[Alex3917]

> "Sadness is when you feel down because things aren’t going your way. Depression is when you feel down even when all is going well."

Sadness is the feeling you get when something bad happens and you are upset about it.

Depression is the feeling you get from brain inflammation, which might feel qualitatively similar to sadness, but which is usually caused by one or more of: chronic stress, lack of exercise, nutritional deficiency, poor sleep habits, lack of sensory stimulation, infection, or twenty other things.

Once you can differentiate between them, depression isn't actually that hard to fix, at least at the early stages. It's like right now if I were to gain five pounds I'd get acid reflux, but I know that, so if that starts happening I just stop eating as much for a couple days and the problem fixes itself. Same deal with mental states.

[yellowapple]

[citation needed] ^

In particular, it looks like you're mixing up cause and effect, and I haven't the slightest idea from where you're getting the "brain inflammation" thing (it sure as hell ain't in the DSM-IV, last I checked (it's been awhile, granted, but still)).

[Alex3917]

> I haven't the slightest idea where you're getting the "brain inflammation" thing from

http://lmgtfy.com/?q=inflammation+depression

[ajkjk]

You shouldn't post this way on this site.

You're claiming matter-of-factly that brain inflammation causes depression. Well, I (we) don't believe you, because that's a far from widely accepted theory. Your condescending google links don't help.

[Alex3917]

> Your condescending google links don't help

Which I posted in response to getting blatantly gaslighted.

I don't care if you disagree with me, but pretending you don't know how to use Google to try to discredit someone is a lame debating technique.

[ajkjk]

You weren't gaslighted. That's not what that word means. And everyone here knows how to use google. The problem here is that you said "Depression is the feeling you get from brain inflammation" instead of "there's a theory that depression is sometimes linked to brain inflammation". The former is far from factual, and it's dead wrong to claim it matter-of-factly.

Totally not surprisingly, when you google brain inflammation and depression, you get lots of references that suggest a possible link and none that justify claiming it as a fact. So, [citation still needed], and it's not because we're bad at using google.

[Alex3917]

> You weren't gaslighted. That's not what that word means.

Gaslighting is a form of personal attack that's designed to make someone doubt the validity of their own senses or personal experience. The reason I took yellowapple's comment as gaslighting is that he was calling into question the existence of a large body of research that shows up with even the most trivial Google search. If you don't buy into the cytokine theory of depression or think that my summary of the theory/research was false or whatever then that's fine. But by implicitly claiming that the research itself doesn't exist and is just something I invented, then at point I take it as a personal attack.

> The former is far from factual, and it's dead wrong to claim it matter-of-factly.

This 2008 paper is already one of the most cited journal articles on depression of all time:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2919277/

"It has been established that pro-inflammatory cytokines induce not only symptoms of sickness, but also true major depressive disorders in physically ill patients with no previous history of mental disorders. Some of the mechanisms that might be responsible for inflammation-mediated sickness and depression have now been elucidated."

"A role for cytokines in depression was first proposed by Smith in the form of the ‘macrophage theory of depression’ and further studied by Maes in the early 1990s. [...] Despite its originality, especially at a time when depression was thought to be associated with decreased rather than increased immunity, this hypothesis failed to attract the interest of the psychiatry community. Because biomarkers of inflammation in clinically depressed patients are not always elevated, the postulate that common pathophysiological mechanisms link depression to inflammation was limited. Other key components that would support this postulate were also missing, such as a demonstration that stimulation of the immune system induces depression-like disorders; identification of a possible common pathophysiological mechanism between the effects of cytokines in the brain and the neurobiological basis of depression; and proof that decreasing the inflammatory response attenuates symptoms of depression. As discussed below, research in this field has now supplied these key components."

"A growing amount of clinical data point to the importance of the relationship between inflammation and depression in physically ill patients and in conditions that are associated with increased activity of the innate immune system, including ageing and obesity. For instance, the prevalence of co-morbid depression in patients with coronary heart disease, a disease in which inflammation is now recognized as a major contributing factor, is three times higher than in the general population."

"A growing amount of clinical data point to the importance of the relationship between inflammation and depression in physically ill patients and in conditions that are associated with increased activity of the innate immune system, including ageing and obesity. For instance, the prevalence of co-morbid depression in patients with coronary heart disease, a disease in which inflammation is now recognized as a major contributing factor, is three times higher than in the general population."

