Talk:Major depressive disorder

To do

Material for Causes of depression Post traumatic stress disorder has been mentioned as a source of depression, as has exposure to large explosions such as are present on a battlefield. While I have read about both as contributors to depression in other sources, I did not see them in the article nor do I feel competant to add them my self. But they should be considered and added if appropriate.article to be placed here until article created.76.111.4.135 (talk) 19:13, 15 September 2010 (UTC)john harrison yr.201076.111.4.135 (talk) 19:13, 15 September 2010 (UTC)
Social rejection also predicts later depression, 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.

Social isolation has also been found to predict onset of a first episode.

A study in Providence, Rhode Island following children from birth found that family disruption and lowsocioeconomic status in early childhood were linked to an increased risk of major depression in later life. 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.

There is mixed evidence regarding the role of social capital (features of social organization including interpersonal trust, civic engagement and cooperation for mutual benefit).

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.

Existential and humanistic approaches are generally grouped together, representing a forceful affirmation of individualism. American existential psychologist Rollo May stated that "depression is the inability to construct a future". 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,whereas the lack of awareness leads to neurotic anxiety, self-alienation, inauthentic living, guilt, 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. 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.

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. This choice was inspired by an essay about free will by French philosopher Charles Bernard Renouvier. 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." Mill took solace in the work of English poetWilliam Wordsworth. 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."

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

"The most common form of treatment for depression is antidepressant medication plus some form of therapy. The medication allows the person suffering from depression to feel much better and then he or she will be in a position to work on the problems which may be contributing to the depressive state while at the same time receiving professional guidance." -http://www.depression-helper.com/treatment.htmKarlp295 (talk) 07:36, 26 July 2010 (UTC)

New meta-analysis

I stumbled across this and think it should go in the article.[2]. Since omega 3 oils are apparently effective against depression, I assume if folk agree it should be added to the article that it should go in the antidepressant section or should there be a seperate section? Literaturegeek | T@1k? 13:29, 9 November 2011 (UTC)

We have to be very careful how we present this. The article does not imply, nor is would it be proper, to imply that these oils are, by themselves, effective in treating all depressions, serious depressions etc. Furthermore, the article clearly stated that Omega 3 oils weren't useful, but only fractions, probably EPA. We do not want people running down to their local GNC and think they're going to treat their depression. It's not going to happen, especially at the doses that may be required. Oh, and of course, there's conflicting publications. In fact, I can find a lot of trials that completely dispute any effect at all for EPA or other fractions of Omega-3 or its fractions. But there is one critical point....why would these oils have an effect based on what we know about what causes depression? Without a knowledge of the causal pathway, we cannot even begin to accept this study as supportive of something here. OrangeMarlin ^{Talk• Contributions} 09:10, 12 December 2011 (UTC)

Well, nobody yet knows the causal pathways by which ECT or total sleep deprivation affect depression, but clearly they do. We don't need to know causal pathways if the direct evidence is strong enough. (Which I don't think is the case for omega 3 agents, though.) Looie496 (talk) 16:53, 12 December 2011 (UTC)

Looie...point taken. But this is my anti-woo defense mechanism always pops up, even where we don't really have to know the mechanism (hell, most of treatment of depression is magic). OK, omega 3 is far above magical water cures, I admit. OrangeMarlin ^{Talk• Contributions} 17:23, 12 December 2011 (UTC)

(outdent) There is a possible theoretical mechanism and perhaps I am straying into synthesis or medical hypothesis territory, but no rule against it acccording to WP:TALK! :-P This recent review paper covers how dietary factors including omega 3 influence mood and wellbeing, by for example reducing or increasing proinflammatory cytokines. Proinflammatory cytokines are involved in major depression,[3],[4] and many antidepressants via their mechanism of actions can reduce neuroinflammation. Very interesting finding the systematic review paper OrangeMarlin that came to an opposing conclusion, thanks for adding it to the article; it may be that omega 3 is indeed ineffective in treating depression, but perhaps it works as a preventative. Perhaps omega 3 just isn't potent enough or its mechanism is not the same as antidepressants to treat depression. I would still say don't throw out the baby with the bath water or more to the point don't throw out that salmon and mackerel just yet! :-) Whether something is natural or synthetic is irrelevant, what matters is does the compound(s) exert a demonstratable pharmacological and therapeutic effect. For what it is worth I have tried fish oils recently and did not notice any significant change in my mood but still probably gonna take them as a possible preventative and for possible general health benefits or treat myself to fish a few times a week, which ever is cheaper or I feel like. :P--Literaturegeek | T@1k? 00:03, 13 December 2011 (UTC)

Vincent van Gogh's painting "At Eternity's Gate"

Why is Vincent van Gogh's painting "At Eternity's Gate" illustrating this article? The painting is not a depiction of depressive disorder.

Its provenance is very well known and very thoroughly researched. It began as a lithograph study made in van Gogh's student days as a painter at Arnhem, at a time when van Gogh himself was in good health. It was always simply and merely a study of an old man, one of a group. Van Gogh himself refers positively to the old man as a "fine sight" in a letter of the time.

The painting itself was made towards the end of van Gogh's life years later, while he was recovering from his nervous breakdown and self-harming incident in an institute at St. Remy, France. It is an exact copy of the lithograph and is one of a group of colour studies made at the time. There has never been any suggestion by academics that van Gogh was attempting to project some private desperation of his own in the painting. It is not included in a list of works from that time suggested by his most authoritative archivist, Jan Hulsker, as possibly indicative of his state of mind at the time.

But it is (or was - I refuse to look at the article again) documented as such in the Wikipedia bio of van Gogh by a cabal of contributors (including a Wikipedia administrator who is a practising psychiatrist in Australia and who I suggest ought to know better), who for some agenda of their own wish to depict Vincent van Gogh as suicidally depressed in the last three months of his life, what is simply not true or at any rate is documented as such. The quite disgraceful story of that is documented here @ http://www.gutclean.com/wpvangoghdarkdebate.html. The fact is, as is agreed by all scholarly biographers, there were no indications of van Gogh suffering from depression in the last months of his life, nor indeed is there any agreement as to the nature of whatever mental illness van Gogh did suffer from. One can add that in the past year plausible evidence has been put forward in a new book from a respected source that van Gogh was in fact the victim of a manslaughter.

