Depression

It means whatever you want it to mean.

That is what I thought.
Meaning means nothing to somebody who uses words to confuse.
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This nonsense is next door to "Whatever I believe is True".
But believing you are making sense with technobabble does not create meaning.
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Only by understanding the subject can one make an intelligent contribution,
whereas the absence of coherent argument illustrates a lack of competence.
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It is a dysService to those who read this thread
to publish meaningless obfuscation as if it were informed opinion.
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Posturing pretenders are dangerous to mental health.
Those seeking insight here are liable to be confused, maybe misled, by such pretentious poppycock.
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A disgusting exhibition of unDisciplined Self-Importance . . .

It means whatever you want it to mean.

Cledwyn Bulbs wrote:As for why people are depressed, why shouldn't they be? I think happiness, as an abiding state of bliss, is just a mirage in the desert of human suffering, a friar's lantern that retreats upon approach, that draws us deeper and deeper into the infernal nether-regions of human misery. Insofar as it can be said that happiness is possible in this world, it is something we happen upon serendipitously in the pursuit of some other goal, which is why hedonism leads to dissatisfaction and ennui. John Mill and Immanuel Kant both believed this.

Another source of depression is the belief that other people are happy. One of the great myths of the age, propagated by the ever-burgeoning mental health- and self-help industry is that there is such a thing as happiness, that is, as an abiding state, outside of the cycle of pleasure and pain, and that withstands the blows of ill fortune. This is largely because psychiatry, as a business, exploits and largely generates this desire for sublunary beatitude because of the revenue it derives therefrom.

This is how big businesses work. They foster a climate of ceaseless craving and desiring for things we don't have, keeping us in a state of perpetual dissatisfaction and frustration so that we keep on consuming their products in the hope that by doing so we will finally reach the promised land. Yet we never do, because even when we can possess the object of our desire, the greater the possession thereof, the greater our desire becomes, hence why wealthy people are so greedy, why the powerful are so greedy for power, and why the famous are so covetous of more fame than that which they have.

Coming back to my point about psychiatry, psychiatry fills our heads with beatific visions of "mental health", creating expectations of a happiness which has no counterpart in the real world of human experience.

True, lots of people claim to be happy, but this is largely because of the stigma attached to depression, and an at least intuitive understanding of the misery, abandonment and loneliness that waits in store for anyone who dares to vent their misery. For this reason, people will even deceive themselves that they are happy when they are not.

TBC>

This fine post encapsulates, in a succinct fashion, the truths that I and, I am sure many, have come to.

I wrote a post in another forum in this same space, I believe, although it is not as eloquent as the above work as my use of language and words, which I'm really not fond of, is less advanced.
avoidant-personality/topic162680.html

I rarely seem to be able to express everything about "X" that I think/feel and so with my post, I would have liked to have added that depression (aside from its label which expresses a condition of being in an undesirable state) seems to me to be a natural consequence of unencumbered realism and that for those who do not see or examine life in such a way, what is called depression may always elude them.

I wonder what would happen to people, who have been told they have depression, were not told any such thing and were just left without any medical diagnosis?

After tons of of talk therapy, drugs and various suggestions to "do stuff" and nothing changing in my mood, mental state & outlook, I have been coming to the idea that the "mental health profession", much like the rest of the sick care industry, is mainly setup and operated on the basis of ensuring endless employment for its alleged purveyors of help.

Apologies if my post is nothing new to others or that it doesn't express/examine the issue enough.
It is quite new to me.

Hi SSDD-247.
Agreed that melancholia is a natural result of seeing the futile stupidity that surrounds us,
and agreed that the para-medicals have no effective answers.

However, I do dissent from Cledwyn's impossible definition of happiness,
. . . that absurdly popular NewAge pipedream of endless bliss.

Tim Lott recently published a very insightful analysis of contemporary expectations of happiness in the Guardian. Well worth a read.

I have proven to my own satisfaction that Vernon Howard's definition "Happiness is the absence of unHappiness" is a workable concept, in that ridding ourselves of the causes of unhappiness results in a pleasantly quiet state that might be termed serenity as accurately as happiness. Easier said than done, this ridding ourselves of unrealistic desires takes years to work through.

It helps to have a purpose larger than ourselves, something for which we can be generous and constructive, but purpose alone is not enough to fend off melancholia.

But the purpose of life is a far more satisfying quest than the meaning of life.
Meaning is too complex to be distilled into something simple,
whereas purpose has a knack of cutting through obfuscation.

Eventually, how we feel towards our own life, our own potential, has a powerful influence on mood.
Could it be that depression is as simple as mood ?

