> Often the individual suffering is fundamentally unaware of their own circumstances. I didn't realize how messed up my family relationships were growing up until much later. There are various reasons for this unawareness, but I believe the depression/anxiety are there to force our conscious self and the people around us to acknowledge that something is wrong.
If a situation is causing no problems outside of depression/anxiety, and you took away the depression/anxiety mechanism, there would be nothing wrong with it.
If there are other problems, then piling depression on top makes it harder to fix.
A lot of medical conditions cause chronic pain. The pain helpfully signals "something is wrong" once, and then keeps unhelpfully reminding over and over. You want to treat the pain itself in that situation. Sometimes the pain is the only thing you need to treat at all.
Being an indicator of other problems does not make chronic pain useful. Depression is similarly crippling and unhelpful.
I've often held that the most insidious part about clinical depression is its self-reinforcing nature. Deep clinical depression is throwing a person into a deep hole with thorns sticking out of the sides- every attempt to climb out of said hole results in swollen cuts and pain to the arms and body, rendering eventual escape more difficult with each struggle.
Eventually, it becomes like trying to climb out of said hole with no arms at all. It's one of my life goals to discover biochemical methods to help such people regain the use of their arms, or even essentially grow new ones.
I find articles like this one useful ONLY* insofar as they assist those who have gained use of their arms and cut away the brambles on the walls of the pit- for most others, it merely ends up encouraging more struggling, self-recriminations, and effectually a deepening of the hole. :(
Sure, they're addictive, but the "opium cure" was used up until the 1950's[1] and it's not like society was overrun by addicts. (I admit it's possible that the circumstances have changed, but I'd need to hear an argument for that.) Plus the fact that both Buprenorphine and Heroin-Assisted Treatment have been successful... opiates can be given as controlled medicine, and I feel like many people could benefit from them.
Over 40,000 Americans die by their own hand every year.[2] I would much rather have 40,000 opioid-dependent living people if it helped them bear the weight.
In my experience (as an anaesthesiologist), people who use opioids as a response to non-pain problems are some of the most miserable people there are. It might work for a couple of weeks, but soon you're tolerant, addicted, intermittently withdrawing and your life becomes a wreck. "The prevalence of suicide attempts among opioid addicts is reported to lie between 8% and 17%, with some studies reporting an even higher rate among special groups of addicts. " http://www.ncbi.nlm.nih.gov/pubmed/9018906
Using MDMA might be useful as it is non-addictive, but again habitual use leads to decreasing benefits and increasing problems.
Are you familiar with studies using NMDA receptor antagonists to reduce opiate tolerance?
For example, here's a study they did on mice: http://www.ncbi.nlm.nih.gov/pubmed/10763858
Also, don't you think your sample is biased as a doctor? As in: the people you're likely to encounter in your line of work are those that are in need of medical care?
In the same vein (no pun intended) I've been looking for stats but not being able to find anything about what percentage of prescription opioid overdoses occur while the patient is being actively prescribed, versus those which occur when the patient is obtaining the drugs illegally once their prescription has been cut off because doctors are afraid they'll become addicted.
Think of all those folks with back pain. Back pain is complex and difficult to treat, but huge components come from 1) the stupid chairs we sit in 2) at our stupid jobs that encourage hours of sitting 3) in our cities that discourage biking or walking to work, all in the context of 4) a food system that gives us crap to eat that makes us mildly addicted to sugar and salt and makes us unhealthy.
So the real cure for back pain for a lot of people is to go back 20 years in time, make a commitment to taking care of their physical selves, aligning their eating, transportation, work, and recreation with health. The second-best cure is physical therapy. Physical therapy right now! But that costs money and time and no one believes it works (it does!!!) so the pain med is seen as the proximate best answer.
Brings us back to the original original post, actually.
Well it seems they are right, if people will move to an illegal substance right after they get cut from it
People need rapid access to pain management clinics, with weight loss and strength building exercise, and access to meds (which in long term pain are often not opioids).
Giving those people opioids increases their risk of accidental death, and suicide. It gives them an addiction. But worse it does not treat their pain - they will still have the pain.
You seem to think pain control is opioids or nothing, and that's not true. There are a range of meds that should be used before opioids are tried. You also seem to think that pain control is only medication, and that's not true either. Exercise is a powerful intervention that can cure some long term pain (especially long term lower back pain). This strength building exercise is really important for older people too.
