Let’s avoid talk of ‘chemical imbalance’: it’s people in distress

“The real hopeless victims of mental illness are to be found among those who appear to be most normal. "Many of them are normal because they are so well adjusted to our mode of existence, because their human voice has been silenced so early in their lives, that they do not even struggle or suffer or develop symptoms as the neurotic does." They are normal not in what may be called the absolute sense of the word; they are normal only in relation to a profoundly abnormal society. Their perfect adjustment to that abnormal society is a measure of their mental sickness. These millions of abnormally normal people, living without fuss in a society to which, if they were fully human beings, they ought not to be adjusted.”

I've been looking at other people only to see how happy they are and how content they with their life. They feel motivated, want something from life and in generally think that being alive is alright, which I just couldn't internalize no matter how hard I tried.

Essentially, I've come to the conclusion that there _must_ be something wrong with my neurotransmitters that I just can't be happy as fellow friends around me.

Many doctor appointments, many different prescriptions.

Antidepressants did their job and I started to care less about what's going on, but they didn't make me any happier. They just made me less miserable. On the other side, I've started to see the world through some kind of fog, which blocked most of my previous perception. My long-term memory started to degradate.

Now, after many years of taking various SSRIs I'm beginning to realize, that there's nothing wrong with my brain.

That's perhaps who I am, maybe either percepting more than many people around or just more sensetive and therefore reacting stronger even on slightest stimulus in a much stronger ways. I have opinions and thougts on a topics that many do not even care about.

So instead of supressing thoughts and emotions I must accept them as they are.

Finally, a thread where I can point out my own experiences.

Around four years ago, it would be fair to call me slightly crazy. It was a harmless sort of crazy, but it was quite self-destructive. I used to wake up wishing to die, genuinely, and not knowing why.

All of that changed after going on Prozac. I don't know why, and I've heard from many others that Prozac was harmful to them. But from my point of view, it was nothing short of a lifechanging miracle. I can't remember the last time I've had suicidal ideation.

Most people keep this sort of thing quiet, and I think silence is part of the problem. When I was younger, I might have looked down on someone for saying what I just said. When you have a broken leg, everyone notices and can relate; when you have a broken mind, no one can see it, and so no one can feel sympathy, let alone empathy.

So what's the takeaway here? One: do not lose hope. I came very close to losing hope, and it would have denied me so much. Two: make a doctor's appointment. There's a chance that you'll wind up on something that makes the situation worse; you need to make a followup appointment ahead of time.

Support networks only got me so far.

That is such an arbitrary distinction. As if being "just a slacker" doesn't have a number of deeper reasons behind it as well. Brains are just machines at the end of the day, every behavior is a result of something material...

But that's not the only element of actual insanity. Real insanity almost always involves a sick social fabric as well that lies to you about critical information, often blaming you for problems over which you have no real control.

They know that schizophrenics often get better with in patient treatment, then go home to their screwed up families and get worse again.

My sister took graduate courses in psychology for a time. She once said to me "We clearly don't have the genes for schizophrenia in the family or someone would have it because the family would have driven them crazy by now." Dad fought in two wars. Mom grew up in a war zone. These were haunted people who could be rather difficult to deal with.

I can understand people wanting to make this distinction "that I just need a pill, it's not like I'm crazy." People who are seriously crazy aren't typically fixable with just a pill. It's more complicated than that and our current system isn't really all that effective at bringing people back once they've gone nuts.

This is part of why I object to the "homeless people are all junkies and crazies" meme: it actively helps make vulnerable people crazy. It actively blames them for things they don't control and denies the existence of systemic issues to the faces of the victims who have such a low social status and are so openly disrespected that they aren't in a good position to argue with it. They are expected to kowtow and agree with everyone hanging their crap on them.

So it actively helps drive homeless people insane and makes it a self fulfilling prophecy. It deepens the problem and is actively abusive of our most vulnerable citizens.

While drugs aren't a panacea, they can help many with fixing psychological processes that are messed up.

First we had to create new terms because the old ones carried baggage. Now we have to righteously and victoriously claim the old ones because we should be proud of our baggage.

Call it chemical imbalance or call it people in distress; is any of this language vacillating actually enabling better treatment or is it just a way for people to get honors and headlines without actually having to actually produce science.

I've noticed in the past, that when I've been under a ton of stress, I drink coffee, soda, ruminate a ton, and things get worse, much worse.

