What is depression?

[patliputra]

Is it a disease ? Why it is so prevelant. Is there any remedy?

[Olderal]

Now you're asking tough questions. My opinon which is n't worth a lot is that an illness or condition sounds more accurate than disease. My guess is that its so prevalent because we did n't evolve to live in the conditions of modern life. 

The human mind is so complex that it reacts in complicated ways to modern stresses,

Medical science would give a lot for a remedy but there are lots of part remedies which are effective to varying degrees for each complicated mind.Overall an individual can ,with medical help, eventually find the right remedies for him/her self which can result in a relatively happy and productive life. Getting to that stage usually involves much mental pain before an acceptable relief from depression is achieved.

That ,I would say, is when one can face all the stresses of modern life,and can continue to function well ,and achieve long periods of contentment. One will still get periods of depression but can accept and counter them ,and know that happiness will come again. I suspect that my hard won remedies will be totally ineffective if Leicester City do not win the premiership , and I am hoping medicak science will make another breakthrough before the end of the season.

Olderal 

[Hidden in reply to Olderal]

I agree with you Olderal.   I will add though that there is some evidence that it is heredity but not enough is known about it.  .

I can't believe Leicester went from being almost relegated last season to running away with it this year.  Amazing.  I wish my team Man Utd were playing as well!   Bev x

[Olderal in reply to Hidden]

Yes ,I agree a lot of it is hereditary. The puzzle is why have so many depressives survived , you'd have thought evolution might have killed us all off long ago. (suicide, helplessness--I would imagine you'd be no good at taking on a sabre toothed tiger when depressed)

A nice and comforting theory is that depressives when hypomanic or manic can achieve a lot and have insights which help the human race and helped primitives to make progress so we were valued and cherished . That was OK except for the fact that our ancestors also paid  for this progress with painful spells of depression. Nice for the tribe ,not so good for us. Maybe if the tribe valued our insights they looked after us when down and more helpless. That thought ought to be of some comfort when life is hell.

Olderal

[Hidden in reply to Olderal]

Ha ha Al.   I reckon most depressives (including me) would take on a sabre tooth tiger even if depressed if it was threatening to eat you! 

I agree with you that we lead unnatural lives these days and aren't built for this type of world.   Maybe people weren't depressed much when they were leading more natural lives?  

I see stories about very poor people in the 3rd world and what they go through is awful but you don't hear too much talk about suicide do you?    Bev x

[patliputra in reply to Olderal]

You are right when you say a depressive can achieve a lot of things. The world does not end with depression.

But hereditary is not a major reason for depression. Yes, it does play a small part, but other factors are more important.

[celtic2746 in reply to Hidden]

Hi be it's nice to see your still here in the group ! As in Leicester I bet they are over the moon nothing to be depressed there yee ha ! I watched your team today sorry to see a once great team struggle  the managers useless nefer been the same since Alex Fergus on left ! Bev I remember you as a nice person and I hope alls well with you now ! Take care and god bless david

[patliputra in reply to Olderal]

Thanks for your response. Asked this question because most of the posts talk about depression. So I thought it prudent to have this thing cleared.

[secondhandrose2]

Depression is a pattern of feeling and thinking negatively, triggered by experience but often part of our personality.  Nobody knows precisely why some people become depressed and others don't but most researchers now agree it is the result of interaction between our genetic make up and our experiences, especially experiences during childhood.  The outcome depending upon our ability to cope with them.

