Some interesting questions about depression:
Depression isn’t new, but its prevalence certainly is.
I wonder why? There has to be some cause, some reason why it affects so many when historically that seems not to have been the case.
My guess is that the narrative of depression – that it is something that just is – is not correct.
Historically, depression is a very new ailment. In the XVIIIth century, it suddenly became fashionable among the European aristocrats to experience bouts of melancholy. In the XIXth century, the representatives of the middle classes who pursued social mobility started to imitate this affliction of the rich and the spoiled.
For most of the human history, all the absolute majority of people did was trying to survive. Not starving or freezing to death and not being murdered were the goals that occupied every waking moment of pretty much everybody with very few exceptions.
In the developed societies today, basic survival is not an issue for anybody. With our basic needs taken care of, we can pursue goals of a higher order. We can now afford to pay attention to our emotional states, our feelings, our moods. Depression is an ailment of a rich, mostly content society, and that’s why it couldn’t have become prevalent at any other moment in history.
Clarissa's Blog 
Clinical psychologist here. Depression is not new. In history it has gone by different names and the medical model has meant we now name things differently. We used to have manic-depressive disorder until the drug Lithium came on the market and then it morphed into bipolar disorder. We had an epidemic of multiple personality disorder until we decided it was being created by mental health professionals and really amounted to elaborate roles which we all have anyway. But fundamental to humanity is depression and anxiety which we have always had and always will have. We merely view them differently from time to time.
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” But fundamental to humanity is depression and anxiety which we have always had and always will have.”
– This position only helps professional depressives to victimize everybody in sight. They are good consumers, buy lots of pills, I get that. But the damage they inflict is horrifying. Every single one of them can choose not to victimize people today. Every single one is choosing the opposite. And the whole world coddles them because of the great, profitable consumers they are.
But at least I can create a space where the damage they inflict can be discussed openly.
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What are professional depressives, and whom do they victimize?
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Professional means those who are doing it for a long time and as a way of life while deriving all sorts of profits and benefits from this occupation. The victims are those poor sods who have to live with them. While adults have the choice of walking away, children don’t, which makes this a particularly delicious way to victimize children.
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Aha, I see!
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I’m not sure what a ‘professional depressive’ is. I can only speak from my own experience. The people I know and have known who suffer from depression are not great consumers, in the main they hide their condition as long as is humanly possible. Depression is not seen in the UK as something to boast about, maybe it is in America. Most depressed people get by, somehow. Those who don’t, end up on the street or in the river, some make it to hospital.
Sometimes depressed people do damage other people, if they kill themselves. Always they harm themselves to some degree. I do see that some are manipulative and attention seeking, but isn’t everybody, on a bad day, a bad week? Maybe when they haven’t had their Berocca? The depressed mostly don’t want prozac and can’t afford psychiatrists; psychiatry is not available on the NHS and mental health services are woefully underfunded. Depressed people would always prefer not to be depressed.
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HS spending on anti-depressants has risen by one third in just a year, as the number of prescriptions reached a record high, new figures show.
Experts on Wednesday said the figures which show 53 million prescriptions dispensed last year – a rise of one quarter in three years – were “staggering” and raised fears that the drugs were being doled out too often.
The UK now has the seventh highest prescribing rate for antidepressants in the Western world, with around four million Britons taking them each year – twice as many as a decade ago.
The new statistics from the Health and Social Care Information Centre, show NHS spending on the drugs rose by 33.6 per cent last year, to £282 million.
http://www.telegraph.co.uk/health/healthnews/10957417/Staggering-rise-in-prescribing-of-antidepressants.html
Britain consumes more anti-depressants than almost all our neighbours in Europe, an international study has found.
The UK has the seventh-highest prescribing rate for drugs such as Prozac in the Western world, with 71 daily doses a day for every 1,000 inhabitants in 2011.
This is almost double the 38 doses a day prescribed a decade earlier, according to the study by the Organisation for Economic Co-operation and Development, which represents the world’s industrialised nations.
