Talk:Major depressive disorder

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  • Expand: material for Causes of depression article to be placed here until article created.
    Social rejection also predicts later depression,[1] and adolescents who are victimized by peers are more vulnerable to developing depressive symptoms if it impacts on the development of their identity, although family cohesion and emotional involvement are protective factors.[2]
    Social isolation has also been found to predict onset of a first episode.[3]
    A study in Providence, Rhode Island following children from birth found that family disruption and low socioeconomic status in early childhood were linked to an increased risk of major depression in later life.[4] The same researcher found a year earlier in another study on the same Rhode Island subjects, that this effect was independent of later adult social status and related to various social inequalities, the consequences of which may be more severe for women.[5] There is mixed evidence regarding the role of social capital (features of social organization including interpersonal trust, civic engagement and cooperation for mutual benefit).[6] Two good studies on bullying this and [1]. In adulthood, a correlation between stressful life events and the onset of major depressive episodes has been found consistently and is likely causal, although the specific mechanisms are unclear. Negative events such as assault, divorce or separation, legal issues, major problems with work, finances, housing, health, or friends and confidants, have been found to precede episodes if they represent a long-term threat, particularly if the threat is of a loss or humiliation that devalues an individual in a core role.[7]
    Existential and humanistic approaches are generally grouped together, representing a forceful affirmation of individualism.[8] American existential psychologist Rollo May stated that "depression is the inability to construct a future".[9] From the existential perspective, in order to construct a future, individuals must be acutely aware of both their mortality and their freedom to act, and they must exercise their freedom within the explicit framework of an acute awareness of their mortality. This awareness produces "normal" anxiety,[10] whereas the lack of awareness leads to neurotic anxiety,[10] self-alienation,[11] inauthentic living,[12][13] guilt,[12][13] and depression. Humanistic psychologists argue that depression can result from an incongruity between society and the individual's innate drive to self-actualize, or to realize one's full potential.[14][15] American humanistic psychologist Abraham Maslow theorized that depression is especially likely to arise when the world precludes a sense of "richness" or "totality" for the self-actualizer.[15]
    could go in history subpage(?) Both William James and John Stuart Mill found relief from their depression in literature. For James, who was nearly driven to suicide during his depression, the choice to believe in free will was instrumental in overcoming this condition.[16] This choice was inspired by an essay about free will by French philosopher Charles Bernard Renouvier.[17] Upon reading this essay, James no longer felt that "suicide [was] the most manly form to put [his] daring into," and declared, "now I will go a step further with my will, not only act with it, but believe as well; believe in my individual reality and creative power."[16] Mill took solace in the work of English poet William Wordsworth.[18] Mill wrote that, "What made Wordsworth's poems a medicine for my state of mind, was that they expressed, not mere outward beauty, but states of feeling, and of thought coloured by feeling, under the excitement of beauty."[18]
  • Other:
    1. ^ Nolan SA, Flynn C, Garber J (October 2003). "Prospective relations between rejection and depression in young adolescents". Journal of Personality and Social Psychology 85: 745–55. doi:10.1037/0022-3514.85.4.745. PMID 14561127. 
    2. ^ van Hoof A, Quinten A, Raaijmakers AW, van Beek Y, Hale WW (III), Aleva L (October 2007). "A Multi-mediation Model on the Relations of Bullying, Victimization, Identity, and Family with Adolescent Depressive Symptoms". Journal of Youth and Adolescence 37: 772–82. doi:10.1007/s10964-007-9261-8. http://www.springerlink.com/content/757281qw715855j6/. Retrieved 2008-10-01. 
    3. ^ Bruce ML, Hoff RA (July 1994). "Social and physical health risk factors for first-onset major depressive disorder in a community sample". Social Psychiatry and Psychiatric Epidemiology 29: 165–71. PMID 7939965. 
    4. ^ Gilman, SE; Kawachi I, Fitzmaurice GM, Buka SL (May 2003). "Family disruption in childhood and risk of adult depression". American Journal of Psychiatry 160: 939–46. doi:10.1176/appi.ajp.160.5.939. PMID 12727699. 
    5. ^ Gilman, SE; Kawachi I, Fitzmaurice GM, Buka SL (April 2002). "Socioeconomic status in childhood and the lifetime risk of major depression". International Journal of Epidemiology 31: 359–67. doi:10.1093/ije/31.2.359. PMID 11980797. 
    6. ^ Kim D (August 2008). "Blues from the Neighborhood? Neighborhood Characteristics and Depression". Epidemiologic Reviews 30: 101. doi:10.1093/epirev/mxn009. PMID 18753674. 
    7. ^ Kendler KS, Hettema JM, Butera F, Gardner CO, Prescott CA (August 2003). "Life event dimensions of loss, humiliation, entrapment, and danger in the prediction of onsets of major depression and generalized anxiety". Archives of General Psychiatry 60: 789–96. doi:10.1001/archpsyc.60.8.789. PMID 12912762. 
    8. ^ Freeman, Epstein & Simon 1987, pp. 64,66
    9. ^ Geppert CMA (May 2006). "Damage control". Psychiatric Times. http://www.psychiatrictimes.com/display/article/10168/51281. Retrieved 2008-11-08. 
    10. ^ a b May R (1996). The meaning Of anxiety. New York: W. W. Norton and Company. ISBN 0-393-31456-1. 
    11. ^ Fromm E (1941). Escape from Freedom. New York: Holt, Rinehart, & Winston. 
    12. ^ a b Heidegger M (1927). Being and time. Halle, Germany: Niemeyer. 
    13. ^ a b Hergenhahn 2005, pp. 526-528
    14. ^ Boeree, CG (1998). "Abraham Maslow: Personality Theories" (PDF). Psychology Department, Shippensburg University. http://www.social-psychology.de/do/pt_maslow.pdf. Retrieved 2008-10-27. 
    15. ^ a b Maslow A (1971). The Farther Reaches of Human Nature. New York, NY, USA: Viking Books. pp. 318. ISBN 0670308536. 
    16. ^ a b James H (Ed.). Letters of William James (Vols. 1 and 2). Montana USA: Kessinger Publishing Co. pp. 147–48. ISBN 978-0766175662. 
    17. ^ Hergenhahn 2005, p. 311
    18. ^ a b Mill JS. "A crisis in my mental history: One stage onward" (txt). Autobiography. Project Gutenberg EBook. pp. 1826–32. ISBN 1421242001. http://www.gutenberg.org/files/10378/10378-8.txt. Retrieved 2008-08-09. 

