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Do you think depression could simply be a dimension of human behavior vs. "mental illness"?
Comments
It's a very interesting question... in some countries like Ghana the word does not exist in their language, and the sickness also does not exist - there are no known cases of it lasting longer than a week or two. So it could well be a cultural phenomenon.
But the fact that antidepressants don't work better than placebo pills is quite well known around here, and I have several friends who were prescribed them and who said "it's making me feel worse, I'm not taking them anymore".
Astounding that millions of people are consuming SSRI's with incomplete science behind the prescriptions - in fact a large percentage of users never even see a physician and have the meds prescribed over the phone. More so, some science points to these meds having the exact opposite effect (as @Kerome mentioned) making users feel more anxious and depressed, not to mention the tortuous withdrawals when they decide to stop. The cultural differences in approach to depression are varied, such as in Korea where depression is considered a sign of weakness so it is reported to physicians infrequently. Imagine one's primary care provider saying, "You are perfectly normal, your depression and anxiety can be expected throughout your lifespan. Find ways to manage it like exercise, diet and meditation."
Its an interesting point of view. I was diagnosed with adjustment disorder with severe symptoms of depression as a reaction to my Schizophrenia diagnosis so being diagnosed with one mental illness gave me another one! I haven't taken anti-depressants in years and I can't remember the last time I felt depressed. My alst appointment with my Psychiatrist ended with the staement that I was showing no signs of pyschosis or depression. I still take the Schizophrenia meds though.
I think we (as individuals and as collective society) cause most of our depression and anxiety. I think there are depths of it that need more, or different, than the typical prescription of exercise, diet and meditation. But I think all treatment plans should include those things, and include having to track details of our lives and find patterns and triggers. But that requires significant effort, and often a lot of time, and trial and error. I think we ignore ourselves so long that things get so out of balance we don't know where to start rather than looking at the little niggles and twitches early on. We want the quick fix, and when it comes to restoring balance in our lives there is no such thing. It is the same problem we have in the west with almost everything. A lack of root cause and treatment only of symptoms. Whether disease or social problems, it's the same issue. Many people with mental illness have brain imbalances. But what CAUSED them? What caused the shift in hormones? Most of the time it doesn't just happen. And it can start in childhood with people being denied value and worth for who they are. Growing up stifled and shut down will cause problems with brain chemistry over time, but rarely are doctors or patients consistent with finding a reason for the now out of control depression and anxiety. We just want to stop feeling that way.
I do think that depression is a dimension of human behaviour; and it all really depends on how you define the term 'mental illness,' which in turn depends upon the baseline you take as being 'healthy.' That said, just because something is essentially 'normal' doesn't mean it's always a good thing, I myself have struggled a great deal with depression over the years and the negative ways it can make me act. I think that if one finds lifestyles or even medicines that help one deal with it and live with less suffering, then that's good. But I also don't think that everyone has to take medication for their depression because other things can help, and as I experienced many years ago, medicines can exacerbate the problem. I've found that external conditions have a big influence on my mental well-being, so I try to work on those a lot.
This is now a policy partly implemented by my Doctor's clinic.
Invisibilia had a great episode on what it would be like if we treated all mental illness as normal instead of a disease.
One town in Belgium, Geel has been taking in mentally ill people since the 14th century and treating them like regular people.
If the idea of thinking about mental illness differently than the disease model I'd highly recommend listening.
http://www.npr.org/programs/invisibilia/483855073/the-problem-with-the-solution
I don't disagree with the basic point, that we individually and collectively cause most forms of mental illness. The 'chemical imbalance' theory of mental illness has been under fire for some time though, the basic fact is that we know very little about what happens in the brain and mind when a mental health condition manifests.
Did you know that the medical establishment has been totally unable to identify physical causes and symptoms for mental illness? They haven't been able to develop physical tests for it, and much of the medication is just taking a lucky dip in the pot of medications.
I suspect that everyone has mental illness - but like most things, there is a range of acceptable levels of mental illness we refer to as 'normal'. Those who fall one standard deviation outside the normal range hide it if they can, those two standard deviations outside the normal range get meds and those three standard deviations or more outside the normal range are locked up.
Life is suffering...for everyone. About twenty-five hundred years ago, some wise guy suggested a path to freedom. Personally, as someone about three standard deviations outside the normal range that has been able to successfully hide it like the single standard deviation folks, I'm going to suggest that it's working.
I suffered from serious clinical depression years ago, following burn-out as a social worker, and it was very debilitating, I was off work completely for over a year. I was on anti-depressants during that period and they definitely helped, though there were some side effects. I also had some counselling, that was helpful too.
