A Note On Depression

It occurs to me that my previous post could give the impression that I think of depression as something that can be effectively handled by a little think-fu.

I don’t. Depression is vicious, bad stuff. If you or someone you care about has depression, grab yourself a copy of _Against Depression_ by Peter Kramer. It’s a discussion of how depression is understood in our culture and includes a roundup of current research on depression — and apparently more has been learned about it in the last 10 years than in the previous 50.

That stuff about “serotonin makes you happy, depressives have low serotonin, so if you take SSRIs it will make you happy”? It’s nowhere near that simplistic, and nowhere near that benign. We are far from fully understanding depression but from what we do understand about it, it is way more complex than that, and more importantly, it is progressively degenerative. The more you have it the more you are prone to have it. Mild episodes tend to lead to severe episodes. It involves a “stuck switch” which keeps the brain from turning off the stress hormones that come out during fear situations, and the stress hormones themselves damage mechanisms which are involved in shutting themselves off so it’s a vicious cycle. And the damage done is permanent. It’s as if there’s a path towards severe depression and with each day of depression you take a step down it, and when you manage to get out of depression then you can stop walking down the path, but when another episode hits you start off as far down the path as you walked the last time.

So grab yourself a copy of _Against Depression,_ and read it, if it’s a topic that matters to you. The important new research hasn’t really begun to filter into discussions of depression out in the mainstream of American discourse, so unless you’re a researcher or very well informed doctor you’re not going to hit this information without going looking for it.

2 thoughts on “A Note On Depression”

  1. A certain percentage of depression cases are actually cases of an UNTREATED CONDITION that doctors DON’T BOTHER TO CHECK and simply accept “depression” as a disease. I don’t know what that percentage is, but I’m afraid that it’s not insignificant.

    Depression is a symptom, not a disease.

    There could be many different underlying conditions. They could be physiological or psychological. They may known to medicine for decades to or not yet identified and understood. These conditions all have depression as a symptom but obviously cannot all be treated the same way. Some of these conditions respond to SSRIs. Many don’t.

    Check the literature. There are many conditions with depression as a possible symptom. Some of them have other symptoms but they may not always apparent. Even if they are, the patient may not realize they could be connected and report them. Even when reported, non-specific complaints by people with depression or often dismissed although they might contain important clues.

    I suffered from depression and inadequate treatment for several years before I found the real problem myself. With proper treatment, depression was gone overnight.

    I’m afraid that the antidepressant “fashion” and they way depression is perceived had a big effect on the willingness of doctors to consider other possibilities. I was stubborn enough to find the problem myself. How many people are still suffering needlessly?

  2. Oh, good point. I think that’s quite consistent with what Kramer was saying. On the other hand, once depression gets started (from any source including another illness) it seems that it increases dangers of worse depression in the future.

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