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Thank God, all those requiring treatment for their depression are finally receiving it. Read More
What is depression?
As someone who has suffered from both, I think that people are often unaware of the distinction between being very sad and clinical depression, which involves physical symptoms and a lessening grasp on reality, and does not necessarily have to include consciously feeling sad.
Unfortunately, we seem to live in a society where being sad is automatically associated with mental illness. The fact is that life sucks sometimes and being sad is the appropriate, healthy response.
It's better to recognise that you feel bad because you are in a bad situation, and then try to do something about it, then simply take a pill to make you think that your situation isn't that bad at all.
Caught 22
"We assume any mentally healthy person is on antidepressants - we simply can't trust anyone who doesn't recognize that they are depressed - or that they should be," the Director of Human Resources told me.
Have you had any dreams set in the world of Catch 22 recently?
Irritating
Dr Peele,
As a layperson I find your posts very irritating and unconvincing. What is your goal with this post? Is it to educate people about what depression is and isn't? Is it to form an argument that depression should not be viewed as a disease and shouldn't be medicated? Pointing fingers and sarcasm doesn't help anyone, and it especially does not convince anyone. This is not your first post that uses such techniques.
I have been diagnosed with major depressive disorder, and over the years have tried to understand what it is. Which am I more likely to accept: Kramer's well-written and well-argued posts, or yours, which are full of sarcasm and insults? If you truly believe you have the correct view on depression, please write posts that help others see the truth, rather than making fun of people who don't agree with you.
You did a reasonable job supporting harm reduction and disclosing the ineffectiveness of AA treatement. If you could do the same here, it would a great.
Well put
Way to go complimenting me while cutting down my post! That is an excellent technique, and shows a well-balanced approach.
On the other hand, I warrant that those who believe themselves to have the disease of alcoholism (which they learned through AA) feel about the same way about those posts as you do about this one.
There are many other areas - ones with which I am less familiar than addiction and alcoholism - where I likewise posit "annoying" questions withoput positing an answer - for example my post on the hyperbolic rise in autism rates.
What do You make of the fact that antidepressant prescriptions doubled in the ten years ending in 2005, so that as of 2005 10% of Americans received such a prescription? I didn't note in my post that there were significant inter-group differences, with minorities receiving fewer antidepressants, although research indicates they have higher rates of depression - so the figure for white Americans was beyond 10% in 2005. Moreover, I WAS being coy, and I believe subsequent research will show the prevalence of depression has continued to rise (as well as to extend to younger and younger groups - including 3 year olds in the current Archives).
Here are three questions I would like your answers to, because perhaps you have more insight depression than I do:
1. At what prevalence rate do you think annual antidepressant prescriptions will peak? Will you be surprised if it doubles again in another ten years?
2. How do you explain the incredible increase that has already occurred (let alone what might come)? Do you believe that the number of people with deep-seated chronic depression doubled between 1996 and 2005?
3. To what do you attribute this rise? Is this kind of depression genetically based (as I think you might believe yours is)? How will your views be impacted if this rate continues to rise rapidly?
Bothered by...
"On the other hand, I warrant that those who believe themselves to have the disease of alcoholism (which they learned through AA) feel about the same way about those posts as you do about this one."
That's an interesting point, but I'm not sure if it's true. I used to think depression was a disease, but not anymore. Or, more accurately, now I think it's irrelevant. What irks me is that your post doesn't help someone who does think it's a disease. In other words, those who most need to hear your ideas about "self-efficacy, environmental conditions, and coping skills" are less likely to accept those ideas after reading your post. They're likely to believe more strongly the very views you criticize. Which is why my primary question was "What is your goal?"
About the rise in depression, I obviously don't really know. I would guess it's a combination of actual cases, better diagnosis, and overdiagnosis. Actual cases meaning more people have depression, possibly due to increased social isolation, longer working hours, divorce, etc. Better diagnosis meaning more awareness, and also allowing for milder cases, as opposed to just "deep-seated chronic depression." And overdiagnosis meaning the 3 years olds you mention and the straight-to-consumer advertising that increases false self-diagnoses.
I believe that depression has genetic factors, just like our personality, athleticism, etc. I also think that drawing the line between unhappiness and pathology is like trying to determine the point at which killing a fetus/baby is murder. It's ridiculous to say that throwing away single-celled embryos is murder, but killing a newborn baby obviously is a crime.
But in the end it doesn't matter if depression is genetic or if it's a disease. What matters is what we can do about it. The color of my hair is genetic, but I can still dye my hair. Heart disease is a disease, but I can still change my diet and exercise. Neither of those things should influence whether I take medicine, either; only its effectiveness, side effects, and costs should matter. If someone made a pill that enabled me to fly like Superman, with no side effects, I'd probably try it, even though "groundedness" is not a disease. (I'd watch out for power lines, though.)
A couple edits
I just wanted to quickly add that whether depression is a disease doesn't matter much at the individual level, but I realized that it might matter more to those who influence or make public policy. And to health insurance companies.
Also, I probably should have used "the temperature at which a pot of cold water becomes hot water" to describe a spectrum.
About addiction and depression policy
Yes, very insightful. We debate addiction and depression, issues from the individual level up. Thus we hear repeated stories about those saved from addiction and depression by either a religious-type experience, or this or that medical remedy. But systematic investigations give entirely different perspectives on these things. The never-ending rise in depression and addiction diagnoses and treatment suggests - at the same time as individuals and treatment authorities laud our unquestionable success - that we are lost in a kind of self-exacerbating cycle, like addiction itself. We knew we had the source of polio and other infectious diseases when their incidence declined. Today, we point with pride at how many people we route into treatment as the mark of our success in conquering addiction and depression. We are lost in the forest.
Squeezed By The Psycho-Industry Vise
This thread just indicates that there are nitwit psychiatrists blithely dispensing toxic pharmaceuticals like pixie-dust on one side. And socially retarded nitwit psychologists dispensing mere inanity on the other.
The patients meanwhile, are caught in the middle.
No isn't that rich...
Fish drowning in water
People who have not considerably recovered from Depression don't get a say in what Depression is. Sincerely,David
Ridiculous. Does a doctor
Ridiculous. Does a doctor have to have had cancer before he can give an opinion on what it is or how to treat it? No one is disputing that people get depressed. The debate is whether it is a necessary, even beneficial part of human experience or not and whether it is caused by environmental/circumstancial/thought pattern factors, genetics or a combination of both and how best to treat it.
I went through a serious depressive episode twice in my life. The first time I used drugs and ended up stagnating for years on them without ever really tackling the underlying problems causing them.
I learned my lesson and years later when starting to feel the stress build up in a new bad situation, instead of turning to drugs I used cognitive behavioral techniques, aggressively focused on fixing myh life situation and avoided a depressive episode.
I used to believe my 'genes' made it inevitable I would always feel blue and depressed. I learned about neuroplasticity and now know I can actually change my own brain structure and wiring without drugs simply by focusing on the positive solutions and reframing things in my head. In short, I don't let myself ruminate so the 'depression' portion of my emotions eventually atrophy away and the 'positive, confident' areas grow stronger.
I look at it the same as exercising a muscle really. I believe just like a skinny 90lb weakling that doesn't have the 'genes' to be a bodybuilder can still build a strong body, so can someone build a strong confident brain even if they have a little more genetic tendency towards being depressed. It just takes a little more self discipline and work. Still can be done though.
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