Just occurred to me that it disempowers those would support the person if they also think "nothing can help, it's an endogenous disease". They get 'recruited' don't they, into the bigger project as well.
In the same way that the medical industrial complex exhorts us to affirm people who feel they are a different sex from their biology... and thus serve them up to the medical industrial complex for 'saving'.
"Don't let your compassion be weaponised" you wrote somewhere in the context of the "transgender debacle". Applies to depression too!
Yes, it's all one sticky ball of goo, isn't it? If it's not all specifically designed to disempower people and make them hapless pawns, then it's the most astonishing coincidence of emergent phenomena ever.
I love love LOVE this article SO SO much! Totally resonates with me and my experiences and those I've observed in others.
So many great quotes and statements in this article that really nail it. In particular I like: "This is likely at least in part because attributing the symptoms to an illness external to one’s life reinforces the beliefs that the problem is immutable and that the individual has little or no control over their suffering".
It's completely disempowering and makes you reliant on the medical-industrial complex - there's nothing you can do but take our treatments for the rest of your life - which curiously, don't actually work and/or make things worse!, funny that! But it's not the treatment, it's "the disease" and hence you have to keep taking the treatment..... !?!?!!?!
Fits perfectly with so much else in the world right now.... the whole CRT which denies everyone any agency or individuality (you are defined only by whatever "group" you fit in according to your sex, skin colour etc etc - nothing else matters). Nope, there's nothing you can do to not get COVID or any other illness or disease - except trust us and do exactly what we say!
Really, it all boils down to disempowerment and control doesn't it? Disavow yourself of any agency and hand over everything to the experts. Don't try to think for yourself, it's all far too complex for you to possibly understand, just trust the experts.
'Trust the experts' has always made me bridle. I'll trust my own judgment, after I've sufficiently informed myself by consulting a wide range of sources on the subject, thanks all the same!
The timing of this piece is excellent and your work impeccable! I appreciated that later in the article you took the time to detail that depression can also be caused by lifestyle and diet. But I would also like to add sleep disturbances. Often the chicken and the egg with depression and sleep is that depression causes sleep disturbances. This likely is true in some cases. But, with any case of depression not easily associated with a depressive life event, I feel that sleep disordered breathing should be ruled out through the treatment phase.
When the body struggles to get oxygen during sleeping hours, healing and recovery are delayed. The sympathetic nervous system stays on high alert and feelings of exhaustion lead to a depressed state.
I had a patient this week with relentless depression of several years. She was calling me with a dental question related to some magnetic brain stimulation she was trying for her depression. When we met in person to discuss I asked if any of her providers had ever talked to her about her diet as a contributing factor, no one had ever related the two (she’s comfortably overweight).
Then I asked about her sleep. She reminded me that I had suspected sleep apnea and had recommended a sleep study. About two years ago she took our home sleep test but failed to put it on for the night because something came up. She’s been putting off trying again because of her depression (which she never told me about until this week).
Her husband was the chief neurologist at the major medical center where I practice. He has never seemed concerned with her snoring. As she admitted to me, likely because he snores louder and does not want to treat.
As always, thank you for all you do to help us stay informed!
Thank you so much for raising the issue of sleep issues in relation to depression. I've edited the article to call attention to inadequate quantity and/or quality of sleep as a contributing factor to chronic depression.
And what an astounding case study! It will be interesting to see what shows up in your patient's sleep study.
This brought back memories from decades past. From what I subsequently deduced was just overtraining, I became lethargic, weak, unable to do my normal workouts, lift the weights I could easily lift before. But, not knowing what was the cause and being bummed out by not being able to do what was normal, fool that I am, I eventually decided to see the doctor. Of course not being able to find anything wrong with me physically, he deduced it was in my head and sent me to a shrink. Again, fool that I am, I went. She diagnosed me with depression and prescribed an SSRI. Trying to explain that I was depressed because of not being able to do my workouts, got me nowhere as she explained, no you can’t do your workouts because you’re depressed. Circular reasoning makes my head spin. Fortunately, I never took the meds and eventually got back to normal.
