Depression: as real as diabetes

This is a very good (but perhaps longish--52 minutes) video with Robert Sapolsky addressing our current understanding of depression and the way various risk factors interact. He gives, a well, as quick summary of the origins of the "chemical imbalance" theory that was once so influential.

In brief, depression is the result of genes + stress; these two interact via brain chemistry.   What I especially appreciate is his understanding that admonishing us to "pull ourselves out of it" is useless. We don't need pep talks. We need treatment for a condition that is, as he says, as real as diabetes.  I would even go so far as to say that telling a depressed person to "pull yourself out of it" is needlessly cruel, despite there being at least one entire  book devoted to that sort of brow-beating and victim-blaming.

Sapolsky is an interesting scholar, having carved out a niche for himself between neurobiology and primatology! He is, in particular, an expert on stress, which plays a huge role in major depression.

Plus ça change??

If I were gay I think I would try to convince this guy to leave his wife for me:

Dear Prudence,
I’m a man in his mid-40s who has been happily married for 10 years. I particularly enjoy my wife’s dry, some would say sarcastic, sense of humor. Her wit not only attracted me to her as a partner, but it was one of the things that got me through a difficult time in my career, enabling me to see the humor in absurd and uncomfortable situations. About 18 months ago my wife’s mother passed away suddenly and my wife began seeing a counselor. After a few appointments, the counselor prescribed an antidepressant medication, Paxil, and my wife’s has been taking it ever since. As a result, my wife's personality has changed. Not dramatically, but enough so that she has become a glass-half-full, constantly cheerful type of person. I have no idea if this is common or perhaps if she was always depressed and her dark humor existed for her to deal with it. I'm glad she's happy now but I thought we were happy before and frankly, I miss my old wife! The new rainbows-and-sunshine person I'm living with gives me a headache and I find myself less attracted to her. I feel like a jerk and don't know what to do. Help!

—Dark Side

Comfort in, dump out

How not to say the wrong thing to someone in a crisis:

Draw a circle. This is the center ring. In it, put the name of the person at the center of the current trauma. . . . Now draw a larger circle around the first one. In that ring put the name of the person next closest to the trauma. . . .  Repeat the process as many times as you need to. In each larger ring put the next closest people. Parents and children before more distant relatives. Intimate friends in smaller rings, less intimate friends in larger ones. When you are done you have a Kvetching Order. . . .

Here are the rules. The person in the center ring can say anything she wants to anyone, anywhere. She can kvetch and complain and whine and moan and curse the heavens and say, "Life is unfair" and "Why me?" That's the one payoff for being in the center ring.

Everyone else can say those things too, but only to people in larger rings.

When you are talking to a person in a ring smaller than yours, someone closer to the center of the crisis, the goal is to help. Listening is often more helpful than talking. But if you're going to open your mouth, ask yourself if what you are about to say is likely to provide comfort and support. If it isn't, don't say it. Don't, for example, give advice. People who are suffering from trauma don't need advice. They need comfort and support. So say, "I'm sorry" or "This must really be hard for you" or "Can I bring you a pot roast?" Don't say, "You should hear what happened to me" or "Here's what I would do if I were you." And don't say, "This is really bringing me down."

If you want to scream or cry or complain, if you want to tell someone how shocked you are or how icky you feel, or whine about how it reminds you of all the terrible things that have happened to you lately, that's fine. It's a perfectly normal response. Just do it to someone in a bigger ring.
Comfort IN, dump OUT.

Read through to the last line.

From the LA Times