Depression is NOT "like diabetus"

If I had an eurocent for each time I see somebody using this metaphore... with good intentions too.

But I just think it simplifies the condition terribly. It makes it seem that depression is something you simply see doctor about, get your happy pills... and la vita e bella.

It ain't so. Depression is a complex issue. Medical? Maybe. Not in all cases. No tests exists, so I am not gonna cling to the chemical imbalance theories. Believing something you cannot see is good for religion and not for science.
Yes, it may be factor, but it is not all there is.

other reasons?

Existential.... trying to find sense where there may be none... one would have to be crazy not to feel blue about that.

Spiritual? Most definitelly. We lose ourselves. We don't have goals beyond ourselves.... and it feels empty. We need something to cling to, but we aren't finding it. Maybe we aren't just looking. Maybe we look in wrong places.

Life sucks.... and sometimes we get stuck in a place and cannot seem to find our way out. "what would people say?" we think and rather do what we never wanted to do than take steps to change it. Good people may go to heaven... but being "good" in life is often hindrance... especially when our perception of "good" is "the one that never rebels".

Psychological reasons... supressed emotions. Traumas. All the jazz. Bad experiences. we all had them. Some are worse. some are allowed to heal better, some never get the change. It is normal to be screwed up after some experiences.

and many other reasons why can one feel/be depressed.... much more complex than simple "diabetus" comparision. As much as it is well-intended... it misses the complexity of the condition. It makes it seem much easier. In the end, it is much worse than "It's all in your head".

I have much the same problem with the "medical models" of alcoholism. Alcoholism is an addiction, it is not like anything else. To say it is simplifies the discussion--and totally screws up the reality of what comprises alcohol addition.

Sorry--about to hijack your thread ...

Roadrunner

Maybe we just haven't discovered the science behind it yet. Do you have to actually visit the New World in 1492 to believe the world is not flat? that is probably not the most reasonable or historically accurate argument, but I think you get my meaning? You use leeches for medical care until something better comes along - they DID help with high blood pressure!

Well said, Venus.

I'd like to add another concept: we all have a pleasure-seeking, goal-oriented system and a separate pain-avoidance system in the brain. They need to have a balance in order for us to function at our best. In my subjective experience, medications seem to reduce activity in the pain-avoidance parts of the brain - with all kinds of unwanted side effects. They often do little, if anything, to trigger activity in the pleasure-seeking, goal oriented system in my case and, I suspect, in many other people's experience as well. The problem for me is that this positive system keeps shutting down under stress. Why? Because I have chronic, subconscious negative expectations which cause me to simply not signal it to turn on under certain stressful conditions!

I have had several recent experiences where I have felt myself getting rather gloomy and fatalistic, and I have asked myself, "what would make you feel great right now?" Inevitably, I realize there is some cherished goal that I feel insecure about getting, due to a disempowered self-image (classic, common issues with self-esteem and self-confidence are at work here). Immediately, I find my mood lifting and my mind beginning - slowly - to consider ways I can solve whatever problem I am facing.

Because I have been engaged in negative patterns of thinking for a very long time (for whatever original reasons), I keep slipping back into a defeatist pattern of thinking as soon as there is stress in my life that reminds me of a previous stressor. What happens if I don't catch it? You guessed it - I start to dwell on what I'm afraid of instead of what I want to achieve, and boom! my mood bottoms out, and my motivation evaporates. I fail to achieve what I really want to, and then I react with a depressive or anxious episode as an understandable reaction to a feeling of having failed and being frustrated yet again!

Is this a purely biological problem unaffected by my own thinking, like diabetes? I really don't think so!!! A biological tendency for depressive states is being triggered by negative habits of thought - this is very clear to me now. In my personal experience (and everyone is different), medications are nowhere near a substitute for reframing my thinking and expectations.

