Depression isn't all in your heads... is it?

[Sniperyeti]

Your friend obviously has an emotional interest in seeing depression as somehow not real. These issues tend to become matters of 'belief' rather than a logically based opinion, leave him to it and if he tries to argue with you point him towards any respected psychiatric journal and continue your day.

The current theory on most clinical disorders in psychiatry is the 'stress-diathesis' approach, which is that a biological tendency towards a condition is set off by 'stress' (something bad happening) in the environment. Chemical inbalances are certainly part of the picture, but not necessary considered the main issue any more.

The DSM IV-TR gives a wide range of symptoms which taken together could constitute a diagnosis of depression. If you wanted to try a different angle on your friend you could point out that depression is a diagnosis, and as long as it is identified and treated adequately the cause of those issues is irrelevant in the immediate term.

 

[AnkaraTheFallen]

Well, far as I know, there is a lot of research to prove it is a medical condition to do with a chemical imbalance. (There are two thoughts on this I've seen. 1. your body makes too much of the chemical that makes you happy, dulling you to it's effect and rendering it useless, and 2. being it makes more of one that makes you depressed.)

There are also different kinds of depression as far as I see it, there's the kind were you are upset all the time about everything. And there's the one I have/had (Not sure if I'm quite over it, but hopefully I'm getting there) were you seem to have no emotions, or you 'feel' nothing, no happiness, no sadness, nothing, it's akin to never caring about anything, but this depression is usually left undiagnosed from what I can tell as it is often just seen that you don't care about anything, rather than having a problem.

Edit: I should also add, there are two things that cause depression:
1. The make up of your brain, the depression is with you from birth and will never go away, there may be times when you can ignore it, but it's always going to be there, pills are the only thing that will help with this, no amount of therapy will sort this.
2. Outside events, this is where outside circumstances cause your feelings of depression, again pills can help stop the feelings but the depression will always be there till you can work around and get away from what caused it.
Or admittedly a combination of the two can cause your depression, either way ignoring it or just getting on with life wont sort it as your friend believes. For a lot of people the pills are needed, personally I took them for a while and have managed to get off them in time, I still have the occasional bout of depression but I am dealing with what caused my depression, so I no longer need the pills, but many still do and may always do.

 

[Falconsgyre]

they only treat symptoms rather than root out the cause.

What if the cause (as it frequently is) is brain chemistry?

But that does raise a question. If your thoughts, feelings, emotions, etc are neural and chemical interactions and systems, then wouldn't the appropriate method of curing it be to alter the thoughts and outlook (and thereby the chemical and neural interactions) in such a way that promotes a chemical balance within the brain? I mean, if you can figure out how to do that, then you could work to cure depression psychologically, rather than medically. I mean sure, drugs are good for the short term until you figure out an approriate method, but what drugs are actually doing is acting to alter the individual on a fundamental level.
Almost like mild brain-washing.

OT: As far as I know (which is very little), clinical depression is when the brain creates a chemical balance prone to depression. So it isn't something that you can just get over on a whim, it is a predisposition that exists independent of external influence, so to 'get over it', as your friend so bluntly puts it, you'd need to alter the basic chemical balance within your brain, and not being a neuroscientist, I wouldn't know exactly by which process that could occur.

Saying the cause is a "chemical imbalance in the brain," as all those asinine commercials do, does cover up what a "chemical imbalance in the brain" actually means. SSRIs (selective serotonin reuptake inhibitors), for example, rely on the idea that you need serotonin hanging around your synapses longer, but putting it in terms of neurochemistry can ignore why it got that way in the first place (and to the best of my knowledge, that answer is "we have no fucking clue as to the exact mechanism") or what exactly that translates to in terms of thought. We're not very far along on the understanding of how chemistry translates into thoughts. For that matter, we're not all that far along on understanding thought in general.

Also, there is therapy that treats depression in a non-chemical fashion.Cognitive behavioral therapy [http://en.wikipedia.org/wiki/Cognitive_behavioral_therapy] is a pretty good choice and is clinically proven to work. Even this, though, works better if you're also taking meds at the same time.

