Depression---on the boundary of rationality---philosophical therapy

Diagnois of Major Depressive Episode from DSM-5

There are the following criteria for Major Depressive Disorder in The Diagnostic and Statistical Manual of Mental Disorders (DSM-5): - Depressed mood (may be subjective, feel sad, empty, hopeless, in child or adolescents, can be irritable mood, may be subjective or observed by others) most of the day, nearly every day. - Markedly diminished interest or pleasure (may be subjective or observed by others) in all, or almost all, activities most of the day, nearly every day. - Significant weight loss when not dieting or weight gain or decrease or increase in appetite nearly every day. - A slowing down of thought and a reduction of physical movement (observable by others, not merely subjective feelings of restlessness or being slowed down). - Insomnia or hypersomnia. - Fatigue or loss of energy nearly every day. - Feelings of worthlessness or excessive or inappropriate guilt nearly every day. - Diminished ability to think or concentrate, or indecisiveness, nearly every day. - Recurrent thoughts of death, recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide. If there are larger or equal to 5 symptoms during the same two-week period that are a change from previous functioning; depressed mood and/or loss of interest/pleasure must be present; exclude symptoms clearly attributable to another medical condition, then there is a likelihood of being diagnosed as Major Depressive Disorder.

Why do adults aged 18-25 years old have higher occurrences of depression?

In the US, adults aged 18-25 years old are almost twice likely as adults aged 26-29 to have mental depression. Mental depression is typically associated with low self-worthiness, which means that individuals have low self-evaluation about their ability to achieve their intended goals or low recognition of their existential meaning in this world. These evaluations are subjective and are not necessarily accurate. Adults aged 18-25 years old typically start to discover themselves, find the self, and become independent. They may take most of the time thinking about what kind of people they want to be and their position of themselves in the world. This thinking process will compare mutually conflicting ideas and values, and it is tricky and painful since there are thousands of ways how to live a meaningful life. How an individual lives life may depend on self-personality and social systems. They may be too ambitious and set super high goals that are easy get frustrated or they may feel that they don’t like the study program they are attending because their choices are out of economic concerns or expectations from society or family, but not out of pursuing the intrinsic value consistent with one’s personality or invisible talents. In summary, Adults aged 18-25 years are vulnerable to depression because it is critical period of discovering self-personality and self-value, determining way of living life and life purposes, and how to achieve those purposes with strengths and perseverance even in times of suffering and difficulties. It is a period of forming strong belief without wavering, at the same time, there is no standardized guidance or formula in pursuing the final goal of life.

The Essence of Depression (Human Being's Instincts: Get Along and Get Ahead)

• The essence of mental disease is the conflict between the agents' beliefs and the outer world. The mental diseases here do not include those mental health issues caused by DNA deficits. Suppose one believes that he or she pays much attention to people's traits, such as empathiness or responsibility when making friends with people, while people around him or her make friends according to social status, and smartness. When this agent fails to conform to social norms, he or she may doubt himself or herself and self-denial of his or her belief as he or she is hard to get along in a large group. This frustration of self-belief being accepted will decrease people's self-esteem and feel low or meaningless in the world. If he or she cannot go through this struggle and confirm that his or her own belief is right, he or she cannot recover from this frustration. But once he or she rationalizes their beliefs, and finds a way to solve the mental conflicts, he or she becomes stronger than before and won't get struck by this belief conflict again. Of course, there may be other conflicts arising again. Whenever the core belief is challenged, the agent has to find a way to rationalize his or her way of thinking to solve these frictions.

Documented medical causes of depression.

• Abuse. Physical, sexual, or emotional abuse can make you more vulnerable to depression later in life.
• Age. People who are elderly are at higher risk of depression. That can be made worse by other factors, such as living alone and having a lack of social support.
  • Getting old companies with loss of esteem and physical power, which may be a crucial motivation for some people's meaning of life.
• Certain medications. Some drugs, such as isotretinoin (used to treat acne), the antiviral drug interferon-alpha, and corticosteroids, can increase your risk of depression.
  • physiological disease
• Conflict. Depression in someone who has the biological vulnerability to it may result from personal conflicts or disputes with family members or friends.
  • conflicts between family members could be value-related, for example, norms and customs evolve across generations and the value conflict between generations makes the less powerful or confident generation, typically the younger generation struggle with the conflicts because they cannot make agreements but at the same time, they may not set up their value or are not confident with their own value.
• Death or a loss. Sadness or grief after the death or loss of a loved one, though natural, can increase the risk of depression.
  • Companionship or love is the meaning of one's life.
• Gender. Women are about twice as likely as men to become depressed. No one's sure why. The hormonal changes that women go through at different times of their lives may play a role.
  • Women per se have the pressure of giving birth and natal pressure, traditional gender norms conflict with nowadays self-actualization, which makes women struggle.
• Genes. A family history of depression may increase the risk. It's thought that depression is a complex trait, meaning there are probably many different genes that each exert small effects, rather than a single gene that contributes to disease risk. The genetics of depression, like most psychiatric disorders, are not as simple or straightforward as in purely genetic diseases such as Huntington's chorea or cystic fibrosis.
  • the culture within the family may affect the likelihood of depression, for example, the siblings of Ludwig Josef Johann Wittgenstein commit suicide because of depression, which may be not the result of genes.
• Major events. Even good events such as starting a new job, graduating, or getting married can lead to depression. So can moving, losing a job or income, getting divorced, or retiring. However, the syndrome of clinical depression is never just a "normal" response to stressful life events.
• Other personal problems. Problems such as social isolation due to other mental illnesses or being cast out of a family or social group can contribute to the risk of developing clinical depression.
• Serious illnesses. Sometimes, depression happens along with a major illness or may be triggered by another medical condition. Substance misuse. Nearly 30% of people with substance misuse problems also have major or clinical depression. Even if drugs or alcohol temporarily make you feel better, they ultimately will aggravate depression.