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PostPosted: Tue Nov 24, 2009 1:08 pm 
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I was browsing around Wikipedia today. As is so easy with that site I got started down a thread of topics completely different from my starting point.

I came upon the page for Atypical Depression.

It describes the following symptions:

A. Mood reactivity (i.e., mood brightens in response to actual or potential positive events)
B. At least two of the following:
1. Significant weight gain or increase in appetite ("comfort eating")[3]
2. Hypersomnia (sleeping too much, as opposed to the insomnia present in melancholic depression)
3. Leaden paralysis (i.e., heavy, leaden feelings in arms or legs)
4. Long-standing pattern of sensitivity to interpersonal rejection (not limited to episodes of mood disturbance; fits of rage, hysteria, aggression and irrational reactions) that results in significant social or occupational impairment

I experience all but #3 on a pretty regular basis.

Following the link to Interpersonal Rejection I find:

Quote:
An early questionnaire measure of rejection sensitivity was developed by Albert Mehrabian.[25] Mehrabian suggested that sensitive individuals are reluctant to express opinions, tend to avoid arguments or controversial discussions, are reluctant to make requests or impose on others, are easily being hurt by negative feedback from others, and tend to rely too much on familiar others and situations so as to avoid rejection.


It's really kind of scary how accurate a picture of my personality that one paragraph draws. Ironically, much of that explains why I don't post here very much. Why I'm posting this here now I'm not really even sure.

I got some small amount of therapy 2 years ago to get myself moving again after a breakup and cross country move. But once I got a job and got at least self sufficient again I was pretty much booted from the program, which was publicly funded.

So now I find myself 2 years later, and things not a whole lot better. I should get into therapy again, I know. But have trouble caring enough to make that step.


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PostPosted: Tue Nov 24, 2009 1:15 pm 
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Hm... I have those same symptoms, almost to the letter.

Especially #4.

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PostPosted: Tue Nov 24, 2009 1:54 pm 
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And me! And me!

Is it medicalising being, you know, a person?


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PostPosted: Tue Nov 24, 2009 2:04 pm 
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The best treatment for depression is 30 minutes of brisk aerobic exercise per day. It is better than medications.

*looks around*

Just looking to make sure I don't get caught telling y'all this.

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PostPosted: Tue Nov 24, 2009 2:11 pm 
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Squirrel Girl wrote:
The best treatment for depression is 30 minutes of brisk aerobic exercise per day. It is better than medications.

*looks around*

Just looking to make sure I don't get caught telling y'all this.



I would prefer pills. Exercise is too much like work.

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PostPosted: Tue Nov 24, 2009 2:13 pm 
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Makes sense, squirreltherapist.

The whole WoW addiction thing makes that more difficult than it would otherwise be, however!

Edit: And yes, too much like work, which I'm allergic to.


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PostPosted: Tue Nov 24, 2009 2:24 pm 
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Pshh. Women get all those symptoms every month... ;)

Squirrel girl is right though. I just read an article this morning about a study they did comparing two groups of depressed individuals. The first group they put on the antidepressant zoloft and the second group they instructed to exercise for 45 minutes 3 times a week.
Both groups improved at the same rate.

If running on a treadmill while listening to some music isn't your cup of tea you could always try something more fun like playing basketball after work, rollerblading, etc. Makes it seem less like exercise.

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PostPosted: Tue Nov 24, 2009 2:50 pm 
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Vigorous sex-drenched sexual intercourse can be substituted. 45 minutes is quite a long time. I believe they call it "****" in some areas.

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PostPosted: Tue Nov 24, 2009 3:13 pm 
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I try not to self-diagnose myself, mainly because I am afraid of the outcome.

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PostPosted: Tue Nov 24, 2009 3:33 pm 
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Rafael wrote:
Vigorous sex-drenched sexual intercourse can be substituted. 45 minutes is quite a long time. I believe they call it "****" in some areas.


Quote:
Long-standing pattern of sensitivity to interpersonal rejection (not limited to episodes of mood disturbance; fits of rage, hysteria, aggression and irrational reactions) that results in significant social or occupational impairment


These two things are related.

