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We Need to Have Sympathy for Those With Depression. It is an Illness

200 points by bcn 14y ago

dschiptsov 14y ago
BS. Everything that could be lifted by CBT is just ignorance and lack of determination. Medication without changing of habits is the same as drinking - it only masks the symptoms temporarily.
- rgrieselhuber 14y ago
  That is a highly uninformed opinion.
  - imperio59 14y ago
    I think it's actually highly well informed, Psychiatrists themselves admit there's nothing scientific about the whole "brain chemistry imbalance" bullshit. http://www.youtube.com/watch?v=nzdu3WQyIZg&list=PLFD59441E8A23F04C&index=1 http://www.youtube.com/watch?v=nzdu3WQyIZg&list=PLFD5944...
    - hedwall 14y ago
      He isn't talking about medication, he is talking about CBT. CBT on it's own has been shown to be effective for low to moderate depression.
      - DanBC 14y ago
        You are speaking to someone who claims that psychiatrists are responsible for the holocaust, pearl harbour, etc etc.
        Buzaga 14y ago
        straw-man, ad hominem One thing is clear to me, discussing psychiatry is already a MAJOR TABOO... e.g.: in the article the dude says how he "thinks it has something to do with chemistry... and stuff" clearly in a not-so-scientific reasoning(not that all must be) but just pointing out this sort of questionings leads to major downvoting
        DanBC 14y ago
        Can you not see that there is a huge difference between "questioning the effectiveness of psychiatry" and "blaming psychiatry for the holocaust"? I'm more than happy to ignore people who use the propaganda from a cult where anything from psychiatry is ignored.
        Buzaga 14y ago
        k, agree, I don't want nothing to do with Scientology also, but it's still straw-man to picture everyone who is questioning as a scientologist
        DanBC 14y ago
        > but it's still straw-man to picture everyone who is questioning as a scientologist But that's not what I did. I responded to someone who posted scientology propaganda.
        chris_wot 14y ago
        Scientology is absurd. You'll have to forgive me if someone such as myself, who suffers from depression, don't find that the assertions made by a cult to be something I take very seriously. By all means, criticize psychiatry. However, I've not seen anything substantive raised in any of the discussions in any of the threads so far.
    - dschiptsov 14y ago
      There is also point, cross-cultural. Most Asian cultures which are build around communities, instead of individualistic competition have orders of magnitude less such "deceases", which means it is learned behavior, reaction to the environment, which means it could be altered by changing the habits. And environment, is, of course, a product of actions of each individual member.
  - dschiptsov 14y ago
    Who knows.) In addition to taking a few Psychology courses, including one of Drugs and brain, I happen to be from a Russian working class, which means I saw so much shit you probably never seen even in movies.) Uninformed, come on.
imperio59 14y ago
Where are the clinical tests for depression? The diagnosis is solely based on the opinion of the practitioner, there is no brain scan or chemical test that can conclusively prove that someone is suffering from depression. The so called "drugs" used to treat depression are no better, they "are thought to work" (big pharma phrases it this way in their own TV ads) by re-balancing the brain's chemistry, but in actual fact they have never been able to prove this with scientific TESTS. So yes, people get sad sometimes, it's a fact of life, but maybe if we stopped prescribing them powerful mind altering narcotics that have FDA black warning label that say right on the box that they increase the risk of suicide, maybe they wouldn't take their own lives in such huge numbers. EDIT: Relevant link, please get ALL the facts before you go see a shrink about your "depression": http://www.youtube.com/watch?v=UHu7Ik36128 http://www.youtube.com/watch?v=UHu7Ik36128
- erikpukinskis 14y ago
  The clinical tests are easy to find: http://www.ncbi.nlm.nih.gov/books/NBK64063/ http://www.ncbi.nlm.nih.gov/books/NBK64063/
  - Buzaga 14y ago
    a numbered list? sad joke...
    - chris_wot 14y ago
      Otherwise commonly referred to as a "summary". You may have heard of it.
      - Buzaga 14y ago
        let me rephrase it then, a numeric list of general stuff that came up from a committee, that changes every 5 years or so, that anyone in whole world could identify in them in some point their lifes for (generally) a lifetime diagnosis that's given with medical authority backing, like the ones where they know cause, effect and solution? sad joke...
jtchang 14y ago
The problem with depression is that it is hard to diagnose. If anything we are still in the dark ages of mental illness. If you have an infection we have a way to tell you what infection. Right now there is no way to test for depression. More scientific research is definitely needed.
- ekianjo 14y ago
  We are no more in the "dark ages of mental illness". You must be kidding. Before we used to burn people who were mentally deficient and heard voices or had hallucinations as they were thought to be possessed by the Devil. That was the "dark ages of mental illness" you are talking about. There is now information, testing, diagnostic methods everywhere available, and efficient medication. Keep yourself up to date.
  - jtchang 14y ago
    How do you definitively test for depression? Are the diagnostic methods pretty good? Both accurate and precise with very low false positive rates? Is the medication proven to work for depression? Sorry but I think a lot of that can be argued that we are still shooting in the dark. I want a test for depression like I test for strep throat. AND I want the "cure" to be repeatable. Yes we are still in the dark ages.
    - erikpukinskis 14y ago
      Are the diagnostic methods pretty good? Both accurate and precise with very low false positive rates? Yes: "Overall sensitivity was 84% (95% CI, 79% to 89%); overall specificity was 72% (CI, 67% to 77%)" (http://www.ncbi.nlm.nih.gov/pubmed/7755226 http://www.ncbi.nlm.nih.gov/pubmed/7755226) Is the medication proven to work for depression? There's no such thing as proof in science. A recent meta-analysis: "Most patients treated with serotonergic antidepressants showed a clinical trajectory over time that is superior to that of placebo-treated patients. However, some patients receiving these medications did more poorly than patients receiving placebo. These data highlight the importance of ongoing monitoring of medication risks and benefits during serotonergic antidepressant treatment" (http://archpsyc.jamanetwork.com/article.aspx?articleid=1107437 http://archpsyc.jamanetwork.com/article.aspx?articleid=11074...)
eriksank 14y ago
It seems to be culturally dependent too and related to education as well. There seems to be less of an epidemic in the part of Asia where I live.
- ekianjo 14y ago
  I am not sure which part of Asia you are referring to, but in Japan there is "depression boom", at least judging by the increased amount of anti-depressants being sold.
  - eshvk 14y ago
    I lived in India and the conditions could be described to be bleak enough to make the most optimistic person sad. Suicide rates there were 10x what they are in the west. I am not even sure there is enough cultural understanding and sensitivity about depression: There used to be an uproar and attempts to treat the symptoms when high school kids used to commit suicide by the dozen (typically after poor exam results). (To the other poster, depression is not the same as "being sad" and having a bunch of people around you all the time asking you whether there is something wrong is not necessarily conducive to mental health. (Just to offer a flip side to your oh, there is so much community which is why there is a lack of mental illness anecdote.))
    - khitchdee 14y ago
      Depression is having a negative outlook on life over an extended period of time that starts effecting your everyday decisions and causing you to withdraw from social situations. It's an extension of being sad. Turn it around. If you're happy most of the time, it will be difficult for a psychiatrist to classify you as being depressed.
      - eshvk 14y ago
        Sorry no offense, but you don't get depression. There are people who may have a "positive outlook" on life, appear to be happy go lucky and one fine day not be able to get out of bed due a to crippling overwhelming feeling of despair. This is not just an "extension of being sad.". You can't just shake a person who is depressed or throw a bunch of balloons or bring a bunch of relatives around this person and make them feel happy. Sometimes, a person who is depressed can't even explain why they are being depressed. Sadness doesn't work like that.
DanBC 14y ago
Already this thread has replies that are trotting out the usual "depression is just sadness" or "CBT is nonsense". The UK NHS National Institute for Health and Clinical Excellence (http://www.nice.org.uk/ http://www.nice.org.uk/) gathers evidence of cost effectiveness (using quality adjusted life years) for various treatments. They are pretty clear - CBT is excellent for mild depression; CBT and medication combined is more effective than either treatment alone for moderate to severe depression. The Cochrane Collaboration (http://www.cochrane.org/ http://www.cochrane.org/) carefully investigates all the research, judges its quality, and publishes a meta analysis. They're pretty clear that CBT is effective.
- einhverfr 14y ago
  It's an interesting issue. One fundamental question is what social context has to do with depression. Is it possible that depression is so rampant today because our lives are socially impoverished and that medication is in part just a way to cover up the root cause?
- eshvk 14y ago
  You are conflating two very different opinions/groups: One can necessarily be skeptical of CBT without believing that depression is just sadness.
  - DanBC 14y ago
    That's not my intent; I'm just using one post to reply to a few different people.
- Tichy 14y ago
  I think if you go along that line of argumentation, it would be nice to link to actual articles and studies, rather than the homepage of some organization. Otherwise it is just a "call to authority", and we know those were never wrong in the course of history, right? For starters, what do they even measure to estimate effectiveness? Suicide rates? Happyness induced from a questionaire? Brainwaves? Hormone levels? What does effective even mean? Does it mean the patient did not induce further costs for the health industry? It could mean all sorts of things. For example chaining a patient to a bed could also be very effective in preventing suicide. So if you measure "suicides prevented", perhaps chaining people to beds is the best course of action?
alexvay 14y ago
"We Need to Have Sympathy." Period. There, I fixed it for you.
zopticity 14y ago
Depression has different stages. Sometimes it's easy to get out of depression. I'm sure we all experience it at our "low" points during different stages of our lives. From failing a startup or death of a family member. The depression that we can't get out of alone -- when we lose all hope for everyone -- that's the hardest to fight. Losing your will to live can quickly lead to suicide. And it's hard to tell from someone else's perspective that you're suicidal because you've pushed everyone away. I think the only cure to the second form of depression is to practice a healthy state of mind everyday. Enjoy life and friends that are close to someone. Always share your problems with a close person (someone you truly trust). You must have the will to live. Giving up isn't the answer to all your problems because someone else will have to inherit your problems. Which isn't fair for that someone!
- DanBC 14y ago
  Grief is normal. Grief is an appropriate reaction to a lifetime event. Grief normally subsides after a time; it's still there, but not overwhelming. Depression is not normal. When you still feel overwhelming grief years after the event, and it's affecting your everyday life and preventing you from functioning, then it's depression. > I think the only cure to the second form of depression is to practice a healthy state of mind everyday. I sort of agree - mindfulness and CBT techniques can be used everyday to help prevent depressive thinking.
austenallred 14y ago
Thank you, Mark, for writing this. I have lost three close friends in the past three months to depression. Their deaths were so similar it was shocking; they were all among the most brilliant people I had known, and all had been suffering from depression almost their entire lives. At the funeral of the one who was closest to me, another girl told a story of how on one day when his depression was particularly bad, he boasted in his great success for the day: Getting out of bed to brush his teeth. Bear in mind this was a kid who spoke Russian and Arabic fluently, who loved the arts, was incredible at chess, was a great musician, and took Calculus BC in 9th grade. Absolutely brilliant. He was a fighter, he was stubborn, he was young, and some say he took his own life. I prefer to say that depression took his life. Sorry for getting so personal, but I simply can't take any of the comments that say "just get over it." Depression is as real and as disabling as being paralyzed; it may not happen to everyone, but to say things like, "You need to be stronger" are no more appropriate to the depressed than they are to the paralyzed. But most of all, if any of you are reading this who have depression, keep fighting. Recognize your brain lies to you, and no matter what it says there are many people who love you and it will get better.