I suspect part of the problem is that talking therapies are relatively expensive to provide, there are long waiting lists here in the UK for example, so drugs are perhaps seen as a quick fix. Mental health has historically been the poor relation in the National Health Service, and there is still a lot of stigma attached to mental illness.
Nine years ago one therapist diagnosed me as having Dysthymic Depression (don't care about much) during which I was taking Prozac or Zoloft (can't remember which and I quit whichever one it was cold turkey after a year - that was a real picnic) and most currently a Psychologist diagnosed "Major Depressive Disorder" for which he prescribed Celexa. I declined after reading the contraindications. So, I continue interacting in the world, alternately hiding and sharing my depression while working for a couple more years before retiring and experimenting with cbd rich cannabis edibles to combat depression on an "as needed" basis. Dosage and anxiety inducement is problematic. Hiding this so called disorder has simply become integrating it in to the fabric of existence. A recent CBT class shed some light on acceptance and the means of finding, creating and holding different perspectives but the main emphasis was on mindfulness (vipassana, zazen, etc.) with which I can't agree more. I know meds do help some, but I am holding a stronger and stronger conviction that a sustained mindfulness practice is essential to physical and psychological survival.
@Kerome I think part of the reason they can't find the "cause" is because they are looking for physical changes, things to be easily measured by current scientific and medical methods. When metal illness perhaps caused by the unmeasurable-years of having emotions shut down by parents, years of being told that you are doing everything wrong, years of never being appreciated for who you are, years of never being good enough, years of being afraid without anyone ever helping you find out why. Things that become patterns and are exacerbated once we hit points in life that our hormones are raging and setting things off, and again when we are expected to take care of ourselves in our early adult lives. Some of the most common ages where new cases of mental illness show up is around these times in life. Times where it is made more obvious that we cannot deal with what we are going through-puberty and independence in taking care of ourselves. And so the things that have been beating us all this time but we've succeeded in hiding, tend to come out in times of stress. Middle age is another common time of emergence of depression and anxiety, and yet another time of high stress-kids are moving out, life is changing, our bodies are getting old and starting to show it, friends might start dying, we start looking back and regretting things, etc.
None of those things can be measured by doctors sa far as how they have effected the brain. It's like weight gain-few people who have gained 200 pounds over a period of 30 years can pinpoint something that tells them why. But rather a vast accumulation of stuff that has happened and has caused shifts in areas of the body. I think mental illness in the way we are discussing is probably a lot the same. Accumulation of years of things that we don't even recognize we need to deal with and they eventual make their existence known.
And why they have had such success with these age groups in using meditation.
There are MANY languages in Ghana. Not just one that's 'their's' .
https://en.wikipedia.org/wiki/Languages_of_Ghana
Just speaking from Asante Twi ...the word that would be used would be - da dwen. Literal translation is "sleeping and thinking".... the English word worrying would be applicable.
To say there are no known cases and the length???... how in the world would you back that claim up for an entire country?
Depression..... It's just treated there as "Eh...you need to get over it...move on".
Religious and superstitious causes also play a role in different ways. Praying, not accepting god's plan, stopping certain behaviors, etc. Suicide rates are high in rural areas...anyway, The more severe cases of mental illness or those seeking help go to the mental hospital at Asylum Down and another one at Pantang.- both in Accra.
There are many articles on GhanaWeb discussing depression.
For example:
http://www.ghanaweb.com/GhanaHomePage/entertainment/Dating-someone-with-depression-Is-it-ever-worth-it-472050
This is an interesting topic for me.
Firstly, how can doctors prescribe anti depressants over the phone? That is wrong on so many levels!
So I have been taking anti depressants for years now and they help me significantly. However, just taking medication is also not the right way. I also have weekly therapy to work through the basis of my PTSD which is the basis for my depression. This is a disorder. Scans of the brain can show differences in a depressed person and a 'healthy' person. Especially when related to trauma, there can be significant differences in brain structure and functioning. Without antidepressants the chemical balance of the brain can cause depression. In some cases.
Before I started taking my medication I couldn't get out of bed. My coping mechanisms were not healthy and I was very very under weight as I didn't eat. Since starting medication I can manage. But I would be no where without my other strategies as well, walking, yoga, meditation, playing with puppies ect.
On the other hand, I lived in Paris and doctors there were very keen to give out medications for depression without any word on other ways to treat the disorder. I think a mix of behavioural interventions; exercise, limiting alcohol, meditation, increased life skills and therapy for under lying issues is the best way to treat depression. Also seeing a doctor can help to increase your support network to provide the right care.
