Since this weekend, when the news of Aaron Swartz’s suicide, there’s been a lot of discussion of the goverments ridiculous pursuit of him, and of the fact that he suffered from depression. I can’t contribute anything new about his prosecution. It was despicable, ridiculous, and sadly, all too typical of how our government works.
But on the topic of depression, I want to chime in. A good friend of mine wrote a post on his own blog about depression in the tech/geek community., which I feel like I have to respond to.
Benjy, who wrote the post, is a great guy who I have a lot of respect for. I don’t intend this to be an attack on him. But I’ve seen a lot of similar comments, and I think that they’re built on a very serious mistake.
Benjy argues that the mathematical/scientific/logical mindset of a geek (my word, not his) makes us more prone to depression:
Someone whose toolkit for dealing with the world consists of logic and reason, ideals and abstractions, may have particularly weak defenses against this trickster disease.
You realize that it’s lying to you, that there are treatments, that that things aren’t objectively as bad as they feel. But you know, on some level deeper than logic, that there is no point, no hope and no future. And to encounter, maybe for the first time, the hard limits of rationality, to realize that there’s a part of your mind that can override the logical world view that is the core of your identity, may leave you feeling particularly helpless and hopeless.
You can’t rationalize depression away, a fact that people who’ve never suffered from it find hard to comprehend. But if someone you care about is struggling with it, and it’s likely that someone is, you can help them find a new way to access their mind.
Tell them that you care about them and appreciate them and are glad to have them in your life. Show them that you enjoy being around them and that you love them. And above all, spend time with them. Give them glimpses of an alternate future, one in which they are secure, happy and loved, tear away the lies that depression needs in order to survive, and in that sunlight it will wither.
Most of what Benjy wrote, I agree with completely. The problem that I have with it is that I think that parts of it are built on the assumption that our conscious reasoning is a part of the cause of depression. If geeks are more prone to suffering from depression because the way that our minds work, that means that the way that we make decisions and interpret the world is a part of why we suffer from this disease. The implication that too many people will draw from that is that we just need to decide to make different decisions, and the disease will go away. But it won’t – because depression isn’t a choice.
The thing that you always need to remember about depression – and which Benjy mentions – is that depression is not something which you can reason with. Depression isn’t a feeling. It’s not a way of thinking, or a way of viewing the world. It’s not something that you can choose not to suffer from. It’s a part of how your brain works.
The thing that anyone who suffers from depression needs to know is that it’s a disease, and that it’s treatable. It doesn’t matter if your friends are nice to you. It doesn’t matter if you know that they love you. That kind of thinking – that kind of reasoning about depression – is part of the fundamental trap of depression.
Depression is a disease of the brain, and it affects your mind – it affects your self in a terrible way. No amount of support from your friends and family, no amount of positive reinforcement can change that. Believing that emotional support can help a depressed person is part of the problem, because it’s tied to the all-too-common stigma of mental illness: that you’re only suffering because you’re too weak or too helpless to get over it.
You don’t just get over a mental illness like depression, any more than you get over diabetes. As a friend or loved one of a person with diabetes, being kind, showing your love for them doesn’t help unless you get them to get treatment.
I’m speakaing from experience. I’ve been there. I spent years being miserable. It nearly wrecked my marriage. My wife was as supportive and loving as anyone could dream of. But I couldn’t see it. I couldn’t see anything.
The experience of depression in different for different people. But for me, it was like the world had gone flat. I wasn’t sad – I was just dead inside. Nothing could have any impact on me. It’s a hard thing to explain, but looking back, it’s like the world had gone two-dimensional and black-and-white. Eventually, I was reading something in some magazine about depression, and it talked about that flat feeling, and I realized that maybe, maybe that was what was wrong with me.
When I started taking antidepressants, it was almost frightening, because it changed the world so much. ANtidepressants didn’t make me happy. In fact, for a while, they made me very sad, because I was realizing how awful I’d been treating my wife and daughter. But they made me feel things again. A few weeks after I started taking them, I realized that I was noticing colors. I hadn’t done that for years. It wasn’t that I couldn’t see colors when I was depressed, but they didn’t mean anything.
