[smegel]

I agree with this, but I also think a lot of "non-real depression" is too easily diagnosed as the real thing. A lot of depressed people could be "cured" by just changing circumstances in their life (not that it is always easy, but saying there is stuff in your life you can't change and it is making you depressed, doesn't make it a mental illness).

But you have worn out doctors facing a tough choice: do the near impossible and try and help someone change their life, or take 40 second to prescribe a pill from a billion dollar drug company that is paying for him to go on a conference in the Bahamas next month.

[TeMPOraL]

I disagree about the way this choice is painted. It's never "just changing circumstances" - people who have problems that directly caused by something in their lives will stumble upon the solution by sheer luck.

We should actually be grateful that there are pills that for many people can insta-cure or significantly reduce the symptoms of depression. It means they get a shot at much better life in exchange of having to take some medication everyday. Contrast that not with "just changing circumstances" - contrast that with no other solution at all.

I'm happy every time we can find a pill for solving a problem - because the pill actually works. Social approaches to solving problems is often a tool for politicians to invent new ineffective methods at non-solving things, and for a lot of people to make money out of it. See e.g. various strategies for solving drug addiction.

Also note an interesting post on the topic: http://slatestarcodex.com/2014/09/10/society-is-fixed-biolog....

[smegel]

> I'm happy every time we can find a pill for solving a problem - because the pill actually works

If a woman is depressed because she is stuck in an unhappy marriage with a man she doesn't love...and she then pops a pill and becomes "happy"...I am not sure that meets my definition of "works".

[TeMPOraL]

We have a solution for that already - it's called "divorce". But this is a very bad example overall, because there's insane amount of complexity hiding under the phrase "doesn't love". Love is a very complicated amalgamate of emotions that routinely escapes comprehension of otherwise healthy people. What do you mean she "doesn't love" her husband - did the relationship between them dried out? Did she get bored? Did they marry on emotional high with no stronger bond being formed between them? Maybe the husband is abusive?

To solve that seemingly simple example case one needs to inspect the exact reasons for the problem. And hell, for some of the particular issues there may even be a pill and I'd be totally happy about it.

[smegel]

> We have a solution for that already - it's called "divorce".

And we can't extrapolate that to "just change the things in your life that are making you unhappy", because?

I understand there are some life circumstances that are difficult to change or rectify. And that sometimes medication might help people cope with difficulties in their life. But let's not pretend that is about mental illness - these people are healthy, their symptoms of depression are a healthy response to negative circumstances - and medication in this case is a palliative aid, not a cure to a disease or malfunction.

[TeMPOraL]

> And we can't extrapolate that to "just change the things in your life that are making you unhappy", because?

Oh we can and we do. If you go to the doctor and say, "I'm unhappy because I am doing X", he'll say you should stop doing X. But those clear-cut issues are the type people tend to solve themselves. You don't go to psychiatrist to ask if maybe you need a divorce. You just get a divorce.

Going back to depression - sometimes it's very hard to tell whether something is a healthy response to negative circumstances. The mental pain tends to interfere with your ability to perceive its cause. So it may be a healthy response, or an amplified response, or it may be a good response to wrong signals, or your brain may just be broken. There are special treatments for the last case, but for the former cases getting an entry-level antidepressant is often enough to help you figure out what's going on (with or without guidance of psychologists).

And even in the cases where you have a healthy response to negative circumstances, people who end up taking pills don't take them because they're too lazy to change the circumstances, but because changing circumstances is an impractical option. If it weren't, they'd have already changed them.

[superuser2]

What is suicide if not the ultimate malfunction of a person as a system? Under what twisted definition of health can something which causes death be considered healthy when there is just a sliver less of it?

We might consider emotional pain "working as intended" when it alerts its victim to a problem and motivates them to fix it.

When they cannot identify the problem, or it is beyond their (suppressed by pain) power to fix, then the pain is no longer working as intended but is going to have some other effect, such as long-term suffering and death. At that point the alert system is itself a problem.

If Nagios wakes you up in the middle of the night to tell you a server's disk is nearly full, great, fix that server. If Nagios sends a few hundred billion alerts a second about this fact causing DoS on your entire network, yes you still need to fix that disk usage, but shut Nagios up first.

[noxToken]

> A lot of depressed people could be "cured" by just changing circumstances in their life (not that it is always easy, but saying there is stuff in your life you can't change and it is making you depressed, doesn't make it a mental illness).

I believe what you're largely referring to is Adjustment Disorder. You're stuck in a situation, and but if the situation changes to something more favorable, the depressive mood (with time) goes away. In my experience, a lot of people in the military with a depression diagnosis tends to be Adjustment Disorder. The PT almost always ceases to display depression symptoms once their contract has expired. This is why (I believe) people tend to say, "Just cheer up, man. It's not that bad!" Others will see that changing something (smiling, going to a movie, visiting friends) can cure a case of the blues.

Note that I am not minimizing the effects that the depressive mood can have on person with Adjustment Disorder. I am just highlighting the difference between Major Depressive Disorder (change the situation, relatively same symptoms) and Adjustment Disoder (change the situation, no symptoms).

[superuser2]

>but saying there is stuff in your life you can't change and it is making you depressed, doesn't make it a mental illness

The only practical consequence of whether something is a mental illness or not is whether the person experiencing it will receive help in feeling better. I would characterize your position as cruelty, bordering on straight-up evil.

[jolux]

Incidentally a lot of antidepressants (like the one I'm taking) have generics available that make this kind of thing less likely. I gotta say though, life with antidepressants for me is a life I haven't experienced in a very, very long time, in fact I can't remember when the last time I felt this way was.