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Depression: Biological versus Social Causes

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    Depression: Biological versus Social Causes

    I would like to introduce this topic with four observations:

    1) Two people who appear to have the same environmental experiences can develop differently in their mental health: one depressed, one reasonably happy.

    2) There is evidence that depression is affected by very early events, such as the amount of stress hormone (specifically cortisol) in the mother's womb

    3) I'm not sure that you can 'talk' your way out of depression (psychotherapy). A better chance of recovery is via group activity, but I'm not sure what kind.

    4) In my own case, the times I rise above depression are when I am teaching, and the times when I'm most vulnerable are when we have long breaks from teaching during the summer.

    Thoughts welcome. I'm happy for the thread to deviate beyond these 4 points but am particularly interested in them.

    #2
    Depression: Biological versus Social Causes

    3) I'm not sure that you can 'talk' your way out of depression (psychotherapy). A better chance of recovery is via group activity, but I'm not sure what kind.

    I believed this for a long time. What's more my doctor agreed — or appeared to. He was pretty eminent in the field — as you can see — and considered himself first and foremost a doctor, so in the business of making people better. He therefore had little time for therapy, believing appropriate intervention was more effective. (occasionally I wondered if he wouldn't have been an advocate of electro-shock therapy back in the day.)

    He was seriously down on SSRI's too, which were just coming onto the market considering them "nothing more than pep pills." In my case he prescribed an old-fashioned tricyclic, imipramine and it seemed to work well, ie: I got better.

    We eventually lost touch when I moved back to Vancouver, though we corresponded a few times — he was of the generation that thought nothing of writing a dozen or so letters a day.

    Looking back I recall my appointments with intense pleasure. Our discussions were wide-ranging, we talked extensively about football for example — he'd been a Hearts fan in his youth and had wonderful stories — also films, books and painting. Sometimes we even talked about depression. So now I do wonder if it was the imipramine, or the long talks with a wonderful listener and raconteur that made me feel better? I also wonder whether he knew that himself? I'm guessing he did. I reckon he pegged me from the get-go for someone who would be therapy averse, so provided it without me realising. If so he was even more brilliant than I realised.

    So I suppose I think therapy works, provided you think it's not therapy.

    Comment


      #3
      Depression: Biological versus Social Causes

      Re: Satchmo's opening post:

      All of those are interesting points, but two of them in particular directly affect my family:

      2) Is this then a combination of biology and situational factors? I ask this because my mum suffers from depression and so does my brother, but my sister and I don't - which could maybe be explained by my mum having a rougher time health-wise while pregnant with my brother than with me or my sis.

      4) sounds very similar to what my brother experiences some of the time: he's a brilliant guy, but sometimes when he's idle and in the house on his own his brain gets stuck on a negative feedback loop and he manages to convince himself he's somehow a failure or a burden (far from it).

      He's hypothesised that this is due to the different paths information takes to get into the brain, and that sometimes the internal ones - the ones you use to reassure yourself that everything's fine - stop working, and only the external ones can pass positive feedback into the brain. And when this happens, the more different external sources the positive feedback comes from (verbal, visual, sharing a laugh with someone, or even something as simple as his wife giving him a hug), the quicker the recovery from the depressive episode.

      Comment


        #4
        Depression: Biological versus Social Causes

        I think there is a 3rd cause as well - chemical. My long term ex and I took now discredited anti-Malarial drug Lariam for 3 months one summer in Africa, and her subsequent long term depression was I am 99% sure was caused by the drug.

        My own fairly recent experience of therapy for my depression was good, though I am not sure if it in any meaningful sense "cured" me. It was a brilliant thing to do though. Paying someone sympathetic and well-trained to ask the right questions and listen to you talk about yourself is something I do not regret doing. Touch wood, I feel I am on the mend at the moment, but I fully intend to go back to therapy before long, just because I felt it to be a very positive experience for me.

        On 4, I suspect this is true for me too. I think this is partly related to the feedback/satisfaction/general interactive nature of the process, and partly because it when i am teaching/training i am forced to be entirely present in the moment. There is no drifting into dark corners of the brain, because there is no opportunity to do so.

        Comment


          #5
          Depression: Biological versus Social Causes

          How long ago were you prescribed Lariam? A med student friend warned me about that in '95: think she took less effective treatments before going out to work in India (she also has fairly severe depressive episodes).

          Comment


            #6
            Depression: Biological versus Social Causes

            We're physiologically hard-wired (males, at least) to sit around shouting occasionally at each other, eat the food our wives/mothers bring us, and masturbate fairly continuously. Other than web development, I expect every other profession takes us away from that lifestyle into areas of stress, and leads to inevitable mental issues.

            Comment


              #7
              Depression: Biological versus Social Causes

              From the NS this week:

              https://www.newscientist.com/article/2095769-gut-bacteria-spotted-eating-brain-chemicals-for-the-first-time/

              New evidence that the gut affects the brain.

