Anxiety and Depression Are Symptoms, Not Diseases

I have this wacky idea that maybe, just maybe we should reconsider the point at which opiates would be appropriate for treating depression. I mean maybe make them a 2nd or 3rd line treatment... right now I'm pretty sure they'd only give you opiates once that whole "induce a controlled seizure" thing fails.

Sure, they're addictive, but the "opium cure" was used up until the 1950's[1] and it's not like society was overrun by addicts. (I admit it's possible that the circumstances have changed, but I'd need to hear an argument for that.) Plus the fact that both Buprenorphine and Heroin-Assisted Treatment have been successful... opiates can be given as controlled medicine, and I feel like many people could benefit from them.

Over 40,000 Americans die by their own hand every year.[2] I would much rather have 40,000 opioid-dependent living people if it helped them bear the weight.

[1] https://www.ncbi.nlm.nih.gov/pubmed/18956529

[2] http://afsp.org/about-suicide/suicide-statistics/

This! So many times I see that "depression is not just something you can address with actionable things, talking about rainbows", etc. and some sort of implicit acknowledgment that psychotropic drugs are necessary and that depression is totally okay and just has to be understood and empathized with. (I wish I expressed this sentiment better, but I hope you know what I mean since the same sentiment keeps appearing.) And then that can lead to downward spirals, drug abuse, and even suicide.

Depression and anxiety are usually symptoms of needs not being met, or embracing a worldview in which one is not living up to things they believe are essential. Often the worldview makes a big difference, including and especially religion and philosophy -- as these affect what the person values the most. That and the interpersonal relationships with people and how they are affected by the person's goals.

If you are close to someone who is depressed, ask them about:

Their worldview

What is important

Their values and goals

Why must they achieve those goals

How have they been achieving them

Their interpersonal relationships

What is wrong is often systemic - it is seen over and over in various people in various ways. The underlying worldview usually is the first factor, followed by interpersonal relationships that are colored by the worldview and goals. Often one's early relationship with the parents sets unconcious goals (eg must get married to someone within the faith, must get good grades etc.) that cause people to expend a lot of effort pursuing while not fulfilling their physical and emotional needs. They end up depressed or anxious as a result.

That seems reasonable, but I'm left wondering what else I can reasonably draw from the article- if we present depression as a reasonable response of our inherent psychology that's attempting to induce us to change, what block can I place in the logic chain that prevents me from therefore automatically asserting that those suffering from depression should therefore "find out what's causing their depression and relieve it?"

I mean, I'm all for exploring the issue from many perspectives, and I don't intend the 'oblique suicide' remark as a condemnation of this line of discussion, I intend it as a condemnation of the natural conclusion of this line of thinking - that is to say, unless we add at least some minor caveat (I didn't see it, did I do a reading comprehension fail, perhaps?) that "this is discussion NOT for people suffering from depression but for their doctors and psychologists, we're just exploring possibilities, here, people!"

Or is this position not asserting that the 'cure' for depression is to find out what's wrong in your life and fix it? I mean, that's absolutely what I took from it, was I wrong in that? If that's the position in the article, is there some piece I'm missing that will prevent me from 'strawmanning' the author?

I guess, for now, I just have to assert that leveling a devastating criticism at a position - "this is tantamount to obliquely encouraging suicide" - that's not always strawmanning, sometimes it's just spot- on criticism. I suppose I ought to be another read-through to be certain, but I'll probably try to move on, for now- I just have to assert that I think my understanding of the author's position and my reasoning from these premises- I do think they lead to exactly the place I've described.

I still don't think that makes anyone evil in this discussion, but I do assert that it may well make them wrong at a deep, potentially axiomatic, level. I appreciate the opportunity for discussion, even if I disagree very strongly with the positions presented. :)

I think the solution to your dilemma is that we have a shared responsibility for each others' mental health. Indeed, isolation and alienation are part of the cycle of depression and breaking it necessarily means relying on others for mutual support and aid. Emotional labor is an often underlooked and undervalued aspect of human relationships. Performing it for each other is one way in which humans support each others' well-being. Depression and anxiety, as problems of environment aren't of the Human and Nature variety, but the Human and Human variety. A person that is depressed has lost the ability, or never had it to begin with, to regulate their social environment. To be quite honest, most of us don't have that much control over our own social environments. It is too costly, too risky to live a life too far off the beaten path. The structure of our society determines what social environments are easy to achieve and maintain and which ones are difficult, and for whom it is easy and difficult.

This can explain why the rich suffer from depression too within the environmental framework. Material wealth usually implies being embedded in a particular part of society, and there's no reason why that environment which is good for making money is any good for one's personal health. It is for some people, not for others. One example in recent memory is Notch, the creator of Minecraft who became a billionaire for it, but a few years ago lamented how socially isolated it made him.

Human beings are fundamentally social creatures. It is often the case excepting physiological disorders that mental disorders are social disorders. No particular feature of our societies' structures is completely fixed. Our relationships are radically different today compared to 50, 100, 1000, 10000, 100000 years ago, and yet our brains have the ability to adapt to such changing circumstances. It's clear however, that what is tolerable for some is intolerable for others. Social problems manifest first as individual problems amongst the most vulnerable. The rising tide of mental disorder is a rising tide of social disorder.