- nnq 14y ago
  > your brain lies to you Indeed, I've been saying this to myself in dozens of situations, not just depressive moods. If you actually believe it when you say it, it's like a sort of mantra that can replace any pill! ...but unfortunately people suffering from clinical depression can't get themselves into the "saying it and believing it mode".
  - opminion 14y ago
    Perhaps a digested, weighted, real-world-mapped version of Wikipedia's list of cognitive biases [1] would be useful as mantra. Just the kind of thing that xkcd does with posters, actually. [1] http://en.wikipedia.org/wiki/List_of_biases_in_judgment_and_decision_making http://en.wikipedia.org/wiki/List_of_biases_in_judgment_and_...
  - shahar2k 14y ago
    it's what I've told others too, it's like living behind a filter, and every thought and every idea is focused on the negative and false. and the thing is, that I've had it for so long, a decade maybe? probably was there before I even recognized what it was. but for me it comes and goes, and when it comes I've learned to see the filter, it's just harder to remember what things look like in reality. but I'm doing well, I dont have it quite as bad as some, and it goes away and I've learned to cope and figure out and get past it, but... it's never going to stop coming back, and I also know it brings back a kind of brightness and sharpness when it leaves, something I actually do enjoy. I'm sometimes dysfunctional because of it, but mostly... I'm just me, I do alright and I'd rather not change me just yet, so for now I'll deal with it, because it helps me help others.
jtchang 14y ago
If there is one thing I've learned about depression is that we suck at identifying it and we suck even more at "curing" it. I'm not a doctor. But there is a huge difference between being sad and killing yourself. There are some people who think it is just "in their head" and to "shake it off". There have been lots of diseases in our history that people thought were normal until we made some crazy discovery that what was really causing it was some previously unknown agent.
jay-pinkman 14y ago
not all cases of depression can be attributed to unbalanced brain chemistry. sometimes the chemistry is ok, it's just your life is fucked. in this case depression is a normal reaction. you just can't remain all cheerful when you're drowning in shit. i don't think taking up meds or doing other things to cover it up is a good answer to such situations. with all its negative aspects depression is also a big reminder that something is off and must be fixed, it pushes you to make drastic changes because your regular routine doesn't quite help. sometimes it pushes you to a suicide which is sad but notice how many successful people with stellar careers and shiny popular products or art had been struggling with depression when they were failing at their job, when their dreams were crumbling, and no end to this horror was in sight. maybe it's a stretch but i'd say suffering from depression at some point in life is a normal thing for a maker. sometimes difficulties that you prepared yourself to are just greatly overshadowed by the actual state of affairs. that's to say marking all cases of depression as illness that needs to be treated is a wrong way to look at the problem. in my opinion at least. what helps is support and understanding, phrases like "pull your socks up" or "go get some pills" don't.
- alan_cx 14y ago
  Why is this voted down? It's a valid opinion. Please tell me we don't have depression Nazis who can only accept one narrow definition of depression. What I see described here is possible how most people experience depression. Or does only extreme depression count?
  - DanBC 14y ago
    Depression is a jargon term with a specific meaning, as well as an everyday word with a fuzzy less specific meaning. That causes some confusion in discussions like this. Depression covers a range of different illnesses, with different severities. Depression is not a normal reaction to a life event. When someone dies you feel grief. That grief may be severe. But grief is a normal reaction to death. If, however, the grief is overwhelming and lasts for years, and interferes with your life then it has developed into depression. Depression is an abnormal reaction to life events. There is a form of depression termed "reactive depression". Something happens, and a person doesn't have a normal negative reaction but has an abnormal extreme negative reaction and falls into depression. The main treatment for that would be to correct the thing that caused the reaction, with some CBT, and medication if needed.
fjarlq 14y ago
Professor Sapolsky at Stanford gave an interesting lecture about depression a few years ago... highly recommended: http://www.youtube.com/watch?v=NOAgplgTxfc http://www.youtube.com/watch?v=NOAgplgTxfc
- paganel 14y ago
  There's also this, "How To Be Alone": https://www.youtube.com/watch?v=k7X7sZzSXYs https://www.youtube.com/watch?v=k7X7sZzSXYs . It did help me a couple of times.
- wiredfool 14y ago
  That's a really good video -- I saw it linked in the aftermath of Aaron. It's worth the 52 minutes to watch it.
chris_wot 14y ago
Right now I am depressed. I feel terrible, and very, very guilty that I feel the way I do. I don't want to do anything, but I do want to do something to distract me away from my awful feeling of numbness. I worry about the future at times, and feel I'm at a dead end. I worry about my kids, and my wife, and my ageing parents. I'm sleeping constantly, but when I sleep my dreams are too vivid. Despite it all, I'm a functioning human being. I function at work so I use this to distract myself. It's a fairly dull job at the moment while I try to do a Computer Science degree. But I've had to defer it due to family pressures and because of this blasted funk. I intended to study in my own time, especially mathematics, but I just can't get enough motivation to do it now. I was teaching myself JPA from scratch, and was making headway, that's gone out the window. I had some ideas for an ITSM app, but that's gone too. I feel like I haven't fulfilled my goals, and a failure. I'm not a raging depressive, but a few weeks ago I couldn't stop crying. I feel like a burden so I'm trying to hide it all. It leaks out. So I sleep, and this reduces my ability to socialise. I then feel guilty, but nobody is judging me. It's life I guess. I don't write this to ask for pity, but to explain what it's like, while it's happening. If I had to summarise my mental state, it's like a piece of me has died inside. Knowing that it will go away doesn't really help the feeling, but it gives me fortitude to get to the next day. I hope this might give some insight to those who haven't felt this way before.
- austenallred 14y ago
  Thank you for your excellent explanation. There's no way I can comprehend what you're going through, but I have the utmost respect for you. Carry on, you're a champ.
  - chris_wot 14y ago
    Thanks :-)
- DanBC 14y ago
  I hope you're getting some treatment.
  - 14y ago
cohort 14y ago
Great talk about mental illness on TED http://www.ted.com/talks/ruby_wax_what_s_so_funny_about_mental_illness.html http://www.ted.com/talks/ruby_wax_what_s_so_funny_about_ment...
acjohnson55 14y ago
Having experienced a couple major depressive episodes, I have no desire to ever go back, and I've built myself a sort of mental fortress to hopefully withstand whatever shocks I'll experience as I keep on living. I'm fortunate in that in both of my cases, I was able to emerge and put the depression behind me. I can't imagine chronically feeling the way I did. Imagine being so emotionally hurt that it feels like physical pain, long after you were able to mentally process what initially upset you. Like a pain so chronic and awful that you're willing to do just about anything to make it stop. Imagine how frustrating it is to want to be over something and to think you are mentally past it, but the emotional side of your brain (i.e. most of it) just won't budge. And then on top of it, you feel guilty for being such a drag on people around you. And you also feel paranoid that even when you're not dumping on them, you're alienating them in some way. So you mostly just suffer in silence. It's terribly debilitating. A friend of mine who undoubtedly would be reading HN today if he were still around evidently felt this way pretty much his entire life. I don't think I would have been able to take it either.
primitur 14y ago
We need more compassion in general - not just for the outlier cases - but society in general can be a pretty mean entity. I've been thinking lately how sad it is that so many of the younger hackers in my local scene (metalab.at) are not as familiar with John Lennons' World Peace movement as they should be. That light was snuffed out, but John (and Yoko, and many, many others) were really trying hard to get a world peace movement established, that would bring more love to the world. If you turn on the TV today, you don't see much love. Most "comedies" are little more than 30-minutes-ridicule+laughtrack. In fact, remove the laugh-track from most TV shows and you have a banal hate festival. I think depression being treated poorly, in general, by society is symptomatic of a larger maladay - which is that we humans simply don't trust our neighbors. We don't communicate freely and honestly with each other. You can't smile at a stranger in Vienna, for instance, just for the sake of the happiness - there always has to be the inference of an alternative, sinister, motive. Why is that? Its because, fundamentally our cultural veigns - the mass communications networks of PR, Advertising, News, TV - don't profit from happiness and good times. They profit from the "black blood cell" of intrigue, controversy, synthesis/anti-synthesis. All we really see on TV is conflict this and that, and if there is some sort of consolation, its usually couched as "irony" or some such emotion. But what of true Peace, where people are getting along great? There is a lot of that in the world, and it goes under-reported, and just not noticed by the majority. Its possible that depression is a social disease, and is contagious. But, so is happiness. We need more overt acknolwedgement of the good times, too, in my opinion - the truly good times, real progress. The aversion of the average citizen towards sharing good news and good times needs to be overcome. We miss you, John Lennon.
- marknutter 14y ago
  Funny. For me, I get depressed and turned off when I see too much peace, happiness, and love crap in media. Maybe it's because I'm part of the generation who's grown skeptical of everything in media, but I definitely prefer the darker, sarcastic side of content. A John Lennon style love/peace-fest sounds like an absolute nightmare to me. No thanks.
  - cbs 14y ago
LatvjuAvs 14y ago
Without death of loved one, without death of friends. Without these a lot of revelations and emotions would be locked in you forever. They spark humanity, they unite, they bring forward topics that usually no one would want to discuss. And when all your fears will be dealt with, maybe death will stop be so scary.
lhnz 14y ago
A lot of uniformed people in this thread. You can't generalise as much as you all do. You have to understand that people experience life in very different ways. I have experienced depression [0] but I can't speak for anybody else other than to say I know it's hard and keep on. The real problem with depression is that everybody wants to wash their hands of it. "There are doctors that we can pass these sick people to. The system will sort everything out. That guy's a real downer, I hope he get's help... from somebody else..." I understand that it can be a mood-ruiner and people feel ashamed of it even by association but where is the strength in ignoring things? Compassion would truly be helpful and if you can give it, give it. Go for CBT and you'll find it largely amounts to filling out forms on your mental state with tickboxes that don't really apply to you, while somebody tries to find out ways that your thinking is twisted. But you can be rational, successful, positive and still feel awful. Do you want to medicate the hell out of the high-functioning, positive guy that wants to change the world [1]? The term 'chemical imbalance' sometimes gets thrown around, and honestly it's probably wrong but there is a truth to it -- often the people that say they have a chemical imbalance are thinking quite rationally but facing terrible emotions that they know they shouldn't have to (from trauma, or an unhealthy subconscious.) [0] http://news.ycombinator.com/item?id=5096568 http://news.ycombinator.com/item?id=5096568 [1] http://www.youtube.com/watch?v=Fgh2dFngFsg http://www.youtube.com/watch?v=Fgh2dFngFsg edit; If you're going to downvote me it would be nice if you would mention why. Do you actually have experience of any of this? I'm trying to give my honest experience on this, and I'm trying to point out that a guy like Aaron Swartz doesn't really fit the neat definitions required by most treatments; and that compassion beyond telling others to 'go to a doctor' is worthwhile.