Perhaps mood is an easier way to think of what is labelled as "depression".
Taking the vagueness out of a concept can make it easier to deal with pragmatically.

Sorry, this took longer than I expected. As it happens, I've been feeling rather depressed lately.

Infinite_Jester wrote:As for the second part of what you wrote, I think you're being overly charitable to people who substitute the term "mental illness" with, the more hedged, "problems in living" (or whatever). What is the semantic distinction being made here? A mental illness is an illness that compromises your psychological abilities and a problem of living is... what exactly? Not having enough money for that vacation you really wanted to go on? Having the fantods because you want to ask a woman on a date? Being stuck in traffic for an hour because there's construction on the highway? It's so vague and leaves out the primary characteristic of mental illnesses: suffering!

Substituting a term might be semantically redundant but who ever proposed substituting just a term? Who did you have in mind? To whom is this a counter-argument? People like Thomas Szasz have tried rather to change the whole discourse and not just a term. And there’s more. These critics have also challenged the authority of psychiatry in framing the problems of human life.

Besides, “problems in living” is just a general term that refers to how we conceptualize our experienced distress.

Take note of what Szasz says:

Our adversaries are not demons, witches, fate, or mental illness. We have no enemy whom we can fight, exorcise, or dispel by "cure." What we do have are problems in living -- whether these be biologic, economic, political, or sociopsychological. In this essay I was concerned only with problems belonging in the last mentioned category, and within this group mainly with those pertaining to moral values. The field to which modern psychiatry addresses itself is vast, and I made no effort to encompass it all. My argument was limited to the proposition that mental illness is a myth, whose function it is to disguise and thus render more palatable the bitter pill of moral conflicts in human relations.

The Myth of Mental Illness, 1960. http://psychclassics.yorku.ca/Szasz/myth.htm

It’s quite obvious he is using “problems in living” as a general term, which encompasses the diversity of problems in human life.

Infinite_Jester wrote:I don't see how one form of description disallows/allows people to do ethics. Maybe certain forms of description can bias how people treat a particular person. For example. describing someone who commits a serious crime as mentally ill, might solicit pity and nudge people in the direction of having compassion for the person, as opposed to the same situation occurring and people describing the person as a "moral monster" (or whatever).

I referred to the fact that the language of psychopathology sets the primary discourse for patient’s problem framing and it purports to be neutral with respect to patient’s values. The patient’s values and his own problem-framing and self-understanding are treated as secondary. This raises an important question: On what grounds do the psychiatrists claim expertise in this problem-framing? What justifies this approach - the use of technical idiom - in framing the patient’s psychological distress? What's wrong with the patients' concepts? I think there are two parts to the question of justification: What justifies this project rationally and what justifies it ethically? (Medicine is not just another science but essentially goal-oriented activity. Keep in mind the Hippocratic oath.)

In other words, is a science of psychopathology possible, and if it is, is it needed? I cannot argue this any further right now but I believe that this attempt to establish “a science of the mind” is at root a Cartesian project, which tries to conceptually separate the inner from the outer, mind from world. If you think this is far-fetched, take a look at the phenomenological emphasis that governed psychiatry most of the 20th century. One very influential work was Jaspers' General Psychopathology (1913). Some 70 years later the authors of DSM-III-R characterized their work still as “phenomenologically descriptive”. And as you know, the early phenomenologists were devoted Cartesians.

Infinite_Jester wrote:Of course, I'm willing to concede that describing psychological events and behaviors as "illnesses" does give the illusion of objectivity to the normative judgement being presupposed, namely, that there's something wrong with a person if they are experiencing or demonstrating the event or behaviors (historical anecdote that confirms this: psychiatrists describing homosexuality as a mental disease). However, even though there's a normative component to describing severe, debilitating depression as an illness, I haven't met anyone who really wants to challenge this. If you're literally incapacitated by overwhelming emotional pain and stifling emptiness, then there's something wrong with you.

I think nobody wants to downplay the suffering of those concerned. But there is a downside in this language-use that has to be regarded too. I wrote above: “The way the language is used in psychiatry resembles the way it is used in other branches of medicine and this shared parlance hides the deeper disanalogy, those diverging features that separate psychiatry from other branches.”

The public tends to make erroneous conclusions of this resemblance and not note the disanalogy. The public assumes that psychiatry, as the rest of medicine, establishes real disease entities that have causal effects. (Even you were flirting with this position.) When we scrutinize what really goes on in the construction of the diagnostic manuals we are able to see this is a highly problematic assumption. And this misunderstanding has some serious consequences. As Cledwyn Bulbs aptly puts it, adopting this model “encourages an attitude of fatalistic resignation on the part of the recipient and on the part of others, disempowering the patient, and encouraging others to see you as a lost case ...”