The increases in antidepressant use has caused concern because rates of depression have not risen to the same extent – indicating that doctors may be prescribing the drugs unnecessarily for people will only mild depression.
Read more: http://www.dailymail.co.uk/news/article-2511186/Pill-popping-Britain-UK-takes-anti-depressants-Europe.html#ixzz3C0RypGqI
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The Organisation for Economic Co-operation and Development warned yesterday that antidepressant consumption “has increased significantly in most [Western] countries since 2000,” with Iceland reporting the highest prescription rates in 2011, followed by Australia, Canada, Denmark and Sweden.
In its 2013 edition of Health at a Glance, the organization’s annual report on world health trends in developed countries, the OECD found that antidepressant consumption within those countries has risen sharply, despite a significant slowdown in health-related spending due to government cutbacks. As the Guardian newspaper noted in an excellent summary, the rate of increase in antidepressant consumption is “not matched by [an] increase in global diagnoses, prompting concern among psychiatrists about over-use of medication.
http://www.psychologytoday.com/blog/side-effects/201311/the-oecd-warns-antidepressant-overprescribing
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Thank you, Lee. “The rate of increase in antidepressant consumption is “not matched by [an] increase in global diagnoses” is precisely what I mean by professional depressives being the perfect consumers. As long as they will keep buying pills, pharmaceutical companies will be happy to sell them and create more opportunities to palm off more pills on them, and so on. And good, whatever, it’s their bodies, they should be able to ingest whatever they wish.
Depression as a way of life is very much supported by the modern developed societies because the sufferers are so useful to make profits. And try saying anything about them, they descend on you like a flock of angry birds who have sensed you are about to take away the carrion they’ve been picking at.
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When Prozac came out there was a big marketing campaign for depression and it. There were articles planted in magazines and so on, you have always been depressed and not known it, but now if you admit it we can fix it, and you will have to be on medication for the rest of your life but you should accept it.
This had a lot of influence and it fits the description of what you are talking about.
But I wouldn’t say treatment, even misguided treatment, is what makes destructive people destructive — having some untreated mentally ill people in the family, I can testify to their destructiveness.
I would actually be all for antidepressant medication if I thought it worked. But there are all these problems with it I am for psychoanalysis but notice how insurance programs fund drug treatment and limit any form of “talk therapy” more and more.
Drugs plus self-help discourse is what depression seems to get most commonly and yes, this does drag things out and drag people in, it is very unfortunate. At the same time I am not sure the sufferers are victimizing in a willful way — although I do know what you mean.
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Of course, medication doesn’t cause depression. It just gives people a bunch of other symptoms that then require more medication, etcetera.
The saddest part is that people have interiorized the sales pitch – depression is part of human condition, it always existed, there is no cause, all you can do is try to manage symptoms, it’s genetic, it’s a brain disorder, this is just how you are, you were born this way, this is part of your brain wiring – that it becomes part of their identity. And any questioning of the sales pitch is perceived as an attack on themselves. The identity of an incurably sick person becomes so important that they can’t even imagine living without it.
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The problem is that people go have made misery the foundation of their identity are going to resent anybody who can’t conform to this kind of existence. There is nobody they will hate more than a person in search for a happy, healthy existence. This is a worldview predicated on accepting one’s lot: this is how things are, this is how they have always been, just accept it. Any non-conformity is threatening.
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And look how convenient the depression discourse is as a form if social control. If this is they way people just are, there can be no legitimate grievances of actual real things that are making them unhappy. You don’t have any problems, you are just wired incorrectly. Here, take a pill and stop complaining.
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The idea that there is no (non-genetic-style) cause and no cure is truly pernicious, yes.
But I think it is some misguided or misguiding of the attempt to assert (correctly) that depression is not just laziness, incompetence or moral failing.
