitating depression. SSRIs and similar drugs never worked. Eventually I was diagnosed with bipolar 2 and given lamotrigine, and it solved my depression completely.
- maleldil 2y ago
  That's a common story. Research has shown that a significant portion of people with treatment-resistant depression are, in fact, bipolar, with bipolar 2 being more susceptible to depressive episodes.
robwwilliams 2y ago
There is an even more fundamental problem. Psychiatrists do not apply uniform diagnostic criteria. This is painfully obvious in genetic studies of depression. The work of Jonathan Flint has highlighted this serious problem. https://pubmed.ncbi.nlm.nih.gov/32231276/ https://pubmed.ncbi.nlm.nih.gov/32231276/ https://pubmed.ncbi.nlm.nih.gov/25062429/ https://pubmed.ncbi.nlm.nih.gov/25062429/

49 points by wjb3 2y ago

We had a thread on this a few days ago but this goes hand in hand with people not knowing what introversion really is. Pop culture and media have significantly distorted things for the purposes of whimsical storytelling and product sales.

HPsquared 2y ago
I think there are a lot of frustrated extraverts out there who don't have "compatible" people to talk to so think they're introverts.
- deleted 2y ago
  [deleted]
- hirvi74 2y ago
  I think the reality is that most people are more ambiverts or closer to the middle than they think they are. I am super social and basically talk perpetually. I talk so much that it's often been problematic in my primary schooling, occupation, social situations, etc.. However, people do not think I am introverted based on those personality traits, and surprised that I basically never leave the house unless I have to. I find more pleasure in being at home alone doing my own thing vs. "going out" and whatnot. Bring me around others though? I won't stop talking nor stop being a "life of the party" type.
interludead 2y ago
Oversimplifying leads to misunderstandings
- hirvi74 2y ago
  The whole concept of introversion vs. extroversion is oversimplified.

mock-possum 2y ago

> the team argues that the understanding of depression conveyed on many sites is often "based on circular logic," which could leave those aiming to understand their low mood worse off. They reference recent research that found that emotional regulation is more successful when people were aware of the causes of their suffering – if educational material bills depression as causative, however, some of those with the condition may not look further to identify potentially-addressable causative factors. I have been under the impression that the deal with ‘clinical depression’ is that there is no reasonable cause - you feel depressed because of your brain chemistry, not because of your circumstances. You would feel depressed regardless of whether your life was good or bad, because it’s not a response to your life, it’s an aberrant behavior by the part of your brain that makes you feel feelings. And to that end, to the contrary of what’s written in the article, trying to find a reason for your depression is a trap - one of your brain’s favorite things to do is to feel an emotion and then find a cause to pin it on. But if the cause is really just weird brain stuff - you risk false accusations or false positives when searching for the source of your depression. I must feel depressed because of my relationship. I must feel depressed because of climate change. I must feel depressed because my kid is away at college, because my car needs work, because I haven’t had sex for a while, etc. All of those things may very well be problems in your life worth addressing - but are they actually the cause of your feelings of depression? Or is that just your brain doing stuff you don’t want it to do?

ghostly_s 2y ago
That is one theory of depression-but it is very much not the only one, and is not how it is defined in the DSM, which generally relies in purely symptomatic definitions of mental illness.
rexpop 2y ago
> you feel depressed because of your brain chemistry, not because of your circumstances. Would that it were so simple. Circumstances can, of course, impact brain chemistry and, over time, neural architecture. Classic example is the learned helplessness of rats[0]. In this context, we know the cause of the depression, because it's the independent variable of our experiment! Is it irrational to project the his framing to learned helplessness or "psychomotor retardation" in the wild? > the cause is really just weird brain stuff Is it weird or is it evolutionarily selected for? > it’s an aberrant behavior Is it abberant or is it consequent? You may benefit from the perspective of Sapolsky's (now 14 year old) lecture on the basics of depression[1] in which he asserts that it's a response to repeated trauma. 0. https://www.sciencedirect.com/science/article/pii/S0376635710002901 https://www.sciencedirect.com/science/article/pii/S037663571... 1. https://youtu.be/NOAgplgTxfc https://youtu.be/NOAgplgTxfc

taeric 2y ago

This is endemic to language, sadly. Descriptive can read the same as explanatory. Or justification. Or causative, as is most applicable to this story. You can see this easily with how hard it is to describe crime as high in some places without sounding like you are explaining that crime is high because of the area. And, no doubt, often this is purposely blurred by people that are bad actors and do have bad intentions. It doesn't help the underlying difficulties to push them as hard as they have been pushed recently.

