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Toward a Predictive Theory of Depression

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Re: Toward a Predictive Theory of Depression

#111

Post by defined »

Oxitendwe wrote: post #71

What I have found through my experiences with depressed people is that the vast majority of them are not insane people in a sane society, but perfectly sane people in an insane society, people who have maladapted to their environment but would otherwise (if they had a better one) be perfectly healthy individuals. Many of them internalize their sadness and helplessness and make it a part of their identity, further rei…

I don't know. Depression has been recorded for thousands of years, so either society has always been insane (quite likely), in which case it's not likely to turn around any time soon, or there are other causes of depression. Some people can also fall into a depression for no identifiable reason (I can vouch for that from experience).

SSRIs and SNRIs and other medications have saved my life and some of my sanity, and I have high confidence that it's not a placebo - for me - having tried and failed with probably a dozen of these over the years, before hitting on a workable combination.

And after maybe 5 years or so, that combination became ineffective, and I had to try a few more.

But that's just me, so this is anecdata.

Re: Toward a Predictive Theory of Depression

#112

Post by defined »

eradicatethots wrote: post #95
fujiters wrote: post #93

Earlier quoted context omitted.

That's the spirit! In all seriousness, what else is there to do? Take whatever relief you can get while you can get it.

Remove bad habits/ behaviors/people... cure the problem

So you are hoping there will be an ELE for the human species? Because that's the only way your prescription is going to cure the problem on a global basis for the foreseeable future.

Re: Toward a Predictive Theory of Depression

#113

Post by eradicatethots »

defined wrote: post #112
eradicatethots wrote: post #95

Earlier quoted context omitted.

Remove bad habits/ behaviors/people... cure the problem

So you are hoping there will be an ELE for the human species? Because that's the only way your prescription is going to cure the problem on a global basis for the foreseeable future.

When I say remove I didn’t mean remove from existence lol, just from your life. It’s true this isn’t a solution that can be implemented by governments, it has to be implemented by the patient.

Re: Toward a Predictive Theory of Depression

#114

Post by eradicatethots »

throwaway197812 wrote: post #108
eradicatethots wrote: post #91

Earlier quoted context omitted.

Don’t really think there are that many. The vast majority are some form of “work out, eat healthy, ...”

I agree. It's clear from this thread (and it fits with my experience as well) that the usual advice only goes so far, and for obvious reasons: if I had enough energy, motivation, and discipline to work out, eat healthy, meditate, whatever -- all the standard advice for lifting my mood -- I wouldn't be depressed! I've been wondering lately if there isn't a model of care that goes beyond just a psychiatrist (to prescri…

Personally decided the advice isn’t helpful at all for me and am trying other things. Talking to my mom helps some. Lots of things for me to figure out still though. Not very hopeful.

Re: Toward a Predictive Theory of Depression

#115

Post by Oxitendwe »

defined wrote: post #111
Oxitendwe wrote: post #71

What I have found through my experiences with depressed people is that the vast majority of them are not insane people in a sane society, but perfectly sane people in an insane society, people who have maladapted to their environment but would otherwise (if they had a better one) be perfectly healthy individuals. Many of them internalize their sadness and helplessness and make it a part of their identity, further rei…

I don't know. Depression has been recorded for thousands of years, so either society has always been insane (quite likely), in which case it's not likely to turn around any time soon, or there are other causes of depression. Some people can also fall into a depression for no identifiable reason (I can vouch for that from experience). SSRIs and SNRIs and other medications have saved my life and some of my sanity, and…

>I don't know. Depression has been recorded for thousands of years, so either society has always been insane (quite likely), in which case it's not likely to turn around any time soon, or there are other causes of depression. Some people can also fall into a depression for no identifiable reason (I can vouch for that from experience).

Of course there have always been depressed people, but the modern phenomenon where supposedly 10% of the population will have it in their lives, or where entire countries experience skyrocketing suicide rates, is certainly not related - I find it very difficult to believe that they all have a biological problem, instead of a cultural or societal problem.

>SSRIs and SNRIs and other medications have saved my life and some of my sanity, and I have high confidence that it's not a placebo - for me - having tried and failed with probably a dozen of these over the years, before hitting on a workable combination.

I don't doubt this - I only said that the vast majority of sufferers of depression do not seem to suffer from a biological problem. From my personal experience, I have seen that most of the depressed people I have known have gotten better not through medicine or medical procedure, but by consciously trying to make their lives better and be the best person they can be. Obviously this won't work for everyone - there really is such a thing as biologically-caused mental illness (see: schizophrenia, for example), but I think it is much rarer than people are willing to admit.

>But that's just me, so this is anecdata.

All data is anecdata. It's not worthless just because it happens to be your actual life and not collated and tallied by some detached scientist, it has meaning and value even without being a part of some anonymous dataset you can take confidence intervals on.