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PostPosted: Tue Nov 24, 2009 4:33 pm 
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1 & 4, yup, though I have insomnea no hypersomnia.

And I've tried the whole excercise thing to help with depression, about the only thing that came from it was feeling exhausted and sore then next morning cause I would be at the gym for 2-3 hours till like 1-2am till I couldn't physically continue when I had to work the next day, though I guess on the plus side it held off the weight gain unlike now where I'm at that why bother stage and never go to the gym so the weight keeps creeping up :/


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PostPosted: Tue Nov 24, 2009 5:12 pm 
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Stormwarden wrote:
I came upon the page for Atypical Depression.

It describes the following symptions:

A. Mood reactivity (i.e., mood brightens in response to actual or potential positive events)

Hmm...yup.
Quote:
B. At least two of the following:
1. Significant weight gain or increase in appetite ("comfort eating")[3]

Eh, not really. And yeah, I've gained weight over the past 10 years, but it's from lack of exercise and abandonment of my diet, not from "comfort eating."
Quote:
2. Hypersomnia (sleeping too much, as opposed to the insomnia present in melancholic depression)

Yes. Mental problem or laziness? Hard to tell.
Quote:
3. Leaden paralysis (i.e., heavy, leaden feelings in arms or legs)

I've felt like that before, but who hasn't?
Quote:
4. Long-standing pattern of sensitivity to interpersonal rejection (not limited to episodes of mood disturbance; fits of rage, hysteria, aggression and irrational reactions) that results in significant social or occupational impairment

Ehhh...not really.

Quote:
Following the link to Interpersonal Rejection I find:

Quote:
An early questionnaire measure of rejection sensitivity was developed by Albert Mehrabian.[25] Mehrabian suggested that sensitive individuals are reluctant to express opinions,

Yeah.
Quote:
tend to avoid arguments or controversial discussions,

Yeah.
Quote:
are reluctant to make requests or impose on others,

Most definitely.
Quote:
are easily being hurt by negative feedback from others,

Yeah.
Quote:
and tend to rely too much on familiar others and situations so as to avoid rejection.

Yeah.

The problem I'm having with this is that most of that is simply human nature. I'm sure that were any of those criteria to reach crippling levels it would be cause for alarm, but with something so nebulous, how do you tell when you're mentally unhealthy vs. simply being a normal person?

Such is the danger with self-diagnosis. And I'm not anti-doctor in the least, but I'd be wary of being clinically diagnosed with such as well.


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PostPosted: Tue Nov 24, 2009 5:29 pm 
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Like LK said, once a month like clock works.
Also add to it the symptoms of blowing up with out cause, tendency to cry over stupid trivial things, and the need to kill co-workers with sporks.

Apart from that I'm totally normal >.>


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PostPosted: Tue Nov 24, 2009 5:51 pm 
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Sui and Squirrel Girl posts are right on the money...

In summary, humans need more exercise.


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PostPosted: Tue Nov 24, 2009 6:33 pm 
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My wife keeps her DSM IV hidden away, because she knows if I get my hands on it, I WILL start diagnosing.


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PostPosted: Tue Nov 24, 2009 6:43 pm 
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Rafael wrote:
Vigorous sex-drenched sexual intercourse can be substituted. 45 minutes is quite a long time. I believe they call it "****" in some areas.


Do you work for the Department of Redundancy Department?

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PostPosted: Wed Nov 25, 2009 10:32 pm 
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If you are in rut, force yourself into immediately completing the first three mundane tasks that come to mind each day. That is all.

:edit; And hard work will bring sound sleep. Yeah!

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PostPosted: Thu Nov 26, 2009 5:10 am 
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When I was in high school I was clincally diagnosed with "Major Depression." I took several tests, one of which was a 500 questionnaire "True/False" quiz that had some bizarre questions on it. Things like "I believe Abraham Lincoln was a better president than George Washington" and it had "I am satisfied with my sex life" more than once (I left it blank each time).

This was all during my stint in a mental hospital that I voluntarily checked into (I was afraid of what I might do to myself). I had quite a few realizations there.

