JonahSinick comments on Methods for treating depression - Less Wrong

17 Post author: JonahSinick 17 February 2014 07:02PM

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Comment author: Stabilizer 17 February 2014 09:27:30AM *  5 points [-]

I often wonder whether "depression" as a blanket term is useful; and whether using it may even be detrimental.

Consider an analogy: diagnosing someone with "pain" isn't very useful. At best you can give painkillers, which only helps temporarily. But there are so many different causes of pain: arthritis, bone fracture, kidney stone, migraine and so on. Different causes require very different treatments. So, you need to be able to identify these causes accurately if you want any hope of curing the patient.

Just the fact that very different people with very different genetics in very different life circumstances experience a similar mental phenomenon called "depression", doesn't necessarily imply they can all be treated the same way. Phenomenological descriptions may be similar, but causally are they similar? A trivial example: a person who's depressed because her husband died would require a different treatment than a PhD student who's depressed because her research isn't progressing.

This is why I'm not too enthusiastic about anti-depressants; they seem akin to painkillers. But the inefficacy of talk therapy makes me wonder whether even experts can tease out the different causes behind depression; or even if they could, whether they can treat them appropriately.

Note: I'm not an expert, so let me know if I'm oversimplifying here.

Comment author: JonahSinick 17 February 2014 11:25:47PM 0 points [-]

Just the fact that very different people with very different genetics in very different life circumstances experience a similar mental phenomenon called "depression", doesn't necessarily imply they can all be treated the same way. Phenomenological descriptions may be similar, but causally are they similar? A trivial example: a person who's depressed because her husband died would require a different treatment than a PhD student who's depressed because her research isn't progressing.

For a given person, some treatments will work while others won't. So yes, there seem to be multiple possible causes. But

  • Sometimes somebody will respond to his or her respond to circumstances differently from how other people would respond in the same circumstances, suggesting the existence of an underlying factor (whether biological or dispositional) that's circumstance independent.
  • Therapy can be customized so as to address a diversity of possibilities.

This is why I'm not too enthusiastic about anti-depressants; they seem akin to painkillers.

A variety of factors may cause undesirable brain chemistry, but sometimes undesirable brain chemistry might be a part of the default physiology of the individual.

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