> My own theory of depression is that it is your brain's way of getting you to change something in your life that is counterproductive to your future wellbeing. Sometimes it isn't entirely obvious what exactly is causing the depression, but if you evaluate all aspects of your life and ask yourself "is this what I really want?", you will eventually figure it out.
Utter crap. If I thought long and hard enough, my depression that was bad enough to cause psychosis would resolve itself? At 12, I had something in my life (good parents, happy home) that was causing me to be unable to get out of bed?
Clinical depression (major depressive disorder) is not related to your circumstances. That is what distinguishes it from situational depression, which many people experience. I was at some of my worst when my external life was at its best.
"Just think really hard about why you've got a broken limb and it'll reset itself!"
As someone with clinical depression, I don't agree with you at all here. (I am tempted to say "Utter crap," but apparently your harshness prompted the other guy to delete his comment.)
How you deal with your circumstances absolutely can cause clinical depression.
Clinical depression can be a brain problem or a mind problem.
It can be faulty hardware or it can be operator error (mistake).
I know it can be a mind problem from experience, and I know it can be a brain problem because any physical system can break down and malfunction.
You are saying something here that isn't true, and it's something that can potentially be very damaging to people (unlike saying something untrue about many things).
I too have had clinical depression since I was a teenager and I thought exactly how you did for two decades, however, I've since come to realise that depression is an extremely complex mechanism that doesn't need a single traumatic event, or an overtly obvious pattern of negative experiences in order to manifest.
What it primarily requires is reinforcement of negative thought patterns, and this reinforcement can exist in many forms, from many places at many severities. Further, because of defence mechanisms (or just natural timidity) we can consciously disregard negative events (while the reptile-brain is still impacted) and by the time depression takes hold we're well past any ability to rationalise away (or even recognise) all the baggage we've collected.
Now, is there an inherent biochemical condition that could make us more susceptible to depression? I imagine there is. But that doesn't discount that there are likely mental mechanisms in play as well, nor that working with those mechanisms could provide some improvement.
Why? I can't see any basis for your belief other than "it just makes sense to me", which is the epistemology of bloodletting and witchburning.
Evolutionary just-so stories have been so thoroughly and repeatedly debunked that no one thinks they can be evidence for anything. They may be useful motivators for testable ideas, but that's all.
So where is your evidence, your clinical studies, your field observations? Anything. You've said that you believe clinical depression--a serious and even deadly disease--is caused by the brain trying to tell you there is something you need to change in your life, and given zero evidence for it. You've barely even motivated it.
Under those circumstances, one either has to assume bad faith, or an astonishing level of hubris and myopia. I'd say the person who responded to you was being rather generous, given what you've said is equivalent to, "It just makes sense to me that your cancer is just your body's way of saying that you need to change something important in your life, at least in the cases I've seen."
Anecdata ("the cases I've seen") is not evidence for anything, because we all know that humans are terrible observers and prone to confirmation bias and other problematic behaviours, so telling us "no really I saw this!" is not evidence of anything except what a naive observer believes, and again: that kind of thinking is what informed pre-scientific medicine for thousands of years, resulting in a vast amount of misery and very few effective treatments.
Okay, we know that CBT works for depression, yeah? CBT postulates that your thoughts cause your emotions. Part of the therapy is identifying and refuting negative thoughts like, "You're worthless!" Well, if other people are telling you that you're worthless, in one way or another, then it has the same effect. It doesn't matter how much CBT you do, if everyone is around you is telling you that you're worthless, you're going to stay depressed, because that kind of treatment makes you feel angry, sad, and ashamed. You can't just reason your way out of it.
Your own thoughts and other people's communication do not have the same effect in the context you're describing.
You could agree or disagree with what other people say (or whether it matters), for one, while the unreasonable thoughts and irrational thought patterns associated with depression is part of your own perspective in this case. These negative thoughts are identified by and refuted because of the fact that they are irrational, resulting from erroneous thinking.
Also, your own thoughts and beliefs would cause or motivate your emotions, but the external forces you describe would necessarily have to be interpreted by you (i.e. pass through the lens of your thoughts and beliefs).
