Depression technically falls under the "mood disorder" category, but does this seem like a misnomer to anyone else? Wouldn't it make more sense to call it an "energy disorder," given that the defining symptom is a lack of energy, fatigue, and lack of ambition?
The term "mood" makes it sound temporary and has a negative connotation imo, almost as if you're incapable of regulating your own emotions. In reality, more often than not depression is a chronic state of being, not a transient mood. If it was indeed just the latter, then the fix would be becoming happier, but if it's the former, then it's recharging your life-battery (or for the more spiritually minded among you, revitalizing your lifeforce) -- which is a very different thing from finding happiness.
This characterization of depression is probably partly responsible for the misconceptions laypeople have about it, ex. parents who think you can come out of depression by "changing your attitude." If they were told their child was suffering from an energy disorder, not a mood disorder, I think they'd be more likely to take it seriously and to understand it better.
I think this redefinition would also make it easier to digest the idea that depression might actually be an evolutionarily advantageous set of behaviours that helps you survive in a particular circumstance by essentially putting your body into hibernation mode. Viewed this way, depression is not a sign that your brain is "broken" or "imbalanced"; rather, it would be an expected reaction to undergoing a high-effort activity that was not followed up by an equally restorative activity. The phenomenon of depressed people not wanting to get better is also better understood under this framework, because we understand that getting better requires energy that they don't have to spare.
Just something I've been thinking about lately, haven't looked at it from all angles yet. What are your guys' thoughts? Do you agree? Disagree? @Forever Sleep
Every time I see this type of uneducated shit on the internet my eyes somehow roll back farther in my head than the last time
Allow me to tell you how exactly you are wrong.
From a historical perspective there never was anything known as "depression." Since ancient greece a disease called melancholia has been observed - over millenia it has been mostly known as a movement disorder because the main observable sign is basically a complete halt of activity and slowness of decision, speech, voluntary action, even gastrointestinal speed. In the 17-1800s it was noted to very frequently occur hand in hand with mania, and the two forms of illness were labelled under one familial disease process, "folie circular" or circular insanity, because it happened in cycles rather than as a degenerative state like a dementia. Circular insanity was treated in locked asylums as a very dangerous illness of the brain. A central nervous system disease. Because it affected the psyche (mind), it was called a "psychosis."
Around the same time sprouted an idea in outpatient neurology clinics that certain people had "weakening of the nerves," or neurasthenia, which caused them fatigue, loss of control over their emotions and anxiety level, easy susceptability to stress, basically what we know as burnout. Because this was a problem of the nervous system besides the brain, it was called a "neurosis." (This term was applied to any general neurological illness such as stroke, etc.) They considered this a problem of the peripheral nervous system (related to adrenal activity) for which thousands of quack remedies came into being; the uniting theme in these "cures" was the effect of placebo. One of these happened to be psychotherapy, popularized by Freud (a neurologist). It was discovered that really all these patients needed was some sort of social support and reinforcement of positive behaviors; the only "medical" need they had was some way to calm their bodies down when very upset. So they were given sedative drugs as needed, which worked well.
Now the term "depression" originally was applied to the concept of melancholia by Emil Kraepelin - he referred to circular insanity as "manic-depressive insanity" because to him the depression of activity in melancholia was the most important aspect to note. Over time the term "depression" became so overused, misunderstood, and bastardized, that it came to be applied to cases of neurosis in addition to psychosis - and there was a very fine deliniation of the two. Neurasthenia (neurotic depression) was treated with psychoanalysis and lifestyle changes, melancholia (psychotic depression) was treated with medical interventions. They never overlapped. All literature was very firm and direct in describing these as completely separate and unrelated problems.
Until 1980.
