> Now you can no longer figure out what it is that moves other people to bustle about out there in the world, doing errands, rushing to appointments, picking up a child from school. You have lost the thread that pulled the circumstances of your life together. Nothing adds up and all you can think about is the raw nerve of pain that your mind has become—and, once again, how merciful it would be to yourself and others to extinguish this pain.
We need another word for what is described above. Most people understand ordinary depression, because most people feel down sometimes and they have techniques for getting out of it. They try to get the "clinically depressed" person to try these techniques.
When I was in my cycle of doom I would set as my goal of the day to get up and take a shower and often couldn't accomplish it. Forget doing the dishes. I knew I needed help, but without medical insurance I couldn't afford it and didn't have the energy or will to try to get medical insurance.
Finally, my family intervened and I was locked up as a danger to myself after I verbalized a few dangerous thoughts. I'm on insurance now and taking medication and things are much better. I'm not necessarily happy, but at least the "black dog" is gone.
I have a lot of respect for people that are even able to maintain for a while during that state. My own experience with this (at least from all the descriptions of clinical depression I've heard it sounds the same) was with a bad interaction with medication as far as I know (Mucinex DM, absurdly enough).
It started by me having a pretty droll day at work, but the first indications something was really wrong (looking back), were when I went home, and literally wanted to do nothing. I didn't want to play or deal with with my young children or significant other, didn't want to eat dinner, didn't want to watch TV or read a book, or use the computer for any reason. I literally wanted nothing, and the best way to achieve that seemed to be to go lay in bed, even though I didn't want to sleep either.
The second day was much the same, but I also realized that I didn't like my job, or career, and wasn't sure what I wanted to do with my life either. Needless to say, this didn't improve my outlook compared to the prior day.
The third day, when I woke up, I was scared. I wasn't sure what was going on, but I stopped taking the congestion medication just in case and because it was the only thing I could think of that had changed recently. I was feeling mostly normal within 24 hours or so. I can easily see how in that state of mind things could escalate. Almost a decade later, I still consider it one of the scariest episodes of my life.
Interestingly, 9-10 months later, a friend who I had told about the incident right after it happened told me the same thing had just happened to him from the same medication.
I'm glad you got everything under control. The brain is a crazy organ.
Did you report the possible side-effect? Depression doesn't seem to be recorded for Mucinex DM, so it might be worth flagging that up with your country's drug regulator, especially considering you know you weren't the only case.
It's my impression they really appreciate reports of unlisted side-effects: bug reports are great for software, but they're even more valuable when they can mean life or death - and when the affected systems are as complex & varied as the human body.
I seem to recall I did, and they said that it wasn't a reported side effect they had heard of before. I reported it after my friend reported it, since there was some corroboration at that point, and I mentioned that. I believe this was a number listed on the package, but honestly I don't recall it all that well, as it was quite some time ago.
It's entirely possible I called the pharmaceutical company, and they may not be incentivized to look into every claim...
If the DM stands for dextromethorphan (an expectorant) it would fit. They warn people on SSRIs to avoid it because of interactions - has some affect on serotonin. It's also usually included in things like Dayquil.
Dextromethorphan is a "dissociative anesthetic" that some people use recreationally. It's a bit of a cliche that kids will sometimes abuse cough syrup because it gives them a mild ketamine-like high. I suppose it's not shocking that it could potentially have a negative psychological interaction.
It looks like it has SSRI-like effects itself. So it also shouldn't be taken by people on older anti-depressants (MAOIs) as it could cause 'serotonin-syndrome' (which can be fatal if not treated quickly).
> We need another word for what is described above.
One plausible candidate is the word (and condition) "melancholia," which has the advantage of being identifiable by means of objective clinical indicators[1].
Melancholia was excluded from DSM-5, not because it lacked objective clinical diagnosis indicators, but because it possessed them. By being open to objective, impartial diagnosis, it set itself apart from the other conditions described in the DSM, in a way that would have exposed something about the DSM that its editors preferred to conceal -- the majority of the DSM's content lacks scientific substance[2].
A quote from the second linked reference: "A single disorder that met the scientific demands of the day, in other words, would only make the failure to meet them in the rest of the D.S.M. that much more glaring."
