[DigitalOne]

Originally Posted by V.Narayan

Medical 'Depression' versus the word 'depression'

This clinical or medical term “Depression” as opposed to the generic word “depression” is more than simply feeling unhappy or fed up for a few days or feeling low over a missed promotion.

Some people think depression is trivial and not a genuine health condition.

Thanks for a very detailed and informative post.

Just one question, as the clinical/medical Depression (capital D), is a physiological condition what are the risky behaviors that leads to this physiological condition? For e.g we all know smoking or living in polluted environments may lead to lung cancer. Similarly are there any behaviors/risk factors which may increase chance of clinical Depression?

[V.Narayan]

Originally Posted by DigitalOne

Thanks for a very detailed and informative post.

Just one question, as the clinical/medical Depression (capital D), is a physiological condition what are the risky behaviors that leads to this physiological condition? For e.g we all know smoking or living in polluted environments may lead to lung cancer. Similarly are there any behaviors/risk factors which may increase chance of clinical Depression?

You will need to talk to a Doctor. Honestly I am not equipped to answer your question.

[vivek95]

This is one of the best threads on Team-BHP, many thanks to the thread starter.

Originally Posted by DigitalOne

Thanks for a very detailed and informative post.

Just one question, as the clinical/medical Depression (capital D), is a physiological condition what are the risky behaviors that leads to this physiological condition? For e.g we all know smoking or living in polluted environments may lead to lung cancer. Similarly are there any behaviors/risk factors which may increase chance of clinical Depression?

Yes, Nutritional deficiencies may also increase chances of clinical depression. This is the most ignored etiologies. One, I know this is medically established and second, I have myself been into severe clinical depression for more than 3 years and have experienced all sorts of its characters and tendencies. I have a first hand personal account of how improved nutrition helped me cope up with my depression. However, it is by the sheer grace of God, my parents and support from select friends that I am reasonably out of it. Also, me being a Doctor helped me understand myself better without the need to go out and seek advise. More on this later.

[Jeroen]

For those who would like to take a slightly deeper look into Depression, what (possibly) causes it, possible treatments etc:

https://www.health.harvard.edu/mind-...ses-depression

It’s a lengthy article, but it did provide me with some further insights and learnings. I had not realised depression and bi-polar appears to run in family, i.e. is likely to be passed on to one generation to the next.

Jeroen

[alpha1]

If there is only one thing I hope people to take away from this thread it is the depression is not a conscious decision and is not under the sufferer's control especially thanks to excellent posts by forum members e.g. Jeroen, VNarayan.

Please understand that everything in our body is due to extreme sensitive balance of internal hormones, enzymes, chemicals. Any disturbance in these and you cannot be "normal". Our personality owes a lot to these factors. If someone boasts about being positive in life, being in control of situations etc - it is only because our mind allows us to think this way.

For someone who suffers a chemical imbalance due to genetics or external factor, it is extremely unfair to expect him to "pull up his socks" and act cheery. Friends and family can only prevent the act of committing suicide, but the "treatment" requires medical help just like any other disorder.

[androdev]

I have to ignore the ridicule I received on this thread and make few further comments about environmental factors. Even if it helps one person not to consider the majority opinion as the scientific Gospel, my effort would not have gone in vain.

• The onset of illness gets delayed (sometimes by decades) in a healthy and loving environment - it's one thing to start medicines before marriage and kids and it's totally another thing if you are in 50s with kids and spouse. Two vastly different worlds enabled by families.
  
• The intensity and self-destructive nature get diminished. You may kill yourself or you may take up working with slum children. Your early life and the love you have experienced shape your choices.
  
• Medicines have serious side affects. The affected person is often not capable of making a decision. It is left to the family to work with a doctor who is conservative with the use of medicine and not with someone who takes pride in quick results.

The role of family, healthy lifestyle, nutrition, optimism, spirituality, work-life balance and various other non-medical things that are fully in our control can delay or prevent illnesses among our family members that are both psychological and physiological. I pulled out an old article by a practicing psychiatrist from my mail archive that helped me develop a more holistic outlook on mental illness and guided me through the last few decades.

