Comment by citrin_ru
9 hours ago
If you view a world at a certain angle there is always something to worry about: 1. World in not perfect, it doesn't confirm to how we want it to be (and could not even in theory given that different people want it to be different) 2. The future cannot be predicted with 100% accuracy so even if all is perfect today you can worry that it will turn bad in the future.
When looking at the same reality one persons sees the situation as OK and another as a an endless and hopeless disaster it is hard to tell who is right. A depressed person would tell that most people around him are wrong and are optimistic only because they don't understand how bad all is.
That's incredibly reductive. I'm sure some people's depression can boil down to a matter of perspective, but it's naive to extrapolate that to everyone with depression.
I'm incredibly optimistic and am content with my position in life. My default state is being mindful of the present and I don't think about things too far into the future. I very rarely ever feel stressed out over things in life.
However, none of that changes the fact that I feel completely empty and find no joy in things. Interests are nearly non-existent, emotions dialed to 1, and the only thing I'm motivated to do is lay in bed staring at the ceiling... unless I'm on sertraline.
Admittedly that's just anecdotal, but I worked in a clinical neuroscience lab researching treatments for severe treatment-resistant depression (read: people who tried so many options including CBT that they even tried electroshock therapy). The only thing that helped those subjects was a regimen of personalized neuroimaging-guided transcranial magnetic stimulation for 10 minutes every hour for 10 hours every day for a week. Even then, it wasn't permanent. Some saw improvement for months, others only weeks.
For some people, it's not just a matter of "perspective".
I'm not telling it's a matter of perspective, my point is that I see no objective metrics to tell apart if the situation is bad so it's one expected to be depressed and when the situation is good (so only medication / therapy would help). And it makes discussions around this topic harder.
If its not just a matter of perspective and only medication can help, etc, then why do we call depression a "psychological" or "mental health" concern? Why isn't it just considered a neurological disease?
Depression is increasingly starting to be seen as a neurobiological disorder as we learn more.
In my own opinion, we need to stop viewing "mental health" as a separate class of conditions from general/physical health. A mental illness is a health/medical condition just like any other and shifting our views and diagnostic criteria in that direction would do a lot to remove the stigma associated with mental illness.
Someone with depression has a chronic illness, not a temporary "it's just in your head" condition.
1 reply →
Not sure what your point is, many mental health concerns are caused by neurological diseases.
In case of depression in particular, it appears to be a label given to a big bag of various issues you may have causing similar symptoms.
> I feel completely empty and find no joy in things.
Maybe the idea that we should find joy and feel full is wrong?
We are on a random planet circling a random star in an unfathomable Universe.
STOP looking for meaning and you are liberated. The quest for meaning by itself might be exhausting and makes you feel depressed.
Who said I'm looking for meaning? I'm not.
It's not as liberating as you might think. A joyless existence is either suffering or nothingness. A life without meaning, either internal or external, is one where nothing is meaningful with no motivation thus one of crippling catatonia til death.
All I can say is just that it doesn't feel good and if you can't feel good about anything, your calculus of your life inevitably leads to the conclusion that existence isn't worth it.
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> A depressed person would tell that most people around him are wrong and are optimistic only because they don't understand how bad all is.
Or because of a legitimate chemical imbalance or some other cognitive issue they can’t control alone. Right?
> "There is no convincing evidence that depression is caused by serotonin abnormalities"
- https://www.psychologytoday.com/us/blog/insight-therapy/2022...
and
> "the etiology of depression is incredibly complex, the narrative that it is caused by a simple “chemical imbalance” persists in lay settings. We sought to understand where people are exposed to this explanation"
- https://pmc.ncbi.nlm.nih.gov/articles/PMC11752450/
and
> "Onset of depression more complex than a brain chemical imbalance. It's often said that depression results from a chemical imbalance, but that figure of speech doesn't capture how complex the disease is. Research suggests that depression doesn't spring from simply having too much or too little of certain brain chemicals."
- https://www.health.harvard.edu/mind-and-mood/what-causes-dep...
and
> "Analysis: Depression is probably not caused by a chemical imbalance in the brain – new study"
- https://www.ucl.ac.uk/news/2022/jul/analysis-depression-prob...
(These are not thoroughly checked articles, they're the first few search results; however claims that depression is caused by a chemical imbalance ought to be able to show where that idea originated, how the imbalance is measured in patients, where that hypothesis is supported by evidence, why antidepressents don't fix depression in half of patients, and several more suspicious things).
I didn’t say it was simply that. You’re twisting my words and these studies to discount all of behavioral health.
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This is the "people with anxiety should just stop being worried" attitude that failed to help for centuries. Whether or not you believe SSRI's are clinically effective, denying the existence of mental health disorders is not helping.
No, anxiety and depression aren't simply a matter of perspective.
My point is that it's hard if not possible to objectively tell if the situation you are in is good or bad. And I'm not trying to deny anything.
So your point is explicitly off-topic to the subject matter (read the title above). Gotcha.
Depression and pessimism are not the same thing.