One is that you can voluntarily check in, but you can't voluntarily check out. It was very similar to a prison. Magnetically sealed doors. People wearing similar garb (hospital garments and slippers). Solitary confinement (rooms with single beds with straps for the more violent patients). Regimented days; you had to get up when they told you, go to bed when they told you, eat when they told you, and you never could just have time to yourself (always had to be under supervision). I was there for exactly 7 days, and it felt like 7 months. To this day nothing in my life has ever felt like such a long time (even the past 3 years).

But I also realized that I wasn't alone in how I felt. And I realized that as bad as I thought I was, there were a LOT of people worse off than I was. I remember one kid who was 16 or so who had been in there for a whole month (Jebus!) and he was finally released to go home. They gave him a razor the day his parents were to come pick him up, so he could shave and look presentable. He comes out with his forearms slashed up and just giggling like Beavis & Butthead. He did not go home that day.

I hated that place so much and I didn't really think the doctors were helping me much so I did a ton of self-examination. I had a lot of time to kill to do so.

The first thing I realized is that I had to ask myself this question first and foremost: "Do I want to be happy?" It sounds stupid. However, it's easier to be depressed. A lot of people seem to prefer it, even if they say otherwise. Ultimately, the answer was "yes." After that I realized I had to work for it, including likely making some sacrifices.

I thought about some of the major triggers my depression fed off of. The biggest one was chatting on a local BBS that I did every single day. There were several reasons, but one of them was that people tended to know me as already depressed so I kind of slid into that role even if I was not quite feeling that way beforehand. It happens to a small degree here on the glade (which is why I haven't been as humorous as I used to be long ago), but it's extremely minor. I realized that I should just go completely cold turkey from that chat bbs, even though the mere thought of doing so did not sit well with me. But I was forced to think of my first question again: "Do I want to be happy?"

I did cut the online chatting out completely after I got out of the hospital and never looked back. It didn't fix everything emotionally, but it made a huge difference and allowed me to continue to improve my mental health. I focused on my good qualities instead of dismissing them and focusing on only the bad. I always suggest people write a list of their good qualities so that they have hard evidence to turn to.

It wasn't an easy road, but becoming happy can be done. I did it without therapy or pills (pills made me feel TOO happy and I didn't like that). But I am not wired like you or anyone else. We're all different. Some people have a chemical imbalance that cannot be fixed by sheer willpower and do in fact need medication to balance their emotions. Some people need the support of a professional. But I can promise you there is happiness to be had. You deserve it. Everyone deserves it. The biggest lie depressed people convince themselves of is that they can never be happy or that it is too far away to reach.

I won't lie and say I never have to battle with it. It's always there, a part of me. But it is not pronounced as much as it was and on the rare occasion it surfaces it leaves just as quickly.

Just know that people care about you (and I am speaking to anyone reading this, not just a particular Glader). Only you have to the power to decide how you want to feel. Nobody else can do it for you. All they can do is help and cheer you on. And if anyone ever needs it, I will most certainly be in their bleachers doing just that.

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PostPosted: Thu Nov 26, 2009 5:39 am 
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Squirrel Girl wrote:
The best treatment for depression is 30 minutes of brisk aerobic exercise per day. It is better than medications.

*looks around*

Just looking to make sure I don't get caught telling y'all this.


and weed

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PostPosted: Thu Nov 26, 2009 10:50 am 
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Numbuk wrote:
The first thing I realized is that I had to ask myself this question first and foremost: "Do I want to be happy?" It sounds stupid. However, it's easier to be depressed. A lot of people seem to prefer it, even if they say otherwise.


How very, very true! I've been in your shoes before. Really. And I came to the same conclusions that you did.
Unfortunately, I also know many people who are still in depression, and not only do they not want to be happy, they continually seek out things, people, situations, and perspectives to purposefully keep themselves miserable. It's very sad.
Such a simple question, but for so many people, impossible to answer...Do you want to be happy?

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PostPosted: Sun Nov 29, 2009 3:15 am 
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Reminds me of the time I was at the doctor's and picked up the "Do You Have ADD?" pamphlet. It asked a series of questions, and at the end said if you answered yes to so many of these, talk to your doctor about ADD. I lol'd because I had answered yes to all of them. Tell me something I don't know already.

