Live data from Hacker News

Anxiety and Depression Are Symptoms, Not Diseases

psychologytoday.com

91–100 of 281 posts

Re: Anxiety and Depression Are Symptoms, Not Diseases

#91
Dis-ease. Semantics. There can be morphological (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2785515/) and biochemical indicators of depression and anxiety.

To make mice depressed they will do a forced swimming test (poor mice). So this is another way to induce depression: physical+psychological stress.

If there were good science with good funding it's feasible to come up with a lab test for depression--and anxiety--that's very, very accurate.

No, the article is incorrect. It does not have citations either. Explore pubmed for plenty of information. (Keep in mind the sad reality is that even good science is wrong lots of the time--I'm hedging, okay most of the time.)

The risks of not properly treating depression and anxiety is very, very high. So the article is very irresponsible in my opinion.

Re: Anxiety and Depression Are Symptoms, Not Diseases

#92
post #19

Amen to this article. As one who myself once believed my depression "came out of nowhere" (but which, in retrospect, was an obvious symptom of my emotionally destructive family and school environment) and who tried for many years to smother those feelings with antidepressants, I feel strongly that this article presents a wiser path. Evolutionarily speaking, it seems likely that depression/anxiety are there for some p…

> Evolutionarily speaking, it seems likely that depression/anxiety are there for some purpose, and yet we treat them both like meaningless pain meant only to be banished using drugs. I believe both are signals that something in our environment is not working for us. They indicate emotional or physical needs unmet---needs for safety, autonomy, connection, etc. > Often the individual suffering is fundamentally unaware…

> If a situation is causing no problems outside of depression/anxiety, and you took away the depression/anxiety mechanism, there would be nothing wrong with it.

My experience with SSRI's has been that taking away that mechanism is taking away creativity, emotional range, and introspective ability. Reality distortion is reality distortion. I reject procrustean medicine that fits humans to the mold of what is best for society, which is the primary environment in which anxiety/depression originate.

Re: Anxiety and Depression Are Symptoms, Not Diseases

#93
post #19

Amen to this article. As one who myself once believed my depression "came out of nowhere" (but which, in retrospect, was an obvious symptom of my emotionally destructive family and school environment) and who tried for many years to smother those feelings with antidepressants, I feel strongly that this article presents a wiser path. Evolutionarily speaking, it seems likely that depression/anxiety are there for some p…

> Evolutionarily speaking, it seems likely that depression/anxiety are there for some purpose, and yet we treat them both like meaningless pain meant only to be banished using drugs. I believe both are signals that something in our environment is not working for us. They indicate emotional or physical needs unmet---needs for safety, autonomy, connection, etc. > Often the individual suffering is fundamentally unaware…

Oh, this is a fantastic and beautiful deconstruction of this argument, I LOVE this. The comparison to chronic pain is fantastic, because indeed, chronic pain is a side effect of many conditions, and if we were able to relieve the chronic pain somehow, we certainly would, but being currently unable, we seek means to treat the chronic pain.

I've often held that the most insidious part about clinical depression is its self-reinforcing nature. Deep clinical depression is throwing a person into a deep hole with thorns sticking out of the sides- every attempt to climb out of said hole results in swollen cuts and pain to the arms and body, rendering eventual escape more difficult with each struggle.

Eventually, it becomes like trying to climb out of said hole with no arms at all. It's one of my life goals to discover biochemical methods to help such people regain the use of their arms, or even essentially grow new ones.

I find articles like this one useful ONLY* insofar as they assist those who have gained use of their arms and cut away the brambles on the walls of the pit- for most others, it merely ends up encouraging more struggling, self-recriminations, and effectually a deepening of the hole. :(

Re: Anxiety and Depression Are Symptoms, Not Diseases

#94
post #85

> Or if you are outside for a long time in the cold with no jacket, upon feeling very cold, you don’t say that you have "a coldness disorder". A better example for anxiety or depression would be standing inside in a warm room, and despite everyone else in the room being comfortable, you are unable to warm up at all. When you complain, you are told that "everyone gets cold sometimes". This article doesn't seem to have…

Let me just take a moment to register monumentally huge agreement with your modification of the the metaphor at hand. The problem here is that huge numbers of other people are living in almost exactly the same circumstances - or ones that are objectively worse - and they register no depression . And here, by objectively worse, we're talking, risk their lives daily on a shoestring lifestyle that barely keeps them from…

Different people have different needs. There is no standard for what an awesome life is. Having an awesome life in some ways can still be miserable in other ways, and only for particular people. An "fantastic life" where one is depressed is not fantastic.

Psychological diversity is a precious resource, and a society that is too inflexible to accommodate those who are particularly sensitive or have exceptionally different needs is a bad society. Depression and anxiety, and a host of other mental disorders for that matter, are an epidemic in too many countries, too many countries that are supposed to have high quality of life.

> if you effectually tell depressed people to figure out what's wrong in their life and fix it- well, it's one way to obliquely encourage suicide.

Kind of a straw man don't you think?

Re: Anxiety and Depression Are Symptoms, Not Diseases

#95
post #91

Dis-ease. Semantics. There can be morphological ( http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2785515/ ) and biochemical indicators of depression and anxiety. To make mice depressed they will do a forced swimming test (poor mice). So this is another way to induce depression: physical+psychological stress. If there were good science with good funding it's feasible to come up with a lab test for depression--and anxiety…

>There can be morphological (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2785515/) and biochemical indicators of depression and anxiety.