I ask that this illustration be deleted forthwith. — Preceding unsigned comment added by 31.6.61.254 (talk) 01:04, 13 January 2012 (UTC)

It is a great picture that illustrates the topic well.Doc James (talk · contribs · email) 03:30, 13 January 2012 (UTC)

Well, that's your judgement. But the fact is that van Gogh did not mean to portray a depressed person and on that ground alone it is out of place. But it also makes a subtle judgement about the nature of depression, that it is necessarily associated with despair of the sort arguably portrayed here. If the article must have a fine art illustation, then I suggest Durer's Melancholia, as was originally used, is much more appropiate. 31.6.53.248 (talk) 03:44, 13 January 2012 (UTC)

We are not the only one who use it for this purppose http://www.washington.edu/news/archive/id/56102 and this ref supports our use http://books.google.ca/books?id=7yqTnHyTbfAC&pg=PA214 Doc James (talk · contribs · email) 22:20, 13 January 2012 (UTC)

That the Washington Post uses it in the same way is not justification in the absence of reliable sources that van Gogh meant the painting to represent depressive disorder (and incidentally sorrow, the title van Gogh himself appears to have given these works, is not a clinical condition). The same remark applies to your other source, a mere glance at whose content moreover suffices to establish that it is in fact a scholarly article about stereotypes, precisely the kind of stereotypes we should wish to avoid in an encyclopaedic article such as this. 31.6.61.199 (talk) 22:48, 13 January 2012 (UTC)

I personally feel that the van Gogh painting is more suitable than the Durer painting, regardless of its history. Looie496 (talk) 21:15, 14 January 2012 (UTC)

And we have another good comment here [5] Doc James (talk · contribs · email) 23:22, 14 January 2012 (UTC)

I replied thus:

No. The painting is at the Kroller-Muller in Holland (the original lithograph is apparently lost). The title "At Eternity's gate" is not van Gogh's but some traditional title and it is exhibited at K-M as "Sorrowful Old Man: At Eternity's Gate" http://www.kmm.nl/object/KM%20111.041/Sorrowing-old-man-At-Eternitys-Gate?artist=Vincent%20van%20Gogh%20%281853%20-%201890%29&characteristic=&characteristic_type=Painting&van=0&tot=0&start=63&fromsearch=1. The same collection has an accompanying lithograph from the period of the original lithograph with a title beginning "Sorrowful woman ... " and in addition there is another lithograph from that period depicting the same old man reading a book with concentration and not displaying any signs of strong emotion. It's not clear what van Gogh's theme was at the time (his letters of the time are concerned only with the technicalities of producing these lithographs) but it's clear that at most he was concerned to depict sorrow, which I expect your trained psychiatrists you mention will concede is not a clinical condition. It is in fact only the subjectivity of the viewer who introduces the idea of 'sorrow' looking at this picture, let alone a diagnosis of depressive disorder your trained psychiatrists apparently make.

If the trained pyschiatrists you mention were writing a book on depressive disorder and wished to illustrate it with a dust-jacket depicting this painting, they would have to seek the permission of the trustees of the Kroller-Muller museum and it is far from clear to me that the trustees would wish to grant that permission. As trustees of the estate and moral rights of one of our greatest ever artists, they would undoubtedly wish to see that his work was viewed freely without stereotyping or mythologising the artist and might very well look askance at this attempt to make, quite gratuitously, the painting an iconic representation of depressive disorder and the more so given the considerable difficulty in assessing to what degree illness played a part in the painter's life and indeed what the nature of that illness was.

What your trained pyschiatrists are really doing with this painting are peddling sterotypes and myths. It is absolutely disgraceful and a matter of concern to all art lovers, 'trained' or otherwise. When you consider further, as every beginning student of art history knows, that van Gogh himself wrote intelligently about the relationship between insanity and artistic creation (he took a view that was to become fashionable decades later, that society 'labelled' artists as mad and so indeed they did eventually become) it becomes little short of outrageous, because that labelling is precisely what your trained psychiatrists are doing with the subject of this painting. Skirtopodes (talk) 00:50, 15 January 2012 (UTC)

And I have replied again, see the page. Basalisk ^{inspect damage}⁄_berate 01:31, 15 January 2012 (UTC)

And I thus:

No again. It is you who deny an issue and you do it in the time honoured way of accusing me of misunderstanding the 'real' issue.

However, I shall take you as face value and treat what you decribe as the real issue - that the painting is a good representation of MDD (Major Depressive Disorder). I did notice, incidentally, that this last reply of yours moves to the royal wikisodality 'we'. Are we by any chance young and naive - a student perhaps? High school?

Whatever, will you please explain what it is about the image that makes it a good illustration of MDD? That the man is old? That he is holding his knuckles to his face in an apparent gesture of depair? What makes you say the image accurately portrays that suicide attempts and suicidal thoughts are amongst the most severe and prominent symptoms of depression (or so you characterised them for my instruction)?

Above all, will you please quote reliable sources, as should be the Wikipedia way, that attest this painting as a good image of MDD. Who are these 'trained pyschiatrists' you mention? It looks likes OR (original research) to me. Skirtopodes (talk) 02:39, 15 January 2012 (UTC)

I seem to recall us having this debate before and there being a commentary that linked the image to depression...only 11 pages of archives to sift through.... Casliber (talk · contribs) 05:32, 15 January 2012 (UTC)

Or alternatively, see my most recent comment here. Basalisk ^{inspect damage}⁄_berate 15:53, 15 January 2012 (UTC)

@ Basalisk. And I record my reply thus:

I have been away. You are quite juvenile. You cannot even distinguish between p -> q and q -> p. The whole point is that this merely a painting of a sorrowful old man. Just because an old man is sorrowful does not imply that he he is clinically depressed whereas indeed it may be true, as I presume you mean to instruct me, that an old man who is clinically depressed is necessarily sorrowful, nevertheless the two are not equivalent. I wonder what your mentor Casliber's professional association would make of this attempt to stereotype the old and sad as clinically depressed and in need of treatment?

I shan't notice any response you make. I have to say that if your would-be profession of choice involves the care of patients, then I can only hope that you were entirely unsuccessful in the examinations you mention. Skirtopodes (talk) 00:17, 7 February 2012 (UTC)

Hard words, Skirt, but hard luck too - I passed my finals. Since your argument has degenerated to a huge tl;dr WP:IDIDNTHEARTHAT, I think the discussion is over. The next time you embark on a tirade of vitriol like this, or the speech below, I'll report you for personal attacks (that's if one of the admins watching this page doesn't block you anyway). Finally, I'm not a psychiatrist. I've never talked to Casliber. He's not my mentor. Everyone who disagrees with you is not in a cabal. Get over it. Basalisk ^{inspect damage}⁄_berate 06:52, 9 February 2012 (UTC)

Oh, he was a troll after all. Too bad, wrestling with pigs and all that... Basalisk ^{inspect damage}⁄_berate 07:46, 11 February 2012 (UTC)

@ Casliber: well I would be grateful if you can point me to the debate. I asked a Wikipedia expert to find me the original edit and she tells me that it was made by a user called 'Sonjaa' on 28 May 2006 at this address http://en.wikipedia.org/w/index.php?title=Major_depressive_disorder&diff=next&oldid=55164823. The original text read ""Vincent van Gogh, who himself suffered from depression and commited suicide, painted this picture in 1890 of a man that can emblematise the desperation and hopelessness of depression." As far as my friend can see it was never subsequently challenged though the text was eventually edited.

I think you will agree that the original falls far short of scholarly standards. Quite apart from the need to cite a reliable source for "emblematise the desperation and hopelessness of depression" there is a problem that you yourself, a practising psychiatrist so I understand, should be acutely aware of and that is that there is no consensus of what Vincent's mental illness (if that is what it was) actually was. I don't doubt that in ordinary terms he suffered depressions but this is an article about clinical depression and whether Vincent was clinically depressed is simply not clear. I repeat there is nothing in his letters of his last three months to indicate that he was depressed, let alone suicidal. It's indeed no longer clear that in fact he committed suicide (but was rather the victim of a manslaughter).

