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    Thread: When Does Depression Become A Disease?

    1. #1
      Senior Member firemonkee's Avatar
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      Default When Does Depression Become A Disease?

      When does sadness cease to be a normal emotional response, and become a mental disorder? Can psychiatrists ‘draw the line’ between healthy and sick moods, and if so, where?




      An important new study offers an answer: When does depression become a disorder? Using recurrence rates to evaluate the validity of proposed changes in major depression diagnostic thresholds (free pdf).

      The authors, Jerome Wakefield and Mark Schmitz of New York, made use of the ECA survey, a 1980s study of almost 20,000 American adults. Participants were surveyed twice each, approximately one year apart. On each occasion, they were asked questions about their mood, emotions, and mental health symptoms.

      Some people reported a history of depression at the first visit. Wakefield & Schmitz wanted to find a way of predicting which of those people were most likely to end up depressed at the time of the second interview, a year later – the recurrence rate. To do this, they examined the particular patterns of symptoms reported at the first visit.

      It turned out that there was a strong predictor of recurrence, which the authors call “complicated” depression. People with a history of complicated depression had a 15% chance of being depressed at follow up. Only 3.4% of those who’d had “uncomplicated” symptoms, however, were depressed a year later. Given that 1.7% of people with no depression history had become unwell by Time 2, this means that “uncomplicated” depression was almost never recurrent.

      So what exactly is “uncomplicated” depression? The criteria were: episodes that last no longer than 2 months, and that do not include suicidal feelings, psychotic symptoms, psychomotor retardation, or feelings of worthlessness. If any of those symptoms were present, or if the low mood lasted longer than 8 weeks, it was classed as “complicated”.

      When Does Depression Become A Disease? : Neuroskeptic
      Yet inside there is this perpetual nagging doubt;
      the feeling we are possessed by a 'subtle lack of togetherness''.

      If we really want to say what helps in mental health, there’s a straightforward mantra and it goes like this:

      “Some people find medication helpful. Some people find therapy helpful. Some people find medication and therapy helpful. Some people don’t find either helpful.”


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    2. #2
      Evelyn2013
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      So is complicated depression classed as a disease then?
      I thought schizophrenia was the only brain disease, and everything else was just an exaggeration of normal human emotion that can be controlled?
      I often feel that my disorder is just normal human emotion with that little weakness in my brain or personality. I don't feel that it is anything more than that, even the psychosis, i think it is all explainable.

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      Active Member judithj's Avatar
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      Thanks for that - very useful xxx
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      Forum Guide MissKitty's Avatar
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      I don't think the author of this factored in neglect by the NHS and treatment with the standard 6 weeks of CBT.

      Depression also becomes recurrent when the NHS do nothing to help you or offer you drugs or 6 weeks of CBT in place of suitable therapy.

      Would recurrence be so much of an issue if things were dealt with properly the first time round I wonder.
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      Senior Member Lillyone's Avatar
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      Quote Originally Posted by MissKitty View Post
      I don't think the author of this factored in neglect by the NHS and treatment with the standard 6 weeks of CBT.

      Depression also becomes recurrent when the NHS do nothing to help you or offer you drugs or 6 weeks of CBT in place of suitable therapy.

      Would recurrence be so much of an issue if things were dealt with properly the first time round I wonder.
      Agree with that.
      I can only relate to how I felt when I first started feeling down/depressed.
      It has been the lack of help and support and the constant battle to try and be heard that has really made my depression take hold.
      There is nothing worse than knowing you are being ignored on nearly all levels.

      When a GP tells you, that you are not depressed get a job, get back into the real world, or else one might as well be dead; combined with a CPN nurse who tells you, tomorrow is another day, and why worry.
      Leaving you to go home alone and cry in despair over the lack of treatment not the actual illness, then something is very, very wrong.

      Combine that with the treatment from the DWP and ATOS it is a ticking time bomb.
      How the heck is anyone meant to get better.

      So many vulnerable people who are having the door slammed in their faces.
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      Senior Member |||ME|||'s Avatar
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      There's no logical reason to make emotions a disease after x amount of time.

      There's often a reason to assume the longer it lasts the less likely it is to not be there tomorrow, which is what this paper really shows. That doesn't make it a disorder a disease or illness. Disorder is just another way of rooting the problem in your deficiencies that need "fixing" rather than your experiences that need "supporting".

      I watch someone eat the last slice of pizza - sadness for a short time.
      Lifetime of abuse - depression for a long time, even for ever if circumstances never promote recovery. Who knows, maybe some traumas can never be recovered from.

      You're still a normal, whole and complete human being having normal human responses to existential circumstances. It's still not a disorder, illness or disease. Disorder labelling is a fudge because illness and disease models have been discredited.

      Depression never becomes a "disease".
      Last edited by |||ME|||; 16-03-13 at 04:51. Reason: Sadness :(
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      Disorder is just another way of rooting the problem in your deficiencies that need "fixing" rather than your experiences that need "supporting".
      Thank you |||ME||| that is exactly how depression was originally for me.

      I'm not sure about what took over after stopping anti-depressants and heart problems. That was different, deeper, much more intense, suicidal and vile. I don't think any amount of support would have stopped it at times. But it does seem to have finally lifted and gone....with therapy. So maybe yes, it is down to support rather than fixing....and time perhaps.
      x
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      Senior Member |||ME|||'s Avatar
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      Pretty sure withdrawal and social situation of trying to prove it and being invalidated is what took over. I guess only hindsight demonstrates what was what.

      I think in many cases "support" helps you through what is being experienced and avoids prolonging it, or helps tackle and remove the causes - whereas attempts to "fix" you just lead to more problems on top.

      Emotional distress is to be expected for durations of ones life. Sometimes for the whole of it if circumstances are such. Labelling it an illness just invalidates the sufferer and their opinions and serves as a value judgement on people.
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      Sadness and depression. Two different words.

      I think it's only people who have never actually experienced the latter, who link these words together and think they are synonyms - and I think - that they think this way incorrectly, through their ignorance or lack of knowledge.
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    10. #10
      Senior Member |||ME|||'s Avatar
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      It's a fair enough criticism. I have experienced the difference over an extended period time and I wish I'd used the term depression and a different example now. Similar things have happened a couple of times, it's fair enough to be picked up on it. It's no good knowing what you know then writing it as something different. Thanks, genuinely, I need to take more care over this stuff at times.
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