I've started taking magnesium l-threonate the past few months and it's literally made me a better person. Thoughts come and go. The rumination, the "voices" are much less.

One scoop, three times a day during stressful periods (166mg of elemental magnesium).

The only other solution that's had this profound of an affect on me was Lexapro, but it had too many side effects.

I've done years of therapy but nothing ever seemed to stick. But the l-threonate, the diminished anxiety, those affects seem to stick. Better than any therapy session I've had.

I'll give this much more time to see how it plays out. But I have had the thought wondering if my mental anxiousness and depression all of these years was just a mineral deficiency.

Not that I wouldn't have gotten really sad or ruminated, but that it didn't have to be so bad. I was stressed. I needed lots of magnesium. I definitely was not getting it.

This is a pretty big assertion that the piece casually drops without backing. The reasoning as to why "chemical imbalance" is a bad descriptor is apparent* from the study [0] the author cites, but there is nothing that backs up this statement, which seems to be the crux of the whole piece.

*Even the study cited about placebo affects on depression doesn't _really_ prove the author's point that "chemical imbalance" is a bad term, it just proves that we do not yet understand the processes by which drugs treat depression. If we do not understand the processes, how can the author make the assertion that the characterization they are against is wrong? At most, they could claim "we don't know yet" but certainly not that "chemical imbalance" is categorically false.

[0]: https://www.frontiersin.org/articles/10.3389/fpsyt.2019.0040...

That said, some people do have genuine chemical imbalances. I've had bipolar disorder all my life. My cocktail of medications has allowed the last 11 years of my life to be the most productive, stable and happiest. There are of course side effects - and I can understand why some people find them intolerable. I have tremendous difficulty ejaculating, for example. But on balance it's worth it as a) I'm alive and b) my quality of life has improved.

Likewise for my grandmother, my mother, my aunt and my cousin. Bipolar disorder ravaged our families at various points and medication has improved our lives immeasurably in various ways. I just feel for earlier generations that didn't have an explanation (let alone cure) for their woes.

Oh, another aphorism that's always stuck with me is "the difference between 'crazy' and 'eccentric' is a million dollars."

Their stories are not mine to tell. I've managed to squeak by with just a scoche of "on the spectrum," myself, so I am quite grateful, but I have watched (often in horror), as people have spiraled down.

People suffering from mental illness can often be impossible to help; regardless of how much we want to assist. They need to initiate and maintain their treatment.

There's so much societal "baggage," here. Mentally ill folks can often be profoundly unattractive, and it can be difficult to have empathy for them, or get support for them.

I remember once, walking down the street in the Union Square district of SF, on a business trip. As folks know, SF has a big homeless population, that is growing. We stepped around an obviously mentally ill man, and one of my employees shouted "Get a job!".

Would it were that simple, but his attitude is quite common.

But when treatment works, it can be absolutely miraculous, and worth every second of the pain.

I've had a lot of mild/moderate anxiety and depression since early in life, and whilst it's never been severe enough for me to be at risk of doing harm to myself or others, it has been a major complication in achieving good outcomes (i.e., always showed some promise and early success at intellectual, sporting and social pursuits, but could never hold it together enough emotionally to get sustained results.)

At times of particular seriousness, medication provided some relief; mostly SSRIs (sertraline/Zoloft), which I've taken in low doses for a total of about 3 years, and occasional valium for acute anxiety. But whilst these medicines made life more bearable, they never made life feel "normal" or felt like any kind of complete solution.

Part of the issue I guess was that I had a really strong feeling that what I was experiencing wasn't a biological malfunction or predetermined trait. I guess I knew that from the fact that I'd been able to do quite well at things, and feel quite happy, at least some of the time, throughout my life. It didn't make sense that I'd be biologically programmed to be well-functioning some of the time, but not at others.

After a long search I discovered deep subconscious emotional healing techniques, that enabled me to connect with the programmed reactions and beliefs that I'd picked up from some unpleasant early life experiences, that had snowballed as I progressed through life.

I've been undertaking various forms of these kinds of practices for about 8 years now, and bit by bit the anxiety and depression has dissipated, and my life outcomes (career/finances, friendships/relationships and physiological health) have steadily improved and are now doing so at an accelerating rate (though of course there are still ups and downs, with or without macro events like pandemics).