For the last time I ask you, a Wikipedia administrator as well as a psychiatrist, to delete this image that is such a disgraceful and quite unwarranted discourtesy to the memory of Vincent van Gogh. His desperately tragic story, as that of his brother Theo, is almost unbearable to read and it is not served at all well by these pathetic and pitiful romanticisations by a clique of misguided Wikipedia editors. In his own life Vincent struggled against this kind of stereotyping and wrote eloquently and intelligently about the link between creativity and madness, which he thought merely a social construct. His own sister Wil, an early champion of feminism, was hospitalised for much of her life (four decades) on the questionable gounds of suffering dementia, a condition that apparently presented in her case in her late thirties. I take it you aware that there is a flourishing van Gogh family who are the direct decendants (through Theo) of his family? It is a disservice to them as well.

Do I really have to petition the art world on behalf of Vincent in this matter? The Kröller-Müller museum for a start might express an interest.

In the meantime I am making an edit to insert the correct title for this painting as it is currently displayed at Kröller-Müller i.e. "Sorrowing old man ('At Eternity's Gate')" http://www.kmm.nl/object/KM%20111.041/Treurende-oude-man-At-Eternitys-Gate?lang=en. The popular name 'At Eternity's Gate' is really another romanticisation, carrying roughly the same degree of authenticity as Beethoven's title 'Moonlight Sonata'. It appears on on of the early lithographs he made and nowhere else. The painting itself, as I note above, was merely a colour study he made as he was convalescing at Saint-Remy from his breakdown (the ear incident, though again it's no longer clear that in fact he mutilated himself). Your original contributor Sonjaa might care to reflect that Jan Hulsker, Vincent's most esteemed archivist and critical authority, thought not to include this painting in a list he made of paintings at the time as possibly reflecting Vincent's state of mind and thus presumably would take issue with "emblematise the desperation and hopelessness of depression".

What a complete disgrace and how utterly pathetic and pitiful your editors' responses. Skirtopodes (talk) 23:01, 6 February 2012 (UTC)

@ CasLiber: Skirtopodes has been blocked by Risker. That makes twice he has been blocked, once by you and once by her.

He posted first on your talk page on 13 January 2011 raising the issue of 'Sorrowing Old Man', the first time he has posted on Wikipedia on this issue. Your reply is above, saying it had been discussed before and that a commentary had been found linking the image to depression. Skirtopodes asked you to point to that commentary, but you did not reply.

I have looked through the archive and can find no such commentary. The only source I can find is the one quoted above, but that, as Skirtopodes pointed out, is in fact an academic paper to do with sterotypes which in no way seeks to support the thesis that van Gogh suffered from clinical depression.

There is no "commentary". That is a fiction.

I did find this from you Talk:Major_depressive_disorder/Archive_4#Illustrations

"Yeah, good point. The painting is rather a good one (of a sad person, that is), unfortunately Van Gogh had other mental health symptoms suggesting problems other than depression. OK, let's leave it open for a little bit but removing I think I agree with. Cheers, Casliber (talk · contribs) 21:39, 24 May 2008 (UTC)"

So why is it still here, why did you change your mind?

Looking at Talk:Major_depressive_disorder/Archive_4#Illustrations I get the impression (the large downer smiley) that you consider the whole business a bit of a joke. Is that so?

I am trying to understand your motives here. Do you perhaps regard yourself as something of an authority on Vincent van Gogh? On his health? Perhaps you have published a dissertation or an academic paper? Or perhaps you regard yourself as something of an art critic? Do you perhaps post in Wikipedia on the visual arts? Do you have any association with editors who do that might lead to conflicts of interests? Perhaps you have patients who are artists or art critics that might lead to similar conflicts of interests? In short, what is this all about?

I trust you will agree there has been adequate time for you to respond here and that if you do not do now respond adequately, then the assumption must be that you do not intend to.

I am posting this on the IP address that Risker blocked and I will copy to your talk page.

Thank you. 31.6.53.252 (talk) 23:25, 12 February 2012 (UTC)

Why are we still debating Van Gogh's mental health when it doesn't make the blindest bit of difference to the appropriateness of the image in this article? Whether Van Gogh was depressed, schizophrenic, manic, a psychopath or completely normal, the picture is still a good illustration of despair and sorrow. That's all that matters. Let's just move on from this, further discussion is not accomplishing anything. Basalisk ^{inspect damage}⁄_berate 09:40, 13 February 2012 (UTC)

I agree the painting is emblematic of the topic, whether Van Gogh intended it to be such or not. (Off topic:There is a short interview with Steven Naifeh, one of the authors of Van Gogh: The Life here.) --Anthonyhcole (talk) 03:00, 17 February 2012 (UTC)

IF people spent more time helping and talking to each other instead of arguing what painting describes what and blah blah blah, we would be a much happier world. The painting is beautiful and so is everything else in the universe, love. — Preceding unsigned comment added by 99.254.240.157 (talk) 10:51, 25 February 2012 (UTC)

I should be curious to know from the user Basalisk above why the painting is a good illustration of despair and sorrow. It was meant to be an illustration of mortality and the divine (see my post below). Even were it a good illustration of despair and sorrow (and that's not what I see), then why should that be an icon for a psychiatric condition? Is it a mental illness to feel despair and sorrow? RobvanderWaal (talk) 07:14, 8 April 2012 (UTC)

Include more emphasis on DSM-IV's criteria

Hello all,

This is an excellent article. Nevertheless, since MDD is diagnosed in the medical and psychological community with criteria from the DSM-IV rather than through questionnaires and scales, it might improve the article if in the introduction there is a clear breakdown of the most recent criteria for diagnosing MDD.

In addition, the section on children and MDD can be improved. The current DSM-IV criteria include three cardinal symptoms for children. In order to qualify, the child must endorse one of the three for more days than not in a two-week period. These cardinal symptoms include a sad/down/empty mood, loss of interest or inability to enjoy most activities, and irritability.

Thanks for your time! Velvsop (talk) 17:31, 2 March 2012 (UTC)

The DSM 4 criteria are copyrighted by the APA and they have asked us not to use them. --Doc James (talk · contribs · email) 19:22, 8 April 2012 (UTC)

Van Gogh's painting "At Eternity's Gate" not a depiction of sorrow

I have made a substantial edit of the article At Eternity's Gate explaining this painting's genesis.

It was never meant to be a depiction of sadness or sorrow. In the two acknowledged catalogue raisonnés it was listed respectively as Worn Out: At Eternity's Gate and Old Man with His Head in his Hands. It was not until it passed into the collection of the Kröller-Müller Museum in 1970 that it was given the fanciful name Sorrowing Old Man, probably because they already had a drawing of a woman burying her face in her hands that they had named Mourning Woman Seated on a Basket.

The genesis of this painting is known in some detail and it is one of the rare examples where van Gogh actually made his intentions clear.

