Depression is often viewed as the “common cold” of mental disorders, because it is so prevalent in our lives. The lifetime prevalence of depression suggests that more than 1 in 9 …
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I really enjoyed this article. I came across a post today actually of a young woman that feels she may be suffering post natal depression in which she has found great difficulty in actually admitting the possibility to herself let alone mention it to someone else.
A well meaning but in accurate reply that could have had disasterous effects on someone stated that “it is a mind problem & if you can’t get you thinking right you are simply weak willed”
I saw many colours all REDDISH LOOKING!!!!
I had to reply to that – don’t know the consequenses of it yet!
I suffered an extremely devasting depressive episode at one point in my life. I think I am one of the strongest willed stubborn, determined, independent people I know!!! Those qualities have a place in live if they are used correctly & in appropriate ways.
But I never knew enough about the illness – I didn’t view it as an illness. I would be dead a thousand times over If I had continued listening to well meaning individuals that had probably only ever experienced the blues with a menstrual period.
If any reader ever comes across someone that finally dares to mention what they may be going through – praise them for their honesty, their trust and advise them to discuss it with a professionally trained person. (if someone had diabetes you would certainly not advise them to take two jelly beans – go to bed & it will all be fine in the morning)
Thanks for educating or alerting people to the facts surrounding this totally self destroying illness.
Sorry for the big grouchy response.
I am dismayed at your item #2. How exactly is depression NOT a legitimate medical illness? Because it has psychological and social components along with the neurobiological?
Would we not counsel someone with high blood pressure to exercise as well as take their medication? Would we not counsel people with any number of chronic illnesses to manage the stress in their life? Just because we use psychotherapy as one of the treatment options does not make depression less of a medical condition.
You cannot separate out psychiatric illnesses as being somehow different or less “real” than other medical conditions. We have the brain scans that show differences between depressed and non-depressed persons. You yourself acknowledge the neurobiological underpinnings. We are treated by psychiatrists, who are medical doctors. Our symptoms are physical as well as “mental”. We know there is a genetic component. We have effective medications as well as other treatment modalities. Just because we do not know absolutely everything there is to know about psychiatric illnesses yet, that does not mean that we don’t know enough to recognize them for the serious medical conditions that they are.
We have had to fight long and hard to inch closer towards something even vaguely resembling parity for treatment. We still fight stigma. I believe that what you have written above in “Myth 2″ is very damaging and IMO, wrong.
Martina
Medical diseases have known biological signs; mental disorders do not. That is the primary difference. Brain scans do not tell a doctor a person has depression, contrary to what you might believe from the hype you read in news articles about such scans. Nobody uses brain scans for diagnosis of mental disorders today.
If all medical diseases have a psychological component (and they do), then of course all mental disorders have a biological component. But diabetes isn’t a psychological disorder (you can’t just go into psychotherapy to learn how to deal with your stress and expect it to help cure your diabetes), any more than depression is a pure medical disease.
All of this could certainly change with our increased understanding of the brain. But as far as we know right now, mental disorders remain just that — mental disorders that involve complex psychological, social and biological factors. To call them simply a “medical illness” is to minimize that complexity and suggest it can be treated and cured by only a medical intervention (e.g., medications).
What exactly do you call a “known biological sign?” That can mean almost anything. What about the fatigue, appetite disturbances, sleep disturbances, and cognitive problems that accompany depression? I would certainly call those biological signs. Of course we are not using brain scans to diagnose depression yet. We have not progressed that far at this time. But I do not think it is valid to disregard the evidence they provide for biological underpinnings and use the lack of current diagnostic capability to dismiss the medical nature of depression.
We have not always had specific diagnostic tests for many illnesses. Was, say, TB less of a medical illness before we identified and could test for the microbe that causes it? For “known biological signs”, let’s take the example of Lyme disease. Many sufferers do not test positive, leaving physicians to diagnose based on symptoms, history, and response to medication (antibiotics). This is similar in some ways to depression. Does someone’s lack of a positive Lyme test make their condition any less medical?
