Depression

This paper introduces a novel thesis about mental imagery; namely, that it is grease for the mind’s gears (MGT). MGT is not a vague analogy. Rather, it outlines an important and overlooked higher-order function of mental imagery: that it aids various psychological faculties in discharging their functional roles. MGT is motivated by reflection on converging evidence from clinical, experimental and social psychology and solves at least two conceptual puzzles about mental imagery. The first puzzle concerns imagery’s architectural promiscuity; that is, (...) its ability to interact with diverse psychological faculties and perform very different functions when doing so. The second puzzle concerns how to square imagery’s architectural promiscuity with its psychopathological relevance; that is, imagery’s capacity to be a maintaining cause, and possibly even a partial constituent, of several psychological disorders, including post-traumatic stress disorder, bipolar disorder and major depressive disorder. Mental imagery helps and harms the human mind to extreme degrees and this is something that calls for elucidation. MGT says that instead of facing perplexing heterogeneities here, we instead face a significant unity. In addition, MGT represents an alternative to the currently dominant conception of imagery in the philosophical literature; namely, as a perceptual or perception-like state of mind. (shrink)

Major Depressive Disorder (MDD) is a serious condition with a large disease burden. It is often claimed that MDD is a “brain disease.” What would it mean for MDD to be a brain disease? I argue that the best interpretation of this claim is as offering a substantive empirical hypothesis about the causes of the syndrome of depression. This syndrome-causal conception of disease, combined with the idea that MDD is a disease of the brain, commits the brain disease conception of (...) MDD to the claim that brain dysfunction causes the symptoms of MDD. I argue that this consequence of the brain disease conception of MDD is false. It incorrectly rules out genuine instances of content-sensitive causation between adverse conditions in the world and the characteristic symptoms of MDD. Empirical evidence shows that the major causes of depression are genuinely psychological causes of the symptoms of MDD. This rules out, in many cases, the “brute” causation required by the brain disease conception. The existence of cases of MDD with non-brute causes supports the reinstatement of the old nosological distinction between endogenous and exogenous depression. (shrink)

This chapter will introduce everyday aesthetics and conceptions of happiness, explore their interconnections, and indicate some ways they might relate to depression. I introduce the main claims and concerns of everyday aesthetics and illustrate these with examples from the Indian, Chinese, and Japanese philosophical traditions. I then consider two popular accounts of happiness – ‘hedonic’ and ‘life-satisfaction’ theories – and offer an alternative phenomenological account of happiness. Aesthetic appreciation and agency and happiness, it is argued, depend on a phenomenologically fundamental (...) capacity to experience different kinds of significant possibility. It is the loss or disruption of that capacity which characterises experiences of depression. (shrink)

Affordances are action-possibilities, ways of relating to and acting on things in our world. They help us understand how these things mean what they do and how we have bodily access to our world more generally. But what happens when this access is ruptured or impeded? I consider this question in the context of psychopathology and reports that describe this experience. I argue that thinking about the bodily consequences of losing access to everyday affordances can help us better understand these (...) reports. An affordance-based approach to psychopathology can illuminate some of the causes, as well as the experiential character and consequences, of affective disorders and diminished spatial agency in self-world disturbances. It also highlights some under-explored ethical and political dimensions of these issues that need further attention. (shrink)

The cognitive science of belief is a burgeoning field, with insights ranging from detailing the fundamental structure of the mind, to explaining the spread of fake news. Here we highlight how new insights into belief acquisition, storage, and change can transform our understanding of psychiatric disorders. Although we focus on monothematic delusions, the conclusions apply more broadly. -/- .

Desire theories of well-being claim that how well someone’s life goes for them is entirely determined by the fulfilment and frustration of their desires. This thesis considers the viability of theories of this sort. It examines a series of objections that threaten to undermine these views. These objections claim that desire theories of well-being are incorrect because they have implausible implications. I consider four main objections over the course of this thesis. The first claims that these theories are incorrect because (...) they implausibly entail that self-sacrifice does not exist. The second claims that these theories are incorrect because they implausibly entail that severe depression does not diminish the well-being of those afflicted by this condition. The third claims that these theories are incorrect because they have implausible implications about the relative importance of fleeting desires, long-standing desires, and fluctuations in desire strength to well-being. The fourth claims that these theories are incorrect because they fail to capture the intuition that desire fulfilments which leave us disappointed and bereft of feelings of satisfaction do not improve well-being. In each of these cases, I find that desire theories of well-being have sufficient resources to refute these objections. The primary finding of this thesis is that many of the arguments against desire theories of well-being are unsuccessful. A secondary set of findings concern observations about the structure of human psychology. (shrink)

Desire theories of well-being claim that how well our life goes for us is solely determined by the fulfilment and frustration of our desires. Several writers have argued that these theories are incorrect because they fail to capture the harms of self-sacrifice and severe depression. In this paper, I argue that desire theories of well-being can account for the harm of both phenomena by rejecting proportionalism about desire and motivation. This is the view that desires always motivate proportionally to their (...) strength. If we reject this view, then we can explain the harm of many cases of self-sacrifice as arising when we act upon our weaker desires and thereby frustrate our stronger desires. Moreover, the harm of many cases of severe depression can be explained by its suppression of the motivational force of desires. This inevitably frustrates desires that we are left unmotivated to fulfil. I argue that this approach captures the experiential quality of self-sacrifice and severe depression better than rival views that seek to problematise these phenomena for desire theories of well-being. Moreover, these theories have sufficient conceptual resources to account for residual cases of self-sacrifice and severe depression that are less well explained by this approach. (shrink)

