Is depression an illness?

[Dancing David]

Are you talking about me?

You're probably right, which further shows how the "chemical imbalance" is just a folk concept.

It is a matter of scale, if you say to someone "hey your depression is caused by a lack of an adequate post sysnaptic receptors/post synatptic response leading to overactivity in the serotonin and dopaminic system which in turn creates the symptoms of depression", they are just as likely to say 'why didn't you just say chemical imbalance?"

It probably be more acurate to say "you have a stress related disorder that manifests itself as depression".

On the whole depression is an illness issue:

There are people who use anything as an excuse. the point to labeling mental illness as mental 'illness' is to get away from the moral judgements that people get into; like; 'they are just lazy','they just don't try hard enough','they just need to get over it'.

When I am depressed it seems to have two effects, one an overwheliming sense of being flooded by sensations and obsessive/compulsive thoughts and behaviors OR feeling like I need to sleep or cry all the time, it is like 'walking under water', everything requires alot of effort in motivation. Fortunately Zoloft does away with most of it.

Wether depression is situational/exogenous or biological/endogenous is not material, if someone is still grieving the loss of a loved one and can't function, they can't function. If someone is jusy totaly lacking in the will to face the day and they can't function, they can't function. The question that leads people to treatment is two fold, are you functioning, what areas would you like to function in?

Mental illness sounds better to me than the one NAMI is proposing 'brain disorder'. I would rather be a patient than a 'mental health consumer'.

Some people can get thier lives back on track with just some cognitive restructuring, some need medication. The biggest problem for most people with depression is giving up thier unhealty coping skills. Like alcohol or avoidant behaviors.

 

[Dancing David]

That authority is sure great! Eat fecal matter. A billion flies can't be wrong.

Well, let's start with the DSM-IV, shall we? Perhaps you can show me the page and paragraph where it describes this.

And what are you some religous kook, did you read a book by Thomas Sasz and just lap it up? There is plenty of research into the biological basis of mental illness.

You must be suffering from some grand delusional scheme to take the DSM as some sort of proof of anything, it is a manual for the description of disorders that psychiatrist and psychologists treat.

What is the matter Epekeke , you want to just stigmatize people because it makes you feel good, you obviously have some critiacl thinking skills, use them! Where did EoE say any of the crap you acuse her of, I suppose you think we should burn witches too?

The problem most likely is that you just want to feel superior to people who live with mental illness, thanks a lot shmuck. Do us all a favor and shut up!

 

[Dancing David]

Unfortunately, this due to the state of the art. The fact that pychs basically have to shoot in the dark to treat depression just shows that we're that much further from having an etiology.

Nobody knows what causes depression. A corrolary of that is that, certainly, nobody knows that there is a single cause for depression. There could be hundreds of diseases, all of which cause depression.

And this is news to who, some ignoramus who just started to spout off in some forum and demostrates the lack of thier knowledge. This is a well known fact in the mental health community, something you could have even read on this board!

Duh, dude! What other pearls of wisdom do you have to offer, anything from this century, there is a sound basis for knowing the roots of a lot of depression.

Which is why a statement like "Nobody knows what causes depression" just shows a contradiction in your thinking. Duh, again. If you already knew that there are multiple neuro transmitters and they they may all be part of depression, then you would already know that. Gee that was common knowledge in 1982!

It just happens that depression manifests in just a few choice systems in the brain, for about 80% of depression, it manifests in the serotonin and the dopamine/acetyl choline system. So those people will respond well to treatment with SSRI or TCA. Recently estrogen therapy is very effective for treating some women.

You are just amazing, there has been research into the causes of depression for over 25 years, good solid nuero-biology and you just missed it all.

A chemical imabalance is as good as most people want to hear.

 

[Dancing David]

When major depression diagnosis is (properly) made, considerations like the ones you mention are thoroughly evaluated. From this page, two diagnostic criteria for major depression:



My point is that psychiatrists know how to make a differential diagnosis and exclude other medical conditions or socioeconimic problems from the picture. When someone is diagnosed with major depression, we are talking about a serious medical condition that can be aggravated but cannot be caused (as far as we know) by misfortunes in one's life.

Check the site I linked for other types of mood disorders that may be more like what you have in mind.

