@100 What that comment means is that stigma is a lot of the problem. The kill rate for mental illness in some countries is very high, like 95%. Used to be double what it is now here, in my lifetime. Reduction of stigma saves lives. Acknowledging that it's real and can't be worked or willed away is part of facing and eliminating that stigma we've all been taught.

Lava @45 "If this LW was such a jerk, why did his ex feel devastated when he left her."

Are you kidding?
1. It hurts to be dumped, whether the person who dumped you was a jerk or a nice person.
2. She's depressed. Every bad thing feels devastating when you're depressed.
3. As has been mentioned, she may not have had much of a support network. She may have become emotionally dependent on him, not to mention physically dependent -- he was cooking for her, and may have done things like clean her house and deal with her mail on days when she was too depressed to even get out of bed.
4. Speaking generally, jerks can be very manipulative and gaslight partners into believing they're the only one who will put up with one's faults, etc. It's called Stockholm syndrome. If you're with a narcissist who's convinced you that you're the one who doesn't deserve them, it would be devastating if that person left you. (Not saying this is the current LW in any way.)

Hell, I'm still struggling to get over my last ex, and he pulled some doozy dealbreakers on me. Love is a spell not easily broken, even when you've been unlucky enough to fall for a jerk.

No- here's basically a book in response to your 20 posts plus your conversation with Lava.

Schizophrenia has always existed. If you mean that there have been cultures in which people had superstitious rather than material explanations for why some people occasionally lapsed into paranoid/terrified states and hallucinated etc then fine, but that's a far cry from "normal" or "not a problem". Sometimes people with severe mental illness were persecuted or stigmatized, other times maybe even exalted or feared, plenty of times they were just considered idiots other times prophets. None of this is "normal" and much of it is, in fact, a problem- usually moreso for the person suffering and for his/her family.

As for depression being crosscultural and historic, I don't know why you'd conclude that this means it's about biology rather than modes of thought or even what you mean by either of those terms. The way we understand clinical depression (an altogether different monster from schizophrenia so let's don't even talk about them in the same way ok?) is currently based on a theory of differing levels of NTs in the brain for which there is very little supporting evidence. Likewise, if it does turn out to be true that clinical depression is caused by imbalances of various neurotransmitters, that doesn't tell us a damn thing about what CAUSED those imbalances in the first place. Yes it could perhaps be some sort of biological fact purely in someone's brain arising from nothing but chance, but it's far more likely that cultural and historic conditions combined with personal tendencies (some of which are biological, others are socially conditioned) result in what we call clinical depression. If this always correlates/causes NT imbalances has yet to be proven, as I said. People accepted the serotonin hypothesis b/c of a very effected marketing campaign and the American desire for simple solutions to complex problems- the science behind it is scant. As I've said several times here, SSRIs and other antidepressants don't work half as often as people seem to think they do- most of the time the result is neutral, sometimes it helps people greatly, sometimes it makes people much worse. And there is a correlation between various antidepressants and subsequent mood/anxiety disorders- how much of that is because a person with more mental health issues is likely to be depressed in the first place and how much of that is actually a response to pharmaceuticals is again controversial. None of this is conclusive yet and yet people go on like "just get some help" is a sure fix. Talk therapy, likewise, usually does not help people.

Which leads me back to the statement that it's biological and not cultural. I disagree entirely. I think the tendency to get depressed has always happened because life is extremely difficult and horrible/unfair things happen to us constantly and over the course of decades, we are often either ourselves in a state of pain/anxiety or else we are caring for someone we love who is. This is before we consider other issues that are out of our control (war, poverty, danger, oppression, famine, etc). So, sure, all around the world and all throughout time, people have been depressed. It's such a pervasive state of being that entire religions, cultures, taboos, works of art have arisen in response- either for solace or explanation. It's a normal part of the human condition.

What has changed in our times isn't the existence of depression but the need to make it pathological and individual- as if it's one person's brain not functioning properly and therefore the responsibility of that person to fix it. In the West we assume that problems have solutions, and because of the miracle of microbiology (bacteria X can be killed by antibiotic Y, virus X can be eradicated by vaccine Y), we assume that all disorders of the body/mind can be cured with similar pharmaceuticals. But that really doesn't work for most conditions. The first antidepressants were being used before most of the neurotransmitters in the brain were even discovered, and as far as I know, none of them take into account how hormones affect your mental state (though this may have changed since I studied this stuff). So we are rolling with a biological theory of mind that was made up quite literally to sell drugs. The evidence is thin.

