We use the word depression to refer to a wide range of states of mind, from severe "clinical depression" to just feeling a bit miserable. A "depressing movie" is not one which is going to make you clinically depressed if you watch it.But the words "mania" and "psychosis" are not like this. People don't often talk about being manic when they're happy - I've heard people describe themselves as "a bit manic", but the bit makes all of the difference. People do use these words wrongly, e.g. some people seem to use "psychotic" when they mean "psychopathic". But even so, these words are always associated with abnormality and pathology. Depression is talked about as "normal" in a way in which mania and psychosis aren't.
This is misleading. True, depression can be hard to distinguish from sadness, stress, ennui, angst and other emotions. But it is a mistake to think that clinical depression is nothing more than a kind of inappropriate or excessive sadness. Being manic is not just being very happy, even if feeling very happy is one of the aspects of mania in some people (but not in all). Depression is not just feeling very sad. In fact, depression can be much more like mania and psychosis than most people tend to think.
In my experience of depression, it's little like sadness. Most people that I've spoken to who have suffered from depression agree; the distinctive thing about depression in most cases seems to be a feeling of lack, or a lack of feeling, in which things lose their value and worth. Textbooks call this anhedonia, a lack of pleasure, which is as good a description as any. Whereas, if you're sad about something, at least you value it.
It's interesting to imagine what things would be like if depression were today a word like mania, as it was 50 years ago.
10 comments:
Very good point. As a long-time sufferer of clinical depression, it gets really old when people try to "cheer you up" when the depression hits. You hit the nail on the head with the lack of feeling. Not giving a shit when, intellectually, you really want to, is a hard concept to explain to people who haven't experienced it.
Point well taken. I think the term "depression" is so misleading. Everyone has felt 'depressed' about something in his or her life. Therefore people often think that they can relate to a diagnosis of depression... "Why can't you just snap out of it? that's what I did".
I've heard that people who work in stroke prevention are trying to rename strokes to "brain attacks", something akin to "heart attacks" that make it seem much more urgent.
I am all for renaming depression. I think that's the draw for wanting a 'scientific' biological explanation. It sounds much more credible in our post-positivist world to say "I suffer from a serotonin deficiency". This implies a 'real' disease, not 'just' a mood.
I'm just starting a new blog on depression. I'm going to spend some time thinking about a better name. One that gives credibility to the sufferer without appealing to faulty science for an explanation.
I'm really enjoying your blog- lots of interesting and challenging thoughts here.
Nice blog post, I just want to pick up on what Penelope has written though. Changing "depression" to serotonin deficiency is reductive and unhelpful as it minimises a complex and potentially fatal disorder. By describing something as a deficiency you suggest that replacement is a cure, and gm depression it is rather more complicated than that. The simple monoamine hypothesis looks more and more flawed as time goes on.
I think what we need is a word which isn't just a description of the mood state. People see "bipolar disorder" as being more of a 'disease' than "depression". Because depression is just a word for something you feel, whereas bipolar disorder is a "thing".
I've always liked the term "melancholia" myself, although it's currently used to mean a specific type of depression.
True true. My manias aren't usually happy. Hyper, yes. Happy, no. More a sense of world conquering and such. Thank you for posting this.
Soveda- just to be clear, I am not advocating that depression be called 'serotonin deficiency'. Perhaps I didn't explain myself well. What I meant to say is that using a biochemical explanation would take the weight of judgement off of the person and more is going on than just a bad day.
I actually think that the serotonin theory has a lot of holes in it...thus my comment about "faulty science".
I agree that its very reductionistic to imply that there is a simple solution. But "depression" doesn't really seem to express the fact that it is much more than a mood that you can snap out of. Nor does it adequately express the urgency and life threatening potential of the illness.
I don't have a solution to offer yet, but I think Neuroskeptic has better articulated my thought - that the term needs to be more than a mood state.
I have jokingly described it on my blog as "necrotizing affectitis"; which, whilst being tongue in cheek, seems to convey a sense of urgency and desperation that "depression" lacks.
Hello NS,
Can you weigh in on the latest vodoo correlations controversy?
See here
Thanks.
Yeah - I've been biding my time but I'm working on it...
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