Opioids really don't work for long term pain. People develop a tolerance, which means they need to take more to get the same effect, but that means they end up taking dangerous quantities, and not getting pain relief.
Here's a Pubic Health England project to support prescribing of opioids: https://www.rcoa.ac.uk/faculty-of-pain-medicine/opioids-awar...
> 1. Opioids are very good analgesics for acute pain and for pain at the end of life but there is little evidence that they are helpful for long term pain.
> 2. A small proportion of people may obtain good pain relief with opioids in the long-term if the dose can be kept low and especially if their use is intermittent (however it is difficult to identify these people at the point of opioid initiation)
> 3. The risk of harm increases substantially at doses above an oral morphine equivalent of 120mg/day, but there is not increased benefit.
> 4. If a patient is using opioids but is still in pain, the opioids are not effective and should be discontinued, even if no other treatment is available.
Here's a BBC Radio programme about health. They visit a pain management clinic. People who visit that clinic usually have to detox from their opioid addiction before they can start the pain management work. This is because opioids really are not suitable for long term pain, and other meds / interventions should be used. http://www.bbc.co.uk/programmes/b04wv052
Here's a physician on HN talking about why opiates are not suitable for long term pain: https://news.ycombinator.com/item?id=10285321
Does that mean it would work for everyone? No. But no doctor told me to go run. they either gave me medicine A or B or C, and changed doses to try and minimize side effects. It's terrible but I understand. I can't go to an overweight depressed friend and tell him he needs to fix his life not take drugs for his bad back.
Someone who isn't addicted to highly addictive substances doesn't engage in risky behavior, disregarding consequences and their well-being, by seeking out undosed, more potent and potentially adulterated highly addictive street drugs.
Maybe their doctor has a valid concern. Opioids are rarely an effective treatment for non-cancer and chronic pain if taken regularly for a variety of reasons.
Ideally, if a doctor is going to stop refilling a prescription of an opioid addicted patient, they should be referred to appropriate services. Detoxification, pain management and mental health specialists should be all be involved for the patient's well-being. The patient should never be cut off cold-turkey like that.
(I'm so not willing to commit to that position, but I mean, just looking at only those facts you've popped in right there, it sure looks like a possibility, no real harm in admitting the possibility of any given conclusion! :) )
I'd rather have opioid dependent folk than suicides, as well, mostly because I strongly trend towards any outcome where there continues to be choice and opportunity for betterment. Certainly worth exploring, at least in thought! :)
I'm not recommending anyone try it... nobody's entirely sure if it's safe, or if it could function as a gateway drug to harder opiates. But it's worth considering the good it may be doing for some people.
The only the good it's doing these people is turing them into opioid addicts with a new problem that has a good chance of eclipsing the original and a certainty of exacerbating it severely in the long-run.
That said, you, or anyone else are not going to get opiates from any doctor in the United States. The federal government is comming down hard on doctors who prescribe opiates.
The FDA just sent out prescribing recommendations to all doctors. It is stern. It's basically telling doctors just don't prescribe them--period! Or, only to cancer, and for palliative care.
It will go down like this; patent will go to that rediculious office visit to discuss their pain(a lot of that pain is real. Opoids make you feel better, so the pain is bearable. There are people who stay on their original doses.)
Doctor will just say--no.
Patient will detox, and might die, if old, or has underlying health problems. Just like the way Jerry Garcia died out in Woodacre, CA.
Or, patient will go to herion? If they live in the right area, and they are willing to break the law?
Whatever--getting any opiates will be very difficult. The average patient will be in pain. I really don't like the way the government is telling doctors how to prescribe.
(Bupenorpine shouldn't be thrown in the opiate mix. I have never seen anyone abuse it--period. I know it's opoid like, but so different. I don't even think it possible to OD on this drug.)
So there's some possibility.
http://mentalhealthdaily.com/2014/12/20/ly-2456302-for-depre...
Opioid replacement therapy seems to work, so I'm just not convinced that all opiates inevitably lead to doom... it feels more like FUD rather than anything backed by scientific evidence.
Depression gives you the power to make really big decisions. Everything hurts about the same. Going to work is about as painful as staying home, meaning it's easier to quit a horrible job. It's easier to divorce an abusive partner. It's easier to pack up life and start over.