Side note: No cause/cure, only management: did they get this from the 12 steps, I suddenly wonder? I do not like Al-Anon but one concept from it that is very helpful for families of alcoholics is the insistence that you, the family member, are not the cause of the situation, nor can you cure it. This is important because it is all too easy to ask oneself, what did I do to upset this person/what can I do to help? and get swept into the vortex. Also: in 12 step theory, the alcoholic who quits is still a problem drinker, he is just managing his symptoms. So you can never escape anything, get over anything; you have to just keep managing it, keep disaster at bay, and so on. (I find this nerve wracking and anxiety producing.) I suddenly really wonder how much this version of therapy is imbricated with 12 step theory … I say this as a person who got victimized by that kind of therapy and whose story on it shocks people, but from what I can gather the therapy I had was not actually very unusual.
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Yes, your story of that therapy is harrowing. It sounds like they specialize in a form of torture aimed at breaking people and making them completely malleable. This is the kind of thing that can produce PTSD later on.
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As for being called lazy or immoral, if think it would be much more unwelcome to hear that one has an incurable brain disease than that one is lazy or immoral. The latter is just an opinion while the former is an actual diagnosis.
To people who find things like “you are lazy” hurtful rather than pleasing, I’d recommend to look carefully at the source of the hurt. This could lead to actual insights.
In general, this is a very useful exercise. Finish the sentence “You are. . . ” with whatever people need to say after “are” to really hurt your feelings. This can generate valuable insights.
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Yes, well, accusation of incurable brain disease is very scary. In general what terrifies me is the idea of permanent injury — “there is something seriously wrong with you that can never be fixed.” Terrifying.
In my case, I would say that sentences like “you are just lazy” from people one thought recognized one are hurtful because they are dismissive — they mean, I am not willing to listen to your point of view, I do not care, I am choosing to judge and not empathize.
What really slams me, though, is “You are hurting me by taking care of yourself rather than destroying yourself.” It gives me major guilt pangs and disables me for the day, I tend to go curl up in a corner and wait for it to pass.
What I should respond, though, is more along the lines of “Good. I am glad I am not destroying myself. I wish you did not need me to, to feel all right, but I am still not going to do it.”
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Nothing eats up energy like guilt. People who want you to feel guilty are being abusive. And then self-punishment begins. You described on your blog the process of waking up and yelling at yourself. I know what that’s like! This yelling can take many forms, like depriving yourself if enjoyment and health.
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Hmm, I think I lost a comment somehow, too bad because I liked it. Anyway, about lazy: I remember being called lazy once when I had pneumonia. People did not believe I did. I remember just thinking they did not know what they were talking about.
Other times, being called something or other means “I do not care about your pain” and can be hurtful depending on who the person is, what you thought your relationship was with them, whether you felt you needed more understanding from them, etc.
My other comment said that the thing that really gets to me is people telling me that I have disturbed their existence by not destroying myself enough. They can really make me feel guilty by saying that and my response really ought to be: well, sorry, but I am not going to destroy myself.
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For me, one of the most destructive things is when people doubt what I’m saying. Not my opinions, of course, but actual facts. Of course, this is all my own trauma, not actual doubts of other people, doubts that I often read into their actions or invent.
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Yes. This is destructive, too, although in my case I am always surprised when they doubt — I do not expect it.
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Oh, I snap at people, don’t come through on things, and have contributed positively to the world much less than I might have done not being depressed.
This having been said, there are many non depressed people who are far more destructive than I.
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I can’t spout statistics, but as I said, most people don’t want the pills. Many don’t ask for treatment, but they aren’t offered any alternative to pills if they do seek treatment. Blame the pharmaceutical companies, not the patients.
As for depression not having any historical basis, how would we actually know? Most of the people in the world couldn’t even read 200 years ago, let alone write a diary of their ailments. They certainly couldn’t access modern medicine. Plague gets into historical records, depression wouldn’t.
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I agree.
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Oh, I think it comes from battering and things like that.
Torture is old, for instance. Its purpose is to oppress, to destroy people (extraction of information is just an excuse).