Wasn’t it this past year that the psychiatric community announced that serotonin had nothing to do with depression and those SSRIs were making things worse?
This is a perfect illustration of the phenomenon of failure feedback! Your inability to lift weights as you usually did, resulted in you feeling miserable. Good on you for declining to take an SSRI despite the psychiatrist's urging.
"A recent preregistered randomized controlled study showed that framing depression as an adaptive response to life events led to less self-stigma among patients, stronger beliefs in their own agency over their symptoms, and more adaptive beliefs about the symptoms relative to framing it as a medical disorder [54]. This is likely at least in part because attributing the symptoms to an illness external to one’s life reinforces the beliefs that the problem is immutable and that the individual has little or no control over their suffering [59-60]—beliefs that can easily become self-fulfilling prophecies—but perhaps also (in part) because framing the problem as an adaptive response does not impede attempts by the individual to understand the singular sources of their suffering."
Sorry for such a long quote, but this is the best approach to depression I've read. Thank you. I felt it needed to be restated for my own sake and hopefully others.
I have read depression is rage turned inward. I've thought about this since I've suffered from depression off and on my entire life and have motivation to study it. It seems this "rage turned inward" also points to self-destructive tendencies as rage is destructive in any form of expression.
I was raised with my three siblings in a very abusive home. Two of my siblings are filled with rage but turn it outward destructively on the world and others around themselves. Neither suffers from depression though both suffer the consequences of the destructive expressions of their respective rages. One becoming an abuser of children and the other a thief and more generalized criminal.
Myself and my remaining sibling have turned our rage inward and have both experienced lifelong depression. We have both been self-destructive rather than "other" destructive. Neither of us have taken the medicated route and instead try to work through it. Though this is a lifelong project for us both. We both feel this is a better path than the paths of the other two siblings who are destructive to others. The cost of lost human potential is evident in all our cases. That's one of the primary costs of abuse. Especially of children.
So... what I'm saying is - I think from my own experiences depression is an adaptive response to very real injuries. Injuries that are a matter of degree, yes, but harm nonetheless. How can the mind be blamed for using depression as a tool in dealing with this harm and why should it ever be medicated to prevent the adaptive, though dysfunctional, coping mechanism? Doping the symptoms will not help in the slightest and I think this is why so many who are taking medications like SSRIs, etc., "go off the deep end" and commit violent acts as their rage becomes unchecked by disabling the adaptive strategy of depression.
Thank you, Robyn, for your in depth, sincere and honest articles. Much appreciated. God Bless.
Medicating the emotional response of people to abuse, trauma and other causes of suffering is in itself abusive.
I am so glad this article landed for you. I know your life has been unbelievably challenging and yet you keep rising to that challenge, over and over. You are very inspirational.
Depression was definitely adaptive in my case - as a child in a somewhat abusive home. It made me "small" - quiet, passive, less of a target. It would have been a disaster for me to direct my response to abuse to my parents - and so those feelings went the only other place they could go at the time - inwards.
Sorry to hear of your abusive upbringing. Glad to hear you are finding you way through it, as incredibly difficult as it might be. I know little about you, but agree with Robyn that you are inspirational - your reflections, wisdom and insight, and sharing them so generously.
I know exactly what you mean when you describe how depression protected you as a child. I'm sorry any of us have to endure any of this, but we do.
I have started a substack about my life and how I'm finding my way out of the wilderness. No pressure, but if you want to check it out. It's not for the faint of heart, though. So...
Have I mentioned how much I LOVE my readers?????? You are such wonderful people. And I'm grateful to Substack for providing a forum where people can find each other.
Amen. I figured out a long time ago that a daily walk does far more good than alcohol or drugs. Productive work is even better. A task that yields a visible and tangible accomplishment, preferably within one day, is the best medicine of all. Most depression comes from prolonged powerless frustration.
1000%! The pathway out of depression is constructive activity that rebuilds one's sense of competence and agency. Exercise fits the bill nicely - no one ever comes back from a walk regretting it!
