Major Depression


[quote="TheGingerMan"]Clinical depression?
What is that but a very contradiction in terms?

Please pardon me if I level much vehemence against the school of thought that pervades the study of depression and mental health. If I have to read any more claptrap jargon, I will surely heave!

I hail from the more practical element of that discipline, and as such, can only offer the following.
1. Exercise of both body & mind are crucial.
2. Avoid advice that is not part of your prism.
3. Study your prism. Note how the refraction changes with the angle of light. Maintain that angle, give it a name. It is yours.
4. Read literature, especially the old stuff. One can find much resonance in the old tales. Don't take it religiously.
5. Build a wall, with whatever it takes. A sanctuary away from the caprice of everyday human evil.
6. Listen to uplifting classical music as much as possible, chamber suites most especially.
7. Maintain the perimetre. Plan ahead tactically, have reserves, and get them out in the field to relieve, and learn from, the grizzled veterans.
8. Above all, Keep on Keepin' On.

Is that really you... the
Caped crusader...the hero of Gotham himself?


I love it when people who don't actually suffer from a major depressive disorder claim you can beat it with cold showers, rigorous exercise and a good book. :sunglasses:


Pretty much how I cured mine. (Substitute hot springs for the cold showers, though). Works.


You were lucky, recognized it early, and clearly were not suffering from a major depressive disorder (and yes we do know that, or can make a damn good inference, from the way you described your feelings online and your ability to still work and deal with family matters). Others aren't so fortunate.

I've worked my way out of many minor depressive states with exercise, sunshine and good diet. I know many others who have as well. That means nothing when faced with a state of profound and debilitating depression.


I had a friend who was suffering from depression. Told him to pull his socks up, and reminded him to "Be British.*" It worked and he's doing okay. Of course, that's just one case - need to run proper clinical trials before it goes mainstream I think.

  • my friend wasn't technically British (although of British stock).

Oh, come to think of it, he changed medication at the time of my advice.


Then it wasn't clinical was just a depression most likely caused by external factors.

My baby sister went through the clinical form of depression as a teenager, and I can assure you that medication was the only thing that could help her at the time (and was the only thing that kept her from taking her life). There were no external factors that would have made her depressed...good family, lots of friends, a very well-adjusted young girl involved in sports, gymnastics, chorus, etc. on top of being an excellent student. It literally came out of nowhere and was a huge mystery until she was diagnosed.


You should write a self-help book AJ...I hear you can make a bundle in that racket. :sunglasses:

Seriously though you (not meaning AJ here) do no one any favors by telling them to "snap out of it" "take up macrame" etc. etc. That simply gives people who need drug therapy further cause to avoid addressing a debilitating illness. It's exactly the same as telling someone who has an infection that requires antibiotic treatment to take an aspirin.




Clinical depression is a chemical imbalance in the brain, no? Acute (episodic) depression is situational. It is hard to know which one it is, although if you are going through a shitty time that is usually a nice way to assign it. My experiences have been that episodic depressives enjoy the relief that meds give them, but there are issues of dependence setting in. Clinical depressives don't usually seek out the meds (contrary to episodic depressives) but the meds are effective to varying degrees because you are trying to restore some sort of imbalance. Of course, all of this is a general picture, and will not chime with many people who don't fit into that pattern.

Despite the paradox of being advised not to listen to advice, this is probably the best piece of advice to give. Anyone trying to shove advice down your throat, telling you to pull your socks up, getting angry with you, or that sort of stuff are usually very well meaning, but so wide of the mark it is untrue. (Although weirdly the friend bollockings you get remain sharply in your mind afterwards.) Listening and just being there is the only thing other people can really do. OWN your depression. Do whatever you need to do to get through it, but if you are damaging your body excessively or harming others.... then we need to talk! :smiley:


I subscribe to bootcamp for bipolars, Valentines for schizophrenics, puppies for heart patients, and caffeine and meditation for Alzheimers.


Cancer can be cured with a combination of apple cider vinegar, courage, a positive outlook and determination to win the battle. People who die of cancer are just losers with a bad attitude.


And like my Italian Great-Grandmother used to say, "When you don't feel well, just sit up and smile!" That was her cure for everything. :slight_smile:


There is such a thing. It basically means "we don't know what's causing it, but it's there anyway". My own personal opinion is that (usually) it does have some cause. I do not subscribe to the theory that it's a "chemical imbalance in the brain", and the fact that some relief can be achieved by fiddling about (on a macro scale) with brain chemistry is not proof that it is. Most of what goes on in your body is under closed-loop control; so if something is measuring "too high" or "too low", it's because some control system in your body thinks it's supposed to be that way. It's a sign, not the disease itself.

