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When You Are Depressed, Make Something

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Re: When You Are Depressed, Make Something

#331

Post by Alex3917 »

ajkjk wrote: post #254
Alex3917 wrote: post #234

Earlier quoted context omitted.

> Your condescending google links don't help Which I posted in response to getting blatantly gaslighted. I don't care if you disagree with me, but pretending you don't know how to use Google to try to discredit someone is a lame debating technique.

You weren't gaslighted. That's not what that word means. And everyone here knows how to use google. The problem here is that you said "Depression is the feeling you get from brain inflammation" instead of "there's a theory that depression is sometimes linked to brain inflammation". The former is far from factual, and it's dead wrong to claim it matter-of-factly. Totally not surprisingly, when you google brain inflamm…

> You weren't gaslighted. That's not what that word means.

Gaslighting is a form of personal attack that's designed to make someone doubt the validity of their own senses or personal experience. The reason I took yellowapple's comment as gaslighting is that he was calling into question the existence of a large body of research that shows up with even the most trivial Google search. If you don't buy into the cytokine theory of depression or think that my summary of the theory/research was false or whatever then that's fine. But by implicitly claiming that the research itself doesn't exist and is just something I invented, then at point I take it as a personal attack.

> The former is far from factual, and it's dead wrong to claim it matter-of-factly.

This 2008 paper is already one of the most cited journal articles on depression of all time:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2919277/

"It has been established that pro-inflammatory cytokines induce not only symptoms of sickness, but also true major depressive disorders in physically ill patients with no previous history of mental disorders. Some of the mechanisms that might be responsible for inflammation-mediated sickness and depression have now been elucidated."

"A role for cytokines in depression was first proposed by Smith in the form of the ‘macrophage theory of depression’ and further studied by Maes in the early 1990s. [...] Despite its originality, especially at a time when depression was thought to be associated with decreased rather than increased immunity, this hypothesis failed to attract the interest of the psychiatry community. Because biomarkers of inflammation in clinically depressed patients are not always elevated, the postulate that common pathophysiological mechanisms link depression to inflammation was limited. Other key components that would support this postulate were also missing, such as a demonstration that stimulation of the immune system induces depression-like disorders; identification of a possible common pathophysiological mechanism between the effects of cytokines in the brain and the neurobiological basis of depression; and proof that decreasing the inflammatory response attenuates symptoms of depression. As discussed below, research in this field has now supplied these key components."

"A growing amount of clinical data point to the importance of the relationship between inflammation and depression in physically ill patients and in conditions that are associated with increased activity of the innate immune system, including ageing and obesity. For instance, the prevalence of co-morbid depression in patients with coronary heart disease, a disease in which inflammation is now recognized as a major contributing factor, is three times higher than in the general population."

"A growing amount of clinical data point to the importance of the relationship between inflammation and depression in physically ill patients and in conditions that are associated with increased activity of the innate immune system, including ageing and obesity. For instance, the prevalence of co-morbid depression in patients with coronary heart disease, a disease in which inflammation is now recognized as a major contributing factor, is three times higher than in the general population."

In order to say definitively that inflammation causes depression there is a lot of stuff we'd need to know that we don't currently know. However, in order for it not to be true, there is a lot of stuff that would need to be false that we know is true. That's why I don't think it's inappropriate to claim it matter-of-factly, even though there are still a lot of missing details that need to be filled in.

Re: When You Are Depressed, Make Something

#332

Post by jpfed »

komali2 wrote: post #117
sixo wrote: post #80

When you are depressed, see if there's a serious problem in your life that is causing you to be depressed and devote as much time and energy as you can muster towards exploring solutions to that problem, even if they entail dramatic life-changing decisions, because that's the kind of problem we're dealing with here. Examples of such problems: you hate your graduate program. You have no friends in your city and no ide…

I completely disagree with you. I believe you are describing solutions to problems that can make someone sad or frustrated, which is a fine thing. I'm all about being real about your life situation and doing something about it. However, depression is a disease independent of external factors. I had it when I had arguably one of the coolest jobs in my life up until that point. I treated it with medication, got out of…

>However, depression is a disease independent of external factors.

