Uncovering depression's web in the brain | Hacker News Reader

Uncovering depression's web in the brain

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85 pointsclumsysmurf26 comments

I think this finding is being overblown in some places, but it does seem to get at part of depressive experience that few people want to acknowledge. You can do everything right, have something good happen as a result of your efforts, recognize your role in the good thing happening, and still feel deeply disappointed. The major psychological models of depression pretty much assume that this kind of backward response can't happen, which can lead to borderline gaslighting about how you're "really" evaluating things.

When this happens, is this a reasonable sign that the depression is clinical? My understanding of clinical is that it's chemical.

"Clinical depression" refers to Major Depressive Disorder, which is the name given to the common set of psychiatric dysfunctions that have persistent depression as their primary symptom. That is, "Clinical depression" refers to an entire disorder (a set of symptoms grouped together in the literature) rather than as an individual symptom. This is to distingish it from "depression" used as the name of a symptom or other disorders, like bipolar.

"Clinical" depression is not depression that is caused by chemistry rather than psychology. We have no idea whose depression is caused by what, really, and chemistry/psychology probably isn't a meaningful distinction to make in this context.

Actual psychiatrists do not distinguish much between so-called "situational" depression, vs some hypothetical "100% organic" depression. That seems to be rampant on Internet message boards for some reason. A psychiatrist will ask about your life circumstances a little bit, but if you have certain symptoms, whether you perceive them as externally caused or not, they will diagnose you with Major Depression, i.e. "clinical depression."

Clinical just means that you have been diagnosed with Depression by someone with a bunch of letters after their name, as opposed to colloquial depression, which means something like 'feeling blue'. To be diagnosed you need to meet a number of criteria like 'loss of interest, fatigue' nearly every day for a long period.

As far as I know there is no expert consensus on whether depression and Depression are different shades of the same thing or qualitatively different.

'Depression is a chemical imbalance', as a model, is about on par with 'the internet is a series of tubes'. It's not flat out wrong, but it's so oversimplified as to be pretty useless for fixing or making predictions about the system.

That might be true, but it may also be that you just haven't found the cause. It's not always obvious what is causing the depression.

In my own case, certain things in my life were just not right (which I didn't realise at the time), and I didn't realise at the time how much they were affecting me. However once I changed those things, the depression cleared up completely.

YMMV.

You just described my entire condition. I've had therapists tell me that I didn't want help because of these feelings and that things were fine I shouldn't really worry (they actually said this to me). Reasonable comment from an outsider perspective maybe, but doesn't really help or offer any insight.

The gaslighting comment is all too real. I wonder what's wrong with me because I don't feel contented. I feel like a fake all the time and then I feel like a fake for feeling like one. It's madness. Somehow I'm still able to carry on, but it's not fun.

Sounds like your therapists were not best suited for you. Mind if I ask which style of psychotherapy they practiced?

I'm not entirely sure. One was a fancy lady with a union square office who was recommended to me by a friend. She was nice but tried directing everything towards my family which I thought was distracting.

The best therapist I ever had was an older man from upstate NY who practiced zen buddhism. He was technically a psychiatrist I suppose but we had incredible talk sessions and he helped me manage it during the worst episodes (first years of college), because we mostly just talked about poetry or writing or anything but normal therapy territory. I'm not sure where he is at now but I would like to find something similar to that. But to be honest I'm pretty burnt out on therapy and my mood swings make it hard to build a consistent rapport with most practitioners. Also therapy is INCREDIBLY expensive and many don't take insurance. It feels screwy.

The list of various styles of psychotherapy is vast and they differ greatly in their approach

https://en.wikipedia.org/wiki/List_of_psychotherapies

Cognitive behavioural therapy is one of the well known ones and to my understanding tends to focus on concrete patterns of behaviour rather than digging out some deficit in parental relationships https://en.m.wikipedia.org/wiki/Cognitive_behavioral_therapy

Totally amateur here but unfortunately a bit familiar of depression. What you described sounds like a familiar pattern and CBT was helpfull in that.

Having gone through some depressive episodes and a variety of clinical work to resolve them, I do not get the sense that anyone really knows what they're doing. The whole process led me to empathize deeply with the perspective of a dart board being used to learn the game.

It's that fine line between "nobody really knows what they're doing" versus "doing anything is almost certainly better than doing nothing."

Disappointed? Like, actually feel disappointed?

I dunno, I just don't feel anything. Good things, bad things - it's all "OK. Next."

But my general mood is leaning towards negative.

It bothers me that they claim to witness "circuits" connecting different areas of the brain. AFAIK they just use FMRI or similar to see which regions are active and make correlations, which is quite different that watching an actual circuit or "neural pathway" firing in real time.

Materialistic science is the #1 obstacle to understanding the nature of depression. Depression is a reaction to an unhealthy environment, but science pathologizes the individual biology.

Biological psychiatrists would not disagree with you.

Serotonin is associated with dominance and social status in animals. If you get "beat down like a minion" you are very likely to have your serotonin system get in bad shape.

How do you decide what's environmental and what's chemical when everything in your brain is chemical, and you can't isolate the environment?

Your brain runs on chemical energy, sugars and such. It is all chemical and it is all the environment.

Isn't a good chunk of depression genetic? That is, sure, it's a reaction to an unhealthy environment, but you have to have the predisposition that makes you respond with depression, otherwise you just deal with it?

It's just another factor. Some people are just more predisposed to depression. However I imagine that it's possible for everyone to get depression with the right circumstances.

> it is increasingly becoming clear that many forms of the condition are caused by either chemical imbalances, brain abnormalities or connections between neurons in the brain

Ka-ching!

A drug company CEO just bought another yacht.

I wonder if the people here who support the pathologising of unhappiness support the mass drugging of school children afflicted by "ADHD". Look at how France deals with such issues and you see there are other ways.

Pills for the brain, mass incarceration, gun culture and junk food - things America fails at and leaves the rest of the world shaking its head in amazement.

I'm glad that you haven't had much experience with clinical depression.

Wow, just read an article on ADHD in France, and I think that their system is incredible. It really aligned with what I've thought all along: depression, ADHD, and a few other "neurological disorders" are symptoms of a person not operating in an optimal environment (for themselves specifically).

Take ADHD for example: A child won't sit still in class, is constantly distracted, and performs poorly at school work. Let's use occam's razor to figure out what's going on here. Was this child born with a rare neurological disorder causing an imbalance in monoamine neurotransmitters? Possibly... Or maybe was the real cause is this: a lack of exercise, a poor diet that includes lots of sugars and unnecessary carbohydrates, lack of socialization outside of the school context. The list goes on and on. I really believe that if you do your due diligence in ensuring your diet, health, social life, and other important factors are all in a good state, these conditions magically disappear. Sure, the kid might have low levels of dopamine because of their suboptimal lifestyle. But there are ways to fix the problem without shoving NDRIs/amphetamines down their throat: change their routine, their diet, their life.

I'm not saying that ADHD doesn't exist, I'm just saying the true percentage of ADHD cases is probably a much lower (see France) than what's purported in the US.

But in the end, it's easier to pop a pill than change you or your child's lifestyle. Plus the pharmaceutical companies make a buck, and tell you what you need to hear to believe that stimulants are the only option for treatment. Sometimes they might be a good option to jumpstart the process of digging yourself out of depression (SSRIs in this case) but I don't think that the chronic administration of drugs is healthy and optimal in the long run. There are better solutions out there.

(P.S. Obviously I'm not stating any of this as fact. It's just what makes sense to me after dealing with, and evaluating my own anxiety and depression.)

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