interludead 2y ago
This underscoring the need for careful and responsible communication in this field
- taeric 2y ago
  I've tried arguing for this in near all fields. My personal view is that most misunderstandings out there fall into traps that can be described this way. It sucks, as motivated reasoning can often be a huge culprit where you interpret a sentence in whichever of those forms fits your reasoning the best. This is also why "charity" in conversation is generally a good thing. People can literally hear the same thing, but come away with different meanings. I'd love if education focused more on this. I'm hoping it does, and I just don't remember it?

alsetmusic 2y ago

> While differences here may seem purely semantic, the team argues that the understanding of depression conveyed on many sites is often "based on circular logic," which could leave those aiming to understand their low mood worse off. They reference recent research that found that emotional regulation is more successful when people were aware of the causes of their suffering – if educational material bills depression as causative, however, some of those with the condition may not look further to identify potentially-addressable causative factors. This makes sense to me. I’d like to see more discussion and research in this area. As someone who has experienced massive depression at different times in my life, I’m reasonably well equipped to manage it. But putting myself in the shoes of someone going through it for the first time, I want people to have the best tools to address it.

__rito__ 2y ago
How do you identify when you are going through depression, and not a temporary down-trending mood for some situation? What are your tools for dealing with it? Any book/therapy came in handy?
- deleted 2y ago
  [deleted]
- hirvi74 2y ago
  > How do you identify when you are going through depression, and not a temporary down-trending mood for some situation? I'm not entirely convinced those are different states of mind. However, that is not really a satisfying answer. In my lived experience, the easiest way for me to tell the difference is mainly by answering these two questions: 1. Am I capable of making and sustaining meaningful changes in order to better my situation? 2. How long have I felt this way? So, I am in a depressed state currently, and I have been in one on/off for about 3 years now. This ain't my first rodeo, and it won't be my last, sadly. I know it because I am seemingly incapable of sustaining necessary changes to better my situations. The low-energy, low stress tolerance, and anhedonia are a PITA to overcome. As for the length of time, I have noticed with something more situational, the issues tend to get an incrementally better with time. With depression, the pattern seems to be more random. I might feel fine for a few days, down for a few, etc.. At least for me, depression has never been a 24/7 kind of issue. Often times, depressive states just seem to spontaneously resolve themselves. Research also somewhat supports this conclusion as well. I think like around half of cases of depression spontaneously resolve within a year.

interludead 2y ago

As someone who struggles with depression, it's frustrating to see so much misleading information online. When trusted sources oversimplify the condition, it can make it harder to understand what's really going on with my mental health and leave me feeling even more confused and isolated.

hirvi74 2y ago

> ...some of those with the condition may not look further to identify potentially-addressable causative factors. I believe in the hypothesis that depression is [more often] a symptom rather than some sort of organic disease. I would also lump anxiety into the same category for what it is worth. Before people get up in arms, I want to clarify that I am talking about the majority of cases of depression, but not all. I am not disputing the idea that in some cases depression could be caused by something more intrinsic, but I am inclined to think those cases are rarer than many claim. A common motif amongst quite a handful of depressed people is that there is some internal belief that they have no reason to be depressed because everything in their life is going well, and they have no reason to be depressed. However, when one peels back that onion -- layer by layer -- I find that, often times, those people might actually have a legitimate and underestimated factor which might be a major contributing factor. My completely pseudoscientific hypothesis is that anxiety and depression are signals. Much like pain, when the signals are firing, then body is trying to alert one that something has gone awry.

ThinkBeat 2y ago

"Determining the cause for negative motions" Sounds simple, but it aint. That requires careful study over along period of time and getting to know the subject well, plus the history, and an understanding of the environment. What a person who is depressed is focusing on, can be unrelated to the deeper reason. If there ever is "a" truly deeper reason. More likely it is a set of / mesh of things that have built up. Lastly nobody can describe depression. Those who have lived and are living with severe clinical depression know what it feels like, (like myself), the rest, the doctors and scientists are guessing.

afpx 2y ago

I used to have debilitating depression. SSRIs and similar drugs never worked. Eventually I was diagnosed with bipolar 2 and given lamotrigine, and it solved my depression completely.

maleldil 2y ago
That's a common story. Research has shown that a significant portion of people with treatment-resistant depression are, in fact, bipolar, with bipolar 2 being more susceptible to depressive episodes.

robwwilliams 2y ago

There is an even more fundamental problem. Psychiatrists do not apply uniform diagnostic criteria. This is painfully obvious in genetic studies of depression. The work of Jonathan Flint has highlighted this serious problem. https://pubmed.ncbi.nlm.nih.gov/32231276/ https://pubmed.ncbi.nlm.nih.gov/32231276/ https://pubmed.ncbi.nlm.nih.gov/25062429/ https://pubmed.ncbi.nlm.nih.gov/25062429/