The conceptions of lovesickness and of its remedies that emerge in the Decameron result from a medical tradition that in previous centuries was assimilated by the Latin culture. The case of the Decameron is particularly interesting because this work was composed during the Black Death epidemic, between 1348 and 1354. Boccaccio’s Decameron seems to be situated in a tension between two diseases: the black plague, from which the brigata tries to escape, and lovesickness. It is quite significant that Boccaccio dedicated (...) his work to women who love and need the comfort of literature, thereby addressing a new ideal of noble women, not based on their wealth, but on their intelligence and sensitivity. Women are often victims of their melancholy, because they have no opportunity to distract themselves, being confined to the private space of their rooms. Boccaccio describes women as being subject to passion and illness, so that the lovesickness cases described in the Decameron strongly allude to the discrimination of women and to the oppression they had to endure. An explicative example that testifies to the preeminent role that the medical culture played is Decameron X, 7, in which Lisa, the daughter of an apothecary, strangely cannot be healed by pharmacological remedies that her father knows, and not a single physician can help to heal her lovesickness. The case of Lisa can be interpreted as an exemplum: a woman afflicted by the same sickness as Lisa could understand how to behave by means of reading of this novella. Moreover, this paper will demonstrate that a useful outline of Lisa’s symptomatology can be found in Dino del Garbo’s commentary on Guido Cavalcanti’s poem Donna me prega. (shrink)

Phenomenologists define social impairments as key aspects of depression and argue that depression is irreducible to the individual. In this article I aim to further elaborate this non-reductionist notion of depression by claiming that depression not only corresponds to an impaired experience of social relations, but also arises from a socially impaired world. To pursue this goal, I will challenge the understanding of depression as an affective disorder blocking the affective communication between individual and environment. I will redefine feelings of (...) depression as situated affections, and hence suggest that they are products of the individual's situatedness in a depressogenic environment and they function in initiating an active withdrawal from such environment. (shrink)

_Abstract_: The overarching aim of this paper is to provide a comprehensive account of melancholic depression from the perspective of hermeneutic phenomenology. More specifically, we propose that this condition should be interpreted as an alteration in the intentional arc that affects corporeality, temporality, and spatiality, rather than as a mood disorder. In fact, classifying melancholic depression as a mood disorder seems a particularly poor choice; the mood disorder is not a cause but a consequence of a primary disturbance in operative (...) intentionality. Our paper comprises four sections: (1) We provide a methodological and conceptual framework for our theoretical work, adopting a hermeneutic phenomenological perspective on melancholic depression, and underlining the main differences between melancholia and depression. (2) We offer a detailed reconstruction of the different interpretations of melancholic depression and their relationships to the issue of temporality. (3) We analyze the disruption of intentionality in melancholic depression and how it affects corporeality and directionality. (4) We focus on the disruption of moods and affects in melancholic depression, observing how they shape subjective experience. The goal of this theoretical contribution is to underscore the role of operative intentionality and its disruptions in melancholic depression. We argue that taking elements such as intentionality, embodiment, and spatiality into consideration could help to direct therapies along more promising paths. _Keywords_: Melancholic Depression; Operative Intentionality; Corporeality; Directionality; Temporality; Mood Disorders _La depressione melancolica. Un’interpretazione fenomenologico-ermeneutica_ _Riassunto_: L’intento generale di questo contributo è di fornire un’interpretazione della depressione melancolica attraverso la fenomenologia ermeneutica. Più specificatamente, la nostra ipotesi è che questa condizione potrebbe essere interpretata come un’alterazione dell’arco intenzionale la quale impatta la corporeità, la temporalità e la spazialità, e non come un disordine dell’umore. Infatti, classificare la depressione melancolica come un disordine dell’umore ci sembra una scelta particolarmente limitata; il disordine dell’umore non è la causa ma la conseguenza di un disturbo a livello primario dell’intenzionalità operativa. Il nostro contributo si articola in quattro sezioni: nella prima, forniamo una cornice metodologica e concettuale finalizzata a chiarificare le fondamenta teoretiche del nostro lavoro, ad illustrare l’utilizzo della fenomenologia ermeneutica in riferimento alla depressione melancolica, e a sottolineare le differenze principali tra melancolia e depressione. Nella seconda sezione, ricostruiamo in modo dettagliato le diverse interpretazioni della depressione melancolica e la loro relazione con la temporalità. Nella terza sezione, analizziamo l’alterazione dell’intenzionalità nella depressione melancolica e come essa impatti sia la corporeità che la direzionalità. Infine, nell’ultima sezione ci concentriamo sull’alterazione degli stati umorali e della componente affettiva, osservando come questi elementi vadano a caratterizzare l’esperienza soggettiva. Il fine di questo contributo teoretico è di evidenziare il ruolo dell’intenzionalità operativa e delle sue alterazioni nella depressione melancolica. La nostra tesi è che prendere in considerazione alcuni elementi, come l’intenzionalità, l’embodiment e la spazialità, possa contribuire a delineare interventi terapeutici in modo più promettente. _Parole chiave_: Depressione melancolica; Intenzionalità operativa; Corporeità; Direzionalità; Temporalità; Disturbi dell’umore. (shrink)