Having been through extreme depression multiple times, I can say with confidence that it makes those really big, really scary decisions a lot easier. You get thoughts like "it would all be over if I never saw that person again". "I would enjoy life if I got a divorce and moved back to my home town". "My job is abusive and it's slowly killing me, having no income is better than hating 70 hours of every waking week".
If you are depressed and having those types of thoughts, you might actually be right. Following through on those major, traumatic changes might actually be what you need to do. And depression makes it easy to do so. Normal life becomes so bad that change is welcome, because change feels like a way out.
This does not work on all people though, I know of one person who's been resistant to medication, meditation, therapy.. none of it seems to truly change thought patterns. It just keeps coming back time after time.
Have you been diagnosed with depression by a mental health professional?
In that model, what you need to fix is not to remove the trigger (e.g. the pollen may be safe) nor to inhibit the ability to respond (sometimes you need a big immune reaction) but instead to focus on whatever's gone awry with the fiddly logic in the middle that normally regulates frequency/severity/duration.
If that were the case, then the "depression reaction" might be a useful adaptation... but for some people it's occuring disproportionately.
The article's premise is that having one's core psychological needs go unmet is like having a broken bone.
If you take away the pain from a broken bone, you still have a broken bone. As you say, there is nothing wrong with taking the pain away. But the bone is still broken, and limits you in ways that a healthy bone would not.
Taking away the symptoms of an unwell psyche still leaves you disabled, even if it isn't as outwardly evident as a broken bone.
Setting the bone is important, but if the pain makes it harder to fix the bone, drug it away asap.
And sometimes non-broken bones ache. No need to suffer it.
There are often complex psychosocial factors involved, with access to disability benefits playing a substantial role in a large proportion of cases. Long-term use of opiates can cause hyperalgesia and rebound pain due to tolerance and withdrawal. Chronic pain is not simply a spontaneous biological phenomenon.
In the relational frame theory that underpins acceptance and commitment therapy, similar mechanisms are seen as integral to chronic anxiety and depression. Experiential avoidance is a common response to unpleasant emotions, but avoiding stimuli that trigger painful emotions tends to cause a paradoxical increase in the intensity and frequency of those painful emotions. Managed exposure to these stimuli is an essential component of a wide range of behavioural therapies.
My experience with SSRI's has been that taking away that mechanism is taking away creativity, emotional range, and introspective ability. Reality distortion is reality distortion. I reject procrustean medicine that fits humans to the mold of what is best for society, which is the primary environment in which anxiety/depression originate.
I'm not talking about SSRI's, I mean a theoretical way of removing only depression and the similar kinds of chronic anxiety. You can be very creative and introspective without being actively depressed.
> Reality distortion is reality distortion.
It's depression that distorts reality, even to the point of making you feel negative emotions that you know aren't true but can't stop.
> I reject procrustean medicine that fits humans to the mold of what is best for society, which is the primary environment in which anxiety/depression originate.
That's great. Me too. But that's really a different issue. You could fix that entirely, and you'd still have people hurt by depression.
I'm well aware of how distorting depression is. I've been nearly bed-ridden for days at the worst of times. I am equally well aware of how distorting the pharmaceutical treatments for depression can be. It is like trying to correct a distorted mirror by putting a distorted lens in front of it for many people.
Some people have mental disorders that respond perfectly to purely pharmaceutical treatment. I don't know how many, but i doubt it's a majority or even a significant minority.
Speaking from personal experience, which is all I can really do given that I am not a medical professional, they brought be back to a basic level of functionality. In direct regards to what you had mentioned they didn't take away creativity, emotional range, or introspective ability, quite the opposite in fact. Before I began treatment I was rapidly falling towards not ever leaving my room and hiding from people all the time. I am not saying they are for everyone. I just want to point out that we all need to be careful assigning our experiences to others on this.
There probably aren't any scenarios where, if you just removed the depression/anxiety "everything else" would be just fine.
What has happened is this: mainstream culture claims that these scenarios are fine when they are not, and so people seek to remove the depression and/or anxiety from them without even questioning whether the scenarios themselves are very healthy.
You're unable (unwilling) to accept that these circumstances are bad. You don't want to change them, you want reality to be something other than it is so that your culture can continue as it has without changing and growing. You would prefer that people numb themselves to it rather than address these defects.
The article's example is full of these.
* People pushed into college who do not want to be there * Parents of young children divorcing * Parents of young children remarrying * Shallow friendships * Hookups
These are not problems that will be easier to fix if he's doped up on prozac, they aren't problems you probably even want to acknowledge as such.