As I look around at all the unrest and widespread mental "illness" in the world, I can easily see links to the distress that so many people feel for all kinds of different specific reasons, but that often boil down to similar patterns: difficulties in childhood (feeling unsafe/unloved/undernourished at home), leading to difficulties getting good social and/or academic outcomes in school, leading to difficulties as people progress into adulthood and try to establish careers, social networks and romantic relationships in a world that can be very hostile to people who don't tick certain boxes.

I'm now quite convinced that the mainstream psychopharmacology industry is a failing effort to paper over the gaping hole in modern society's ability to provide people with the nurturing, confidence and agency needed to build satisfying lives.

From my own experience I'm sure things can be much better, but it will take a major rethink about much of the way we go about supporting people on their life journeys.

I think the actual crisis is a lack of good judgment in the scientific arena. There are obvious cases we can imagine where a "chemical" explanation is simply bone-headed. Joe's dog dies, his house burns down, he is laid off from his work. His resultant emotional distress surely involves chemistry; he's a person, after all. But it is depersonalizing, naive, and a bit creepy, to suggest that his distress is "just chemical" and should be treated with a drug. That's just gross, and I take it the author's point.

But consider another example. Terry has great friends, rewarding job, engaging hobbies, etc., but spontaneous and overwhelming anxiety over the possibility of being hit by a meteorite. This is now entering the territory of an irrational psychological reason, and it isn't "de-personalizing" or naive for a doctor to suggest that there might be a purely chemical explanation. We seek the chemical explanation when there just isn't any other sufficiently motivating factor.

There's a time for both approaches.

While I do believe our understanding of how the brain functions still has a long way to go, which includes treatments for mental illness, there is something to be said about acknowledging more the external factors of our modern day lives that fill us with so many problems.

Personally, realizing where I have "disconnected" from people, values, and truly human experiences has been a large step forward in improving my mental health. I hope it's something that others who feel so many emotional challenges can try as well to see if they can make progress with their own mental health.

Personally having experienced depression myself and knowing many others who have experienced it, I’m of the opinion that a lot of mental issues are either symptoms of some other condition (like diarrhea or coughing) or the result of learned behavior / maladaptive coping mechanisms. Or simply us treating emotional states or personalities that aren’t socially acceptable as illnesses (of course this doesn’t include things like psychosis, nor is it meant to diminish how serious depression and anxiety can be). That’s a bit uncomfortable for the existing mental health complex though

However, in the real world many people are resistant to the idea of therapy and/or medication as it feels like admitting defeat. Or perhaps they've read cherry-picked horror stories of bad therapists or medication side effects on the internet.

Giving people the "chemical imbalance" narrative is a way to short-circuit many of those internal objections. It gives people a notion that the depression isn't their fault, but rather they are a victim of a chemical change in their body not unlike getting the flu or having low testosterone levels.

In terms of getting people to accept treatment, it's a win. Getting past the ego can be surprisingly hard, but the idea that we're treating chemicals instead of treating the person is a clever trick to sidestep that obstacle and shortcut to the treatment.

In terms of giving people the tools to address their problems, it's not so clear. The more we reinforce the idea that depression is simply chemicals in the brain, the longer it takes for people to realize that they do have some power to influence their thought processes and voluntarily replace negative thought processes with positive ones.

However, it's important to remember what a typical course of treatment looks like. If someone is suffering from depression, getting them to commit to weekly therapy sessions with another person as well as following up with the therapy homework (that is, actually implementing what was discussed at therapy) can be a difficult proposition. Getting someone to stop by the pharmacy on the their way home and spend 10 seconds taking a pill every morning for the next 30 days is an easier proposition. The medication is often the jolt that gets people into a place where they're receptive to therapy, or they start making life changes to improve their depression. It's a quick and easy way to give people space to solve their problems, which is why the "chemical imbalance" sales pitch has become the entry point to getting people on board with treating their depression. Get them to lower their guard, get them started on the easiest treatment, and then work on scaling the treatment up to a more intensive, longer-term plan after they've seen hints of success.

I don't particularly like the "chemical imbalance" sales pitch either, but it really does function as a decent hook for getting people over their objections to starting treatment.

There is some truth to the metaphor, but I wonder if it’s doing more harm than good.

My summary: psychiatrists have been orchestrating a campaign of disinformation aimed to remove the stigma of mental illness from our culture, but it appears they may have made the stigma worse.