A brilliant article Robyn, concise, well-researched and hits so many excellent points. I've never suffered a lasting or debilitating depression, but have endured them in close relatives. They are convinced their depression is all about imbalances in brain chemistry (as professionally diagnosed by their shrinks) and that I am soo fortunate not to have those same imbalances. They love their meds, uppers in the morning, then downers to sleep at night.
"failure feedback" - I heard Doug Lisle talk about this and it helped me so much. Caused a big shift in my thinking, in a 'rut' of sorts I'd been stuck in for decades. Instead of trying in vain to try to reach a certain goal (and some 'imposed' by others), and getting depressed about my failure, somehow it flicked a switch. Nope. I'm not good enough for that / haven't got what it takes, move on. And that was it! Still can't quite believe it. It was very freeing.
I remember having a huge 'aha' moment when I first heard Doug Lisle use this phrase. I was so struck by it, I started digging into the evopsych literature and found that there are many variations on this theme - trust evolutionary psychologists to be curious about the possibility of depression being an adaptation!
I agree that the notion of depression as the spur for a recalibration process is absolutely liberating. How many people chase impossible dreams for most of their lives - trying to be the best tennis player, rock singer, novelist, barrister or whatever the hell, only to realise that they've sacrificed their lives to this bloody dream and now they're 55, broke, single and washed up?
I agree for the most part, and I would add that anxiety disorders are similarly diagnoses based on circular reasoning.
I think that certain environmental toxins can cause the physical symptoms of depression and anxiety, but maladaptive responses to those symptoms myelinate neural pathways that lead to chronic symptoms. The initial symptoms which were caused by a physical insult to the body give way to patterns of behavior that reinforce the idea of a "medical condition".
I think you're right about anxiety disorders. People don't "have anxiety", they experience anxious reactions to challenge, which become self-reinforcing.
I would put environmental toxins in the same bucket as diet & lifestyle factors that can turn an acute bout of depression into a chronic condition.
Just occurred to me that it disempowers those would support the person if they also think "nothing can help, it's an endogenous disease". They get 'recruited' don't they, into the bigger project as well.
In the same way that the medical industrial complex exhorts us to affirm people who feel they are a different sex from their biology... and thus serve them up to the medical industrial complex for 'saving'.
"Don't let your compassion be weaponised" you wrote somewhere in the context of the "transgender debacle". Applies to depression too!
Yes, it's all one sticky ball of goo, isn't it? If it's not all specifically designed to disempower people and make them hapless pawns, then it's the most astonishing coincidence of emergent phenomena ever.
I love love LOVE this article SO SO much! Totally resonates with me and my experiences and those I've observed in others.
So many great quotes and statements in this article that really nail it. In particular I like: "This is likely at least in part because attributing the symptoms to an illness external to one’s life reinforces the beliefs that the problem is immutable and that the individual has little or no control over their suffering".
It's completely disempowering and makes you reliant on the medical-industrial complex - there's nothing you can do but take our treatments for the rest of your life - which curiously, don't actually work and/or make things worse!, funny that! But it's not the treatment, it's "the disease" and hence you have to keep taking the treatment..... !?!?!!?!
Fits perfectly with so much else in the world right now.... the whole CRT which denies everyone any agency or individuality (you are defined only by whatever "group" you fit in according to your sex, skin colour etc etc - nothing else matters). Nope, there's nothing you can do to not get COVID or any other illness or disease - except trust us and do exactly what we say!
Really, it all boils down to disempowerment and control doesn't it? Disavow yourself of any agency and hand over everything to the experts. Don't try to think for yourself, it's all far too complex for you to possibly understand, just trust the experts.
'Trust the experts' has always made me bridle. I'll trust my own judgment, after I've sufficiently informed myself by consulting a wide range of sources on the subject, thanks all the same!
The timing of this piece is excellent and your work impeccable! I appreciated that later in the article you took the time to detail that depression can also be caused by lifestyle and diet. But I would also like to add sleep disturbances. Often the chicken and the egg with depression and sleep is that depression causes sleep disturbances. This likely is true in some cases. But, with any case of depression not easily associated with a depressive life event, I feel that sleep disordered breathing should be ruled out through the treatment phase.