The entire premise of the DSM is a bit of a crock: mental illness simply doesn't fit well into the disease model of illness. Mental dysfunction is not binary, it is measurable on a continuous scale. And although some symptoms do present in certain 'groups' more frequently than others, symptoms of mental illness are more 'mix and match' than the DSM would lead one to believe. This sometimes means that people are either diagnosed with 2-3 'co-morbid' disorders or none at all.
> We need another word for what is described above. Most people understand ordinary depression, because most people feel down sometimes
No we don't, it's called depression.
What we need is people to realize that depression is not 'people feel down sometimes.' That is feeling down. Depression is not something that you just work through, it is an actual, real thing going on in your brain.
But hell, most people act like armchair psychologists so ya, lets create another term that they'll also misuse.
Any word you try to create for the same thing would be as well because it would be the new word for it.
Also, there is Depression (condition) and Depression (colloquial usage) that's the way language works. The problem is not that the word is used, but that people believe the colloquial usage is the medical usage. They believe that when they feel depressed (colloquial) they just eat a cake or do something they like to get over it so why can't you when you're depressed (actual medical depression).
The way I've often described this to people is that at some point I got off the merry-go-round and I haven't a clue how to get back on. This was (and remains) a turning point in my own depression, which is why it's interesting. Prior to that I felt like I was holding on to something for dear life, then at some point 5-10 years ago it became a feeling much more akin to the above. "Nothing adds up" is a great way of describing it. I also sometimes say I feel like I'm living a in mirror universe where nothing makes any sense.
And I'm speaking as someone who deals with this every day, not as someone who's recovered and is looking back. Recovery isn't possible anymore, unfortunately. I guess my advice to anyone is if you're not as far along as I am... Don't get off the merry-go-round. You really can't get back on.
In my case I didn't choose to get off the merry-go-round. It happened. I choose to get back on with meds because not choosing was too painful possibly leading to unfortunate ends. I am lucky that meds worked for me. My heart goes out to people like David Foster Wallace for which the meds stopped working.
It is, but it's also important not to alienate the person you're trying to help.
I'm not being sarcastic - you're absolutely right - but it's very easy to come across as spouting happy-clappy cliches ("it gets better!"), or claiming to know their life situation better than they do.
Depressed people aren't always right about their prospects, but they aren't always wrong, either.
It is important to realize that other people in this world may have lived longer, gained more experience, and understand more than you do.
It's also important to realize that a huge part of depression therapy is trying to convince people they can be "cured" or can recover, when evidence points to that being highly unlikely - all the actual studies suggest that it causes permanent, irrevocable changes. And the author of the very book we're discussing specifically expresses skepticism about the efficacy of therapy.
It doesn't always get better. In fact, most times it doesn't.
I have 0 experience of your life. What I do know is that if there's a small chance that I'd never have to suffer another major depressive episode again, I'd consider that good information to have. Even when the odds aren't in my favor, I consciously make the choice to focus on the possibility. This isn't Pollyanna, it's practicality -- thoughts impact mood. Part of CBT is learning about your thinking, and one of the things that helped me get into a pattern of recognizing my own thoughts was to separate observations, suspicions and conclusions.
I appreciate your trying to help, and I don't mean that in any kind of a condescending or patronizing way. I shouldn't have been so quick to disregard what you're saying. And it's certainly true that variations of "binary thinking" are a hallmark of depression - although I guess what you're describing isn't quite binary thinking even if I think it comes from the same place, an absolute certainty of negative aspects of something and bottomless doubt of anything positive, or anything else at all about it. I'm glad you found CBT helpful to you and I wish you luck and happiness in your future.
There's a bit of medical jargon to describe this, but it's pretty antiquated: 'psychomotor retardation'. Definition from Wikipedia:
'Psychomotor retardation (also known as "psychomotor impairment" or "motormental retardation") involves a slowing-down of thought and a reduction of physical movements in an individual. Psychomotor retardation can cause a visible slowing of physical and emotional reactions, including speech and affect. This is most-commonly seen in people with major depression and in the depressed phase of bipolar disorder...'
This was/is my most prominent symptom. I once sat in a chair for three days straight (fortunately I had a glass of water within arm's reach), during a two-ish week period where I couldn't summon the motivation to leave my house. It was godawful.