ObjectiveDepression is one of the most prevalent mental disorder in college students. The traditional screening method for is psychological measurements or scales, but social desirability can cause students to mask their thoughts, and an auxiliary projective test may be needed. This study was designed to measure the validity of applying human figure drawing test as an auxiliary tool for depression screening in this population.MethodsThe HFD test was administered to 113 clinical participants diagnosed with major depressive disorder and 97 healthy college (...) students with self-rating depression scale scores <50. Correlation analysis, chi-square tests, and logistic regression were conducted to identify specific drawing features that associated with depression and could differentiate between the clinical and control subjects. ROC curve was also implemented to evaluate the diagnostic accuracy.ResultsEleven drawing features were significantly related to depression based on the chi-square test results and seven drawing features were associated with depression based on correlation analysis. After logistic regression by controlling gender and age, three drawing features were associated with depression: shaded eyes, drawing clothes in detail, and drawing other personal belongings. Further, drawing clothes in detail and drawing other personal belongings were two significant variables in ROC curve analysis.ConclusionLogistic regression showed that shaded eyes, drawing clothes in detail and drawing other personal belongings were significant drawing features. Individuals with depression will have less energy to put extra effort into drawing and are less likely to have detailed drawings. And the shading of eyes may represent that depressive individuals have a low willingness to communicate and tend to isolate themselves. The results indicated that Human Figure Drawing could be used as an auxiliary tool in college students’ depression screening. Further, the ROC curve analysis showed low discrimination of single drawing features, suggesting that the application of Human Figure Drawing should be considered as a whole instead of focusing on the single drawing feature. (shrink)

Marion Godman makes the argument that Pathological Withdrawal Syndrome (PWS) makes the case for psychiatric disorders as a natural kind. Godman argues that we can classify kinds according to their shared ‘grounding’, but we need not know what the grounding is to know that the natural is a natural kind. However, I argue that Godman erroneously classifies PWS as its own natural kind when it is in fact a variant of depression, which is its own natural kind. Cooper highlights culture-bound (...) syndromes, which can explain the discrepancy between the different diagnosis rates for psychiatric disorders among different cultures. Taking culture-bound syndromes into account, I conclude that PWS is a type of depression that is culture-specific. (shrink)

Nowadays, the major depressive disorder is a common disease that negatively affects the life quality of many people around the world. As MDD symptoms are closely related with the changes in food and eating, the relation between patients’ emotional responses and food tastes could be used as criteria for diagnostic. Until now, studies on the emotional response to different food tastes for patients affected by MDD have been poorly described in literature. Therefore, the aim of this study was to evaluate (...) the emotional response of patients suffering from MDD to the imagined different food tastes and to compare the results with a control group. Emotional responses in tested participants were induced by using cards with words of basic food tastes such as “sweet,” “salty,” “bitter,” “sour,” and “neutral.” The assessment of emotional response was performed with FaceReader 6 software. The outcome of this study showed that participants with MDD expressed lower “happy” and “contempt” and higher “surprised” emotions, along with a higher negative valence mean, in comparison with controls for all tested basic tastes of food. When Likert scale was used, significant differences in response were only found for “sour” and “salty” imaginary tastes between healthy group and patients with MDD. The findings of this study provide the additional data on food–associated emotion analysis of MDD patients and could be useful for the further development of the contactless method for early diagnosis of MDD. (shrink)

This article examines the historical construction of depression over about a hundred years, employing the social life of methods as an explanatory framework. Specifically, it considers how emerging methodologies in the measurement of psychological constructs contributed to changes in epistemological approaches to mental illness and created the conditions of possibility for major shifts in the construction of depression. While depression was once seen as a feature of psychotic personality, measurement technologies made it possible for it to be reconstructed as changeable (...) and treatable. Different types of scaling techniques (Likert versus dichotomous scales) enabled the separation of depressive personality from reactive depression, paving the way for measuring the severity and intensity of emotions. Techniques to test sensitivity to change provided a means of demonstrating the efficacy of new psychoactive drug treatments. Later, more advanced techniques of precision scaling enabled the management of a new measurement problem, clinician unreliability, associated with the growing number of professionals involved in mental health care. Through statistical management of unreliability, the construct of depression has dramatically reduced over this period from hundreds of questionnaire items to potentially just two. Exploring the history of depression through this lens produces an alternative narrative to those that have emerged as a result of medicalisation and the actions of individuals and pressure groups. (shrink)