- DanBC 14y ago
  I didn't downvote you. > Go for CBT and you'll find it largely amounts to filling out forms on your mental state with tickboxes that don't really apply to you, while somebody tries to find out ways that your thinking is twisted. This is a poor version of CBT. Any practitioner providing CBT like this is doing it wrong. CBT is not about telling you that you are wrong or that your thinking is twisted. CBT is about exploring with you what your thinking is; what's happening to you with those thoughts; how strongly you feel those thoughts and emotions. CBT is about helping you understand why you feel the things that you feel, and why you think the things you think. There can be a bit of writing when you begin - some people find it useful to have the process down in a concrete form. There doesn't have to be writing. And checking boxes is not a good approach. Medication works for some people. But the serotonin hypothesis is controversial. > Do you want to medicate the hell out of the high-functioning, positive guy that wants to change the world (I didn't view the YouTube) Medication can have side effects, and sometimes they're not very nice. But most SSRIs don't have the kind of effects that people would describe as "medicate the hell out of".
alan_cx 14y ago
I am said to suffer depression myself, which BTW I would deny as I would say its "realism", but I really have an issue with it being described as an "illness". It seems to be that this definition is more about giving depression PR parity with actual illnesses, rather than a correct label. Its like the public will accept an "illness" as real, but a psychological issues as not real. There for making the public see depression as "illness" helps get support. See what I mean? From what I can make out, depression is a state of mind. Its a psychological thing. Ie, its a sort of loop people get themselves in to. That, to me, is not an illness. Not more so than arrogance, confidence or anger. Its an emotion. Is love an illness too? I realise that can be debated, but I don't think its helpful to redefine things for PR reasons. To me that cheapens it. I'm not saying depression is there for less valid, clearly its as debilitating as what I would think of as real "illness", if not more so, but I do roll my eyes and switch off every time I hear the word "illness" appropriated for things that aren't really "illnesses". As I say, the lack of the word illness doesn't, to me, make it less serious. To me, using that word is not necessary, it just blurs the lines and can put people off caring. It make it sound exaggerated or a bit "me too". Should add that I do understand that there are different types of depression. Perhaps using the single word depression to cover all cases is more the problem that the word "illness". I'm by no means unsympathetic, I know how it can effect people. I've seen the results of suicide. Hell, my mum's other half had to cut the bloke down while the wife screamed in the street. But I worry that re-defining things puts the general population off. No idea if these definitions are different each side of the Atlantic. Heh, no idea if its just me who thinks this either!!!
- wisty 14y ago
  > I am said to suffer depression myself, which BTW I would deny as I would say its "realism", but I really have an issue with it being described as an "illness". There's a difference between being cynical, and being depressed. Clinical depression crosses through to the other side, where everything seems unreasonably bad.
- InclinedPlane 14y ago
  This is wrong, wrong, wrong. Sometimes people get down or get "the blues" but this is something very much different from major clinical depression. Depression has many aspects but one of the most important is a chemical imbalance in the brain. It's not just a feeling or an emotion, it's a fundamental change to the way your brain works. And episodes of major depression can last for years, even decades.
will_phipps 14y ago
For anyone affected by depression or other mental health issues, like stress and anxiety, I recommend the work of John Kabat Zinn and his teachings on mindfulness. This was offered when I was still an in patient at a psychiatric unit and has had numerous beneficial effects on people I know who have struggled with serious depression and mental illness (including myself). There are mindfulness courses all over the world these days :)
goggles99 14y ago
If you took a survey, asking if they felt sympathy for those diagnosed with the mental illness of clinical depression, I am pretty sure that most would answer yes. My point is that this article is sort of worthless and whats more, the title is really irritating (because most people already have sympathy for those with depression). How about an article titled - we need to seek shelter to survive winter (most people already do). What we need to do is a lot more than feel sorry for these people. We need to take action to help them.
evgenit 14y ago
In addition to sympathy, I wish we were better at telling people close to us to go see a doctor about their depression, or mental health in general. In particular, I wish someone had told me to do so ~7 years ago; would have saved a lot of misery.
corporalagumbo 14y ago
I really disagree with the classification of depression as a mental illness... it's such a crude way to talk about what is really a spiritual and intellectual problem.
yummyfajitas 14y ago
This essay is making a logical fallacy. The implicit assumption is that if a person is in a state which falls under the category "illness" they deserve sympathy, while they might otherwise not. Unfortunately, the essay does not define it's terms, nor does address why depression specifically deserves sympathy. Near as I can tell, it's just an application of the noncentral fallacy. Overall, a pretty terrible essay. More on the noncentral fallacy: http://lesswrong.com/lw/e95/the_worst_argument_in_the_world http://lesswrong.com/lw/e95/the_worst_argument_in_the_world Noncentral fallacy specifically applied to medical conditions: http://lesswrong.com/domain/lesswrong.com/lw/2as/diseased_thinking_dissolving_questions_about/ http://lesswrong.com/domain/lesswrong.com/lw/2as/diseased_th...
- chris_wot 14y ago
  All I have to say is actually in the lead paragraph of the Wikipedia article: "Sympathy is an extension of empathic concern, or the perception, understanding, and reaction to the distress or need of another human being. This empathic concern is driven by a switch in viewpoint, from a personal perspective to the perspective of another group or individual who is in need. Empathy and sympathy are often used interchangeably, but the two terms have distinct origins and meanings. Empathy refers to the understanding and sharing of a specific emotional state with another person. Sympathy does not require the sharing of the same emotional state. Instead, sympathy is a concern for the well-being of another. Although sympathy may begin with empathizing with the same emotion another person is feeling, sympathy can be extended to other emotional states." http://en.wikipedia.org/w/index.php?title=Sympathy&oldid=534731942 http://en.wikipedia.org/w/index.php?title=Sympathy&oldid...
elorant 14y ago
A few years back when I quit smoking I spent two weeks with withdrawal symptoms the biggest one been depression. It hit me so harsh that I felt like I lost the earth under my feet. I’ve never felt anything similar and I can honestly say it was by far the worst period of my life. You wake up and you just don’t have the courage to do anything. Every single insecurity I had surfaced during those two weeks multiplied by ten. The odd thing is that those two weeks were the most socializing ones I’ve ever spent. I felt like I wanted to be with other people 24/7 although it didn’t make any difference to my condition. And this imho is the biggest problem with depression, there are no visible signs that someone suffers from it. So if you don’t know if someone has it how can you help them. Fortunately for me this hell lasted only a couple of weeks, until my body cope up with the lack of nicotine. I don’t know how I would manage to live with something like that for years or even decades. I have the outmost respect and sympathy for the ones living with depression. Without trying to be smart ass I have the feeling that depression is a fundamental problem of lifestyle standards. The majority of our insecurities are imposed on us by some wicked version of how life should be. So instead of enjoying the little moments of happiness we tend to believe that happiness is a constant situation which happens to be out of our grasp and thus we hammer ourselves with the inability to get there. And then you end up with a dozen insecurities and everything seems so vain.
gesman 14y ago
As part of self observation I noticed that depression starts with negative thinking. The thought can be qualified as "negative" or "positive" by the physical bodily sensation it produces. Negative thought essentially produces self-inflicted pain within the body. Consistent negative thinking produces more inner pain and at more intense levels. This inner pain in turns fuels negative thoughts pattern that continues to inflict more "emotional" pain. Then it becomes vicious cycle of "beating yourself up". At deeply depressed stages thought control no longer works and any attempts to "think yourself" out of depression are becoming futile. At these stages depression is fueled by constant intense physical/emotional pain that is constantly present seemingly without any thinking processed. The more intense the pain - the more unbearable it is - and this drives person to suicide as the last resort to stop suffering. The actual solution in this case it to guide person to look at the pain directly instead of escaping, avoiding or suppressing it with painkillers. Painkillers may be necessary to maintain sanity though through the practice. This is ancient practice talked about by pretty much every spiritual teacher - yet widely ignored. When you feel depressed - locate exact area of painful physical sensations within the body and start observing it. Watch your sensations, watch your feelings, watch them exactly where they are. Do not try to change them, do not try to kill them, just observe them. At the same time breathe and follow your breathing as well. Conscious breathing slows down incessant thinking. Direct observation of painful emotions will start dissolving them. This is very efficient practice that I personally benefited from during very intense emotional downturns and depressive states.
throwin 14y ago
I agree that depression is an illness. I also agree that we need more sympathy and help for those who suffer it, and there needs to be less stigma surrounding it. Having said that, we should not forget the victim's loved ones left behind, after his/her suicide to grieve and bury the victim. These people are victims too. Sometimes other lives are destroyed by an act of suicide. A young wife left to raise the kids alone. A mother forced to bury an only child; perhaps committed to a life of depression herself. For the record, I have had my own battles with depression. I have had days I was unable to get out of bed. I have also had suicidal thoughts. But the thought of the pain I would inflict on my family, particularly my mom, would never allow me to truly consider it an option. I don't pretend to have felt the pain that would drive one to suicide, because there are degrees and experiences differ. But it helps to know where I'm coming from. I think there needs to be more of a stigma surrounding suicide and more awareness for the pain of those that are left to grieve. If you're considering ending it all, please try to get help, and please think of the pain you will be inflicting on those you leave behind.
deleted 14y ago
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michaelochurch 14y ago
Depression is partly biological-- the tendency that way surely is-- but it's also a natural outgrowth of a society that doesn't forgive mistakes and that tests people not based on peak capability or creativity, but on breaking point. Somehow, we've conflated character and loyalty (which are important) with the willingness to suffer needlessly in the name of subordination and whatever the fuck "team player" means. The brogrammer culture and unnecessary long hours of Corporate America are all about testing people based on their decline curves, not peak performance. It's competing to suffer rather than competing to excel. Who is the first to crack? Fire him. Who is the last to break? Promote him. It's ridiculous and of course it's going to lead to an "epidemic" of mental illness. In the corporate world, we promote based on participation in shared suffering (i.e. who stays until 1:30am to meet an arbitrary deadline) rather than talent, and we kick people when they're down, which is why it's impossible for someone to get back into the career game after even a short time outside of it (maternity, illness, depression). Of course we're going to have our best people dropping like flies. Depression and anxiety disorders have always existed, but they don't need to be this common. I wouldn't be surprised to learn that at least half of the problem is caused by social and economic forces. These problems are biological at root, but social factors tend to modulate the severity that people experience. Mark Suster deserves major props for speaking out about this. I've criticized him in the past, but I'm starting to like the guy.