Just to clarify, are you saying that systems as intensely interconnected as brains in bodies in the world only ever enter depressive states... for no externally visible reason? What kinds of external factors are you counting (or discounting) here?

Re: When You Are Depressed, Make Something

#333

Post by drewmol »

So I texted this link to my mom and told her to read the comments, she's struggled with depression her whole life, as have I, but thought her experience and response might be insightful or interesting to some: (She's 60, single, of Christian faith, and just got back from a year in Kenya/Madagascar a few months ago. Last year, she quit her stressful job as CFO of a construction company in Cleveland, Ohio and moved to Nirobi to volunteer in an orphanage. After about 7 months the foundation who runs the project heard of her accounting experience, and offered her a volunteer position setting up the financial system for a new clinic in Madagascar being built by the Freedom from Fistula foundation, which she took. She's back in Cleveland now, but still remotely assisting in the payroll and accounting as they transition to local Madagascar permanent employees handling the finances. She just started a new position with a different local Cleveland construction company as she plans/saves for retirement. Her new position is much less stressful, according to her mainly due to the respect and treatment from the owner which she was not afforded from her previous employer)

Her response: [Wow. I didn't read the article either but the comments are really insightful. There is no "right" answer for everyone, but it's reassuring to read that people who are susceptible to depression can acknowledge it, find ways to fight it, and live well in spite of it. I think that's much healthier than looking for a 'cure'. I believe that I will always be the type of person who struggles with depression, but over the years God has given me the coping skills to have a full and joyful life as who He created me to be, not who other people think I should be. Does that make sense?]

Note that I am not advocating nor denouncing a faith based approach here, but as many here have recommended, I think openness to complete lifestyle changes is something to seriously consider for those struggling.

As always, thanks for keeping these discussions civil, insightful and constructive!

Re: When You Are Depressed, Make Something

#334

Post by oddlyaromatic »

jpfed wrote: post #332
komali2 wrote: post #117

Earlier quoted context omitted.

I completely disagree with you. I believe you are describing solutions to problems that can make someone sad or frustrated, which is a fine thing. I'm all about being real about your life situation and doing something about it. However, depression is a disease independent of external factors. I had it when I had arguably one of the coolest jobs in my life up until that point. I treated it with medication, got out of…

>However, depression is a disease independent of external factors. Just to clarify, are you saying that systems as intensely interconnected as brains in bodies in the world only ever enter depressive states... for no externally visible reason? What kinds of external factors are you counting (or discounting) here?

Not parent, but I think I can help clarify. As goofy as it can sound: "being depressed" or in a "depressive state" can have many causes and some of them are obvious, but those states are not the disease of depression, exactly. They are serious, of course, and can be life threatening in their own right. But the distinction here is that depression can act like any other disease or illness - like, would making more friends improve tuberculosis? Too often we treat depression as a puzzle that can be solved. But it can just be something a person "has" and is stuck with, and needs medical treatment for.

Re: When You Are Depressed, Make Something

#335

Post by nulbyte »

kzrdude wrote: post #325
camtarn wrote: post #307

Earlier quoted context omitted.

Er, no. You can reduce your risk of cancer greatly by living and eating healthily, but you cannot avoid it. Being alive is in itself a cancer risk, because there are many different cancers and many different ways they can arise - and some of those ways are pretty much purely random.

Having a chance to avoid and reduce the risk of it sounds like the same to me.

Indeed, they do sound the same. They are not.

If I buy a lotto ticket, I have a chance to avoid losing. If I win, it's over. If I lose, it's over. It's only good for one drawing.

However, I have some risk of cancer as long as I am alive. I may be able to do things to reduce that risk, but my chances are infinite as long as I breath. I can choose not to play the lotto, but I can't choose not to get cancer.

