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WP:UNDUE, POV, uncited text removed. SandyGeorgia (Talk) 03:39, 9 January 2009 (UTC)[reply]

Over the years cannabis has come to be demonized by misinformed and selfish people, so much so that propaganda (Above the Influence) are spread about its effects and by a combination of lies and scare-tactics this wonderful plant has been made and kept illegal in the US. Sensible people are now learning of the plants medical value, and more and more people are being prescribed medical Marijuana (as it's now called so that it sounds more friendly) every day. Cannabis has virtually no side affects, is much much more affective than any pain pill or anti-depressant, and is %100 natural.

Read a paper a while back about how THC increases ones risk of both anxiety and depression over baseline.--Doc James (talk · contribs · email) 22:10, 9 January 2009 (UTC)[reply]

I've read that paper. Correlation does not equal causality. Unless you have some other evidence? 219.89.98.127 (talk) 10:53, 27 February 2009 (UTC)[reply]

Correlation may not be causality, but that doesn't look like a very promising correlation. I agree that marijuana has been irrationally demonized, but where's the evidence--correlational or otherwise--that it's a helpful medication for depression? Cosmic Latte (talk) 14:21, 27 February 2009 (UTC)[reply]

I am very surprised not to see this mentioned in the article. The World Health Organization's study "The global burden of disease: 2004 update" is cited in this article here as stating that "depression is the leading cause of years lost due to disability."

http://blogs.psychologytoday.com/blog/in-practice/200901/the-major-scourge-humankind

any comments? Brian Fenton (talk) 21:32, 29 January 2009 (UTC)[reply]

Done. See section Epidemiology. - Hordaland (talk) 02:19, 30 January 2009 (UTC)[reply]

I think it's really important to get the general understanding of depression according to psychoanalysis into this article. There is a substantial body of work on depression there, and while psychoanalysis is mentioned, it's theories of depression are not featured. Here's a summary, it could do with some work and references. I might come back and develop this again before adding it to the article. Any comments?

Psychoanalytic understandings of depression are based in the ideas first advanced by Freud in "Mourning and Melancholia", later developed by Klein in the object relations school of thought. In this paper, Freud discusses the process of grieving the loss of a loved one and working through the personal impact of their absence from the world. Unhindered, this process eventually results in the mourner coming to possess a reliable and loving "inner voice" of their lost love, which Klein would call a "good object". In everyday terms, we might imagine a widow having come to terms with their grief and being able to think fondly of their former partner, remembering them in a warm and affectionate way and thinking how they might respond and comment on the widow's life in the present.

Melancholia, which we would now call depression, shares the initial trajectory of the loss of a love but leads instead to a pathological, deadening grief. Freud and Klein argue that depression is brought about by a combination of hostility toward the lost object and an inability to let it go. For example, a child of an emotionally unresponsive and threatening father may feel inadequate and afraid around them. If the father then leaves, the child may be left with unexpressed anger and disappointment. This hostility cannot be directed at the actual father, who is now absent, so instead becomes directed at the "bad object" of the father, the inner memories and "voice" of that parent internalised and carried by the child. Thus the anger intended for the other becomes directed at the self, accounting for the depressive's tendency to deride and denigrate themselves ("I'm worthless" etc.).

This also explains why other people around the depressive person cannot argue them out of their self-hatred ("I'm worthless", "No you're not", "Yes I am" etc.), as the derisive remarks are not really directed at the depressive them self, and the irritation others can feel when trying to do so.

N.b. I think this should include some words on counter-transference (this is my aim in the third paragraph), some better words succinctly explaining the idea of an object, a note that the lost object could also be an ideal, a country etc., and some explanation of the gap between how the depressed person understands (or doesn't understand) their condition and this theory, i.e. some brief notes on the details of the loss being unconscious.

—Preceding unsigned comment added by 78.105.159.2 (talk) 03:00, 19 February 2009 (UTC)[reply]

Hi and thanks for commenting. Much of this was in an older version of the article but had to be reduced due to the article's huge size....I was frustrated too. I cna't remember if we kept it on a daughter page. We were going to make a causes of depression page at some point. Casliber (talk · contribs) 05:39, 19 February 2009 (UTC)[reply]

Hi, thanks for that. I'm interested to see the material and how that was decided, I'll have a look through the archives. Whitespace (talk) 16:33, 19 February 2009 (UTC)[reply]

Eek, the dreaded archives! Feel free to read them, but here's a summary of the situation: Freud's contribution is discussed at Major_depressive_disorder#History; it's also in History of depression. I was among those who felt that it belonged in Major_depressive_disorder#Psychological, but agreed (still against my overall inclination, however) to moving it only following much debate and after Casliber made the very valid point that psychodynamic thinking has a rich post-Freudian history. So I eventually added a much-condensed version of Freud's theory to "Psychological causes," attributing it specifically to Freud's "classical psychoanalytic perspective." However, if you can improve any of the three places in which psychoanalytic theory is mentioned--Major_depressive_disorder#Psychological, Major_depressive_disorder#History, or History of depression--then please, by all means, feel free to do so. Cosmic Latte (talk) 17:31, 19 February 2009 (UTC)[reply]