Antidepressants aren’t a panacaea. They don’t work for everyone. But there are treatments that can help. The way to defeat depression is to do something that changes the way the brain is functioning. For some people, the exercise of therapy can do that. For others, it’s medication. For still others, exercise. The key is to get to someone who understands the disease, and who can help you find what will work for your brain.
My point here is that when we’re talking about depression, we need to realize that most of the time, no one is at fault. People don’t suffer from depression because they did something wrong, or because they’re weak, or because they’re flawed. People don’t suffer from depression because their friends and family are inadequate. Depression is a disease – a treatable, chronic disease. It needs to be recognized, and it needs to be treated.
In my case, my depression wasn’t caused by my wife and daughter. It wasn’t their fault, and it wasn’t my fault. No amount of support, love, and appreciation could have helped, because the nature of my depression meant that I couldn’t see those things. The only thing that anyone could have done for me is recognized that I was suffering from depression, and pushed me to get treatment sooner.
If someone you know is suffering from depression, then they need help. But the help they need isn’t any amount of love or appreciation. It isn’t instilling any kind of hope, because depression kills hope in your brain. The thing that you can do to help is to help them get the treatment that they need.
“It’s treatable” – ideally, and as I understand it, for most people. But sometimes the treatments don’t work, or it takes years to fine-tune the chemicals used to counter the state the brain gets in. And sometimes a treatment that had been working ceases to work, and you have the same problem recognizing that the cure has become ineffective that you had with the initial diagnosis. In this way, it’s not much different from other chronic diseases that require constant monitoring.
An excellent fictional description of depression: http://dailysciencefiction.com/science-fiction/robots-and-computers/ekaterina-fawl/the-curious-case-of-version-4713
Yes, exactly.
That’s why I think it’s so important to stress the idea that if you know someone who’s suffering from depression, that it’s not their fault, and it’s not your fault either.
People need to remember that depression is that it isn’t just one thing. It’s a catch-all description of a range of illnesses, and unfortunately, we don’t (yet) have the tool to distinguish between them except for trial and error.
It’s a damned tricky disease. We’re getting much, much better at treating it. But finding the right treatment can take time. If something doesn’t work for you, it doesn’t mean that you failed. It doesn’t mean that you’re beyond hope.
Excellent post! Thank you 🙂
I’m pretty sure there are different kinds of depression. You had one sort, but it doesn’t sound like the same as mine at all – like many others I know, I became depressed because of external factors. I did not lose the ability to feel or care, even to feel happy, but the problems (the external factors) absorbed all my thinking, ruining my memory and ability to concentrate, and eventually things that healthy people do without even thinking (such as locking doors or turning off cooking plates) required intense effort to perform.
I often compare it to solving a crossword in a dream, if you’ve ever done that. It’s a frustrating and sluggish experience, by the time you fill out one word suddenly the rest isn’t like you remembered it, and nothing fits any more. Planning and problem-solving was impossible. It’s like walking around in a labyrinth, and if you touch the foggy walls you forget where you were headed, or what was the point of it. I just couldn’t find the way out on my own.
I used to think depression was sadness, or lack of ability to feel anything (like you describe). Since I could still enjoy a few activities, I didn’t think that was what it was, so I didn’t seek help.
When I did eventually get help, antidepressants did nothing for me, good or ill (except the ones which were supposed to help with anxiety and sleep problems, neither of which I had! They made me extremely sleepy.) It was cognitive-behavioral treatment which helped me, and it is in many ways a way to use reason to attack the problems, what Benjy and you said won’t work. It’s true, it _wouldn’t_ have worked without systematic external help, and other people as external anchors to “check” my depressive perception of reality.
Aaron’s depression seemed different from either of us. From what I’ve read of it (I only exchanged some mails with him many years ago, not about anything personal), he had more big ups and downs, mood swings. He did not have a flat affect like you had, at least not over time. Lots of things had a strong emotional impact on him – and given his mental capacity to the end he certainly couldn’t have the mind-crippling fog I encountered.
Excellent blog article. Depression is also found at a higher than typical rate among writers as well, and I think many of them would relate to this blog.