While I think it's important that we find various abnormalities and take care of them as best we can, I think at this point some of the various mental "issues" have just gone to far. Last figure I read said one of four people had some form of ADD. I'm sorry, but that's not a disorder. If 25% of people have it, it's pretty normal.

We've just gotten to the point where we're trying to remove tendencies or actions that society has deemed "bad" even if they're completely normal. Don't get me wrong, there are legitimate mental and physical issues, of course, but far too many people are medicated or cast out or whatever else for things that are normal and have been for thousands, if not millions, of years.


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PostPosted: Mon Nov 30, 2009 3:23 pm 
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That Wikipedia article doesn't adequately explain what this is. "Atypical Depression" isn't a diagnosis unto itself. The DSM-IV criteria in that article are actually the criteria for the "With Atypical Features" specifier. This is a specifier which clarifies or extends the criteria for an underlying Depressive Disorder (ex. Major Depressive Disorder, Dysthymic Disorder). That is, the criteria listed for Atypical Depression must be in addition to the criteria for a Depressive Disorder.

The "With Atypical Features" specifier mainly stands in contrast to the "With Melancholic Features" specifier. It should not be used if the patient meets the criteria for "With Melancholic Features":

Quote:
A. Either of the following, occurring during the most severe period of the current episode:
  1. loss of pleasure in all, or almost all, activities
  2. lack of reactivity to usually pleasurable stimuli (does not feel much better, even temporarily, when something good happens)

B. Three (or more) of the following:
  1. distinct quality of depressed mood (i.e., the depressed mood is experienced as distinctly different from the kind of feeling experienced after the death of a loved one)
  2. depression regularly worse in the morning
  3. early morning awakening (at least 2 hours before usual time of awakening)
  4. marked psychomotor retardation or agitation
  5. significant anorexia or weight loss
  6. excessive or inappropriate guilt


For reference, these are the criteria for a Major Depressive Episode:

Quote:
A. Five (or more) of the following symptoms have been present during the same 2-week period and represent a change from previous functioning; at least one of the symptoms is either (1) depressed mood or (2) loss of interest or pleasure.

Note: Do not include symptoms that are clearly due to a general medical condition, or mood-incongruent delusions or hallucinations.

  1. depressed mood most of the day, nearly every day, as indicated by either subjective report (e.g., feels sad or empty) or observation made by others (e.g., appears tearful). Note: In children and adolescents, can be irritable mood.
  2. markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day (as indicated by either subjective account or observation made by others)
  3. significant weight loss when not dieting or weight gain (e.g., a change of more than 5% of body weight in a month), or decrease or increase in appetite nearly every day. Note: In children, consider failure to make expected weight gains.
  4. insomnia or hypersomnia nearly every day
  5. psychomotor agitation or retardation nearly every day (observable by others, not merely subjective feelings of restlessness or being slowed down)
  6. fatigue or loss of energy nearly every day
  7. feelings of worthlessness or excessive or inappropriate guilt (which may be delusional) nearly every day (not merely self-reproach or guilt about being sick)
  8. diminished ability to think or concentrate, or indecisiveness, nearly every day (either by subjective account or as observed by others)
  9. recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide

B. The symptoms do not meet criteria for a Mixed Episode (See linked section).

C. The symptoms cause clinically significant distress or impairment in social,
occupational, or other important areas of functioning.

D. The symptoms are not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition (e.g., hypothyroidism).

E. The symptoms are not better accounted for by Bereavement, i.e., after the loss of a loved one, the symptoms persist for longer than 2 months or are characterized by marked functional impairment, morbid preoccupation with worthlessness, suicidal ideation, psychotic symptoms, or psychomotor retardation.


A Major Depressive Disorder, then, is the presence of one or more Major Depressive Episodes. It may be classified as either single-episode (296.2X) or recurrent (296.3X). A Major Depressive Disorder should have one of these mandatory specifiers: Mild, Moderate, Severe Without Psychotic Features, Severe With Psychotic Features. Additionally, it may have several optional specifiers: Chronic, With Catatonic Features, With Melancholic Features, With Atypical Features, With Postpartum Onset. Catatonic, Melancholic, and Atypical are mutually exclusive. The Chronic specifier requires that the full criteria for a Major Depressive Episode be met continuously for at least 2 years. It can also have the In Partial Remission or In Full Remission specifier depending on the age of the last Major Depressive Episode.