The other issue is that it can very hard to get an accurate history when a decompensated person presents for the first time, depression and schizophrenia look amazing alike when the person is full blown and florid. Are they psychotic or do they have obsessive compulsive disorder? Are they really psychotic or are they way manic? Are they really bipolar or just high on cocaine? What possibility is there that they have suffered organic braib damage of some sort?

Great post!

 

[Dancing David]

If you do a google search on neuro-biology/neuro transmitter/depression you get over 9,700 hits and there is only one woo woo enough to use the phrase holisitic on the first two pages.

Following are four links out of the first two pages, Folk medicine indeed, folk doctors only wish!

Abnormal signaling, over secretion.
http://www.neurotransmitter.net/crf.html

Neurotransmitters activate secondary message
http://www.psychiatrist.com/pcc/brainstorm/br6010.htm

Neurobiology of depression
http://www.sci.sdsu.edu/classes/psychology/psy760/handouts/depression.htm

Stress and depression
http://cpn.umc.edu/NSSP/presenations/PrestSMcDaniel.pdf

 

[hammegk]

You mean it isn't possession by demon(s)?

HUH? Oh, OK.


Nevermind!

 

[epepke]

It is a matter of scale, if you say to someone "hey your depression is caused by a lack of an adequate post sysnaptic receptors/post synatptic response leading to overactivity in the serotonin and dopaminic system which in turn creates the symptoms of depression", they are just as likely to say 'why didn't you just say chemical imbalance?"

Well, this is not known. That's what it means to say that the cause of depression is not known.

It probably be more acurate to say "you have a stress related disorder that manifests itself as depression".

Or, rather more honestly, "you have something that manifests itself as depression, and although we don't know what causes it, tinkering with serotonin sometimes helps."

Depression isn't necessarily stress-related. It may be, but at the crude and imperfect level of psychiatric medicine, those generally tend to get labeled as situational depressions.

There are people who use anything as an excuse. the point to labeling mental illness as mental 'illness' is to get away from the moral judgements that people get into; like; 'they are just lazy','they just don't try hard enough','they just need to get over it'.

That's a very good point. There do exist what for want of a better word one might call "moral models" of depression. Of course, one of the symptoms of depression is feeling bad about one's character, and it seems fairly clear that depression can amplify these messages.

Without pointing fingers, I think that some people have glommed onto the "chemical imbalance" concept as the only possible alternative to a moral judgement and stick to it for that reason. And so, when the "chemical imbalance" concept is questioned, they consider it an attempt to take away what they consider to be their only bulwark against a moral judgement.

Yet this is a kind of a mythological battle here, and while I do consider mythology to have some value, I would hope that the researchers who are looking for the ultimate causes work in terms of something better and more accurate and precise than mythology.

When I am depressed it seems to have two effects, one an overwheliming sense of being flooded by sensations and obsessive/compulsive thoughts and behaviors OR feeling like I need to sleep or cry all the time, it is like 'walking under water', everything requires alot of effort in motivation. Fortunately Zoloft does away with most of it.

Fairly classical descriptions of depression. For me, Zoloft just gave me anorgasmia, which didn't exactly cheer me up.

Wether depression is situational/exogenous or biological/endogenous is not material, if someone is still grieving the loss of a loved one and can't function, they can't function. If someone is jusy totaly lacking in the will to face the day and they can't function, they can't function. The question that leads people to treatment is two fold, are you functioning, what areas would you like to function in?

That seems to me an eminently healthy attitude. But I have to reiterate that what I am saying doesn't really impinge on the idea of whether it's exogenous or endogenous. Of course, this too is all going to have to be worked out. But simply saying that the notion of a chemical imbalance is folk medicine does not mean that there is not an endogenous condition. It really doesn't enter into the picture at all.

It also doesn't say anything about the value of medication. As I think I posted before, NSAIDs such as aspirin can be used to treat headaches. I'm simply pointing out that there is no evidence that headaches are caused by an "NSAID imbalanace."

Mental illness sounds better to me than the one NAMI is proposing 'brain disorder'. I would rather be a patient than a 'mental health consumer'.

I've often found that I have a problem with the tendency to call mental health patients "clients," but this is still an observation based on mythology. Whether one is called a patient or a client or a consumer says little or nothing about underlying causes.