Depression is an affective disorder involving a significant change in an individual’s emotional and affective experiences. While the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition mentions that social impairment may occur in depression, first-person reports of depression consistently name isolation from others as a key feature of depression. I present a phenomenological analysis of how certain interpersonal relations are experienced in depression. In particular, I consider whether depressed individuals are able to enter into “we-experiences” with other people. We-experiences (...) are experiences had with two or more people as a we, experiences that allow one to enter into robustly shared experiences with others. I claim that the ability to enter into we-experiences is eroded in depression due to an overwhelming feeling of being different to and misunderstood by others. As such, I suggest that depression should be conceived of as fixing an individual in their first-person singular perspective, thus inhibiting their ability to experience in the first-person plural and to feel a sense of connectedness or togetherness with others as part of a we. By attending to on-going impacts of a diminished ability to enter into we-experiences, we can provide a situated and more nuanced account of the changes of interpersonal relations in depression that captures the progressive nature of the disorder. In turn, this analysis furthers our understanding of the emergence, frustration, and erosion of actual and habitual we-experiences. (shrink)

This article describes a case of a teenager with early complex trauma due to chronic domestic violence. Cannabis use triggered auditory hallucinations, after which the teenager was diagnosed with an acute schizophrenia-like psychotic disorder. Antipsychotic medication did not fully resolve symptoms. Eventually the teenager chose to self-medicate with LSD in order to resolve a suicidal condition. The teenager carried out six unsupervised LSD sessions, followed by an extended period of almost daily use of inhaled low-dose DMT. Psychotic symptoms were mostly (...) resolved after approximately one year. Subsequent cannabis use caused a transient relapse. -/- While his psychosis may have been due to cannabis use in the presence of a genetic predisposition, LSD and DMT did not promote psychotic symptoms in this case, and resolved the suicidal condition in one session. Additional high-dose LSD sessions and low-dose DMT sessions appeared to resolve the symptoms related to the early complex trauma. Alternatively, if psychosis is understood as a massive defense system resulting from early complex trauma, and if his psychotic symptoms were partially due to such trauma, psychedelics appeared to transcend this defense system, providing access to traumatic memories in order to allow for an integrative treatment effect. -/- Information was acquired from medical record excerpts provided by the patient, a semi-structured retrospective video interview, and follow-up interviews a year later. The present case suggests a need for further studies on the relationship between psychedelics and psychotic disorders, the feasibility of supervised vs unsupervised settings for various situations, and alternative therapeutic models for utilizing the hyperaware-hypersensitive state induced by psychedelics. With regard to self-treatment, a harm reduction approach should be adopted. Low-risk psycholytic self-treatment protocols could be developed for future use in public health care systems. (shrink)

What exactly do we mean when we refer to disability as a social construction? How viable are the justifications for this? These questions are explored in this paper. To this end, various theories that are influential in German-language disability studies are examined and criticised. These include Oliver's social model, furthermore the "Thomas theorem", Berger and Luckmann's sociology of knowledge, Foucault's discourse theory and Waldschmidt's theory. Subsequently, social constructivist approaches of Watzlawick and Gergen and Gergen are discussed. It is shown that (...) a relativistic understanding of social construction can be used to deny facticity and thus undermines the foundations of scientific knowledge. This danger must be taken seriously when defending the scientificity of disability studies. (shrink)

Emotion Review, Volume 14, Issue 1, Page 55-65, January 2022. Phenomenologists define social impairments as key aspects of depression and argue that depression is irreducible to the individual. In this article I aim to further elaborate this non-reductionist notion of depression by claiming that depression not only corresponds to an impaired experience of social relations, but also arises from a socially impaired world. To pursue this goal, I will challenge the understanding of depression as an affective disorder blocking the affective (...) communication between individual and environment. I will redefine feelings of depression as situated affections, and hence suggest that they are products of the individual's situatedness in a depressogenic environment and they function in initiating an active withdrawal from such environment. (shrink)

Emotion Review, Volume 14, Issue 1, Page 55-65, January 2022. Phenomenologists define social impairments as key aspects of depression and argue that depression is irreducible to the individual. In this article I aim to further elaborate this non-reductionist notion of depression by claiming that depression not only corresponds to an impaired experience of social relations, but also arises from a socially impaired world. To pursue this goal, I will challenge the understanding of depression as an affective disorder blocking the affective (...) communication between individual and environment. I will redefine feelings of depression as situated affections, and hence suggest that they are products of the individual's situatedness in a depressogenic environment and they function in initiating an active withdrawal from such environment. (shrink)

This work analyzes the conceptual metaphors of depression in a corpus of 23 blogs written in Catalan by people suffering major depressive disorder. Its main aim was comparative, in order to check w...

Melancholy occupies a privileged place in the Kantian taxonomy of temperaments since the pre- critical phase, but it is in the Nineties that it reveals its philosophical fecundity. Melancholy becomes, in fact, an interesting notion not so much because of its relationship with Kantian biography, nor because of its presence in the description of psychopathies, but because it lies, unique in this, on the borderline between pathology and sanity. Melancholy thus provides an opportunity to show the topicality of Kantian reflection (...) on mental illness since it underlines the continuity, and not the rupture, between the healthy mental state and that affected by illness, in line with today's most widespread tendencies to consider mental illness as a privileged observatory of the subject. (shrink)

