5 ms·

What I'm about to say isn't to deny that inflammation might trigger or contribute to depression. In fact, anyone who thinks depressed people are just self-indu

What I'm about to say isn't to deny that inflammation might trigger or contribute to depression. In fact, anyone who thinks depressed people are just self-indulgent whiners and that there is no biochemical basis for depression are simply living in the 1950s. My wife has clinical depression. To describe depression, as this article does, as just not wanting to get off the couch is hugely insulting to people with clinical depression. My wife isn't alone in wishing that there was another word for "depression" of the sort arises because your team lost, your dog died, you got passed over for a promotion. Those are disappointing and can be a problem in the short term. Clinical depression is not just not wanting to get off the couch. It is a profound loss of hope, and the inability to even connect with your previous mental state of what it was like to have hope or find things interesting. The present appears fucked, and even after racking your brain for some way out, every path looks even more dismal. Situations in the real world are often complicated and can be interpreted in more than one way, but to a depressed person, the most terrible interpretation is evaluated as being a very likely outcome. And, just like 9/11 conspiracy theorists construct self-consistent theories by bending facts and through selective filtering, clinically depressed people often build an elaborate, self-consistent understanding that, yes, they and their future are completely fucked.

WalterSear 12y ago
And even when things are going well, there's no way to feel happiness.
JohnBooty 12y ago
My wife isn't alone in wishing that there was another word for "depression" of the sort arises because your team lost, your dog died, you got passed over for a promotion. Those are disappointing and can be a problem in the short term. FWIW, depression resulting from those sorts of events is typically termed "situational depression." Regarding everything else you said: totally on board. And I wish you and your wife lots of strength and luck.
erikpukinskis 12y ago
I'm someone who has ranged from what I would call mild to moderate depression. I've had periods approaching year-scale where I found no particular joy and struggled to find any hope. I immersed myself in reading and work, and lived a difficult, one-dimensional life. I have no idea how that compares to your wife's experience. I'm not particularly interested in drawing comparisons. I would like to ask you: why does your wife need a different word? Why not just say one bout of depression is more severe and one is more mild? To me it's the same as autism or cancer or any other sickness. Sometimes it's a challenge, and sometimes it's a wrecking ball through your life. What's inadequate about using an adjective for that?
- tjradcliffe 12y ago
  The need for a different word comes from a bit of linguistic trickery we tend to perform. Because we tend to think of people with "depression" as being "depressed", we are apt to ask questions, like, "What do you have depression about?" This question makes no more sense than "What do you have cancer about?" (thanks to Stephen Fry for the comparison) but because it does make sense to ask, "What are you depressed about?" it can be difficult to explain this to people. Physiologically, it isn't at all clear that "depression" and "being depressed" are species of the same genus. The latter is a transient, perfectly healthy, emotional state. The former is a persistent, unhealthy neuro-physical state. So having less similar words for things of a different kind that are often confused would be a good thing.
  - HCIdivision17 12y ago
    Just for those curious about the Fry quote, I think it might originate from his blog, himself quoting Alastair Campbell. At the very least there's a nice reference to it, and I'm happily crawling along the links enjoying it. http://www.stephenfry.com/2013/06/24/only-the-lonely/ http://www.stephenfry.com/2013/06/24/only-the-lonely/ http://www.alastaircampbell.org/blog/2013/06/10/response-to-stephen-fry-suicide-interview-shows-attitudes-are-slowly-changing/ http://www.alastaircampbell.org/blog/2013/06/10/response-to-...