That said I have some very real anecdotes related to emotional responses to things. These are things I've noticed that very much link short term emotional effects to physiological effects in the brain.

The first, is a tool I learned from someone living with a type1 diabetic. He noticed that occasionally they'd end up in weirdly emotional antagonistic discussions with his partner, and eventually linked it to when his partner had low blood sugar. So, they established, that whenever conversations turn irrational, they pause and do a blood sugar check. Usually addressing this underlying problem made their conversation much more productive (and certainly just taking a break helped too). Similarly with my wife, we've established rules that allow one of us to pause the conversation to make sure the other is dealing with some underlying physical issue, usually one or both of us are tired or hungry when we start fighting. Tired and hungry both have profound effects on brain chemistry, so addressing them can have very real psychological effects.

My other anecdote is related to a correlation I've found with mental health and taking a vitamin D supplement. It's not entirely clear to me whether taking vitamin D prevents my tendency towards mild depression, or if I'm tending towards depression so I stop taking vitamin D. But I know that if I keep taking it on a daily basis, my mood tends to be more stable. If I were to replace it with a sugar pill it may have similar effects, but given I live in Seattle where many tend to be deficient, I'd probably start to notice in a couple weeks.

I had severe depression as a young man, and I remember being confused about it, as when I objectively examined my life there was no reason for it. But I was drowning in despair. When depression was explained to me, with the idea of a chemical imbalance, it all clicked. It enabled me to fight back appropriately and win back my mind. Without medication. It took a few years to get back to normal but I am a much, much stronger person for it, and have never had a hint of a relapse despite actually going through difficult times since then.

Humans are, as much as we hate to admit it, fundamentally emotional thinkers. And when we have emotions we immediately conjure up logical reasons for those emotions to exist, whether they are truly justified or not. And then we tell ourselves the reasons came first, and caused the emotions. Depression can be a bad feedback loop of chemicals that color the way we see the world, and then we justify how bad we feel, making us feel worse.

This might not be the solution for everyone, but for me the trick was not to try to understand my emotional suffering, but to ignore it. I would think, "that's the depression talking, its meaningless, you will feel bad today but it doesn't matter, get on with life". It was very hard, but as I stopped feeding the beast it slowly died away. Of course there are those that truly have reasons to be depressed, but I still think, after processing what happened, the best approach is to move on.

It lends the impression that you're saying something like: "Brains of well-adjusted humans have a dopamine to seratonin ratio of X, but my brain puts out X + epsilon. So, I take this pill, and it moves the dopamine amounts down to normal, and leaves everything else the same."

But, as everyone cringing right now at that statement knows, not only do we laymen not understand how the brain works well enough to make any such statement, but no one can make any such statement. There are multiple levels of problems involved:

1. Determine with certainty that a given psychological problem to one that is purely solved by altering brain chemicals in principle (vs. neuronal structure or environment, etc)

2. Determine that this living individual, whom you cannot crack open the brain of, is suffering from this psychological disorder because of a brain chemical imbalance.

3. Synthesize a drug that alters this chemical imbalance, leaving everything else the same. This would involve understanding both the immediate effect of the drug, and the eventual ramifications as the brain reacts and compensates for the drug's presence, such that the final steady state of the drug is the desired brain chemical balance.

The state of our science is such that we really can't do any of these with the precision the "chemical imbalance" framing implies. Compared with this unrealistic standard, we're barely better than alchemists. We know that in principle, some psychological problems are caused at least in part by brain chemical imbalances. But I agree with the article that we should stop giving the impression that this awareness implies an ability to diagnose and solve these imbalances.

Psychiatric research doesn’t support the notion of simple cause and effect in mental health, instead uncovering a far more complex and indeterminate picture of vulnerabilities. There is no evidence to justify the continued promotion of one-dimensional theories such as ‘chemical imbalance’. Nor does the beneficial use of psychiatric medicines require it. In fact, their precise mechanism of action and relation to troublesome experience remains a mystery. It would be more truthful for mental health professionals and public health campaigns to acknowledge this.

