Depression is situation dependent, but a confluence of two simple factors: psychological (the enviornment) and sociobiological (medically definable causes for functional mental or emotional impairment).
Well I am saying that I believe depression to not be a transitory state, according to the DSM the symptoms should have occured for a two week period, I tend ot think three weeks or more of persistant symptoms.
So again to call something depression is to identify the state, the state is the same regardless of wether the depression is purely physiological, strees related and a physiological vulnerability or a physiological state totaly from stress.
The end sate is depression, and the causal factots do not change the end state.
The person is depressed irregardless of the cause. At least in my bloated opinion.
Yes, and? If I self-induce chemical depression, I'm going to have a very lousy day regardless of anything that happens.
When I think depression I think something that is not transitiory, so it would require a series of lousy days lasting at least three weeks.
It is very difficult to sort of drug induced depression fro the effects of a SoA, especialy cocaine, alcohol and methamphetamine. usualy the person has to dry out first, and then the depression alliviates. (That would be a substance induced depression).
Under anhedonia, I would not be able to positively respond to say, winning the lottery.
Ahedonia is one of the criteria that qualifies as a depressed symtoms, so I am not following you here, please elaborate
If this deficiency isn't there, and an unpleasant series of events occur, my mood will similarly be affected. Why do you think I distinguished a relationship between the two.
Perhaps I would say that i draw a distinction between a depressed mood and depression. One is like the weather on a daily basis as oppoosed to a seasonal change in weather. Depression is when there is a long term shift in the weather.
Ok, now this is insighful. That is correct, someone with chemical depression often considers "everything depressing", that is, without reasonable cause.
See there is the hitch, the rub , the sticking point. Define reasonable cause. Unemployment, reasonable, loss of relationship, reasonable, mean employer reasonable, bad things happening, reasonable.
So how to make a clear distinction between what is reasonable and what isn't?
Depressed people have the same bad things and good things happen to them that happen to other people.
I tend to use time and functional impairment.
9 weeks is the arbitrary time frame in the DSM for an 'adjustment disorder', so if someone is having functional impairment and I should say substantial functional impairment nine weeks after the event then I would say they have gone from adjustment disorder into depression.
Grief is a very good example, if you are still unable to force yourself through your day nine weeks after a traumatic event then you most likely have dperssion. However if your skills are starting to carry you through and there are times where your mood is not totaly trashed, then you are not having deperssion. PTSD mopre likely or acute stress disorder, which can co-occur with depression.
Events are viewed through a washed out, grey and emotionally ineffectual lens. Their lives are like a continuous C-SPAN marathon. Someone with purely psychological depression does not have this deficit, but trauma due to a situation and memorex cause persistent disruption in outlook and productivity.
I would say someone with chemical depression doe shave that deficit. So maybe we disagree on that. In the
Cognitive Theory of Depression Beck points out what he calls the cognitive triad of depression, negative world view , hopelessness and negative self image.
I can't believe you find this difficult to distinguish?
Not when it comes to the state defined as depression. They are same:same , irregardless of the cause.
That is clearly chemical depression. It's like wearing glasses that distort everything as shades of grey. A chemically depressed person is not capable of interpreting events in a positive manner because the mechanisms involved in this are disrupted. Hence, a medical condition. The problem vanishes like a gentle breeze when this deficit is corrected.
I wouldn't say that either, usualy a person need some CBT to deal with the symptoms that remain with the ADs.
See above. Not what I meant: the problem vanishes when the deficit is corrected, when this occurs, you perk up immediately.
As I said, even on antidepressant the sysmptoms usualy persist for quite a while, in my cases usualy about six months, I have to use the CBT skills on a dialy bvasis to maintain healthy cognitive patterns.
So I am not sure what you mean when you say
"perk up immdeatly".
How effective SSRIs/SNRI's are at actually correcting this I'll have to bow to your experience, as I have none..
depends on the person and the depression, some respond to SSRIs, some to TCAs, some to the SSNRIs, some to Webutrin and the other atypicals, some to mood stabalizers.
usualy CBT is also recomended.