Treatment:

"Cognitive therapy is a treatment process that enables patients to correct false self-beliefs that can lead to negative moods and behaviors. The fundamental assumption is that a thought precedes a mood; therefore, learning to substitute healthy thoughts for negative thoughts will improve a person’s mood, self-concept, behavior, and physical state." - http://www.aafp.org/afp/2006/0101/p83.html

"Bibliotherapy is a treatment where a depressed patient reads a self help book such as Feeling Good by Dr. Burns in between therapy sessions. Dr. Burns says in the introduction that "more and more therapists are beginning to assign bibliotherapy to their patients as psychotherapy 'homework' between therapy sessions." A nationwide survey of psychotherapists published in 1994 also reported that out of a list of 1000 self-help books recommended for patients listed, Feeling Good was the number-one-rated book for depressed patients." - http://www.jaoa.org/cgi/reprint/103/3/131.pdf

Archives
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Contents

[edit] Reporting Bias

This whole section makes it sound like reporting bias is exclusive to antidepressants or something. There are literally hundreds of studies and reviews on reporting bias. Here's just a few: http://www.ncbi.nlm.nih.gov/pubmed/19584207?ordinalpos=15&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum http://content.nejm.org/cgi/ijlink?linkType=ABST&journalCode=jama&resid=291/20/2457 http://www.ncbi.nlm.nih.gov/pubmed/3576013?dopt=Abstract —Preceding unsigned comment added by Skrewler (talk • contribs) 23:15, 17 October 2009 (UTC)

Those are interesting sources; but I've read, re-read, and re-re-read that section, and for the life of me I can't figure out where it's suggesting that nothing else is biased. Are there particular words or phrases that you find problematic? Cosmic Latte (talk) 15:32, 18 October 2009 (UTC)
Also, do the first or third of those sources (I currently can access the full text of only the second) actually mention antidepressant studies and note that publication bias extends beyond these studies? If not, then while your point here may be perfectly valid, it could turn out to be an original synthesis that falls outside the scope of an encyclopedia. Cosmic Latte (talk) 17:18, 18 October 2009 (UTC)
The three studies do not discriminate in what drugs were included in their meta analysis. Perhaps my comment was out of line if I can't find a source for that specific comment -- although I haven't really looked. I think there should be a link to a separate page and maybe include a special section for specific classes of drugs that may be more biased than others (if there are credible sources of course). I don't see why antidepressants (does not even differentiate the type) include this special section while other drugs do not? No clue on the policy for that. Skrewler (talk) 00:36, 19 October 2009 (UTC)
Antidepressant: "An antidepressant is a psychiatric medication used to alleviate mood disorders, such as major depression and dysthymia." It makes sense that they're used most commonly to treat depression. MichaelExe (talk) 01:13, 19 October 2009 (UTC)
Your comment is not germane to any point made in this discussion. Skrewler (talk) 01:17, 19 October 2009 (UTC)
Doh. I thought you were asking why antidepressants would have their own section, and not other less frequently used drugs used for the treatment of depression (some antipsychotics). PMID 18514154, PMID 19666685 and PMID 11229783 might be useful for the Antidepressants section as a whole. MichaelExe (talk) 01:47, 19 October 2009 (UTC)