Depression isn't an ilness, but can certainly have it's effects on the body (sleeping disorder, headaches and feeling the lack of energy (nearly) all of the time) so one can follow from the other. Certainly the way you deal with things and the impact you 'let' it get on you is something to keep in consideration when you are going trough a thing like that. But there is no doubt that it starts in the head. Pills.... I'm not for them. My thought on them are that they only prolongue the problem, not solve it but make it extend to 'go away to hunt you another day'.

Liking the discussion thus far, love opposing opinions.... This is basically the claim my bud and several other people we know will make to me when the topic arises.

What is wrong with taking pills to stop a negative affect on your mood and lifestyle? they only correct the imbalance, making you your normal self rather then the depressed you? If its not an illness, what is it? care to explain?

I am not really an expert on medication, I can only tell you something about my experience with them to 'correct' the 'chemical imbalance' I (had to) deal with: True that they help to a certain extend in calming you down or let the depression subside. But as some people here said, it only takes away the problems on the surface. You just cover it up. I began to feel less and less to the point where I felt like a drone. Thinking that depression sucks... well.. at least I felt SOMETHING. I couldn't describe or retrace my own being anymore and thus couldn't tell where my feelings came from (so much for treating the problem). While everybody was telling me I was doing 'great!' or 'better!' with those chemicals, I sunk away in myself and nearly didn't feel human anymore. Getting out of depressions takes time and people to help and talk to.. not meds as far as I see.

Oh, this can be so true. However, part of the problem might be that you were on the wrong medication or the wrong dosage; it's not really supposed to affect you that much. My first psychiatrist prescribed an overdose of Zoloft (my second psychiatrist had a "what the fuck?" moment when he saw it, actually), and it kind of screwed me up. Switching medications and dosages helped me avoid feeling like a zombie. Though to be fair, I still kind of preferred being a zombie to being absolutely crushed and unable to feel joy.

 

[Jordi]

Ah, the 2am forum post. 3 cheers for healthy sleep habits.

My close friend has for years defended his idea that depression doesn't exist, that it isn't a clinical issue, and that anyone who takes pills for depression is in fact, as he so intellectually puts it, a "puss who can't deal with reality", so those who take anti-depressants don't have a malady, but are just altering their reality with drugs because they can't deal with negatives.

He ultimately views it as a "mindset" of sorts, rather then an illness to be treated, either with meds or even counseling to a degree.

Try as I might, I can't convey to him how the illness (is it an illness? I can't think of the word that describes it) that is depression is in fact a chemical imbalance in your brain (as I understand it) that makes your body produce more of the negative emotion chemical (forget the name) and et cetera.

Although I personally think he's wrong, I can't convince him and do wonder if he has some shreds of truth tacked to his argument.

Is depression a real illness, or is it real all in your heads, to an extent?

(would be cool if you could gimme something to shut him down in our next debate once and for all, btw. just puttin it out there...)

EDIT: Feel I should point out that, ironically, my buddy has been sent to a doctor several times for depression (at his parents behest) and recently one attempted to diagnose him with depression and prescribe him medication. He flat out denied the doctors claim and refused meds. He real is stubborn about the pills, very against the "altering your brain" based on the morality and level of control you therefore have over yourself and your person. And another friend of ours supports him just as vehemently in his views.

Though he'll probably never admit it, he has some very odd mental issues, has since I met him, but refuses to succumb to falling back on them as excuses or reasons for any deficiencies he has. I slightly admire him for that, and am infuriated by his stubbornness at the same time.

I think neither of you is really wrong, although your friend shouldn't be so quick to judge people. The thing is, when it comes to matters of the mind the line between illness, personality, state of mind, etc. is extremely blurry.
Some gay people have used neurological evidence to show that being gay is innate and identifiable in the brain and is therefore not a disease (as some people claim). A lot of people accept this as evidence, but still think that pedophiles are sick (I know it's just an expression, but I think some people mean it). If the tech would allow for it, we could probably identify structures and chemical (im)balances that cause people to be lazy, altruistic, assholes, geniuses, etc. I imagine at some point we could device pills to suppress each of these traits, but should we?

I think chronic depression can be seen as a personality trait. It means you have a very negative outlook on the world, don't like anything and can't really experience happiness. Because that all sucks so much, we call it a disease. Not on technical grounds, but just because it is undesirable.