  - andrewflnr 12y ago
mrec 12y ago
> clinically depressed people often build an elaborate, self-consistent understanding that, yes, they and their future are completely fucked Which reinforces the apathy and anhedonia, which (assuming you're aware of them) just feed back into the mental model. Obvious vicious circle is obvious, but still vicious.
coldtea 12y ago
>What I'm about to say isn't to deny that inflammation might trigger or contribute to depression. In fact, anyone who thinks depressed people are just self-indulgent whiners and that there is no biochemical basis for depression are simply living in the 1950s. Well, there's also us, who don't believe "depressed people are just self-indulgent whiners" but don't believe depression is just a "biochemical distrubance" either. Rather, it's a byproduct of a seriously messed up world/society/personal relations landscape, that depressed individuals are more sensitive to or have felt more deeply. (This is not the same as "situational depression" -- I'm talking about the real deal, where still the causes can be numerous and not known to the sufferer at a conscious level). (I find the whole "it's all just bio-chemistry" idea akin to reductionistic scientism. It's inherent in the prevalent attittude to not attempt to go beyond that level and question "why the inbalance", except in mechanistic terms).
- SamReidHughes 12y ago
  > Rather, it's a byproduct of a seriously messed up world/society/personal relations landscape, that depressed individuals are more sensitive to or have felt more deeply. You can proclaim whatever you want, that don't make it true.
  - coldtea 12y ago
    Sure. Doesn't make it false either. For starters, a lot of modern "science" is hastily written papers for research grants or keeping the researcher up there, the majority of which doesn't even hold in a second examination (this was shown in several meta-reviews, including in biology/medicine, e.g.: http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.0020124 http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fj... ). I'm not for reductionism when it comes to complex emergent phenomena like our sense of self and feelings. Especially when things like "depression" (or ADD etc) are not atemporal facts of life, but change with the decades and with interpretation. Starting with a specific epistemology it's easy to interpret anything in a certain way. Those who've followed 19th and 20th century medicine have seen so many bullshit fads and theories that were debunked later. Even being gay was a medical issue, not many decades ago. No reason to believe "it's really different this time". Some people treat science like some neutral agent -- as if interests, stupidity, fads and ideology don't play any role in shaping it (they have the idea that the "scientific methodology" sorts everything out). They probably just want a substitute for religion, an authoritative source of knowledge.
sambe 12y ago
I agree that depression is an overused word and wish your wife the best. However, the article absolutely does not say that depression is "just not wanting to get off the couch". It specifically states that this is referred to as sickness behaviour, not depression, and the very next paragraph contrasts them as distinct but superficially similar.
chazu 12y ago
Thank you for posting this. As someone who has dealt with crippling Major Depressive Disorder for over half of my 30 years so far, and who would not be alive without SSRIs, these kinds of misunderstandings on the topic of depression are gravely insulting.
bertil 12y ago
> My wife isn't alone in wishing that there was another word for "depression" of the sort You won't be understood (my girlfriend is a psychiatrist, so I can guaranteed it's never used medically) but 'acedia' is a lost Latin word that corresponds well: it was the original word for the cardinal sin now known as Sloth, and was described as a profound and dark disease of the soul. How the sin changed is a fascinating piece of spiritual and theological history -- shifting the definition of sins from things that hurt you to things you can do something about. Now that clinical depression is something that offers potential treatment options, that debate might re-enter the rarefied spheres of moral debates.

