A memetic auto-immune disorder?

[nancylebov]

What's so weird to me about depressive self-hatred is that here you have a person who doesn't have energy to do useful and/or pleasant things [1], but there's both a lot of energy going into thinking about how awful they are and a lack of the "ouch that hurts don't do it!" reflex.

About the ouch! reflex: It took a lot of therapy to get to the point where I can fairly reliably realize that there's a me getting hurt instead of just identifying with the attacking voice.

As for guilt and depression, does anyone have information about how depression plays out in non-Christian cultures?

One other angle on culture: I think there's pressure in America to be busy, happy, and social all the time. This could add to depression, both by defining people who are don't fit the ideal as depressed, and by setting up people who are a little depressed to think they're deeply defective, which knocks them down farther.

I have a notion that people have a "that action sounds good or bad to me" slider in their minds. It's probably physiological. If the slider is stuck on the sounds bad side, you get the inert sort of depression. If it's stuck on the sounds good side, you get hypomania or mania.

Heading off into tentative hypothesis land, there might be two sliders, one for action, and the other for thought. If just the thought part is activated on the sounds bad side, then a lot in your head automatically seems bad to you, though you might be able to take reliable action. If the sounds good is too active, then you might get racing thoughts, hyperfocus, or obsessive-compulsive disorder.

Anyway, it's conceivable to me that depression is an overamplification of the necessary ability to choose not to do things.

[1] There are other sorts of depression. Some people have a strong sense of duty and do the useful stuff, but are miserable and possibly suicidal (see Good Mood by Julian Simon), some people can do the low effort pleasant things but not the useful things, and I think obsessing about how awful other people are rather than how awful you are is something like the depressive pattern, but probably less self-destructive, especially in the short run.

Comments

[whswhs.livejournal.com]

My observation has made me think that guilt, specifically, has a kind of payoff: You do something you think you ought not to do, you feel guilty, you beat yourself up over it, and then you feel some combination of (a) I've made myself suffer and that pays for the self-indulgence and (b) I resent the suffering I put myself through and a deserve another indulgence in compensation. That is, guilt seems sometimes to be more a way of maintaining the guilt-inducing behavior than of stopping it. I'm not sure I've seen anyone who was made a better person by feeling guilty; it's just an emotional state without a lot of behavioral consequences.

I'm not sure if this is directly relevant to what you're writing about, though.

[nellorat.livejournal.com]

I read the "payoff" Idea and thought "yes, yes," and then I completely disagree with the rest! Well, actually, I do know some kinds of self-abnegation that do work that way, but I'm not even sure they're what I would define as guilt.

What I define as guilt has definitely made me a better person: there is a certain amount of just beating myself up, especially at first, but that leads to "I've done this horrible thing; how can I fix it now or at least not do it again in the future?" and finally that leads to a kind of acceptance, but still knowing I did wrong, and resolve for the future. If I never felt guilty, I don't think I would self-examine and resolve in the same ways.

I recently accidentally killed a beloved pet rat, so I've been thinking about this & observing that process up close and in detail.

[noveldevice.livejournal.com]

I think that depends on the person.

I don't get any kind of payoff from feeling guilty; it just makes me feel lousy. But I don't bother feeling guilt or shame about anything minor or fixable, because they're minor, and fixable. It would be pointless to feel guilty about them. Maybe you're talking about non-minor stuff, but--wow has that not been my experience.

[freyas-fire.livejournal.com]

I started thinking a long time ago that fibromyalgia came about as a physical manifestation of our body's need to slow the f*ck down. I was diagnosed shortly after dealing with a few years of constant moving, two divorces nearly back to back, a move from NJ to central PA, then back to SE PA within a period of eight months, financial problems, and a psychotic roommate. My fibro is at its worst when I am at breaking point with stress. So, there was a definite need to learn to slow down, to not always be busy, to learn how to say no when my hands were already full with other stuff. A lot of my depression stems from still being in the learning process; of feeling guilty for staying in bed and doing nothing, of not feeling like I'm doing enough, and having to have other people do things for me if the fibro has me incapacitated to the point of being bedridden. I'm getting to the point of coming to terms with it, but I still backslide once in a while.

[noveldevice.livejournal.com]

That can't be universally true, or every grad student would have fibromyalgia.

[freyas-fire.livejournal.com]

Maybe not, I guess it depends on individual's capacity for stress. Fibro is usually brought about by a viral infection or a major trauma, like a car accident. In the midst of all the other crap I had going on, I had a severe allergic reaction to a sulfa-based antibiotic that put me in the hospital for a week with a 106.1 fever and hives from head to toe. The regular doctors I've gone claim there's no correlation, but I was never quite "right" after recuperating from that.
It's just an observation that I've noticed after being on a few fibro support groups and talking with friends that also have it. The depression that goes hand in hand with fibro tends to be about the same issues - guilt over not being able to do as much as they used to, and having to actually ask for help for sometimes the simplest of tasks.