Furthermore, we know that experience in the real world can affect the chemical (im)balances in your brain. A lot of depression can be "cured" through psychological means. If you can be cured by talking to a psychiatrist, why can't you cure yourself by talking to yourself? Maybe the people who don't get depressed have "mastered" this skill while those who do haven't (and therefore need help from a professional).

BTW: If your friend refuses to take meds for his condition, I think you should respect that. I would be extremely reluctant to take mind altering drugs as well. It's not like we know so much about the brain that scientists can foresee everything that can go wrong beyond the already known side effects (which are often no pick-nick either). I would be afraid of how the drugs would change me. Maybe I'd be happier, but would it come at the cost of my critical outlook and thinking? Because I don't think that is a sacrifice I would be quick to make.

 

[Polarity27]

No. No no no no, not *this* thread again, dear god we just went through this agony last week!

As for your friend, do either of you have access to a university library? If so, go there, ask the librarian how to access PsycINFO or MEDLINE, and do some searches on depression and drug therapy or depression and fMRI (a type of brain imaging that's proving quite a number of interesting things about "invisible" disabilities) studies. Read the abstracts. Accept the science.

I read this material daily as part of my job, and seeing people who just up and decide that something that's been medically proven six ways from Sunday doesn't exist because they don't want it to exist/want to think people who have it are weak and just need to cheer up/think people who have it are faking make my head split. This information is not that hard to find! Hell, you'd probably find a lot of scientific references with just a google and a trip to Wikipedia. Don't ask other people to do the research for you, do it yourself and you'll understand it better.

 

[Ruuvan]

I'm not as knowledgeable as most people who have replied to this thread, but I'll just relate my personal experience.

You know those types of medication that list depression as a side-effect? I considered it to be bollocks, but not long into it I suffered ten minutes of what I can only call depression. You can all laugh and say "Well that's naff all compared to a lifetime" and I completely agree, I'm just talking about it to say I think it's completely real and I feel for those who suffer.

For those ten minutes I just felt empty, no other word for it. I didn't have a drive to do anything, I didn't WANT to do anything - even thinking of getting up and getting a glass of water seemed useless, as silly as that sounds - I just felt like shit and it was utterly terrifying. Those who truly suffer from depression have it bad. Those who fake depression or say "I'm depressed" when they've had a bad day at work don't really know what they're talking about and, for that matter, neither do I.

 

[Guitarmasterx7]

Supposedly I have almost all the symptoms of clinical depression. If I'm left with nothing to do but think for an extended period I guess it does start to get to me but for the most part it's really easily suppress or distract myself from. I have pretty much the same mindset as your friend, and I think that's why we can overcome it so easily. If you're depressed and your mindset is "oh I'm so sad there's nothing I can do about this, it's a medical condition, I'm a victim" then of course you won't be able to overcome depression. You just admitted defeat to something in your own cognitive working. If you're thinking to yourself "What the fuck are you doing, pussy. This moping around shit is pointless. You know it's pointless. Get over it and do something with yourself." then you don't need pills or therapy. I would say it's a mind over matter thing but it's more a mind over mind thing given the nature of depression.

So in a way your friend is right, but only relative to his mindset. Don't get me wrong, it's definitely a serious problem, and your mind is capable of fucking with you pretty badly, but there are ways to get past it without drugs or therapy.

 

[AnkaraTheFallen]

I'm not as knowledgeable as most people who have replied to this thread, but I'll just relate my personal experience.

You know those types of medication that list depression as a side-effect? I considered it to be bollocks, but not long into it I suffered ten minutes of what I can only call depression. You can all laugh and say "Well that's naff all compared to a lifetime" and I completely agree, I'm just talking about it to say I think it's completely real and I feel for those who suffer.

For those ten minutes I just felt empty, no other word for it. I didn't have a drive to do anything, I didn't WANT to do anything - even thinking of getting up and getting a glass of water seemed useless, as silly as that sounds - I just felt like shit and it was utterly terrifying. Those who truly suffer from depression have it bad. Those who fake depression or say "I'm depressed" when they've had a bad day at work don't really know what they're talking about and, for that matter, neither do I.