Genetically we are born with different temperaments as a result of the balance of chemicals within us.  Some people's temperament makes them respond more negatively than other people - they may be more sensitive, quick to react, or react more strongly than others when their needs are not met.  There are also events that most people would respond to negatively whatever their temperament (abuse, trauma, constant criticism or control, abandonment before we are able to look after ourselves) but the effect of those experiences differ depending upon the age at which they happen.  If a tiny baby is abandoned it may not feel loss because it lacks the maturity to know what exactly is missing but their body will experience stress and may even shutdown physically until external circumstances change - a survival mechanism.  A toddler who is abandoned may experience acute distress and anger because it feels dependant upon the carer and may find it impossible to forgive because they feel so let down.  When a child of school age is abandoned they may feel sadness and not want to play but may look to other adults for care if they have not had too many bad experiences before.  An adult who has had previously secure experiences and not been depressed may grieve the loss of someone they depended upon but in time they may go on to live a happy life.  Similar experiences affect us differently according to how mature we are - it is not about age but about our ability to understand the emotions we experience, to make sense of them.  Depression comes about when we are unable to understand what we feel, why we are feeling it, and how to change things.  A failure to understand makes us feel helpless because our brains are programmed to understand, so helplessness is stressful.  When we are able to understand our feelings and change them by getting others to respond differently or by being different ourselves we feel empowered.  Those of us who experience ongoing depression are likely to have had a temperament that lead us to be sensitive but also repeated experiences that were beyond our ability to understand and so we felt helpless, overwhelmed emotionally.   If those experiences occurred early we are likely to become more depressed as a person than if they were later when our personality had already developed.

There are lots of different thoughts about whether we can overcome depression but most people believe it can be treated to some extent.  My own view based upon experience as a person who experienced lifelong depression but also as a therapist who worked within the NHS is that we can be helped to overcome the extreme aspects of depression once we understand their cause.  

Medication can be useful to alter the symptoms of depression and as a result we may be able to find experiences that make up for earlier stressful experiences. CBT can enable an understanding of what we think and feel, enable us to think more deeply about things so we may be more able to control our responses. However rational thought can lower the capacity to stay with feeling emotion.  

My own belief is that once we understand the cause of our depression and have re-experienced the emotions that led us to feel helpless but in more supportive circumstances we understand and feel less helpless.  Using my own experiences as an example, I was a sensitive baby with a responsive  temperament - I feel things intensely, love music, art, colour, have a strong vibrant constitution and a strong need to express myself - that will have made me more difficult baby to look after than a placid child.  I had difficult experiences - my mother was depressed as a result of early abandonment and as a result she was unable to enjoy me or play with me as much as I needed and my father was critical and a perfectionist who expected a lot from me but saw wrong in whatever I was doing.  As a result by the time I started school I had low self-esteem and didn't know how to mix with other children which led to my being isolated and despite being outgoing and sociable in temperament I became timid and withdrawn, so was bullied which exacerbated my negative self-esteem.  Then my family split up after I was involved in a row with my father and I felt to blame - children think everything, good or bad, is their doing because their understanding is sufficient to enable them to take account of other people's motives as we hopefully can once we are mature.  My guilt, grief, stress and confusion was such that I struggled to function, especially as I was entering adolescence which is such a time of change.  I was then sexually abused which was traumatic especially as I was just becoming aware of my own desires.  I felt emotionally overwhelmed, totally helpless.  With the lack of an understanding environment to support me but having a strong constitution in time I seemed to get over it, seemed normal and happy though I felt something was missing in me or in my life.  It wasn't until I had a sensitive daughter myself which brought back the emotion from the time when I had needed mothering myself but been unable to get my mother to respond that I became depressed and sought help in therapy.

Why is depression so prevalent?  There are so many reasons...  The world no longer allows children be children with a need to play, be noisy, make a mess, have fantasies and emotions knowing adults will keep them safe, no longer has much safe physical contact with caretakers (may be abused) or play with peers. Adults are stressed, our lives are more complex than ever before and there is little time or energy for parents to think about others.  Children are fed and clothed well, given things, but for many there is less of feeling loved and wanted, knowing where they fit in the world, home being stable and secure.  At school they are expected to compete and perform which raises stress levels even further.  The world is more and more complex, through media we are exposed to things that are beyond even adult understanding (wars, inequality, prejudice, hatred) and as a result there is less contact with emotion, fantasy and creativity, more concern with the mind, achievement and the virtual world.  It isn't possible to shut off from emotion, there is a biological drive to feel and a need to understand and feel safe with feelings.  Much of Western life doesn't allow for that.