Robert Spitzer was an ex psychoanalyst with a chip on his shoulder who was put in charge of organizing the third edition of the DSM. The first 2 DSMs were very small army medicine manuals used to quickly screen american soldiers for any sort of mental impairment or personality issue. Spitzer was an enormous egomaniac and wanted to change that very drastically. Out of thin air he conjured the plethora of "diagnoses" known today. Initially the DSM (1/2) was split very cleanly into "psychoses" (physical diseases of the brain) which included things like dementia, autism, manic-depressive illness, and schizophrenia; and "neuroses" which included neurasthenia and its offshoots, problems of personality development, criminal and sexual behavior issues, etc. So for example each diagnosis had its own suffix - and the two "depressive" disorders in each section were depressive psychosis, and depressive neurosis. Spitzer hated the organization and suffixes so did away with all of them. He decided to mix together the two very different illnesses of melancholia and neurasthenia under a new term he invented, "major depressive disorder." Everything was appended with "disorder" instead of the previous way. Everything was candycoated to look the same, with the stated and express intent to sell more medications to this now inflated group of patients, which seconds before that keystroke it was inappropriate to treat in the same way.
In addition, Spitzer invented all kinds of offshoots of neurasthenia - "anxiety disorders," he called them, and made up as many as he could with zero historical precedence. Again with the stated and express purpose of selling drugs specific to each "anxiety disorder." He was an unapologetically evil man and thought he was really improving the field with his "insight." The only one with any sturdy background was OCD, but mixing it together with the rest was a mistake still not fully corrected today. Anyhow, he was very proud of his work.
The worst of it was the splitting of melancholia from manic depressive illness. It was no longer a singular disease process that could manifest as either melancholia or mania at different points of the patient's life - now it was "major depressive disorder" and something completely separate, "bipolar disorder." So all manic depressive patients without a history of experiencing mania were lumped together with the 10x higher population of neurotics, their physical brain problems lost in the sea of life problems.
So today when someone who would previously have been diagnosed with manic-depression is stamped with "major depressive disorder," they are given statistical treatment - "MOST people with that label respond to yoga, diet changes, job changes, therapy, soul searching, attitude changes, etc etc etc... they just aren't trying hard enough!!!" You can see where this thinking leads and it is extremely dangerous. The few desperately in need of physical interventions will never get the ones they need because they have been erroneously lumped with the worried well. And the best intervention for melancholia regardless of manic history, has always been lithium and electroconvulsive therapy.
If you would like to read more on this topic I can suggest a few authors, experts in the field of mood disorders and psychiatric diagnosis.
Gordon Parker - Melancholia: A disorder of movement and mood
Michael Alan Taylor and Max Fink - Melancholia: The Diagnosis, Pathophysiology and Treatment of Depressive Illness
Edward Shorter - How Everyone Became Depressed: The Rise and Fall of the Nervous Breakdown
Thanks for coming to my TED talk.
EDIT:
I got distracted... I completely forgot to address the aspect of "mood."
Since the deliniation of "neurotic depression" and "psychotic depression", there have been ways to identify the two by their differences, mainly in internal state:
Melancholia presents with an extremely entrenched, unchangeable mood of despair. Anhedonia is very prominent, not even physical pleasures such as sex or food can reach the patient. There can be extreme implacable anxiety and physical agitation that can be severe enough to cause a heart attack, or such inertia that the patient cannot move for days even to close their eyes. Nothing can reach them. they cannot have emotional reactions, and outwardly their face may resemble that of a parkinson's patient - they cannot emote. Their distress is not a reaction to outside circumstances and it is not rational. One of the most prominent signs is an unshakable compulsion to commit suicide, they might not even know why, they just have to do it and are very secretive and planful about it. They physically cannot cry. They cannot sleep, they don't eat and they lose weight, their stress system is in such permanent overdrive that they sweat heavily, have a fast heart rate, high temperature, and have an abnormal circadian rhythm. Notably they blame themselves for everything and are consumed by irrational guilt over the smallest imagined slight.
Neurasthenics are almost the opposite. Their emotions are reactive to the environment, even improving if their situation does, they are extremely sensitive to change and can be labile in their expression, ranging from very anxious to angry at others to helpless and defeated. They can cry and are pretty tearful. If they are suicidal at all it is impulsive and may be unlikely to work. They may even desperately want help and simply make a gesture to get it. They overeat and oversleep and blame others around them for everything, feeling immense self pity. Their body works properly and their vital signs are normal. They can feel pleasure even if their motivation to do things is lower than usual. They respond very well to social kindness and change of atmosphere. Outwardly they do not seem physically "ill" in the same sense as one gets by looking at a melancholic.
Neither of these is any sort of "adaptation" and neither is useful to anyone.