I'd say you know better than most, as those ten minutes, I'd also say were what can only be called depression, and that's how I used to feel before I was able to work through what caused mine (Well, mostly I still have the occasional bout of it from time to time, but not as bad as I used to). Even feeling a few moments of it must be horrible to experience.

 

[lionsprey]

It's a illness just look up what the word means.
Can't say much that hasn't already been said.
Would like to add in another Your friend is wrong though.

 

[AnkaraTheFallen]

Supposedly I have almost all the symptoms of clinical depression. If I'm left with nothing to do but think for an extended period I guess it does start to get to me but for the most part it's really easily suppress or distract myself from. I have pretty much the same mindset as your friend, and I think that's why we can overcome it so easily. If you're depressed and your mindset is "oh I'm so sad there's nothing I can do about this, it's a medical condition, I'm a victim" then of course you won't be able to overcome depression. You just admitted defeat to something in your own cognitive working. If you're thinking to yourself "What the fuck are you doing, pussy. This moping around shit is pointless. You know it's pointless. Get over it and do something with yourself." then you don't need pills or therapy. I would say it's a mind over matter thing but it's more a mind over mind thing given the nature of depression.

So in a way your friend is right, but only relative to his mindset. Don't get me wrong, it's definitely a serious problem, and your mind is capable of fucking with you pretty badly, but there are ways to get past it without drugs or therapy.

Personally I believe the symptoms they use are very wide ranged, and a lot of people can have them without actually being depressed.
But I agree, you need to want to get past it to overcome it.
Though for my thoughts on it being a medical condition see my first post.
In short though, I'd say even if you want to overcome it, for many the pills help and ultimately give enough stability to overcome it, but for some it will always be there and there is no way to overcome it.

Edit: And I personally feel the therapy is necessary, as the one thing that helped me through my problems more than anything was just having someone impartial to open up to, you can't really do that to yourself in the same way.

 

[Griffolion]

There have been records of depression that stretch thousands of years back. It's a clinical illness that severely reduces ones ability to function in life. Some people try and battle through it with a strong head, other's aren't able to do so and rely on medication/therapy to get through it.

No. No no no no, not *this* thread again, dear god we just went through this agony last week!

As for your friend, do either of you have access to a university library? If so, go there, ask the librarian how to access PsycINFO or MEDLINE, and do some searches on depression and drug therapy or depression and fMRI (a type of brain imaging that's proving quite a number of interesting things about "invisible" disabilities) studies. Read the abstracts. Accept the science.

I read this material daily as part of my job, and seeing people who just up and decide that something that's been medically proven six ways from Sunday doesn't exist because they don't want it to exist/want to think people who have it are weak and just need to cheer up/think people who have it are faking make my head split. This information is not that hard to find! Hell, you'd probably find a lot of scientific references with just a google and a trip to Wikipedia. Don't ask other people to do the research for you, do it yourself and you'll understand it better.

This too.

 

[aussiebee]

From my experience (studied psychology for a year and been seeing a psychiatrist for nearly 5) depression is most certainly a recognised disorder, and it can be either a physical chemical imbalance or something not as clearly understood - that's why medication works for some people and not for others, and why therapy works for some and not others.

Personally, I am in the chemical imbalance group. Basically, life was so crap for so long that my brain now thinks producing all those negative feeling chemicals is the normal/right way to be.
While on antidepressants, the imbalance is corrected, and keeping them up is training my brain what is the right balance again so that I can eventually get off the meds completely.


I would point your friend to a DSM(Diagnostic and Statistical Manual of Mental Disorders), and if they don't accept that it is a recognised condition then, then they're just not willing to accept it at all.

 

[Guitarmasterx7]

snip

Personally I believe the symptoms they use are very wide ranged, and a lot of people can have them without actually being depressed.
But I agree, you need to want to get past it to overcome it.
Though for my thoughts on it being a medical condition see my first post.
In short though, I'd say even if you want to overcome it, for many the pills help and ultimately give enough stability to overcome it, but for some it will always be there and there is no way to overcome it.

Edit: And I personally feel the therapy is necessary, as the one thing that helped me through my problems more than anything was just having someone impartial to open up to, you can't really do that to yourself in the same way.