Dysthymic Disorder is essentially a less severe, but chronic version of a Major Depressive Episode. The criteria for Dysthymic Disorder (300.4) are:

Quote:
A. Depressed mood for most of the day, for more days than not, as indicated either by subjective account or observation by others, for at least 2 years. Note: In children and adolescents, mood can be irritable and duration must be at least 1 year.

B. Presence, while depressed, of two (or more) of the following:

  1. poor appetite or overeating
  2. insomnia or hypersomnia
  3. low energy or fatigue
  4. low self-esteem
  5. poor concentration or difficulty making decisions
  6. feelings of hopelessness

C. During the 2-year period (1 year for children or adolescents) of the disturbance, the person has never been without the symptoms in Criteria A and B for more than 2 months at a time.

D. No Major Depressive Episode (See linked section) has been present during the first 2 years of the disturbance (1 year for children and adolescents); i.e., the disturbance is not better accounted for by chronic Major Depressive Disorder, or Major Depressive Disorder, In Partial Remission.

Note: There may have been a previous Major Depressive Episode provided there was a full remission (no significant signs or symptoms for 2 months) before development of the Dysthymic Disorder. In addition, after the initial 2 years (1 year in children or adolescents) of Dysthymic Disorder, there may be superimposed episodes of Major Depressive Disorder, in which case both diagnoses may be given when the criteria are met for a Major Depressive Episode.

E. There has never been a Manic Episode (See linked section), a Mixed Episode (See linked section), or a Hypomanic Episode (See linked section), and criteria have never been met for Cyclothymic Disorder.

F. The disturbance does not occur exclusively during the course of a chronic Psychotic Disorder, such as Schizophrenia or Delusional Disorder.

G. The symptoms are not due to the direct physiological effects of a substance e.g., a drug of abuse, a medication) or a general medical condition (e.g., hypothyroidism).

H. The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.


Dysthemic Disorder should be classified as either Early Onset (age <21) or Late Onset (age >= 21). As with a Major Depressive Disorder, it may receive the With Atypical Features specifier, however it does not permit the Catatonic, Melancholic, or Postpartum specifiers. It also doesn't permit the Chronic specifier, merely because Dysthymic Disorder is inherently chronic.

In any case, it's important to realize that the DSM-IV criteria are only a portion of the full DSM-IV description for each disorder. This leaves out a lot of important information included in the Diagnostic Features, Associated Features and Disorders, Specific Age and Gender Features, Prevalence, Course, Familial Pattern, and (perhaps most importantly) the Differential Diagnosis sections.

Even if you do have the full DSM-IV available, I have to give the usual caveats about the dangers of self-diagnosis. As well, the DSM-IV is an important resource and set of guidelines, but it's not the sum entirety of mental health or the practice of psychiatry.

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PostPosted: Mon Nov 30, 2009 9:12 pm 
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We're all depressed. Learn to live with it.


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PostPosted: Tue Dec 01, 2009 9:39 am 
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While I don't battle depression (I'm just a naturally feel good, happy type person) I to have to deal with mild to moderate Obsessive Compulsive Disorder (OCD). It manifests in a variety of ways for me, but is typically the root of all conflict and unhappiness in my life.

We had an interesting Thanksgiving as both my younger and my older brother were visiting. We had a number of discussions which also covered my "gift" (of OCD). Fortunately, it's not life controlling for me, but something I have to self-monitor.

The biggest manifestation is in daily routines and specifically when things minutely alter or change them. A big change is not a problem, especially when I know something is going to be different, but minor changes can cause inordinate amounts of stress and consternation.


What's this have to do with depression? Probably not much, but it does seem like a thread where people are admitting to their faults and describing how they deal with them in hopes others can deal with theirs as well.

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Drexel wrote:
We're all depressed. Learn to live with it.