I agree that depression is NOT a simple illness like influenza, which can be alleviated by getting a vaccine or taking a pill. It is a complex issue, caused by a wide possible range of variables. That's why there are so many theories and treatment options. In my opinion, it is most commonly a mood reaction to other, underlying biological and/or psychological issues, which then makes these other factors greatly intensified.

Well, given how complex diabetic management can be, and the degree of changes in lifestyle which are required, I wouldn't say that this analogy oversimplifies depression. However, I agree that it gives a false impression of depression as a medical issue which is measurable, well understood, and should be primarily dealt with by medication for a 'missing substance'.

Although we know that psychiatric medication effects our moods, we do not understand the system as a whole. We know neurochemicals exist and we can influence them. However, I'm more prone to believe that this is a mechanism upon which thought and mood can work rather than the actual cause of emotional changes we have deemed pathological. In short, I do not believe the theory of 'chemical imbalance' and view it as oversimplified (with a strong economic base). Thus, by modifying these neurochemicals, I do not believe we are actually solving the root cause of depression in most cases. Instead, we are masking the symptoms and often ignoring the causes. Venus and Onward touched very well on some of these underlying issues and alternative ways to proactively deal with depression, respectively.

Part of why I think this way is because every therapist and psychiatrist I have seen has pinpointed my depression as having a very, very strong genetic basis. I concur with this evaluation, although I know that's not all there is to it. Even as a child I would have been considered melancholic. The difficulties which I experienced in my life hit me harder than they would have others. However, I have come miles with very focused thought, behavioral, and lifestyle changes. I don't think I'll ever be the ever happy optimist - and that's something to accept in my eyes, rather than to fight and lament. I think if I had taken medication, it would have retarded by ability to see where changes needed to be made in my life. My focus would have been on being happy rather than becoming well. I would rather grow as a human being and learn to live with myself.

This doesn't mean that I think there is no place for medication in treatment for depression. It just comes with a cost and a lot of unknowns which need to be evaluated heavily. It is certainly not the same as medication for diabetes, which is absolutely required in most cases if they are to live a healthy, long life.

I have both depression and diabetes (<--the correct spelling) and I think a lot of people who tell me how to manage them know very little about either one.

I agree, we haven't even begun to understand the complexities involved. But the brain isn't "just another organ." We know essentially nothing about the brain, compared with the rest of the body. Medicine involving the brain isn't "like" anything else. Thought, memory, processing--we're only beginning to glimpse what's involved.

Leeches, btw, are still being used--haven't been improved on.

Maybe we just haven't discovered the science behind it yet. Do you have to actually visit the New World in 1492 to believe the world is not flat? that is probably not the most reasonable or historically accurate argument, but I think you get my meaning? You use leeches for medical care until something better comes along - they DID help with high blood pressure!

Maybe science is not the answer when it comes to human psyche. Maybe less science and more simplicity would do better job. Not saying we all should live in woods, but maybe stopping to consider what are we doing this for and if this is how we want our life to be.

Icarus project in one of the publications raised a question about how impact health is measured in missed days of work... but what if the person never wanted to do that job in first place?

Science, even social science uses reductionism and simplifies things. But can our psyches really be put into a formula?

I'd like to add another concept: we all have a pleasure-seeking, goal-oriented system and a separate pain-avoidance system in the brain. They need to have a balance in order for us to function at our best. In my subjective experience, medications seem to reduce activity in the pain-avoidance parts of the brain - with all kinds of unwanted side effects. They often do little, if anything, to trigger activity in the pleasure-seeking, goal oriented system in my case and, I suspect, in many other people's experience as well. The problem for me is that this positive system keeps shutting down under stress. Why? Because I have chronic, subconscious negative expectations which cause me to simply not signal it to turn on under certain stressful conditions!


This is interesting.... but yeah, I tend to believe it is partly "in your head".

Many people tend to view it as offensive when told they don't have coping skills... but thse can be taught. And sometimes when we find ourselves in new situation... we don't know how to react.