What I think has happened is that our support systems have broken down under late capitalism (family, community) and all the things that used to give people meaning are mostly now either cynically dismissed, scientifically proven false or else not valued in our culture. We also, for probably the first time in history that I know of, live in a culture in which being positive and personally happy are not only just highly valued expectations but also considered "the right way" to live. If you are melancholy or pessimistic you are considered a major drag. When else in time has massive suffering not been considered a major part of life? Life has historically been looked upon as a struggle. So I think these false expectations combined with lack of structures for support combined with individual responsibility combined with understanding emotions as a pathology combined with isolation/alienation of individuals in our society all add up to an epidemic of depression that a very lucrative pharmaceutical industry seeks to pathologize for its own benefit.

Not to say that people shouldn't take antidepressants if they do help them- depression can be brutal. But Lava is absolutely 100% correct that a lot of what we call clinical depression is actually what in Buddhism we call thought-habits. If you want to think about this in terms of biology rather than philosophy, then you can consider the way you train your brain by reinforcing neural paths the more you practice something. This works with thoughts as well. And a lot of this can be taken care of both by a philosophical shift and actual practice on delaying gratification/distraction and limiting self-absorption and building up resilience and focus through meditation. It's basically what Cognitive Behavior Therapy is, except CBT is a watered down version of a serious meditation/mindfulness practice that is over 2.5 thousand years old.

Now where I split with the hippie Sea Org types is that I also recognize that the extent to which a person's material conditions and physical health and family/community/work network override all of this other stuff. I suspect that a diligent practicing smart physically health meditating person who is stuck in a shit situation (or even just facing the shit in the world if you are looking at it honestly, even just our own lack of purpose/meaning) is still going to be depressed. I think they could help themselves- they could get a little better- but they are still going to be depressed. And more importantly, all these self-help self-care self-discipline approaches are out of the reach of someone immobilized with depression, especially if that person is also facing the rigors of poverty or physical illness, both of which put you permanently in survival mode. The whole point about culture is that in other times, support systems and regular practice were more taken on by a community and family rather than by an individual. The TLDR is basically the old "everything is happening too much" except added to it, "and I'm accepted to handle it all alone and be happy about it".

Anyway, I could talk about this until the cows come home but I'll stop now.

EmmaLiz: Excellent post. Thank you.

I can't believe we are having an argument about if depression is a real illness or not. I'm not going to seriously engage in this argument except to express my disgust at the appalling ignorance being displayed. Yes, I'm sure if we all became disciples of The One True Religion all of our problems would be solved, but sadly we live in the real world and not fantasy land. I've practiced serious meditation for my entire life and I'm still a sad sack.

Anyway,

@82, Paperbag, I am really happy you have such healthy coping skills and strong relationships. Communication and honesty are really important. It's hard for a vulnerable person to find a healthy relationship, because you need to have confidence and much more self awareness than most people have. I'm going to try to think about your comment when I become afraid people are judging me.

I read this letter when it was first published, in 2013. My reaction to it was very different when I first read it. I looked up my comment on the original letter. My response was positive, and I said the LW had done everything right. This is because I didn't know myself well enough to know what works for me and what doesn't. I didn't actually figure out I was suffering from depression until recently, although I have had it for a long time. Possibly my entire life. When I first read the letter I had lower self esteem, and I probably thought my issues were just a lack of discipline and I deserved to be treated poorly. I wasn't even fully aware I was being treated poorly, because I didn't respect myself well enough to know how I should be treated.

Since 2013, I have left behind some people who thought they were helping but they were actually just being controlling and unsympathetic. I'd much rather be forever alone than be in a relationship with someone who demands I exercise until the depression is gone.

Emma Liz-- Nice. I hope you'll keep typing long enough to help with the lowered sex drive aspect of antidepressant drugs.