When the body struggles to get oxygen during sleeping hours, healing and recovery are delayed. The sympathetic nervous system stays on high alert and feelings of exhaustion lead to a depressed state.
I had a patient this week with relentless depression of several years. She was calling me with a dental question related to some magnetic brain stimulation she was trying for her depression. When we met in person to discuss I asked if any of her providers had ever talked to her about her diet as a contributing factor, no one had ever related the two (she’s comfortably overweight).
Then I asked about her sleep. She reminded me that I had suspected sleep apnea and had recommended a sleep study. About two years ago she took our home sleep test but failed to put it on for the night because something came up. She’s been putting off trying again because of her depression (which she never told me about until this week).
Her husband was the chief neurologist at the major medical center where I practice. He has never seemed concerned with her snoring. As she admitted to me, likely because he snores louder and does not want to treat.
As always, thank you for all you do to help us stay informed!
Thank you so much for raising the issue of sleep issues in relation to depression. I've edited the article to call attention to inadequate quantity and/or quality of sleep as a contributing factor to chronic depression.
And what an astounding case study! It will be interesting to see what shows up in your patient's sleep study.
This brought back memories from decades past. From what I subsequently deduced was just overtraining, I became lethargic, weak, unable to do my normal workouts, lift the weights I could easily lift before. But, not knowing what was the cause and being bummed out by not being able to do what was normal, fool that I am, I eventually decided to see the doctor. Of course not being able to find anything wrong with me physically, he deduced it was in my head and sent me to a shrink. Again, fool that I am, I went. She diagnosed me with depression and prescribed an SSRI. Trying to explain that I was depressed because of not being able to do my workouts, got me nowhere as she explained, no you can’t do your workouts because you’re depressed. Circular reasoning makes my head spin. Fortunately, I never took the meds and eventually got back to normal.
Wasn’t it this past year that the psychiatric community announced that serotonin had nothing to do with depression and those SSRIs were making things worse?
This is a perfect illustration of the phenomenon of failure feedback! Your inability to lift weights as you usually did, resulted in you feeling miserable. Good on you for declining to take an SSRI despite the psychiatrist's urging.
It was mid-2022 when the systematic umbrella review was published that thoroughly dismantled the serotonin theory of depression: https://robynchuter.substack.com/p/has-psychiatry-finally-reached-its
"A recent preregistered randomized controlled study showed that framing depression as an adaptive response to life events led to less self-stigma among patients, stronger beliefs in their own agency over their symptoms, and more adaptive beliefs about the symptoms relative to framing it as a medical disorder [54]. This is likely at least in part because attributing the symptoms to an illness external to one’s life reinforces the beliefs that the problem is immutable and that the individual has little or no control over their suffering [59-60]—beliefs that can easily become self-fulfilling prophecies—but perhaps also (in part) because framing the problem as an adaptive response does not impede attempts by the individual to understand the singular sources of their suffering."
Sorry for such a long quote, but this is the best approach to depression I've read. Thank you. I felt it needed to be restated for my own sake and hopefully others.
I have read depression is rage turned inward. I've thought about this since I've suffered from depression off and on my entire life and have motivation to study it. It seems this "rage turned inward" also points to self-destructive tendencies as rage is destructive in any form of expression.
I was raised with my three siblings in a very abusive home. Two of my siblings are filled with rage but turn it outward destructively on the world and others around themselves. Neither suffers from depression though both suffer the consequences of the destructive expressions of their respective rages. One becoming an abuser of children and the other a thief and more generalized criminal.
Myself and my remaining sibling have turned our rage inward and have both experienced lifelong depression. We have both been self-destructive rather than "other" destructive. Neither of us have taken the medicated route and instead try to work through it. Though this is a lifelong project for us both. We both feel this is a better path than the paths of the other two siblings who are destructive to others. The cost of lost human potential is evident in all our cases. That's one of the primary costs of abuse. Especially of children.
So... what I'm saying is - I think from my own experiences depression is an adaptive response to very real injuries. Injuries that are a matter of degree, yes, but harm nonetheless. How can the mind be blamed for using depression as a tool in dealing with this harm and why should it ever be medicated to prevent the adaptive, though dysfunctional, coping mechanism? Doping the symptoms will not help in the slightest and I think this is why so many who are taking medications like SSRIs, etc., "go off the deep end" and commit violent acts as their rage becomes unchecked by disabling the adaptive strategy of depression.