[nancylebov.livejournal.com]

It may be useful to pin down that "not quite right" feeling as closely as possible.

[freyas-fire.livejournal.com]

They did, eventually. When I was going to the Fibro & Fatigue Center in King of Prussia, they did a blood screen that involved taking about 23 vials of blood to test for damn near everything under the sun. What they eventually came up with was a positive result for both the Epstein-Barr virus, and Mycoplasm Pneumonie, which they claim is the "non-spotted" version of Rocky Mountain Spotted Fever, which is a bacterial infection caused by ticks, but after looking up both in Wikipedia, it doesn't look like the two correlate at all. I stayed with them for about a year, and saw improvement, as long as I kept up with their treatments, which were expensive and not covered by insurance. When the money ran out, their desire to help me ran out, too. They put me on a high dose of Valtrex for two months straight to treat the EBV.
Right now, I keep the fibro mostly in check by watching what I eat, not overexerting myself, and dropping quite a bit of weight, which has helped with the pain and ambulatory issues. Only meds I take are Ultram for pain, and low dose xanax for anxiety (not really related to the fibro, but does help with the insomnia).

[thette.livejournal.com]

I'm glad it helped, but I'm very sceptical about their claims. Almost all adults will get a positive IgG for EBV. If it's an IgM reaction (current first time infection), you'll get mono, which can have fibro-like symptoms. Mycoplasma pneumoniae is a respiratory bacteria that sometimes give prolonged cough (and antibiotics have no net effect on the duration of symptoms) and sometimes pneumonia, often not very severe. Since it's a common bacteria in the general population, it would not be uncommon to find in a patient who presents with other symptoms.

The bad side of testing everything is that you usually find one or two positives, but it's very hard to determine whether the positives are relevant to the clinical picture.

[freyas-fire.livejournal.com]

I became very skeptical about what they were doing as well....in retrospect, it seems like too little temporary relief for far too much money out of pocket. When people ask me about it, I tell them to not bother going there unless they have a lot of money to burn. I've done better controlling symptoms on my own.

[nellorat.livejournal.com]

There are different capacities for stress (both mental and physical); also different ways of demonstrating stress. For instance, I don't know if stress had anything to do with becoming diabetic (though overeating to calm stress probably did), but now that I am diabetic, stress definitely sends my blood sugar high.

Condolences on the fibro. My sister's lupus started after an odd virus that was never diagnosed.

[firecat]

The "self-hatred" symptom and the "no energy to do useful/pleasant things" symptom are sometimes but not always related. I've experienced each without the other at times.

There is an "ouch that hurts don't do it" reflex in some forms of depression. It can lead to suicide.

I think there's pressure in America to be busy, happy, and social all the time.

Yes, and it does add to depression. Martin Seligman's recent book Authentic Happiness has a poignant anecdote about this. Kramer's Listening to Prozac also discussed it at length.

depression is an overamplification of the necessary ability to choose not to do things.

I don't think that's the whole story but I do think it's part of the story. Recently there's been talk about a link between depression and the immune system:
http://www.biopsychiatry.com/immunesystem/index.html

[nancylebov.livejournal.com]

There is an "ouch that hurts don't do it" reflex in some forms of depression. It can lead to suicide.

What's the connection?

Thanks for the link about the immune system and depression.

[firecat]

What's the connection?

If you're dead it won't hurt any more.

[xiphias.livejournal.com]

The thing that hurts is living. Don't do it.

[andrewducker]

Depression, in my experience, comes about when people are stuck in a situation that makes them frustrated. When the frustration cannot be turned outwards it turns inwards instead, and they end up feeling miserable about everything. Given the chance, and support, to turn their emotions outwards again, and gain a feeling of self-efficacy and ability, people deal with their situations and get better.

Taking time off usually helps an awful lot - and you're right, not being able to take time out, or feeling trapped by social convention into having to be busy, happy and social all at once can definitely lead to more depression.

All IMHO of course.

[green-knight.livejournal.com]

I'm not saying you're wrong - your experience comes from somewhere and I don't want to devalidate it - but there are a lot of causes and a lot of triggers for depression, and your description does not resonate with me at all.

[andrewducker]

I'd be very interested in hearing your experiences, if you were interested in sharing them. I'd entirely understand, of course, if you didn't feel like sharing that kind of thing with a random stranger on the internet.

[xiphias.livejournal.com]

You're mistaking "depression", as a result of a situation, for "Depression", a clinical pathological disease.

This is something I've said dozens of times, and probably should just write up so I can link to it:

The term "depression" means dozens of different, only tangentally-related things. Some of them are normal responses to situations. Some are pathologies.

They all have different causes, different pathologies, different effective treatments, and even different symptoms. But they all have some sort of apparent external similarity.