Some history: I was diagnosed with depression in my 20s, saw a talk-therapist, stopped going a few years later when I considered myself cured.

I'd always felt some pre-menstrual depression, but it was mild and never lasted more than a few days. I waited it out. At one point a gyn prescribed a progesterone only birth control pill (not for birth control). It was like the pre-menstrual depression all the time. I stopped taking the pill and blamed the doctor for prescribing what for me was a dangerous drug. I'd told him about the pre-menstrual symptoms.

Many years later I had a condition that put me in considerable pain intermittently. A doctor prescribed prozac with the explanation that it wasn't for depression. Rather, people on anti-depressants were reporting less physical pain so this was worth a try. I'd heard of prozac but didn't know much about it. I didn't read up on reported side effects so for me personally, it was almost like a blind study. Since I didn't know about side effects, I wasn't feeling anything that had been suggested.

I took the prozac as prescribed. At the time, pre-menopause, I was having sex with my boyfriend when I felt like it which was more during the ovulation phase of my cycle, less often during menstruation. I usually initiated, though if he initiated, he could generally convince me, put me in the mood. One time I didn't come. No big deal. I did (do) usually orgasm, but I didn't drive myself crazy if I didn't. Then as I was on the drug for a few more weeks, I stopped feeling like sex. The fantasies that had always been hot for me stopped working. I felt flat. If I did convince myself to have sex in the ways that were habitual for me, there were still no orgasms. No desire to masturbate, nothing.

I looked up prozac and side effects. I'm not normally dramatic, but I sort of freaked. Turned out everyone but me knew about prozac's sex killing characteristics. I got off the drug as quickly as I safely could. It hadn't done anything much for the pain anyway. I did fantasize about what I'd do to the doctor if my sexual desire and sex life and orgasm ability didn't return. They all did.

My conclusion is that the prozac does do something. I'm just not sure what.

@53 "Love is the main requisite, always."

Love is great, but you can't love somebody out of depression. And it's deeply unfair to the depressed person to give them love as your main offering; they're left feeling guilty that you're giving all this love and it's not enough.

Love is not usually what's lacking. Lots of good partners for depressed people who have love, lots of bad partners who have love.

I see in the response to the LW and a lot of comments that people assume the depressed person isn't trying hard enough to get better.
It may take time, maybe a long time. Just cos your taking medication and doing as much as you can doesn't mean your going to get better in leaps in bounds no more than if you had cancer.
When I was ill I was bed bound, sleeping all the time and unable to do anything. I didn't need to 'sort myself out', I was fighting for my life.

Last Comment, if you are referring to me, then I don't see how what I wrote contradicts what you did. I did not deny it has biological causes. I said we don't understand them, they are probably multifaceted (more biology than just neurotransmitters- hormones obviously play a part, and including social/cultural aspects as well), that there is very little evidence for the chemical imbalance in the brain theory of clinical depression, and that antidepressants don't help as much as people seem to think they do. Moreover, as for the "one true religion"- if you read what I wrote, you'll see I never claimed meditation practice (especially in isolation) could cure depression. I said it could help - and within a framework of greater practice/support- it could help a lot- and that it's unreasonable to expect individuals to be able to achieve this for themselves, especially if they were suffering from depression. Likewise, exercise and a good diet, etc. The point is that cultural/community structures used to provide for support of these things, and expectations of outcomes is different, but I'll not repeat myself. I also said in a prior post that any religion/philosophy has it's helpful/harmful aspects and I too get sick of Western obsession with Buddhism as some mystical Jedi shit. But it happens that I grew up in a Hindu/Buddhist family so it's really the only practice I can speak of, and it's the only one addressed in this thread (as Lava brought it up).

My life is a testimony that i keep testifying in every forum. my husband filed a divorce he moved in with his new mistress he left me and our two kids, i was confused and tears roll down my eyes all day and night . needed to be with my husband again so desperately. a friend directed me to meet the priest of the Love Spell Temple, i ordered a reuniting love spell from him and he told me to expect positive result within 24hrs and exactly that was the way it happened. i am glad that my husband is back to me and the kids. if you also want his help, email is 24hrslovespell@gmail.com or lovespellsolutiontemple.webs.com