Medications can effectively improve depression, relieve severe anxiety, stabilize serious mood swings and lessen psychotic symptoms. These successes are real in that they improve the quality of life of patients who are genuinely suffering. But in reality, i.e., the reality of treating patients, medications have profound limitations. I know that if the only tool I had in treatment was a prescription pad, I would be a poor psychiatrist. The center of treatment will always need to be listening to and speaking with the patients coming to me. This means listening seriously to what they say about their lives and history as a whole, not merely listening for which symptoms might respond to medications. Although it seems astounding that I would have to state this, biologic psychiatrists as a whole really only listen to that portion of the patient's discourse that corresponds to their biologic paradigms of mental illness. It is the nature of dogma that its practitioners hear only what they want to hear.

So what are the limitations of biologic psychiatry? First of all, medications lessen symptoms, they do not treat mental illness per se. This distinction is crucial. Symptoms by definition are the surface presentation of a deeper process.

For example the "illness" major depression is defined by its set of specific symptoms. The underlying "cause" is presumed to be a biologic/genetic disturbance, even though this has never been proven in the case of depression. The errors in logic here are clear. A set of symptoms is given a name such as "major depression," which defines it as an "illness," which is then "treated" with a medication, despite the fact that the underlying cause of the symptoms remains completely unknown and essentially untreated. I have seen repeatedly that, for example, in the case of depression, once medications lessen the symptoms, I am still sitting across from a suffering patient who wants to talk about his unhappiness. This process of equating symptoms with illnesses has been repeated with every diagnostic category, culminating in perhaps one of the greatest sophistries psychiatry has pulled off in its illustrious history of sophistries, namely the creation of the Diagnostic and Statistical Manual (currently in its fourth incarnation under the name DSM-IV), the bible of modern psychiatry.

In it are listed all known "mental disorders," defined individually by their respective symptom lists. Thus mental illnesses are equated with symptoms. The surface is all there is. The perverse beauty of this scheme is that if you take away a patient's symptoms, the disorder is gone. For those who do serious work with patients, this manual is useless, because for me it is simply irrelevant what name you give to a particular set of symptoms. It is an absolute myth created by modern psychiatry that these "disorders" actually exist as discrete entities that have a cause and treatment. This is essentially a pseudo-scientific enterprise that grew out of modern psychiatry's desire to emulate modern medical science, despite the very real possibility that psychic pain, because of its existential nature, may always elude the capture of modern medical discourse and practice.

https://www.psychiatrictimes.com/vie...gic-psychiatry

[Jeroen]

Originally Posted by androdev

. I pulled out an old article by a practicing psychiatrist from my mail archive that helped me develop a more holistic outlook on mental illness and guided me through the last few decades.

Click a little bit deeper through on the good doctor David Kaiser whose 1996 work you are quoting from and you end up with the people I was referring to in my earlier post.

You get linked to this for instance:

https://www.bible.ca/psychiatry/welcome.htm

Quoting from this fine website I found through our good doctor Kaiser:

The wise old church elder said, "Depression is not a medical problem, it is a faith problem."

Since insanity, schizophrenia, bipolar and depression have no biological cause, this essentially banishes Biopsychiatry to the Junk Science Hall of Fame beside Humoral Medicine. Psychotic behaviour is never caused by demon possession, but is a simple behaviour choice. This obsoletes psychiatric drugs and shocks as cures. It extincts all psychiatrists who claim to be experts in something they do not think exists ("psychiatrist" lit. Greek: "doctor of the soul"). What is left standing is the Bible and Christians who had it right all along as the historic experts on human behaviour.

Really?

You google and click some more, you end up in the realms of the home schoolers, flat earthers and fake moon landing lot. I.e. people who cast aside what is considered main stream science. Whereas they could be individually, very nice and pleasant people, as I said before, their world view is completely different from mine. In fact, it is so far removed, that I find some of their beliefs and statements shocking and potential dangerous to others, if not offending for denying that depression is an illness. That with modern techniques and practices can be properly diagnosed and to a degree be cured.

In defence of biological Phychiatry:

https://www.psychologytoday.com/intl...cal-psychiatry

Modern criticism of biopsychiatry is almost always based on the logical fallacy that mental illness is not genuine disease. The idea that contemporary psychiatrists see mental illness as simple "chemical imbalance"—an argument frequently leveled by those opposed to psychiatric medication—is another grossly inaccurate characterization. Most psychiatrists today subscribe to the biopsychosocial model as pioneered by George Engel.