The philosophical concept of anxiety, which is usually associated with Kierkegaard and Heidegger's existential philosophy, seems to be an underestimated notion in Paul Ricoeur's phenomenological hermeneutics, while its role is important - anxiety appears to serve as the grounding for hope in his hermeneutics of self. The article aims to show how the anxiety is explained in Ricoeur's philosophy through attention and recognition, and how the anxiety is reflected in the narrative forms, or descriptions of vivencia. These descriptions may be (...) seen as the verbal explanation of the so-called affective niche or affective scaffolding, which is a form of cultural adaptation, attempting to interpret and comprehend one's state of mind and way of the perception of the world as such in the given moment. The research and further dialogue based on these narrations may become an important source to recover from anxiety disorder, by discovering its existential meaning and, at the same time, accepting personal responsibility for it. Ricoeur's phenomenological hermeneutics made an important theoretical contribution in understanding the essential aspects of anxiety and hope; but it also developed prolific methods of interpretation, that could be practically applied in health care and psychotherapy; these can be shown on the example of the psychotherapeutic method of the usage of so-called 'anxiety protocols', which aim to arrange the hermeneutical co-research to help patient/client to recognize and overcome its anxiety disorders. (shrink)

Depression has been widely studied by researchers from different fields, but its causes, and mechanism of action are still not clear. A difficulty emerges from the shifting from objective diagnosis or analysis to exploration of subjective feelings and experiences that influence the individuals' expression, communication and coping in facing depression. The integration of the experiential dimension of the first-person in studies on depression–and related methodological recommendations–are needed to improve the validity and generalizability of research findings. It will allow the development (...) of timely and effective actions of care. Starting from providing a summary of the literature on theoretical assumptions and considerations for the study of the mind, with particular attention to the experiential dimension of patients with depression, this contribution is aimed to provide practical suggestions for the design of research able to incorporate first- and third-person accounts. It is also aimed to review qualified phenomenological methods for the acquisition and interpretation of experiential data in patients with depression. Recognizing the first-person perspective in the study of depression is a major step toward a better understanding and treatment of this disorder. Theoretical constructs and technique suggestions that result from this review offer a valid starting point for the inclusion of the experiential dimension to common third-person research in the study of the mind. (shrink)

Ongoing electroencephalography signals are recorded as a mixture of stimulus-elicited EEG, spontaneous EEG and noises, which poses a huge challenge to current data analyzing techniques, especially when different groups of participants are expected to have common or highly correlated brain activities and some individual dynamics. In this study, we proposed a data-driven shared and unshared feature extraction framework based on nonnegative and coupled tensor factorization, which aims to conduct group-level analysis for the EEG signals from major depression disorder patients and (...) healthy controls when freely listening to music. Constrained tensor factorization not only preserves the multilinear structure of the data, but also considers the common and individual components between the data. The proposed framework, combined with music information retrieval, correlation analysis, and hierarchical clustering, facilitated the simultaneous extraction of shared and unshared spatio-temporal-spectral feature patterns between/in MDD and HC groups. Finally, we obtained two shared feature patterns between MDD and HC groups, and obtained totally three individual feature patterns from HC and MDD groups. The results showed that the MDD and HC groups triggered similar brain dynamics when listening to music, but at the same time, MDD patients also brought some changes in brain oscillatory network characteristics along with music perception. These changes may provide some basis for the clinical diagnosis and the treatment of MDD patients. (shrink)

Much of the literature on impairment to self-governance focuses on cases in which a person either lacks the ability to protect herself from errant urges or cases in which a person lacks the capacity to initiate self-reflective agential processes. This has led to frameworks for thinking about self-governance designed with only the possibility of these sorts of impairments in mind. I challenge this orthodoxy using the case of melancholic depression to show that there is a third way that self-governance can (...) be undermined: an agent may fail to form the desire she most wants to act on. (shrink)

There has been recent work on acedia and its relationship to depression, but the results are a mixed bag. In this essay, I engage some recent scholarship comparing acedia with depression, endeavouring to clarify the concept of acedia using literature from theology, philosophy, psychiatry, and even a 16th-century treatise on witchcraft. Along the way, I will show the following key theses. First, the concept of acedia is not identical to the concept of depression. Acedia is not merely a primitive psychological (...) predecessor to depression, but it marks off significantly different ways of being, not least because of one’s spiritual relation to God. As Lucrèce Luciani-Zidane (2009: 13) has said, “acedia is entangled in the heart (or life) of Christian dogma.” Second, however, it is still possible that an instance of acedia can coincide with an instance of depression, if one’s condition, or state, is such that each term can be correctly and truthfully applied. By the conclusion of this piece, I begin to explore what practical implications this view has for practitioners and laypersons. (shrink)

Immediately before the release of DSM-5, a group of psychiatric thought leaders published the results of field tests of DSM-5 diagnostic criteria. They characterized the interrater reliability for diagnosing major depressive disorder by two trained mental health practitioners as of “questionable agreement.” These field tests confirmed an open secret among psychiatrists that our current diagnostic criteria for diagnosing major depressive disorder are unreliable and neglect essential experiences of persons in depressive episodes. Alternative diagnostic criteria exist, but psychiatrists rarely encounter them, (...) forestalling the discipline’s epistemological crisis. In Alsadair MacIntyre’s classic essay, such crises occur in science when a person encounters a rival schemata that is incompatible with their current schemata and subsequently constructs a narrative that allows them to reconstruct their own tradition. In search of rival schemata that are in conversation with their own tradition, psychiatric practitioners can utilize alternative diagnostic criteria like the Cultural Formulation Interview, embrace an epistemologically humble psychiatry, and attend to the narrative experience of a person experiencing a depressive episode. (shrink)

