Evil Deeds

A Forensic Psychologist on Anger, Madness and Destructive Behavior

Dr. Stephen Diamond is a clinical and forensic psychologist in LA and the author of Anger, Madness, and the Daimonic: The Psychological Genesis of Violence, Evil, and Creativity. See full bio

September 1, 2008, Depression

Comments on "Is Depression a Disease?"

Is Depression a Disease?

By Dr. Stephen A. Diamond, Ph.D. on September 1, 2008 in Evil Deeds

What is depression? Is it a disease? A mental disorder? Biochemical imbalance? A brain dysfunction? A psychological syndrome? An existential or spiritual crisis? Several of my fellow PT bloggers posted on depression recently. I want to discuss depression here as a clinical and forensic psychologist who has been practicing psychotherapy for more than three decades. Read More

Great article, but what is

Submitted by anonymous on September 2, 2008 - 3:00am.

Great article, but what is the answer then? What are the more effective ways of psychotherapy?

CBT and Depression

Submitted by Wendy Aron on September 2, 2008 - 8:31am.

I'm also eager to learn of psychotherapeutic models other than Cognitive Behavioral Therapy. I've been in CBT for major depression for over ten years and and in that time have not been hospitalized once. I find it pretty effective, but would love to learn more about other modalities.

Wendy Aron, author of Hide & Seek: How I Laughed at Depression, Conquered My Fears and Found Happiness
http://www.wendyaron.com

Response to Wendy and Anonymous

Submitted by Dr. Stephen A. Diamond, Ph.D. on September 2, 2008 - 9:24am.

Wendy: If it ain't broke, don't fix it! Sounds like your cognitive-behavioral psychotherapy is working well for you. But if you're interested in exploring other approaches, you might try taking a look at my book Anger, Madness, and the Daimonic, in which I present what I call Existential Depth Psychology.

Anonymous: Check out my book or other writings, including previous posts here at PT. I will elaborate further on therapy regarding depression specifically if there is sufficient interest expressed here.

Dr. Diamond

Kramer killed FREUD

Submitted by david Petropoulos on September 4, 2008 - 4:52pm.

Either you haven't read Kramers books or you've read without understanding. Suggesting that depressives have emotional problems not because of their depression is so 20th century. You seem smart so catch up on your (KRAMER) reading when you get some free time. -P.S. Freud's dead and peter Kramer killed him, in his book "FREUD'' - Sincerely, DAVID

Depression

Submitted by Jeffrey Kelley on September 6, 2008 - 11:57pm.

Very interesting...I believe depression is a feeling of not being understood by anyone, including oneself and the lack of self control one would expect from someone who lacks understanding of oneself...and if you add hopelessness to depression, then one can join the group of people who are suicidal...Think about living a life were you nor anyone else you know understands you and then add being out of control and hopelessness to the ride, who would not want to kill themselves? I also believe bi-polar and many other diagnosis add to peoples inability to understand and thus control themselves, but in itself bi polar is not depression... I believe we should spend more time trying to understand ourselves based on who we are, without judgement (self respect)... And we can hone are skills by listening to understand others based on who they are (respect). I believe people who are able to listen to understand people, and who see themselves as people can learn to respect the person they are...self respect... 3 questions to ask a potentially suicidal person. (1) do you feel anyone understands you? (2) do you feel you have control over your life? (3) do you have hope that 1 & 2 can change?...if the answers are all no, this person will need some help to understand themselves so the can get some control back so they can get some hope...if only 1 & 2 are no's then we have a depressed person who may eventually lose hope and join the suicidal...

Actually, bipolar

Submitted by david Petropoulos on September 7, 2008 - 3:32pm.

Actually, bipolar depression is like ordinary depression,they just have delusional ups and a delusional down. They are wrought with the same inner rage and self hatred also known as low self esteem like those with depression have. They just move from here to a grandiose self importance.

Depression closely related to Insomnia

Submitted by sleeptreatment on September 13, 2008 - 9:57am.

Emerging scientific research clearly shows that the relationships between depression and insomnia are far more complex than originally understood.Do you agreee... reply
Related site
check it out
http://sleeptreatment.com/Depression-&amp-Insomnia/Mental-Health-&-Sleep...

Sleep and Depression--Reply to "Sleep Treatment"

Submitted by Dr. Stephen A. Diamond, Ph.D. on September 13, 2008 - 4:30pm.

Yes, there is a complex relationship between depression and sleep, especially insomnia. Lack of sufficient quality sleep can exacerbate the symptoms of almost any mental disorder, including depression. Insomnia is also associated with anxiety, which freguently accompanies depressive disorders. Chronic sleep deprivation can indeed induce depression in my view, as well as other psychiatric symptomatology. So it becomes very important in the treatment of depression to specifically attack the sleep disturbance, which is one of the psychovegetative symptoms antidepressant drugs can and do regulate. As you mention, some depressed patients sleep too much (hypersomnia) due to lack of energy, social withdrawal, apathy and avoidance of life. This is another dysregulation of sleep that certain more stimulating antidepressant medications can help regulate. Regulating sleep disturbance can have therapeutic effects for the depressed patient,since dealing with the Hydra or one's demons and difficult circumstances requires energy and motivation.