Additionally, chronic pain conditions generally strike late in life whereas depression/anxiety come earlier. The emotional pain seems more likely to be adaptive whereas the seemingly meaningless physical pain later in life seems more like people's bodies breaking down.
Thanks for the critique.
The problem is that the connection between depression/anxiety and interpersonal relationships has been programmed into our systems by evolution. So the question remains if it is wise to alter our biochemistry to suppress mental illness.
Though it must have some function or evolution would have got rid of it. My theory is keeping your head down may be helpful if you are screwing up socially. These days if the people who know you don't like you you can just move but in the hunter gatherer days that may have been fatal.
1. Is in a stable part of the genetic code, giving opportunity for bad traits to be weeded out.
2. Is not correlated with a different useful trait that overshadows its goodness/badness.
3. Shows up early enough to affect reproduction.
Human intelligence is quite recent, so prerequisite #1 is not met. We have no idea if prerequisite #2 is met, and prerequisite #3 is met.
So natural selection can't tell us if depression is/was useful. The kinks of human intelligence are not yet worked out.
#2 Depression has a major effect, I doubt it's overshadowed
#3 You get depressed teenagers
So I'd think 1,2 and 3 are met.
Re #2: Your doubt does not constitute evidence in any reasonable sense.
Similar with depression. Unless it is severe, it gives a hint to try to change something. Those changes can be really small, like getting enough sleep, or going to sea once in a while, or talking to an old buddy, or joining some volunteer activity. The key is to try and recognize the feedback that is impossible under antidepressants.
It's not even that they are lying, but we humans are very good at hiding truths, even from ourselves. It can be very hard to truly admit that one is unhappy about one's life, and frankly many people have never really experienced a true sense of fulfillment, peace, belonging, purpose and happiness, and don't know what it would feel like or understand how lacking the feeling is in their lives.
"My life is fine" generally means "I've checked the right boxes: 'success', 'friends', a relationship, but I still feel empty." Don't use drugs to numb that feeling. Listen to it.
These symptoms can be caused by trauma that happened in the long ago past. Your current life situation could actually be fine but you have symptoms of past trama.
Seen too many people running around making drastic changes in their lives in an attempt to feel happy but each change just brings more depression because it doesn't work.
"Just make a change in your life" is some feel good bullshit. It's not that simple.
Seriously though, compared to being depressed when you can't fix it because you don't have any idea that something is wrong, drugs are fucking amazing. The shitty part is people end up trapped now as the drugs can fuel the negativity which lead to the depression in the first place.
The common thread though is that a single dose of the drug offers long-lasting protection, weeks or months or years. It's not about chemically changing the brain day after day, it's about using neurochemicals to jolt the brain out of a rut. It's about occasionally kickstarting the brain back into normal self-regulation, not using externally supplied chemicals to permanently supplement dysregulation.
Completely depends on the drug, person and context.
The painkillers when I dislocated my shoulder and they had to reset it? Wonderful.
The antidepressants that after several weeks (so once they'd started "working properly"), made me feel "not unhappy" but like a robot and then also gave me vivid, real nightmares in which I died horribly over and over again? Not so great...
I'd never touch antidepressants ever again. For some people they do work, but for others they don't. Yet we still push them on everyone.
No doubt medicine has its uses in treating anxiety and depression, a momentary reprieve can grant you the clarity to see what you do need to change to feel better. However, I see many people online who cling so strongly to the idea that anxiety and depression are chemical imbalances that you are unlucky enough to be predisposed to developing and that balance can only be restored through medication, that when you suggest that anxiety and depression are not diseases and so can be treated to the point that they are not a problem anymore, people will react violently, as if you just assaulted their identity.
This line of thinking makes it extremely difficult for them to get relief. It is also beneficial to pharmaceutical companies who can make a customer for life by convincing customers that if they don't have a certain medication they will always feel miserable.
What we need is to foster open discussion of both viewpoints because both are fully valid explanations of anxiety and depression. For those who truly do need[1] such medicine it is demeaning and disheartening to hear views like yours touted as the only valid point of view because it implies they are invalid, or that they're cheating because they're not managing without drugs.
I similarly take issue with the article's claim that "anxiety and depression are symptoms of psychosocial needs and threats" because it completely rejects neurological causes of anxiety and depression. There's nothing that says predisposition to neurochemical imbalances will never be more severe than what can be managed without medication. And the same can be said for environmental factors (e.g. ingested and inhaled compounds from the area around where you live, just by happening to live there).