@newlotus, one thing in your post rings louder than any other for me; "Limiting Alcohol"! This is, and has been a topic in other discussions, but this particular libation has a double sided history. Fine wines, ales, beers, whiskeys and cordials have a revered place on our palates, but science is constantly pointing out the poisonous psychological and physical effects humans suffer from its use. Little wonder Shakyamuni saw fit to include its abstinence in the five precepts. Many will insist that mindful imbibing is pleasurable and harmless but that is a wonderful and tasty delusion. It perpetuates the harmlessness of a substance that has very serious implications for those suffering depression. It may even cause depression in some. I'm not advocating abstinence for everyone (even though it seems Gautama did) but it is worth considering as purely a personal choice. Not an easy one either.
On the other hand, not being a mental health professional or doctor, I would never advise somebody to come off their medication. Neither would I claim meditation to be a "cure" for serious mental health issues.
Great insights guys.
Some might be interested in this long anti psychiatry page
https://en.m.wikipedia.org/wiki/Anti-psychiatry
I had to stop here and laugh but will continue ...
A madness of civilization: the American physician Samuel A. Cartwright identified what he called drapetomania, an ailment that caused slaves to be possessed by a desire for freedom and a want to escape
Modulating between two extremes of mania and depression- human sensitivity and expression is typically both embraced and eschewed simultaneously by the wise throughout history. (e.g. Lao Tzu, Chuang Tzu).
They probably "normalize" by realizing (understanding) that the ego-I, that billiard ball solid-"self" we falsely and typically detect on the inside of our forehead, just between our eyes.....is not at all real. An illusion. (Very Buddhist/Zen). Is the resultant normality causal or effectual?
In doing so sages "stand-under" an entirely new relativistic (temporal) frame of reference. Another paradigm of self which is possibly more Quantum-like not only to their perception, but certainly to the perception of others. Not solid and not entirely wavelike either. Transcendent. (see manomayakaya in Lankavatara sutra)
They become unstoppable in effect. Extremes of emotion cease and equanimity prevails. This almost certainly evokes some kind of mutually inclusive "coarse" psycho-bio-electrochemical artifact in the brain-machine (my term), or "mind-system" as described in the Lankavatara sutra. (again cause or effect?)
My late Hindu teacher, H. H. Shankaracharya of Kahmir, Gaddi Swami Swanandashram admonished me to "Integrate the mind and be blissful." "If it comes let it come. If it goes let it go." Easier said than done.
Bowing Deeply with Loving Kindness,
Suiseki
When I work out what that is in plain-speak English, I'll be happy to respond.
Obviously we all get a bit down from time to time. Some people more than others. And we've all met people who are too down, for too long. Mental illness clearly exists. So how do we decide where to draw the line? And do we even need to draw a line? If I can meditate, or consume some chemical concoction, or go for a run, and feel better as a result, then why do I need a label?
I don't think that drugs are intrinsically bad. Certainly overused in some cases, but clearly beneficial in others. I know several people who take Zoloft, for example. And believe me, if you'd known them before the Zoloft, you'd certainly concur that it's a beneficial chemical.
Still, I'd advise anyone who was thinking of going the medical route with antidepressants or other psychiatric medication to first exhaust the holistic alternatives. Diet is a root cause of many mental symptoms and disorders - it is worth first checking whether you are experiencing a shortage of some mineral or vitamin, or a thyroid problem, and trying to rectify that before you mask the symptoms with more chemicals.
Then, it is scientifically proven that roughly half of all depressives respond to a combination of daily running and meditation. There are other holistic methods that you might examine as well, some people find acupuncture beneficial for instance. At least trying a period of abstinence from alcohol is also a good idea. Or try talking therapy.
Psychiatric medication is very over prescribed. I've come across cases where a lady with depression from grief was put on Quetiapine, an antipsychotic for 'mood stabilisation', Prozac, an antidepressant, and sleeping pills for something that in the old days people would just have gotten over, and that with no plan for ever decreasing or coming off the meds.
In the end the medications are not a cure, they are merely a patch on the symptoms. The underlying cause of your problem is still there, sitting untreated.
For many of us.
As someone with delusions of being normal, I find the world is crazy enough for me. Dharma is the uncrazing. Please dedicate some puja my way, some of it might rub off.
Easier done. Then said. Tee Hee.
Good question by the OP.
I doubt anybody said that being a human was eas, meanwhile,
Israeli doctors watch epileptic’s brain while he ‘sees God’
During treatment at Hadassah Hospital, patient has a spontaneous
religious experience, claims to converse with the Lord
... Discovery Magazine added that the experience of seeing God
is “reminiscent of that of many religious figures, from Moses to
Jesus to Mohammed.”
It said, however, that “this doesn’t mean that any of those leaders
had epilepsy, but it is interesting that this phenomenology can
occur in this disease.” ...
http://www.timesofisrael.com/israeli-scientists-seeing-god-may-be-caused-by-epilepsy/