But the truth is we don’t have control over others so it’s a fool’s game to maintain an image. things can happen to “pop” it, and then you are crushed. Like the Michelin chef who committed suicide when he was in debt, felt washed up as culinary trends changed, and recently had a slight downgrade in his reviews (https://en.m.wikipedia.org/wiki/Bernard_Loiseau)

A better way I am learning (and far yet from fully realizing) is to anchor your self identify to things you can control. So rather than thinking of yourself as confident, normal woman, you might think of yourself as a woman who feels deeply and takes action. In this case, feeling depressed is not a threat to that identity - it becomes a challenge to rise up and meet, and focuses on what YOU can do, not what others think.

This all comes from the book “mindset” if you want more info.

And this is why I don’t like elitists telling me what I should or shouldn’t say.

I agree that, often, these disorders are a product of environment, along with economic, social and material conditions. However, medications can and do improve the quality of life for people who cannot change those conditions due to their station in life.

> Psychiatric research doesn’t support the notion of simple cause and effect in mental health, instead uncovering a far more complex and indeterminate picture of vulnerabilities. There is no evidence to justify the continued promotion of one-dimensional theories such as ‘chemical imbalance’.

I wholeheartedly agree with this, and believe that it's a huge problem with the mental health discourse. However, the author then goes on to say:

> Mental health treatment needs to re-engage with the language of persons. This means suspending the detached, third-person stance toward patients, and attending to their actual experience and circumstances. And it means encouraging patients themselves to avoid this stance and draw on the normal ways that people make sense of their emotions and actions.

A problem I've experienced is that "the normal ways that people make sense of their emotions and actions" do not seem to work for me. I haven't found a good description of it, but something in my sensory and cognitive feedback loop seems to be broken such that I don't get any useful sense of things in the moment and need to reverse-engineer my emotional state after the fact when it seems important to do so (NB: I don't just mean that this disconnect occurs when there's some kind of intense moment; it's pretty much constant). So I don't see how it's possible to both hold that up as the standard and also respect my "actual experience and circumstances". In other words, this sure seems like exactly the sort of one-dimensional theory of mental illness that the author decried earlier.

I think that contemporary society puts a lot of pressure and expectations on people at a young age. I suspect this is not a very healthy way to find your way in the world. Some people conform, some people follow the rules of the game, some people rebel to the rules, some are not even aware of the game. A little compassion and empathy would go along way, rather than treating each other as automata.

> that mental illnesses are ‘just like’ other chronic physical ailments, such as ‘heart disease or diabetes’

I would argue that in most cases chronic ailments (including mental illness) are not a consequence of "the way a person is made", but their lifestyle. Many people with chronic ailments accept the medication as a solution and don't make the necessary changes in their lives. I think making mental illness comparable to chronic illness made people think of it as something that can be addresses with just a pill.

We're very caught up in naturalistic thinking. Speaking of a soul or the mind is frivolous at best, and superstitious at worst. But look where this way of thinking has brought us.

The brain and the heart are two different organs. But while we can use science to gain an understanding of the brain, the mind is understood by philosophy and religion.

Case in point, I once asked a friend of mine if he could prove that he loved his wife. He said if he were able to freeze time, and gain knowledge of every synapse, every chemical reaction, every electrical potential -- he could definitively prove that he loved his wife, and she loved him.

"When you get home," I responded, "remember to duck when you tell your wife you want to go have her brain scanned to prove she loves you."

Just to give one case - last month I tried to get back into keto, as the lockdown had worn away my resistance to junk food and bad eating habits began.

In the process, I bounced in and out of ketosis, and my emotional state was all over the map. Crying, ecstatic, and everything in between. It was like being bipolar (I have a family member who is clinically bipolar, so I know firsthand what that does to someone).

But then, two weeks ago, I finally was able to get into my Keto diet fully. And for two weeks, my personality has been back to normal, and much more calm, less emotional, more focused, etc. [0]

Also, while I was going through the transition phase in/out of keto last month, I had several days of really vivid bad dreams and poor sleep. Several days of bad dreams was weird. Being tired on top of it made it worse.

So that's why I disagree. My firsthand experience with changing my food made a huge difference. (The first time I got into keto - about 2 years ago - I did so with a doctor who specializes in eating habits. This time was with that knowledge, but without my doctor as a guide. Thankfully my wife was a month ahead of me in the process, which made it tolerable.)

[0] - note to anyone trying Keto - go in fully, not halfway, and you'll only have a day or two of being grumpy (usually day 3 or 4). Have a guide to support you, as being on the cusp, but not truly in keto really sucks!