If you were dropped in a foreign country without a map, knowing the language, or knowing where you are.... you would probably first try to analyze the situation. Try to figure out where you are and what are the habits of people. Maybe you would try to find some tourguide. You would try to learn few usefull phrases..... and this is simmilar to finding ourselves in situation we weren't prepared for. Freaking out is natural... maybe some are better equipped to orient themselves quickly, but most people can do it.


Is this a purely biological problem unaffected by my own thinking, like diabetes? I really don't think so!!! A biological tendency for depressive states is being triggered by negative habits of thought - this is very clear to me now. In my personal experience (and everyone is different), medications are nowhere near a substitute for reframing my thinking and expectations.

Power of thought is very strong and should not be underestimated. I think it is criminal to tell people they cannot control their thoughts and cannot help themselves.




Vibe... word on what you said. I don't have problem with people who chose to take meds... but many take them for wrong reason, believing the whole chemical imbalance theory. Many take them with faith that taking few pills will solve most of the problems. Yes, they may make you feel better and your life livable, but we don't really know why. If it works for you and is worth the risks.... than go ahead. But that should be a personal informed choice.

By talking about medical model.... it misses the point. And I am tired of well intending friends recommending me good srhinks and good drugs as if that would solve my situation. Stigma? Yes, there are people among the normals who think depression is nothing. But then there are some who believe one needs to take drugs... otherwise I am walking on an a-bomb.... hard to explain them it is not just lack of serotonin for me.

I have both depression and diabetes (<--the correct spelling) and I think a lot of people who tell me how to manage them know very little about either one.


Thanks for correcting my spelling, it greatly contributes to the debate.

I am not telling you how to manage it. I am just sharing my point of view. Spreading the medical model hurts me and hurts many people.

I agree, we haven't even begun to understand the complexities involved. But the brain isn't "just another organ." We know essentially nothing about the brain, compared with the rest of the body. Medicine involving the brain isn't "like" anything else. Thought, memory, processing--we're only beginning to glimpse what's involved.


So I rather not mess with it. You wouldn't let a guy who know little about computers and would speak of "well, there is a theory that deleting this program may get rid of the problem, but it works only for 60% of users" to repair yours, would you?

I have always hated the diabetes comparison, but I understand why it is used. It demonstrates that there are necessary behavioural modifications and, at times, medication may be necessary as well.

I know that the "chemical imbalance" theory is not shared by all mental health professionals anymore. I know that my psychiatrist does not believe that depression and bipolar are that simple. I think, baring severe, life-threatening, symptoms or psychosis, it is preferable to try behavioural modifications first, as well as cognitive strategies. I do think that it can be necessary to use meds, but not immediately.

If I'd tried all other solutions, I might.

well, but the awareness campaigns still seem to be pushing it, without realizing they are in fact doing more harm than good. Some of these people are League of Nation of mental health.

And of course you have those advertisments on TV with cute computer animations of neurons....

It is much more complex and much deeper and I think we should acknowledge it. No easy solutions when it comes to life.

To say that depression is not like diabetes I think is a bit premature at this stage. Clearly both are complex, chronic conditions. In fact, there are multiple different types of diabetes, some are due to a lack of insulin, others are not. It is likely that there are multiple types of depression, some with biogenic origin, some that are not.

It's not really faith I think, but rather a learning curve.

I think it's just too early to make blanket statements. Thoughtful deliberate choices are are important.

So there's not a blood test for it. So what? There's not a blood test for pain either, but, well, the symptoms are treatable even if the underlying condition is not. Is pain caused by a deficiency in endogenous pain modulators, no, but low levels of them make pain worse.

To each his own. There is certainly nothing criminal about people's choices or how they opt to manage and survive. Most of aren't blind children being led hither and yon by some evil doctor at the mercy of the pharmaceutical industry. Most of us don't want a happy pill, but to just feel better in order to live the life we chose.

Sometime theory is important, and sometimes outcome is even more important.