Jeroen

[Thermodynamics]

From time to time, we would have come across some suicide report in our village/colony/school/college/office etc., I often wondered how could they go to such extremity because they were really cool personalities. No one could have doubted, they seemed to be perfectly normal.

Originally Posted by Jeroen

It’s a lengthy article, but it did provide me with some further insights and learnings. I had not realised depression and bi-polar appears to run in family, i.e. is likely to be passed on to one generation to the next.

Thanks for the article, I had no knowledge of science behind depression and always thought it was a psychological problem resolvable by proper counselling. But this article is an eye opener to me, it says "When genetics, biology, and stressful life situations come together, depression can result".

Link to genetics is very scary. Reminds me of a recent movie "Joker".

[Jeroen]

Originally Posted by Thermodynamics

From time to time, we would have come across some suicide report in our village/colony/school/college/office etc., I often wondered how could they go to such extremity because they were really cool personalities. No one could have doubted, they seemed to be perfectly normal.
.

Suicide is such a heart breaking terrible thing. And sometimes you just don’t understand.

My youngest sister committed suicide when she was about 22. I was still in the merchant navy at the time, out on the ocean. I did not hear about it, till we docked in NewYork and the company repatriated me right away. Even so, the funeral had already been held. My sister suffered from various mental disorders, but nobody had seen this coming. It was devastating for my parents, who never ever really got over, or to terms with it. It will be forty years, next year.

Last year a friend and colleague of mine, came with his wife and teenage daughter to stay with us for a few days here in the Netherlands.

We took them to see the tulips / Bulb fields, wind mills etc. We had a really nice time.

I happened to be in Stockholm later that year, where they lived, and on my second day heard their daughter had committed suicide. No indications, no note, absolutely nothing. She appeared to be a perfectly normal, happy, teenager, doing well at school, lots of social activities etc. Both parents were absolutely devastated. They are both deeply religious people and I hope their faith gives them some comfort. Because I sure could not, what do you say/do? Had my friend and his wife crying on my shoulder. Not more you can do at that point.

To date they have no indication as to what happened. Apparently, statistically, these days in western societies, when young people (teenagers) take their own life, more often than not, they are being bullied. Be it at school, the Internet. But as far as we, her friends, the school, the various organisation she was a member of, there was no evidence whatsoever.

What is probably does mean is that somewhere, something was missed, not seen. Which makes it even more sad.

Loosing a child is one of the most upsetting life events for any parent. Bad enough if it is due to an accident. If it is due to suicide that must be a lot worse.

I don’t think depression and suicide go hand in hand at all. But sometimes they can/do I imagine.

Jeroen

[androdev]

@Jeroen

Nobody's word should be taken as Gospel. It is not black and white. Each person has to connect his own dots. I am not his follower and in fact I don't even remember his name. Some points in that article resonated and stayed with me and helped me form an opinion I am comfortable to live with.

My conscience doesn't permit me to take medicine route without fully understanding the consequences - this is a very common cultural aspect of most Indians and you are probably unable to relate to it. India has a thriving health care industry in non-allopathic approaches, I am not endorsing them but it shows the open-mindedness to look at alternatives. This whole "pill for every ill" need not be the only option. It doesn't mean I am from scientology, flat-earth, home-school, anti-vaccine stereotypes you are so keen to tag me with. Blind faith in unverified science is no better than superstition.

Do you at least acknowledge that the medicine treats only symptoms of mental illness and things come back in raging intensity if you stop medicine? Do you acknowledge that patients on these medicines gain weight, have difficulty to conceive, suffer from constipation, guys tend to develop breasts, women miss periods and so on. These are not just low probability side affects that are routinely printed for paracetamol. Drug companies have been successfully sued for huge compensations by the affected patients of psychiatric medication.

Do they give you a brain chemical imbalance or genetic defect report, like a blood test report or CT scan? No. It is always a simple question and answer session to diagnose you. After the medication, do they do any test or scan and show you an improvement? No. It is just a Q&A session again. So why are you guys who have never seen chemical imbalance report keep insisting on chemical imbalance/genetics as the real cause. At least, say probable cause.

Similar misinformation has been spread about diabetes, heart diseases and obesity since 1960. Patients all over the world are being injected with insulin when the actual problem is there is too much insulin in the body already. Totally off topic but the incorrect messaging of medical establishment is getting defeated as we speak. In 10 years from now, the treatment of diabetes, heart diseases, obesity will be completely different from how it is now. This is happening against the immense resistance by medical establishment.