So what should we (the

Submitted by Elodie on September 19, 2008 - 5:44pm.

So what should we (the patients) do? Specially those with chronic depression? Read your book? Will your therapy be more useful than CBT? So are we doomed for the rest of our lives? What do we gain from this kind of articles? You're not giving any hope!

Reply to Elodie and others

Submitted by Dr. Stephen A. Diamond, Ph.D. on September 20, 2008 - 5:42pm.

I prefer realistic to unrealistic offerings of hope to patients suffering from chronic depression. In my experience, the more chronic the condition, the more reason to use a combination of antidepressant medication and intensive psychotherapy. Sometimes it can take significant time to find the right medication for you, and many patients must try different medications before finding one or two that have an adequate therapeutic effect. This requires working closely with a competent and caring psychopharmacologist/psychiatrist. But for me, the medication is not the primary treatment. It is secondary in importance to finding the right psychotherapist. As with medications, sometimes you have to search for the right psychotherapist, which can also take time. While research suggests that the efficacy of psychotherapy is less about the particular orientation (e.g., CBT) than the therapeutic relationship itself, each approach has something different and valuable to offer. You may need to try consulting with several different experienced therapists of differing orientations before settling on working with one. I would generally recommend checking out at least one psychodynamically-oriented psychotherapist, an existential therapist, as well as a Jungian analyst before deciding. Once you find someone you connect with, commit to see them regularly (maybe even twice per week at first if possible) and stay with them for at least six months or so and see how things go. Recovery from chronic depression is difficult: it takes hard work, courage and commitment. And the right kind of professional help. It will take some time. There's no magic. But there definitely is hope!

AGREE!

Submitted by Jennifer Ryan on September 27, 2008 - 12:40pm.

"I prefer realistic to unrealistic offerings of hope to patients suffering from chronic depression." -- I couldn't agree more! I think as patients, we have to be realistic AND proactive about our own care. We live in a world where we have made it so normal to have depression, and so normal to take medication, that we forget that it's OUR job to take a proactive approach in our own mental health.

As a Psychotherapist, I prefer working with individuals who are more than ready to do whatever is necessary to make change in their lives. I've never NOT seen change happen when someone is highly committed, ready, and makes the decision once and for all to change. =)

Great post!

May the Hero Win Today!

Submitted by Jane D. on February 18, 2009 - 6:07pm.

My Soul is a hero
My Ego is a zero
Two warring factions
Driven to distractions

My Soul has a vision
Of an Ego rescue mission
But my Ego wants to rot
and complain about what's not

Two minds in one brain
Is the reason I'm insane!

May the Hero win today!

Nice article. But depression

Submitted by drug intervention on April 2, 2009 - 12:51am.

Nice article. But depression is hard to determine whether is it a disease or what. It just comes without knowing really the cause.

Wow... To even think that

Submitted by RICH on April 2, 2009 - 7:09pm.

Wow...

To even think that depression is this or that, to me misses the point and our time, money and proper time spent trying to beat this bully!

Think of doctors, before they give radiation to a much needed tumor of questionable size (lol), but saying or rather arguing how big or small it needs to be for this procedure???

Problem is, whithin the vastly prolific and infinite world of depression, and on my own "abhorrently f'd trip of depression/suicide attempts in my past; depression is in my book the bane of human kinds existence and if not that at least on the list...

I agree wholeheartedly

Submitted by LyraStorm on July 16, 2009 - 5:52pm.

I've suffered from depression for a V. long time and I agree wholeheartedly with everything that has been said in this article, which could be a first for me (generally there is something I disagree with). I especially love the Hydra reference - so true! And the chicken and egg thing is pretty on the nose as well - it gets hard to see the start and know if what we are experiencing and seeing in the body is due to knock on effects of what happened first or if it is the initial cause for our misery...

I also agree that realisim is good when approaching depression - false hope crushes far more painfully than saying it's going to be tough.

I have hope that with people like yourself looking into depression perhaps in the future there will be a greater understanding and thus perhaps more answers. Fingers crossed.

Depression and suicide

Submitted by Anonymous on November 5, 2009 - 9:42am.

What about so called reactive depression .. if you suddenly wake up one day and realize that your life has been wasted or a shambles and decide that ending things is a reasonable way to go? Obviously the situation is depressing to think about but hardly qualifies as an "illness". Everyone's life has to end at some point so why is choosing that time any less rational then being hit by a bus? In one case that comes to my mind a Chicago university student was driven to suicide by massive student loan debts. He did not have a "chemical imbalance" or a disease. The fellow just said "enough is enough".