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Quick Edit - there ARE people in distress, and I'm not trying to take away from that, rather I'm talking about the everyday person who has some things out of whack sometimes.

By all means, if you are depressed, PLEASE talk to someone - it will probably save your life.

We should try to fix this problem not patch it up with medication. In terms of evolution, our social system selects for mental illness. Rewards the psychopaths and medicates the altruists so that they learn to tolerate it.

The idea that 'mental illness' is a boogyman label which one will avoid at all costs is a good one. Who would want to self apply this label? You'll throw your lot in with the person talking to themselves on the street corner.

Instead of this, we are now supposed to start trying to encourage people to humanize mental distress (no need to say disorder now), indeed to extend this even to those suffering from more severe problems.

All of this is well and good, but the problem isn't really the term 'mental illness' is it? It's that we have decided as a society to reject all mentally ill people as hopeless cases, broken beyond repair.

It doesn't have to be this way. Many mental disorders are recoverable, and there is a huge amount of unknown about the rest. We have literally made a poor cost benefit analysis years ago and stuck with it for far too long without much thought.

What we should do is recognize that mental illness impacts most of us at some point in our lives, and that it severely impacts members of our own families (if you don't think it does, they are probably not telling you because of the stigma).

What would we have to do to resolve this? We would have to decide to dedicate large financial resources to helping the mentally ill recover if possible, or to find an existence which is mutually beneficial if not. Many countries have done exactly this, and with the considerable resources we have in this society, there is little doubt that we could find more answers to helping find real recovery.

Once people observe that mental illness is not a badge of shame, but an actual illness like many others, I believe that many more will be encouraged to seek assistance, and that we will all be much better off for it. As a nice side effect, you will no longer have to feel like shit knowing that the bipolar person on the street is likely to get roughed up frequently and meet an early end because we decided that's the way it is.

I was aware, though,of the yawning abyss between my mood disorder and "real" mental health issues. I have a very good friend who is very affected by bipolar disorder, and while they maintain that depression and bipolar are as debilitating as each other, I see the shit they go through and shudder. But then, I've seen the shit they went through and shudder. Correlation is not causation, but everyone I've met who is working their way through mental health problems has a proportionate amount of trauma to go with it.

In solid state physics, where reductionism is definitely a powerful and useful tool, the following article seems to be interesting. It's a possible reminder of what you maybe can and can't get from reductionism. https://science.sciencemag.org/content/177/4047/393

No clue how much of that (if any) might apply to psychology.

If lifestyle and/or environmental conditions were not enough to derail a healthy mind, the information streams run with psychopath+ variables are sure to catch many who didn`t fall through the cracks (given enough time).

If the imbalance is artificial or synthetic in nature, the corner to turn is now.

The quality of an individuals information diet holds the key for many (IMHO). This also leaves room for medical conditions and other reasonable observations that may cause an imbalance of this type.

[0] https://www.goodreads.com/book/show/34921573

Attributing mental health issues to physiology might look like a convenient way for a distressed individual to escape the associated social stigma, but in absence of causal mechanisms pointing that way it is a dangerous assumption to make, prompting symptomatic treatments that leave the underlying cause to fester.

Unintentionally perpetuating the stigma of mental illness through e.g. mindlessly used unfortunate figures of speech is among the worst casual slips one can make.

"He feels his mania is what we all have and deny, that insanity is a rational adjustment to an insane world." [0]

[0] https://www.spin.com/2017/06/tupac-birthday-danyel-smith/

It was always linked to some stressful event. Loosing a job, not being able to keep the lights on, loosing a partner, or an abusive partner....

We can write and read articles like this all day. But if Rx advertisers can create new, stupid ideas in commercials faster than we can dispel them, then there's no use.

It's like diagnosing someone as a diabetic without measuring glucose levels directly or indirectly.

Just experiencing these emotions and meditating on their cause will relieve a lot more people.

For people facing psychological issues, see the resources I've collected in the "Health and Wellness" section of this reading list I have put together: https://github.com/pdfernhout/High-Performance-Organizations...

If you can only look at one resource, read or watch something by Stephen Ilardi, PhD, author of "The Depression Cure: The 6-Step Program to Beat Depression without Drugs", whose advice is built around this quote of his: "We were never designed for the sedentary, indoor, sleep-deprived, socially-isolated, fast-food-laden, frenetic pace of modern life."