It is obvious we can not convince each other but I am posting my thoughts for others to read and draw their own conclusions. My understanding and interpretation served me extremely well and it actually helped me make the right choices (from my POV) in so many other aspects of life. It is one thing to be a problem-free sedated person and another thing to experience life with all emotions intact. Not easy, but if that's your goal for your family, you can achieve it.

[Jeroen]

Originally Posted by androdev

Do you acknowledge that patients on these medicines gain weight, have difficulty to conceive, suffer from constipation, guys tend to develop breasts, women miss periods and so on. .

All patients? You got to be kidding!

Do they give you a brain chemical imbalance or genetic defect report, like a blood test report or CT scan? No. It is always a simple question and answer session to diagnose you

There are many many physical phenomena we can not measure or explain directly. But we have many examples where we can find ways of dealing with them very effectively.

A very different example: Nobody to date can explain at a fundamental level how the wings of a plane develop lift. There are several theories, none are complete on a fundamental level. However, by observing and experimenting scientist can actually not only design a wing but constantly improve on its design. But to date we still can’t fully explain how it works! But we can observe how it works and deduce conclusion on how to improve.

A lot of medical science is based on observations in combinations with all sort of measurements. These days we can actually measure a lot of what goes on in a brain, right down to neutron emissions. If you can observe and measure that, you can make conclusion as to what chemical reaction need to have taken place in order to witness these observations.

So the whole notion of “not being able to measure chemical imbalance” is simply not true. Science very often comes to conclusion via indirect ways, endless observations, trial and errors.

You can take any scientific journey on any topic you care to choose and you will find reports that describe an observation and subsequently they will try to find what causes these observations, what influences it etc.

It is too limited an approach to think, just because you can not measure it, it does not exist.

Unfortunately, I hate to point this out, this is how the home schooling, flat earthers and fake moon landing conspiracist often think.

Science has always been much more and much more complex than a simple direct measurement. More often than not, science reaches conclusion on its observations and correlations, rather than its direct measurements. That makes it very complex and not easy to understand and a breeding ground for conspiracist theories and the denial brigades have another field day!

Another example: remember Newton and the apple falling from the tree. That observation led to the theory of gravity. Again, to date we do not fully understand gravity. We can not measure gravity. We can observe how objects behave when subjected to gravity, we can calculate to some extend the force of gravity, we can predict it, but we can not measure it directly! Do you believe gravity is real? It can only be measured and observed indirectly. Just like the effects of a chemical imbalance in your brain can be observed and measured indirectly.

As science progresses insights get adjusted, sometimes radically, more often I think it is a stepwise increase in our understanding of the topic at hand. That doesn’t mean what we know and do today is wrong. Progress is just like that, new and additional insights.

I can tell you first hand that diagnosing depression is not a simple Q&A session at all. I have witnessed it first hand. It takes all kinds of tests, scans and a lot of talking to the patient and often family.

I had to sit through endless multiple sessions over the course of several weeks, including various brain activity scans, whilst performing all sort of activities.

There was a whole multi disciplined team of specialist involved. Interestingly enough, pause for thought, it was a neurologist as lead doctor, not a psychiatrist!

They never ever prescribed any drugs to me. My treatment was part counseling, part cognitive approach.

Jeroen

[jkrishnakj]

I am thinking aloud here - reflecting actually.

I grew up spending time in several small / big cities, moving places and schools right through my child hood, thanks to Dad being a banker. We have had some joyous times living in Madras, Coimbatore, Coonoor, Tanjavur, Tiruchy. I do have very fond memories of each of these houses we had rented out, the memory of the lime yellow Vijay Super Scooter that dad used to drive, the vivid memories of the school at Theni where i did my high schooling etc..Suffice it to say that, Life was good. Easy. Pleasant. Simple. Happy. Contented.

Fast forward a few years. Engineer, a job in a different city, the corporate rat race ( its a different story that regardless of winning or losing this race, its a Rat that wins ), clients, projects, cars, homes, air, hotels, dining etc...etc...Over the years, we escape from what was a joy to what we think is a deterrent - Example -. a ride in the scooter, a Train journey from Madras to Bombay in II class with loads of packed food etc. These were joys once upon a time. These are deterrents, these are somehow no good these days..or maybe i lost the art of appreciating these pleasures.

