to think that depression is a natural and rational response to life?

[ghostland]

Since Robin Williams death, there has been a lot of discussion about depression, almost as though it is some obscure, uncommon, illness that RW death has broken the taboo regards to speaking about it (this happens every few years it seems until depression once again becomes unspoken of and shameful to polite society).

Am I right in thinking that not only is depression extremely common but that it is a natural and rational response to life (in the sense that life is very complex and full of extremes that provoke much mental anguish). I don't think the prefix "mental" when talking about mental health or mental illness helps either as it makes it sound like something that is unnatural (akin to psychosis/schizophrenia which is very different) whereas I think "mental illness" is actually a valid and rational response to being human and living life (I know the juxtaposition of rational and mental illness seems weird but in this context I think it makes perfect sense). Anyone agree with the premise that depression is a natural and rational response to life and that the majority of the population are depressed to some degree?

People keep mentioning 'feeling sad' in relation to depression. Feeling sad doesn't cut it. Feeling completely detached, ambivalent and catatonic is more like it along with a lucid feeling of what the hell is wrong with me why am I feeling like this? But being powerless to do bugger all about it.

Unfortunately it is impractical to expect someone with insulin dependent diabetes to cure themselves with a lifestyle change.

Lifestyle changes may reduce inherent (? genetic) vulnerability to depression, but does not invalidate the diagnosis.

Clinical depression has been described for centuries (see en.wikipedia.org/wiki/History_of_depression).

Ronald I think there is some recognition of that 'shit life syndrome' and it's separateness from clinical depression.

The problem is that the same things can help in the short term - cbt or medication - can ease the symptoms and make it easier to cope day to day but the things that would make a real difference are social changes which are dealt with outside of medicine.

Sadly sometimes you can only do what you can do.

I haven't read the thread but OP, have you looked into depressive realism at all? That sounds like (possibly) the kind of thing you're talking about. I've had periods of depression that have had no obvious direct cause, but I've also had acute depressive episodes that stem from seeing or finding out about terrible things, which normally last a few days or weeks. In both cases I feel like I'm seeing the 'truth' about the world, that it's actually full of evil and there's nothing I or anyone can do to change that. Most of the time I don't feel that way, but I'm still aware when I'm well that in some ways I'm deluding myself - there is a huge amount of evil in the world, some happening right now, and the fact that I'm not thinking about it doesn't change that.

You might be right in saying that depression is a rational response, but I don't think it's the 'normal' one - I think the natural 'defence mechanism' if you like is to minimise the bad things so that we can get on with life. If we could truly appreciate the evil that exists in the world then we'd all be constantly traumatised and people/society wouldn't be able to function at all. I see depression as a breaking down of the normal self-protective response, rather than the natural state. (I don't know if that makes any sense, but I know what I mean!)

I've always felt like that OP. It's been really interesting to read these responses.

yes, alAswad, me too

Mongoose

I have ongoing, professional concerns about what the aims of mental health provision truly is everyday/from time to time.

Shit life syndrome? I dunno.
Sometimes there is an accuracy to people's feelings of helplessness and hopelessness that we ask them to accept or medicate into submission
I know the idea is that we medicate,categorise, treat - whatever. the symptoms should be alleviated and then they can go about solving their life situation etc

The reality often is, we quickly categorise, offer 6 sessions of cbt and medicate on mostly for the rest of their lives
Diagnosing it is a recurrent depressive disorder when in fact it is inescapable dreadful shit more than anyone should put up with alone..that could be made better with a great deal of social support, therapy and innovative thoughtful work undertaken with people treated as individuals

"If you're not pissed off, you're not paying attention" Is that what you're getting at OP? Because, apart from the biochemical reasons for depression there is so much in the world to depress us.

I cannot believe the evil in this world, and I would venture that the reasons for women's higher levels of depression has something to do with the constant news of rape, sexual abuse, kidnapping etc, and the knowledge of our own physical powerlessness in the face of that. I watch the news and I feel a constant anxiety and sense of threat.

Thank you for posting OP and others ; this is so useful and something I have been thinking about.
Ronald very interesting post - strikes home.

I have had serious bouts of depression around puberty, pregnancy and menopause but also vicious spates of it lasting long periods due to life events.

Help with those would help my depression

YANBU, ghostland, that's exactly what I think.

Sorry, I used the term shit life syndrome as it's colloquially known not to belittle it in any way.

I absolutely agree that we should be dealing with causes in those cases and not just treating the symptoms.

Catorgorising mental health issues is a nightmare and often unhelpful but the current system requires it to access services.

My point really was that I think there is an awareness of it but that services aren't really equipped for dealing with it. So for a GP or therapist the only help they can offer is to treat short term symptoms. Often the help that would make a lasting difference isn't available.

It would be a better place if was.

I agree with alAswad.
I have bipolar disorder and I accept that there's something wrong with my brain, but I still think that catatonic depression is actually a 100% rational and sane response to life - not just really bad life events, but life in general: life is fucking relentless, and I admire myself and others every day for getting out of bed and battling through another 24 hours of shit. And when I hear that someone I know is so depressed that they haven't showered for a week I have nothing but sympathy and understanding for them. Sometimes you can swim against the tide and sometimes you just can't any more, and both of those states make sense.

I think the word 'unhappiness' should often be substituted for Depression, which is a term used far too frequently when people are unhappy or sad. It demeans Clinical Depression, which to my layman's mind is a state without a clearly identifiable cause or solution, and not a rational response to a situation.
It is dangerous when parents of young children describe them as being Depressed when, for example, they have fallen out with their friends; they are not, they are unhappy.This plants the idea of Depression as a response to a difficult situation from a very early age.
(capitals used deliberately to define medical term.)