The inspiration for the original drawing, entitled Worn Out, was a print by the British graphic artist Hubert von Herkomer depicting a Chelsea pensioner slumped dead at Sunday service, a fellow beside him anxiously checking his pulse. This print was enormously popular and Herkomer worked it up into an oil painting with the sentimental title The Last Muster, which was exhibited at the Royal Academy 1875 and which cemented his career. Van Gogh certainly saw this when he was in London and his letters include several references to the print, which he admired greatly.

In 1882 van Gogh was looking for a subject that too would draw attention to him as a serious graphic artist and he elected on mortality as a theme. His drawing (and subsequent lithograph) was entitled Worn Out and was the basis of his later painting. In his letters he makes it clear that he was at pains to express the divine in his drawing, 'something on high' as he expressed it, quoting Millet, and later he wrote that he wanted to express the special mood of Christmas and New Year.

The later painting of 1890 was done at Saint-Rémy either during or directly after his longest and most acute episode of mania, which lasted some nine weeks. Generally speaking he was unable to paint or draw, or even to write letters, during his attacks, but on this occasion he was able to paint a few souvenirs of the North as he called them i.e. scenes from memory of Holland. Whether this painting was one of them or not is not known, if not it was painted directly afterwards.

Of course it's very curious and unsatisfactory that it has apparently become an icon of mental anguish and despair. RobvanderWaal (talk) 04:33, 8 April 2012 (UTC)

Not sure why it is unsatisfactory that it is an icon of mental anguish but this discussion is probably best at At Eternity's Gate Doc James (talk · contribs · email) 19:21, 8 April 2012 (UTC)

The article At Eternity's Gate is about a painting and not an article about a psychiatric condition that the painting is purported to represent. If you look at the various international wiki articles linking this painting, it's clear that the painting is now iconic for depiction of mental anguish in a way it was never before and wikipedia is quite plainly responsible for this. Of the various scholarly sources I have examined for this painting, none suggest it is a depiction of despair and anguish, precisely because of course scholars are aware that in fact van Gogh was on the contrary concerning himself with the themes of mortality and the divine. I was asked to provide an edit describing its genesis and I have done that. I merely wish to point out here that representing the painting as a depiction of despair and anguish is entirely misconceived. Since this is where that painting is so represented, it seems reasonable to me this is where to point that out. I did consider consider adding a section in the painting's article about wikipedia's iconisation of the painting but was advised by my editor that self-references of this kind in wikipedia is not advised.

There is no discussion needed here because the issues involved are simple matter of facts and I have nothing further to add for myself beyond noting that I will be following the development of this painting as a cultural icon as a matter of historical interest.

Thank you. RobvanderWaal (talk) 21:15, 8 April 2012 (UTC)

It doesn't matter whether the image was initially intended to represent despair or sorrow; the fact remains that that is the way it looks. The painting is a good visual representation of despair and that's all that matters. The article makes no mention of van Gogh's intentions and thus discussion over said intentions is irrelevant to this article's talk page. Basalisk ^{inspect damage}⁄_berate 22:13, 8 April 2012 (UTC)

I asked you above to explain to me why this image was a good image of despair and sorrow and all you do here is repeat your opinion that it is. Do you in fact have an argument to back your assertion or not?

I do not see this image at all as being about sorrow or despair. On the contrary I see it exactly as we know van Gogh intended it, as an image of frailty and resignation, consistent with the context of other studies he made of Zuyderland at the time such as F1002 Saying Grace.

If you wish to advance a drawing in which van Gogh unequivocally wished to make a representation of sorrow, or something of the sort at any rate, then I suggest you choose his famous study F929 of his partner Sien Horrnink at this time at The Hague, actually entitled Sorrow by him in English (in deference by the way to the British graphic artists of the time he so much admired) although I suspect that if his English had been better he might have chosen a word such as "desolation". Even in that image we know, because of another rare pronouncement of his intentions he made, he was also at pains to depict life's struggle, and again I would ask why you would wish to illustrate a psychiatric condition with a representation of a perfectly normal emotion, without which we would in fact not be healthy, possibly indeed the sort of desensitized pyschopath, if that indeed can be properly represented as a pyschiatric condition, you ludicrously include in a list you make above of the possible conditions van Gogh suffered from.

Of course it matters. I shan't make an excursion into explanations of the function and purpose of art, such as that put forward by Heidegger I personally espouse, but briefly it is to teach us a way of viewing the world:

“ [Art] gives things their look, and human beings their outlook. ” — Heidegger

Van Gogh quite literally did do just that with his work, precisely why images such as The Starry Night F612 are quite so popular. Popular taste is an uncertain referee of works of art, but in the case of van Gogh's major paintings (of which the color study in question here is decidedly not, whatever the merits of the original drawing) I doubt any serious art critic or historian would doubt its verdicts.

Do you in fact know van Gogh's figure drawing dating 1881/82 at The Hague? Few artists, if any, have ever embarked on a study of the human figure with the same intensity as Vincent brought to bear on his task at that time, in fact decisively ruining himself in the process. I am currently preparing an article in my sandbox on his Hague studio for Wikipedia and you might to like to glance through the finished article when I upload it a few weeks hence. I can't help but think if you did know this work in the context of his other works of the time, you would not be quite so insistent that the drawing in question here represents sorrow and despair.

As I understand, or at any rate as it was represented to me and I have no reason to suppose it was unfairly represented, the origin of all this here was a plainly neurotic post a few years ago suggesting van Gogh's painting can be taken as an icon of mental suffering. All I wish to do here is record the facts and note that I will be following its development. I think I'm entitled to aver the situation is unsatisfactory. While I'm happy to debate any serious argument about what is portrayed by this painting, I'm afraid I don't see any point in entering discussions which essentially deny the facts of the matter and merely repeat personal points of view.

I hope you will agree I have given generously of my time here, and I thank you for yours. Thank you. RobvanderWaal (talk) 09:00, 9 April 2012 (UTC)

Note: RobvanderWaal has been blocked as a sockpuppet of User:Rinpoche. Basalisk ^{inspect damage}⁄_berate 03:10, 10 April 2012 (UTC)

I have substituted van Gogh's 'Sorrow' image as per RobvanderWaal's suggestion. I trust this will be satisfactory to all parties and we can move on here. RUCloseYet? (talk) 05:13, 10 April 2012 (UTC)

I've reverted it. Please do not repeat this change; it is clearly against consensus and has been for ages (check previous discussions about this). In fact, I'm redacting RvdW's comments as he is a sock of a banned user. Basalisk ^{inspect damage}⁄_berate 08:25, 10 April 2012 (UTC)

Please do not refactor Talk pages per WP:RTP. I shall ask for eyes if you persist. RobvanderWall, a valued editor in the Visual Arts, is appealing his block initiated by you. I ask that his edit above be kept as evidence. It is not in your remit, as apparently some sort of injured party in a dispute, to act like this. Thank you. 31.6.27.228 (talk) 11:43, 10 April 2012 (UTC)