So, is it also to do with the life style ? If i had continued living in Coonoor, in that small house, with Plums and Peach trees around, with a salary enough to take me through the month / next month, would that have given a lot more peaceful time ? I don't know?

So, putting it out there to learn - What extent does Nature, Food, Lifestyle, Social circles and other circles of influence play a role in this D topic ? When is it really enough? Is that also a state of mind ? I do have my own story to share, where i believe i plummeted to some levels that i had perhaps never imagined, and till date, i ponder what happened then? That's a story to share for sometime sooner on this thread at an appropriate time

[androdev]

Originally Posted by Jeroen

All patients?

Great debate technique to answer a question with another question

flat earthers...

There we go again. You are obsessed with flat earthers.

I can tell you first hand that diagnosing depression is not a simple Q&A session at all. I have witnessed it first hand. It takes all kinds of tests, scans and a lot of talking to the patient and often family.

I had to sit through endless multiple sessions over the course of several weeks, including various brain activity scans, whilst performing all sort of activities.

There was a whole multi disciplined team of specialist involved. Interestingly enough, pause for thought, it was a neurologist as lead doctor, not a psychiatrist!

They never ever prescribed any drugs to me. My treatment was part counseling, part cognitive approach.

This is unheard of in India. You get max 15 minutes of name-sake Q&A if you are a rich person and you can visit different doctors in the hope of seeing something different.

If you can observe and measure that, you can make conclusion as to what chemical reaction need to have taken place in order to witness these observations.

This is such a nascent field of study and human brain is so little understood that risk vs benefit angle has to be looked at seriously by the potential recipient of the treatment. This is the crux of my argument. You can get a high with real emotions or with drugs - maybe very similar chemical reactions take place. Why not try real emotions as a first line of treatment - it comes without any side effects.

I have shared my views on this topic and I have nothing further to add. Thank you for the motivation to put across my points. I would not have elaborated so much but for your posts. Except for your repeated flat-earther reference, I consider it a good debate.

[Joxster]

Saw this in my LinkedIn feed, and thought that this is the perfect place to share it. It's free seminars from a professional psychiatrist. I sincerely hope that this helps someone. Even if it helps 1 person, it was worth it!

Originally Posted by GTO

A Team-BHP Fan would like to share this anonymously

I would firstly like to thank the person who sent this to you, GTO. To the anonymous person who wrote to Team-BHP: you know who you are, and you just helped someone with your post!

I have a close friend who is always focused on his and his family's debts, financial status etc., constantly comparing himself to people who are better off in life, and just seems like he isn't able to enjoy his life. I've tried getting through to him about this, but have no idea how successful or unsuccessful I have been in my attempts so far. However, I shared your post with him, and he just thanked me for it.

Cheers

[roby_dk]

Originally Posted by androdev

This is unheard of in India. You get max 15 minutes of name-sake Q&A if you are a rich person and you can visit different doctors in the hope of seeing something different.

I would like to pitch in especially on this point. I have a first hand experience on this as I took my son to a homeopathic doctor close to my house in Delhi. My son suffered with mild coughing from the day he was born and it somehow get worse as winter progresses every year. Initially it was a routine to take extra care of him or trying to avoid items like toffee, chocolates, ice-creams and other items which we suspect could elevate his problem further.

One fine day my mom told me we should try homeopathy, visit the doctor and try his medicine. If we talk about time he almost took over an hour on the first appointment where he asked so many question that I was like I am recalling the whole story about about my son from the day he was born. He kept noting down things in his notebook and you wont believe with only the bullet points he filled two pages. He asked about each and everything when he sleeps, when he wakes, how many members in family, how is he interacting with them, to whom he is more attached, siblings if any, how he behaves in play school, what does teacher has to say about him, how he behaves with strangers, etc etc. the list was so long that at some point of time I was lost that why he is asking so many questions about him and are these even relevant for the diagnosis. My boy turned 4 now and I went to him when he was 3 after 6 month of medication he is doing good now.

The whole point of above rant was it is not true for all doctors and we do have doctors who listen very patiently. This is one instance and if I relate this to the doctors and experts who deal with depression let me confirm this again from my personal experience they take much longer time than the general physicians. There prime objective is to listen the patient history before prescribing anything.