Actually, geeks, engineers, scientists, and the like, seem to be LESS frequently affected by depression than many other people are, partly BECAUSE they routinely cope with problems by means of reason. Rationality is no panacea, but it tends to reduce the extent to which a person unwittingly exacerbates his problems, and, once a rational person recognizes a problem as something that might be treatable, he is more likely than some to seek help.
Reason, as a cognitive process, may not cure a problem (you cannot cure a headache by thinking about it), but it can lead one to correctly identify a problem and then to choose well what might be needed to solve it (such as taking a headache medicine). In the case of depression, this could mean taking medications (for neurological depression) or cognitive therapy (for situational or psychogenic depression), or both.
There is, of course, no guarantee that geeks (etc.) will be as rational about their psychological well-being as they may be about their work, but the requirement of objectivity in such fields as engineering and science may actually benefit a person by promoting a similar objectivity about one’s own mind and emotions, and it may thus help both to counteract depression and to lead one to seek help when it’s needed.
Thank you for writing on this topic.
From my own experience, pharmaceutics work well with cognitive therapy. Pharmaceuticals, over time, may have a drastic reduction in their efficacy. It is good to have techniques for “talking back” to harmful thought processes, and replacing them with helpful thought processes.
would you say that if someone gets diabetes, then no one is at fault? surely the diabetic could have done some things, like regular fasting, healthy lifestyle, etc, that would greatly reduce their chances of getting diabetes?
Yes, I would say that.
Diabetes isn’t a simple matter of “you’re fat, so you’re going to get diabetes”.
It’s a fact that being overweight can increase your chances of getting type II diabetes. That doesn’t mean that all type-II diabetes is caused by the weight or behaviors of the person with diabetes.
Some people who are rail-thin and eat a perfectly healthy diet will develop type-II diabetes; others will be morbidly obese for their entire lives, and never develop it.
And that’s just type-II. Type-I diabetes is generally something that you’re born with. Nothing about your behavior, your diet, or your physical condition has anything to do with type-I.
This is completely wrong.
First, if depression is some kind of disease addling with our brains there would be geographical correlations. But the main cause of suicide which is depression does not show such a relationship:
http://en.wikipedia.org/wiki/List_of_countries_by_suicide_rate
How would you react to the sentence: “Post-traumatic stress syndrome from war experience, torture or rape is a disease of the mind” ? It is not a “disease” of the mind, it is a fully understandable reaction for an event which has put too much stress on your ability to cope. And it is measureable, it often afflicts your amygdala
severely.
Depression is caused almost always by your environment, either by putting you on too much stress , experiencing a current trauma (loss of partner, job etc.) or other people treating you badly (or having treated you so badly that your ability to cope is permanently damaged). There are sometimes incidences where there are other causes but they are rare.
And yes, you are absolutely right that the person who is suffering from depression
often cannot be helped by relatives or friends. Like a person who e.g. are severely
injured during an accident (and cannot heal by themselves or by bystanders) you need immediate and extensive care like antidepressants/therapy/professional help.
But like an accident there is a definite cause. The assholes who cornered Aaron are accessaries to his suicide.
Setting aside the fact that the statistics in that table are incredibly muddled (“Male … suicide rates are … total number of male suicides divided by total male population” leading to a UK rate of 10.9? 11 times as many male suicides as male population?), and that your own concept of statistics seems equally muddled (what do you mean by “geographic correlations”? there most certainly are areas which are more and less prone to suicide), you seem to be using a very odd and restrictive sense of “disease”. Your condition would seem to rule out Down Syndrome, cystic fibrosis, and any number of other genetic anomalies. Are you possibly — intentionally or not — confounding “disease” with “infection”?
And there we have the real motive: facts and analyses that don’t support a presumed narrative must be wrong.
I appreciate the thoughtful response to my post.
My original point seems to have been misinterpreted. It was that geeks (to use your terminology) may have worse symptoms, all else being equal; not that geeks can cure their own depression by changing how they think or decide. Think of it as the psychological equivalent of immunodeficiency: geeks may be more susceptible to “infection” than the next person. I think I was pretty clear about the fact that you can’t will your way out of depression any more than you can will your way out of pneumonia. But you can bolster your defenses against depression just as you can bolster your immune system.