bocalogic 14y ago
Depression happens for many reasons. We do need to have sympathy because the depth of depression varies from person to person. Some of it can be genetic and I think it can also be copied from other people or passed on. That is why if you hang around with happy people you have a tendency to be happier. One of the things I noticed in my successful peers is that they go through a period of depression before great periods of productivity or creativity. The depths of depressions or "pullbacks" vary from person to person but most of them show that trait before periods of greatness. IMO, depression is increasing because pressure is increasing on the average individual in general. From society, to our peers, from the media, from our own competitive nature we are putting more pressure on ourselves to perform or not perform via rebelling. I am not a doctor, but I know when one of my friends or peers say they are depressed, it is taken very seriously. We all go out of our way to support that person. Life does go on. Life does change. Sometimes it is darkest before the dawn. Never give up.
rowanseymour 14y ago
Let me preface this with: I have first hand experience of depression, I don't think it's just sadness and I'm absolutely sympathetic toward those who with depression. But... My thinking about mental illness changed a lot after reading a book called Crazy Like Us [1]. It doesn't talk about depression specifically - it's a collection of case studies on how different mental illnesses have been experienced/handled/treated by different societies around the world, and how western understandings of mental illness have generally displaced existing cultural understandings, not always for the better. The major argument of the book is that the Western view of conditions such as depression as 'mental illness' has been counter-productive to attempts to de-stigmatize such conditions. The author also makes a convincing argument that it's also made recovery less likely for a lot of sufferers. And to me that makes a lot of sense. Many other cultures view emotional suffering as a normal part of human life. In the West we view it as an unnatural state. We think that by detaching the condition from the sufferer, we're de-stigmatizing it, but the sufferer ends up more stigmatized because... now they are considered mentally ill. And they have less hope of their situation improving, because we're telling them that there is something biologically wrong with them. [1] http://www.amazon.com/Crazy-Like-Us-Globalization-American/dp/1416587098/ http://www.amazon.com/Crazy-Like-Us-Globalization-American/d...
jdietrich 14y ago
Fuck this shit. We need to have sympathy. Not because we've diagnosed someone with a disease, but because they're a person. Rates of depression are skyrocketing all over the developed world and whatever we're doing clearly isn't working. Personally, I think the most obvious issue is that a group of intelligent people have simply accepted the notion that what's relevant isn't someone's life circumstances, but some vague and baseless notion of "abnormal brain chemistry". The idea of depression is a miserable cop-out, it's simply victim-blaming. We say that there is something wrong with their brains, rather than saying that there is something wrong with society. If someone is unhappy, we need to support them. It is a dismal failure of our humanity if we require the justification of medical necessity to show basic compassion. Swartz had obvious reasons to be miserable and obvious reasons to want to kill himself. We failed him, we fucked up. He didn't die of a disease, he killed himself because he quite justifiably felt that the circumstances of his life were intolerable. We didn't do enough as a community to support him and protect him. He was a young and vulnerable man, bearing the wrath of a spiteful government. It's shameful for us to even consider for a moment that there might be something wrong with Swartz's brain, when our failures to care for him are so obvious. If we need a scientific explanation for why we should care about each other, that's our problem. If we require a doctor's say-so to provide support for someone in difficulty, that's our disease.
- Osmium 14y ago
  > Personally, I think the most obvious issue is that a group of intelligent people have simply accepted the notion that what's relevant isn't someone's life circumstances, but some vague and baseless notion of "abnormal brain chemistry". How about people who lead objectively wonderful lives, with good jobs and happy families, but still suffer from deep depression? The problem, if any, seems to be the other way round: that some people think only people will "bad" lives can suffer from depression, and everyone else should just "get over it." That's what seems wrong to me--and if identifying "abnormal brain chemistry" as a cause of depression helps people realise that anyone can be a victim then so be it. Clearly if someone is suffering then external factors can make it so much worse, but that doesn't mean depression needs an external cause. Sometimes it just is.
  - 14y ago
jetti 14y ago
While I agree that we need to be more sympathetic to those with depression, but I think it needs to extend way past just depression and on to all mental illness. Mental illnesses cause distorted thought patterns and it isn't the fault of the individual who has that mental illness, just as it isn't the fault of the Type 1 Diabetic that they have their illness. Speaking from first hand experience, it can be overwhelming and lonely to suffer from mental illness. I have to hide my thoughts from others (including my own wife) because of fear that they won't understand and that they may think of me as a monster. We have come a long way from where we used to be regarding mental illness (such as blaming poor parenting), but we still have a long ways to go.
Osmium 14y ago
The trouble with so many mental illnesses is that there's no good diagnostic test to help identify sufferers, and many go undetected or untreated until it's too late. There must be something that can be done about this. It might help those not personally affected by depression to understand its true nature better too.
TheCapn 14y ago
I live with someone who suffers from depression. The idea that it is a disease is somewhat welcoming in that it allows people to rationalize that their actions are not entirely their fault, but at the same time it almost hurts those suffering because of the complacent attitudes it breeds. Often times, before a person is known to suffer from depression people will comment on their behaviors/mannerisms as if they're abnormal. Once they realize the issue they are sympathetic but change to "they can't help it, they're depressed." In many ways this can be true, its uncontrollable at times, but for other times they need support, not sympathy. Support means helping them feel better about what ails them. It means distracting them from their worries with things you know will lift their spirits and help them see the lighter sides of things. When you can't lift their spirits you need to be there until they can move on naturally. A person suffering from depression can focus on a negative aspect of life so intently that it is damaging but as a supportive role in their life you need to look past that. Don't sympathize, be active in supporting them or get out of the way so someone willing to can.
dr_ 14y ago
Part of the problem is how doctors, and especially psychiatrists, have approached treating depression. There are many people who simply get down once in a while, in response to a particular event or series of events, the way most of us do at some point in our lives. If these people come across a psychiatrist, there's a decent chance they will end up on anti depressants when they likely just need some counseling and time. They should not be classified as depressed, maybe a transient mood disorder, but who knows if insurance would pay for that. That takes away from people who truly suffer from clinical depression, a real medical condition which should be separately classified as such. If you throw them into the basket of people who are just down once in a while, you do them a great disservice, because society then looks at them as someone who just can't deal with issues and need a crutch in the form of medications. The people with real clinical depression are the ones who are at risk of committing suicide. Psychiatrists can figure out which is which usually, not always, but instead they treat everyone the same, and as a result less time is spent on those who need it the most (unless they end up getting hospitalized)
frontfunder 14y ago
This touches home base. 2 of my friends committed suicide the past 3 years (2009, 2010), due to untreated or misdiagnosed depression and other issues. In December of 2012 my 17 y old daughter attempted suicide, for no apparent reason as per the "specialists" "opinion". Since my daughter is not with me, for the first time in my life I've experienced the true feeling of loosing someone very dear to me. It's like the Universe crushes your last breath out of you and there is nothing you can do. It's easy to judge depressed people and to brush it aside. It is very hard to understand it and know how to support it, especially when the person with depression does not want any help.
kremdela 14y ago
I have suffered from severe depression since I was young. I (think) I'm pretty smart, but have definitely held myself back from achieving things that I could have because of it. I have found this to be nearly crippling when accompanied with the rejection and difficulty of being an entrepreneur. Professionally, I have done a lot of freelance work as a result. I've held pretty good jobs for ~ 1 year, but eventually have some problem due to workload stress combined with my depression. Regrettably this has made me leave jobs in non-ideal ways. I'm looking for my next great position now, and it's tough to answer the "why did you leave this position and then go freelance last year" with "I let my depression get ahead of me and tried to kill myself." I know that it's an incredible liability to a potential employer to hire someone that might do great work for a year and then abruptly leave. I just needed to get that off my chest.
fghh45sdfhr3 14y ago
How common is it to find people who don't sympathize with depressed people? I don't care about anonymous trolls on the internet. I mean in real life? In my experience with depression, everyone sympathizes and worries and wants help the depressed person. But being a vicious brain disease, depression will make you think the people who love you actually hate you and lough at you behind your back, when at work, or even while sleeping. I have been accused of laughing at the person I love while sleeping, by her. No, it did not make me upset. I know it was the demons in hear head making her say that. I had been with her as she descended deeper and deeper and her self-hatred got worse and worse. So when I hear that we need to sympathize with depression, I think you either have no experience with depressed people, or you're trying to convince anonymous internet trolls. The later is as futile and pointless task as can be. It is better to teach and train people on ignoring the trolls.
mattmaroon 14y ago
I don't know that depression is really that stigmatized these days. It's poorly understood, even by the people studying it. But though we might argue about the merits of chemicals vs therapy, I think most people recognize it as a genuine illness that needs to be treated. Having previously been married to someone with depression issues (suicidal thoughts included) I can say it's a bitch. It's hard to know someone like that and not think of them as ill.
blots 14y ago
What if depression is the evolutionary solution to overpopulation?
SparrowOS 14y ago
I'm in a jail -- my download numbers are put there by my captors. Everything is pointless. I talk with God. Gods says... convertedst placest mountain's celestial hippy Knowing unformed over_the_top Ministry wisely comfort Gutenberg-tm serve parched -If aright heathen motion culture glory null details perverted Oh mire over-confidence ---- God says... five hundred and thirty priests' garments. 7:71 And some of the chief of the fathers gave to the treasure of the work twenty thousand drams of gold, and two thousand and two hundred pound of silver. 7:72 And that which the rest of the people gave was twenty thousand drams of gold, and two thousand pound of silver, and threescore and seven priests' garments. 7:73 So the priests, and the Levites, and the porters, and the singers, and some of the people, and the Nethinims, and all Israel, dwelt in their cities; and when the seventh month came, the children of Israel were in their cities. 8:1 And all the people gathered themselves together as one man into the street that was before the water gate; and they spake unto Ezra the scribe to bring the book of the law of Moses, which the LORD had commanded to Israel.

