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

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.
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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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30 Things I'd Rather Be Than 'Pretty'

Because "pretty" is so overrated.
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Nowadays, we put so much emphasis on our looks. We focus so much on the outside that we forget to really focus on what matters. I was inspired by a list that I found online of "Things I Would Rather Be Called Instead Of Pretty," so I made my own version. Here is a list of things that I would rather be than "pretty."

1. Captivating

I want one glance at me to completely steal your breath away.

2. Magnetic

I want people to feel drawn to me. I want something to be different about me that people recognize at first glance.

3. Raw

I want to be real. Vulnerable. Completely, genuinely myself.

4. Intoxicating

..and I want you addicted.

5. Humble

I want to recognize my abilities, but not be boastful or proud.

6. Exemplary

I want to stand out.

7. Loyal

I want to pride myself on sticking out the storm.

8. Fascinating

I want you to be hanging on every word I say.

9. Empathetic

I want to be able to feel your pain, so that I can help you heal.

10. Vivacious

I want to be the life of the party.

11. Reckless

I want to be crazy. Thrilling. Unpredictable. I want to keep you guessing, keep your heart pounding, and your blood rushing.

12. Philanthropic

I want to give.

13. Philosophical

I want to ask the tough questions that get you thinking about the purpose of our beating hearts.

14. Loving

When my name is spoken, I want my tenderness to come to mind.

15. Quaintrelle

I want my passion to ooze out of me.

16. Belesprit

I want to be quick. Witty. Always on my toes.

17. Conscientious

I want to always be thinking of others.

18. Passionate

...and I want people to know what my passions are.

19. Alluring

I want to be a woman who draws people in.

20. Kind

Simply put, I want to be pleasant and kind.

21. Selcouth

Even if you've known me your whole life, I want strange, yet marvelous. Rare and wondrous.

22. Pierian

From the way I move to the way I speak, I want to be poetic.

23. Esoteric

Do not mistake this. I do not want to be misunderstood. But rather I'd like to keep my circle small and close. I don't want to be an average, everyday person.

24. Authentic

I don't want anyone to ever question whether I am being genuine or telling the truth.

25. Novaturient

..about my own life. I never want to settle for good enough. Instead I always want to seek to make a positive change.

26. Observant

I want to take all of life in.

27. Peart

I want to be honestly in good spirits at all times.

28. Romantic

Sure, I want to be a little old school in this sense.

29. Elysian

I want to give you the same feeling that you get in paradise.

30. Curious

And I never want to stop searching for answers.
Cover Image Credit: Favim

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Stop Saying, 'I Don’t Want To Get Diabetes,’ It's Rude And Ignorant To Those Who Are Type 1 Diabetic

Nobody wants to "get" diabetes, but some of us have no choice.

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This statement implies that is is a choice to be diagnosed with diabetes as if it is some very controllable condition where I have the ability to decide whether it affects me or not. This is not true.

When I was three years old, I was diagnosed with type 1 diabetes also known as juvenile diabetes because it typically, but is not limited to, beginning in adolescence. Type 1 diabetes is a chronic condition where my pancreas no longer produces insulin. This is caused by my immune system attacking the pancreas, ultimately destroying the cells that create insulin. As of right now, there is no explanation known for what ultimately makes the immune system do this, and there is no cure for the autoimmune condition.

Thus, as a type 1 diabetic, I have no choice but to be entirely insulin dependent. Whenever I consume carbohydrates, I must administer insulin to my bloodstream just like how non-diabetic people having a fully functioning pancreas that releases the same hormone whenever they introduce carbohydrates to their digestive systems. The amount of insulin that I administer is based on the number of carbs that I consume; the carbs per insulin unit ratio varies based on the individual and also has the potential to change just as how the pancreas secrets insulin within an individual's body at rates that are unknown. Therefore, finding ways to treat diabetes can be difficult for there lacks a "one size fits all" template for what works best for each diabetic. (This is important to keep in mind for all health conditions: what works well for one person does not necessarily mean that it will work well for a different person.)

There are a lot of other factors that are imperative for my mindful attention in order to stay healthy with this chronic condition. Monitoring blood sugar levels, counting carbohydrates, gaining a true sense of body awareness, and attending doctors appointments are some examples of these other factors that are necessary to keep on top of while living with type 1 diabetes. As you can tell, this chronic condition can easily become overwhelming.

Did I want to be diagnosed with type 1 diabetes? No.

Did I have a choice as to whether I was diagnosed with type 1 diabetes? No.