[edit] depression rates / suicide

The article says that 60% of people who commit suicide have depression. Surely, it is closer to 100% at the moment of suicide? I think this is supposed to read that 60% of patients had already been diagnosed with depression before killing themselves. I think this is an important distinction to make. Can someone who has access to the reliable source cited ("Barlow 2005"?) please check that this is what was meant by the source? Thank you! Gregcaletta (talk) 06:47, 21 October 2009 (UTC)

Psychosis (hallucinations and delusions), drugs ("Over fifty percent of suicides are related to alcohol or drug dependence. In adolescents alcohol or drug misuse playing a role in up to 70 percent of suicides"), having a reaaaaalllly bad day (so you can't say they had depression, because there are minimum durations for every type). "Suicide may occur for a number of reasons, including depression, shame, guilt, desperation, physical pain, emotional pressure, anxiety, financial difficulties, or other undesirable situations." Also, "Studies show a high incidence of mental disorders in suicide victims at the time of their death with the total figure ranging from 98% to 87.3% with mood disorders and substance abuse being the two most common." MichaelExe (talk) 11:19, 21 October 2009 (UTC)
I'd also add bipolar disorder and borderline personality disorder. Somewhat counterintuitively, there are folks who look forward to suicide, seeing it as an escape from whatever maladies are plaguing them. And these maladies don't even have to be depression of any sort: Samurai commit seppuku out of shame; a friend of mine thought suicide was kind of cool, and could talk about hurting herself with a smile on her face; George Sanders killed himself out of boredom; and Hunter S. Thompson (I don't think anyone will ever really figure that guy out) did so because "football season is over". Cosmic Latte (talk) 09:43, 23 October 2009 (UTC)
As an afterthought, I'd suggest that many suicides are better explained in social-psychological, sociological, philosophical, or literary terms than in clinical ones. We have the kamikaze and other suicide attackers; we've got prisoners who hang themselves in order to regain from the state some control over their destiny; but there's also Socrates, who (among other reasons) felt he had no right to do so. And then there are various people who (according to Albert Camus) remain unreconciled with existential reality (i.e., the Absurd), or (according to Émile Durkheim) with social facts (i.e., integration and regulation). There's even the Shakespearean suicide of "star-crossed love"; nobody says, "Well, Romeo and Juliet just had MDD. So did Antony and Cleopatra." And, last but not least, let us not forget the mass suicide by a group that (quite understandably) could find no other logical way to board the flying saucer that was following a comet (social psychologists had a field day with that one). In fact, come to think of it, even though I'm the one who added that 60% statistic, I actually find it surprisingly high. In any case, the reasons people kill themselves are probably as varied as the reasons they do anything else. Cosmic Latte (talk) 08:23, 24 October 2009 (UTC)


[edit] I am a patient, currently

i have been suffering from paranoia and depression for over 6 months now, can anybody tell me how i should help myself overcome this disorder. this is a relapse which follows the one i had earlier about 2 1/2 years ago. that one was really bad, but i got out of it in 3 months time. this one is taking longer, GOD KNOWS FOR WHAT REASON.--Bdwolverine87 (talk) 05:49, 8 November 2009 (UTC)

I'm sorry to hear this, but I'm afraid there's not much that Wikipedia can do, apart from providing you with information and resources in articles like this one or this one, or (if by "paranoia" you mean anxiety) in those like this one or this one. Apart from that, I'd recommend the same thing that anybody else would recommend: namely, that you talk to a counselor or physician about the matter. Cosmic Latte (talk) 12:23, 8 November 2009 (UTC)

[edit] Link Psycheducation.org

Please look at the link to Psycheducation.org . The description is lively, popular and entertaining. However, the author is clearly out of his depth. For example, he states as a confirmed fact that antidepressants work by stimulating BDNF and reversing brain shrinkage. That is misleading and oversimplifying the state of the art much like the original serotonin hypothesis did. I think this link should be removed. The Sceptical Chymist (talk) 11:42, 25 November 2009 (UTC)

I rather like the site, but I've been tempted to remove it myself, simply because it doesn't focus on MDD in the first place; it focuses more on BPD, especially bipolar II. Cosmic Latte (talk) 12:30, 25 November 2009 (UTC)

[edit] Depression out of the shadows?