I never said it wasn't a medical condition. Thoughts and feelings are technically a biological thing, and the brain has a huge effect on the rest of your body. The fact that you can get physically ill from stress illustrates that quite well. However, chemical imbalance or not, if your brain's natural state of functionality results in depression it's still your brains natural state of being. If your personality doesn't provide you with a functional way of thinking to deal with it, then yes, you'll probably need drugs and/or therapy. My point was just that it can be overcome mentally by people with the right state of mind for it like myself and the OP's friend.

 

[Lexodus]

Depression is a very serious problem, whatever the cause, and anything that can lead to self harm or suicide isn't just a 'pussy who can't deal with reality'. As a psych student, somebody with a lot of friends who suffer, and somebody who suffers heavily myself, nothing pisses me off more than people with that attitude. You wouldn't tell somebody with shell-shock they were just a wimp, would you?

 

[Kapol]

Depression is when your parts of your brain stop functioning correctly (at least clinical depression is). More specifically, it's when certain neuron receptors stop taking in the chemicals they are supposed to as much as they are supposed to. The chemical in question is serotonin. That is the chemical that makes you feel 'happy.' When the receptors in your brain fail to intake that chemical, that leads to feelings of depression. When the serotonin crowds the area due to not being able to go into the receptor it's supposed to be going into, it's brought back in by a re-uptake area and stored for later use.

Anti-depressants block the re-uptake area, meaning that serotonin continues to build up. Since it builds up so much, the receptor is forced to accept more of it. This causes depression to get at least somewhat better. The downside is that, while the lows aren't as low, the highs also aren't as high, as the serotonin isn't being stored for those big bursts of happiness (like, say, winning the lottery).

This can be caused by a number of issues ranging from emotional problems that have to deal more with the person's psyche, to genetic or other chemical influences that causes the receptor to work less effectively. The main way to improve the receptor's uptake without pills, if I remember correctly from my Psych class, is to go through therapy. Releasing stress and dealing with problems can cause the receptor to being working better.

So, in conclusion, it can be caused by the person (though not, as your friend says, by how they see the world, but instead by stress and personal factors) as well as other various sources like genetics and chemical imbalances.

 

[Togs]

There's a strong genetic component, making you predisposed to having depressive episodes.
In fact its been shown that the variety of mutations that have been linked to an increased risk of depression have also been shown to be linked to a number of personality traits such as interpreting negative life events much more negatively, a heightened panic response and harsher personal evaluation.
These things can be combatted through the application of cogntive behavioural therapy, its not easy but it is possible.

So basically your body makes your mind weaker, but the mind can still override the bodies imperatives.

 

[DoctorPhil]

EDIT: Feel I should point out that, ironically, my buddy has been sent to a doctor several times for depression (at his parents behest) and recently one attempted to diagnose him with depression and prescribe him medication. He flat out denied the doctors claim and refused meds. He real is stubborn about the pills, very against the "altering your brain" based on the morality and level of control you therefore have over yourself and your person. And another friend of ours supports him just as vehemently in his views.

Isn't your body overproducing negative emotion chemicals altering your brain much more? Depression holds you back way more than happy pills. At least, I think, I've never been depressed, but I'm right, no?

 

[InfiniteSingularity]

I'm probably going through some sort of depression right now, however for the sake of not wanting to sound like a whiny ***** I'm going to say I'm not.

Depression is that feeling when you feel like nothings worth it. It's a feeling. And it's fucking horrible. It can be "diagnosed" just like anything on a relative scale. It's like when you drop below a certain level of average happiness per day you are considered to be "depressed".

Feelings are in your head, but it doesn't make it any less real. The circumstances that cause it or trigger it are just as real also. And it needs to be addressed in a way that isn't medical or procedural - it needs proper social and emotional guidance.

Depression isn't about being a pussy and not being able to deal with reality. It's about your perspective giving you no hope or purpose. It's about how you've been treated, raised, and considered. It's about how your environment affects you. It's about how you feel. It is definitely real

 

[Gustavo S. Buschle]

Depression is when you can't recover from being sad, for example: Imagine the person you love most died, normally you would be sad about it for a couple months, if you have depression you could spend many years sad and never recover.

 

[Ace of Spades]

Well, consider how the world would have to work assuming depression didn't exist. That would require a good portion of the population to be so crippled by their problems that they physically can't deal with reality, which personally I have a hard time believing.