Humor will not be tolerated!! -Portia

http://www.npr.org/sections/goatsandsod ... up-on-life

So doctors are primed to think about how social conditions can affect health. And I think culture shapes the way we express our despair. Once a particular set of symptoms becomes sanctioned as a way of showing suffering, it becomes more common.

Was thinking about this in relation to the local culture and social conditions and how despair may manifest quite differently. There certainly seem to be some patterns, and I wonder if researchers have delved into it. Would be interested in hearing the medically-minded board members' thoughts.

Yeah, a lot of psychologists and sociologists study this kind of thing. Someday if I find time I'll write you up some of it.

TheBlackSheep wrote:Yeah, a lot of psychologists and sociologists study this kind of thing. Someday if I find time I'll write you up some of it.

Awesome, thanks! If you're participating in reunion, maybe I'll ask the question then. :-)

As of right now, I'm sitting this one out. We'll see when the time comes, but I'm probably not writing. There are other social scientist types who I'm sure will be in, though.

The podcast Freakonomics: The Suicide Paradox also demonstrates how different cultures may affect mental health.

This is one man's theory:

If your quality of life if poor, and it may be you’re unemployed, you’re an oppressed minority, whatever it might be, there’s a civil war going on, you know why you’re miserable. You know as the quality of life in a nation gets better and you are still depressed — well, why? Everybody else is enjoying themselves, getting good jobs, getting promotions, you know, buying fancy cars. Why are you still miserable? So, there’s no external cause to blame your misery upon, which means it’s more likely that you see it as some defect or stable trait in yourself. And therefore you’re going to be depressed and unhappy for the rest of your life.

So wait, what is he saying there? Is he saying not to view it as some stable part of yourself? Is that the takeaway?

I think the key is to remember that our bodies and minds can heal and life can change.

If you want a good podcast about how much our brains and thoughts are influenced by various hormones, last week This American Life rebroadcasted episode #220 Testosterone and it was pretty excellent.

Regarding that episode of This American Life, I'm not a dualist, so while I agree it was well put together, especially for 15 years ago, I wouldn't call it much else. Then again, I am very, very angry about this whole S-Town thing, so it could just be that.

As for the quote, I haven't listened to the Freakonomics episode, but that is a pretty heinous oversimplification. The psychological definition of depression is that you feel depressed without an obvious external cause (mourning, say, or unemployment). That's what depression IS. I spent a lot of years thinking that if I tried hard enough and was positive enough and got the right treatments I could cure my depression and anxiety. But you know what, my depression is always always always always always gonna come back. I'm always gonna have PTSD nightmares, and I am always going to get irrationally anxious enough to power small villages with my angst. The stories we tell about mental illness go something like, "I used to be super outgoing and happy and I was an overachiever, but then I got the sads and even thought about killing myself once But then I tried my very first antidepressant ever and went to therapy for a minute and now I am completely all better!" But that isn't my reality or the reality of many people, and I think it's harmful to pretend that that has to do with us telling ourselves the story that we just are this way or that we have some tragic flaw. I thought for years I could change it. I feel more peace now that I don't think I can. Because I don't have some flaw, other than my brain is just broken for some reason that is obviously beyond my control, and it has been ever since I hit puberty. I'm just doing my best with what I have, which is a broken brain that makes my life harder than it would be otherwise. I can manage small parts of it, and I can always do better, but my brain is not healing. Putting the blame for that on my bad attitude isn't helpful.

TheBlackSheep wrote:Regarding that episode of This American Life, I'm not a dualist, so while I agree it was well put together, especially for 15 years ago, I wouldn't call it much else. Then again, I am very, very angry about this whole S-Town thing, so it could just be that.

As for the quote, I haven't listened to the Freakonomics episode, but that is a pretty heinous oversimplification. The psychological definition of depression is that you feel depressed without an obvious external cause (mourning, say, or unemployment). That's what depression IS. I spent a lot of years thinking that if I tried hard enough and was positive enough and got the right treatments I could cure my depression and anxiety. But you know what, my depression is always always always always always gonna come back. I'm always gonna have PTSD nightmares, and I am always going to get irrationally anxious enough to power small villages with my angst. The stories we tell about mental illness go something like, "I used to be super outgoing and happy and I was an overachiever, but then I got the sads and even thought about killing myself once But then I tried my very first antidepressant ever and went to therapy for a minute and now I am completely all better!" But that isn't my reality or the reality of many people, and I think it's harmful to pretend that that has to do with us telling ourselves the story that we just are this way or that we have some tragic flaw. I thought for years I could change it. I feel more peace now that I don't think I can. Because I don't have some flaw, other than my brain is just broken for some reason that is obviously beyond my control, and it has been ever since I hit puberty. I'm just doing my best with what I have, which is a broken brain that makes my life harder than it would be otherwise. I can manage small parts of it, and I can always do better, but my brain is not healing. Putting the blame for that on my bad attitude isn't helpful.

Just stopped by to say that I really like this explanation. I'm on my third antidepressant, my sixth month of focused therapy, my tenth month of my depressive episode, and it's really easy to think like this. While there are things that I can do to help myself stay off the edge (CBT, meditation, that kind of thing), I still can't will myself out of feeling like this anymore than I can will myself out of having a migraine. Anyway. Thanks.

Do you mean "dualist" in the philosophical sense or a different one?

Oh yeah, I'm talking about philosophical dualism. The TAL episode references dualism (though not by name) so that's why I brought it up.

The Freakonomics episode is more talking about causes and trends in people who commit suicide, so if we take it back to the original part of this where we're asking how local culture and social conditions affect health, it's intriguing that suicide is less prevalent in certain demographics, cultures, and more.

I get that depression is a long term perpetual condition with no underlying outside factor. I get that it is incredibly difficult to treat. I know what it's like to be broken, but I have been incredibly lucky that we have (so far) known how to fix it. I personally find it fascinating that we have so many more options today and we're actually getting better at evidence based medicine. It's amazing what we've actually learned about our bodies and how finicky they are in some areas. It's also incredibly frustrating how little we know about our brains. If your brain isn't fully working, we have a bunch of things we can try, but we don't really know why one thing works for one person and doesn't work for another. I'll admit that using the word "heal" was a poor choice. We can't heal a thyroid or pancreas, but we can balance them. There are plenty of other organs that we can't "heal", but we can remove them or replace them. We don't really have that same option with our brains.

Though, who's to say that the person who is unemployed, a minority, etc, doesn't also have a flaw in their brain that is beyond their control? Why does having external factors to 'blame' seem to reduce suicide?

My grandfather was a straight, white, middle-class male who killed himself. YMMV!

ETA: I'm in a very irritable part of my cycle and shouldn't get into this. Carry on and ignore me.

I think it has a lot to do with it being comforting that there is something to blame your misery on. That and other cultures' takes on community, etc. I mean, I agree that it is a big, complicated, interesting subject. I think it should always be characterized as a big, complicated, interesting subject.

For the record, and perhaps predictably, I changed my mind. I'll be participating, in some way anyway. Looking forward to seeing you all at reunion week!