That doesn't really have any bearing on the accuracy of the article. PTSD is also associated with reduced hippocampal volume, which reverses with successful treatment. It isn't as if the hippocampus suddenly shrinks for no apparent reason...

>So this is another way to induce depression: physical+psychological stress.

The article is talking about psychological stress, so you're really just discussing the same underlying cause.

>No, the article is incorrect. It does not have citations either. Explore pubmed for plenty of information.

I don't see how it is incorrect. It is just discussing the problem at a systems level rather than a biochemical level. Both explanations can be correct.

>The risks of not properly treating depression and anxiety is very, very high. So the article is very irresponsible in my opinion.

On the contrary, I think it's very irresponsible to dismiss articles like this out of hand, as that will likely prevent people from seeking the correct treatment.

Re: Anxiety and Depression Are Symptoms, Not Diseases

#96
Depression is commonly defined as the inability to recover from negative emotional state. To then call that a symptom of emotional needs seems to miss the distinction.

If we compared this to injure and clotting, it would be weird to describe a clotting disorder as a symptom of injuries. Preventing more injuries is likely going to help and is a good step forward, but it do nothing to address the issue on why the recovery process is impaired.

Re: Anxiety and Depression Are Symptoms, Not Diseases

#97
post #10

> Or if you are outside for a long time in the cold with no jacket, upon feeling very cold, you don’t say that you have "a coldness disorder". A better example for anxiety or depression would be standing inside in a warm room, and despite everyone else in the room being comfortable, you are unable to warm up at all. When you complain, you are told that "everyone gets cold sometimes". This article doesn't seem to have…

The problem with using a purely neurochemical explanation like this is the rates of these disorders differ dramatically between societies and within societies geographically, demographically and over time. It is clear that the United States in particular is, especially in recent years, churning out unprecedented numbers of severely psychologically ill individuals. The idea this is solely due to previously undiagnosed…

Medication is essentially victim blaming by society unto the individual reacting against its conditions. And the medical health specialists are agents of society, not the person they're ostensibly helping.

Re: Anxiety and Depression Are Symptoms, Not Diseases

#98
post #9

This is pure generalization and does not apply to those who are clinically depressed or suffer bipolar.

I think it's generalization to say that it doesn't apply to those who are clinically depressed. I know many (previously) clinically depressed people who it definitely does apply to.

The article wasn't talking about bipolar.

Re: Anxiety and Depression Are Symptoms, Not Diseases

#99
post #41

Earlier quoted context omitted.

My info was first hand from the Chief of Psychiatry, Westchester County Hospital, NY, USA. He seemed darned serious, bright, well informed, enormously experienced, and competent.

Perhaps you misunderstood the Chief; CBT is the gold standard for treating anxiety-related disorders. See this meta-analysis: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3263389/

Naw, I understood the Chief.

I followed your link to that paper -- sure, CBT, once unwind the acronym, sounds fine. That's what I thought would work on the patient in my family (by marriage, not by birth). But CBT didn't work. Not even a little, not a chance. And the patient was just awash in cognitive ability -- brilliant, actually. Or, maybe the brilliance caused seeing more threats and, thus, more anxiety.

The usual suspects, say, SSRIs, etc. didn't work, either. The result was, right, the worst possible, and of course there are hints that SSRIs can contribute to that result.

Much of the problem was social phobia, e.g., as in the link. Well, it was strongly in common to the mother and all three daughters. So, nature or nurture? If just nurture, maybe CBT, etc. should have worked. But, gotta tell you, at least on the social phobia part, nothing made a dent. All three of the daughters had at least talk therapy, and, no help at all. None.

If CBT can work, as in the link, fine, no, terrific. But, for anyone facing the problems mentioned in the link, need to keep in mind that for a specific case the averages don't have to matter and have to entertain that maybe CBT won't work.

Just why the Chief was so down on talk therapy, or CBT if that is close enough, I don't know. But, we're talking 20+ years ago.

It can be serious stuff, and darned tough to deal with.

Or, the Chief's summary remark went: "Get the patient all calmed down, stable, happy, and then suddenly there will some little event, say, a new file folder of work, and the patient will be all stressed out again."

Or, in my intuition, provide something like a padded cell life for the patient, and things could look fine. But, try to have the patient address the real world, and just some random, new event, say, where there might be some risk that they would have to think through and handle, and they could get all "stressed out" again -- sleepless nights, GI problems, tears, depression, clinical depression, etc.

I'm no expert, but, again, overall IMHO the OP is a bit simplistic.

Re: Anxiety and Depression Are Symptoms, Not Diseases

#100

So I have depressive symptoms for quite some time. I've talked to my doctor like 2 years ago about it. He told me that the only way to get a therapy is to seek out a therapist on my own. This is fine, I can understand that. Just like an alcoholic must accept that he has problems and seeks out for help. I am not going to lie, it is a tough thing to do. But as an general scepticist I have the huge problem to find someo…

> But I can't really see myself to visit mutliple therapists just to find someone that can work with me.

You want help, right? If so, then pick up the phone, and keep searching until you find a fit.

Post reply on HN