No one feels ashamed of seeking treatment for pneumonia, but there's no way you would say it's independent of external factors. That depression is affected by external factors should neither be controversial nor related to your concerns about society's acceptance of its treatment. You seem to be conflating "dependent on external factors" with "arises due to bad life decisions", which is bizarre as it's kinda the exact thing you're worried about.

In a strictly clinical discussion it is fine to use language like "dependent on external factors" with its technical meaning. But when you're talking to someone potentially suffering from depression and not a clinician, you need to be aware of how they will respond to your words. The average person conflates "dependent on external factors" with "arises due to bad life decisions" and so we need to adapt our language accordingly in an average conversation.

I'd think most people would mistake it as implying that depression was caused by, say, lead in your pipes or that time they were mugged and felt powerless. External factors seem to me to push the blame away, not towards, the individual. The alternative of saying that depression is causeless to me sounds more likely to induce people to think it's "just their fault" or "if there's no cause, why can't they snap out of it?" But I don't have much experience dealing with such people to know.

When you are down, nothing can really make you feel like it is not your fault or that you don't somehow deserve the feeling. Except perhaps, at least among the people I know, this knowledge: That feeling of worthlessness, itself, is the symptom of a condition you have. That condition is called Depression, and Depression lies. So the depressed person can maybe make it through for a little while longer by trying to actively distrust their own feelings and thoughts and waiting for the episode to pass. If they wait long enough, the episode will pass. If they can't wait, they may end up taking their own lives, which is really the only other option they see in the worst moments of this disease. So recognizing that it is a medical condition for which you are not to blame could be very useful for people right on the margin of surviving a depressive episode vs not surviving. I hope this was not too much of a reply!

> true only in the narrowest sense

I think it's true in the right-width-of-sense. Illnesses like depression are difficult because they certainly _do_ lie somewhere closer to the symptom side of the "symptom-disease" spectrum than cancer.

Alcoholism is good for comparison, because it presumably falls even further towards the "symptom" side of the spectrum. But there is certainly a spectrum!

So we have Cancer which is mostly-disease and Alcoholism which is mostly-symptom, and Depression which is somewhere in between.

The fact that these complications lead to weird moral baggage (socially-derived feelings of guilt, etc.) is completely separate from a good analysis of the situation. Depression and cancer are just very different phenomena.

This thing you assert hasn't been proven though. We still don't know what causes depression, we don't know what causes cancer and we don't know what causes alcoholism. Out of the 3, we understand how cancer works the most, because it is the most life threatening one, and affects the most people, and is also probably easier to understand. So we are putting more money and effort into cancer research.

There's as many known external factors for cancer as depression. And as with cancer, they've got only a small impact of likelihood of reducing your risks of getting the disease.

It's therefore unknown if depression is caused by external factors, or simply triggered by them, or a combination, and if so, we're not exactly sure what all the factors which have an influence are.

As it stands today, it's still very possible depression is caused by generic defects, bacterial infection, virus, or some other unknown external factor like polution, exposure to some toxins, or very early development problems, etc.

Honestly, I'd love to be enlightened on some very definite research that knows what causes depression, but as far as I'm aware, science doesn't know.

So there is this problem that some people have depression, and we assume it's just there lifestyle, or they were raised poorly. This is due to the nature of mental diseases, which we understand poorly, and often we associate our mental state as our conscious of our own doing free will. Like someone who is naturally grumpy, we say that's who he is, no one questions that it might be he's got a disease, maybe there is a brain anomaly, or a weird communication of his neurones happening that don't balance out his emotions properly and skew him to being grumpy. But being a grumpy guy would never affect your life enough that you'd seek medical help. So people who are depressed, they're like grumpy guy, except it affects their life so much that we put some research into addressing it. Sad truth is we found very little yet.

With that said, we can see how socially we should be careful how we speak of this, because we're often giving the impression that external factors is the known cause, and that a few lifestyle change is the cure. Except that's false. The cause is unknown, and exercise is just the best we got to help. Imagine if we thought similar of cancer, we'd cut funds for cancer research, we'd just tell people they should eat better, stop smoking and exercise. And everyone who gets cancer got it because they probably didn't follow the right lifestyle.

Robert Sapolsky compares depression to cancer in another way.

https://www.youtube.com/watch?v=NOAgplgTxfc

The acceptance for cancer is great, but I believe both cancer and depression can be avoided with good chance due to factors you decide yourself. Living healthily, eating healthily.

Er, no. You can reduce your risk of cancer greatly by living and eating healthily, but you cannot avoid it. Being alive is in itself a cancer risk, because there are many different cancers and many different ways they can arise - and some of those ways are pretty much purely random.

Having a chance to avoid and reduce the risk of it sounds like the same to me.

Indeed, they do sound the same. They are not.

If I buy a lotto ticket, I have a chance to avoid losing. If I win, it's over. If I lose, it's over. It's only good for one drawing.

However, I have some risk of cancer as long as I am alive. I may be able to do things to reduce that risk, but my chances are infinite as long as I breath. I can choose not to play the lotto, but I can't choose not to get cancer.

Let us assume the goal of a human is to 'lead a long and happy life'.

The chance you win the jackpot with Lotto is miniscule. It is basically so small, that it isn't worth the investment. You're better off not taking that chance because the risk isn't worth the reward. These games are, basically, fallacies designed to manipulate humans, tricking them into behaviour they should not [logically] resort to.

With cancer, you have genetic risks to get (certain types of) cancer, sure.

However, for example living next to a highway increases the chance you get cancer. So, not living there increases your chance of not getting cancer [at a young(er) stage of your life]. Which increases the goal of human life as we agreed upon.

So I agree they're not the same, but your example of Lotto (or similar games) I find rather bad.

I think with regards to cancer this is related to risk/reward. People take risks such as speeding, eating overburned food, or living near a highway. They feel the risk is worth the reward, and they live under the assumption they get away with it.