Illness-discourse has some advantages too. In this respect, a key concept is responsibility. We don’t hold ill people fully responsible. And there are various reasons why this is an ethical thing to do.

Personally I think there are viable ways to conceptualize distress without resorting to the concept of illness.




Homosexuality is a revealing example, I’m glad you mentioned it. Homosexuality was listed as a mental illness in DSM until it was voted out of it in the 1970s. Since the number of diagnostic categories continues to grow we have to ask: is the practice that lead to this questionable pathologizing of behavior still there? I’m afraid it largely is.

By the way, homosexuals experienced some real suffering back then. We now understand that this suffering was not the result of some inner pathology but of social origin. The solution was a change in social circumstances. I have no doubt that today there are still many of those that are unnecessarily diagnostically labeled that would benefit of such a solution.

Infinite_Jester wrote:However, even though there's a normative component to describing severe, debilitating depression as an illness, I haven't met anyone who really wants to challenge this.

Take a look at Mad Pride and the whole service-user movement.

Infinite_Jester wrote:If you're literally incapacitated by overwhelming emotional pain and stifling emptiness, then there's something wrong with you. It's possible to challenge this, but I just don't see the argument being successful. Why should we believe that this is what you're brain is supposed to do under normal conditions?

It’s worth noticing that you are now talking about the brain and not the person. A reductionist in disguise? This is somewhat surprising from a Wittgenstein enthusiast.

Infinite_Jester wrote:we shouldn't dismiss the behavioral sciences, the mental health care system or psychopharmacology altogether

To some extent, I agree. I think psychiatrist Pat Bracken presents a quite balanced position that is critical of the current institutional psychiatry and yet wants to retain some elements of psychiatric care. He expresses his position in this lecture, “Postpsychiatry - Reaching beyond the technological paradigm in mental health care”. I recommend it to everyone here.

https://www.youtube.com/watch?v=cV5RKT6Q8qU


By the way, we are quite far from the subject matter. A separate thread might be in order.

Hey El Nino,

I wrote a long reply to your post, but I was logged out from Psychforums while writing it, which caused everything I wrote to be lost. How fitting for a thread on depression?

I think we really disagree about whether or not the alternative discourses about depression (and mental and emotional suffering generally) introduce practical distinctions that are helpful and about what depression is.

What you've described above is really the bio-psycho-social perspective of mental disorder, which has been part of psychiatry for decades. Of course, clinicians have to focus on, among other things, the person's history, personality, relationships, resources, developmental stage, health status and lifestyle. That's true for psychiatry as much as it's for cardiology. If a client presents with high blood pressure, of course you're going to ask questions about the person's life to figure out what the best treatment/intervention is going to be. Medicine is much more broad than you're giving them credit. It's not all: "you're broken, let's fix you".

If you disagree, feel free to sample the literature. Pick up a sample of textbooks on psychopathology and look for references to the bio-psycho-social perspective of mental disorder, tacit or otherwise.

As for what depression is, you're absolutely right that I'm a reductionist and physicalist. Depression is a common-or-garden psychological concept we use to refer to particular internal states and behaviors. Internal states and behaviors have proximate and distal causes. The proximate cause is the behavior of the marco-molecules that make up our bodies and the surrounding electrical and magnetic fields. The distal cause is external events that affect/change our bodies. Depression is just as biological as cardiac arrest, urination, digestion and growth. Granted, we don't have a robust reductionist account of depression, but that's not required for designating something as an illness/disease.

The logic goes like this: severe, debilitating depression is a cluster of psychological and behavioral states of organisms that have the capacity to express emotion. Severe, debilitating depression is characterized by suffering that impairs the organisms' ability to function and is therefore an illness/disease.

As much as I would like to believe the Cartesian view that we have an immaterial soul that lives inside of our head, produces changes in the behavior of the marco-molecules and fields that make up our nervous system, and is somehow not made of matter and energy, I can't. There's no evidence for it aside from some peoples' intuitive introspection, which is an awfully lousy method for figuring out the nature of reality. And, the evidence from neuroscience overwhelmingly supports the view that all our psychological abilities and states of consciousness are causally produced by patterns of activity in our nervous system. Just because depression involves thoughts and feelings doesn't mean it belongs in a separate ontological category. Or, if you really really want to put it into another ontological category because there's something subjective and qualitative about the experience of depression, there's also something subjective and qualitative about the experience of having cancerous white blood cells ravage your body, but that doesn't mean leukemia is not an illness/disease.