It would not be other the other people's criticism that leads to any emotion, but rather your thoughts about it, according to CBT.
Depression (clinical, major depressive disorder) is also something wholly different than feeling angry, sad and ashamed, and is (generally) in fact not a results of bad treatment or other external factors.
Correct. You are clearly dealing rationally with a complicated topic, and for someone to just spit in your face about it (the Google link comment) is incredible. There is a sibling comment to your own addressing this.
While the comment you're referring to is in poor tact, I think it's also kind of telling.
I've discussed a few similar topics on HN, and I'm sad to see that the ignorance surrounding mental illness is pervasive here as well. What's worse is that most of the erroneous assumptions could be corrected by a cursory reading of the Wikipedia pages of respective diagnoses.
Well, my response certainly was short and snappy, I'll give you that. I know that not taking the time to properly explain myself may come across as naive and can be frustrating to deal with. It's just that I'm not up for a lengthy debate about psychology. In fact, people often treat me like I'm naive about things, even in situations where I have a lot of experience. It's like a disarming technique I learned or something, plus it just makes me uncomfortable to be recognized as good at things. I would rather just do good things.
So... are you guys in therapy? It's been really helpful for me.
TLDR; It's not so much that it seems naïve, as it is about not providing any reasoning, sources or data to back it up - thereby not being reliable. Also, tone is hard to convey on the internet.
While I think many would agree that the answer is short and snappy, I don't really care and I don't take it personally. And it's not about you "not taking the time to properly explain" yourself, nor your experience - and I say this in an apathetic, and not an antipathetic sense.
It's about your non-answer response to my pointing out your invalid assumptions (and thereby faulty reasoning) about CBT and depression, which indicates that you either couldn't or wouldn't argue your point.
This makes it have very little to no value in a discussion, where one ideally makes logically coherent and well reasoned arguments (perhaps even backed by data), since no one can assess any claim properly without the application of skeptical inquiry.
Also, as javert pointed out, the response appears overtly patronizing.
Additionally, I think that participants in discussions pertaining to mental illness (amongst other subjects) in particular have a unique responsibility (i.e. a moral obligation) to back their claims up and rely upon knowledge, as the subject is fraught with ignorance - which results in all sorts of negative outcomes for those affected (see stigma and history of societal views of mental illness, provably ineffective treatments leading to avoidable suffering, etc.)
If you were not up for a "lengthy debate" about psychology, I have a hard time seeing your previous contributions in this thread as anything other than the airing of an opinion for its own sake followed by closing of the ears.
And an opinion holds no merit by virtue of being an opinion.
You also have yet to comment upon a single point I've made in either comment, and the only response is a google query presented as a retort - the results for which don't even make the point you set out to make, as far as I can tell.
I'm sorry if this comes off as cranky - I'm really not!
My point was that CBT is ineffective against depression in the face of a hostile environment. As in, the depression will not lift, even if it gets a little better. I wasn't clear about the role of sadness, anger, and shame in depression; those aren't wholly different, but they aren't wholly the same either. I didn't feel like getting into it based on how receptive you were in general.
You wrote: "Depression (clinical, major depressive disorder) is ... (generally) in fact not a results of bad treatment or other external factors."
This is a straightforward dismissal of what I wrote. Furthermore, there are no sources. I knew you were wrong, and I knew a simple Google search would suffice to prove it. You failed to concede the point graciously, although you did actually concede it. At this juncture I decided I didn't want to argue with you.
> Additionally, I think that participants in discussions pertaining to mental illness (amongst other subjects) in particular have a unique responsibility (i.e. a moral obligation) to back their claims up and rely upon knowledge
I don't owe you anything - that's a cognitive distortion, number 8 on the classic list in Feeling Good ("should statements").
If your point was external actors of a hostile environment potentially reinforcing the cognitive distortions of a depressed person, rather than a healthy person developing major depressive disorder solely from disparaging comments, then I agree.
I don't think that it's made very clear, though.
