Discussion Depression vs. Sadness.

[Forever Sleep]

I've just watched an interesting interview with Jimmy Carr. He made the distinction between sadness and depression. Saying that depression was an illness. A serotonin imbalance (haven't they disproved that?) But also that if it's only sadness- then you're in luck. Sadness because of your situation means you can change it. I'd argue that though. I'd say longer- term sadness because you find you can't change your circumstances (adequately) is likely why people become depressed. So, in a way, sadness can lead to depression. So- we're probably depressed because we are or were sad about something. Maybe not so much that we just happen to 'catch' depression that causes us to be sad. I suppose that can happen too though. I imagine most depressions are triggered by something though. What do you think? What was your experience?

He also quoted that cliche: 'Suicide is a permanent solution to a temporary problem.' Which I utterly hate to be honest. Plus, that suicide was a symptom of depression. I agree it can be but I don't like the usual parallel between suicicide = depression = diseased, irrational mind.

He made the point that people don't want to die, they want their life to be better. Maybe but, we're with it enough to realise it doesn't magically get better. It requires a great deal of work and, the results aren't always worth the effort. I imagine most people start considering suicide seriously when other attempts to 'fix' their life/ depression even have failed. I doubt too many people leap straight to suicide as a solution.

Asides from that, I think he came up with some interesting perspectives. I just wondered what other people here would think. I always like to read the comments section to judge how random people think. Most seem to agree with him. What do you think? Here's the interview:

 

[Darkover]

i became sad because my first and only girlfriend dumped me at aged 18 then i became depressed because i know i would never have sex again then i became suicidal then i realized we are nothing forever which cause even more depression

 

[Holu]

Psych Grad student here.

Firstly, and this is a disclaimer, but I'm not watching that video, since no offense but why are you listening to Tate regarding depression. Not to knock your particular tastes but I will say the dude is entirely unscientific about many of his beliefs. As such, since I'm not watching the video or even reading the transcript, I can't really give a fair assessment on this individuals opinion besides what you have already described. Nonetheless I will do my best.

Clinical depression, as in Major Depressive Disorder(MDD), Persistent Depressive Disorder(PDD), Seasonal Affective Disorder(SAD), and even the depressive parts of Bipolar 1(BP-I) and 2(BP-II) are all DISORDERS, meaning the symptoms have patterns and last for at least 2 weeks, whereas sadness is just an emotion, albeit an emotion which can last quite long.

As for the idea that MDD or any depression is a chemical imbalance… well that's complicated. It's not untrue to suggest that it's a serotonin imbalance, and it's a theory which isn't actually debunked. It's just not a complete truth. Depression is caused by… well it's caused by a lot of possible things, and we really and I mean really suck and struggle with identifying the root cause/causes.

Some people do in fact, suffer from a natural serotonin deficiency, in which SSRI(selective serotonin reuptake inhibitors) can help solve this deficiency. But then again, some people respond much better to NDRIs(norepinephrine dopamine reuptake inhibitors). And some people don't respond to these meds at all, because for them it could be as little as say a testosterone/estrogen deficiency, an iron deficiency, or most notably a glutamate deficiency. In fact, the glutamate deficiency is really noteworthy because if you have TRD(treatment resistant depression) then glutamate treatments like ketamine therapy have been shown to help tremendously.

The reality of depression is that we just don't really understand enough. It's why treatment is mostly just a shotgun blast of different things rather than a silver bullet. Its also why it's so difficult to tackle, because it can take weeks to find the proper medicine, then on top of that the person has to take their medicine, has to go to therapy, has to eat healthy(microbiome is important for depression!), has to exercise regularly, has to socialize regularly, has to minimize screen time and social media, has to find a meaningful job/hobby, and 30000 other different things. Most people if your curious can barely do two of these if they aren't already things the person already did regularly lol. The reality is a proper "foolproof"(it's not but it's as close as it gets atm) solution is something only a small amount of people can even afford the money and time to pursue.

TLDR: Clinical depression and sadness are different. One is a pattern of symptoms whereas the other is an emotion. The serotonin imbalance theory isn't debunked, it just oversimplifies what depression is. Finally depression and more specifically its treatment are both multi factorial meaning you have to basically throw shit until something sticks. Hope this helped!

Edit: I just looked up Jimmy Carr. THIS IS NOT SOMEONE YOU SHOULD BE GETTING CLINICAL ADVICE FROM. Anything and everything both him and Tate say in regards to this are just opinions and should be treated with skepticism. I'm not saying you don't have to trust them or agree with them, I'm saying these aren't really people who are operating off the same standards as any clinician or student.

 

[Forever Sleep]

Psych Grad student here.

Firstly, and this is a disclaimer, but I'm not watching that video, since no offense but why are you listening to Tate regarding depression. Not to knock your particular tastes but I will say the dude is entirely unscientific about many of his beliefs. As such, since I'm not watching the video or even reading the transcript, I can't really give a fair assessment on this individuals opinion besides what you have already described. Nonetheless I will do my best.

Clinical depression, as in Major Depressive Disorder(MDD), Persistent Depressive Disorder(PDD), Seasonal Affective Disorder(SAD), and even the depressive parts of Bipolar 1(BP-I) and 2(BP-II) are all DISORDERS, meaning the symptoms have patterns and last for at least 2 weeks, whereas sadness is just an emotion, albeit an emotion which can last quite long.

As for the idea that MDD or any depression is a chemical imbalance… well that's complicated. It's not untrue to suggest that it's a serotonin imbalance, and that isn't actually debunked. It's just not a complete truth. Depression is caused by… well it's caused by a lot of possible things, and we really and I mean really suck and struggle with identifying the root cause/causes.