 

[epepke]

And this is news to who, some ignoramus who just started to spout off in some forum and demostrates the lack of thier knowledge. This is a well known fact in the mental health community, something you could have even read on this board!

Duh, dude! What other pearls of wisdom do you have to offer, anything from this century, there is a sound basis for knowing the roots of a lot of depression.

I'm honestly unsure of what exactly you're excited about.

I made what seemed to me a fairly obvious observation, that nobody knows what causes depression, and that the "chemical imbalance" was a folk medicine concept and inadequate to describe an actual etiology. I fully expected the matter to die out there.

However, Eos of the Eon's went and got all huffy about it. So, given that challenge, I felt that I had to respond and reiterate that the cause is not known, because she, at least, as a participant in this thread, has demonstrated hostility toward the idea.

Now you are getting all huffy because, what, it isn't New™ or Exciting Enough™ for you?

Just what the hell is wrong with you?

It just happens that depression manifests in just a few choice systems in the brain, for about 80% of depression, it manifests in the serotonin and the dopamine/acetyl choline system. So those people will respond well to treatment with SSRI or TCA. Recently estrogen therapy is very effective for treating some women.

You are just amazing, there has been research into the causes of depression for over 25 years, good solid nuero-biology and you just missed it all.

And, how, exactly, does that contradict anything that I have said here?

 

[epepke]

And what are you some religous kook, did you read a book by Thomas Sasz and just lap it up? There is plenty of research into the biological basis of mental illness.

You must be suffering from some grand delusional scheme to take the DSM as some sort of proof of anything, it is a manual for the description of disorders that psychiatrist and psychologists treat.

What is the matter Epekeke , you want to just stigmatize people because it makes you feel good, you obviously have some critiacl thinking skills, use them! Where did EoE say any of the crap you acuse her of, I suppose you think we should burn witches too?

Man, this is so over the top that I can only hope that it's a satire. It reads like a satire.

 

[epepke]

I'm glad to see someone knows what they are talking about

***pokes epeke with a stick***

Have you learned how to read yet?

 

[Dancing David]

Man, this is so over the top that I can only hope that it's a satire. It reads like a satire.

All good satire contains an element of the truth. And yes when i find myself getting prosaic, I tend to lampoon myself.

Whats your excuse?

 

[Dancing David]

I'm honestly unsure of what exactly you're excited about.

I made what seemed to me a fairly obvious observation, that nobody knows what causes depression, and that the "chemical imbalance" was a folk medicine concept and inadequate to describe an actual etiology. I fully expected the matter to die out there.

Yeah well, it is a useful term for those in society who use the medical system but don't want to understand what a post synaptic response is.
Your still foolish for dictating what is basicaly a biochemical imbalance and not being a chemical imbalance. But then I suppose you never had to talk to someone who never went to high school about why thier family member should take medicine to reduce thier psychosis. I am sure that telling them "the eitiology of mental illness is not clearly understood but we highly recomend that your family member take this medicine because it seems to provide some relief from the symptoms, although we don't know if the effect is pallative or restorative" would get a resounding, yes I understood that.


However, Eos of the Eon's went and got all huffy about it. So, given that challenge, I felt that I had to respond and reiterate that the cause is not known, because she, at least, as a participant in this thread, has demonstrated hostility toward the idea.

Now you are getting all huffy because, what, it isn't New™ or Exciting Enough™ for you?


No, because you just demonstrated a complete and total lack of any knowledge about the traetment of mental health in the USA, if you did have any knowledge then you would not state these facts as though they weren't already known in the mental health community.
The issue is that there is one percent of the population that lives with schizophrenia and similar numbers for people who have severe depression and bipolar disorder. If they are helped to get relieve from thier sysmptoms by the phrase 'chemical imbalance', then fine.

You see when you say the phrase you have to hold your hands out and make this balancing motion. When you talk about someone getting 'sick', ie thier symptoms getting worse, then you move your hands out of balance and then you talk about the role of medication and bring your hands back to the same level.

The importance of the phrase is in the hand gestures!

The other point being that it is very hard to get family memebers to stop plying thier menatly ill family members with alocohol and street drugs, unless you brandish the phrase 'chemical imbalance'.


Just what the hell is wrong with you?