Dr. Ilardi prescribes an easy-to-follow, clinically proven program that harks back to what our bodies were originally adapted for and what they continue to need with these six components:

    * Brain Food [supplement with Omega 3s; remember your brain is mostly fat]
    * Don't Think, Do [avoid excessive rumination by doing things]
    * Antidepressant Exercise [aerobic exercise is medicine]
    * Let There Be Light [get natural sunlight and supplement as needed with vitamin D3]
    * Get Connected [engage in face-to-face social activities regularly]
    * Habits of Healthy Sleep [get enough sleep by following basic guidelines]

Other books that address specific aspects of depression and related issues of addiction, trauma, and perfectionism (and how they are at root deep cultural issues related to recent Western lifestyle changes) include:

    * "Lost Connections: Uncovering the Real Causes of Depression – and the Unexpected Solutions" by Johann Hari. From the last chapter of the book: "You aren’t a machine with broken parts. You are an animal whose needs are not being met. You need to have a community. You need to have meaningful values, not the junk values you’ve been pumped full of all your life, telling you happiness comes through money and buying objects. You need to have meaningful work. You need the natural world. You need to feel you are respected. You need a secure future. You need connections to all these things. You need to release any shame you might feel for having been mistreated."
    * "Chasing the Scream: the First and Last Days of the War on Drugs" by Johann Hari
    * "The Globalization of Addiction: A Study in Poverty of the Spirit" by Bruce Alexander
    * "In the Realm of Hungry Ghosts: Close Encounters with Addiction" by Gabor Maté, MD
    * "The Story You Need to Tell: Writing to Heal from Trauma, Illness, or Loss" by Sandra Marinella
    * "Writing Hard Stories: Celebrated Memoirists Who Shaped Art from Trauma" by Melanie Brooks
    * "The Gifts of Imperfection: Let Go of Who You Think You're Supposed to Be and Embrace Who You Are" by Brené Brown
    * "Daring Greatly: How the Courage to Be Vulnerable Transforms the Way We Live, Love, Parent, and Lead" by Brené Brown

For those facing specific issues related to suicide for themselves or a loved one, a key book is: "Out of the Nightmare: Recovery from Depression and Suicidal Pain" by David Conroy. By reconceptualizing suicide as an involuntary action that occurs when total pain exceeds resources for coping with pain, David Conroy provides a morally neutral way for organizations and society to think about suicide prevention in a productive way. Rather than focus mainly on intervening in a crisis, organizations and societies can rethink their operations to reduce participant pain and to increase coping resources. This helps everyone -- not just those who have reached a threshold where pain is very close to coping resources. Aggregate pain includes physical pain, emotional pain, and social pain. Reducing pain in any area by even a small amount may bring a person below a threshold for suicide. Similarly there are many types of coping resources from interacting with a friend, to going to a funny movie, to receiving adequate health care, to interacting with a pet. There are also some short-term coping strategies like denial or drinking which may have long-term negative consequences that become new sources of pain when done to excess.

As David Conroy says: "Suicide is not chosen; it happens when pain exceeds resources for coping with pain. That's all it's about. You are not a bad person, or crazy, or weak, or flawed, because you feel suicidal. It doesn't even mean that you really want to die - it only means that you have more pain than you can cope with right now. If I start piling weights on your shoulders, you will eventually collapse if I add enough weights... no matter how much you want to remain standing. Willpower has nothing to do with it. Of course you would cheer yourself up, if you could. Don't accept it if someone tells you, "That's not enough to be suicidal about." There are many kinds of pain that may lead to suicide. Whether or not the pain is bearable may differ from person to person. What might be bearable to someone else, may not be bearable to you. The point at which the pain becomes unbearable depends on what kinds of coping resources you have. Individuals vary greatly in their capacity to withstand pain. When pain exceeds pain-coping resources, suicidal feelings are the result. Suicide is neither wrong nor right; it is not a defect of character; it is morally neutral. It is simply an imbalance of pain versus coping resources. You can survive suicidal feelings if you do either of two things: (1) find a way to reduce your pain, or (2) find a way to increase your coping resources. Both are possible."

(I write this in memory of my friend from Princeton, Robin Rochlin Cooperman, M.D. Psychiatry, 1963-2010. I can wish that she was still alive to talk with about all this newly emerging information about increasing wellness in a wide variety of ways beyond prescription pharmaceuticals. And also I write this in memory of other friends I have lost along the way...)

