Depression: Misunderstood, Not Defunct

Depression Isn't A Sign That Something Is Wrong With You— It's A Sign That Your Needs Aren't Being Met

If you were suffering and in pain, if you are suffering and in pain, do the same and remind yourself that there's nothing wrong with you - that you're not crazy.
Ryan Fan
Ryan Fan
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On January 7, 2018, Johann Hari published an article in The Guardian titled "Is everything you think you know about depression wrong?" The author, Hari, calls for a new approach to our treatment of depression, as someone who took antidepressants himself for 13 years (something that didn't work for him).

The article begins with an exploration of the "grief exception." As many people who are grieving suffer symptoms of depression, in the 1970s, the authors of the Diagnostic and Statistical Manual (DSM) had this problem: "if they followed this guide, they had to diagnose every grieving person who came to them as depressed and start giving them medical treatment." For people who had lost a loved one in the past year, these symptoms were not a disorder - they were natural. The authors of the DSM called it the "grief exception."

As the years and decades since the 1970s passed, doctors came up with a different narrative. "All over the world, they were being encouraged to tell patients that depression is... produced by low serotonin, or a lack of some other chemical. It's not caused by your life - it's caused by your broken brain." Some doctors began to question how this narrative co-existed with the grief exception. Sometimes, the symptoms of depression are just a reasonable response to life circumstances, from losing a loved one to losing your job to being alone.

The grief exception would be whittled away, from a few months to such an extreme that "if your baby dies at 10 a.m., your doctor can diagnose you with a mental illness at 10:01 a.m. and start drugging you straight away."

Dr. Joanne Cacciatore, a professor at Arizona State University's School of Social Work, says this about how we talk about depression, mental illness, and suffering in general: we don't. To have a serious conversation and talk about them requires that we, as a society need to "stop treating the symptoms. The symptoms are a messenger of a deeper problem. Let's get to the deeper problem."

Hari himself had taken antidepressants for 13 years, going back to his doctor time and time again because he kept returning to his normal level of depression. His dose would increase from 20 milligrams to 30 milligrams, but the "pain [would] come back through once more." Eventually, his dosage went as high as 80 milligrams, and still, his depression wouldn't get too much better.

In researching this book, and in the context of his own experiences, Hari went on a 40,000 mile journey across the world to find what actually causes depression and anxiety. One professor, Irving Kirsch, found a fundamental flaw in the scientific evidence that 70% of people who took antidepressants got better. Many drug companies would fund a large number of studies and discard the studies showing that antidepressants don't work. One example was so extreme that a drug was given to 245 patients, but the drug company published results for only 27 of them. For those 27 patients, the drug worked. He would discover that the figure couldn't be right, and later discover that between 65% and 80% of people are depressed again in a year.

Let's take a quick stop and acknowledge this number. This means that medication and antidepressants are a long-term solution for 20 to 35% of depressed people, and they do work. But antidepressants "clearly can't be the main solution for the majority of us, because we're still depressed when we take them." Hari's article isn't trying to falsely dismantle the effectiveness of antidepressants and the veracity of the serotonin story - it just says that some people, and maybe even the majority of people, need something else, or just something more.

In Hari's research, he found that just as human beings have physical needs (according to Maslow's hierarchy of needs), so too do we have psychological needs, like feeling like we belong, like we're good at something, like we need to feel valued, like what we do matters. "There is growing evidence that our culture isn't meeting those psychological needs for many - perhaps most - people." I really resonated with this article because Hari is telling us that depressed and anxious people aren't crazy - there isn't anything wrong with them. Maybe they just have needs that aren't met. Maybe the problem, for most people, is not "a problem with their brains, but a problem with their environments."

Hari found anecdotal ways depression was treated in many local places, natural and lasting "antidepressants" that addressed the deeper problems behind different individuals' depression and anxiety. One family in Baltimore, the Mitchell family, was a prime example. Meredith Mitchell suffered severe anxiety, and hated her office job. Josh Mitchell and his friends were depressed, working in a bike store where they were ordered around with little to no power.

The Mitchells both quit their job and set up their own bike shop. They decided to run it as a democratic co-operative rather than a traditional bike shop, and they would "all, together, be the boss." The staff of this store, Baltimore Bicycle Works, explained to Hari how this environment allowed them to lift their overbearing depression and anxiety. Although they weren't doing much different, they met their previously unsatisfied psychological needs - "giving themselves autonomy and control over their work." For Josh Mitchell, depression and anxiety is not some sort of "biological break," but a "rational reaction to the situation." For Josh, the solution for many more people would be to "move together, as a culture, to workers controlling their own workplaces."

I think there are two keys and takeaways from Hari's article, the first of which is to not see anything wrong with suffering from the symptoms of mental illnesses. We feel as we do for perfectly normal reasons, and we are not "machines with malfunctioning parts. [We] are human being[s] with unmet needs." I have always felt that attributing feelings of being sad, lonely, and unfulfilled to biochemical imbalances was inherently reducing. Yes, a serotonin or other neurotransmitter imbalance is a part of it. But that's not all - many other pieces fit into the equation.