The pathologization of women’s depression covers over the social and institutional causes of that symptomology. Insofar as patriarchal values continue to devalue and debase women and mothers in ways that colonize psychic space, and depression becomes a cover for what I call ‘social melancholy.’ This is not the melancholy of traditional psychoanalysis, but a form of melancholy that results from oppression, domination, and the colonization of psychic space. Social melancholy differs from both Freud’s notion of melancholy in that it is (...) the result of social factors that constitute the depressed subject as ashamed and lacking agency. Crucial to my analysis is a distinction between shame and guilt missing from traditional psychoanalytic accounts of melancholy and depression. (shrink)

This dissertation in Theory of Practical Knowledge contends that depression is a disorder of the self. Using the existential-phenomenology of Maurice Merleau-Ponty, I argue that if we want to disclose the basic structure of depressed experience, then we must likewise disclose how selfexperience is inseparable from depressed experience. However, even though depression is a contemporary psychiatric category of illness, it is nevertheless a historically and heterogenous concept. To make sense of depression in the context of contemporary psychiatric practice, I show (...) that depression has historically been characterized by two broad models of causation; that is, a phenomenon that is causally explained by either a biological dysfunction or a psychological conflict. But this stark characterization is not limited just to history; by conducting qualitative interviews with psychiatric professionals, I illustrate how this causal dichotomy remains prevalent in contemporary psychiatric practice. On one hand, the clinicians report dissatisfaction with the depression diagnostic criteria (i.e. it is impersonal or vague), while on the other hand, the clinicians also recognize that a depression diagnosis is useful insofar as a diagnosis facilitates access to various resources associated with psychiatric care. Consequently, clinicians have developed a coping strategy that is witnessed in their empathetic desire to distance patients from their depression diagnosis, which led to statements such as, “you are not the problem, the problem is depression.” One consequence of this approach is that depression is artificially cleaved from the person who experiences depression, which subsequently means that depression is viewed to be something independent of oneself. Because I argue that depression and the self are mutually implicated, it is crucial to disseminate some of the most influential contemporary models of selfhood. I show that the brainbound, situated, psychological, and narrative model of self, all have respective strengths and weaknesses. But I also go beyond these models and characterize selfhood as a developmental phenomenon that is expressed as an embodied-style. This style reflects the way in which we establish perceptual contact with the otherness, without which there could be no self-experience. (shrink)

In the current study it was investigated whether a maternal depressive disorder influences the mother-infant-interaction in infancy and the later ToM-understanding. Therefore, it was examined if there is a relationship between early mother-infant-interaction and later ToM-understanding. To our knowledge this is the first study that investigated gender as moderator for this relationship and that investigated if the infant’s ability of self-regulation is a predictor for ToM-understanding. It was examined if boys and girls of depressed mothers differ concerning their ability of (...) self-regulation. 53 mother-child dyads were studied over the period of 4 years, 20 mothers had a postpartum or lifetime depression, 33 mothers didn’t have any mental disorder. The mother-child-interaction was studied using the Face-to-Face-Still-Face-Paradigm. In preschool age ToM understanding was measured by using content-false-belief- and location-false-belief tasks. There was no difference between the mother-infant-interaction and ToM understanding between the experimental group and the control group. Furthermore, neither a relationship between early mother-infant-interaction and later ToM understanding nor a moderating influence of gender were found. Only the behavior of self-regulation during an interactive stress situation in FFSF was a marginal significant predictor for later ToM understanding for all participants. Furthermore, a significant difference between boys and girls was found within the experimental group. Girls of depressive mothers showed more behavior of self-regulation during an interactive stress situation than boys. Further research about the relationship between self-regulation in infancy and ToM understanding is needed. (shrink)

Adherence to certain religious beliefs is often cited as both an efficient deterrent to immoral behavior and as an effective trigger of morally praiseworthy actions. I assume the truth of the externalist theory of motivation, emphasizing emotions as the most important non-cognitive elements that causally contribute to behavioral choices. While religious convictions may foster an array of complex emotions in a believer, three emotive states are singled out for a closer analysis: fear, guilt and gratitude. The results of recent empirical (...) studies are examined to evaluate the relative motivational efficiency of all three emotions, as well as the likely negative psychological side-effects of these affective states, such as aggres­sion and depression. While an action motivated by fear of punishment can be seen as a merely prudential strategy, the reparatory incentive of a guilty subject and a desire to reciprocate of the one blessed by undeserved favors are more plausible candidates for the class of genuine moral reactions. The available evidence, how­ever, does not warrant a conclusion that a sense of guilt before God or as a sense of gratefulness to wards God, may produce a statistically significant increase in the frequency of prosocial actions aimed at other humans. (shrink)