It has always disturbed me greatly that pharmaceutical companies can go around claiming disorders in the DSM based on tons of research, but where is the pathway testing done? Why don't we see that happening with regular patients? There is a very strong disconnect between how these diseases are agreed upon AND treated VS the Hippocratic oath, objectivity, scientific, methodological reasoning.

What's even more disturbing is how completely normal mental health issues are then twisted in main stream culture, and used to control or hurt people, rather than help them. Mental health virtue signaling amongst psychiatrists is at an all time high with people bragging about how wonderful their disorder is and how proud they are. Does nobody else see something wrong with that? These doctors are convincing people they are permanently damaged (DNA/hereditary) and then pumping them full of drugs that don't quite do the trick. And this is happening in MASS. Mutagenic drugs fed to children and industry insiders have been blowing the whistle on overdiagnosis and overmedication for decades. And people wonder why our country is going crazy... wow.

Just. wow.

Mental health professionals in our society are failing us hard as a group and as individuals. I would cry myself to sleep, tears of sweet joy if I knew this was getting fixed and regulated and that psychiatrists had to undergo psychiatric evaluations themselves because I know several who are downright sociopaths and think that it's their right to tell other people they're permanently damaged and therefor wrong about <insert whatever random disagreement they have here>. It's honestly scary as hell because psychiatrists have made my life a living nightmare and nobody seems to want to listen or help, or the ones that do can't or don't know how. I even talked to Monica W. of proxy project and she is only putting money she gets into research or legal testimony. MSbP victims aren't being helped on a big scale and this is an issue serious enough that if left unchecked is going to (and already is) cause untold damage to our culture and society, shit I'd wager our ability to survive even.

I do blame fakes like Dr. Phil for making everyone afraid of MSbP victims. He sensationalized the case about the girl and her boyfriend who killed her mom. Then he just makes it seem like some horrifying rare condition. No other cases to go over, no suggestions about how we can tackle this problem. Just straight up fear mongering. he's a real big piece of . While in fact this is happening all the time everywhere in front of our noses, but we somehow went from blindly trusting in Pastors who rape boys to Psychiatrists who convince everyone they need to pay them the rest of their life and take pills that will permanently alter their body chemistry in unintended ways.

Find out more about medical abuse at proxy project.

Are lifetime outcomes really better on all these Drugs? Maybe after you already created drug addictions, a different drug would help.

Prior to drug use, I imagine therapy, monetary support, education, etc... Would all be better than 2020s brand name Adderall.

Mental illness that is constitutional, what used to be called psychosis, may be patholigized, but it is hardly as common as some shrinks seem to think.

There is also another source of mental illness, probably the most common one. In an age that receives the words "sin", "vice", and "immoral" with amusement, discomfort, indifference, or even outright hostility, we seem to have lost the ability to confront this cause of mental illness, namely, sin, vice, and immorality.

There is no crisp line between physical, mental, and moral maladies, so to speak. And in this respect, vice can produce what used to be called neurosis. Sins and vices harm the sinner, and when left unacknowledged and undealt with, the guilt can manifest in a variety of bizarre ways that twist our emotions, appetites, motives, perceptions, and reasoning. It can reinforce cycles of vice. Pathologizing can be one way to find temporary, illusory relief by scapegoating one's guilt by invoking "chemical imabalance". Sure, there may be a chemical change in the brain, but that change in this scenario is the effect and not the cause.

If you take offense to this, im sorry, but you have a chemical imbalance.

Depression can feel like your whole world is upside down, an imbalance in the way your head works is a perfectly apt metaphor for how your brain works in this state.

These ideas arent mutually exclusive either. Context matters, I wouldnt point at jane and say, this is the one i was telling you about, the one with the imbalanced brain.

I would say, this is jane, the one going through some depression as of late.

If someone says well whats depression? Then maybe it would make sense to explain how depression works, maybe then it would come up.

If we discard true clinical depression where a young dude in perfect health feels suicidal in his own bentley, my approach to treat depression would be reading books that stimulate imagination, from Harry Potter to more exciting literature like Transcendental Magic by Eliphas Levi.

- homeless <=> crazy, bad

- Some anxiety <=> type A hustler, good

- And now: a little depression + access to healthcare <=> "it's just bug", neutral