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Re:Ketamine’s effect bolsters a new theory of mental illness by slapshot on Friday December 18, 2015 @07:16PM (#10761938)
I am close to somebody who has been strongly affected by depression. She has, in any material respect, a perfect life. She has food, clothes, a supportive family, a great job, plenty of money, etc. There is nothing "wrong" with her life.

But she suffers off-and-on depression. Not just "I feel bad" depression. Crippling, "can't get out of bed" depression. Periodic suicidal ideation. Occasional suicide attempts.

She knows she has depression. She talks about it. And she wants to be done with it. She knows how she feels when her brain is "in balance" and how it feels when she's depressed. One of these states is much more preferable to the other.

She's tried drugs, ECT, talk therapy, etc. And, yes, she's tried ketamine. Anything that will put her back to a state where she is able to get out of bed and function, and reduce the odds of her killing herself when she's depressed.

I'm sure there are a lot of people who are depressed due to outside factors -- poverty, oppression, war, etc. But I can tell you quite certainly that there are people who have "perfect" lives who find themselves clinically depressed. And at least some of those people want to get back to a non-depressed state. This research helps them.

TL;DR: Not all people are depressed because their life sucks, nor is depression something that all people can "cure" by thinking harder or trying harder. Some people have a brain imbalance and would like to fix it so they can have a life. Literally.

Re:Ketamine’s effect bolsters a new theory of mental illness by tachyonbeam on Friday December 18, 2015 @08:08PM (#10762114)
I fully agree.

I dated for 5 years a woman in the same situation as what you describe. She has money, friends, family, a roof over her head. She hasn't suffered childhood trauma or anything abnormal, but she's consistently depressed and lethargic.

I'm bipolar myself. I've been through some difficult things, but my condition makes me acutely aware of how subjective human emotions are. How much of our thinking is influenced my neurochemistry rather than rational thoughts or memories. I'm pretty stable these days, but I've had times where I would just wake up in the morning and feel happy to be alive. Energized, stress-free, and confident in my abilities. The next day, I wake up depressed and I feel like my life is shit, not worth living. A few days later I feel fine again. No major life events, no major causes of stress, just my neurochemistry being unpredictable.

I think that the overinsistence in some circles on past trauma causing mental illness is harmful. There is definitely such a thing as genetic predispositions. Some depression and mental illness just does not have a cause you can point to. It's not all about overcoming negative experiences and willing yourself out of it. Genetic defects can cause all sorts of physical problems, just think of psoriasis, asthma, acne and peanut allergies. I'm not sure why people think that the brain can't have such issues. Believe me, people with peanut allergies won't overcome that through psychotherapy and confronting their mommy issues.

Re:Ketamine’s effect bolsters a new theory of mental illness by tomhoward on Friday December 18, 2015 @08:10PM (#10762120)
I empathise with your friend's plight, and her exasperating struggle to get well. I've been similar in terms of having a life that others would consider pretty darn good but where you find yourself depressed to the point of being largely unable to function, no matter what treatment you try. I get it, it's profoundly awful, and the world needs to to better at dealing with it, and that has become somewhat of a calling for me now that my own mental health is improving.

But all my research and experiences support the notion that both one's experiences and one's emotional reactions to those experiences are crucial. This is why you can have some people living seemingly perfect lives and winding up depressed, and others living through war and oppression and coming out fine.

In your friend's case, the environmental factors could be: (1) pressure from outsiders to "keep up appearances", (2) the negative messages and images that proliferate through the media of war, poverty, murder, terrorism, climate change etc, (3) a world that offers so many options of how to live but little consistent guidance about what is best, (4) living in a society that can still be very difficult for women, due to career challenges, threat of abuse, paternalistic attitudes etc.

These are just hypothetical of course, given that I don't know her.

And for her to be crippled by depression in response to these or other stimuli would be as much to do with a difference in the way she responds to such things vs the "average" person.

