Posted by SLS on September 22, 2012, at 15:22:40
In reply to Depression - an illness of the strong?, posted by SLS on September 20, 2012, at 7:31:12
> Nice article:
>
> http://www.familyhealthguide.co.uk/depressive-illness-the-curse-of-the-strong.htmlA good friend of mine didn't like the article. He was particularly critical of the view that stress was the most common cause of depression. I think where the article fails is in its neglect of the question of whether or not there are genetic or epigenetic variables that leave someone more biologically vulnerable to developing a depressive disorder. I believe that there are.
As far as the article is concerned, I thought it represented an interesting observation regarding the personality traits that they described as being more likely to be associated with depressive disorders. The article also gave some hints as to why, in an otherwise healthy person, depression has an important function. It prevents one from expending too much energy and experiencing potentially damaging chronic stress if they were to endlessly engage in futile efforts in thinking or behaving. Evolution got it right sort of.
For those with biological vulnerabilities, this system breaks down. First episodes of depressive illness often occur in association with psychosocial stress. If the illness is left untreated, depressive episodes occur with greater frequency or chronicity. They also become more easily triggered. Through a kindling-like process, it takes progressively less stress to precipitated subsequent episodes until, at some, point, the illness becomes autonomous and no longer requires stress to drive it. It is a form of sensitization.
I think that if you were to take 100 people who are experiencing their first episode of major depressive disorder (MDD), you would find that more than 50 of them will have had a significant psychosocial stress (acute or chronic) associated with it. I can't be sure, of course, but it would make for an interesting study. I haven't encountered any retrospective life charting or prospective investigations to verify this. Perhaps there are twin studies that lend insight on the issue.
Now, what about bipolar disorder (BD)? This was not mentioned in the article. I would not extrapolate exactly the phenomenology of MDD to BD. Perhaps someone would like to comment on this?
- Scott
Some see things as they are and ask why.
I dream of things that never were and ask why not.- George Bernard Shaw
poster:SLS
thread:1026204
URL: http://www.dr-bob.org/babble/20120922/msgs/1026364.html