One of the major difficulties with mood disorders is that the symptoms are all things which everyone has experienced to one degree or another. It isn't like a delusional disorder, for instance. Truly delusional thinking (i.e. when we're not using the word hyperbolically) is not something that most of us have experience with. It isn't "normal", and therefore we find it easy to delineate between those who have it and those who don't. Depression, like manic disorders and anxiety disorders represents an excess of something which is otherwise a normal part of human experience.

Andrew Solomon wrote in "The Noonday Demon":
Quote:
[...] Perhaps depression can best be described as emotional pain that forces itself on us against our will, and then breaks free of its externals. Depression is not just a lot of pain; but too much pain can compost itself into depression. Grief is depression in proportion to circumstance; depression is grief out of proportion to circumstance. It is tumbleweed distress that thrives on thin air, growing despite its detachment from the nourishing earth. [...]

[...] It is too much grief at too slight a cause, pain that takes over from the other emotions and crowds them out. [...]

[...] There are two models for depression: the dimensional and the categorical. The dimensional posits that depression sits on a continuum with sadness and represents an extreme version of something everyone has felt and known. The categorical describes depression as an illness totally separate from other emotions, much as a stomach virus is totally different from acid indigestion. Both are true. You go along the gradual path or the sudden trigger of emotion and then you get to a place that is genuinely different. [...] No one has ever been able to define the collapse point that marks major depression, but when you get there, there's not much mistaking it.

Influenza is straightforward: one day you do not have the responsible virus in your system, and another day you do. HIV passes from one person to another in a definable isolated split second. Depression? It's like trying to come up with clinical parameters for hunger, which affects us all several times a day, but which in its extreme version is a tragedy that kills its victims. [...]

[...] There is a basic emotional spectrum from which we cannot and should not escape, and I believe that depression is in that spectrum, located near not only grief but also love. Indeed I believe that all the strong emotions stand together, and that every one of them is contingent on what we commonly think of as its opposite. I have for the moment managed to contain the disablement that depression causes, but the depression itself lives forever in the cipher of my brain. It is part of me. To wage war on depression is to fight against oneself, and it is important to know that in advance of the battles. I believe that depression can be eliminated only by undermining the emotional mechanisms that make us human. Science and philosophy must proceed by half-measures.

"Welcome this pain," Ovid once wrote, "for you will learn from it." It is possible (though for the time being unlikely) that, through chemical manipulation, we might locate, control, and eliminate the brain's circuitry of suffering. I hope we will never do it. To take it away would be to flatten out experience, to impinge on a complexity more valuable than any of its component parts are agonizing. If I could see the world in nine dimensions, I'd pay a high price to do it. I would live forever in the haze of sorrow rather than give up the capacity for pain. But pain is not acute depression; one loves and is loved in great pain, and one is alive in the experience of it. It is the walking-death quality of depression that I have tried to eliminate from my life; it is as artillery against that extinction that this book is written.


Anyone who has experienced major depression will recognize what Solomon is talking about. Everyone experiences symptoms of depression, but not everyone is depressed. Except in some specific circumstances like post-partum onset depression, you cannot pinpoint a precise time that you crossed over that threshold into depression, but you know when you've been there, and you know that it isn't "normal".

Nothing that you experience is, in and of itself "abnormal", but it there comes a point at which these things take on a life apart from yourself that is utterly alien and foreign. It thrives, as he described, on thin air, existing without cause, purpose, or reason and feeding on seemingly nothing.

"Tumbleweed distress" is apt analogy, but so is the image of vine that Solomon uses elsewhere -- a choking, alien thing that keeps on drawing your life out of you even when there seems to be nothing left to give it. You sense these leaves that are not your leaves, moods that are not your moods. And yet from a distance, you cannot see the vine from yourself. The entanglement of depression with personality and identity is perhaps one of its most vexing characteristics. What is normal and what is not? "Normal is a word that haunts depressives."

_________________
Sail forth! steer for the deep waters only!
Reckless, O soul, exploring, I with thee, and thou with me;
For we are bound where mariner has not yet dared to go,
And we will risk the ship, ourselves and all.


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