And I don't see why it would necessarily keep depression from lifting regardless of the subject's own thoughts.
What I meant was that depression (major depressive disorder) does not equal anger, sadness and shame.
Though it does involve them to some extent, depression is something different than a combination of these emotions.
Yes - I straightforwardly dismiss what you wrote. No concession, sorry.
There are plenty of sources in my response to your google-search, but I'll summarize:
First of all: environmental factors are not the same as external causal agents or events.
They may be anything from triggering scenarios to contributing factors (such as childhood trauma, disease, pollution, malnutrition and drug abuse).
The American Psychological Association [0], the American National Institute of Mental Health [1] , the University of Maryland's patient education article [2], and Saveanu and Nemeroff's paper "Etiology of depression: genetic and environmental factors" [3] (all results from the google search you linked) describe major depressive disorder and its causes (as they are currently understood). They describe an interplay of various factors (see biopsychosocial and diathesis-stress models), but none of them mention anything about it being a response to external events in the way that "normal"/healthy emotions are - which is what I'm getting at in previous comments.
My point here is that major depressive disorder isn't something that spontaneously arises from a difficult circumstance.
Feel free to correct me if I'm wrong here, though I'd prefer some sources.
There is, however, something which is sometimes called reactive or situational depression - adjustment disorder - which is not the same as major depressive disorder.
The fact that you think you knew that I was wrong holds no meaning here, as you are basically claiming to be right (surprise) - and you have yet to prove your point, e.g. reference an authoritative definition that supports your case - which should be no problem if what you "know" is indeed knowledge.
Even if you had been right, a link to a google search wouldn't prove your point any more than a search for "vaccines cause autism" would prove Jenny McCarthy's "point". Not to mention that the results from the link did not back up your claims, as far as I could tell.
I never claimed that you owed me anything. I merely presented my opinion on why participants in discussions regarding mental illness (amongst other subjects) should take caution, as people's opinions and perceptions of mental illnesses have practical consequences, and so the usual no standard opinion-spouting carries a greater risk in this context.
This is no cognitive distortion, and if I were to use the same poor understanding and low standard of classifying these, I could claim that your allegation is a cognitive distortion itself - number 5 on the same list.
I don't know if you've actually read any of the credible results from the google query you link to, but there being environmental factors (including triggers and contributing factors) to depression does not mean that depression is a response to external events in the way that "normal"/healthy emotions are - which is what I'm getting at in the previous comment.
You might want to take a look at what the American Psychological Association and the American National Institute of Mental Health have to say about the case [0, 1], the University of Maryland's patient education article [2], Saveanu and Nemeroff's paper "Etiology of depression: genetic and environmental factors" [3], and clinical criteria (like DSM and ICD).
That isn't correct, exactly, and your response to someone else who tried to point this out that only contained a link to a naive google search is really offensive. (Because it is patronizing, because it trivializes a complex issue, because it poses as a retort without actually being one.)
Drawing correct conclusions from correctly interpreted personal experience is a lot more important than clinical studies.
People brandy about "clinical studies" and "show me the data" constantly, and yet such studies generally are open to interpretation and seem to conflict with one another. If we rejected all other forms of learning, we wouldn't know anything at all.
I didn't see the guy's comment (it's deleted now), but the mistake isn't not having a clinical study, it's not correctly interpreting the "data" he has actually seen in real life.
In other words, the right policy is actually being rational, and clinical studies cannot replace that.
I realize now this is kind of a nit pick/off topic, but I've already typed it so there it is.
Yes, I deleted all my comments here (under another username), due to the ridiculous responses that it prompted. Sure, I have some personal experience of depression -- both myself and family members. However there is also a lot of evidence behind what I'm saying, namely:
- situational depression, which -- as it's title says -- is in fact in response to situations.
- situational depression (e.g. bereavement) has been shown to meet all the criteria of clinical/major depression in many cases.
My hypothesis simply involved making a small (in my opinion) logical jump to offer a possible explanation for why situational depression exists. Given that the article itself mentioned a number of theories for the evolutionary role of depression, I didn't think mentioning my own theory would start such a firestorm. I think it is logically tenable.