Fair enough, I apologise for removing the comments. Give me a break, though, I didn't "initiate" any block. I just raised concerns that RvdW and Skirt were the same person as Rinpoche, and turns out they were. That's not my fault; I didn't block anyone. This doesn't matter now anyway as RvdW has "retired". Basalisk ^{inspect damage}⁄_berate 13:18, 10 April 2012 (UTC)

No, no breaks here for you Basalisk. RobvanderWaal, Skirtopodes and Rinpoche are all different people. I know them well. Rob is simply defeated. One of the nicest people I know. Congratulations. But relax. No one is going to come after you. No one is going to sue you. Enjoy your little moment of triumph. LHirsig (talk) 15:19, 10 April 2012 (UTC)

Note To get a long standing image changed you will need to get approval through a WP:RfC. Cheers Doc James (talk · contribs · email) 16:47, 10 April 2012 (UTC)

Rob wasn't trying to change the image here. He wasn't trying to edit the article. All he was at pains to do was to point out that At Eternity's Gate isn't about sorrow or despair. It's about mortality and dying. Anyone with eyes and a modicum of sensitivity to painting can see that. The title makes it clear it's about mortality. And Rob's edit at At Eternity's Gate wasn't about original research. It's well known what this painting is about and his edit is meticulously cited. All it needed was a knowledgable opinion to set it right. He left it to you to put it right (it does need putting right) and this was how you treated him. Nor is it as if Skirtopodes was the first to raise the issue of the painting's suitability here. It was raised here before, acknowledged as pertinent and then just ignored. This isn't something that should need a WP:RfC. It's just plain wrong and you and your co-editors here are in denial. An image of mortal frailty illustrating a psychiatric condition noted for its suicide risk? Come on ... It's bizarre and not a little creepy. What can you be thinking? LHirsig (talk) 21:41, 10 April 2012 (UTC)

Nevertheless I've added a WP:RfC. Perhaps it will give one you boys (we are talking boys here, right?) a nudge. LHirsig (talk) 23:36, 10 April 2012 (UTC)

• And I've WP:DENYed it below. Sockpuppet, see [6] Dennis Brown (talk) 01:10, 15 April 2012 (UTC)

Hello Dennis. I am William Boyd, the infamous Rinpoche. Thank you for your remark about this image below. That was exactly my own thoughts when I first saw the article. Regarding all these socks identified, Skirtopodes, RobvanderWaal, and LHirsig, these are all known to me. They opened their accounts in good faith and have never edited disruptively. I am indeed sorry to be the cause it seems of so much grief.

Incidentally, the man in the image is not bowing his head in sorrow. He is in fact praying. Can you imagine anything more comical?81.178.38.169 (talk) 01:43, 15 April 2012 (UTC)

