The main reason for this is that it's fallacious to think that your emotions are "completely independent of your life circumstances". They're symbiotic.

I was born into modest privilege and had an upbringing that was free of abuse or major trauma, and the only things that have gone severely wrong for me in life have been through my own poor decisions.

Yet I can now easily see how the depression I've experienced was due to a combination of living in a somewhat unhealthy environment and having a propensity to respond to that environment by becoming depressed and fatigued. I can now see the same applies to everyone else I know of who experiences depression.

The explanation you've given is embraced by mental health professionals as it allows them to justify attempting to cure it with pharmaceuticals and short therapy consultations, but as the data shows, that approach has a pretty low success rate.

I also agree with your point about "people reacting to things with the wrong emotions or the wrong intensity of emotion"; understanding and addressing this has been fundamental to my own recovery.

What I'm disputing is the notion that there is a clear-cut distinction between "exogenous" and "endogenous" depression, and that one is "totally unrelated" to the other. Nothing in biology - or in and truly complex system - works like that.

That said, I'm not presuming to be able to change your mind, but more pointing out that the premise your position relies on - that one's environment and one's emotional response to their environment are completely independent - is neither an undisputed scientific fact nor true in my own experience or anyone else I've observed.

While I agree that neither exist in complete isolation, it still doesn't preclude one from being the dominant cause.

Moreover, not many people would advance the same argument in regards to conditions such as schizophrenia or bipolar disorder—how clinical depression is somehow special and not deserving of the same [endogenous] understanding is beyond me.

Well the argument I was responding to was that the two are completely unrelated, so if you accept that they're not, we're mostly on the same page.

The question then is how common it is for one to be overwhelmingly dominant.

From my experiences and research, I'd suggest that like most other biological phenomena, it fits a Gaussian distribution, in which for the majority of people it would be within 75/25 in either direction.

Moreover, not many people would advance the same argument in regards to conditions such as schizophrenia or bipolar disorder

This may be where I lose you completely, but I would make the same argument for those conditions.

It's common for the manifestations of those illnesses to be triggered by an acute trauma or prolonged exposure to abuse. But of course the innate propensity to develop that condition had to be there too.

In my own experience, I exhibited bipolar tendencies years ago (as strongly as others I know who were formally diagnosed with it). Since changing both my environment and my emotional tendencies, I no longer do.

Others with schizophrenia report becoming symptom-free by following a similar approach.

I'd contend that the whole reason mainstream medicine continues to be so hit-and-miss when it comes to treating mental "illness" is that it continues to resist viewing it in this way.

While I'm not disputing that emotional techniques can be beneficial, my main point was that in certain cases, the cause of the condition is probably the result of overwhelmingly dominant biochemical or physiological factors.

Meta-analysis has shown that approximately 80% of all cases of depression are initially caused by a major life stress (1). So "exogenous" factors seem to play a large role in triggering most depression. That said, not everyone develops depression following a major life stress - people have different levels of "endogenous" stress resilience/susceptibility. "Endogenous" stress resilience can be modulated, however, by "exogenous" interventions. For example, resilience can be increased by behavioral stress inoculation or even exercise, and it can be decreased by things like sleep deprivation or illness. It can also be partially inherited (i.e., if someone's parents were "exogenously" stressed, the offspring can inherit lower levels of stress resilience through "endogenous" epigenetic changes) (2).

And though 80% of initial depressive episodes may be triggered by stress, this tight correlation between stress and depression does not persist as strongly after the first depressive episode. Essentially, once someone has been depressed a first time, they are then "endogenously" more susceptible to subsequent episodes of depression.

So, is it exogenous or endogenous? Long story short, in most cases, it's both. Even if it doesn't start as both, it becomes both. And both "exogenous" and "endogenous" contributing factors interact in an on-going dynamic process.

1. http://hammenlab.psych.ucla.edu/pubs/05stressand.pdf 2. http://www.ncbi.nlm.nih.gov/pubmed/26410355

My own view is that depression is an evolved response to negative stresses and situations, and that clinical depression is the far end of this scale. Depression is therefore your brain's way of telling you that you need get out of a bad situation. Schizophrenia seems to be akin to a flaw resulting from some evolutionary aspect of the brain's operation, perhaps due to creativity/intelligence.

How do you reconcile this with cases of clinical depression where the person's life is otherwise fantastic, and yet they suffer from crippling depression anyways—absent any negative stresses or situations?

I think the mistake here is to assume that a privileged life is a good life.

All the comments here that say things like "they had plenty of money, good looks, great career etc but were crippled by depression" make that mistake.

If there's biological factors working against a person harder than any emotional/environmental/life changes can correct for, then those techniques are ultimately rendered inadequate.

The biological factors are symbiotic with the environmental factors. One does not function in isolation from the other. If your biology is preventing you from enjoying your supposedly "good" life, you don't really have a good life at all. Depression is one way in which the mind signals that.

The way to have a life that is actually good is to bring your environment and your biology into balance.

Such techniques exist and are highly effective for people who are fortunate enough to be able to discover and adopt them (of whom I'm one).

That they're not widely accepted in the mainstream doesn't diminish from their existence or their effectiveness.

As I've said earlier, I understand your point of view as it's one I held for a long time.

Since I learned the way of thinking about it that I've been arguing here, I've been able to take meaningful action that has allowed me to overcome depression and build a life that is actually good rather than just appearing good (both to outsiders and to my delusional self).

Anyway, I won't be responding further; you've made your point well, I've made mine and I hope my comments have helped you to clarify your own thinking, as yours have mine. Thank you for the discussion, it's an important issue that I appreciate people making the effort to engage in.

Agreed. To note I had originally phrased it as an "otherwise fantastic life" but it kind of turned into a semantics argument.

>The way to have a life that is actually good is to bring your environment and your biology into balance.

My position wasn't that environmental or emotional techniques are ineffective, just that sometimes they're inadequate in face of overwhelming biological factors, necessitating biological intervention as well. But hey—I think we're finally in agreement.

>Since I learned the way of thinking about it that I've been arguing here, I've been able to take meaningful action ...

That's great. Please don't take what I said as an indictment or assault against what works for you, I certainly didn't mean it that way.

>Anyway, I won't be responding further; you've made your point well, I've made mine and I hope my comments have helped you to clarify your own thinking, as yours have mine. Thank you for the discussion, it's an important issue that I appreciate people making the effort to engage in.

Likewise. Have a good one. :)

https://news.ycombinator.com/item?id=10761938

Perhaps they can provide some insight as to how.

I was in similar denial at the beginning, until I realised that these factors are important.

I'm certainly open to the possibility that depression might be possible for someone with a fantastic life, but from what I've seen that doesn't correspond with the experiences of myself and friends/family who have experienced it.