What is the reason for the hostility? Are we supposed to write peer-reviewed comments for HN? Is it just that many HN posters exhibit excessive negativity and mispaced arrogance? I've certainly seen a lot of negativity and mispaced arrogance in the past on HN, and a number of times it has made me reconsider whether or not I want to be part of this community. This time I'm getting closer to that decision.
It could also be depression itself. As others have noted, sometimes it isn't necessarily the situation that is the problem, but your reaction to events (this is what CBT aims to fix). Perhaps the excessive negativity in HN is what is causing/exacerbating some people's depression?
Anyway, I'm not really interested in interacting with idiots (and I'm not referring to you here, javert) who downvote and are overly hostile when people like me share their personal experiences and make general comments on science without posting a frickin peer reviewed paper. Feck that...
As far as I can tell, people were claiming you were wrong because their anecdotal data showed the opposite of your anecdotal data (upon which you built your hypothesis) or because they were not persuaded by your argument.
Situational depression (adjustment disorder) is not the same as clinical depression (major depressive disorder), which is what it seems people are discussing in this thread.
While the original comments are now deleted, the quotes I can see refer to "depression", which it seems people interpreted as major depressive disorder.
I think this is why people have reacted strongly to the idea that it is "your brain's way of getting you to change something...", as major depressive disorder is not situational, and sufferers are often not able to change much, if anything without proper treatment. The history of societies' views on mental illness (stigma and discrimination), as well as peoples own horrible experiences with mental illness, probably also contributes to emotional and sometimes hostile responses in these discussions.
Depression is a pretty touchy topic. People use their own beliefs about depression either as a buffer that helps them feel that they can handle their problems, or as an excuse for not being able to handle them. I can forgive people for being sensitive to disagreement on this topic. Also, it's easy to damage people if you convince them of a wrong view of depression. I'm concerned about that.
> I've certainly seen a lot of negativity and mispaced arrogance in the past on HN, and a number of times it has made me reconsider whether or not I want to be part of this community. This time I'm getting closer to that decision.
I've had that feeling sometimes. I've just changed my behavior to not get into debates when it isn't worth it. I find that people tend to appreciate my comments... some get upvoted a moderate amount, some get downvoted a moderate amount, but it comes out in the positive territory.
> Perhaps the excessive negativity in HN is what is causing/exacerbating some people's depression?
Well, people need to diagnose that and then stop participating in HN if that's the case. I think that can be a completely reasonable course of action. Ultimately, you can't blame HN for it; you have to blame the person's choice to stay or leave.
There is a lovely quote that I think might apply here: "Complex problems have simple, easy to understand, wrong answers". You're presenting a simple answer to a complex, multi-faceted problem and presenting it without any evidence besides your experience. This problem is also deeply personal and challenging to many people (sometimes life-endingly challenging), but your suggestions are coming off as flippant.
If you want to be heard I would suggest presenting scientific evidence, and presenting it gently.
Depression affects about 4-12% of the people -- depending on how you look at the numbers -- not insignificant. What you seem to be talking about is not major depression. I grant it may be an interesting theory for some mild depressions, although I'd prefer to see some evidence presented. To suggest it to someone who has actual, clinical depression can come off as offensive and patronising, thus the kind of response you received from Devthrowaway80.
That's not true (your 2nd paragraph), and I speak from experience (of course, i cant speak for everyone.
There is a saying that "happiness is a state of mind, not a state of thing". There are always things to strive for, regrets to be had, if not merely because there are not enough time in the world.
Learning to be content with oneself? I was talking to a friend lately that told me "we (as in me and him) only keep living because we believe the future will get better". If you tell us to accept who we are yadda yadda... you can follow the conclusion.
You keep saying "many", despite being asked to back it up with something better than anecdote.
I talk to plenty of people with a clinical diagnosis of depression (of all severities - some use self guided CBT from a computer; some use face to face CBT; some people were detained against their will in hospital; one or two even had ECT.) If we're trading anecdotes most of these people did not have situational depression.