Suex

[Hidden in reply to secondhandrose2]

 However Wow that's very powerful Sue and really made me think.   My mother always said I was the healthiest,  liveliest and most outgoing of her children (out of 4)  with a happy go lucky nature.   It didn't take much to make me happy and I seemed to enjoy life. 

I don't know what changed between the ages of 6/7 but I found I was unable to make friends and no one seemed to like me.   I think my depression started then.  I was very unhappy and needed emotional support which I didn't get.  I got the reverse instead.  I was told by my mother that I was a horrible person and that I was obnoxious and no one liked me.   Everything I said or did was wrong and I didn't know why or how to change it.   I realised no one wanted me and I had only my own resources to rely on.    Every time I tried my best to be good and the child she wanted me to be I was slapped down so in the end I gave up trying.  

Like you I became timid and withdrawn going against my nature but I couldn't control all the feelings seething within me and they exploded from time to time.  Then followed more criticism and ostracisation and it became a vicious circle.    My moods swung wildly and I was either very high or deep in the depths of depression.   I also became (along with my father) the main scapegoat of the family - most things were my fault and the constant criticism and judgement wore me down in the end to such an extent that I was a total emotional mess with a whirlpool of emotions I couldn't handle. 

My mother encouraged us children to 'compete' against each other and there was very little simple kindness in my family.  Thank goodness I knew my father loved me otherwise I don't know what would have become of me.    My mother slagged him off as much as me and seemed jealous of our relationship which soured it for me.    I felt I was wrong in loving my dad and he for loving me.   According to my mother my dad had all these terrible 'faults' and she would accuse me of having the same traits.   She would constantly say to me things like (said very contemptuously)  'You up to your tricks again'?  looking at me with hatred in her eyes.    It would confuse me terribly because I didn't know what I had done wrong. 

I was chatting to my youngest sister the other day and was very surprised because she had picked up on that (she is 5 years younger than me),  and said she always thought it was very unfair of her to keep blaming me.  

Very interesting discussion,  thanks for posting it.   Bev x 

[patliputra in reply to secondhandrose2]

Hi, secondhandrose , that was wonderful summery written brilliantly. It does explain several aspects of depression. Thanks a lot.

[Hidden]

Hello patliputratheir

Generally some pros say it is up to us to approach life in a way that we remedy what is causing our depression. Of course some sufferers can do this and never look back.

Some sufferers will never control their depression, it all depends on us so sad to say this for many can just be to much.

All I can suggest is if you can approach your problems and activate that self help you never know, you may be lucky in your task

[patliputra in reply to Hidden]

Hi borderreiver ,you are right when you say that you can turn your negative feelings into positive by dint of your mental power and use it for your well being. So most important factor is you and only you can decisively come out of any depression. Sometimes it may be difficult but it is not insurmountable.

[Lin1944]

Hi what is the difference between depression and anxiety. From Lin 

[secondhandrose2 in reply to Lin1944]

Anxiety is the sign of fearing the possibility of being overwhelmed emotionally, of something awful happening, whereas depression is the sign that emotionally something awful has already happened and that it was too difficult to cope with so the person felt helpless.x

[patliputra in reply to Lin1944]

Hi Lin, a very pertinent point. Anxiety is normal ,may be negative emotion which all of us have at one time or other. It not lasting and goes away within a short time,when you get what you are trying to do. Reverse to this when anxiety is prolonged for a much longer period and starts interfering with your daily routine then it is depression. Depression is like sea waves and sea when waves tries to draw you inside it and try to drown you into sea.the negative feelings become so strong as to make a vicious circle of negative emotions from which it becomes difficult to come out .Then you need help and even medication.

[Gambit62]

As I understand it depression is a label for a cluster of symptoms that can have a number of causes.  In some cases the cause is something that is treatable within current medical knowledge - eg thyroid problems, B12 deficiency - in other it is more complex - and that gets worse if there are other things going on.

There are some life events that result in symptoms similar to depression and can lead to depression - eg bereavement - mourning has most of the characteristics of depression and for some people get stuck in the 'depressed state' and need help getting out of it.