MM mentioned adolescence and I believe many (maybe most) adolescents are depressed during those years. My opinion is that adolescence needs to be explicitly recognised as a discrete stage of life (some societies do exactly that). As it is, we westerners imagine that there is childhood; and there is adulthood; and nothing in between. Adolescence is that time when you are figuring out how to change from one to the other, yet adolescents really receive no instruction or advice on how to do that. The "cause" of depression, in this instance, is that a teenager is sometimes treated as a child, sometimes treated as an adult, and sometimes simply as a waste of space. There are certain things that ought to happen during those years, yet in our so-called advanced society we spend an awful lot of time telling teenagers what they can't do. In fact it's the best time in your life to try lots of things, make lots of mistakes, and discover who you are - preferably with some trusted older-and-wiser person to help you along. What we call "rebelliousness" is generally just nature reasserting itself over a dysfunctional culture.


I have absolutely no expertise in this but isn't the basic "cause" of clinical depression that serotonin gets re-absorbed into the synapses too quickly? Hence most anti-depressants (and MMDA) work by slowing the re-uptake of serotonin. Again while a lot of us get an occasional peek into the abyss for those that actually fall into it drug therapy may be the only way to get themselves pulled out. For sure you can look at environmental causes and issues that began in adolescence but there are some people with absolutely no identifiable issues for whom you can only conclude there's a chemical imbalance in the body or faulty wiring in the brain.


Medscape gives a good overview.


You are absolutely correct.

Essentially, ALL depression is chemical. The initial cause may not be chemical, but the depression always is.

The problem is that once you get stuck into depression - for whatever reason - you can get stuck there permanently even though the initial cause of the depression is gone. I guess that it might be the body getting adjusted to the new serotonin level and maintaining that level.

Sorta like metabolism and dieting?

So, I absolutely believe that medication is a smart way to go - especially, once the initial cause of depression has been dealt with. Medication cannot and should not replace dealing with your problems. But, it's a valuable tool to help you get out of that hole you've dug for yourself.


I always found it irritating when (it was more fashionable at the time) our lecturers were keen to ascribe all psychological disorders to chemical "imbalances". While I agree that drug therapy has its place, drugs are far too often used where they are not appropriate, or where some other form of therapy is also called for. Saying depression is caused by low serotonin levels is like saying headaches are caused by pain. It's a facile, pseudoscientific non-explanation. IIRC serotonin is used in two ways: as an ordinary neurotransmitter (between neurons) and also as a modulator (a chemical that pervades the brain and affects a large number of receptors). Dopamine likewise. Serotonin analogs or MAOIs can only perform the modulation function, and by their presence can interfere with the systems that are producing endogenous serotonin. SSRIs essentially have the same effect by allowing serotonin to 'leach out' of synapses. I don't know much about them because they weren't popular when I was at university, but I believe they're going out of fashion lately because they simply don't do anything useful.

The brain is a highly dynamic system capable of rewiring itself in response to environmental stimuli; while it may occasionally become seriously "de-tuned" and need a quick fix to prevent escalating problems, it's not a substitute for finding out what the underlying issue is. Over the years, I've got to know several people who struggle with depression, and it's often become apparent that they have deep, festering emotional problems that would depress anybody. Note especially that the behavioural symptoms of depression are almost identical to those of learned helplessness. I also vaguely recall a study that discovered depressed people have a very realistic and rational assessment of their world. It's the rest of us who are over-optimistic.

Yeah, I'd say that's a good way of looking at it. I'm not a luddite, but I do believe there's a lot of truth in the saying "when the only tool you have is a hammer, everything looks like a nail".


I remember reading Prozac Nation years ago and being profoundly moved by Wurztel's accounts of chemical depression, and how medication just wasn't cutting it for her. I think we have to take science as a: best guess discipline, much in the same way that religion requires a little faith. We all have massively different levels of serotonin and it is used to explain away a variety of behaviours and maladies. I like the old introvert/extrovert one. That theory goes that introverts have too much serotonin flowing and extroverts have too little. Essentially introverts are constantly alert and thinking and are highly stimulated by the world around them. Any form of extra information, like noise or social groupings causes the introvert brain to shut down because it can't handle any more serotonin. The extrovert by contrast is therefore a bit of a dullard who doesn't have very much serotonin and needs to seek out thrilling experiences to make life seem to have any sort of stimulating point to it. Introvert: overbalance. Extrovert: underbalance. Sounds like a load of old nonsense, right? Well, scientifically it is highly observable. As is the old chemical imbalance theory in depressive people. It doesn't mean it is true. It doesn't mean it is false. I am starting to read more Ben Goldacre, and more about scientific statistical proof, as I feel this is where the future path of scientific truth lies.