I have some doubts if the link to "Depression out of the shadows show" Depression, out of the shadows is appropriate. It features infamous Charles Nemeroff who took ~2 million from pharmaceutical companies without reporting it, "authored" ghost written articles, argued (we now know why) against the FDA antidepressant - suicide link warnings, and is not really a credible source by any stretch of imagination. The documentary was criticized by the Columbia Journalism Review (see here [2], by other mental health advocates for giving disproportionate time to ECT and mentioning CBT only in passing, and at best deserves only "C" grade, for example [3] [4]. Stanford Wellsphere.org holds similar opinion [5]. Should we keep it or delete it? Is there anything better around to replace it? The Sceptical Chymist (talk) 12:25, 25 November 2009 (UTC)

This one encompasses anxiety and stress along with depression, but no discussion of depression would be complete without mention of these comorbid and/or causal factors. The man behind this film is an MD and a published researcher,[6][7] and looks reliable to me--certainly a great deal more reliable than Nemeroff. Cosmic Latte (talk) 15:52, 25 November 2009 (UTC)

[edit] Unjustified use of fair use image

Depression is frequently a recurrent, sometimes chronic, disorder. (Illustration by Lucy Bristow.)

This image makes no sense to me as an explanation of depression. The picture is not explained in the text, as is required by the fair use criteria for a copyrighted image. Therefore, I don't think fair use of this justified. Regard, —mattisse (Talk) 22:20, 10 December 2009 (UTC)

I completely agree.--Garrondo (talk) 22:32, 10 December 2009 (UTC)
Glad to receive agreement! The image was not in the article when it passed FA. I am quite sure it would have been removed then as there is no rationale for using it. . It is a relatively new addition to the article and I cannot even figure out what it is saying about depression! Regards, —mattisse (Talk) 22:47, 10 December 2009 (UTC)
To me it just looks like some lying in bed sleeping at night.--Literaturegeek | T@1k? 00:26, 11 December 2009 (UTC)
What is that big orange-yellow thing to the right with tentacles? In any event, what does it describe about depression that cannot be expressed in words? Since it is a fair use image violating a copyright, the standards for inclusion are very high. Regards, —mattisse (Talk) 00:34, 11 December 2009 (UTC)
Ha, I dunno, I thought a cat at first for some weird reason but then when I looked closer I got even more confused. I think that it should be deleted for the reasons you gave as well as the picture not being easily related to depression. If a better picture is found I guess it could be considered for addition.--Literaturegeek | T@1k? 00:37, 11 December 2009 (UTC)
By all means. I was just trying to address the inadequacy of the Van Gogh image. To paraphrase LG "To me it just looks like some man with hangover sitting in a chair." The Sceptical Chymist (talk) 11:57, 11 December 2009 (UTC)
That was very...shall we say, clever. Even so, the picture is kinda nightmare-ish and seems to fit the mood. Not enough that I'd put it back in the article, but still perhaps enough to shed some light on the van Gogh piece: It seems (at least to some) to be intuitively appropriate, even if doesn't seem to fit so well on more articulable grounds. Not that this is (or isn't) ideal--it's just hard to figure out how better to illustrate the entirety of an abstract idea like MDD. Cosmic Latte (talk) 20:37, 12 December 2009 (UTC)
Yes, everybody (myself included) agrees that Van Gogh is inadequate but we have nothing better. While it may seem "intuitively right" to you, this illustration creates an incorrect impression of a typical depression patient as a desperate penniless male.
The questions asked above equally apply to the Van Gogh picture. "What does Van Gogh describe about depression that cannot be expressed in words?" "This image makes no sense to me as an explanation of depression. The picture is not explained in the text" "As I looked closer I got even more confused." "What is that falling-apart floorboards thing?" What does it mean? Why the the walls are dirty? What is that supposed to say about people with depression?! ;))
On the other hand, Lucy Bristow's picture is an "intuitively right" symbol of chronic depression for Jules Angst, BMJ editors[8] and yours truly. The Sceptical Chymist (talk) 01:44, 13 December 2009 (UTC)
Of course the selection is going to be somewhat arbitrary; but as long as it's at least reasonably plausible, it (whatever "it" is) may be the best one can do to illustrate a concept that's almost impossible to illustrate. Unless, of course, we'd rather go with a yellow frowny face that has a speech bubble saying, "Hi, I have major depressive disorder!" :-) Cosmic Latte (talk) 16:55, 13 December 2009 (UTC)
P.S.: The BMJ is a far more reliable source than I, so perhaps the Bristow picture is, after all, the better one. Cosmic Latte (talk) 16:58, 13 December 2009 (UTC)
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