But it may not even be unhealthy. Maybe her true calling is to work as a humanitarian helping the needy rather than doing what she's been trying to do, and her depression is her mind's way of making her realise she needs to make that kind of change.

Having gone through this process in myself and with others, when you dig deep enough, something like this always turns out to be there.

But my main point is that the mind does not and cannot function independently of a person's environment, and paths to mental wellness that really work (and they do exist), involve addressing both one's inner reactions to things and one'e outer environment.

Re:Ketamine’s effect bolsters a new theory of mental illness by spangry on Friday December 18, 2015 @10:17PM (#10762457)
I'm very much in this category of depression. I have what is unfortunately termed 'melancholic depression'. I should note that I'm very sceptical of the DSM 'disease model' of mental illness, and am glad to see psychiatry and neuroscience beginning to converge. 'Discrete disease' is a poor abstraction for most mental illnesses. A better term for my kind of depression would be 'endogenous depression' (i.e. depression that comes from within). I have an objectively good life: I have a family that loves me, friends that care about me, and a job that I enjoy with colleagues I respect.

Yet I still have episodes where I sometimes can't get out of bed, or can't bring myself to leave the house. A couple of months ago I spent three days just sitting (and occasionally sleeping) in a chair, not even getting up to eat or shower. I just simply couldn't do it.

While it's true that people can experience temporary depressive episodes due to 'exogenous' factors (e.g. the death of a loved one), it is very different to 'endogenous' depression, and requires different types of treatment. While talk therapy and time can be very helpful for people to work through difficult and temporary 'adverse circumstances', it is of little help for endogenous/biological depression.

No amount of 'talk therapy' can convince my pre-frontal cortex to operate within 'normal' parameters or to get my brain to produce appropriate quantities of neurotransmitters like serotonin, dopamine and noradrenaline. I'm reasonably sure this is a chronic illness that I will never be rid of (as I've learned from 15 years of failed treatment attempts). On the upside, there's a good chance that there is some treatment out there, coupled with sustained lifestyle changes, that will allow me to stave off the symptoms so that I can live a relatively 'normal' life. In some ways it's similar to how type 1 diabetics can survive and live normal lives with regular injections of insulin.

Re:Ketamine’s effect bolsters a new theory of mental illness by Abraln on Saturday December 19, 2015 @01:36AM (#10762860)
It does get pretty tiring explaining the difference between them. Mine is definitely biologically based, although stress exacerbates it like it does many other things like acne. My "eureka" moment came in high school (when brain chemistry changes from puberty can cause such issues). I was at home playing video games online with friends when I noticed my vision was blurry. I went to the bathroom and saw tears streaming down my face, which baffled me as my conscious thoughts were in no way sad/negative at the time. There was just an underlying feeling of heartache. Over the next 4-5 years I worked with a professional and finally managed to find a drug combo that balances me out. I still get sad, but only for logical reasons, and only as much as I used to before my symptoms developed. It has been a full year for me now without any "episodes", something I had not thought possible previously. I just figured I would share this in case someone else might benefit from reading it.
Re:Ketamine’s effect bolsters a new theory of mental illness by cpncrunch on Saturday December 19, 2015 @11:17AM (#10763927)
A lot of the time with depression there is no logical "reason" for it, and no negative thoughts at the time. For example:

- running multiple ultramarathons with too little rest can cause depression, even if you love it. - working very hard in a job you like with too little sleep for a long time can cause depression.

In both cases it's likely your brain it just telling you that you're pushing too hard.

Some people -- like me -- find it easier to get into these mental overdrive situations, and some people might be more likely to suffer depression from the same stressors, but ultimately it seems to be the same factors at work.