My experiences of modern science are that we are applying new techniques and new words to achieve the same aims as medicine was try to achieve before. We don't blood let to reduce/remove pressure, we use pharmacology. We don't believe in phrenology, but use MRi to achieve the same/similar belief that functioning is localised. I hold my head in my hands as my professor bangs on about Broca's area in one sentence, then talks about connectionist modelling with the next. WHICH IS IT TO BE? We still really cling to the same biological and physiological beliefs, we just use new technologies, new words, and new treatments to describe what is going on. New wallpaper on top of old wallpaper.

So I say again, science is the stuff of best guessing. Whilst we may only have a hammer and everything may only look like a nail, people still want some sort of solution thrust at them for what is going on with their body and science is trying to be the best hammer it possibly can be when people arrive with nails sticking out, wanting them banged back in.

Side note: I read yesterday that before we had street lighting we hairless humans used to sleep in two shifts during the 24 cycle. Once the world became lit 24 hours a day we switched to this 8 hours sleep pattern that we have now. This was accompanied by the notion that lying about in bed is a massive waste of your time. This may be unnatural and could explain why we seem more stressed and uptight as a species now. Not enough quality rest, and not enough time to introspect between each sleep period.


The mind-brain connection is poorly understood and depressive feelings may just as much indicate a purely biochemical misfunction as any 'deep emotional issues" (what the hell are they?).

Simply look at the effects diminished sunlight has on people in northern climates during winter. The symptoms of SAD are the same as a deep depression. Mentally and experientially they are also the same. I know as I used to suffer from it terribly. Is there some deep emotional issue I and millions of others have with winter?

Why do I no longer suffer seasonal depression? Because I have learned that at least one day a week of prolonged outdoor exercise (say a 6-8 hour hike or bike ride) in addition to a couple 1-2 hour bouts of exercise, and of course good diet, ect, is enough to keep it in check. I also used to use high spectrum lights though I don't need them now in Taiwan: just pop down south a few times.

No need for therapy, no underlying emotional problems. And the same negativity that I used to record year after year in a journal is suddenly mysteriously no longer there. If you don't get that last part I'll explain. If you read my journals, and no you won't, you'll find that every December through January I was writing about the same doubts, feelings of insecurity and hopelessness. Often times I was using the exact same words. It's quite clear to me that there was no issue. My mind was simply making up negative issues to explain in a sense the way I was feeling.

Depression is a symptom of many types of common illnesses; again because the mind tends to want to dwell on negative emotions when the body is out of sorts. And as is obvious, when depressed it is difficult to concentrate, to focus, and hence to think clearly. Self-esteem issues are as often the result of depression as the provocation.


MM: I wasn't implying the cause of depression was always an emotional issue ("what the hell are they"=bad or abusive families, chaotic or dysfunctional living environment, bereavement, drug/alcohol abuse, bullying ...). That's just the one I've encountered most often. I was thinking of one particular person when I wrote "emotional issues" - she was fucked-up on so many different levels it's hard to know where one thread ended and another one began. My point was, there is often a cause, or causes. "Low serotonin" is not a cause, at least not an ultimate cause. Even in those cases where someone's brain has, apparently, just thrown a random wobbly, there must be a reason. Just because we don't understand what it is doesn't mean it's not there.

In your case, obviously the cause was SAD (I used to have terrible problems with that myself back in England - it's one reason I don't want to go back there). No need to invoke biochemical mumbo-jumbo.

But yes, the brain does tend to invent stories to justify its physical reactions. That's the theoretical basis of Cognitive Behavioural Therapy. And of course there is mutual interaction so that it's hard to tell what's "body", what's "brain", and what's "mind". But surely that's another reason for not taking too seriously any half-assed theory that talks only about brain chemistry and ignores everything else.

That's what I said. Mostly, it's a symptom/sign, not a disease process per se, and therefore not treatable as such. Any medication should be considered palliative rather than curative.