Well, there's also us, who don't believe "depressed people are just self-indulgent whiners" but don't believe depression is just a "biochemical distrubance" either.
Rather, it's a byproduct of a seriously messed up world/society/personal relations landscape, that depressed individuals are more sensitive to or have felt more deeply. (This is not the same as "situational depression" -- I'm talking about the real deal, where still the causes can be numerous and not known to the sufferer at a conscious level).
(I find the whole "it's all just bio-chemistry" idea akin to reductionistic scientism. It's inherent in the prevalent attittude to not attempt to go beyond that level and question "why the inbalance", except in mechanistic terms).
You can proclaim whatever you want, that don't make it true.
For starters, a lot of modern "science" is hastily written papers for research grants or keeping the researcher up there, the majority of which doesn't even hold in a second examination (this was shown in several meta-reviews, including in biology/medicine, e.g.: http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fj... ).
I'm not for reductionism when it comes to complex emergent phenomena like our sense of self and feelings. Especially when things like "depression" (or ADD etc) are not atemporal facts of life, but change with the decades and with interpretation.
Starting with a specific epistemology it's easy to interpret anything in a certain way. Those who've followed 19th and 20th century medicine have seen so many bullshit fads and theories that were debunked later. Even being gay was a medical issue, not many decades ago. No reason to believe "it's really different this time".
Some people treat science like some neutral agent -- as if interests, stupidity, fads and ideology don't play any role in shaping it (they have the idea that the "scientific methodology" sorts everything out). They probably just want a substitute for religion, an authoritative source of knowledge.
I'm glad that you're not "for" reductionism when it comes to complex emergent phenomena, but I'm not sure anyone is "for" reductionism. Some people are "for" useful abstraction.
Epistemologies... my take on them is as follows. An epistemology restricts the ways in which something can be interpreted. Periodically, this has indeed been a problem. I am not sure that it is the problem you are describing; I think perhaps you mean to say that starting with an arbitrary epistemology, its easy to interpret anything to justify prior beliefs. As soon as you formalized your epistemology, though, it would start to lock you into its logic. What sounds right would take more and more work to justify if it was not, in fact, true. That's one of the benefits of having an epistemology. That's also one of the reasons there is a history of prior false belief for you to point at. All of the "fads" you mention are beliefs that can no longer be justified within the context of a scientific method. They are not arbitrary fads; they arose out of specific, historical misapprehensions, and it is not that they cannot be individually repeated; they categorically cannot be repeated. Within the context of a specific, logically coherent method, error runs out of space. Comparing the methods and knowledge of late 20th century medicine to those of early 19th century medicine --- should you chose to --- would refute the point you are trying to make.
Meanwhile, you are responding to a person who has related his first-hand experiences and observations about a personally tragic case of clinical depression with a glib, slightly incoherent and profoundly reductionistic non-theory about the causes of his wife's illness. This is probably the product of a messed up personal relations landscape, but I will tell you that it is one to which I am extremely sensitive. Nothing is inherently false just because you pulled it out of your ass, but it is not a reliable method of producing anything you should share with anyone without making damn sure it is to the point and useful.
Yeah, that's were traditionally people engage in discussion and evaluating each other's arguments (and even each other's opinions). Instead of expecting to settle things with some link to some research here or there, that they know even less about it that the ones that conducted it, and they have at best took a quick read of the final paper, without attempting to verify the results or anything.
Really, scientific papers, as far as their consumers in popular science are concerned, are not more than the holy scriptures of yore. Something you believe because it comes from a source of Truth.
Personally, if I'm allowed to say so, I don't believe in anything not mature enough to make it to a university syllabus. That would be 20 years and several papers by different authors at least to get to that.
>As soon as you formalized your epistemology, though, it would start to lock you into its logic. What sounds right would take more and more work to justify if it was not, in fact, true. That's one of the benefits of having an epistemology.
That's only true if epistemologies are not, like religion, flexible. But epistemologies are not some external entities, they are practiced and believed by fallible (like everyone) people.
>Meanwhile, you are responding to a person who has related his first-hand experiences and observations about a personally tragic case of clinical depression with a glib, slightly incoherent and profoundly reductionistic non-theory about the causes of his wife's illness.
Well, I'll have to disagree about the "slightly incoherent and profoundly reductionistic non-theory" part. Modern life is out of touch with the human animal and messed up, what's incoherent about it? It's an insight we celebrate in our most famous poets, writers, artists and philosophers. It's also something that can be gauged by the increase of depression incidents in particular countries and particular decades.
And who told you I, and people close to me, haven't experience depression? It's not like that persons first hand experiences are the be all end all, and it's not like first hand experience mean that much in any case.