I apologize for being blunt. I just think it's better to avoid euphemisms and pleasant re-descriptions of events, which I think most of the Mad Pride/Consumer/Survivor movement does. I say that as someone with a severe, debilitating mood disorder that spent more than a decade doing rhetorical handsprings to convince myself and everyone around me that there was nothing wrong with me while I was in agony and unable to function. In the end, you just have to own it.

Anyways, take care.

-A person with a very sick mind

And, just for the record:

El Nino wrote:It’s worth noticing that you are now talking about the brain and not the person. A reductionist in disguise? This is somewhat surprising from a Wittgenstein enthusiast.

You're right. Wittgenstein argued that psychological concepts don't refer to particular brain states because particular brain states aren't directly observable. We learn to use psychological concepts by being taught to use the concept to refer to particular instantiations of the concept. For example, to learn to use the concept "depression", members of the community show the person behaviors that are criteria for instantiation of the concept "depression", including the person's own behavior. Over time, the person becomes able to use the concept to refer to internal states that accompany the behaviors. Thus, the person learns the third-person use of the concept, with reference to others' behavior, as well as their own behavior; then learns the first-person use of the concept, with reference to what they're experiencing. This is what L.W scholar's call the First Person/Third Person Asymmetry (See P.M.S Hacker).

However, there's nothing about this view of concept acquisition and mastery that is incompatible with physicalism or reductionism. You can use the concept "depression" to refer to the state the person is in and still be committed to the view that persons' don't have immaterial/non-physical bits and pieces, as well as, the view that the locus of our psychological abilities and states of consciousness is the brain.

Just to be sure what your take on this is... Do you believe that the rejection of the prevalent reductionist model of depression will inevitably lead to Cartesian substance-dualism?

For I'm certainly not a proponent of either.

Infinite_Jester wrote: Medicine is much more broad than you're giving them credit. It's not all: "you're broken, let's fix you".

I was mainly talking about the assumptions of the current biomedical model in the framework of DSM. My position on medicine in general is much more complex than you seem to assume.

El Nino wrote:Just to be sure what your take on this is... Do you believe that the rejection of the prevalent reductionist model of depression will inevitably lead to Cartesian substance-dualism?

No, but I'm not sure there's a more nuanced, middle ground between physicalism and dualism. Particular mental states are either identical to particular brain states or they're not identical to particular brain states. Feel free to explain where I'm wrong if you know of a more naunced, middle ground between physicalism and dualism.

El Nino wrote:I was mainly talking about the assumptions of the current biomedical model in the framework of DSM. My position on medicine in general is much more complex than you seem to assume.

Okay. I'm just not sure I understand your objections to the biomedical model of severe, debilitating depression? I know you wrote that the phenomenology of depression makes it distinct from other illnesses/diseases and that the determinism presupposed by reductive neurobiolgical explanations of depression can induce resignation in people with depression, but I'm not sure these are very good arguments against the biomedical model.

-IJ

Way off topic.
The subject is depression, not the primitiveness of medicine.

Infinite_Jester wrote:I know you wrote that the phenomenology of depression makes it distinct from other illnesses/diseases and that the determinism presupposed by reductive neurobiolgical explanations of depression can induce resignation in people with depression, but I'm not sure these are very good arguments against the biomedical model.

-IJ

I don’t think those were the explicit arguments. Besides, there were quite many points of critique I alluded to. But I might as well admit I didn’t do a very good job in framing them.

Let’s go back to the beginning. I’m opening a new thread for this.

Depression is a FEELING. The feeling is caused by not achieving goals.

By using the quackery jargon, naming several pseudoscientific subdisciplines of quackery, and mixing it up with philosophy, you appear to be very blunt and uneducated since you are overcomplicating simple and understandable primitive feeling into an extremely complex invented medical pseudoillness.

That is the full truth, and it is valid. Unless depression was caused by drugs, it is the natural, normal feeling. Strong feelings of depression mean that you strongly feel your goals are not being achieved.

Drugs do not make you achieve your goals, drugs disable you, typically making everything worse, since disabled people become very often suicidal since the last thing they had was taken from them. And if they abruptly withdraw the poisonous chemically disabling drug, they get very unusual behavior and often get complained about, so that they get imprisoned in a hospital and drugged to the max again for the effect of disability.

Everybody who proposes that feelings are illnesses is sick. It is not unimportant to mankind to treat feelings as feelings, behaviors as behaviors, thoughts as thoughts, and CHARLATANS as CHARLATANS, QUACKERY as QUACKERY, DISABLING DRUGS as DISABLING DRUGS. There are no medical qualities in the disabling drugs, and so there are no medical qualities in psychiatry. Thus, I propose it is all quackery with only one quality, that is to sell disabilities to anyone who has disagreeable feelings, behavior, or thoughts.