Re: Toward a Predictive Theory of Depression

#116

Post by fragmede »

cassowary37 wrote: post #65

Professor of psychiatry here - I've spent the past 20 years trying to help folks with depression, and related illnesses, and trying to study these diseases at a genetic level. I suspect this will get me down-voted as I know the medical/biological perspective is often unwelcome on hn. However: a key error people make here and elsewhere in speculating about depression (and suicide, and ADHD, and...) is either extrapola…

There's an opioid epidemic sweeping the nation. If psychiatry has anything more effective for treatment than court-mandated AA (well, NA), now would be the time to do something, because people are dying left and right. Current treatment regimes are totally ineffectual. 30-days of rehab, along with religion-based and "addition is a moral failing" 12-step programs isn't cutting it.

It's not the number of theories that count, what counts is if there is a theory is actually useful in modeling results. If the car won't run and there's no gasoline, call it a disease of gasoline if you have to, but adding gas does wonders for my car actually running.

The late 1800's opiate epidemic called; they want to know if psychiatry has actually advanced in the interceding years.

Re: Toward a Predictive Theory of Depression

#117

Post by [deleted] »

defined wrote: post #110
icc97 wrote: post #103

I typically have odd thoughts that are often wrong. But I really like quote from 'The Martian', "let's science the shit out of it". I don't know if it's possible to science your way out of depression. If in some way the curiosity gives a small enough lift to keep you getting one foot in front of the other and learning about what's causing your depression. It at least seems relatively risk free way of tackling depress…

> But is this something you can tell people that are seriously depressed or is it just another useless bit of advice? From my point of view, it's not useful advice, partly because severe depression utterly saps the motivation to do virtually anything , and partly because depression is highly resistant to rationality. Mandatory references to "Hyperbole and a Half"[1][2]. [1]: http://hyperboleandahalf.blogspot.com/2011…

[deleted]

Re: Toward a Predictive Theory of Depression

#118

Post by icc97 »

defined wrote: post #110
icc97 wrote: post #103

I typically have odd thoughts that are often wrong. But I really like quote from 'The Martian', "let's science the shit out of it". I don't know if it's possible to science your way out of depression. If in some way the curiosity gives a small enough lift to keep you getting one foot in front of the other and learning about what's causing your depression. It at least seems relatively risk free way of tackling depress…

> But is this something you can tell people that are seriously depressed or is it just another useless bit of advice? From my point of view, it's not useful advice, partly because severe depression utterly saps the motivation to do virtually anything , and partly because depression is highly resistant to rationality. Mandatory references to "Hyperbole and a Half"[1][2]. [1]: http://hyperboleandahalf.blogspot.com/2011…

Yes, this wouldn't work for the most serious cases of depression. It might help for those who are at a stage where they're willing to try something.

Re: Toward a Predictive Theory of Depression

#119

Post by jschwartzi »

eradicatethots wrote: post #74
theptip wrote: post #39

Earlier quoted context omitted.

> What if people get depressed because their lives suck and they had a shitty childhood? But people don't only get depressed because of those things; plenty of people's "lives suck" who aren't depressed, and plenty of people with good lives _are_ depressed. https://en.wikipedia.org/wiki/Major_depressive_disorder says: "The cause is believed to be a combination of genetic, environmental, and psychological factors....…

Beliefs are passed down like genes.

This is true in the case of my family. My brother and I learned how the world worked from my parents, and it's taken years for me to unlearn what they taught me instead of some actually useful beliefs.

Re: Toward a Predictive Theory of Depression

#120

Post by defined »

Oxitendwe wrote: post #115
defined wrote: post #111

Earlier quoted context omitted.

I don't know. Depression has been recorded for thousands of years, so either society has always been insane (quite likely), in which case it's not likely to turn around any time soon, or there are other causes of depression. Some people can also fall into a depression for no identifiable reason (I can vouch for that from experience). SSRIs and SNRIs and other medications have saved my life and some of my sanity, and…

>I don't know. Depression has been recorded for thousands of years, so either society has always been insane (quite likely), in which case it's not likely to turn around any time soon, or there are other causes of depression. Some people can also fall into a depression for no identifiable reason (I can vouch for that from experience). Of course there have always been depressed people, but the modern phenomenon where…

You make your points persuasively and elegantly, and I agree with you for the most part. I think much of what is diagnosed as depression in recent times may be a synonym for despair at these times (echoing Cicero : "O tempora! O mores!"). On the other hand, clinical depression of the kind that has assailed me since my teenage years (and from which my son suffers and showed signs of since 5 or 6 years old) appears most certainly to be genetically caused.

I suspect that maybe a physical cause of depression is less rare than you think.

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