Some people do in fact, suffer from a natural serotonin deficiency, in which SSRI(selective serotonin reuptake inhibitors) can help solve this deficiency. But then again, some people respond much better to NDRIs(norepinephrine dopamine reuptake inhibitors). And some people don't respond to these meds at all, because for them it could be as little as say a testosterone/estrogen deficiency, and iron deficiency, or most notably a glutamate deficiency. In fact, the glutamate deficiency is really noteworthy because if you have TRD(treatment resistant depression) then glutamate treatments like ketamine therapy.

The reality of depression is that we just don't really understand enough. It's why treatment is mostly just a shotgun blast of different things rather than a silver bullet. Its also why it's so difficult to tackle, because it can take weeks to find the proper medicine, then on top of that the person has to take their medicine, had to go to therapy, has to eat healthy(microbiome is important for depression!), has to exercise regularly, has to socialize regularly, has to minimize screen time and social media, has to find a meaningful job/hobby, and 30000 other different things. Most people if your curious can barely do two of these if they aren't already things the person already did lol. The reality is a proper "foolproof"(it's not but it's as close as it gets atm) solution is something only a small amount of people can even afford the money and time to pursue.

Thank you for your interesting response. The interview wasn't with Tate. It was with Jimmy Carr. They touched on a bunch of issues before they talked about Tate- I actually hadn't reached the end when I decided to post here. I think they've only used Tate to pull the views in.

Yeah, I got the impression too that depression is still a bit of a mystery. In a way though- my argument sort of stands. If a person doesn't feel able to change the circumstances which make them feel sad- they'll continue to feel sad. Maybe there are outliers. There are here. They seem to be ticking all the boxes with regards to health, wealth, social support and yet, they still suffer.

Still, I suppose I just didn't especially like the whole: 'If you're sad because of your circumstances- you're lucky- change them!' Some people simply struggle too much to do that. Not necessarily because they're depressed too. If they can't seem to find employment no matter what they try, the fear of destitution may well make them depressed. I think it's easier for someone who has found success to assume all people can. Of course, that's not to say people shouldn't try but, even hard work doesn't always pay off.

 

[Holu]

Thank you for your interesting response. The interview wasn't with Tate. It was with Jimmy Carr. They touched on a bunch of issues before they talked about Tate- I actually hadn't reached the end when I decided to post here. I think they've only used Tate to pull the views in.

Yeah, I got the impression too that depression is still a bit of a mystery. In a way though- my argument sort of stands. If a person doesn't feel able to change the circumstances which make them feel sad- they'll continue to feel sad. Maybe there are outliers. There are here. They seem to be ticking all the boxes with regards to health, wealth, social support and yet, they still suffer.

Still, I suppose I just didn't especially like the whole: 'If you're sad because of your circumstances- you're lucky- change them!' Some people simply struggle too much to do that. Not necessarily because they're depressed too. If they can't seem to find employment no matter what they try, the fear of destitution may well make them depressed. I think it's easier for someone who has found success to assume all people can. Of course, that's not to say people shouldn't try but, even hard work doesn't always pay off.

Ngl in my tangent I completely forgot to address the other points you made lmao so I will now.

Firstly, even if the interview wasn't between Tate and Carr, if Carr wasn't the interviewer in this but the interviewee, then I recommend you approach everything he says with heavy skepticism. That said, thank you for clarifying because while I'm not personally familiar with Tates opinions on depression, given his personality and identity, I would recommend avoiding trusting him on such a topic.

As for your point on whether a person feels capable to change their circumstances, this is even murkier territory. On one hand, it could absolutely be learned helplessness, which is the a phenomenon in which an individual develops a sense of powerlessness and inability after say 1 or more failed experiences with something. This is dangerous when it comes to treating depression or any disorder for that fact, because if the first attempt fails the individual can very easily just assume it will never work, and thus it never does.

That said, there is also the possibility that depression is so intertwined with an individuals identity, especially if they have had it for a long period of their life, in which depression has shaped their choices, experiences, relationships, and identity. In that case, it gets way more tricky because it's arguably a philosophical problem.

A quick side note, but since you mention health and wealth, there is a statistical paradox that wealthier(and subsequently healthier) countries struggle with depression more than poorer countries. There are a variety of theories attempting to explain this, such as a theory that people focused on survival aren't able to truly focus on more internal things like meaning, connection to others, and such. But it is worth noting because money at least from a meta perspective does not bring happiness lol.

Now, from here on out I'm going to stop operating from a somewhat objective perspective and tell you my genuine albeit subjective opinion.

I agree wholeheartedly that circumstances being bad is absolutely a reasonable cause for depression and even defeatism. It might not be the healthiest response to such a situation, but it's very much a reasonable one. I find perspectives like Carrs to be juvenile in nature and heavily meritocratic, and like all of meritocracy, it means nothing if you don't actually bother acknowledging any systemic problems that undermine the situation. Personally, I think ones finance situation is by far the most relevant to one's ability to recover. Let me give you a brief example.

Let's say we have two recovering drug addicts, one from a rich family and another from a poor family. Let's assume everything about them is entirely identical except for their financial situation. Who do you think has a better chance of fully recovering and rejoining society? It's pretty obviously the wealthier individual, because they can afford things like rehab, likely have less stress which could drive them into relapse, and have the spending money to distract themselves.

Thats basically my personal issue with Carrs, yes the situation being bad means it can be recoverable, but if you don't bother to actually look at why the situation is bad, then you are just shaming people for failures in which they don't even have the necessary tools to fight back with. Sure the poorer individual can recover fully, but the difference is quite literally 10000 steps on an escalator that's going against them, whereas the rich individual took the elevator.

It's hard to find the strength to fight, and especially hard if you are dealing with more problems than just one bad situation.

Anyways I hope this helped in some way.