WalterSear 12y ago

And even when things are going well, there's no way to feel happiness.

JohnBooty 12y ago

My wife isn't alone in wishing that there was another word for "depression" of the sort arises because your team lost, your dog died, you got passed over for a promotion. Those are disappointing and can be a problem in the short term. FWIW, depression resulting from those sorts of events is typically termed "situational depression." Regarding everything else you said: totally on board. And I wish you and your wife lots of strength and luck.

erikpukinskis 12y ago

I'm someone who has ranged from what I would call mild to moderate depression. I've had periods approaching year-scale where I found no particular joy and struggled to find any hope. I immersed myself in reading and work, and lived a difficult, one-dimensional life. I have no idea how that compares to your wife's experience. I'm not particularly interested in drawing comparisons. I would like to ask you: why does your wife need a different word? Why not just say one bout of depression is more severe and one is more mild? To me it's the same as autism or cancer or any other sickness. Sometimes it's a challenge, and sometimes it's a wrecking ball through your life. What's inadequate about using an adjective for that?

tjradcliffe 12y ago
The need for a different word comes from a bit of linguistic trickery we tend to perform. Because we tend to think of people with "depression" as being "depressed", we are apt to ask questions, like, "What do you have depression about?" This question makes no more sense than "What do you have cancer about?" (thanks to Stephen Fry for the comparison) but because it does make sense to ask, "What are you depressed about?" it can be difficult to explain this to people. Physiologically, it isn't at all clear that "depression" and "being depressed" are species of the same genus. The latter is a transient, perfectly healthy, emotional state. The former is a persistent, unhealthy neuro-physical state. So having less similar words for things of a different kind that are often confused would be a good thing.
- HCIdivision17 12y ago
  Just for those curious about the Fry quote, I think it might originate from his blog, himself quoting Alastair Campbell. At the very least there's a nice reference to it, and I'm happily crawling along the links enjoying it. http://www.stephenfry.com/2013/06/24/only-the-lonely/ http://www.stephenfry.com/2013/06/24/only-the-lonely/ http://www.alastaircampbell.org/blog/2013/06/10/response-to-stephen-fry-suicide-interview-shows-attitudes-are-slowly-changing/ http://www.alastaircampbell.org/blog/2013/06/10/response-to-...
- andrewflnr 12y ago

mrec 12y ago

> clinically depressed people often build an elaborate, self-consistent understanding that, yes, they and their future are completely fucked Which reinforces the apathy and anhedonia, which (assuming you're aware of them) just feed back into the mental model. Obvious vicious circle is obvious, but still vicious.

coldtea 12y ago

>What I'm about to say isn't to deny that inflammation might trigger or contribute to depression. In fact, anyone who thinks depressed people are just self-indulgent whiners and that there is no biochemical basis for depression are simply living in the 1950s. Well, there's also us, who don't believe "depressed people are just self-indulgent whiners" but don't believe depression is just a "biochemical distrubance" either. Rather, it's a byproduct of a seriously messed up world/society/personal relations landscape, that depressed individuals are more sensitive to or have felt more deeply. (This is not the same as "situational depression" -- I'm talking about the real deal, where still the causes can be numerous and not known to the sufferer at a conscious level). (I find the whole "it's all just bio-chemistry" idea akin to reductionistic scientism. It's inherent in the prevalent attittude to not attempt to go beyond that level and question "why the inbalance", except in mechanistic terms).

SamReidHughes 12y ago
> Rather, it's a byproduct of a seriously messed up world/society/personal relations landscape, that depressed individuals are more sensitive to or have felt more deeply. You can proclaim whatever you want, that don't make it true.
- coldtea 12y ago
  Sure. Doesn't make it false either. For starters, a lot of modern "science" is hastily written papers for research grants or keeping the researcher up there, the majority of which doesn't even hold in a second examination (this was shown in several meta-reviews, including in biology/medicine, e.g.: http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.0020124 http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fj... ). I'm not for reductionism when it comes to complex emergent phenomena like our sense of self and feelings. Especially when things like "depression" (or ADD etc) are not atemporal facts of life, but change with the decades and with interpretation. Starting with a specific epistemology it's easy to interpret anything in a certain way. Those who've followed 19th and 20th century medicine have seen so many bullshit fads and theories that were debunked later. Even being gay was a medical issue, not many decades ago. No reason to believe "it's really different this time". Some people treat science like some neutral agent -- as if interests, stupidity, fads and ideology don't play any role in shaping it (they have the idea that the "scientific methodology" sorts everything out). They probably just want a substitute for religion, an authoritative source of knowledge.

sambe 12y ago

I agree that depression is an overused word and wish your wife the best. However, the article absolutely does not say that depression is "just not wanting to get off the couch". It specifically states that this is referred to as sickness behaviour, not depression, and the very next paragraph contrasts them as distinct but superficially similar.

chazu 12y ago

Thank you for posting this. As someone who has dealt with crippling Major Depressive Disorder for over half of my 30 years so far, and who would not be alive without SSRIs, these kinds of misunderstandings on the topic of depression are gravely insulting.

bertil 12y ago

> My wife isn't alone in wishing that there was another word for "depression" of the sort You won't be understood (my girlfriend is a psychiatrist, so I can guaranteed it's never used medically) but 'acedia' is a lost Latin word that corresponds well: it was the original word for the cardinal sin now known as Sloth, and was described as a profound and dark disease of the soul. How the sin changed is a fascinating piece of spiritual and theological history -- shifting the definition of sins from things that hurt you to things you can do something about. Now that clinical depression is something that offers potential treatment options, that debate might re-enter the rarefied spheres of moral debates.