I was recently reading about how “Depression can show up so many different ways.”

In my little world, that may not be quite correct.

A statement like that posits, first and foremost, without questioning the assertion/assumption, that there IS in fact a “thing” called “Depression.”

But most psychiatric diagnoses are hypothetical constructs, and as we love to do in the field of Psychology and Counseling, we elevate them to Reified Hypothetical Construct status. We no longer consider them constructs, but facts, self-evident facts.  Like “Of COURSE Depression in a thing!”

But I’m at least as much a student of Language as I am of Psychology, and I’m not so sure.

What I am sure about is that there are people who experience:

• Sadness or irritability
• Loss of interest in once enjoyed activities
• Sudden weight changes
• Sleep disruption
• Tiredness
• Restlessness
• Feelings of worthlessness
• Feelings of Hopelessness
• Suicidal ideation
• Down mood
• Loss of interest in pleasure

I get that some teens:

• Experiment with substances
• Have poor academic performance
• Experience isolation and withdrawal
• Have problems with peers

I also get that some older folks:

• Experience some of the above and physical pain

And some men may have:

• Bouts of anger
• Constipation
• ED
• Low T

All of those have been listed as possible signs of “Depression.”

But here’s something I find this interesting:  I could gain 30 pounds, feel worthless about that, feel tired, have disrupted sleep, and lose interest in going to the gym, once a source of some joy. Throw in an angry mood, maybe, and low T as symptoms 6 and 7.

You could lose your partner, feel very sad, hopeless about your future, lose interest in the things the two of you enjoyed, have trouble sleeping and have recurring thoughts about ending it all.

BOTH of these qualify for a diagnosis of Depression. You need 5 symptoms, and we both have 5. Yet only one symptom overlaps. My 5 symptoms are very real, and so are yours. Is it not enough to say “I am experiencing these 5 things, and you are experiencing those 5 things”?

What is gained when we collect 5 things together and decide to assign them an over-arching Noun, a Label, of Depression? Did we get more information by so doing? (My grad school advisor would say we like to Nounify experiences and processes—turn them into a “thing.”  Depression. Anxiety. TBI. PTSD. All the so-called Personality Disorders. Bipolar. And so on…)

Do we really BOTH have “the same thing”? Depression? Is “HAVE” even the right verb? 

So DO we know more when we assign the Noun? It’s not clear to me that we do. Some might say “Well, now we have a diagnosis and we know how to treat “Depression”, but I’m sure you can see how circular THAT line of thinking is. And it STILL assumes there is this THING, this DEPRESSION thing, that needs “treatment.”

Oh, yeah, and by the way:  Anti-Depressants

Google this:  “research does not support anti-depressants”

You’ll see refereed sources that suggest anti-depressants are not, in the long term, associated with improved quality of life. You’ll see lots of stuff refuting the once glibly-stated and widely accepted “Chemical Imbalance” narrative. We have not solved so-called depression. Now people are Ketamine-ing and micro-dosing, and MDMA-ing and so on, and why? Because the stuff we’ve been doing for many years does not appear to have great efficacy. I am not saying NOBODY benefits from anti-depressants. But anybody who has been in the field for longer than ten minutes has had dozens or scores of clients who did NOT benefit from anti-depressants. I am not suggesting that anybody in the field is bad, or stupid. I am suggesting we need to be asking better questions, and not taking the party line as truth.

Maybe people have “problems in living.” Maybe “treating Depression” is not the way to look at it. The history of Psychiatry and Psychology is embarrassingly replete with ridiculous metaphors, wrong-headed hypothetical constructs (wandering womb? Google “The Troubled History of Psychiatry) and the pathologizing of common human experiences (Homosexuality was a Mental Disorder until 1973. I could go on and on…)

Anyway…Psychology does not have one Strep Throat on its resume. (“Hey, we know how to test for that, and Antibiotics make it go away!!”)

Nobody says “Man, remember when people used to have ANXIETY?? Dude, that sucked, right? Thank God we figured THAT s*** out and nobody has it anymore!”  That’s not where we are at. Maybe Nounifying collections of human experiences and “treating” hypothetical constructs is not the way to go?

But what do I know?

I’m smart enough to know to ask better questions, but not smart enough to have the answers to those questions.

Still, I believe it is really important to keep asking more and better questions…

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