I am depressed from having been told so many times I was wicked and evil and deficient and did not deserve to live. I am betting that very many serfs and servants and other oppressed beings have gotten depressed, even very long ago.
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I completely agree that “depression” (as a medical diagnosis rather than a kind of temporary state that almost everyone has occasionally) would be meaningless to most of our ancestors (and many humans in the world today whose efforts are aimed at simply keeping their heads above water).
I also think there’s an element of … modeling going on. I’m reminded of how some traditional mental illnesses have disappeared in parts of the world (like Asia) in favor of well-described western ones. Or an article I read years ago in Polish about a young woman who found about bulemia and thought (paraphrasing) “I must be the least imaginative person in the world, why didn’t I think of this myself?!” voila she’s found a model for having an eating disorder and followed through with it.
I think that most people with depression are completely sincere (at the conscious level) about being wracked with a debilitating illness. But I think that at another level many (not all by any means) people who think they have depression are doing so because they can get something by being depressed that they think they can’t get if they’re not.
Whatever that is, will depend on the person’s circumstances of course.
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” If this is they way people just are, there can be no legitimate grievances of actual real things that are making them unhappy. You don’t have any problems, you are just wired incorrectly.”
People are amazingly hostile to the idea that depression could be related to actual bad things going on in their lives.
I struggled with depression for at least a decade. I went to doctors, I took pills, I read books. I only escaped depression after a period of crisis in which several major aspects of my life fell apart and I was forced to find some new arrangements and take a hard and honest look at my life. I was in a bad relationship, I was pursuing a career path for which I was not well suited, I had a bully for a boss and less that supportive co-workers, I didn’t have many friends in the city where I was living, and I had many unresolved issues with my parents – I was always afraid to disappoint them and did all sorts of things trying to make them happy. I also didn’t take good care of myself in terms of diet, exercise, or doing things that made me happy (this is partly connected to the bad relationship – lots of things that made me happy were ridiculed as wastes of time and money.)
I’m now in a healthy relationship with someone who supports me instead of tearing me down. I’ve shifted my job and my career goals. I have a less prestigious job now, but it’s a job that feels right for me. I’ve stopped trying to please my parents at all costs; our relationship is now somewhat strained because I no longer share their ambitions for me, but that’s their fault, not mine. I have pets and a weird assortment of friends and I rarely feel alone.
The depression went away when I got out of the bad romantic and job situations and started standing up for and taking care of myself. I stopped taking the anti-depressants cold turkey (which you aren’t supposed to do) almost seven years ago, and I’ve never looked back. It’s very clear to me that my depression was the result of being in a bad relationship, a bad (for me) career path, and never really learning to stand up for myself. Those are the things I needed help with, but the doctors I saw in that decade of depression only asked superficial questions about my life and gave me pills.
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TomW: this is exactly, exactly what I’m talking about! It’s really great that you found your way out of depression and turned your life around in such a major way. You totally rock!!!
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Thanks Clarissa! There was quite a bit of luck involved in my path out of depression. But this is a story that no one wants to hear. I’m willing to believe that some depressed people really do have unbalanced brain chemicals, but that’s probably a small group compared to those who are simply in bad romantic, family, work and living situations that they can’t find their way out of. But that’s an opinion that gets you nothing but hostility. I’ve learned to keep it to myself.
Now when I encounter depressed people, I just ask them questions about what makes them happy and what makes them unhappy. I think I might have helped at least one person by doing this. She told me months later that my questions about what made her happy had helped her make the decision to switch careers. She seems to be doing really well in her new job and has seemed really happy the last few times I saw her. Fingers crossed.
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I’m sure your story will help many people. We just need to work to change the public consciousness that has been colonized by the agenda of pharmaceutical companies.
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I wish society would return to a better level of toughness, self-reliance and rationality.
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And when in the past did more rational society exist? I’m wary of nostalgic yearning for a golden age. The best time to live is now. Because it’s true and because we don’t have a choice.
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If we don’t have a choice, there is no point mentioning we don’t have a choice, since the material fact is — we do not have a choice.
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