"Depression" isn't a disease, it's a category of diseases, like "cancer". You can say that "cancer is caused by smoking." That's true, but it doesn't explain cancers caused by radiation exposure. Or viral infections. Or genetic factors. All of those have different pathologies, and many will respond to different treatments. There are similarities, and some things are worth trying for most cancers, but they're different diseases.

Similarly, some "depression" is just normal variation, and a normal response to stress. But what you're talking about doesn't even rise to the level of NORMAL response depression. Normal response depression is when you suffer a grievous loss, such as the death of a spouse or child, or the loss of one's home, and your emotional core shuts down, sort of like a circuit breaker, giving a chance for some sort of "emotional callus" to build up around the experience before your emotions come back online and you start feeling again.

However, clinical, pathological depression DOESN'T have that sort of cause. It may have many different causes -- some depressions are caused by low metabolism and respond to increasing one's thyroid medication. Some respond to exercise. Some are caused by not making neurotransmitter precursors, and taking vitamin B-12 supplements will help. Some are caused by failing to make seratonin, or by breaking down seratonin too fast, and will respond to either adding seratonin, or to slowing down the breakdown process.

Mine is caused by I-don't-know-exactly-what, but it responds to anti-seizure medication.

Many of those will look similar from the outside, and, in fact, several of them will feel similar from the inside. But they have different causes, pathologies, and respond to different treatments. An anti-seizure medication will do NOTHING for other forms of depression; increasing my seratonin levels will have only limited and temporary effects for me. Vitamin B-12 absolutely cures some people I know, and has zero effect on me. Exercise helps me to a very limited extent, but certainly not enough to make a difference on its own, although, in my case, it helps "round out the corners" when the majority of the depression is treated with medication. And normal situational-response depression will go away on its own.

It's damaging and dangerous (not to mention infuriating to us depression survivors) to lump all those together. It's frustrating when just normal people on the street do this; infuriating when people write articles in magazines doing this (because it increases the chances that more people will do it to us), and downright dangerous when doctors do.

[nancylebov.livejournal.com]

One more point about the specificity of depression-- one of my friends was being treated for depression, and it wasn't working very well, for a definition of not working very well which meant she'd occasionally need to check herself into an institution because she was so suicidal. It turns out that she's got bipolar 2, a sort of bipolar where the manic phase is very small, and the drugs for that work for her.

[xiphias.livejournal.com]

Yup, that's what I have.

It was only a few years ago that they realized that you can be bipolar without any sort of "bi" in your polarity at all. For us, anti-seizure medications work, and SSRIs do little. And yet, Lamictal changed my life.

[nellorat.livejournal.com]

In my case, it's pretty clear that I needed/need to do the cognitive/emotional work you mention but I also needed/need medication-- On medication, I can handle normal stresses of life (even an above-average stressful job), feeling my emotions and carrying on; without it, even with the cognitive work, many ordinary things are too much to process and I can get into a depressive loop because I really cannot cope as well.

I think minor depression can respond to many things major depression can't, including cognitive and emotional work alone.

Depression seems to me a total bodymind issue, with many, many ways to make it better--or worse--many cybernetic and many physiological. For instance, I've found a light-box very helpful for Fall depression, but this year I didn't seem to need it, possibly because of changes in my nutrition and/or having taken up yoga.

[andrewducker]

Absolutely. Sometimes things can't be changed from where you are, and you need chemical help to get to the stage where any kind of cognitive/emotional work can begin.

And sometimes (as in the other comment) the effect is entirely chemical.

[nancylebov.livejournal.com]

And sometimes the chemicals are needed to supply an ongoing basis for the cognitive and emotional work.

[noveldevice.livejournal.com]

Sometimes the place where they are, though, is defined by their brain chemistry.

I feel like the sort of basic position where you're coming from is that if people with Depression would just get themselves out of something that "caused" their Depression, they'd be okay. Which is, from what I can tell about Depression versus depression, inaccurate as well as having a bit of a BOOTSTRAPS! reek to it.

[andrewducker]

I'm not at all sure where you're getting that from. I'm certainly saying that there are a variety of approaches to dealing with depression, from the purely chemical to the purely emotional/supportive, but I'm not in any way saying that people who have depression should "just snap out of it" or anything like that.

[green-knight.livejournal.com]

My depression is related to anxiety; and some of my anxiety has rational foundations, some of it does not; which makes no difference to the way it _feels_.

[papersky.livejournal.com]

firecat once said that there are cultures, like classical Japan, that value a sense of pleasant melancholy, and that getting to that point might be easier for depressed people than getting to the US expectation of happy, busy, social. Then there's the Always Coming Home thing of having cultures for personality types.

[xiphias.livejournal.com]

Depends on the depression. The kind of depression I have is just about as far from the one as it is from the other.