[Virax]

Depression is very much a malfunction. When I was depressed, I wasn't functioning, and now that I take drugs every day to control it (over-the-counter drugs, btw), I function quite well.

What is true is that being just shy of depression is probably adaptive and beneficial, which is why there are many examples of brilliant people who spent part of their lives depressed. It also explains why genes "for depression" haven't been selected out of the gene pool - it is likely that they are beneficial for the majority of carriers (makes you work harder, you're less satisfied with what you have, etc...) but if you have too many of these genes, then you just hate life and want to kill yourself, at least sometimes.

BTW the Wikipedia article on depression is very good and has links to some relatively accessible journal articles on current thinking about depression.

[tokenadult]

As noted in the previous HN thread

http://news.ycombinator.com/item?id=788259

that submitted this article, Kay Redfield Jamison, author of Touched with Fire: Manic-Depressive Illness and the Artistic Temperament,

http://www.amazon.com/Touched-Fire-Manic-Depressive-Artistic...

and co-author of the definitive text on manic-depressive illness

http://www.amazon.com/Manic-Depressive-Illness-Disorders-Rec...

has thought out loud in her writings over the years about whether treatments for depression that help suffering people may also deprive society of creative output. Her current thinking on the issue--and she takes lithium herself every day--is that the best-evidenced mood-stabilizing treatments for mood disorders are helpful to patients and increase rather than decrease their ability to contribute useful work product to society. Her co-author, Frederick K. Goodwin, M.D., is still deeply skeptical of some antidepressant medications (e.g., the selective serotonin reuptake inhibitors) because of their capacity for inducing mania in many bipolar patients.

[karzeem]

Yeah, it was a little surprising not to see the piece emphasize more the fact that for seriously and/or chronically depressed people, the condition is very much a net loss. Going through a down period of two weeks can ultimately be helpful. But accomplishing nothing and taking pleasure in nothing for months or years is clearly destructive. I don't think the piece meant to suggest otherwise, but it came off seeming as if it did.

[dkarl]

But accomplishing nothing and taking pleasure in nothing for months or years is clearly destructive. I don't think the piece meant to suggest otherwise, but it came off seeming as if it did.

That's because years of raising public awareness of depression as a serious problem has led to people no longer labeling minor episodes "depression." It used to be common for someone to say, "I'm depressed," or "I'm feeling depressed," when they were, umm, down in the dumps. People have stopped saying that now that clinical depression has become the primary meaning of the word. A lot of public awareness work went into making people realize that major clinical depression is very, very different from just feeling sad. It was important for people to realize that. However, it doesn't mean there aren't illuminating connections between major clinical depression and just feeling down in the dumps for a while. Consider the difference between a burning house and a burning candle -- it's important for people to understand the difference, but they're both "fire." If we redefined the word "fire" to only mean life-threatening, out-of-control forms of fire, wouldn't that actually weaken our understanding of fire?

To support my point that the meaning of the word is changing, consider the difference between the dictionary definition: http://dictionary.reference.com/browse/depression

and the way the word is defined at NIMH: http://www.nimh.nih.gov/health/publications/depression/compl...

There are a whole bunch of people jumping into this thread to make the point that using "depression" to refer to anything other than a mental illness is wrong. But that is a recent redefinition of the word justified by the laudable goal of helping people realize how serious depression can be. (Basically, it's PR elevated to PC by its good intentions.) That meaning has obviously served a valuable purpose. The question is, does the traditional definition of depression actually encode a better understanding than this new PR/PC definition? Maybe, as with "fire," it's best to distinguish different forms of depression by qualifiers and special terms rather than pretend they're entirely different and unrelated things.

[spydez]

What OTC drugs are there for depression?

[njharman]

Having good diet is very important and if you don't have that, take vitamin supplements esp selenium and iodine. Don't over take anything. Depression is an imbalance (of mostly brain chemicals).

sam-E, Valarian, GABA, Gotu Kola, Skull Cap.

I'm a firm believer in people are different and need to find their own solution (which may involve going to professional and subscription drugs). It took me several years to find what works for me. St John's Wort did not at all. YMMV

I guess most those are anti-anxiety / mood levelers which works for me but I'm probably MD.

The thing that has broken me out of depression the most is sunshine! Just going out and standing in the sun, eyes closed face towards sun. I also take off my glasses and let reflected sunlight directly into eyes. 2-5min. Preferably around middle of day. Which I'm guessing is some combination of vitamin D and getting my circadian rhythm straitened out.

[netsp]

From: http://altmedicine.about.com/od/healthconditionsatod/a/Depre...

  St. John's Wort
  Omega-3 fatty acids
  Sam e
  Folic Acid
  5-HTP
  Diet (sugar, caffeine, alcohol, vitamin b6, magnesium)
  exercise
  sunlight
  etc.

I suppose you might include psychotherapy, various other non drug therapies, a whole range of activities, socialisation, sex, pets...

Most of those probably wouldn't be considered drugs at all. I think the jist is that you can get good results managing depression with a mix of treatments (that may include drugs), which will vary from person to person. I think it is similar to how HIV or high blood pressure gets treated. You need to find what works by trial and error.

I like the fact that in the above list it is not obvious where the lines are: drug or non drug, medicine, paramedicine, pseudo medicine, alternative medicine or old wives tale. That kind of blurriness also applies to the diagnosis of the condition itself.

[mj001]

St John's wort is one

[mattmaroon]

Beer.

[gojomo]

While a popular home remedy, beer often makes the condition worse.

[delackner]

You may be right, but there's an alternative explanation that would make both your perspective and the article's theory hold. You chose the word "function" to describe how you feel. Functioning means I suppose meeting the expectations (both internally and externally imposed) in the society you are in, in the activities that you engage in, in the roles and relationships (personal and professional) that you are connected to.

If any those connections seemed to be wrong for you, but you were unable to see an alternative, wouldn't depression in the sense of the article be a good way for your body to try to devote lots of energy to finding an alternative?

Maybe a world with such tangled and deep functional requirements implies that in some cases the "solution" that depression tries to help you find, might not always exist. Or might require such a huge allocation of effort that one alternative - ignoring the dissatisfaction - becomes attractive.