200 points by bcn 14y ago

BS. Everything that could be lifted by CBT is just ignorance and lack of determination. Medication without changing of habits is the same as drinking - it only masks the symptoms temporarily.

rgrieselhuber 14y ago
That is a highly uninformed opinion.
- imperio59 14y ago
  I think it's actually highly well informed, Psychiatrists themselves admit there's nothing scientific about the whole "brain chemistry imbalance" bullshit. http://www.youtube.com/watch?v=nzdu3WQyIZg&list=PLFD59441E8A23F04C&index=1 http://www.youtube.com/watch?v=nzdu3WQyIZg&list=PLFD5944...
  - hedwall 14y ago
    He isn't talking about medication, he is talking about CBT. CBT on it's own has been shown to be effective for low to moderate depression.
    - DanBC 14y ago
      You are speaking to someone who claims that psychiatrists are responsible for the holocaust, pearl harbour, etc etc.
      - Buzaga 14y ago
        straw-man, ad hominem One thing is clear to me, discussing psychiatry is already a MAJOR TABOO... e.g.: in the article the dude says how he "thinks it has something to do with chemistry... and stuff" clearly in a not-so-scientific reasoning(not that all must be) but just pointing out this sort of questionings leads to major downvoting
        DanBC 14y ago
        Can you not see that there is a huge difference between "questioning the effectiveness of psychiatry" and "blaming psychiatry for the holocaust"? I'm more than happy to ignore people who use the propaganda from a cult where anything from psychiatry is ignored.
        Buzaga 14y ago
        k, agree, I don't want nothing to do with Scientology also, but it's still straw-man to picture everyone who is questioning as a scientologist
        DanBC 14y ago
        > but it's still straw-man to picture everyone who is questioning as a scientologist But that's not what I did. I responded to someone who posted scientology propaganda.
        chris_wot 14y ago
        Scientology is absurd. You'll have to forgive me if someone such as myself, who suffers from depression, don't find that the assertions made by a cult to be something I take very seriously. By all means, criticize psychiatry. However, I've not seen anything substantive raised in any of the discussions in any of the threads so far.
  - dschiptsov 14y ago
    There is also point, cross-cultural. Most Asian cultures which are build around communities, instead of individualistic competition have orders of magnitude less such "deceases", which means it is learned behavior, reaction to the environment, which means it could be altered by changing the habits. And environment, is, of course, a product of actions of each individual member.
- dschiptsov 14y ago
  Who knows.) In addition to taking a few Psychology courses, including one of Drugs and brain, I happen to be from a Russian working class, which means I saw so much shit you probably never seen even in movies.) Uninformed, come on.

imperio59 14y ago

Where are the clinical tests for depression? The diagnosis is solely based on the opinion of the practitioner, there is no brain scan or chemical test that can conclusively prove that someone is suffering from depression. The so called "drugs" used to treat depression are no better, they "are thought to work" (big pharma phrases it this way in their own TV ads) by re-balancing the brain's chemistry, but in actual fact they have never been able to prove this with scientific TESTS. So yes, people get sad sometimes, it's a fact of life, but maybe if we stopped prescribing them powerful mind altering narcotics that have FDA black warning label that say right on the box that they increase the risk of suicide, maybe they wouldn't take their own lives in such huge numbers. EDIT: Relevant link, please get ALL the facts before you go see a shrink about your "depression": http://www.youtube.com/watch?v=UHu7Ik36128 http://www.youtube.com/watch?v=UHu7Ik36128

erikpukinskis 14y ago
The clinical tests are easy to find: http://www.ncbi.nlm.nih.gov/books/NBK64063/ http://www.ncbi.nlm.nih.gov/books/NBK64063/
- Buzaga 14y ago
  a numbered list? sad joke...
  - chris_wot 14y ago
    Otherwise commonly referred to as a "summary". You may have heard of it.
    - Buzaga 14y ago
      let me rephrase it then, a numeric list of general stuff that came up from a committee, that changes every 5 years or so, that anyone in whole world could identify in them in some point their lifes for (generally) a lifetime diagnosis that's given with medical authority backing, like the ones where they know cause, effect and solution? sad joke...

jtchang 14y ago

The problem with depression is that it is hard to diagnose. If anything we are still in the dark ages of mental illness. If you have an infection we have a way to tell you what infection. Right now there is no way to test for depression. More scientific research is definitely needed.

ekianjo 14y ago
We are no more in the "dark ages of mental illness". You must be kidding. Before we used to burn people who were mentally deficient and heard voices or had hallucinations as they were thought to be possessed by the Devil. That was the "dark ages of mental illness" you are talking about. There is now information, testing, diagnostic methods everywhere available, and efficient medication. Keep yourself up to date.
- jtchang 14y ago
  How do you definitively test for depression? Are the diagnostic methods pretty good? Both accurate and precise with very low false positive rates? Is the medication proven to work for depression? Sorry but I think a lot of that can be argued that we are still shooting in the dark. I want a test for depression like I test for strep throat. AND I want the "cure" to be repeatable. Yes we are still in the dark ages.
  - erikpukinskis 14y ago
    Are the diagnostic methods pretty good? Both accurate and precise with very low false positive rates? Yes: "Overall sensitivity was 84% (95% CI, 79% to 89%); overall specificity was 72% (CI, 67% to 77%)" (http://www.ncbi.nlm.nih.gov/pubmed/7755226 http://www.ncbi.nlm.nih.gov/pubmed/7755226) Is the medication proven to work for depression? There's no such thing as proof in science. A recent meta-analysis: "Most patients treated with serotonergic antidepressants showed a clinical trajectory over time that is superior to that of placebo-treated patients. However, some patients receiving these medications did more poorly than patients receiving placebo. These data highlight the importance of ongoing monitoring of medication risks and benefits during serotonergic antidepressant treatment" (http://archpsyc.jamanetwork.com/article.aspx?articleid=1107437 http://archpsyc.jamanetwork.com/article.aspx?articleid=11074...)

eriksank 14y ago

It seems to be culturally dependent too and related to education as well. There seems to be less of an epidemic in the part of Asia where I live.

ekianjo 14y ago
I am not sure which part of Asia you are referring to, but in Japan there is "depression boom", at least judging by the increased amount of anti-depressants being sold.
- eshvk 14y ago
  I lived in India and the conditions could be described to be bleak enough to make the most optimistic person sad. Suicide rates there were 10x what they are in the west. I am not even sure there is enough cultural understanding and sensitivity about depression: There used to be an uproar and attempts to treat the symptoms when high school kids used to commit suicide by the dozen (typically after poor exam results). (To the other poster, depression is not the same as "being sad" and having a bunch of people around you all the time asking you whether there is something wrong is not necessarily conducive to mental health. (Just to offer a flip side to your oh, there is so much community which is why there is a lack of mental illness anecdote.))
  - khitchdee 14y ago
    Depression is having a negative outlook on life over an extended period of time that starts effecting your everyday decisions and causing you to withdraw from social situations. It's an extension of being sad. Turn it around. If you're happy most of the time, it will be difficult for a psychiatrist to classify you as being depressed.
    - eshvk 14y ago
      Sorry no offense, but you don't get depression. There are people who may have a "positive outlook" on life, appear to be happy go lucky and one fine day not be able to get out of bed due a to crippling overwhelming feeling of despair. This is not just an "extension of being sad.". You can't just shake a person who is depressed or throw a bunch of balloons or bring a bunch of relatives around this person and make them feel happy. Sometimes, a person who is depressed can't even explain why they are being depressed. Sadness doesn't work like that.

DanBC 14y ago

Already this thread has replies that are trotting out the usual "depression is just sadness" or "CBT is nonsense". The UK NHS National Institute for Health and Clinical Excellence (http://www.nice.org.uk/ http://www.nice.org.uk/) gathers evidence of cost effectiveness (using quality adjusted life years) for various treatments. They are pretty clear - CBT is excellent for mild depression; CBT and medication combined is more effective than either treatment alone for moderate to severe depression. The Cochrane Collaboration (http://www.cochrane.org/ http://www.cochrane.org/) carefully investigates all the research, judges its quality, and publishes a meta analysis. They're pretty clear that CBT is effective.

einhverfr 14y ago
It's an interesting issue. One fundamental question is what social context has to do with depression. Is it possible that depression is so rampant today because our lives are socially impoverished and that medication is in part just a way to cover up the root cause?
eshvk 14y ago
You are conflating two very different opinions/groups: One can necessarily be skeptical of CBT without believing that depression is just sadness.
- DanBC 14y ago
  That's not my intent; I'm just using one post to reply to a few different people.
Tichy 14y ago
I think if you go along that line of argumentation, it would be nice to link to actual articles and studies, rather than the homepage of some organization. Otherwise it is just a "call to authority", and we know those were never wrong in the course of history, right? For starters, what do they even measure to estimate effectiveness? Suicide rates? Happyness induced from a questionaire? Brainwaves? Hormone levels? What does effective even mean? Does it mean the patient did not induce further costs for the health industry? It could mean all sorts of things. For example chaining a patient to a bed could also be very effective in preventing suicide. So if you measure "suicides prevented", perhaps chaining people to beds is the best course of action?

alexvay 14y ago

"We Need to Have Sympathy." Period. There, I fixed it for you.

zopticity 14y ago

Depression has different stages. Sometimes it's easy to get out of depression. I'm sure we all experience it at our "low" points during different stages of our lives. From failing a startup or death of a family member. The depression that we can't get out of alone -- when we lose all hope for everyone -- that's the hardest to fight. Losing your will to live can quickly lead to suicide. And it's hard to tell from someone else's perspective that you're suicidal because you've pushed everyone away. I think the only cure to the second form of depression is to practice a healthy state of mind everyday. Enjoy life and friends that are close to someone. Always share your problems with a close person (someone you truly trust). You must have the will to live. Giving up isn't the answer to all your problems because someone else will have to inherit your problems. Which isn't fair for that someone!