However I think you’ve presented a false dichotomy. There’s no contradiction between the fact that depression is a disease of the brain (or, more precisely, of the mind) and the fact that the way you think is a participant in depression. The first is attested to by the efficacy of antidepressant medication. The second is attested to by the efficacy of Cognitive Behavioral Therapy in treating depression.
It’s well-known that depressive episodes can be triggered by negative events. But clearly the depression is actually triggered by your thoughts about those events, since the event itself has no effect on you until you become aware of it (and in fact the event need not even have occurred; You merely have to believe it has). So it is not at all controversial to assert that cognition plays an important role in depression.
To use an analogy to a physical malady: Crohn’s Disease is a chronic disorder of the immune system, so immunosuppressants are the gatekeepers of prevention. But it primarily affects the digestive tract, and a flare-up can be triggered by digestive distress. Therefore diet plays a role in both prevention and treatment, as does gastroenterological surgery. Diet is not the cause of Crohn’s, and no one would say that you can cure Crohn’s disease by changing what you eat, but it is nonetheless an important aspect of managing the disease.
So while it is not true that how you reason is a cause of depression, it is true that altering your cognition can be a big part of managing and curing it. The crucial point is not that changing how you think doesn’t help, but that you can’t just alter your cognition by force of will, any more than you can perform your own bowel resection. It requires a lot of very tough work with a psychotherapist. And of course you could also be taking antidepressants at the same time. It’s best to attack depression on multiple fronts at once.
It is the cognitive aspect of depression that your loved ones can help with, somewhat. The advice I gave to the loved ones of people with depression doesn’t imply that this alone is a cure, merely that this is the best thing for them to do to provide support, the psychological equivalent of bringing you soup when you have mono. It doesn’t amount to a cure on its own, but it can help support CBT treatment, by reinforcing new cognitions.
In my experience, I *was* able to will myself out of depression. The key realization that made it possible was that my depressed thoughts were fundamentally irrational. My own veritable rationality (ha!) allowed me to recognize whenever I was following irrational thought patterns, and eventually I learned to literally snap out of it. I understand that it may not work the same for everyone or even just most people with depression, but improving your meta-cognitive ability is an important factor in preventing depression. To that end, I recommend looking into mindfulness meditation.
It is the standard rate of incidences per 100 000 people per year as indicated by the caption of the table.I do not see that it is “incredibly muddled”.
Thanks that you understand the argument even if it was muddled in your viewpoint.
I wrote “some kind of disease addling with our brains”. See further down
There aren’t facts and analyses which don’t support a presumed narrative.
I paraphrase this article:
Mark cites a blog post where the author thinks that people with a logical mindset may be more prone to depression. He states (and I and Mark do agree) that depression is a very serious condition and it is also very improbable that you can cope with it on your own. He thinks that the best friends and relatives can do is to give as much appreciation as possible.
Mark now partly agrees, but disagrees on the point that “a logical mindset may be more prone to depression” may imply that people are able to “reason” their way out of depression. Here he strongly objects and tell his own experience with depression.
Where I now very strongly object is that Mark (perhaps unaware of it) looks like he is equating depression too much with some kind of sickness. If “that most of the time, no one is at fault” is true, it sounds that you get depression out of the blue.
So Marks article alone neither supports nor refutes the exact causes of Aaron Swartz death. It could have been written at any time. So your assumption that it “don’t support a presumed narrative” is rather baseless.
The problem I see is that depression *has* causes: stress put on you on your environment, mistreatment by other people or traumatic loss of loved ones.
It does not matter if Aaron was healthy, had already depression or if the depression was caused by other matters: Threatening a person with decades of jail and a damage of millions of dollars pushes people *always* to a much worse condition.
So I feel fully justified to call the people responsible for this “assholes”.
And while we’re on the subject, I have a special helping of bile for people who post this ‘inspirational’ claptrap on Facebook, over and over again:
http://www.livelifehappy.com/if-you-are-depressed/
If you are depressed you need treatment. If you are anxious you need treatment. If you are at peace – good for you! Enjoy it while it lasts!