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by DanBC 5068 days ago
"clinical" depression is meaningless. Literally, it has no meaning. Perhaps you mean "Diagnosed by a real doctor", as opposed to "self diagnosed from a check list"?

But when we look at depression diagnosed by experts we see a variety of forms, and a variety of strengths.

I agree that well meaning people sometimes offer really bad advice.

But advice about developing a healthy lifestyle (being careful with caffeine, alcohol, recreational drugs; eating better; sorting out sleep; getting exercise) and developing a social life are important, because these thing help people with very serious, life threatening, illness. In combination with therapy they can be part of an effective cure for many people. (At least leaving others with several years of recovery). If needed, this advice can be combined with medication. And, if needed, all of this stuff can be started if the patient is in hospital. (At least in England all MH hospitals should have programmes of OT to start social life outside hospital and they should have some kind of exercise stuff, and contacts with local gyms.)

I've known people who are ill enough to require electro convulsive therapy and they said that this other stuff was important to them, but that they needed help to apply it.

And that's the important thing. Saying "I am to ill to do this stuff" is not the same as saying "this stuff would not be helpful to me if I did it". What people need is help to apply this stuff.

4 comments

Well, to me 'clinical' depression implies diagnosed by a doctor, yes.

Sure, and it does vary a lot. So perhaps I meant to say severe vs. mild.

People overstate these things to a degree. Like I said, sure they help, but it's scratching the surface IMHO. What's more important is to attack the depression itself, directly.

And, though anecdotal, I've been through periods being severely depressed despite going to the gym a lot, and eating relatively well, and had it make very little difference. I've also socialised a lot and had that make no difference. So this isn't just conjecture.

I guess part of it is that it varies from person to person. Also the degree of the depression at any given time waxes and wanes.

And agreed, a key thing is to admit you can't do it all by yourself, and go and get help.

The key thing, however, is for people to lose that attitude of 'go get a life doing things I think are healthy/fun and you'll be happy' because, basically, that's b.s. projection, and for some it borders on blame-the-victim mentality.

I think diseases like depression are particularly problematic because people don't take them seriously and imagine that they're not all that serious, perhaps slightly made up, or not as solid and easy to diagnose and understand as a physical illness. Perhaps people need to come to respect it more.

In most cases CBT & exercise and better food is attacking the depression itself, directly.

> The key thing, however, is for people to lose that attitude of 'go get a life doing things I think are healthy/fun and you'll be happy' because, basically, that's b.s. projection,

Yes, I agree.

Yeah, I guess I'm saying CBT (+ related, I find SBT[1] very effective myself) >>> lifestyle improvements.

[1]:http://en.wikipedia.org/wiki/Schema_therapy

The phrase "clinical depression" distinguishes depression (in the clinical, officially-diagnosed sense) from depression (in the informal, no-more-cookies-angst sense).

If you want to know more about the technical meaning of "depression," consult DSM.

But "clinical" has no meaning. It is not mentioned in DSM or in ICD.
There are hundreds of types of cancer - does the DSM have a general entry called 'cancer'?

'Clinical depression' is a way of specifying something more problematic than simple sadness. When your sports team loses, you get depressed.

No, depression is enough to distinguish from simple sadness, or grief, or other forms of sadness which are not pathological. Depression is already defined as an illness, and not simple sadness. Prefixing nonsense words does nothing to increase understanding of the illness of depression or of the normal forms of sadness that people experience.

Medical professionals do not ever call something clinical depression. They'll use words like reactive or endogenous etc.

The solution to people mis-using the term depression to apply it to things which are not depression is to stop people mis-using that term, not to invent other terms.

> When your sports team loses, you get depressed.

No, you are sad, fed-up, gutted, sick as a parrot, annoyed, frustrated, mournful, etc. You are not depressed, because depression is an illness.

The other problem with "clinical" is that it is widely used by cranks - see for example "clinical nutritionist".

'Depressed mood' is regularly used in both psychology and medicine. "The patient arrived in a depressed state" does not mean that they have one of the ongoing illesses of Depression.

Medical professionals do not ever call something clinical depression.

I used to work in a neurology lab, and I heard consultant neurologists use the term. I do not agree with 'do not ever'. Unless you're counting medical specialists that take 13 years to train as somehow not being 'professionals'.

Just googling 'clinical depression' comes up with a few links of professionals (like the Mayo Clinic) using the term. The important thing to not is that just because a term might not be in the DSM does not mean that the term is not used or meaningless. Yes, I'll agree, it's not used to refer to one specific disorder, but that doesn't make it meaningless.

You are not depressed, because depression is an illness.

Depression is an illness. It is also a transient state. You're doing the same thing as those people who say "but 'kid' actually means 'baby goat'".

The other problem with "clinical" is that it is widely used by cranks

Fallacy of association: Cars are widely used by criminals, therefore we should not use cars. Would you really correct a co-worker who said 'bob is depressed because his team lost last night' with 'no he's not, because depression is an illness'?

Let it go man. The distinction makes sense for a lot of people and you're just being a stickler and a contrarian at this point.
> "clinical" depression is meaningless. Literally, it has no meaning.

That would be incorrect, sir: http://www.mayoclinic.com/health/clinical-depression/AN01057

'clinical depression' has a biological base and responds better to pharmaceutical intervention, and generally covers the diagnosable stuff in the DSM. 'regular' depression is just being sad because of life events - when your wife leaves you and your dog dies, that's when you get 'regular' depression.