              Comment


                #8
                Depression: Biological versus Social Causes

                It's my answer to everything, but...

                Dogs!!!

                (Though they obviously don't help inspire better webpage design!)

                I wonder, MsD - could the reasons you like being around your students be similar to those that people enjoy being around dogs?

                Comment


                  #9
                  Depression: Biological versus Social Causes

                  Uh? What students? Who's been talking?

                  Comment


                    #10
                    Depression: Biological versus Social Causes

                    Bruneau wrote: I'd never heard that about the anti-malarial drug. I was on one for three months when I was 13, don't know what kind. My life hasn't been depression-free though.

                    I think it's kind of impossible to separate chemical from environmental causes, though. Well, setting aside particular drugs that have a clearly disruptive effect. If some people are prone to depression, their brain chemistry is that way, but brain chemistry can be altered by environmental things and behaviors, as I understand it.

                    I see it as nature, being something of an inhospitable clusterfuck, placing inevitable psychological burdens on everyone who's paying attention. Some react by becoming depressed, others become angry or impatient or violent or selfish or narcissistic or passive aggressive or some combination of the above.

                    Maybe depression is more of a modern-day ailment, and when we was cavemen there was less time for it with all the basic survival distractions. But those distractions produced other afflictions and neuroses, the effects of which we're still dealing with.
                    People in the past were depressed, we just didn't have all the medical literature about it. Lincoln supposedly stayed in bed for days with melancholy and Kierkegaard was clearly depressed, to name two examples.

                    But, having said that, the modern world is clearly conducive to depression. We're more disconnected from our families and communities than we once were. We are bombarded with messages about how we're not living the life we should or could be. Alienation and ennui and what not.

                    I have had a better experience with SSRI. I've tried a bunch and seemed to have found a scheme that works ok. They don't provide any "pep" whatsoever - I don't know why anyone would think they do - they just put a floor on the depths of the down times. And that is vital. I've also seen a variety of therapists. Results vary widely. And yeah, just talking about random stuff seems to be helpful.

                    Comment


                      #11
                      Depression: Biological versus Social Causes

                      They don't provide any "pep" whatsoever - I don't know why anyone would think they do

                      I think he was being provocatively cranky, possibly to gauge my reaction. It was tough to tell, he was in his mid-eighties at the time. The more I think about our meetings though the more I realise that, as informal as they often seemed, little on his part was said by chance.

                      I've met a couple of people like that in my life, the other was my doctoral supervisor who has the phenomenal abililty to get people to learn without, apparently, teaching anything.

                      Comment


                        #12
                        Depression: Biological versus Social Causes

                        Just like Leonard Nimoy. https://m.youtube.com/watch?v=1aQLsPCxkPw

                        My current therapist and I mostly just talk about how I'm doing with my insomnia and headaches. I also see a neurologist and I also see somebody regularly to do what's called "spiritual formation," which isn't "helpful" so much as an end in itself. And I'm on multiple drugs, which is interesting. The concerta looks a lot like one of the sleep aids, so last week I accidentally took a downer when I meant to do an upper. I felt like a 70s rock star.

                        Comment


                          #13
                          Depression: Biological versus Social Causes

                          Lang Spoon wrote: How long ago were you prescribed Lariam? A med student friend warned me about that in '95: think she took less effective treatments before going out to work in India (she also has fairly severe depressive episodes).
                          It will have been 94

                          Comment


                            #14
                            Depression: Biological versus Social Causes

                            blameless wrote: Re: Satchmo's opening post:

                            All of those are interesting points, but two of them in particular directly affect my family:

                            2) Is this then a combination of biology and situational factors? I ask this because my mum suffers from depression and so does my brother, but my sister and I don't - which could maybe be explained by my mum having a rougher time health-wise while pregnant with my brother than with me or my sis.

                            4) sounds very similar to what my brother experiences some of the time: he's a brilliant guy, but sometimes when he's idle and in the house on his own his brain gets stuck on a negative feedback loop and he manages to convince himself he's somehow a failure or a burden (far from it).

                            He's hypothesised that this is due to the different paths information takes to get into the brain, and that sometimes the internal ones - the ones you use to reassure yourself that everything's fine - stop working, and only the external ones can pass positive feedback into the brain. And when this happens, the more different external sources the positive feedback comes from (verbal, visual, sharing a laugh with someone, or even something as simple as his wife giving him a hug), the quicker the recovery from the depressive episode.
                            That's an excellent model, and I agree with it. Humans can be both "sociocentric" and "egocentric", with the balance depending on the person and the culture. If your lifestyle becomes out of whack with the balance you need between socio and ego, you become unhappy and potentially depressed.

                            There are also some amazing stats, that I quote in class, about how factors such as religion and marriage affect variations in physical health as well as depression.

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