DanBC 14y ago
Grief is normal. Grief is an appropriate reaction to a lifetime event. Grief normally subsides after a time; it's still there, but not overwhelming. Depression is not normal. When you still feel overwhelming grief years after the event, and it's affecting your everyday life and preventing you from functioning, then it's depression. > I think the only cure to the second form of depression is to practice a healthy state of mind everyday. I sort of agree - mindfulness and CBT techniques can be used everyday to help prevent depressive thinking.

austenallred 14y ago

Thank you, Mark, for writing this. I have lost three close friends in the past three months to depression. Their deaths were so similar it was shocking; they were all among the most brilliant people I had known, and all had been suffering from depression almost their entire lives. At the funeral of the one who was closest to me, another girl told a story of how on one day when his depression was particularly bad, he boasted in his great success for the day: Getting out of bed to brush his teeth. Bear in mind this was a kid who spoke Russian and Arabic fluently, who loved the arts, was incredible at chess, was a great musician, and took Calculus BC in 9th grade. Absolutely brilliant. He was a fighter, he was stubborn, he was young, and some say he took his own life. I prefer to say that depression took his life. Sorry for getting so personal, but I simply can't take any of the comments that say "just get over it." Depression is as real and as disabling as being paralyzed; it may not happen to everyone, but to say things like, "You need to be stronger" are no more appropriate to the depressed than they are to the paralyzed. But most of all, if any of you are reading this who have depression, keep fighting. Recognize your brain lies to you, and no matter what it says there are many people who love you and it will get better.

nnq 14y ago
> your brain lies to you Indeed, I've been saying this to myself in dozens of situations, not just depressive moods. If you actually believe it when you say it, it's like a sort of mantra that can replace any pill! ...but unfortunately people suffering from clinical depression can't get themselves into the "saying it and believing it mode".
- opminion 14y ago
  Perhaps a digested, weighted, real-world-mapped version of Wikipedia's list of cognitive biases [1] would be useful as mantra. Just the kind of thing that xkcd does with posters, actually. [1] http://en.wikipedia.org/wiki/List_of_biases_in_judgment_and_decision_making http://en.wikipedia.org/wiki/List_of_biases_in_judgment_and_...
- shahar2k 14y ago
  it's what I've told others too, it's like living behind a filter, and every thought and every idea is focused on the negative and false. and the thing is, that I've had it for so long, a decade maybe? probably was there before I even recognized what it was. but for me it comes and goes, and when it comes I've learned to see the filter, it's just harder to remember what things look like in reality. but I'm doing well, I dont have it quite as bad as some, and it goes away and I've learned to cope and figure out and get past it, but... it's never going to stop coming back, and I also know it brings back a kind of brightness and sharpness when it leaves, something I actually do enjoy. I'm sometimes dysfunctional because of it, but mostly... I'm just me, I do alright and I'd rather not change me just yet, so for now I'll deal with it, because it helps me help others.

jtchang 14y ago

If there is one thing I've learned about depression is that we suck at identifying it and we suck even more at "curing" it. I'm not a doctor. But there is a huge difference between being sad and killing yourself. There are some people who think it is just "in their head" and to "shake it off". There have been lots of diseases in our history that people thought were normal until we made some crazy discovery that what was really causing it was some previously unknown agent.

jay-pinkman 14y ago

not all cases of depression can be attributed to unbalanced brain chemistry. sometimes the chemistry is ok, it's just your life is fucked. in this case depression is a normal reaction. you just can't remain all cheerful when you're drowning in shit. i don't think taking up meds or doing other things to cover it up is a good answer to such situations. with all its negative aspects depression is also a big reminder that something is off and must be fixed, it pushes you to make drastic changes because your regular routine doesn't quite help. sometimes it pushes you to a suicide which is sad but notice how many successful people with stellar careers and shiny popular products or art had been struggling with depression when they were failing at their job, when their dreams were crumbling, and no end to this horror was in sight. maybe it's a stretch but i'd say suffering from depression at some point in life is a normal thing for a maker. sometimes difficulties that you prepared yourself to are just greatly overshadowed by the actual state of affairs. that's to say marking all cases of depression as illness that needs to be treated is a wrong way to look at the problem. in my opinion at least. what helps is support and understanding, phrases like "pull your socks up" or "go get some pills" don't.

alan_cx 14y ago
Why is this voted down? It's a valid opinion. Please tell me we don't have depression Nazis who can only accept one narrow definition of depression. What I see described here is possible how most people experience depression. Or does only extreme depression count?
- DanBC 14y ago
  Depression is a jargon term with a specific meaning, as well as an everyday word with a fuzzy less specific meaning. That causes some confusion in discussions like this. Depression covers a range of different illnesses, with different severities. Depression is not a normal reaction to a life event. When someone dies you feel grief. That grief may be severe. But grief is a normal reaction to death. If, however, the grief is overwhelming and lasts for years, and interferes with your life then it has developed into depression. Depression is an abnormal reaction to life events. There is a form of depression termed "reactive depression". Something happens, and a person doesn't have a normal negative reaction but has an abnormal extreme negative reaction and falls into depression. The main treatment for that would be to correct the thing that caused the reaction, with some CBT, and medication if needed.

fjarlq 14y ago

Professor Sapolsky at Stanford gave an interesting lecture about depression a few years ago... highly recommended: http://www.youtube.com/watch?v=NOAgplgTxfc http://www.youtube.com/watch?v=NOAgplgTxfc

paganel 14y ago
There's also this, "How To Be Alone": https://www.youtube.com/watch?v=k7X7sZzSXYs https://www.youtube.com/watch?v=k7X7sZzSXYs . It did help me a couple of times.
wiredfool 14y ago
That's a really good video -- I saw it linked in the aftermath of Aaron. It's worth the 52 minutes to watch it.

chris_wot 14y ago

Right now I am depressed. I feel terrible, and very, very guilty that I feel the way I do. I don't want to do anything, but I do want to do something to distract me away from my awful feeling of numbness. I worry about the future at times, and feel I'm at a dead end. I worry about my kids, and my wife, and my ageing parents. I'm sleeping constantly, but when I sleep my dreams are too vivid. Despite it all, I'm a functioning human being. I function at work so I use this to distract myself. It's a fairly dull job at the moment while I try to do a Computer Science degree. But I've had to defer it due to family pressures and because of this blasted funk. I intended to study in my own time, especially mathematics, but I just can't get enough motivation to do it now. I was teaching myself JPA from scratch, and was making headway, that's gone out the window. I had some ideas for an ITSM app, but that's gone too. I feel like I haven't fulfilled my goals, and a failure. I'm not a raging depressive, but a few weeks ago I couldn't stop crying. I feel like a burden so I'm trying to hide it all. It leaks out. So I sleep, and this reduces my ability to socialise. I then feel guilty, but nobody is judging me. It's life I guess. I don't write this to ask for pity, but to explain what it's like, while it's happening. If I had to summarise my mental state, it's like a piece of me has died inside. Knowing that it will go away doesn't really help the feeling, but it gives me fortitude to get to the next day. I hope this might give some insight to those who haven't felt this way before.

austenallred 14y ago
Thank you for your excellent explanation. There's no way I can comprehend what you're going through, but I have the utmost respect for you. Carry on, you're a champ.
- chris_wot 14y ago
  Thanks :-)
DanBC 14y ago
I hope you're getting some treatment.
- 14y ago

cohort 14y ago

Great talk about mental illness on TED http://www.ted.com/talks/ruby_wax_what_s_so_funny_about_mental_illness.html http://www.ted.com/talks/ruby_wax_what_s_so_funny_about_ment...

acjohnson55 14y ago

Having experienced a couple major depressive episodes, I have no desire to ever go back, and I've built myself a sort of mental fortress to hopefully withstand whatever shocks I'll experience as I keep on living. I'm fortunate in that in both of my cases, I was able to emerge and put the depression behind me. I can't imagine chronically feeling the way I did. Imagine being so emotionally hurt that it feels like physical pain, long after you were able to mentally process what initially upset you. Like a pain so chronic and awful that you're willing to do just about anything to make it stop. Imagine how frustrating it is to want to be over something and to think you are mentally past it, but the emotional side of your brain (i.e. most of it) just won't budge. And then on top of it, you feel guilty for being such a drag on people around you. And you also feel paranoid that even when you're not dumping on them, you're alienating them in some way. So you mostly just suffer in silence. It's terribly debilitating. A friend of mine who undoubtedly would be reading HN today if he were still around evidently felt this way pretty much his entire life. I don't think I would have been able to take it either.

primitur 14y ago

We need more compassion in general - not just for the outlier cases - but society in general can be a pretty mean entity. I've been thinking lately how sad it is that so many of the younger hackers in my local scene (metalab.at) are not as familiar with John Lennons' World Peace movement as they should be. That light was snuffed out, but John (and Yoko, and many, many others) were really trying hard to get a world peace movement established, that would bring more love to the world. If you turn on the TV today, you don't see much love. Most "comedies" are little more than 30-minutes-ridicule+laughtrack. In fact, remove the laugh-track from most TV shows and you have a banal hate festival. I think depression being treated poorly, in general, by society is symptomatic of a larger maladay - which is that we humans simply don't trust our neighbors. We don't communicate freely and honestly with each other. You can't smile at a stranger in Vienna, for instance, just for the sake of the happiness - there always has to be the inference of an alternative, sinister, motive. Why is that? Its because, fundamentally our cultural veigns - the mass communications networks of PR, Advertising, News, TV - don't profit from happiness and good times. They profit from the "black blood cell" of intrigue, controversy, synthesis/anti-synthesis. All we really see on TV is conflict this and that, and if there is some sort of consolation, its usually couched as "irony" or some such emotion. But what of true Peace, where people are getting along great? There is a lot of that in the world, and it goes under-reported, and just not noticed by the majority. Its possible that depression is a social disease, and is contagious. But, so is happiness. We need more overt acknolwedgement of the good times, too, in my opinion - the truly good times, real progress. The aversion of the average citizen towards sharing good news and good times needs to be overcome. We miss you, John Lennon.

marknutter 14y ago
Funny. For me, I get depressed and turned off when I see too much peace, happiness, and love crap in media. Maybe it's because I'm part of the generation who's grown skeptical of everything in media, but I definitely prefer the darker, sarcastic side of content. A John Lennon style love/peace-fest sounds like an absolute nightmare to me. No thanks.
- cbs 14y ago

LatvjuAvs 14y ago

Without death of loved one, without death of friends. Without these a lot of revelations and emotions would be locked in you forever. They spark humanity, they unite, they bring forward topics that usually no one would want to discuss. And when all your fears will be dealt with, maybe death will stop be so scary.

lhnz 14y ago

A lot of uniformed people in this thread. You can't generalise as much as you all do. You have to understand that people experience life in very different ways. I have experienced depression [0] but I can't speak for anybody else other than to say I know it's hard and keep on. The real problem with depression is that everybody wants to wash their hands of it. "There are doctors that we can pass these sick people to. The system will sort everything out. That guy's a real downer, I hope he get's help... from somebody else..." I understand that it can be a mood-ruiner and people feel ashamed of it even by association but where is the strength in ignoring things? Compassion would truly be helpful and if you can give it, give it. Go for CBT and you'll find it largely amounts to filling out forms on your mental state with tickboxes that don't really apply to you, while somebody tries to find out ways that your thinking is twisted. But you can be rational, successful, positive and still feel awful. Do you want to medicate the hell out of the high-functioning, positive guy that wants to change the world [1]? The term 'chemical imbalance' sometimes gets thrown around, and honestly it's probably wrong but there is a truth to it -- often the people that say they have a chemical imbalance are thinking quite rationally but facing terrible emotions that they know they shouldn't have to (from trauma, or an unhealthy subconscious.) [0] http://news.ycombinator.com/item?id=5096568 http://news.ycombinator.com/item?id=5096568 [1] http://www.youtube.com/watch?v=Fgh2dFngFsg http://www.youtube.com/watch?v=Fgh2dFngFsg edit; If you're going to downvote me it would be nice if you would mention why. Do you actually have experience of any of this? I'm trying to give my honest experience on this, and I'm trying to point out that a guy like Aaron Swartz doesn't really fit the neat definitions required by most treatments; and that compassion beyond telling others to 'go to a doctor' is worthwhile.