Chemically depressed people are often not able to distinguish between how they interpret situations and the fact the reason they are doing this is due to a deficit. Serotonin induced anhedonia, by contrast, is characterized by emotional retardation and despair.
Those are also sysmptoms of depression, so how would you distinguish the two?
A chemically depressed person cannot identify the cause, it is identified as a variety of reasons, or they instantly diagnose themselves by admitting "..everything is so damn depressing!".
I would disagree, they will tell you very specific stressors in most cases and again they are often the same as the ones given by someone who would have 'reasonable response to stress". So up front it is almost impossible to distinguish the two. A person who reports grief and stress leading to depression from the death of a child is going to look the same as someone who has chronic de and stress leading to depression.
Most people don't realize that a neurobiological mechanism exists that regulates the ability to positively interpret the world around you - often it is interpreted as a "crisis" of religious gravity!
And you can not distinguish between the two, if someone has a biological vulnerability to depression, a stress induced biological vulnerability to depression, a stress induced depression, they are going to act the same, they are going to report the same range of symptoms. It is very hard in an assesment to distinguish, and in fact the symptoms presented will be the same regardless of which of the three categories presented.
It would take an extensive history and collateral verification to identify which people have low levels of stress and serious impairment in functioning to find the people who have purely a biological vulnerability to depression.
And then when you think you have it sorted away, you find out that crucial piece of information
"My husband rapes my daughter every night"
and so it turns out that it is a stress induced depression , albeit with a possibility of a biological vulnerability to stress.
Any unpleasant or disordered situation will have a magnified negative effect on their mood. They mistakenly interpret the event as the cause.
But the rub is in finding a way to objectify that judgement. Usualy it comes from the individual after they start treatment, get well and then stop treatment. Most people will move on and not have a reoccurance of symptoms, those with the higher biological vulnerability will have a stress related reoccurance of symptoms.
No disagreement, that should always be applied.
If someone has purely chemical depression, the problem is superficial. It is corrected by treatment. Psychological depression cannot be treated by anything, but can be masked by narcotics and alcohol. Only resolving the disordered situation works; often that is impossible, as any Iraq war vet, or oxycodone, alcohol and sex addled Hollywood star will tell you.
What , HUH?
What evidence do you have that situational (stress induced) depression does not respond to treatment?
Where is that study? How many people were in it?
What the Fred?
I am refraining from name callling which will deter from the conversation.
Show me the evidence. You have just decribed the vast majority of people who seek mental health treatment.
Indeed, it is very difficult for those with a genetic low set mood to distinguish. They have no subjective frame of reference, except everyone else coping much more positively.
I am saying that you can not distinguish that up front, only after they start treatment and get off treatment.
The only problem is the rebound, which in the case of an addict, is horrific. Pu agonist opioids are very dangerous if a chemically depressed person becomes addicted to them. Delta opioid agonists, such as mitragynine however aren't, in fact their rebound is trivial - certainly compared to an SSRI from what I've read. As a side note, it
was found that saliva contained the precursor to an endogenous morphine like chemical.
Evidence that opiods can be used to treat depression?
What?
Where?
Addicted thinking?
The only real 'globally' effective antidepressent in existence is Tramadol hydrochloride, which combines a lightly acting pu opioid receptor agonist which also acts as an SSRI, and is freely available without prescription.
Citations, evidence, proof?
How do they define effective and how do they define treatment?
What?
The combination provides the best of both worlds, and has a dosage ceiling of about 300mg, the only drawback being the somewhat harsh rebound if stopped cold at maximum dosage, but easily stepped down from.
This is actually a fascinating
research question, as opioid agonists seem, despite the rebound, to instantly and globally treat depression.
I will read.
They should, although I don't see how a regulator like an SSRI will do anything unless the person has a deficit. I'll bow to your experience in this regard..
No bowing, because depression is depression, irregardless.
All chemical depression magnifies stress, anxiety, intrusive negative thoughts. If someone is psychologically depressed, the process is reversed: memorex of a actual hopeless, negative and depressing event affects mood balance. This is turning into a Taoist dialogue.
How can you tell the differnce?
Follow the way of the tao, follow the way of the tao, follow the, follow the, follow the, follow the, follow the way of the tao