In order to say definitively that inflammation causes depression there is a lot of stuff we'd need to know that we don't currently know. However, in order for it not to be true, there is a lot of stuff that would need to be false that we know is true. That's why I don't think it's inappropriate to claim it matter-of-factly, even though there are still a lot of missing details that need to be filled in.

[yellowapple]

For reference: https://en.wikipedia.org/wiki/Gaslighting

"Gaslighting or gas-lighting is a form of manipulation through persistent denial, misdirection, contradiction, and lying in an attempt to destabilize and delegitimize a target."

There's a clear difference between that and calling out (EDIT for clarification: what I believe to be) incorrect information, and my admittedly-biased opinion is that my previous two comments in response to your own are squarely in the latter camp versus the former. I'd also hardly call one or two comments "persistent", though - again - my viewpoint is obviously biased in my favor.

I'll admit that pulling a [citation needed] was excessively snarky, though. I'm sorry. I ought to know better than to be a jerk, no matter how right I think I am.

----

With that said, "just Google it" (and similar approaches, like linking to a search engine query or some snarky wrapper thereof) is a very poor rhetorical technique in general; as I've already demonstrated, it's not guaranteed to actually prove one's point, and it reeks of either or both of two hidden meanings:

1. "I don't really care enough about the topic to give a meaningful citation, so I'm just going to tell the other party to find citations oneself"

2. "I don't actually have any source for the information I've provided (maybe I did once upon a time, but I sure don't anymore), so I'm going to tell the other party to 'just Google it' and hope that said other party is somehow impressed by the number of search results regardless of the sites in question or what the linked pages actually say"

Thus, it's generally a good idea to avoid those potential hidden meanings and just provide an actual source.

[yellowapple]

From your Google query: http://www.medicalnewstoday.com/news/severe-depression-linke...

"The Duke team concluded that depression, therefore, is more likely to contribute to inflammation in the body as opposed to arising as a consequence of inflammation."

[Alex3917]

The Duke research is interesting.

But saying that because they didn't find a pathway that inflammation is unlikely to cause depression doesn't really make any sense, given that major triggers for depression are surgery, infection, autoimmune diseases, etc.

I don't think anyone is disputing that depression also causes inflammation, but the idea that the causality only goes one way just seems very counter to everything else we know.

[yellowapple]

The point is that there's no clear causation in either direction, and certainly not in even a significant minority of cases (let alone all or even a majority). We just don't know nearly enough about how the brain works to be able to chalk up something as complex as major depressive disorder to "your brain's inflamed; take some Aleve".

In fact, the DSM definition of major depressive disorder/episode (or at least this summary thereof (I unfortunately don't have a copy of any DSM version on hand): http://www.mental-health-today.com/dep/dsm.htm ) explicitly excludes cases where the symptoms are caused by some other physical case:

"Note: Do note include symptoms that are clearly due to a general medical condition, or mood-incongruent delusions or hallucinations."

I would think brain inflammation would count as a "general medical condition" in this context, though whether or not "clearly" is applicable is admittedly very unlikely. Regardless, the DSM seems to maintain a distinction between "depression symptoms caused by some other disorder, whether psychological or physical" v. "only exhibiting symptoms of one or more major depressive episode(s)". In the former case, yeah, totally work on fixing that inflammation with lifestyle changes or whatever. In the latter case, it ain't really that simple.

[Alex3917]

> The point is that there's no clear causation in either direction

C.f. my other comment. I think there is good evidence for causation in both directions.

> In fact, the DSM definition of major depressive disorder/episode

I wouldn't use the DSM definitions of depression due to, among other reasons, the fact that there is very little iter-rater reliability:

http://behaviorismandmentalhealth.com/2013/03/30/dsm-5-inter...

I think the article I linked to in my other comment has it correct, where depression should be considered as something that exists within all people on a spectrum rather than as a mental illness. Now obviously if depression gets to the point where it's causing health problems and interfering with your ability to work and enjoy life then that may be a diagnosable issue, but it's a mistake to think of depression as being something that you either have or don't have in the more general case.