Lead image

WP:DENY. Dennis Brown (talk) 01:03, 15 April 2012 (UTC)
The following discussion has been closed. Please do not modify it.
The following discussion is closed. Please do not modify it. Subsequent comments should be made on the appropriate discussion page. No further edits should be made to this discussion. ♦ Should the article continue to be illustrated by Vincent van Gogh's At Eternity's Gate now it has been unequivocally established that this painting, as its title suggests, is a depiction of mortality and dying and not sorrow? Thanks. LHirsig(talk) 23:36, 10 April 2012 (UTC) Yes we should keep this image This book [8] appear to state that this image represents depression. Thus I support I keeping it.--Doc James (talk · contribs · email) 00:05, 11 April 2012 (UTC) The book (Gilman, Sander L. - Seeing the Insane) does not say that in the Google selection you link. It says that in At Eternity's Gate van Gogh portrays an individual driven to the brink by society's inhumanity and that is all he says about the painting. Mostly the excerpt, and it is only an excerpt, is about Sorrow, the van Gogh image RobvanderWaal suggested should illustrate the article. Is this your only source, an excerpt from a single Google book, and are you incidentally denying the theme of this painting is mortality and sanctity, as van Gogh expressly said it was? LHirsig (talk) 00:50, 11 April 2012 (UTC) This source also states that the painting gives the impression of despair. I think it's a good illustration; I feel that this image has been used successfully for a long time and what van Gogh intended to convey through the painting is irrelevant - the point stands that it illustrates despair and depression well. This RfC is the result of a single editor (who is, in my view, very likely a sock puppet of another blocked user) trying to use wikipedia as a soapbox to make a point about modern art. The objection has nothing to do with trying to improve the Major depressive disorder article. Basalisk inspect damage⁄berate 06:48, 11 April 2012 (UTC) Come on, Bailisk. It's a blog from the Tokyo Times making unsourced and uncited assertions, not a RS and it's not even primarily about van Gogh. I should think the sources of the author's assertion is Wikipedia itself (this indeed being what RobavanderWaal is currently tracing in his investigations into the development of this icon: I should think he's probably contacted the author by now :)). LHirsig (talk) 08:44, 11 April 2012 (UTC) "Your source is not reliable"; the last bastion of the tendentious editor. Basalisk inspect damage⁄berate 10:37, 11 April 2012 (UTC) And the second pillar of Wikipedia I believe, but naturally I am pepared to defer to a physician who contributes such a lot to Wikipedia. LHirsig (talk) 01:37, 12 April 2012 (UTC) No we should not use this image The editors should use van Gogh's image Sorrow instead, as RobvanderWaal suggested. It's plainly bizarre and unsatisfactory that the article is presently illustrated by a painting whose theme, as its title suggests and van Gogh's own letters confirms, is mortality and death. LHirsig (talk) 01:03, 11 April 2012 (UTC) Even though depression carries a high mortality rate? Basalisk inspect damage⁄berate 06:53, 11 April 2012 (UTC) Well yes absolutely, good point. Rob kept away from this issue because he didn't want to pass himself off as physician. While you may not be sensitive to it, the image nevertheless conveys subtle messages about an old man quietly facing his passing with calm resignation (that is after all, what the title suggests and what van Gogh says he was trying to express). Is that really suitable for an article on depression? The issue has been raised before here. I'm not going through these archives again, but they were expressly raised, acknowledged by an administrator (a physician like you) with eyes on this page,and nothing ever done about it. LHirsig (talk) 08:44, 11 April 2012 (UTC) If you've raised this before, several times, others acknowledged what you were saying, and yet failed to act on it, then don't you think it's time to accept the possibility that you're the only person who thinks this way? Whether or not you are sensitive to it, the image conveys completely unsubtle messages about a man who looks in visible despair. This is not rocket science; we don't need to supply sources stating that this looks like a man in despair any more than we need to supply sources to say the clothes he is wearing are blue - it's just an obvious, intrinsic fact of the painting. Why should we sacrifice that which is obvious for that which is obscure, particularly as there are indeed sources to support the most obvious interpretation? Basalisk inspect damage⁄berate 10:58, 11 April 2012 (UTC) First of all I haven't raised anything here before. Secondly, and I'm sure as a busy physician working long hours in the public service you will be the first to acknowledge this, only the most immediately involved editors generally have time for a Talk page topic. I can assure you that there are lots of people I know who are concerned, or at least interested, by this issue and I ask you to accept this in good faith. I should also be grateful if you were to be slightly less agressive and patronising in your remarks. I appreciate that physicians sometimes have to be blunt in their dealing with patients, but I am not one of your patients. I repeat, this is not an images of a man in despair. I do not see it as such, art citics in general do not see it as such and van Gogh did not intend it as such, quite the contrary. In recent times it has become an icon of despair only because of Wikipedia (I see the corresponding Dutch article notes this). The origin of it, as far as we can see, is the Kröller-Müller's somewhat gratuitous retitling of the painting when they took possession of it in 1970, and I know Rob is currently chasing that up. Without getting bogged down in a long discussion no one will read anyway, I suggest there are two factors at work here: first of all the generally ambiguous nature of sorrow itself, the most motile and reserved of our emotions, and secondly the narcissism of our present age, its present tendency to distance itself from, or even to deny, the fact of death, and the present day disinterest in the sacred, the "something on high" Vincent wrote about, quoting Millet. As a physician of course, you will be aware that we see is not a given but a matrix we work on. I am surprised that a physician such as yourself is quite so blithely unconcerned by the possibility that an article dealing with depression, with its known suicide risk, is illustrated by a painting which essentially celebrates death as a passage to eternity. A related issue that was raised in the past, and again never satisfactorily addressed, is that most depressions are in fact not accompanied by manifestations of acute despair as you claim the painting depicts. As a physician you will be aware all too often of suicides that present without any indications of mortal despair. In the UK there was just such an example a few months ago of a noted celebrity hanging themself just hours after appearing relaxed and happy on television. Don't you worry that a sufferer of depression seeing this illustration might conclude that it's not depression they're suffering from but something else and refrain from seeking treatment? LHirsig (talk) 01:37, 12 April 2012 (UTC) Since you seem to be seeking my medical opinion, I'll tell you you are completely incorrect - despair and hopelessness are virtually universal symptoms of major depression. You can have a look at the NICE guidelines if you don't believe me. I am indeed aware of cases whereby patients commit suicide without appearing publicly depressed, but in private these kind of feelings are a constant in depressed patients. Please heed my advice when I tell you that your persistent argument that depressed people do not suffer from feelings of despair is simply incorrect. As for the painting: look, I understand that, with your knowledge of the world of art, you have a different interpretation of the painting to what it's being used for here, but you have to accept that your interpretation differs from the common one. Two sources have already been supplied to support the views of the majority of editors here, namely that the painting depicts a sorrowful man. This is the only reason why the image is appropriate - it gets the message across to the majority of readers. Basalisk inspect damage⁄berate 09:18, 12 April 2012 (UTC) Yes, I very much doubt that a well conducted survey among the general public would find that people generally felt the subject of the painting was in a happy position! I think that's the basis for its inclusion here. Of course, there is much more to be seen and said about the painting than that, but this is not a page about Art. —MistyMorn (talk) 09:40, 12 April 2012 (UTC) Yes that is my point entirely. I'm sure there is much more to the painting than what the layman sees, but that is beyond the scope of this article and should be taken up on the painting's article. Basalisk inspect damage⁄berate 09:42, 12 April 2012 (UTC) And of course an understanding of the artist's intentions is just one aspect of art history and criticism. The clothes may appear celestial, but the posture speaks of grief—as almost anyone who sees this painting will immediately feel. I think that's sufficient editorial justification for this particular illustration. —MistyMorn (talk) 10:07, 12 April 2012 (UTC) @Bailisk I was not seeking your medical opinion. Despair and hopelessness are not 'virtually universal' symptoms of depression. If that were so the article would surely say so, but it does not. The NICE guidelines you reference says nothing of the sort. Nice CG90 references WHO ICD-10 which lists hopelessness only three times as one of a constellation of key features in schizoaffective disorders (F25.1), post-traumatic stress disorders (F62.0), and depressive conduct disorders of childhood (F92.0) and certainly not as a universal vector, and lists depair only in acute stress reaction (F43.0). The situation, which as a recently qualified physician you surely must know (or at any rate ought to know), is that suffering from depression makes it difficult to deal with feelings of despair and hopelessness, but the subject need not feel despair or hopelessness. This is especially true of children and teenagers: "Children and adolescents may display mood that is cranky or irritable rather than mood that appears sad or despondent" (NICE CG90 and cf. the article here). It is also culturally dependent. Your talk page says you are Welsh. As a Welsh pysician you will therefore surely know of the distressing epedemic of teenage suicides in Bridgend. Most of these teenagers appeared to have no personal issues involving unhappiness at the time. A plausible theory about possible causes were that that they were signing onto internet sites romanticizing suicide, just as this image in question does of van Gogh, and of depression in general. I find it quite extraordinary in the circumstances that you dismiss the point made (not by me, I am merely repeating it) earlier on this Talk page and, as I say, acknowledged but never addressed. To repeat: the painting depicts an old man on the threshold of leaving life and facing his end with resignation and dignity. No doubt it is misunderstood today for the reasons I sketch above but nevertheless that is what its intent was, and who is to say how much of that might still be subconsciously conveyed, for example, to an impressionable youngster? If I might suggest, Vincent's vision is likely more acute and enduring than yours. @ MistyMorn The blue color is merely the color of the bomabazine suits worn by almshouse pensioners such as the model Zuyderland (the linked article is one of the stubs provided by Rob while he was editing). I don't think there is any color symbolism in this painting. I should imagine the blue was Cerulean blue, a rather cold blue, recently discovered, that Vincent liked. The painting is an entirely unremarkable, frankly pedestrian, color-study exploiting the contrast between the cold blue of the suit and the warm red of the fire. Its interest lies in the figure, but that is an exact copy of his 1882 drawing (and subsequent lithograph) Worn Out (F997). You might like to look at the article At Eternity's Gate, largely contributed by Rob and the noted Visual Arts editor Modernist, for its backgound. You are wrong I think to imply the body language is sorrow (grief). In sorrow you have a shielding or covering of the face, but in this painting the subject is simply holding his head in his hands in fatigue, his arms resting on his knees. The other major characteristic of sorrow is collapse, but there is no collapse here. The issue here isn't of art history. It is rather of seeing things as they really are, ultimately of being free to see things as they really are. Thank you for your input. LHirsig (talk) 21:01, 12 April 2012 (UTC) Well, thank you for your civil comment. I did of course peruse the article, which I found interesting, and actually made a very small copyedit. My point wasn't primarily about the blue, as I think you gathered. I have thought carefully about this question and believe that the illustration sends a very valid message to visitors to this page, without providing misleading information about van Gogh. I do think this picture elicits a strong emotional response related to grief (certainly that's my own quite involuntary response!), and is an effective way of communicating something important about the subject matter of this page which words don't easily carry. At the same time, I agree that the picture is not an illustration of a "disorder" as such—rather of an experience related both to that disorder and to major life events involving intense emotional pain. I've suggested that the caption could clarify the reason for the illustration's inclusion. However, the present caption does correctly report the title of the work, so I can't see any form of disinformation—something which would of course be quite wrong even on a page not related to art. In brief, I've come to think this is a very effective illustration: it's highly communicative and has a real-world feel which people spontaneously relate to. —MistyMorn (talk) 23:08, 12 April 2012 (UTC) Skirtopodes was certainly only concerned with what you might term Vincent's moral rights. I don't know what the situation is there. I might seek to open a discussion in Wikipedia about it when I'm through here. It seems to me whereas Wikipedia can assert its right to reproduce a faithful image of a work of art out of copyright, it can't ignore the artist's moral rights in doing so. For example if Wikipedia was in the funeral homes business, it couldn't use Vincent's painting here to advertise its business, and I don't really see why that same principle shouldn't apply to an encyclopedia. However I know nothing about that and I might simply be just plain wrong. But Vincent's moral rights aren't really my concern. I asked Rob to contribute his edits because I wanted truth to prevail. That's all. I've gone the Wikipedia way of asking for sources and I think a dispassionate observer will agree they simply haven't been provided. I expect Rob will eventually supply elsewhere a history of this icon (and once we have that to cite we will provide an article about it in Wikipedia). Basilisk's naive remark that not everything needs to be cited is wrong-headed. If it's challenged, and we are challenging it, then it must be cited, otherwise Wikipedia's verifiability model collapses and truth is on a hiding to nothing. The origin of all this was a neurotic post suggesting Vincent's painting can "emblematise" (I think that was the word) the suffering of depression. But that simply misunderstands the painting. You can misunderstand paintings in the same way you can misunderstand a novel or a mathematical equation. An article suggesting Winnie the Poo is about gay rights or that Einstein's mass-energy equation E = mc^2 is about dieting wouldn't, I suppose, last very long in Wikipedia. Why should it be different for a painting? The reason people are seeing this painting as an icon of mental anguish is because Wikipedia is telling them to see it as such. That's all. There are also cogent medical concerns here as well. I frankly think it beyond appalling that the medical community (I mean the real medical community) is not addressing the issues raised here and never have.. It worries me that the community building this article is not addressing the issues raised here and never have. They have all been raised before and simply ignored, fobbed off with a downer smiley. Have a look at this image of van Gogh's that Rob suggested. That is incontrovertibly about sorrow. Wouldn't that be a better image? LHirsig (talk) 01:02, 13 April 2012 (UTC) You're free to take this question elsewhere. Please note that the remark about the "real medical community", and others you've made above, could be found offensive (see WP:CIVIL). You'll find I did reply above to your suggestion about "Sorrow". I've finished here. —MistyMorn (talk) 07:35, 13 April 2012 (UTC) I took a coffee break and when I returned, I found you had revised your edit! To deal first with your reproach about the "real medical community": that wasn't a personal attack (I see you sometimes edit on medical matters) and I'm sorry if it offended you, I really didn't mean to. I simply meant the medical community who are building this article. You originally remarked that you doubted I had a case concerning moral rights. I thinks that is indeed probably so. Just to clarify, those aren't my own concerns here. They were Skirtopodes's concerns. We had in mind something like the Visual Artists Rights Act in US jurisdiction, but those aren't granted posthumously. That is not to say Wikipedia should not extend these rights posthumously. I shall probably draft in an expert to raise the issue, who will in due course be banned as a sock of Rinpoche :). Thank you again for your time. Appreciated. LHirsig (talk) 09:01, 13 April 2012 (UTC) Thank you for striking that sentence, which I felt could be offensive to some well intentioned and hard working editors on this page. I struck my observation about legal issues as I was not sure how to interpret your remarks. Obviously, non-disruptive, civil, good faith discussions on the Wikipedia site about issues of legality are acceptable, but to prevent potential misunderstandings when raising legal questions I guess it is really important to bear in mind rather carefully the issues outlined in WP:THREAT. I cannot comment about questions of sockpuppetry (other than noting the existence of WP:CheckUser). I have given my editorial opinion, as requested, and do not have anything further to add in that regard. Sincerely, —MistyMorn (talk) 10:36, 13 April 2012 (UTC) No, I certainly didn't mean to be offensive. Nor would we be raising any sort of legal threat in raising the question of moral rights. Copyright issues are often debated on Wikipedia without, as far I know, necessarily invoking legal threats. I mean the issue we would raise is whether Vincent has some moral rights to his work and reputation after his death. From a legal point probably not, but we are talking his moral rights in themselves and not any legal protection that may or may not exist. For example, Vincent is an example of a historical figure for whom some sort of case can in fact be made out for his being bisexual. Adding a GLBT category to his bio is the sort of things that Wikipedia characteristically debates at some length and the issue in the end is protecting the individual's moral rights. I wasn't trawling you for on opinion about the vexed problem of Rinpoche's sock-puppetry! He's retired now anyway. Others continue the thankless task :). He was simply a conduit, active on that thing he was doing long, long before Wikipedia came on the scene. Kind regards. LHirsig (talk) 11:44, 13 April 2012 (UTC) Without wishing to take sides or enter into any of the details, could I just add that WP:JUSTICE may indeed be of relevance to this sort of longstanding and deeply felt issue? Thanks, —MistyMorn (talk) 12:45, 13 April 2012 (UTC) No, I don't agree. As I remarked before it's just plain wrong to label this image as an image of sorrow. Easy mistake to make, the Kröller-Müller Museum apparently made it in 1970. Even Skirtopodes, who happens to own a few of these things, didn't really know the facts. Rob wasn't indulging in any OR. He replied immediately to my initial email of enquiry setting out the facts of the matter. It's well known. For the last time, we are not setting any great wrongs right here. We are not telling the editors what they should do (although we have made a reasonable