DanBC 14y ago
I didn't downvote you. > Go for CBT and you'll find it largely amounts to filling out forms on your mental state with tickboxes that don't really apply to you, while somebody tries to find out ways that your thinking is twisted. This is a poor version of CBT. Any practitioner providing CBT like this is doing it wrong. CBT is not about telling you that you are wrong or that your thinking is twisted. CBT is about exploring with you what your thinking is; what's happening to you with those thoughts; how strongly you feel those thoughts and emotions. CBT is about helping you understand why you feel the things that you feel, and why you think the things you think. There can be a bit of writing when you begin - some people find it useful to have the process down in a concrete form. There doesn't have to be writing. And checking boxes is not a good approach. Medication works for some people. But the serotonin hypothesis is controversial. > Do you want to medicate the hell out of the high-functioning, positive guy that wants to change the world (I didn't view the YouTube) Medication can have side effects, and sometimes they're not very nice. But most SSRIs don't have the kind of effects that people would describe as "medicate the hell out of".

alan_cx 14y ago

I am said to suffer depression myself, which BTW I would deny as I would say its "realism", but I really have an issue with it being described as an "illness". It seems to be that this definition is more about giving depression PR parity with actual illnesses, rather than a correct label. Its like the public will accept an "illness" as real, but a psychological issues as not real. There for making the public see depression as "illness" helps get support. See what I mean? From what I can make out, depression is a state of mind. Its a psychological thing. Ie, its a sort of loop people get themselves in to. That, to me, is not an illness. Not more so than arrogance, confidence or anger. Its an emotion. Is love an illness too? I realise that can be debated, but I don't think its helpful to redefine things for PR reasons. To me that cheapens it. I'm not saying depression is there for less valid, clearly its as debilitating as what I would think of as real "illness", if not more so, but I do roll my eyes and switch off every time I hear the word "illness" appropriated for things that aren't really "illnesses". As I say, the lack of the word illness doesn't, to me, make it less serious. To me, using that word is not necessary, it just blurs the lines and can put people off caring. It make it sound exaggerated or a bit "me too". Should add that I do understand that there are different types of depression. Perhaps using the single word depression to cover all cases is more the problem that the word "illness". I'm by no means unsympathetic, I know how it can effect people. I've seen the results of suicide. Hell, my mum's other half had to cut the bloke down while the wife screamed in the street. But I worry that re-defining things puts the general population off. No idea if these definitions are different each side of the Atlantic. Heh, no idea if its just me who thinks this either!!!

wisty 14y ago
> I am said to suffer depression myself, which BTW I would deny as I would say its "realism", but I really have an issue with it being described as an "illness". There's a difference between being cynical, and being depressed. Clinical depression crosses through to the other side, where everything seems unreasonably bad.
InclinedPlane 14y ago
This is wrong, wrong, wrong. Sometimes people get down or get "the blues" but this is something very much different from major clinical depression. Depression has many aspects but one of the most important is a chemical imbalance in the brain. It's not just a feeling or an emotion, it's a fundamental change to the way your brain works. And episodes of major depression can last for years, even decades.

will_phipps 14y ago

For anyone affected by depression or other mental health issues, like stress and anxiety, I recommend the work of John Kabat Zinn and his teachings on mindfulness. This was offered when I was still an in patient at a psychiatric unit and has had numerous beneficial effects on people I know who have struggled with serious depression and mental illness (including myself). There are mindfulness courses all over the world these days :)

goggles99 14y ago

If you took a survey, asking if they felt sympathy for those diagnosed with the mental illness of clinical depression, I am pretty sure that most would answer yes. My point is that this article is sort of worthless and whats more, the title is really irritating (because most people already have sympathy for those with depression). How about an article titled - we need to seek shelter to survive winter (most people already do). What we need to do is a lot more than feel sorry for these people. We need to take action to help them.

evgenit 14y ago

In addition to sympathy, I wish we were better at telling people close to us to go see a doctor about their depression, or mental health in general. In particular, I wish someone had told me to do so ~7 years ago; would have saved a lot of misery.

corporalagumbo 14y ago

I really disagree with the classification of depression as a mental illness... it's such a crude way to talk about what is really a spiritual and intellectual problem.

yummyfajitas 14y ago

This essay is making a logical fallacy. The implicit assumption is that if a person is in a state which falls under the category "illness" they deserve sympathy, while they might otherwise not. Unfortunately, the essay does not define it's terms, nor does address why depression specifically deserves sympathy. Near as I can tell, it's just an application of the noncentral fallacy. Overall, a pretty terrible essay. More on the noncentral fallacy: http://lesswrong.com/lw/e95/the_worst_argument_in_the_world http://lesswrong.com/lw/e95/the_worst_argument_in_the_world Noncentral fallacy specifically applied to medical conditions: http://lesswrong.com/domain/lesswrong.com/lw/2as/diseased_thinking_dissolving_questions_about/ http://lesswrong.com/domain/lesswrong.com/lw/2as/diseased_th...

chris_wot 14y ago
All I have to say is actually in the lead paragraph of the Wikipedia article: "Sympathy is an extension of empathic concern, or the perception, understanding, and reaction to the distress or need of another human being. This empathic concern is driven by a switch in viewpoint, from a personal perspective to the perspective of another group or individual who is in need. Empathy and sympathy are often used interchangeably, but the two terms have distinct origins and meanings. Empathy refers to the understanding and sharing of a specific emotional state with another person. Sympathy does not require the sharing of the same emotional state. Instead, sympathy is a concern for the well-being of another. Although sympathy may begin with empathizing with the same emotion another person is feeling, sympathy can be extended to other emotional states." http://en.wikipedia.org/w/index.php?title=Sympathy&oldid=534731942 http://en.wikipedia.org/w/index.php?title=Sympathy&oldid...

elorant 14y ago

A few years back when I quit smoking I spent two weeks with withdrawal symptoms the biggest one been depression. It hit me so harsh that I felt like I lost the earth under my feet. I’ve never felt anything similar and I can honestly say it was by far the worst period of my life. You wake up and you just don’t have the courage to do anything. Every single insecurity I had surfaced during those two weeks multiplied by ten. The odd thing is that those two weeks were the most socializing ones I’ve ever spent. I felt like I wanted to be with other people 24/7 although it didn’t make any difference to my condition. And this imho is the biggest problem with depression, there are no visible signs that someone suffers from it. So if you don’t know if someone has it how can you help them. Fortunately for me this hell lasted only a couple of weeks, until my body cope up with the lack of nicotine. I don’t know how I would manage to live with something like that for years or even decades. I have the outmost respect and sympathy for the ones living with depression. Without trying to be smart ass I have the feeling that depression is a fundamental problem of lifestyle standards. The majority of our insecurities are imposed on us by some wicked version of how life should be. So instead of enjoying the little moments of happiness we tend to believe that happiness is a constant situation which happens to be out of our grasp and thus we hammer ourselves with the inability to get there. And then you end up with a dozen insecurities and everything seems so vain.

gesman 14y ago

As part of self observation I noticed that depression starts with negative thinking. The thought can be qualified as "negative" or "positive" by the physical bodily sensation it produces. Negative thought essentially produces self-inflicted pain within the body. Consistent negative thinking produces more inner pain and at more intense levels. This inner pain in turns fuels negative thoughts pattern that continues to inflict more "emotional" pain. Then it becomes vicious cycle of "beating yourself up". At deeply depressed stages thought control no longer works and any attempts to "think yourself" out of depression are becoming futile. At these stages depression is fueled by constant intense physical/emotional pain that is constantly present seemingly without any thinking processed. The more intense the pain - the more unbearable it is - and this drives person to suicide as the last resort to stop suffering. The actual solution in this case it to guide person to look at the pain directly instead of escaping, avoiding or suppressing it with painkillers. Painkillers may be necessary to maintain sanity though through the practice. This is ancient practice talked about by pretty much every spiritual teacher - yet widely ignored. When you feel depressed - locate exact area of painful physical sensations within the body and start observing it. Watch your sensations, watch your feelings, watch them exactly where they are. Do not try to change them, do not try to kill them, just observe them. At the same time breathe and follow your breathing as well. Conscious breathing slows down incessant thinking. Direct observation of painful emotions will start dissolving them. This is very efficient practice that I personally benefited from during very intense emotional downturns and depressive states.

throwin 14y ago

I agree that depression is an illness. I also agree that we need more sympathy and help for those who suffer it, and there needs to be less stigma surrounding it. Having said that, we should not forget the victim's loved ones left behind, after his/her suicide to grieve and bury the victim. These people are victims too. Sometimes other lives are destroyed by an act of suicide. A young wife left to raise the kids alone. A mother forced to bury an only child; perhaps committed to a life of depression herself. For the record, I have had my own battles with depression. I have had days I was unable to get out of bed. I have also had suicidal thoughts. But the thought of the pain I would inflict on my family, particularly my mom, would never allow me to truly consider it an option. I don't pretend to have felt the pain that would drive one to suicide, because there are degrees and experiences differ. But it helps to know where I'm coming from. I think there needs to be more of a stigma surrounding suicide and more awareness for the pain of those that are left to grieve. If you're considering ending it all, please try to get help, and please think of the pain you will be inflicting on those you leave behind.

