> I'm not trying to trivialize depression.

As someone who has been catatonically depressed for a couple years now, I'm not so sure about this! People with chronic pain also often can't identify any physical source, but obviously you would never start posting "is this really an illness though?" or "aren't we distracting and misleading people??" in a thread about that.

The undercurrent of your post is that depressed people need to snap out of it, and falling back on the "illness" label reduces personal responsibility. Trust me, many people feel like imposters claiming they have depression, despite being completely non-functional. Thanks but no thanks to this proposed contribution to the discourse.

Are you really here to understand, or is it just to judge? Want some MRIs and EKGs of depressed brains?

> undercurrent of your post is that depressed people need to snap out of it,

Please point to where I say that. I explicitly do not say that. That's not an undercurrent because I don't believe it.

I do also believe that people don't have zero agency in this problem. There is SOME ability and necessity for people to work on these types of problems. That's what therapy with a therapist is right?

And that does differentiate depression from tuberculosis which cannot ever be improved by sitting down and talking about it.

Okay, my mistake for getting dragged into the archetypal HN argument. It's clear you cannot be convinced. Your original point - that depression has no biomarkers and is extremely subjective - has been proven wrong by a couple others and you've shown no gratitude or interest in this information. Only replying where you think there's an argument to be won.

Maybe you, some random person on Hacker News, are not in fact smarter than the medical consensus?

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

And again, I didn't say there are no biomarkers. I belive there are biomarkers.

The idea that I'm not coddling your victimhood/ helpless mentality is offensive to you, not any specific argument I'm making.

Uh no, sorry, it's the argument. You've been on this site for four years now - be honest, have you ever seen someone with a lazy armchair opinion enter a debate, receive strong pushback including scientific citations, and then refuse to change their opinion? It's literally every fifth thread here. Though imo, more fun when it's idiots telling tptacek he's wrong about security than when it's someone a dick to someone with depression (my victim mentality!!)

But sure, let me actually respond to you:

* At no point have you acknowledged or shown any awareness that depression is not "one thing". Like how people discuss "curing cancer" as if that's any sort of meaningful statement. How complex do you think depression is? What point of complexity does something need to reach before you defer to experts? Depression is still more or less a black box (watch the Sapolsky video I linked or look up some starslatecodex articles on ketamine.) Again, no sign of awareness of this on your part, which suggests you haven't done the most basic research.

* Yep, you never said there are no biomarkers. You said:

> Depression is a set of guidelines in a book that ask vague subjective questions about how someone perceives the world. And then if the person decides you have it you have it. If they don't you dont. This has very little to do with the first scenario."

This was your reason for stating that depression wasn't an illness. That it was based on a list of subjective questions. Sadly you didn't respond to the person saying that this was equally true for schizophrenia. Is schizophrenia an illness?

* I said it was an undercurrent, meaning subtext. Do you understand why subtext can't be quoted, and why that's work that you need to do for yourself? (If you somehow can quote subtext, though, immediately switch careers to political journalism, you'll be a wonder.)

* The only really offensive part was when you said "I do also believe that people don't have zero agency in this problem." Like, cool, a few sentences in and you've also added in a complete strawman to make yourself look reasonable. So this was just debate club to you.

The last point, combined with the fact that you're only responding when it might let you feel superior, leads me to believe you're not here in any sort of attempt to learn. How's your own mental health? You're clearly get some need fulfilled by arguing on the internet, which generally isn't the best sign. Watch that video, it's good, and absolutely full of things you do not know.

ah, also - are you cool with suicide? if so I think your hardline approach is fine, it's really just being forced to live + treated like shit (ref. your post) if you don't enjoy it enjoy it enough that I think is the real issue

Visiting a professional is generally a necessary step in recovering from tuberculosis. In that way it is not different from depression. In most forms of depression, talking with someone and doing nothing else is guaranteed to do no good. In that way they do not differ from tuberculosis.

There are different types of depression. It can be an illness caused by some brain imbalance, or it can be a normal human reaction to things being a bit depressing. For the first maybe seek medical help and for the second maybe try to improve your situation eg. go somewhere sunny, get a better job, make more friends etc. Also things like gratitude journals, DIY CBT and so on can help with the second. It the US there seems a tendency to overmedicalize and put people on antidepressant pills for life although they have no more effect than taking up exercise for example.

Diagnosis of depression is clinical. Self reporting via standardized questions is an ordinary medical method. "Where does it hurt?" "When did it start?" "Is there a history of heart disease in your family?." "When did your baby start crying?"

'Illness' provides a framework for recognition and treatment. The book with the guidelines is medical not religious. The guidelines are guided by empiricism not revelation. Treatments are selected based on statistics rather than authority. There's general agreement that the book's content might be wrong. There's a process for changing it and the expectation that it will be rewritten.

Criteria for diagnosing depression in the DSM include behavioral "thinking of suicide," physically measurable "weight loss," and general well being "fatigue." The suicide criterion is more conducive to empirical confirmation than "headache" or "joint pain."

Once all fevers were "ague". Now we have flu (dozens of strains), malaria, encephalitis, toxemia, etc., with a different treatment for each.

Depression is still at the "ague" stage. For certain varieties, certain medications completely resolve them. For some, a treatment hasn't been identified. Approval of treatments is crippled by lack of diagnostic tools, so to test one, it has to be used on people who have all kinds, and then it only helps the small minority of them who have what it's good for. Statistically, one that works 100% for the actual illness it treats looks like it helps only 10-15% of the sample.

You write this:

> I'm not trying to trivialize depression.

And then:

> at worst seriously misleading and distracting to people who have serious issues to deal with.

Implying that it isn't a serious issue.

I literally used the phrase "serious issue" in the proceeding sentence to describe the situation.

??? I'd be very curious to hear this one explained. I'm totally baffled.

You are mistaken about depression not having observable effect on the body. I wrote a post about that; it's a direct sibling to your original post.

Your point is a bit conflicted. Like this person pointed out, it seems that you're saying that it's serious and not that serious at the same time.

However, I think that the observation you wanted to convey wasn't about the comparative seriousness of depression, but rather that it's in some sense in a different realm than for example AIDS or shingles, even if the realm of some of its effects are similar (which you argued against, but you're wrong). And, I sympathize with that. Depression does seem to be made of a different cloth, but it's quite hard to elaborate further, and I won't get into it here.

It is odd to mention shingles in this context, as depression is a very common symptom of herpes infection, actually fixed by antiviral medication.

So, even on its own terms, the argument is incoherent and, not to put too fine a point on it, wrong.

this is equally true of, say, schizophrenia — there’s no physical test for it as far as I know, just questionnaires about how someone perceives the world.

but i don’t think anyone would argue it’s not a biological disease at this point, even if we don’t yet know what biological parameters to measure.

Science is getting there.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5436791/table/t...

Just because you can't measure something doesn't mean it's not there. Perhaps we don't have the tools or knowledge yet to measure depression, like countless other human ailments of the past that are now treatable.