There are all kinds of people with a wrong opinion (could be me, for example, as I'm saying this) that had "first had experiences" that got them to that opinion.
Going on a complete tangent here. And I'm not disagreeing with anything you said.
The substitute for religion is philosophy, not science.
I do believe in objective morality. Morality is simply the study of what we should do. What should we do? That question is perfectly open to scientific enquiry.
If Hume was right---that the question cannot be answered scientifically---then that's the end of moral philosophy and the beginning, perhpas, of morality based in faith. but I do not agree with Hume.
Philosophy has not offered me the easy, yet wholly unsatisfying, answers that my baptist upbringing did. I wouldn't say that it is the best substitute for religion.
There's a huge difference between "blathering", i.e. incoherence, and disagreement. If you truly find coldtea's comment incoherent, you may have an issue with reading comprehension.
- Even if this were true, that doesn't preclude depression from causing biochemical changes (e.g. inflammation).
- Saying this is the only cause of depression doesn't make a lot of sense because it doesn't account for, say, post-surgical or post-viral depression.
As I went to bed last night, I found myself thinking about this comment.
A couple of years ago, I was working at a well-known tech company and doing very well. My boss was a legitimate, clinical psychopath, but I made the most of it, working hard, coming in on weekends and snow days, etc. For my effort and talent, I received a raise and super-secret "restricted stock units we only give to the people we want to keep" after only a few months. My final performance review was glowing.
Having had enough of my boss and feeling that I'd built up enough runway to make a jump, I asked my boss's boss for a transfer to a different manager. The request was received positively and as it was in process, my immediate boss found out (probably from another manager asking about me) and summarily fired me. The act of cleaning out my desk and saying an awkward goodbye to people in the office is as clear to me as if it happened yesterday.
Because he had neglected to consult with his management chain about it, he was also out the door as soon as the threat of a lawsuit from me had passed a few months later. (If you're wondering, I did make some empty legal threats after the fact, which is why I couldn't go back. In retrospect, I probably could have returned if I'd kept my cool. I regret this mistake more than anything I did beforehand, without a doubt.)
Since then, I've suffered from PTSD, extreme anxiety and secondary depression, have been almost completely unemployed and largely withdrew from normal society. I don't have many friends anymore, don't date, don't go out... I basically just keep to myself, code, and play video games. Interacting with people didn't work out so well, so I guess, subconsciously and maybe a little consciously, I just decided not to deal with them anymore.
Getting back to your comment, @coldtea, I've often wondered which is true: Do I (a) have a "chemical imbalance" caused by unmet life expectations that causes me to be anxious and depressed or am I (b) depressed because the veil that had theretofore kept me from seeing/understanding the true shitty nature of the world was lifted?
I find my mind frequently drifting into "wow, everything is fucked up" territory. And there's plenty of fuel to keep the engine running. Everything from terrorism to wealth inequality to labor destruction to race issues to dictatorships to privacy loss to partisan gridlock in Washington... the world is absolutely and in a thousand different ways, flagrantly unfair. Then I get even further depressed about feeling depressed when I compare my relatively cushy life to that of, say, a Palestinian or Ugandan.
Wealth (and as a corollary, race) inequality is the one that gets me the most. Technology is advancing to post-scarcity -- the point where there are enough resources on this globe that everyone should be able to make it by with minimal (or even zero) effort.
But that's not what's happening. Keynes was wrong about the 15-hour work week of the future. Instead, we've gotten a bi-modal distribution of the disgustingly wealthy and growing numbers (in the US) of the destitute who have to work more hours at degrading jobs just to get by. Most people still have to work at things they do not enjoy, an artificial construct held in place by the powers that be. In this 21st century, there is enough to go around, it's just not distributed properly.
To be clear, I don't mind working and have a long history of hopefully-interesting side-projects (which I'd hoped would break me out of the must-work 99% group). What I do mind is working for "them" because I need to make X dollars to live in the world "they" have constructed. Even when I did work for "them" I didn't hate it. But now... it's harder to accept.
What pill is going to make me forget these harsh realities of the world? What pill is going to make me say "Oh sure, I'll get a wife and have some kids, even though they'll be relegated to psuedo-slavery just like I am." None.
So I think what you said (which I quoted above) is dead-right. Because of an event in my life, my eyes were opened to the real unfairness of the world.
And that's the real reason I struggle with depression -- my understanding of the world improved.
My wife isn't alone in wishing that there was another
word for "depression" of the sort arises because your
team lost, your dog died, you got passed over for a
promotion. Those are disappointing and can be a problem
in the short term.
However, the article absolutely does not say that depression is "just not wanting to get off the couch". It specifically states that this is referred to as sickness behaviour, not depression, and the very next paragraph contrasts them as distinct but superficially similar.