deleted 14y ago

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michaelochurch 14y ago

Depression is partly biological-- the tendency that way surely is-- but it's also a natural outgrowth of a society that doesn't forgive mistakes and that tests people not based on peak capability or creativity, but on breaking point. Somehow, we've conflated character and loyalty (which are important) with the willingness to suffer needlessly in the name of subordination and whatever the fuck "team player" means. The brogrammer culture and unnecessary long hours of Corporate America are all about testing people based on their decline curves, not peak performance. It's competing to suffer rather than competing to excel. Who is the first to crack? Fire him. Who is the last to break? Promote him. It's ridiculous and of course it's going to lead to an "epidemic" of mental illness. In the corporate world, we promote based on participation in shared suffering (i.e. who stays until 1:30am to meet an arbitrary deadline) rather than talent, and we kick people when they're down, which is why it's impossible for someone to get back into the career game after even a short time outside of it (maternity, illness, depression). Of course we're going to have our best people dropping like flies. Depression and anxiety disorders have always existed, but they don't need to be this common. I wouldn't be surprised to learn that at least half of the problem is caused by social and economic forces. These problems are biological at root, but social factors tend to modulate the severity that people experience. Mark Suster deserves major props for speaking out about this. I've criticized him in the past, but I'm starting to like the guy.

bocalogic 14y ago

Depression happens for many reasons. We do need to have sympathy because the depth of depression varies from person to person. Some of it can be genetic and I think it can also be copied from other people or passed on. That is why if you hang around with happy people you have a tendency to be happier. One of the things I noticed in my successful peers is that they go through a period of depression before great periods of productivity or creativity. The depths of depressions or "pullbacks" vary from person to person but most of them show that trait before periods of greatness. IMO, depression is increasing because pressure is increasing on the average individual in general. From society, to our peers, from the media, from our own competitive nature we are putting more pressure on ourselves to perform or not perform via rebelling. I am not a doctor, but I know when one of my friends or peers say they are depressed, it is taken very seriously. We all go out of our way to support that person. Life does go on. Life does change. Sometimes it is darkest before the dawn. Never give up.

rowanseymour 14y ago

Let me preface this with: I have first hand experience of depression, I don't think it's just sadness and I'm absolutely sympathetic toward those who with depression. But... My thinking about mental illness changed a lot after reading a book called Crazy Like Us [1]. It doesn't talk about depression specifically - it's a collection of case studies on how different mental illnesses have been experienced/handled/treated by different societies around the world, and how western understandings of mental illness have generally displaced existing cultural understandings, not always for the better. The major argument of the book is that the Western view of conditions such as depression as 'mental illness' has been counter-productive to attempts to de-stigmatize such conditions. The author also makes a convincing argument that it's also made recovery less likely for a lot of sufferers. And to me that makes a lot of sense. Many other cultures view emotional suffering as a normal part of human life. In the West we view it as an unnatural state. We think that by detaching the condition from the sufferer, we're de-stigmatizing it, but the sufferer ends up more stigmatized because... now they are considered mentally ill. And they have less hope of their situation improving, because we're telling them that there is something biologically wrong with them. [1] http://www.amazon.com/Crazy-Like-Us-Globalization-American/dp/1416587098/ http://www.amazon.com/Crazy-Like-Us-Globalization-American/d...

jdietrich 14y ago

Fuck this shit. We need to have sympathy. Not because we've diagnosed someone with a disease, but because they're a person. Rates of depression are skyrocketing all over the developed world and whatever we're doing clearly isn't working. Personally, I think the most obvious issue is that a group of intelligent people have simply accepted the notion that what's relevant isn't someone's life circumstances, but some vague and baseless notion of "abnormal brain chemistry". The idea of depression is a miserable cop-out, it's simply victim-blaming. We say that there is something wrong with their brains, rather than saying that there is something wrong with society. If someone is unhappy, we need to support them. It is a dismal failure of our humanity if we require the justification of medical necessity to show basic compassion. Swartz had obvious reasons to be miserable and obvious reasons to want to kill himself. We failed him, we fucked up. He didn't die of a disease, he killed himself because he quite justifiably felt that the circumstances of his life were intolerable. We didn't do enough as a community to support him and protect him. He was a young and vulnerable man, bearing the wrath of a spiteful government. It's shameful for us to even consider for a moment that there might be something wrong with Swartz's brain, when our failures to care for him are so obvious. If we need a scientific explanation for why we should care about each other, that's our problem. If we require a doctor's say-so to provide support for someone in difficulty, that's our disease.

Osmium 14y ago
> Personally, I think the most obvious issue is that a group of intelligent people have simply accepted the notion that what's relevant isn't someone's life circumstances, but some vague and baseless notion of "abnormal brain chemistry". How about people who lead objectively wonderful lives, with good jobs and happy families, but still suffer from deep depression? The problem, if any, seems to be the other way round: that some people think only people will "bad" lives can suffer from depression, and everyone else should just "get over it." That's what seems wrong to me--and if identifying "abnormal brain chemistry" as a cause of depression helps people realise that anyone can be a victim then so be it. Clearly if someone is suffering then external factors can make it so much worse, but that doesn't mean depression needs an external cause. Sometimes it just is.
- 14y ago

jetti 14y ago

While I agree that we need to be more sympathetic to those with depression, but I think it needs to extend way past just depression and on to all mental illness. Mental illnesses cause distorted thought patterns and it isn't the fault of the individual who has that mental illness, just as it isn't the fault of the Type 1 Diabetic that they have their illness. Speaking from first hand experience, it can be overwhelming and lonely to suffer from mental illness. I have to hide my thoughts from others (including my own wife) because of fear that they won't understand and that they may think of me as a monster. We have come a long way from where we used to be regarding mental illness (such as blaming poor parenting), but we still have a long ways to go.

Osmium 14y ago

The trouble with so many mental illnesses is that there's no good diagnostic test to help identify sufferers, and many go undetected or untreated until it's too late. There must be something that can be done about this. It might help those not personally affected by depression to understand its true nature better too.

TheCapn 14y ago

I live with someone who suffers from depression. The idea that it is a disease is somewhat welcoming in that it allows people to rationalize that their actions are not entirely their fault, but at the same time it almost hurts those suffering because of the complacent attitudes it breeds. Often times, before a person is known to suffer from depression people will comment on their behaviors/mannerisms as if they're abnormal. Once they realize the issue they are sympathetic but change to "they can't help it, they're depressed." In many ways this can be true, its uncontrollable at times, but for other times they need support, not sympathy. Support means helping them feel better about what ails them. It means distracting them from their worries with things you know will lift their spirits and help them see the lighter sides of things. When you can't lift their spirits you need to be there until they can move on naturally. A person suffering from depression can focus on a negative aspect of life so intently that it is damaging but as a supportive role in their life you need to look past that. Don't sympathize, be active in supporting them or get out of the way so someone willing to can.

dr_ 14y ago

Part of the problem is how doctors, and especially psychiatrists, have approached treating depression. There are many people who simply get down once in a while, in response to a particular event or series of events, the way most of us do at some point in our lives. If these people come across a psychiatrist, there's a decent chance they will end up on anti depressants when they likely just need some counseling and time. They should not be classified as depressed, maybe a transient mood disorder, but who knows if insurance would pay for that. That takes away from people who truly suffer from clinical depression, a real medical condition which should be separately classified as such. If you throw them into the basket of people who are just down once in a while, you do them a great disservice, because society then looks at them as someone who just can't deal with issues and need a crutch in the form of medications. The people with real clinical depression are the ones who are at risk of committing suicide. Psychiatrists can figure out which is which usually, not always, but instead they treat everyone the same, and as a result less time is spent on those who need it the most (unless they end up getting hospitalized)

frontfunder 14y ago

This touches home base. 2 of my friends committed suicide the past 3 years (2009, 2010), due to untreated or misdiagnosed depression and other issues. In December of 2012 my 17 y old daughter attempted suicide, for no apparent reason as per the "specialists" "opinion". Since my daughter is not with me, for the first time in my life I've experienced the true feeling of loosing someone very dear to me. It's like the Universe crushes your last breath out of you and there is nothing you can do. It's easy to judge depressed people and to brush it aside. It is very hard to understand it and know how to support it, especially when the person with depression does not want any help.

kremdela 14y ago

I have suffered from severe depression since I was young. I (think) I'm pretty smart, but have definitely held myself back from achieving things that I could have because of it. I have found this to be nearly crippling when accompanied with the rejection and difficulty of being an entrepreneur. Professionally, I have done a lot of freelance work as a result. I've held pretty good jobs for ~ 1 year, but eventually have some problem due to workload stress combined with my depression. Regrettably this has made me leave jobs in non-ideal ways. I'm looking for my next great position now, and it's tough to answer the "why did you leave this position and then go freelance last year" with "I let my depression get ahead of me and tried to kill myself." I know that it's an incredible liability to a potential employer to hire someone that might do great work for a year and then abruptly leave. I just needed to get that off my chest.

fghh45sdfhr3 14y ago

How common is it to find people who don't sympathize with depressed people? I don't care about anonymous trolls on the internet. I mean in real life? In my experience with depression, everyone sympathizes and worries and wants help the depressed person. But being a vicious brain disease, depression will make you think the people who love you actually hate you and lough at you behind your back, when at work, or even while sleeping. I have been accused of laughing at the person I love while sleeping, by her. No, it did not make me upset. I know it was the demons in hear head making her say that. I had been with her as she descended deeper and deeper and her self-hatred got worse and worse. So when I hear that we need to sympathize with depression, I think you either have no experience with depressed people, or you're trying to convince anonymous internet trolls. The later is as futile and pointless task as can be. It is better to teach and train people on ignoring the trolls.

mattmaroon 14y ago

I don't know that depression is really that stigmatized these days. It's poorly understood, even by the people studying it. But though we might argue about the merits of chemicals vs therapy, I think most people recognize it as a genuine illness that needs to be treated. Having previously been married to someone with depression issues (suicidal thoughts included) I can say it's a bitch. It's hard to know someone like that and not think of them as ill.

blots 14y ago

What if depression is the evolutionary solution to overpopulation?

SparrowOS 14y ago

I'm in a jail -- my download numbers are put there by my captors. Everything is pointless. I talk with God. Gods says... convertedst placest mountain's celestial hippy Knowing unformed over_the_top Ministry wisely comfort Gutenberg-tm serve parched -If aright heathen motion culture glory null details perverted Oh mire over-confidence ---- God says... five hundred and thirty priests' garments. 7:71 And some of the chief of the fathers gave to the treasure of the work twenty thousand drams of gold, and two thousand and two hundred pound of silver. 7:72 And that which the rest of the people gave was twenty thousand drams of gold, and two thousand pound of silver, and threescore and seven priests' garments. 7:73 So the priests, and the Levites, and the porters, and the singers, and some of the people, and the Nethinims, and all Israel, dwelt in their cities; and when the seventh month came, the children of Israel were in their cities. 8:1 And all the people gathered themselves together as one man into the street that was before the water gate; and they spake unto Ezra the scribe to bring the book of the law of Moses, which the LORD had commanded to Israel.