I wonder if it's a vestigial evolutionary trait, particularly in the case of seasonal depression. It would make sense in some contexts: if you're a hunter-gather, resources are scarce during winter. Your chance of survival might therefore be higher if you expended as little energy as possible while waiting out the winter...
I remember reading that and thinking "bingo!" It described what I had felt. Your thought about it being an evolutionary advantage is an interesting one and could explain seasonal affective depression (disorder)
The words we don't have yet are the ones we will need as weapons in the imminent revolution/paradigm shift of mental health.
Some words we already have include (descriptions from wikipedia):
anomie: a "condition in which society provides little moral guidance to individuals"
acedia: "also accidie or accedie /ˈæksᵻdi/, from Latin acedĭa, and this from Greek ἀκηδία, "negligence") is a state of listlessness or torpor, of not caring or not being concerned with one's position or condition in the world. It can lead to a state of being unable to perform one's duties in life. Its spiritual overtones make it related to but arguably distinct from depression. Acedia was originally noted as a problem among monks and other ascetics who maintained a solitary life."
todestrieb: "the death drive (German: Todestrieb) is the drive towards death and self-destruction [...] This concept has been translated as, "opposition between the ego or death instincts and the sexual or life instincts" [...] The death drive opposes Eros, the tendency toward survival, propagation, sex, and other creative, life-producing drives."
weltschmerz: "(from the German, meaning world-pain or world-weariness, pronounced [ˈvɛltʃmɛɐ̯ts]) is a term coined by the German author Jean Paul and denotes the kind of feeling experienced by someone who believes that physical reality can never satisfy the demands of the mind."
joie de vivre: "a French phrase often used in English to express a cheerful enjoyment of life; an exultation of spirit."
ubuntu: "the belief in a universal bond of sharing that connects all humanity"
From the preface of Foucault's "Madness and Civilization": "...modern man no longer communicates with the madman [...] There is no common language: or rather, it no longer exists; the constitution of madness as mental illness, at the end of the eighteenth century, bears witness to a rupture in a dialogue, gives the separation as already enacted, and expels from the memory all those imperfect words, of no fixed syntax, spoken falteringly, in which the exchange between madness and reason was carried out. The language of psychiatry, which is a monologue by reason about madness, could only have come into existence in such a silence."
Emile Durkheim's "Suicide" is a work that touches upon the co-incidence of depression, existential apathy, and repurposed religion as affected by the industrial revolution. Here's a neat animated video by the School of Life: https://youtu.be/z9W0GQvONKc
The gifted (and, sadly, recently late) Mark Fisher's explanation of capitalist realism: "Capitalist realism as I understand it cannot be confined to art or to the quasi-propagandistic way in which advertising functions. It is more like a pervasive atmosphere, conditioning not only the production of culture but also the regulation of work and education, and acting as a kind of invisible barrier constraining thought and action."
> "Capitalist realism as I understand it cannot be confined to art or to the quasi-propagandistic way in which advertising functions. It is more like a pervasive atmosphere, conditioning not only the production of culture but also the regulation of work and education, and acting as a kind of invisible barrier constraining thought and action."
Can relate to this so hard. Capitalism defines our lives, even the concept of time. It divides our waking hours between consumption, production and rest. I feel it drives people to be unproductive outside of work, because we have conditioned society to respond to payment for labor, when one works for oneself, it is harder to conceptualize the reward.
I'm all for progress, not sure if we are on the best path. Where is the balance, the respect for nature at large and our own human nature?
We need another word for what is described above. Most people understand ordinary depression, because most people feel down sometimes and they have techniques for getting out of it. They try to get the "clinically depressed" person to try these techniques.
When I was in my cycle of doom I would set as my goal of the day to get up and take a shower and often couldn't accomplish it. Forget doing the dishes. I knew I needed help, but without medical insurance I couldn't afford it and didn't have the energy or will to try to get medical insurance.
Finally, my family intervened and I was locked up as a danger to myself after I verbalized a few dangerous thoughts. I'm on insurance now and taking medication and things are much better. I'm not necessarily happy, but at least the "black dog" is gone.