I have no idea how that compares to your wife's experience. I'm not particularly interested in drawing comparisons.
I would like to ask you: why does your wife need a different word? Why not just say one bout of depression is more severe and one is more mild?
To me it's the same as autism or cancer or any other sickness. Sometimes it's a challenge, and sometimes it's a wrecking ball through your life. What's inadequate about using an adjective for that?
Because we tend to think of people with "depression" as being "depressed", we are apt to ask questions, like, "What do you have depression about?"
This question makes no more sense than "What do you have cancer about?" (thanks to Stephen Fry for the comparison) but because it does make sense to ask, "What are you depressed about?" it can be difficult to explain this to people.
Physiologically, it isn't at all clear that "depression" and "being depressed" are species of the same genus. The latter is a transient, perfectly healthy, emotional state. The former is a persistent, unhealthy neuro-physical state.
So having less similar words for things of a different kind that are often confused would be a good thing.
http://www.stephenfry.com/2013/06/24/only-the-lonely/
http://www.alastaircampbell.org/blog/2013/06/10/response-to-...
I propose we just say we're "feeling down" to describe "situational depression".
Because stories like yours, in context, tend to say (in subtext or not) "I was sad once but then I did X and I was fine, so what are you whining about? Just go do X!" This often includes an implication that the depressed person should not receive empathy, comfort, or even respect because their failure to make themselves 'snap out of it' indicates a moral weakness that ought to be punished. The statement may or may not include something along the lines of "she just likes drama" or "she just wants attention."
From the perspective of someone with a more or less normal emotional range, this kind of makes internal sense. You've been sad before, you equate that with the depressed person's mental state, and then you think, "Wait, when I was sad, at least I didn't Y or mope around in front of my friends or ask for disability accomodiations, etc. That person is weak and needy and whining." If your experiences were, in fact, equivalent, that might be valid.
But they are not. Not close. Not by several orders of magnitude. It's like seeing someone throw up and chiding them for not knowing their limits, when in fact they are in chemotherapy.
It is that "your experience does not make you qualified to pass negative judgements on others who are probably experiencing something very different from you."
Changing the name of a diagnosis does nothing to reduce ignorance of that diagnosis.
"Oh, that is so sad. When I had depression, I found that picking up a new hobby, like gardening, did wonders for me! I have some gardening books you can borrow."
"Depression? Well, the trick is to just put whatever it is that caused it behind you."
"How can you be depressed? You look great, you have a wonderful family, and you are in good health! Stop focusing on the negative and open your eyes to the great things you have!"
"Where do you attend church?" ... "Oh, you don't? What you need to do is let Jesus Christ into your life. God has a wonderful plan for you and I'm sure you'll be better once you open your ears and listen to His message. Once you realize that Jesus walks with you every step and loves you unconditionally, it will absolutely lift your spirits up!"
"I was depressed too, but then I found this wonderful energy worker. He completely reshaped my life energy field and I've never felt better. What is your email? You need to call him today!"
John Diamond (died of throat cancer) wrote some books about it.
It doesn't matter what you call a mental illness: you're going to find ignorant idiots giving stupid worthless advice or voicing their horrible uninformed stigmatising opinion as if it's obvious fact.
Which reinforces the apathy and anhedonia, which (assuming you're aware of them) just feed back into the mental model. Obvious vicious circle is obvious, but still vicious.
You won't be understood (my girlfriend is a psychiatrist, so I can guaranteed it's never used medically) but 'acedia' is a lost Latin word that corresponds well: it was the original word for the cardinal sin now known as Sloth, and was described as a profound and dark disease of the soul. How the sin changed is a fascinating piece of spiritual and theological history -- shifting the definition of sins from things that hurt you to things you can do something about. Now that clinical depression is something that offers potential treatment options, that debate might re-enter the rarefied spheres of moral debates.
My wife has clinical depression. To describe depression, as this article does, as just not wanting to get off the couch is hugely insulting to people with clinical depression.
My wife isn't alone in wishing that there was another word for "depression" of the sort arises because your team lost, your dog died, you got passed over for a promotion. Those are disappointing and can be a problem in the short term.
Clinical depression is not just not wanting to get off the couch. It is a profound loss of hope, and the inability to even connect with your previous mental state of what it was like to have hope or find things interesting. The present appears fucked, and even after racking your brain for some way out, every path looks even more dismal. Situations in the real world are often complicated and can be interpreted in more than one way, but to a depressed person, the most terrible interpretation is evaluated as being a very likely outcome. And, just like 9/11 conspiracy theorists construct self-consistent theories by bending facts and through selective filtering, clinically depressed people often build an elaborate, self-consistent understanding that, yes, they and their future are completely fucked.