It would be interesting to know the correlation between childhood unhappiness and adult full-blown clinical depression. The books I've read on mindfulness suggest that the more we trample our neural pathways with negativity we lay down the seeds for reoccurring depression.

I kind of see your point OP but clinical depression is not always a reaction to life events, it can loom out of nowhere and make you want to die which is NOT natural.

The way that depression is diagnosed is actually fairly straight forward- there is a book called the ICD 10 (America uses the DSM v). It lists every psychiatric diagnosis used in the UK. For every diagnosis, there is a list of symptoms and you need a certain number to 'qualify' for a particular diagnosis.
The symptoms listed for depression are in 3 'clusters, a,b and c and I think you have at least one from each category (I don't have access to one at this moment so this
may not be 100% accurate but you get the idea.) .Also, for depression to be diagnosed, symptoms have to have been present every day or most days for at least 2 weeks. The number of symptoms you have determines whether depression is classified as mild, moderate or severe. There is also a questionnaire called the Becks Depression Inventory (BDI) which asks the patient to rate 25 questions from 0-3 and is pretty accurate.
I have episodes of extreme sadness and episodes of severe depression for which I've been hospitalised and you really cannot compare them.
I had very clear biological symptoms - I lost over 2 stone and could only manage to get any sleep by drinking half a bottle of vodka and , even then, woke up at 3 am and stayed awake.
One thing that's hard to get across to people who haven't experienced depression is how even the slightest thing can feel like the most enormous effort. Also, how nothing gives you any pleasure. If I'm sad, there are certain things I can do that usually cheer me up. When I was depressed, I could have won the lottery and it wouldn't have changed the way I felt.
I agree that sadness can be a rational response to life. Depression absolutely isn't.
I don't agree with every psychiatric diagnosis and think there is an increasing trend to pathologising everyday life (there is a diagnosis of Adjustment Disorder which could basically apply to anyone who is upset because their boyfriend's dumped them) but The description of depression in the ICD is pretty accurate.

I strongly believe that many people have undiagnosed anxiety disorders which can be lead to depression. If your brain is in a constant state of hyper alertness to a perceived threat or something going terribly wrong then this can have serious consequences. It makes you withdraw from life and social situations which in turn can lead to depression.

A psychologist, Dr David Smail, wrote a lot about the relationship between life circumstances, anxiety and depression. I had a book of his called 'Taking Care' which I remember finding very inspiring, haven't read it for years. He's rather anti-therapy, or at least sceptical of its claims, and talks a lot, iirr, about the effect of society on mental wellbeing.

I think, though, that we forget how influential families are psychologically. Two lines of poetry are always in my mind, Eliot 'Human kind cannot bear very much reality' and Larkin, 'They fuck you up, your mum and dad'. Between them, they seem to imply that when we're happy - OK, perceive ourselves to be happy -we're in a state of at least partial unreality. Cos the 'truth' is too harsh to bear. But who gets to define truth? I don't want to get too philosophical but I don't actually care that much about how 'true' what I'm feeling is. If 6 sessions of CBT can peel a few layers off my onion and as a result I can survive rows with my OH without feeling the sky's going to fall, I'm fine with that. My perception of my own happiness - and hers! - has increased. I may well be deluded, my depression, when it comes, may well be related primarily to social & economic circumstances, hey maybe I've got Marxist depression!
But I feel I can't afford to care much. Got 3 kids to raise, and my fight is with the determinism of Larkin's poem, I'm determined my boys will be less fucked up by their family than their parents. Will perceive themselves less fucked up.

MandatoryMongoose; "I think there's a pretty generally accepted view of what comprises 'mind'. If I were to break it down, I would explain it as thoughts, feeling, emotions, perceptions - all of the things that your brain is responsible for that relate to the way we view and respond to the world. As oppose to the other more practical side of the brains work keeping the machine going."
-- That is a good summing-up of most people's non-scientific or medical view, but nothing very close to what those who study brains malfunctioning in this way would be interested in researching. Essentially, anyone suffering with depression (or the symptoms caused by a malfunction within the brain that affects mood or personality) only focuses on the way they react - the way the problem makes them feel and behave. This is the 'all' for them. But the solution, if that is the word, lies in the brain as a physical organ. It affects very many other functions (hormones, for example) which really does throw the body's machinery out in many other different ways. Unfortunately they really don't seem to have a handle on the brain as a physical organ in a lot of respects. I recommend especially Paul Broks (Into the Silent Land) and Alison Gopnik (The Philosophical Baby) for some fascinating but properly scientific insight into the questions you are posing. You'll see how the brain problems link to the manifestation of the illness and some of the strange issues about brains (for example, they seem to behave differently if you are talking to (even) a (very unwell) patient who is consulting as part of a couple or on their own).

YABU. Being or feeling depressed because of "life" is not the same as a diagnosis of clinical depression. In just the same way having a broken leg or asthma is not part of life.

I haven't read the whole thread, and probably don't intend to.
If 'depression' is just being sad, then how would you explain PND? You're sad because you just had a baby? That's not a terribly rational response, you must admit.

I have bipolar depression, which is actually not quite the same as 'normal' clinical depression in that it behaves differently.
I've had people try to 'help' me by asking why I'm depressed, what I'm sad about particularly, and there's no answer to that. My life is actually pretty good. Depression can hit when you're having the best day of your life and it doesn't just (or always) make you sad. It can make you anxious, or unbearably tired, or numb, or all of the above. And it can make you genuinely believe that the world would be a better place without you in it.

The idea that depression is just extreme sadness is not only wrong, it's dangerous.