suggestion as a compromise) and we have not attempted to edit the article. We are not frantically enlisting support from some 40 at least associates of ours who have Wikipedia accounts. We will move on here if we cannot accomplish what we wish. Eventually there will be a RS published pointing out the facts and we will return then. Why all the resistance? It's not like some enormous paradigm shift we are talking here. LHirsig (talk) 13:06, 13 April 2012 (UTC) Pretty well through here until our RS appears. I'm sorry, and frankly unimpressed, that the medical community have not responded here. There is of course one final salient issue raised very early one on by retired User AnmaFinotera and that is why is this image here at all? Accepting momentarily that it might evoke thoughts of sorrow and despair when placed in this context, why is it given prominence as a lede image when in fact sorrow and despair are only fleetingly referenced in the article? That does seem to be contrary to the spirit of Wikipedia:Images#Images_for_the_lead. Perhaps our resident Welsh physician might care to comment on behalf of the medical community. And while you're at it Eddy, Joel (whomever), would you care to explain the meaning of "I'm a doctor, bitches". I happen to be a woman. Would that be what I am to you then? A bitch? I would like an explanation please on behalf of my gender. Thank you. I will be back probably :). LHirsig (talk) 06:07, 14 April 2012 (UTC) Whatever is this cryptically worded link is supposed to refer to? The edit/diff you cite as "I'm a doctor, bitches" is a tiny format change connected with WP:IRL. There are settings where stuff like this can be used to send a veiled message in real life. Obviously, I do trust there is no implied threat here. But I think you need to be much more careful in the wording of your remarks and their potential interpretations. Cryptic personal remarks are always unpleasant. —MistyMorn (talk) 10:24, 14 April 2012 (UTC) Ok, I've just spotted the "bitches" reference in the edit summary of that diff, but in practice this question has caused me concern and eaten up an hour of my morning. I really don't think this is an appropriate way of communicating on Wikipedia. To an innocent eye, it looked like it could have been a threat and that concerned me. Please be more careful about how you express yourself. That personal issue had absolutely nothing to do with the subject of this page anyway, and this Talk page is not the right place to raise such matters. —MistyMorn (talk) 11:38, 14 April 2012 (UTC) Just thought I'd respond, as while I don't believe Hirsig is being truthful about his gender, he does raise a valid point. The diff he posted was from the day I got my exam results (I passed my finals), and naturally I was pretty happy about this. Hence the zealous edit summary. For the record, my name in real life is Joel. Back to the discussion in hand... Hirsig, I suspect no one is responding to you because you don't listen to what other people are saying unless it's what you want to hear. Nothing productive ever comes of talking to you. I've already made my point, there's nothing left to say. Basalisk inspect damage⁄berate 12:23, 14 April 2012 (UTC) Same here. I've said what I had to say, and tried to restrict the drama. But I've found myself getting caught up in it myself by accident, and will now quit. —MistyMorn (talk) 12:36, 14 April 2012 (UTC) I'm not concerned about my anonymity (though I am with my privacy). My name is Leah Hirsig. I am an art teacher and a woman. Rinpoche's name is William Boyd (he is happy for me to give out this information, which is indeed available on his IP talk page). He is a retired mathematics teacher. He has a family connection with Vincent van Gogh and indeed with me, though that goes back generations. Skirtopedes is a Swiss art collector. RobvanderWaal (a pseudonym) is an Amsterdam auctioneer. It was William who tipped me off about this image early last year in connection with one of his I agree rather frequent dramas on Wikipedia. I happened to mention it casually to Skirtopedes around the summer of last year. I had no idea he had an account on Wikipedia until he emailed me to say he had been banned, explaining the circumstances. I contacted Rob about the background and he immediately replied with the information he sketched above. I suggested he provided an edit for At Eternity's Gate and he did so, as well as all the other edits he subsequently made. I do hope this helps allay your feeling of threat, which I have to say seem somewhat developed to me. Why did you originally call yourself Eddy? Why 'bitches' please? Are you going to respond to the points I make that sorrow and despair is only fleetingly addressed in the article? To the remark I make about the Bridgend teenage suicides, which must surely be a matter of concern to you as a Welsh physician? Can I ask you what input you have made to this article itself (not the Talk page, the article)? The list of contributors is rather long and I couldn't find you, but I perhaps do you a disservice. Finally, don't you think that if you elect to pass judgements on clinical matters (especially when they are in fact false) as you did above, then you ought not to remain anonymous so that you are available for peer review and oversight by your professional body? LHirsig (talk) 13:36, 14 April 2012 (UTC) I thought this obvious by now, but you don't seem to understand, so I shall make this clear - I disagree with what you're trying to argue about the painting. I've explained why many times over. For a brief summary, see the "Yes we should use this image" section above. I have no desire to discuss anything other than this issue (such as my professional standing) with you, and I have said everything there is to say in this regard. There is nothing left to say, and I won't be responding to your comments any further. Basalisk inspect damage⁄berate 14:00, 14 April 2012 (UTC) We are not arguing anything about the painting. Just stating what is a simple matter of fact, videlicet that far from being a depiction of sorrow it is in fact a depiction of a tired old man contemplating his passing from this life with dignity and resignation, and thus probably not so fantastically suitable for an article about a psychiatric condition with a known suicide risk. But I do appreciate, Joel, that as you venture out on those first crucial steps in your professional career as a Welsh physician working long hours, 80 hours or more a week typically I understand when you start out, you will have less and less time for Wikipedia so I shan't press you. It's been a fascinating exchange of views I must say! I do wish you could perhaps put your name and practice details on your userpage so that those of us in Wales can make better informed choices about their preferred physician (I mean really that wouldn't count as advertising and would be quite acceptable I think, honest). I do sense a certain reservation in your leave taking and I'm sorry for that. I want to wish you all the best, Joel, and indeed make you an offer. If that work-load does get too much and you need some help and advice with difficult presentations, do feel free to post on my talk page and I will look it up myself on NHS Direct and Wikipedia for you and post it back. That should be really useful. Pob hwyl! (Bless x - Leah) LHirsig (talk) 16:55, 14 April 2012 (UTC) Oh well. I have tried to reason with you, but I'm bored of this now. You can go explain yourself at ANI. Go troll someone else. Basalisk inspect damage⁄berate 17:07, 14 April 2012 (UTC) LHirsig wrote: ...don't you think that if you elect to pass judgements on clinical matters ... then you ought not to remain anonymous so that you are available for peer review and oversight by your professional body? Again, this deeply ambiguous (albeit quite implausible) suggestion seems to me to be very unfortunately worded and also, to my knowledge, completely out of line with Wikipedia policies on the right to maintain anonymity. Please desist. —MistyMorn (talk) 14:09, 14 April 2012 (UTC) Other comments Comment - I don't think this issue should be a big drama. I think it's important to remember that the main focus of this article is Medicine and Psychology rather than Art. From that standpoint, I think the current illustration -- unlike Van Gogh's more symbolic portrayal of Sorrow -- has the not inconsiderable advantage of communicating intuitively to a general readership (for which Wikipedia is primarily written) the real-world suffering of despair inherent in a condition which, like most psychiatric conditions, still tends to be stigmatized. At the same time, I can also understand how an art critic may question the correspondence between the subject of the painting and the specific topic of the article. My own feeling is that the page illustration does not do any violence to the reputation of the artist. Suggest: Maybe the caption could be expanded to clarify the reason for its usage here? 2 cents, —MistyMorn (talk) 14:13, 11 April 2012 (UTC) Comment I stumbled across the article before I saw the dicussion, and I have to say that my first impression was "what is that picture doing in the lead?". I have no idea if the lead should have an image or not, but it isn't a topic I would be expecting one, and this one seems out of place. I have no desire to get into a debate on the image, but again, does Wikipedia NEED an image here at all? Does it add understanding of the topic? I don't have the answer to that. Dennis Brown (talk) 17:39, 14 April 2012 (UTC) The discussion above is closed. Please do not modify it. Subsequent comments should be made on the appropriate discussion page. No further edits should be made to this discussion.

Accelerated aging-like Telomere-related issue, reference

• New View of Depression: An Ailment of the Entire Body April 9, 2012;

108.195.138.124 (talk) 02:20, 12 April 2012 (UTC)

Primary research

This article has a huge issue currently which is that it is not based fully on secondary sources per WP:MEDRS. I have just removed 154, 155, and 156. For this article to stay featured these issues need to be addressed. I will take a stab at it eventually unless someone else wishes to begin. --Doc James (talk · contribs · email) 23:12, 14 April 2012 (UTC)

I think "huge issue" is perhaps an overstatement. After your edits I am having difficulty spotting any more. Looie496 (talk) 00:41, 15 April 2012 (UTC)