Is Depression Over-Diagnosed?

[Marat]

If people felt sad simply because sad things happened to them, then psychologists and psychiatrists would lose sadness as a disease of the mind they could claim to treat, rather than as a highly varied problem in the outside world they could not, and with this they would also lose income, social prestige, and power. The usual phenomenological distinction to separate the 'depression disease' from ordinary sadness in response to sad events is that depression is deep and lasting while normal sadness is temporary, but what about sad events which are long-lasting, constantly evolve so that people can never accommodate to them, and cannot be fixed? It would seem that the normal response to such depressive, real-world triggers would be perpetual sadness, and that any reaction other than sadness would be the 'belle indifference' of schizophrenia, or some form of mania. However the person reacts, he falls into one diagnostic category or the other and so never escapes the power of the psychotherapeutic establishment.

 

But the psychotherapeutic establishment claims that depression is 'real' and distinct from ordinary sadness because it corresponds to chemical changes in the brain. But since no modern scientist believes that thoughts, emotions, and mental states occur in an immaterial soul, but believes instead that all thinking goes on in a material brain where it corresponds to physical changes in that brain, then obviously all thought, pathological as well as healthy, corresponds to chemical changes in the brain. When we see an apple, there corresponds to it some electro-chemical state of the brain which we could call 'seeing an apple disease' if we wanted to, and if psychiatrists were particularly short of business, perhaps they could define this in the Diagnostic and Statistical Manual as a form of mental illness which required talking therapy, social management, and medication to remove, rather than just removing the apple, to cure it.

 

The true treatment for lasting sadness is to get rid of the objective stimuli in the outside world causing it, rather than to tinker with the mind of the perceiver until he can't respond to it normally any more, so when he is drugged to the point of feeling better we can say he is 'cured.'

 

A diagnosis of depression only seems appropriate where extreme sadness exists where there is no objective stimulus which could account for it, but what adult human has ever been fortunate enough to live in a world where there is nothing -- from the thought of the inevitability of death to concern over the suffering of other people -- that could prompt feelings of extreme and lasting sadness?

[Mr Skeptic]

Yes, sadness is part of human nature but so is happiness. Many people find a way to be happy even in depressing circumstances. Being always sad can make you non-functional, which means that eventually if you can't fix yourself you need to be fixed. Depression is real, and treatable -- but I do agree that it is probably over-diagnosed. The fact that the treatment often involves giving mind-altering drugs is also worrisome.

[Marat]

I heard a lecture by a Jungian once who argued that depression used to be regarded in earlier cultural periods as a normal aspect of life, to be experienced to the fullest as part of the total human development. 'Melancholy,' as it used to be called, had to be controlled rather than explored once we moved to a capitalist economy, since the new economic form required people to be constantly engaged in working and shopping, neither of which people are eager to do when depressed. At that point 'melancholy' became a 'mental disease' labeled as 'depression' and simply had to be eliminated. The famous early 17th century work, Burton's 'Anatomy of Melancholy,' represents the more positive view of the condition as an important maturing experience which is now nearly forgotten.

[lemur]

I heard a lecture by a Jungian once who argued that depression used to be regarded in earlier cultural periods as a normal aspect of life, to be experienced to the fullest as part of the total human development. 'Melancholy,' as it used to be called, had to be controlled rather than explored once we moved to a capitalist economy, since the new economic form required people to be constantly engaged in working and shopping, neither of which people are eager to do when depressed. At that point 'melancholy' became a 'mental disease' labeled as 'depression' and simply had to be eliminated. The famous early 17th century work, Burton's 'Anatomy of Melancholy,' represents the more positive view of the condition as an important maturing experience which is now nearly forgotten.

 

This approach to melancholy is still evident today in cultures of tragedy-celebration. The interesting part is why higher class-status tends more toward such tragedy-celebration while lower-class status tends more toward life-affirmation. Ever noticed, for example, that blues music has become a middle-class taste while lower-class prefers up-beat hip hop and rap?

It may not be purely about class or ethnic identity, though. Romeo and Juliet and other lover tragedies are popular, imo, because the happiness of love insulates you emotionally against the suffering of tragedy. It's like only picking a scab when it's healed enough that you can endure the pain, then seeing how much you can endure before you get the wound open again.