I am quite aware that diabetes is not a psychological disorder. However, exercise and diet can bring Type II diabetes under control for some. And I have had a psychologist who works with diabetes patients tell me she has seen many diabetes patients’ blood sugar worsen due to stress and that she works with them on stress management. So where exactly is the dividing line between mental and physical? You are making an arbitrary distinction between illnesses rooted in the brain and those rooted in other parts of the body.
I don’t believe for one minute that recognizing that psychiatric illnesses are truly medical conditions minimizes their complexity. Since when are medical conditions by definition simple??? Besides, I consider both medication and psychotherapy to be medical intervention.
I have noticed for quite some time that you seem to be rather anti-medication. I can tell you that the biological component of my illness is so pronounced that all the psychotherapy in the world will not bring me into remission, nor will it keep me there (and I’ve tried). I’ve benefitted from very fine counseling, as I think most people can. But at the end of the day, what keeps me well is medication and careful oversight from a good psychopharmacologist. It gave me my life back, and you can’t mess with success.
Well, Martina, Depression can also be a symptom of another illness, just like insomnia is a symptom of Depression. High blood sugars cause Depression as well as does Hypothyroidism, and/ or can Beta Blockers that are used for the treatment of High Blood Pressure, and/or Cardiac Disease and/or hormonal treatment with estrogen antagonists.
Not everyone has the same experience as you do, and for some people medicine does not help their Depression.
I would also argue that Depression is not more or less either a psychological or medical issue but
instead a ‘sickness of the soul’.
I never said everyone has the same experience I do, and yes, of course other illnesses can have depression as a symptom. However, I think it’s important to recognize that there’s going to be a certain subset of the depressed population who respond well and do best with long term medication. There will also be a certain subset of the population who will do well with just psychotherapy. But I still believe it is an illness.
I’m just curious. Where do you believe the ‘sickness of the soul’ comes from for those for whom depression is not a by-product of another illness?
I think it comes from when we are in some way prevebted from, as in not allowed to, or not able to speak our own truth, and it is not heard.
For myself, injury to the soul causes pain unlike no other can, that severe. For me Depression always comes from the soul, or it has been in connection with hormonal stuff.
But for me, also, Martina, meds work great and I have been on the same prozac for some 25 years with only one dose increase after the first 15.
Dear Friend,
I would be honoured if you could help the Answer. I became depressed in part to help my brother and others who no longer had the will to live. I thought that I could think himself and others out of depression. It was only with his death that I again saw the world in a normal light. 12 months after this the Answer to depression and the like became apparant. I would be honoured if you could help this cause.
kind regards,
Tim Heywood
Until recently, it was thought that there was no universal way that people could think and behave that was deemed as “normal” to a society or culture. This however has been proven wrong with the discovery of a “universal belief system” which is thought to help prevent and cure psychological disorders.
Thanks for a well-balanced, factual article.
Our society has a tendency lately to offer up easy excuses to repudiate personal responsibility, and the pharmaceutical industry spends millions of dollars every year to encourage that.
If you have diabetes, it is your responsibility to manage it, and to adopt coping strategies that serve you well. And if you don’t, you suffer the consequences.
If you have depression, it is your responsibility to manage it, and to adopt coping strategies that serve you well. And if you don’t, you suffer the consequences.
Both conditions absolutely require behavioral changes (unless you’re intent on slow suicide). Both conditions absolutely require mental, emotional, attitudinal, and maybe even spiritual accommodation.
Only some with either of these conditions require and/or are helped by medication.
What we do know, from broad and extensive study, is that talk therapy is *in the aggregate* more effective than medication alone. And talk therapy plus medication is only slightly more effective than talk therapy alone. Talk therapy helps more people and helps them to a greater degree than medication. And medication has side effects, some of them very unwelcome.