Background: Depression (major depressive disorder) is a common and serious medical illness that negatively affects how you feel, the way you think and how you act. Fortunately, it is also treatable. Depression causes feelings of sadness and/or a loss of interest in activities once enjoyed. It can lead to a variety of emotional and physical problems and can decrease a person’s ability to function at work and at home. Depression affects an estimated one in 15 adults (6.7%) in any given (...) year. And one in six people (16.6%) will experience depression at some time in their life. Depression can strike at any time, but on average, first appears during the late teens to mid-20s. Women are more likely than men to experience depression. Some studies show that one-third of women will experience a major depressive episode in their lifetime. Objectives: The main goal of this expert system is to get the appropriate diagnosis of disease and the correct treatment and give the appropriate method of treatment through several tips that concern the disease and how to treat it and we will see it through the application on the expert system. Methods: in this paper the design of the proposed Expert System which was produced to help Psychologist in diagnosing depression disease through its symptoms such as: a loss of energy, a change in appetite, sleeping more or less, anxiety, reduced concentration, indecisiveness, restlessness, feelings of worthlessness, guilt or hopelessness and thoughts of self-harm or suicide. The proposed expert system presents an overview about depression disease is given, the cause of diseases is outlined and the treatment of disease whenever possible is given out. SL5 Object Expert System language was used for designing and implementing the proposed expert system. Results: The proposed depression disease diagnosis expert system was evaluated by psychologist students and they were satisfied with its performance. Conclusions: The Proposed expert system is very useful for psychologist, patients with depression and newly graduated psychologist. (shrink)

The aim of my paper is to review the discussion concerning various difficulties which surround the definition of depression and the methods of diagnosing and treating the disease against the background of the now dominant reductionist paradigm in psychiatry, as well as to answer the question whether a new approach to psychiatric disorders proposed by philosophers of psychiatry working within the phenomenologically inspired embodied and enactive paradigm indeed offers a solution to these difficulties. I present the issues specific to the (...) subject of depression in light of the more general problems related to biological psychiatry that have recently caused much debate. In the second part of the paper, I consider enactive, phenomenological and embodied theories of depression and the possibilities of new methods of treatment. My goal is to assess whether these theories indeed add anything important to the conceptions that are already present in psychiatry. I conclude that even if the embodied philosophy of psychiatry does not solve many of the problems faced by modern psychiatry, it can, nevertheless, provide a useful theoretical basis for future changes. (shrink)

Although scholars have read “The Depressed Person” in relation to questions of the self and problems of communication and self-expression, this paper reads the story as an entry point for examining the religious dimensions of Wallace’s work. Comparing Wallace with G.K. Chesterton, the paper argues that if we can accept that the depressed person’s condition is not a biologically grounded clinical depression but an exaggerated personification of a common ailment—a particular brand of loneliness—then we can see that we each have (...) a stake in the search for a way to break the dehumanizing pull of our own egos. Wallace and Chesterton point to submission and attention as potential means of escape, even if they disagree about how to do this. When confronted with the challenge of finding happiness, joy, and connection in a world that encourages introspection, explanatory mastery, and mechanistic views of the self—of finding meaning in the face of forces of meaninglessness, nihilism, and self-centeredness—both draw on imaginative literature as a source of knowledge. Wallace stops just short of orthodoxy, but his works stand as courageous defenses of the human person against the strange but dangerous foes of modern American life. (shrink)

This article examines the role of time as a methodological tool and pathological focus of clinical psychiatry and psychology in the first half of the 20th century. Contextualizing ‘psychopathologies of time’ developed by practitioners in Europe and North America with reference to the temporal theories implicit in Freudian psychoanalysis and Henri Bergson’s philosophy of durée, it illuminates how depression, schizophrenia, and other mental disorders such as obsessive-compulsive behaviours and aphasia were understood to be symptomatic of an altered or disturbed ‘time-sense’. (...) Drawing upon a model of temporal synthesis whereby in healthy individuals, a subjective temporal sense ( Ichzeit, durée, or personal lifetime) was perceived and understood in relation to objective time frameworks ( Weltzeit, clock-time, or quantitative time models like historical chronology), clinicians argued that mentally ill patients were unable to synthesize Ichzeit and Weltzeit, using variations in this disturbance to define specific pathological conditions. (shrink)

Advocates of physician-assisted suicide often argue that, although the provision of PAS is morally permissible for persons with terminal, somatic illnesses, it is impermissible for patients suffering from psychiatric conditions. This claim is justified on the basis that psychiatric illnesses have certain morally relevant characteristics and/or implications that distinguish them from their somatic counterparts. In this paper, I address three arguments of this sort. First, that psychiatric conditions compromise a person’s decision-making capacity. Second, that we cannot have sufficient certainty that (...) a person’s psychiatric condition is untreatable. Third, that the institutionalisation of PAS for mental illnesses presents morally unacceptable risks. I argue that, if we accept that PAS is permissible for patients with somatic conditions, then none of these three arguments are strong enough to demonstrate that the exclusion of psychiatric patients from access to PAS is justifiable. (shrink)

This paper is a response to Justin Bell's “Depression Applied to Moral Imagination: Deweyan Tools for Moral Inquiry." The author first contextualizes Bell’s use of evolutionary psychology in the context of two influential philosophical engagements with medicine: Alasdair MacIntyre’s concept of the therapeutic and the recent turn towards person-centered medicine over disease-centered medicine. He then raises two concerns about the accounts of depression used in the sources Bell draws on: the way they identify depression as oriented towards social problems and (...) the way they view depression as intentional. (shrink)