 

The problem with diagnosing depression or any other cognitive-emotional problem is that the label can cause the person diagnosed to feel even more said or stressed about their "condition." Really, the best way to deal with depression or any other problem is to treat it as normal feelings that have the potential to cause depression or other problems if adequate cognitive-emotional behavioral adjustments are not pursued. Things like physical exercise, paying more attention to positive thoughts and less to negative ones, learning to relax, etc. can all lessen tendencies toward depression. Such things should be treated as regular exercise, the way regular physical exercise is important to preventing physical health problems.

 

Please note: this is not medical advice nor am I suggesting that anything is a substitute for seeking professional treatment/therapy. However, methods of staying healthy should not be ignored, imo, just because medical treatments are available once you get sick.

[divagreen]

If people felt sad simply because sad things happened to them, then psychologists and psychiatrists would lose sadness as a disease of the mind they could claim to treat, rather than as a highly varied problem in the outside world they could not, and with this they would also lose income, social prestige, and power. The usual phenomenological distinction to separate the 'depression disease' from ordinary sadness in response to sad events is that depression is deep and lasting while normal sadness is temporary, but what about sad events which are long-lasting, constantly evolve so that people can never accommodate to them, and cannot be fixed? It would seem that the normal response to such depressive, real-world triggers would be perpetual sadness, and that any reaction other than sadness would be the 'belle indifference' of schizophrenia, or some form of mania. However the person reacts, he falls into one diagnostic category or the other and so never escapes the power of the psychotherapeutic establishment.

 

But the psychotherapeutic establishment claims that depression is 'real' and distinct from ordinary sadness because it corresponds to chemical changes in the brain. But since no modern scientist believes that thoughts, emotions, and mental states occur in an immaterial soul, but believes instead that all thinking goes on in a material brain where it corresponds to physical changes in that brain, then obviously all thought, pathological as well as healthy, corresponds to chemical changes in the brain. When we see an apple, there corresponds to it some electro-chemical state of the brain which we could call 'seeing an apple disease' if we wanted to, and if psychiatrists were particularly short of business, perhaps they could define this in the Diagnostic and Statistical Manual as a form of mental illness which required talking therapy, social management, and medication to remove, rather than just removing the apple, to cure it.

 

The true treatment for lasting sadness is to get rid of the objective stimuli in the outside world causing it, rather than to tinker with the mind of the perceiver until he can't respond to it normally any more, so when he is drugged to the point of feeling better we can say he is 'cured.'

 

A diagnosis of depression only seems appropriate where extreme sadness exists where there is no objective stimulus which could account for it, but what adult human has ever been fortunate enough to live in a world where there is nothing -- from the thought of the inevitability of death to concern over the suffering of other people -- that could prompt feelings of extreme and lasting sadness?

 

Are you begging the question as to whether or not a general malaise is congruent with the sense of powerlessness that is associated with apathy or the overwhelming sense of moroseness that stems from failing to overcome the world's ills?

 

Then I don't think seeing an apple is a disease.

 

But please keep in mind it is their apple.

 

Is it reactive or endogenic?

Edited September 9, 2010 by divagreen

[Violet Mistress]

Put simply, it may be. However, we are individuals, and thus, we cannot understand exactly what the other person is going through. We can only imagine, and try to empathize. We may have gone through it ourselves even, but there are varying degrees of severity. We can certainly help people out of their depression, however, by exposing them to a positive environment and reassuring them of their abilities, because often depression and low self-esteem go hand in hand. And by doing this constantly, and I emphasize constantly, you can help the person regain his/her confidence and happiness back. Sure, good things might be harder to find in some people, but there is always something good in people, even the smallest thing. Always a silver lining, as my sister would say.

 

Honestly, I wouldn't be surprised if every single patient who is diagnosed with depression actually have it. This is due to the fact that we probably have a lesser capacity for suffering than people who have to deal with the things that depress us every day. But due to the luxuries that we now have, we don't usually deal with these things every day. Not anymore, at least. I don't claim to be a depression expert, this is just my opinion.

Edited September 11, 2010 by Violet Mistress

[Mr Skeptic]

Come to think of it, there was some interesting stuff regarding depression, pharmaceutical companies, and Japan. Basically, Japan didn't regard any mild depression that didn't require hospitalization, as a disease. We changed that.

Did Antidepressants Depress Japan?

Drug Companies Push Japan To Change View of Depression