Thank you, Robyn, for your in depth, sincere and honest articles. Much appreciated. God Bless.
Medicating the emotional response of people to abuse, trauma and other causes of suffering is in itself abusive.
I am so glad this article landed for you. I know your life has been unbelievably challenging and yet you keep rising to that challenge, over and over. You are very inspirational.
As are you - inspirational. Thank you.
Depression was definitely adaptive in my case - as a child in a somewhat abusive home. It made me "small" - quiet, passive, less of a target. It would have been a disaster for me to direct my response to abuse to my parents - and so those feelings went the only other place they could go at the time - inwards.
Sorry to hear of your abusive upbringing. Glad to hear you are finding you way through it, as incredibly difficult as it might be. I know little about you, but agree with Robyn that you are inspirational - your reflections, wisdom and insight, and sharing them so generously.
What a sweetheart you are! Thank you.
I know exactly what you mean when you describe how depression protected you as a child. I'm sorry any of us have to endure any of this, but we do.
I have started a substack about my life and how I'm finding my way out of the wilderness. No pressure, but if you want to check it out. It's not for the faint of heart, though. So...
But thank you again. Much appreciated.
Have I mentioned how much I LOVE my readers?????? You are such wonderful people. And I'm grateful to Substack for providing a forum where people can find each other.
I'll take a look!
Amen. I figured out a long time ago that a daily walk does far more good than alcohol or drugs. Productive work is even better. A task that yields a visible and tangible accomplishment, preferably within one day, is the best medicine of all. Most depression comes from prolonged powerless frustration.
1000%! The pathway out of depression is constructive activity that rebuilds one's sense of competence and agency. Exercise fits the bill nicely - no one ever comes back from a walk regretting it!
A brilliant article Robyn, concise, well-researched and hits so many excellent points. I've never suffered a lasting or debilitating depression, but have endured them in close relatives. They are convinced their depression is all about imbalances in brain chemistry (as professionally diagnosed by their shrinks) and that I am soo fortunate not to have those same imbalances. They love their meds, uppers in the morning, then downers to sleep at night.
Aren't you lucky to not have any chemical imbalances?!?!?!? I struggle to understand how people are attracted to disempowering narratives.
I reckon many are in it for the drugs, what do you think?
Sad, if true.
Agree.
"failure feedback" - I heard Doug Lisle talk about this and it helped me so much. Caused a big shift in my thinking, in a 'rut' of sorts I'd been stuck in for decades. Instead of trying in vain to try to reach a certain goal (and some 'imposed' by others), and getting depressed about my failure, somehow it flicked a switch. Nope. I'm not good enough for that / haven't got what it takes, move on. And that was it! Still can't quite believe it. It was very freeing.
I remember having a huge 'aha' moment when I first heard Doug Lisle use this phrase. I was so struck by it, I started digging into the evopsych literature and found that there are many variations on this theme - trust evolutionary psychologists to be curious about the possibility of depression being an adaptation!
I agree that the notion of depression as the spur for a recalibration process is absolutely liberating. How many people chase impossible dreams for most of their lives - trying to be the best tennis player, rock singer, novelist, barrister or whatever the hell, only to realise that they've sacrificed their lives to this bloody dream and now they're 55, broke, single and washed up?
I agree for the most part, and I would add that anxiety disorders are similarly diagnoses based on circular reasoning.
I think that certain environmental toxins can cause the physical symptoms of depression and anxiety, but maladaptive responses to those symptoms myelinate neural pathways that lead to chronic symptoms. The initial symptoms which were caused by a physical insult to the body give way to patterns of behavior that reinforce the idea of a "medical condition".
I think you're right about anxiety disorders. People don't "have anxiety", they experience anxious reactions to challenge, which become self-reinforcing.
I would put environmental toxins in the same bucket as diet & lifestyle factors that can turn an acute bout of depression into a chronic condition.