Has anyone done a scientific study on the common root causes of anxiety and depression? Do we even know enough about the brain to be able to confidently identify the root cause?
[1] If you know there are no such people, I'd like to learn about how you know that.
It's a surprisingly cushy lifestyle, and some would do anything to keep it. And that entire structure is dependent on depression/anxiety being seen as a medical problem with no solution, only medication.
They are very vocal in it's protection.
could you explain this? I've never heard about it.
Evolutionarily speaking, just because something has evolved does not mean it happened for a purpose, or is useful at all.
Pathological anxiety and depression may actually be purely disadvantageous mutations which nevertheless still passed evolution filters because they are not disadvantageous enough to wipe out 100% of their carriers.
Or they may have a much uglier purpose than you have assumed, for example, to force weak individuals (in)voluntarily withdraw from consuming resources useful to others, or even to kill themselves completely, which might be "wise" during foraging times but is nothing but useless breakage in civilized age.
So many adaptations are sledgehammers for a smaller problem. Evolution doesn't plan; it just diddles around until something (sort of) works. And our bodies are the unfortunate result!
After all, there are quacks out there trying to explain away cancer as a symptom, not a disease (see: http://www.goodreads.com/book/show/163184.Cancer_Is_Not_a_Di...).
You can accept or ignore this, and it won't change the science at all.
"Depression and anxiety are, for the large majority of cases, emotional signals that one’s psychological health is not ideal and that one’s psychosocial/relational needs are not being met."
looks like a theory and and experimentally testable and falsifiable one at that. Take a bunch of depressed people, try to fix their relationship needs along the lines mentioned in the article, survey the people who now have friends, get on with their family and so on and see if they are still depressed and compare to a control group. Simples.
And almost no ones social needs are ever truly completely met. we also know already that social support helps anxiety and depression regardless of whether it is a root cause. So your test wouldn't falsify if it returned a negative value, nor support with a positive correlation.
The wonderful thing about scientific progress is that it shrinks the space quacks and charlatans have to peddle their pet theories and cures.
I think that suicide could have some evolutionary advantage in a group. Say there is a member of a group who has become sick, injured, or otherwise incapacitated and is unable to contribute to the group. The group must spend more work to take care of the member than they receive back from the individuals paltry, or nonexistent contributions to the group. If the member's ailment is temporary, then it would be advantageous for the group to bear the burden of taking care of the member, as they would benefit more in the long run.
However, if the member's condition is more permanent, then they represent a net loss to the group's well-being. It would then benefit the group as a whole if that member were to commit suicide, eliminating their burden from the group.
I think this is something that many individuals with suicidal ideation feel on some level. They think that they cannot contribute to their group (family, friends, job, community, country, etc), and that their lack of contribution will be indefinite. For example, a person with anxiety so bad that they are unable to leave the house or get a job might feel like a burden to their family, and unable to contribute. Or, a person with depression might have such a low opinion of themselves that they are unable to see the contributions they are making, or think that their contributions are meaningless and so feel like they are not contributing anything at all worthwhile.
Even though suicide could have had evolutionary advantages in the earlier days of human existence, in modern times I don't think this is the case any longer. With modern medicines and technologies, medical conditions are not as crippling as in the past, and there are more ways to contribute to a group than ever, even without being able to walk or leave the home. The difficulty would then seem to be either helping the suicidal individual to find a group and method of worthwhile contribution, or helping the individual to understand the ways they are already contributing to a group and why that contribution is worthwhile.
Of course, this is just a baseless theory of mine, and I would be very curious to see if there is any actual evidence to back this up.
Sounds like archives of Sarah Perry’s The View from Hell[0] may be something you’d interested in checking out. She touches upon a range of suicide-related topics and provides references for further reading.
It seems like any characteristic that prevents the individual from reproducing is by definition not selected for. But I could be misunderstanding something.
Maybe it could work in the case of people who are already parents. Favoring the group could increase the likeliness of their children surviving perhaps?
I believe there is similar thinking for genetic passing of traits like homosexuality.
Even if some individuals in the group do not reproduce, their relatives in the group do reproduce. So say 1 person self-sacrifices and does not reproduce, and as a result of their sacrifice 10 others in the group survive and reproduce that would not have been able to if the first individual had not self sacrificed. The family all has gene A, so this results in a net gain of 9 individuals with gene A. So the amount of people with gene A increases, even though some individuals with gene A potentially do not survive and reproduce.