Re:Ketamine’s effect bolsters a new theory of mental illness by curun1r on Saturday December 19, 2015 @04:19PM (#10764900)
Your description sounds pretty similar to my condition. I've tried SSRIs and they, to some extent, worked. But while they allowed me to reliably function, they caused a numbness in all non-physical sensations that made life seem meaningless, so I stopped taking them. What has worked a bit lately has been meditation. I'm starting to believe that my depression is caused by my mind not switching off properly and meditation is a sort of off switch. The nice part about meditation is there's really no down side and you don't really have to summon the energy to do it. If you're catatonic in a chair, just start focusing on your breath and trying to clear your mind of other thoughts.

I don't want to be preachy...one thing I've come to realize from many online discussions with other people suffering from depression is that almost every case is unique in some way and that the mental health community's efforts to try to group together what we're feeling into a single problem with prescribed courses of treatment is probably counterproductive. People believe that because they've experienced depression, either first- or second-hand, that they understand what all depression is like...astazangasta's comment is an example of this.

I try not to be one of those people, so what I'm offering is a suggestion, not an answer. My depression is by no means fixed, but meditation has helped me. It's one datapoint in case you want to try it.

Re:Ketamine’s effect bolsters a new theory of mental illness by cpncrunch on Friday December 18, 2015 @11:21PM (#10762608)
If you don't mind me asking, is there anything you can identify in the days/weeks before you become depressed, such as working long hours for a long period, boring work, excessive negative emotions, etc.

It's not that I don't believe your depression is endogenous, I'm just curious. I was in a similar position to you until I looked closely at my life and identified the factors that were causing my depression/CFS.

Re:Ketamine’s effect bolsters a new theory of mental illness by emmelaich on Saturday December 19, 2015 @12:30AM (#10762754)
I agree mostly, but how do you know for sure that there is some stress or thought there which is perhaps unacknowledged?

I think that someone can be affected by somethings in their earlier life that can affect them forever. I'm not talk about repressed memories, I'm talking about the lack of positively formative experiences at critical moments of their life.

Example - what happens when say someone starts school or is a teenager at the same time their mother is undergoing menopause and their father has lost their job and they're both starting to drink? The child will feel a lack of something but not sure what. If they do think of it all, they'll think of it as partly their fault.

Re:Ketamine’s effect bolsters a new theory of mental illness by kstenerud on Saturday December 19, 2015 @02:29PM (#10764546)
How do you know for sure that it's not something in the water?

How can you be sure it's not WiFi radio waves messing with her brain?

Can you really rule out space aliens trying to stop her from reaching her potential?

There's a reason we use the scientific method.

Re:Ketamine’s effect bolsters a new theory of mental illness by emmelaich on Sunday December 20, 2015 @06:10AM (#10766742)
How do you control for those things? Do you believe those things are equally likely? Part of the scientific method is attempting to be aware of you don't know.
Re:Ketamine’s effect bolsters a new theory of mental illness by tedks on Saturday December 19, 2015 @02:34AM (#10762962)
> She has, in any material respect, a perfect life. She has food, clothes, a supportive family, a great job, plenty of money, etc. There is nothing "wrong" with her life.

Could it possibly be that there is more to life than these things?

Re:Ketamine’s effect bolsters a new theory of mental illness by TeMPOraL on Saturday December 19, 2015 @08:13AM (#10763473)
Could be, but those things are the basics; lack of them is a cause of misery for people in today's society. Depression is something that makes you miserable even if all objective factors about your life are stable and comfortable.
Re:Ketamine’s effect bolsters a new theory of mental illness by tedks on Saturday December 19, 2015 @04:14PM (#10764866)
>Depression is something that makes you miserable even if all objective factors about your life are stable and comfortable.

...could it be that there is more to life than these "objective factors"?

Re:Ketamine’s effect bolsters a new theory of mental illness by TeMPOraL on Saturday December 19, 2015 @06:41PM (#10765370)
Could be, but if you can figure out what exactly it is and how to package it nicely, then you'll become a billionaire overnight.
Re:Ketamine’s effect bolsters a new theory of mental illness by tedks on Saturday December 19, 2015 @06:56PM (#10765424)
Could it perhaps be that there are things people need that can't be bought?

Hacker news is pretty depressing.