10 Insights into a Misunderstood Condition

A couple of interesting items in this UK article. For instance:

4. Depression blurs memory

One of the lesser known symptoms of depression is its adverse effect on memory.

Over the years studies have shown that people experiencing depression have particular problems with declarative memory, which is the memory of specific facts like names or places (Porter et al., 2003).

Part of the reason for this may be that depressed people lose the ability to differentiate between similar experiences (Shelton & Kirwan, 2013). It’s another facet of the tendency to over-generalise.

Depression blurs other types of memory as well, though, including the ability to recall meanings and to navigate through space.


Red State Blues

Fascinating piece in today’s New York Times regarding differences between “red states” and “blue states” and their utilization of psychotherapy. It’s a thoughtful piece, and the author Seth Stevens-Davidowitz, takes some pains examining the data.

Compared with blue states, red states have roughly 30 percent higher suicide rates and around 20 percent higher rates of major depression. Among many other factors, lack of therapy is probably playing a role in these outcomes.

And this on the economics of therapy:

Sure, therapy can be pricey, but it is important to keep the costs of depression in mind. A recent study led by Paul E. Greenberg of the Analysis Group, an economic consulting firm, found that the average person with major depression costs some $7,000 per year in lost economic productivity. In study after study, therapy easily passes the many cost-benefit tests that have been applied to it.

Again, you can take a look at the article here. It’s worth a look.

Peter Kramer on Romanticizing Depression

And why it’s so pernicious. Brilliantly stated:

Other questioners set aside that van Gogh was actually ill. They took mood disorder to be a heavy dose of the artistic temperament, so that any application of antidepressants is finally cosmetic, remolding personality into a more socially acceptable form. For them, depression was less than a disease.

These attributions stood in contrast to my own belief, that depression is neither more nor less than a disease, but disease simply and altogether. Audiences seemed to be aware of the medical perspective, even to endorse it — but not to have adopted it as a habit of mind. To underscore this inconsistency, I began to pose a test question: We say that depression is a disease. Does that mean that we want to eradicate it as we have eradicated smallpox, so that no human being need ever suffer depression again? I made it clear that mere sadness was not at issue. Take major depression, however you define it. Are you content to be rid of that condition?

Always, the response was hedged: aren’t we meant to be depressed? Are we talking about changing human nature?

I took those protective worries as expressions of what depression is to us. Asked whether we are content to eradicate arthritis, no one says, “Well, the end-stage deformation, yes, but let’s hang on to tennis elbow, housemaid’s knee and the early stages of rheumatoid disease.” Multiple sclerosis, acne, schizophrenia, psoriasis, bulimia, malaria — there is no other disease we consider preserving. But eradicating depression calls out the caveats.

To this way of thinking, to oppose depression too completely is to be coarse and reductionist — to miss the inherent tragedy of the human condition. To be depressed, even gravely, is to be in touch with what matters most in life, its finitude and brevity, its absurdity and arbitrariness. To be depressed is to occupy the role of rebel and social critic. Depression, in our culture, is what tuberculosis was 100 years ago: illness that signifies refinement.

There’s Nothing Deep About Depression

From an old Peter Kramer New York Times Magazine article. You may recall that Kramer was the author of the bestseller, Listening to Prozac. He found the response to his book highlighted many curious attitudes toward depression:

Like tuberculosis 100 years ago, depression today carries with it an element of refinement, of sacredness. Kramer writes, “We idealize depression, associating it with perceptiveness, interpersonal sensitivity and other virtues. Like tuberculosis in its day, depression is a form of vulnerability that even contains a measure of erotic appeal.” He goes on to say that “Depression is not a perspective. It is a disease…We should have no trouble admiring what we do admire – depth, complexity, aesthetic brilliance – and standing foursquare against depression.

If you’ve ever struggled with depression, did you ever idealize it? Even once? It’s a fascinating read, explores the way depression has been romanticized. Kramer knows his stuff and writes persuasively and knowledgably. Worth a look. You can read the article here: There’s Nothing Deep About Depression.

The Illness That’s Still Taboo

This is an article from the Guardian, a first-person piece by Mark Rice-Oxley. It’s unusual in that it contains an unusually clear description of how depression can start. It also continues, heartbreakingly, to describe his descent into the worst parts of the illness:

Christmas was the lowest ebb. All that snow, all the lovely children with faces shiny like apples. I couldn’t be near them, but couldn’t be alone. I trailed around the house after my poor wife like a small dog with internal bleeding. I slept eight hours in four nights. On 23 December, I went for an emergency meeting with my psychiatrist who shook his head and said, “I’m sorry it’s turned out this way.” Afterwards, in the thickening twilight and with the first vapours of sedation gathering, I felt my wretchedness in the joy of others: the shoppers and their gift bags; the lovers giggling; the young man on the tube engrossed in a book. I wish I was him, I thought. I wish I was engrossed in a book on the tube.

And also what worked for him, and the struggles. It’s all so well described.

The four things that really helped: meditation, love, time and therapy. I discovered the first through a colleague who sent me some CDs. At first, meditation feels hard and slightly odd. In time, it’s a valuable technique. Love – in a child’s Halloween face, or a friend’s casual invitation to lunch, boosted morale. Time worked away on the broken bits. Therapy taught me that I’m not who I think I am, that some of my reflexes and instincts are unhealthy.

But it wasn’t a smooth ride. Some days, exercise would help. Some days, it was too much and I’d suffer for two or three days. Some days, odd jobs felt wholesome, sometimes they felt depleting. Some days, just making dinner would be too much. Other days, I would feel like doing nothing, but know that doing nothing was the worst thing I could do. Some days, most painfully of all, being with the children was just too much. At other times, just to sit and watch them climb or paint was a blessed relief. I could still parent, after all.

I’ve not just taken out the good parts. There’s a lot more to the piece. It’s a terrific article. I think if you’ve ever had major depression, it will be all too familiar. The piece is here.

10 Notable Depression Blogs

Not my list. This came last year, from PsychCentral. Check out number 9, Gretchen Rubin’s site (author of The Happiness Project). She focusses on the power of habits, an often overlooked behavioral component to managing depression.

The main list is here, Top 10 Depression Blogs.

And here is Rubin’s site.

Depression in Pregnancy

Andrew Solomon has published an adaptation of a new final chapter to his book, Noonday Demon in today’s New York Times magazine. After a dramatic and sad opening the pieces settles into the an exploration of the lethality and stigma of depression in pregnancy, and the risks and benefits of medicating depression during pregnancy — it’s not as obvious as you might think. Bottom line? There are no easy answers. It’s really thoughtful piece. Recommended.