If you want to learn more about this kind of thing, look into "Selfish Gene Theory".
Suppose we did not separate these things. In that case, for an entire group to have A, that implies that some ancestor of that entire group had A. But this contradicts the premise that the gene makes people less likely to reproduce.
It works if you accept the idea that genes which are fit in some situations are less fit in others. In that case you could have a person who developed this mutation of feeling suicidal when they feel useless, but it doesn't "activate" because they aren't in a situation where they feel useless. But once a whole group has this gene, then your theory of propagation through siblings/cousins is more plausible.
The example frequently citied in this area is sickle cell anaemia, which can be inadvertently selected for in areas where Malaria is common. Having one 'bad' gene protects the person from Malaria, having two means that one has sickle cell anaemia.
This means that people with a single gene are more likely to survive, and hence pass on their gene, but this sometimes manifests as someone with sickle cell anaemia. See https://en.wikipedia.org/wiki/Sickle-cell_disease#Epidemiolo...
> if you reach a certain age and are not already a parent, it means you're deficient. It's better for the gene pool if you die without reproducing.
This explanation makes no sense to me. Evolution doesn't select for the overall gene pool AIUI, it selects for fit individuals. I can't see how, even in theory, this explanation would be plausible.
> If you're a parent and you did all that was needed for the offspring to survive the early development period, you're no longer needed and probably better off dying instead of consuming resources your children need.
This explanation sounds at least mathematically plausible to me.
By your logic, males should be continuously fathering offspring throughout their lives, as soon as they reach puberty.
If the answer is that they come to the conclusion of suicide because they are deluded by depression, it comes back to the question in the OP: how does the grandparent's hypothesis explain the symptom of suicidal ideation/acts in depression?
That would also explain how people are able to get out of unexplainable depression after a period of time, and why people sometimes seem to seek out more sadness when they're already sad. They're looking for perspective.
Awareness is the goal of some forms of meditation. I'd like to see more studies on the effects of meditation on those who have various forms of depression.
Yes, that's all true IMO, but the problem is that many times, it simply isn't feasible to change your environment. So antidepressants are a good way to deal with the problem.
For instance, suppose you live in the ghetto and are constantly struggling to make ends meet. How do you change your environment here? Well, here in American, you don't. You just suffer. If it were that easy to get out of poverty, most people in that trap would do it. Indeed, many things in society seem to be actively designed to keep people trapped in poverty.
What if you're lonely because you're single and have never had any success dating, and the reason is that you're cursed with being extremely unattractive? There again, there's only so much you can do to change that. (Or worse, you have a serious physical disability, which really limits how many people are willing to date you.)
>but I believe the depression/anxiety are there to force our conscious self and the people around us to acknowledge that something is wrong.
Sounds like an interesting theory, but in reality, at least in this society, it seems to have the opposite effect: it makes you an outcast. No one wants to be around depressed people, so they're stuck being lonely, which feeds the depression, it's a vicious cycle. Antidepressants can really help a lot here, by giving you a short-term boost to jump-start your social life and just to help you cope with life in general.
>This is a completely different paradigm that explains depression and anxiety as meaningful signals of underlying problems rather than as inexplicable suffering to be numbed through prescription medication. I believe it will prove the more robust and also the wiser way of looking at these experiences.
I think the problem with this idea is that this seems to require some gigantic changes in our very culture and how we deal with people who are depressed.
Evolutionarily speaking, it seems likely that depression/anxiety are there for some purpose, and yet we treat them both like meaningless pain meant only to be banished using drugs. I believe both are signals that something in our environment is not working for us. They indicate emotional or physical needs unmet---needs for safety, autonomy, connection, etc.
Often the individual suffering is fundamentally unaware of their own circumstances. I didn't realize how messed up my family relationships were growing up until much later. There are various reasons for this unawareness, but I believe the depression/anxiety are there to force our conscious self and the people around us to acknowledge that something is wrong.
This isn't just the old nonsense about depressed people needing to cheer up, and that it will pass in a day. This is a completely different paradigm that explains depression and anxiety as meaningful signals of underlying problems rather than as inexplicable suffering to be numbed through prescription medication. I believe it will prove the more robust and also the wiser way of looking at these experiences.