There are lots of things that can help even where the cause isn't something 'obvious' like thyroid - such as antidepressants and meditation/cognitive behaviour therapy which help to change ways of thinking that are likely to lead to a depression but they don't work/help everyone ... 

exercise and socialising also seem to be important - though know it is tough to keep those going when you are depressed.  One of the cruel things about depression isthat it seems to result in the link between motivation and action getting switched so you have to do something before you start to feel motivated and enjoy it if you are in a depressed state.

So, basically - lots of causes - mechanisms of all causes aren't fully understood and isn't always clear what the cause is - so not surprising that finding a treatment can bevery hit andmiss.

[patliputra in reply to Gambit62]

Yes it is true that thyroid pathology can be a factor in depression. But thyroid problems are associated with other symptoms specific to thyroid gland. But generally advanced depression is associated with certain neurotransmitter changes in brain. It may develop into bi polar psychosis, when medication becomes a must. Sometimes even electric shocks are prescribed.

[Gambit62 in reply to patliputra]

however,clinical diagnosis of depression is done based on symptoms not on an analysis of neurotransmitters - and GPs can be quite quick to jump straight to treating depression with ADs without looking into other causes.  This is probably more common with B12 than thyroid because the standard tests aren't specific enough even when they are done.

[patliputra in reply to Gambit62]

What you say it true but AD is though related to depression is entirely a different thing.

[Gambit62 in reply to patliputra]

sorry but I don't understand this response.

AD in my reply was Anti-depressants but I can't make sense of using it as that in your response

[patliputra in reply to Gambit62]

AD means Alzheimer disease.

[Gambit62 in reply to patliputra]

Agree that Alzheimers is a different disease but as you will see from my reply it wasn't what I meant by AD in the response - and, I think, isn't generally what most people use AD to mean on this forum - but it does underline the dangers of using abbreviations.

Depression is one of the symptoms of a B12 deficiency,which left untreated can result in brain damage (though reversible if caught in time) which causes cognitive impairment which is why B12 screening is now on the list of tests done when evaluating someone with cognitive problems.  Unfortunately I suspect that interpreting the test is still being done on the numbers in a lot of cases and a deficiency can actually start well into the normal range so suspect that there are cases that are being missed with quite tragic consequences.

[secondhandrose2 in reply to Gambit62]

Depression can be a symptom of thyroid deficiency as it can be a symptom of many different things, but most depression is not a result of a thyroid problem and most people on this particular site will become confused by lots of discussion of thyroid issues.  There are other sites for that particular problem. 

[Gambit62 in reply to secondhandrose2]

Sorry but I think it is important that people are aware that depression can have a 'physical' cause.  

[secondhandrose2 in reply to Gambit62]

Yes of course, it just sounded as though you were suggesting depression is often caused by thyroid problems whereas many people have depression going back to a time when any issue with their thyroid was unlikely to have been an issue.  I agree though that it is impossibly difficult to get thyroid treated in this country because the scale they use is so high, in the US they treat at a much lower level.

[Gambit62 in reply to secondhandrose2]

Most of the thread is actually about B12 deficiency - having had 4 decades of depression and anxiety  because it never occurred to anyone to look at it I'm afraid I'm a bit touchy on the subject. 

[secondhandrose2 in reply to patliputra]

Depression doesn't ever develop into bi-polar, bi-polar is a specific form of depression but separate from it and needs very different medication.   

[celtic2746]

My personal opinion is that depression is more prevalent  now a days is to the pressures of modern life and also the financial pressures we have also we are more ready to seek help for depression than in our parents day  they were told to just get on with it there's thank god more help for anyone suffering from depression ! I hope I've made some sense and I wish you well david !

[Hidden in reply to celtic2746]

That's true David.   I remember well in the 'old days'  people referring to others as being 'nervous'.  I never remember the word 'depression' or 'anxiety' even being mentioned.  x

[patliputra in reply to celtic2746]

Yes, the stress and strain of life which includes financial problems,inability to cope with office work and management of home,problems of children etc.Many times we find ourselves difficient in coping with situation and that leads to negative thought vicious circle.

In initial stages family,friends and relatives play a major role by emotional support and encouragement to bring back to normalcy.