Re: When You Are Depressed, Make Something

#336

Post by 6stringmerc »

yellowapple wrote: post #185
6stringmerc wrote: post #24

Very good front half. The second half ruffled my feathers with conflating lifting other people's work via sampling and tossing flourishes in and suddenly feeling like an authority on creativity. I say this as both a 100% from scratch producer and frequent unsanctioned remixer of other people's work. Glad it's therapeutic for him, genuinely so. He's wrong though, not every human is "innately creative" in the sense tha…

"I just think false hope can lead to, eh, other depressive tailspins." This right here. These sorts of feelings are very similar to piloting an airplane in a stall. You can pull the nose up as hard as you can, but unless you fix the problem (e.g. by increasing the throttle) the plane is going to "fix" the problem for you (usually by nosediving and/or spinning out of control). If the engine is broken, then the only re…

You basically just described why the Air France flight out of Brazil went into a stall and dropped 30,000 feet to smack into the ocean. All I can hope in such a scenario, as a passenger, is that the DMT kicks in and I go out in a dream state. What happened was the pilots weren't experienced enough in the emergency scenario to go against their instincts and with their training - granted, there was a mechanical issue of the pitot tube freezing up, but in depression, emotional physiology is also a mechanical issue of sorts. That crash, to me, is an exceptionally clear example of how our own gut feelings can be ones that have to be overcome if we want to survive.

Re: When You Are Depressed, Make Something

#337

Post by oddlyaromatic »

tgb wrote: post #305
jackpirate wrote: post #273

Earlier quoted context omitted.

In a strictly clinical discussion it is fine to use language like "dependent on external factors" with its technical meaning. But when you're talking to someone potentially suffering from depression and not a clinician, you need to be aware of how they will respond to your words. The average person conflates "dependent on external factors" with "arises due to bad life decisions" and so we need to adapt our language a…

I'd think most people would mistake it as implying that depression was caused by, say, lead in your pipes or that time they were mugged and felt powerless. External factors seem to me to push the blame away, not towards, the individual. The alternative of saying that depression is causeless to me sounds more likely to induce people to think it's "just their fault" or "if there's no cause, why can't they snap out of i…

When you are down, nothing can really make you feel like it is not your fault or that you don't somehow deserve the feeling. Except perhaps, at least among the people I know, this knowledge: That feeling of worthlessness, itself, is the symptom of a condition you have. That condition is called Depression, and Depression lies. So the depressed person can maybe make it through for a little while longer by trying to actively distrust their own feelings and thoughts and waiting for the episode to pass. If they wait long enough, the episode will pass. If they can't wait, they may end up taking their own lives, which is really the only other option they see in the worst moments of this disease. So recognizing that it is a medical condition for which you are not to blame could be very useful for people right on the margin of surviving a depressive episode vs not surviving. I hope this was not too much of a reply!

Re: When You Are Depressed, Make Something

#338

Post by didibus »

samirillian wrote: post #216
jackpirate wrote: post #195

Earlier quoted context omitted.

>What? No disease is independent of external factors. This statement is true only in the narrowest sense and is actively harmful to people with mental health issues. Let's compare depression and cancer to see why. It is common to say something like "cancer is independent of external factors" to mean that anyone can get cancer. It doesn't matter how healthy of a lifestyle you live. Due to random chance, the guy who re…

> true only in the narrowest sense I think it's true in the right-width-of-sense. Illnesses like depression are difficult because they certainly _do_ lie somewhere closer to the symptom side of the "symptom-disease" spectrum than cancer. Alcoholism is good for comparison, because it presumably falls even further towards the "symptom" side of the spectrum. But there is certainly a spectrum! So we have Cancer which is…

This thing you assert hasn't been proven though. We still don't know what causes depression, we don't know what causes cancer and we don't know what causes alcoholism. Out of the 3, we understand how cancer works the most, because it is the most life threatening one, and affects the most people, and is also probably easier to understand. So we are putting more money and effort into cancer research.