No doubt that lives are saved through medication treatment of mental conditions. Just not that many, compared to the number of positive outcomes from talk therapy.
You, Dear Reader, are not an aggregate. You are an individual. Your Mileage May Vary. Please respect the “mileage” of those you share a planet with.
No Rebecca, I am not an aggregate. I am an individual, and a grateful one. I am grateful that after years of effort with a top-notch psychopharmacologist and the support of fine therapists, I have finally achieved a large degree of remission.
I am grateful for the scientists that formulated the medications that make it possible for me to work at a challenging job and enjoy my friends. I am immensely grateful that there is a variety of treatment options out there for those of us (and there are LOTS of us) for whom psychotherapy alone (or exercise or yoga or vitamins or whatever good things we try – and they are good things to do) doesn’t get the job done.
It was long, hard work to get as well as I am. I hope my outcome offers encouragement to others who are experiencing treatment resistant depression. Taking medication is far, far from an easy way out. It requires diligence and responsibility to work with one’s doctor, as does talk therapy.
I am not sure why you think I do not respect the experiences of others. I have never disparaged psychotherapy, and if that enables one to get well, then that is excellent. If talk therapy is not sufficient, but medication helps, that is excellent too. The important thing is to get someone well so they can participate fully in life. I do think it’s critically important that depression be recognized for the serious and sometimes life-threatening illness that it is.
Martina
This is a very interesting article regarding depression, and some very good comments have been placed on this site. My own personal knowledge of this illness is of myself and what i went through some years ago, i am 62 years old now. mine was caused by a miscarriage in the 1970′s and also moving to new area and it was during the recession of the 1970′s and i was unable to find work in my new area of Sutton Surrey and i became very lonely at home all day. I came from the East-end of London and always had a job to go to be it only part time. I was put onto anti-depressants by my doctor and was sent to a doctor at a local hospital who dealt with this type of illness. I did get better in time but it took two years in all, i have had a touch the illness again but nothing like the previous bout years before. I think that depression can happen to anyone circumstances can bring it on and this myth only certain types of people get it i don’t agree with. But i think that more women seem to suffer it as my doctor told me at the time could be true as woman have more hormonal problems than men, and perhaps also the pressures that women have running homes etc and looking after children if they have any if also a factor in my opinion. And the theory that more intelligent people seem to get depression is most likely true in some cases Vivien Leigh the actress had bi-polar (know as manic depression by many people, and she was a very intelligent woman who was well read and spoke about seven different languages. To try and avoid depression if you can you must try to relax and unwind and try not to let things get to you if you can it isn’t easy the fast pace of life today. I go swimming every week and go for a long walk with my dog and i feel much calmer when i return. It is also said another factor is the winter months that does get some people down i know. Depression is a horrible illness sufferers have my sympathy i know what your going through.
im goin thru serious “depression”. what makes u think its real. i feel like i can pull thru and make sumn out my life if im lucky. but what if i stay a loser. is depression fake and who in the world is so sure of them selves to make that definite? are we all just a show for the doctors. i feel like any pys. doctors get payed to manipulate people having a hard time. pretty easy to take advantage of. no matter how a paitient questions a “psy” doctor, the paitient is wrong. who knows the patient?
I am a counselor who has struggled with depression and fibromyalgia in the past. I loved your “7 Myths…”. Would it be possible to include them on my web site? I think they would be very helpful for people who are trying to decide whether to get help and what kind of help to get. Certainly, I would identify you as the author. Thank you for your insight!Lori Capri, L.P.C.
I’m of the opinion that we need to stop using the term depression at all, as it seems to have become a very vague and woolly term that seems to mean a dozen or more things.
I’m pretty sure that medication has done very little to aid me over the many years, but I’m far from keen on CBT which is the only thing currently available on the NHS in my area. What I’d really like is something akin to Logotherapy, something or someone ( a soul-friend) to help me explore the darker aspects of my psyche which seem to be at the root of my own distress.