What is the relationship between negative experience, artistic production, and prudential value? If it were true that (for some people) artistic creativity must be purchased at the price of negative experience (to be clear: currently no one knows whether this is true), what should we conclude about the value of such experiences? Are they worth it for the sake of art? The first part of this essay considers general questions about how to establish the positive extrinsic value of something intrinsically (...) negative. The second part emphasizes the importance of various distinctions within the realm of the negative. We must distinguish between adversity (which is non-mental) and negative mental states, and between negative thoughts (or attitudes) and negative affect. Within the realm of negative affect, we must distinguish between negative emotions and moods, on the one hand, and negative affective perspectives on the other, and then between mildly negative affective perspectives and severely negative ones (for which I reserve the term ‘suffering’). These distinctions matter greatly, since different types of negative experience have very different degrees of prudential disvalue. Although many types of negative experience may be “worth it”—because their positive extrinsic value outweighs their negative value—this is rarely true of severe suffering. (shrink)

In his "Let the drugs lead the way! On the unfolding of a research program in psychiatry," Shai Mulinari nicely lays out the evolution of theories of depression since the late 1950s; that is, understanding depression as ultimately a brain disorder centering on the functioning of monoamine neurotransmitters. Moreover, the emergence of various psychotropic drug treatments have provided researchers with a "pharmacological bridge" to gain a more precise understanding of depression by observing the effects of these drugs on patients' monoamines (...) and mood. This evolution, Mulinari argues, fits Imre Lakatos's concept of a research program. Mulinari's narrative is clear, compelling, and informative and it generates some... (shrink)

In current mental health care psychiatric conditions are defined as compilations of symptoms. These symptom-based disease categories have been severely criticised as contingent and boundless, facilitating the rise to epidemic proportions of such conditions as depression. In this article we look beyond symptoms and stress the role of epidemiology in explaining the current situation. By analysing the parallel development of cardiovascular disease and depression management in Finland, we argue, firstly, that current mental health care shares with the medicine of chronic (...) somatic conditions an attachment to risk factor epidemiology, which accentuates risk and prevention in disease management. However, secondly, due to the symptom-based definitions of psychiatric conditions, depression management cannot differentiate properly between symptoms, signs and risk factors such as, for example, cardiovascular medicine, but treats symptoms as signs or risk factors in contexts of treatment and prevention. Consequently, minor at-risk conditions have become difficult to separate from proper cases of depression. (shrink)

Anastasia Philippa Scrutton renders helpful service to philosophers and mental health clinicians by highlighting strongly voluntarist approaches to depression within some present-day Christian writers and communities, particularly Pentecostal and Evangelical Christian communities in the United States and the United Kingdom. Drawing on a number of evangelical Christian books and online resources, she argues that these resources are "voluntaristic because they emphasize the role of libertarian free will and choice in the attitudes and behaviors of people with depression, such that depression (...) is seen to be a sin, or the result of sin, because depression sufferers are able to do otherwise." She counters these... (shrink)

Technical Delusions in Schizophrenia: productivity and Limits of an AnalogyIn the debates on psychosis, the cases of "technical delusions" or "influencing machines" are regularly coming back, both in phenomenological and psychoanalytical psychiatry. As Alfred Kraus points out in the 1990s, "Even if such delusions do not represent the most frequent content in schizophrenia, they receive relatively high consideration for the diagnosis of schizophrenia". And more recently, he notes that, "It is not by chance that people with schizophrenia so often use (...) technical metaphors to explain their schizophrenic experiences", but he then concludes that they are not in fact metaphors, at least... (shrink)

In this paper, I offer an argument for cultivating cheerfulness as a remedy to sadness and other emotions, which, in turn, can provide some relief to certain cases of depression. My thesis has two tasks: first, to establish the link between cheerfulness and sadness, and second, to establish the link between sadness and depression. In the course of accomplishing the first task, I show that a remedy of cultivating cheerfulness to counter sadness is supported by philosophers as diverse as Thomas (...) Aquinas, Baruch Spinoza, and David Hume in their writings on the passions. I also show that my argument can generalize to promote the cultivation of other emotions. In the course of accomplishing the second task, I consider different models of depression and how the emotions are related to depression. The purpose of this paper is to offer conceptual, philosophical support that is consistent with the most current empirical data on depression. (shrink)

I am grateful to Dien Ho and James Phillips for their comments on my article. Although they approach the topic from different perspectives, they both seem to find my account of the evolution of monoamine theories into neuroplasticity theories to be compelling. They especially seem to find my principal argument to be persuasive: Until quite recently, the use of drugs to generate and test pathophysiological hypotheses—the pharmacological bridge—has been a paramount driving force in psychiatric research.In his thoughtful commentary, Phillips is (...) right to draw attention to the role of "nonbiological" factors, which tend to be overlooked by biological psychiatry, in the etiology of depression. He... (shrink)

Recent years have witnessed an intensification of historical and philosophical research on the link between psychotropic drugs and psychiatric theories. For example, Kendler and Schaffner detailed how the dopamine hypothesis of schizophrenia was intimately linked to the dopamine theory of antipsychotic drug action. Here, a related case is explored: the use of antidepressants' neurochemical effects to speculate about the pathophysiology of depression.This rationale was central to American psychiatrist Schildkraut's landmark article on the catecholamine hypothesis of affective disorders. Accordingly, the paper's (...) hypothesis—that depressions may relate to decreased... (shrink)