There's as many known external factors for cancer as depression. And as with cancer, they've got only a small impact of likelihood of reducing your risks of getting the disease.

It's therefore unknown if depression is caused by external factors, or simply triggered by them, or a combination, and if so, we're not exactly sure what all the factors which have an influence are.

As it stands today, it's still very possible depression is caused by generic defects, bacterial infection, virus, or some other unknown external factor like polution, exposure to some toxins, or very early development problems, etc.

Honestly, I'd love to be enlightened on some very definite research that knows what causes depression, but as far as I'm aware, science doesn't know.

So there is this problem that some people have depression, and we assume it's just there lifestyle, or they were raised poorly. This is due to the nature of mental diseases, which we understand poorly, and often we associate our mental state as our conscious of our own doing free will. Like someone who is naturally grumpy, we say that's who he is, no one questions that it might be he's got a disease, maybe there is a brain anomaly, or a weird communication of his neurones happening that don't balance out his emotions properly and skew him to being grumpy. But being a grumpy guy would never affect your life enough that you'd seek medical help. So people who are depressed, they're like grumpy guy, except it affects their life so much that we put some research into addressing it. Sad truth is we found very little yet.

With that said, we can see how socially we should be careful how we speak of this, because we're often giving the impression that external factors is the known cause, and that a few lifestyle change is the cure. Except that's false. The cause is unknown, and exercise is just the best we got to help. Imagine if we thought similar of cancer, we'd cut funds for cancer research, we'd just tell people they should eat better, stop smoking and exercise. And everyone who gets cancer got it because they probably didn't follow the right lifestyle.

Re: When You Are Depressed, Make Something

#339

Post by [deleted] »

samirillian wrote: post #216
jackpirate wrote: post #195

Earlier quoted context omitted.

>What? No disease is independent of external factors. This statement is true only in the narrowest sense and is actively harmful to people with mental health issues. Let's compare depression and cancer to see why. It is common to say something like "cancer is independent of external factors" to mean that anyone can get cancer. It doesn't matter how healthy of a lifestyle you live. Due to random chance, the guy who re…

> true only in the narrowest sense I think it's true in the right-width-of-sense. Illnesses like depression are difficult because they certainly _do_ lie somewhere closer to the symptom side of the "symptom-disease" spectrum than cancer. Alcoholism is good for comparison, because it presumably falls even further towards the "symptom" side of the spectrum. But there is certainly a spectrum! So we have Cancer which is…

[deleted]

Re: When You Are Depressed, Make Something

#340

Post by Alex3917 »

yellowapple wrote: post #264
Alex3917 wrote: post #250

Earlier quoted context omitted.

The Duke research is interesting. But saying that because they didn't find a pathway that inflammation is unlikely to cause depression doesn't really make any sense, given that major triggers for depression are surgery, infection, autoimmune diseases, etc. I don't think anyone is disputing that depression also causes inflammation, but the idea that the causality only goes one way just seems very counter to everything…

The point is that there's no clear causation in either direction, and certainly not in even a significant minority of cases (let alone all or even a majority). We just don't know nearly enough about how the brain works to be able to chalk up something as complex as major depressive disorder to "your brain's inflamed; take some Aleve". In fact, the DSM definition of major depressive disorder/episode (or at least this…

> The point is that there's no clear causation in either direction

C.f. my other comment. I think there is good evidence for causation in both directions.

> In fact, the DSM definition of major depressive disorder/episode

I wouldn't use the DSM definitions of depression due to, among other reasons, the fact that there is very little iter-rater reliability:

http://behaviorismandmentalhealth.com/2013/03/30/dsm-5-inter...

I think the article I linked to in my other comment has it correct, where depression should be considered as something that exists within all people on a spectrum rather than as a mental illness. Now obviously if depression gets to the point where it's causing health problems and interfering with your ability to work and enjoy life then that may be a diagnosable issue, but it's a mistake to think of depression as being something that you either have or don't have in the more general case.

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