The second takeaway from the article is to do what works for you, and what fulfills your individual needs. I know that my unhappiest moments are when I feel alone, both socially and emotionally. Being amongst my friends and having fulfilling conversations are the two ways I fulfill my deep need for connection. The message from Hari is this: don't just treat your symptoms - address "the problem causing your depression in the first place."

For validation, the UN criticized the medicalization of depression on World Health Day in 2017, saying that "the dominant biomedical narrative of depression...is shortsighted and insufficient." It is spurred by "the biased and selective use of research outcomes." The biomedical approach that emphasizes the excessive use of medications "causes more harm than good, undermines the right to health, and must be abandoned." While the UN does not condemn the use of medications for treating severe depression or other mental health conditions (that it works for), the UN emphasizes a "shift in investments in mental health, from focusing on 'chemical imbalances' to focusing on 'power imbalances' and inequalities."

If Hari were to go back in time and speak to his teenage self, he would give this message to himself: "the pain you are feeling is not pathology. It's not crazy. It is a signal that your natural psychological needs aren't being met...It is telling you that you need to be connected in so many deep and stirring ways that you aren't yet - but you can be, one day."

If you were suffering and in pain, if you are suffering and in pain, do the same and remind yourself that there's nothing wrong with you - that you're not crazy. Find what really matters to you, for your life, and do what you can to reach it.

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I Weigh Over 200 Lbs And You Can Catch Me In A Bikini This Summer

There is no magic number that determines who can wear a bikini and who cannot.
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It is about February every year when I realize that bikini season is approaching. I know a lot of people who feel this way, too. In pursuit of the perfect "summer body," more meals are prepped and more time is spent in the gym. Obviously, making healthier choices is a good thing! But here is a reminder that you do not have to have a flat stomach and abs to rock a bikini.

Since my first semester of college, I've weighed over 200 pounds. Sometimes way more, sometimes only a few pounds more, but I have not seen a weight starting with the number "1" since the beginning of my freshman year of college.

My weight has fluctuated, my health has fluctuated, and unfortunately, my confidence has fluctuated. But no matter what, I haven't allowed myself to give up wearing the things I want to wear to please the eyes of society. And you shouldn't, either.

I weigh over 200lbs in both of these photos. To me, (and probably to you), one photo looks better than the other one. But what remains the same is, regardless, I still chose to wear the bathing suit that made me feel beautiful, and I'm still smiling in both photos. Nobody has the right to tell you what you can and can't wear because of the way you look.

There is no magic number that equates to health. In the second photo (and the cover photo), I still weigh over 200 lbs. But I hit the gym daily, ate all around healthier and noticed differences not only on the scale but in my mood, my heart health, my skin and so many other areas. You are not unhealthy because you weigh over 200 lbs and you are not healthy because you weigh 125. And, you are not confined to certain clothing items because of it, either.

This summer, after gaining quite a bit of weight back during the second semester of my senior year, I look somewhere between those two photos. I am disappointed in myself, but ultimately still love my body and I'm proud of the motivation I have to get to where I want to be while having the confidence to still love myself where I am.

And if you think just because I look a little chubby that I won't be rocking a bikini this summer, you're out of your mind.

If YOU feel confident, and if YOU feel beautiful, don't mind what anybody else says. Rock that bikini and feel amazing doing it.

Cover Image Credit: Sara Petty

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The Lazy Girl's Guide To The Gym

Also, everything else you should know if you're a slightly out-of-shape girl (like me).

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With my freshman year coming to an end, I realized a lot of things. I made new friends, I found new hobbies, and I learned a lot of lessons. One of them being that the "Freshman 15" is very real and very scary.

While my friends and family have attempted multiple times to convince me that I'm just being dramatic (I am), I still want to make a change in my lifestyle or I will, in all seriousness, be on track to the "Sophomore 20".

Here is a list of my best gym and healthy lifestyle tips that I am slowly attempting to live by this summer in order to resurrect Emily's 18-year-old body and health.

1. Increase water intake.

2. Find a gym buddy.

3. Start off with cardio.

4. Don't stop on your cardio until you're dripping in sweat.

5. Chug a LOT of water an hour before the gym.

Do not do it right before, or you will be in pain.

6. Eat light beforehand but just enough to hold you over. 

7. Plan out what your routine will be BEFORE you get there.

My routine: Elliptical for a mile, Stairmaster for 10 minutes, ab HIIT workout for 10 minutes, 5 more minutes on Stairmaster.

8. Buy healthy foods while you're feeling motivated.

9. Find a gym that isn't too far from your house. 

10. Don't get mad at yourself if you don't see results in a day.

I know this is a hard one.

11. Try fitness classes. 

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