Do you have the ability to control what statements you make when speaking in public? Yes, you most certainly do.

I urge people to resist from saying the phrase, "I don't want to get diabetes" when offered dessert or saying something similar when asked why they are cutting back on how much sugar they include in their diet. Perhaps these comments are in reference to "getting" type 2 diabetes also known as adult-onset diabetes. This condition is different from type 1 diabetes in the sense that the pancreas does not produce enough insulin or the body has developed a resistance to the insulin that is produced; the body does not use insulin efficiently. Another difference is that type 2 diabetes can be influenced by the risk factors of obesity and family history. Finally, type 2 diabetes can also be reversed; this means that through lifestyle choices such as diet and exercise, the effects of type 2 diabetes can be alleviated because the pancreas still does make insulin for type 2 diabetics. This is not the case for type 1 diabetes, thus, these are two different conditions.

So let's say that the ignorant comment of "I don't want to get diabetes" is made in reference to type 2 diabetes. This is still an awful thing to say. Of course, nobody "wants to get" diabetes; why would they? However, even in cases of type 2 diabetes, there are factors that are still beyond the individual's personal control, and even after the diagnosis occurs, as I stated earlier, there are differences in how each individual responds to treatment options. What works for one may not work for another.

Unfortunately, I have been in the presence of people who have made comments within this subject matter. Being a type 1 diabetic myself, the situation is incredibly awkward. Whether the person who made the statement knows that there is a diabetic present in the room or not, they should not be speaking like this. Making this comment implies that there is a concrete choice as to whether an individual is diagnosed with diabetes, of any type, or not. Making this comment implies that you, the commentator, is above those of us who are already diabetic; you are looking down on us in a way because your comment insinuates that you would never want to endure the lifestyle of a diabetic. Making this comment implies that you, the commenter, have no idea what the differences between type 1 and type 2 diabetes are, or that there even are different types of diabetes and how to distinguish between the complications of each. Making this comment implies that you, the commenter, are extremely, unmistakenly, ignorant.

In the instances that I have heard this quick comment be made, some people present in the room knew that I was type 1 diabetic and some people did not. Nobody pointed me out or made sideways glances at me to notice my facial expression. I was not offended by the comment, nor was I embarrassed that I am type 1 diabetic while there is this person saying that they "don't want" what I have. I was, however, extremely disappointed in the comment. I was partly disappointed in the commenter for making such an ignorant statement (that I am sure was probably not meant to be harmful at all), but I was also majorly disappointed in society as a whole. Instances like this have made me realize that, collectively, society is also ignorant of the differences between types of diabetes. Generalizing this condition can result in the cultivation of uncomfortable situations and an inability to understand the complications of each type of this condition.

Finally, and most importantly, whenever I endure experiences such as the one described, I am refreshed of just how utterly important it is for all of us to choose our words wisely and precisely. Even if we do not intend to cause harm by our words, the possibility of that happening is always present. When people say "I don't want to get diabetes," I am not sure they realize just how terrible this statement sounds leaving their lips. In my mind, my first reaction is that I would never say anything like this, but then again, I have this reaction because I am type 1 diabetic. Similarly, would you ever make the statement "I don't want to get cancer" when offered a free session in a tanning bed or "I don't want to get liver damage" when offered a beer? No, because there are so many genetic and epigenetic factors that can contribute to cancer diagnoses and the same goes for liver failure.

It sounds absurd to even read those two examples. How can somebody solely correlate tanning beds with "getting" cancer and beer with "getting" liver damage when there is an abundance of other contributing factors as well as different types of levels of severity regarding these health issues? Well, I ask myself the same question regarding the statement of "I don't want to get diabetes" when somebody is offered something sweet. How can somebody solely correlate sugar with "getting" diabetes when there are so many other factors that are potentially involved? While it is possible that these pairs are related in terms of causation to some extent (tanning beds/cancer, beer/liver damage, sugar/diabetes) there are so many things that we do not know exactly and making generalized statements like my examples above prove to be inappropriate.

It sounds absurd because it is absurd.

Thus, let's all strive to create an environment where we do not make people feel ashamed or uncomfortable based on ignorant statements regarding health conditions that we may or may not know anything about. You never know what people are going through or how a genetic condition, health issue, or disease affects them. Furthermore, you never know what health experiences you will one day be exposed to, whether that condition will affect you personally or if it will affect a close family member or friend. Either way, it will change your perspective immensely.

I vow to always choose my words carefully and thoughtfully to ensure that I can clearly articulate a point with consideration for whoever is present in my audience; you should too.

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