I don't know, you seem to be the one with the problem!
Have you vere worked in menatl health, do you even have an idea of what you are talking about. I mean really, there are people who take insulin for thier 'sugar' as well.You aren't one of those people trying to turn every one into 'prosumers' are you?



And, how, exactly, does that contradict anything that I have said here?

You act as though these things are not aleady well know, which they are.
The myth of mental illness causes many people to suffer when they could be helped.
The point is that you need to educate yourself about the current level of treatment in the USA. It is a fine philosophical point you have made, but believe me when you talk to the average person recieving mental health services about 'post synaptic response' and how 'depression is caused by overactivity of a brain area', and 'schizophrenia is caused by a lack of activity in a brain area' they will just look at you and say
"Why didn't you tell me I have a chemical imbalance!"

 

[Dancing David]

You mean it isn't possession by demon(s)?

HUH? Oh, OK.


Nevermind!

Could be, thats why I have a priests bless my medicine!

 

[Eos of the Eons]

Have you learned how to read yet?

I think Dancing David pointed out who can't/won't read.

I asked you for one simple thing, back up for your opinion that chemical balances don't cause depression.

You have yet to do that, but slander you do instead.

Just goes to show who doesn't have a clue what he is talking about.

Thank you for the good posts Dancing David, with some great technical information.

 

[Dancing David]

Well, this is not known. That's what it means to say that the cause of depression is not known.

Must they wait for the cause to be understood to get help?
The treatment of cholesterol in the uS in much more expensive and likely to be a total waste of money. But I don't read you calling that folk medicine.



Or, rather more honestly, "you have something that manifests itself as depression, and although we don't know what causes it, tinkering with serotonin sometimes helps."

You left out dopamine and GABA.


Depression isn't necessarily stress-related. It may be, but at the crude and imperfect level of psychiatric medicine, those generally tend to get labeled as situational depressions.

i beg to differ, most mental illness have a stress related component, if you look at the course of a person in recovery with mental illness, their progess almost always requires they learn to keep thier stress levels under control.

That's a very good point. There do exist what for want of a better word one might call "moral models" of depression. Of course, one of the symptoms of depression is feeling bad about one's character, and it seems fairly clear that depression can amplify these messages.

Without pointing fingers, I think that some people have glommed onto the "chemical imbalance" concept as the only possible alternative to a moral judgement and stick to it for that reason. And so, when the "chemical imbalance" concept is questioned, they consider it an attempt to take away what they consider to be their only bulwark against a moral judgement.

And getting people to give up thier less than healthy behaviors is very difficult, especialy the self medication and avoidant behaviors.
But if someone's lack of progress is stressing you , the best you can do for them is take a vacation.
When you have schizophrenia or depression it is important that people try to not moral trump you.

Yet this is a kind of a mythological battle here, and while I do consider mythology to have some value, I would hope that the researchers who are looking for the ultimate causes work in terms of something better and more accurate and precise than mythology.

The Atkins diet would be a better example, or the get more exercise and you will feel better myth.

Fairly classical descriptions of depression. For me, Zoloft just gave me anorgasmia, which didn't exactly cheer me up.

I will agree that the treatment of depression is totaly hit or miss, even though they could measure the level of serotonin and dopamine byproducts in the urine.
I thought I had bipolar disorder and OCD, the doctor chose to treat me for derpression, And I am very lucky I responded in two days.

Worst side effect ever(except for TD and EPS): is the 'retrograde ejaculation'.

That seems to me an eminently healthy attitude. But I have to reiterate that what I am saying doesn't really impinge on the idea of whether it's exogenous or endogenous. Of course, this too is all going to have to be worked out. But simply saying that the notion of a chemical imbalance is folk medicine does not mean that there is not an endogenous condition. It really doesn't enter into the picture at all.

It also doesn't say anything about the value of medication. As I think I posted before, NSAIDs such as aspirin can be used to treat headaches. I'm simply pointing out that there is no evidence that headaches are caused by an "NSAID imbalanace."

I've often found that I have a problem with the tendency to call mental health patients "clients," but this is still an observation based on mythology. Whether one is called a patient or a client or a consumer says little or nothing about underlying causes.

It is not mythology, if you are a professional providing a service you call the recipients 'clients', and in the 1990s there was this whole movement by people with too much time on thier hands to be called 'consumers'.

Clients recieve services from mental health professionals, i always called mine by thier names.