Thank you for your summary. I've been intending to edit and write the above paragraphs into the Major_depressive_disorder#Psychological section but I haven't done so yet. I am very keen to get Freud's explanation in there somewhere (basically: lost love object + hostility / ambivalence + regression of libido into the ego = bad object stored in ego + hostility towards self). It's readily understandable in everyday language and opens the door for the reader to learn more if they wish, ie. it seems at exactly the right level for a general encyclopaedia article. In response to the work since Freud, I'd argue that this framework from his Mourning and Melancholia paper is a crucial part of the psychoanalytic canon of thought on depression. There have been significant later developments (Klein and Bowlby come to mind), certainly, but it remains a cornerstone of the work on this subject. Perhaps it would be a good idea to collate all of the material so far into a new Psychological approaches to depression article, where we can work the finer points out in detail? Whitespace (talk) 00:49, 26 February 2009 (UTC)[reply]

Yep - spinning out into daughter articles is a good idea. Orignal material is here. Note the box above has more too. Casliber (talk · contribs) 01:43, 26 February 2009 (UTC)[reply]

This treatment has been approved recently in USA and Europe, has a well proven efficacy, and its likely to be increansingly used. It does not seem logical to have it under a "other" subsection, side by side to an "over the counter herbal remedy" or a recommendation on physical exercise non proved by reviews; it may also confuse its importance the fact that just under the subsection title there is a "see also:self medication"; when nobody can use TMS by their own... I believe these are all reasons for it to have its own subsection just after ECT (since it says that it is used as an alternative to it). Best regards.--Garrondo (talk) 08:30, 6 March 2009 (UTC)[reply]

I've removed the "self-medication" bit from that section because neither rTMS nor VNS can be considered self-medication. As for the placement in an "other" subsection, that is probably okay given that these treatments are newer and less well established. Xasodfuih (talk) 19:59, 8 March 2009 (UTC)[reply]

The article Are bad sleeping habits driving us mad? in New Scientist states:"TAKE anyone with a psychiatric disorder and the chances are they don't sleep well. The result of their illness, you might think. Now this long-standing assumption is being turned on its head, with the radical suggestion that poor sleep might actually cause some psychiatric illnesses or lead people to behave in ways that doctors mistake for mental problems. The good news is that sleep treatments could help or even cure some of these patients. Shockingly, it also means that many people, including children, could be taking psychoactive drugs that cannot help them and might even be harmful.". In short, sleeping disordes may cause deperssive disorders. I couldn't find it in the article. Maybe I just overlooked it, if not shouldn't it be in here? regards --Cyrus Grisham (talk) 18:28, 6 March 2009 (UTC)[reply]

It actually is here, in Major depressive disorder#Other theories: "Depression may be related to abnormalities in the circadian rhythm…". We've talked about discussing this more extensively, but there really isn't space. Still, if you have suggestions for getting the message across more clearly, feel free to make them. Looie496 (talk) 00:19, 7 March 2009 (UTC)[reply]

Well, it is there an it is there not. The Chronobiology (circadian rhythm/Circadian rhythm sleep disorders) part is there (at least partly, but how different wavelengths of the "light" affects our body clocks is another story), but not quality of sleep part (see also Sleep disorder), for example sleep-disordered breathing like sleep apnoea or Insomnia (well, I can't see the part). I qoute the article: "Adults with depression, for instance, are five times as likely as the average person to have difficulty breathing when asleep, while between a quarter and a half of children with attention-deficit hyperactivity disorder (ADHD) suffer from sleep complaints, compared with just 7 per cent of other children.. Normally, like in the Insomnia article:"Poor sleep quality can occur as a result of sleep apnea or clinical depression.", but what if sleep apnea could cause poor sleep quality and clinical depression? Thats what the weblink from New Scientist suggests: that sleep disorders may lead to the depression, and not "just" However, certainly not every depressed person has a sleep disorder, but this should be thought of!

This leads to the question how this could be included. Well thats not so easy, but first we should agree that this part is not in and then how we can implement it to fit nicely into the article. --Cyrus Grisham (talk) 14:54, 7 March 2009 (UTC)[reply]

I agree that it's not in there, and it should be. I do have a feeling (like you?) that research and time will show that sleep disorders cause depression more often than the opposite. They cause "ADHD", too. - Hordaland (talk) 18:59, 8 March 2009 (UTC)[reply]

I have the same opinion, but unfortunately the psychiatric community as a whole doesn't seem to be fully convinced yet, so there's a limit to how much weight the article can give these ideas. We gotta follow the mainstream even if we think they're behind the times. Looie496 (talk) 19:51, 8 March 2009 (UTC)[reply]

Well, this is not the psychiatric community, this is wikipedia. The Peptic ulcer is one example were the psychiatric community told the people it is just "stress" (bad childhood, stressful job, etc), which is causing this. They were wrong! Stress might be a factor (maybe even an importend or the one), but then what is stress? When were are answering this question, we also have to think about stress hormones! Here the problem begins, because when are these hormons released into the body and where are those produced? Here the psychiatric community gives some answers, but is it the full picture? I don't think so. Why? Scientific evidience shows that stress hormons can also be released, when you have a sleeping disorder or when you're on nightshift(?)! Thats a measurable fact. I have no idea what happends, when the organs which is producing these hormones is not working as it should, for whatever reason. Therefore, I believe that this should be included into the article under a section like "Depression and sleep", where both possibilities should be fairly weighted (depression->bad sleep, bad sleep->depression or better depression <-> bad sleep). There is from my point of view a lot from the psychiatric community, so why not add this stuff? The source is there and I think that New Scientist is a realiable one, don't you? What do you think? Best regards! --Cyrus Grisham (talk) 20:32, 8 March 2009 (UTC)[reply]

That article in New Scientist relies almost entirely on this paper for the link with depression. If anything, that study should be cited directly, and the New Scientist article be cited with the "laysummary=" param. I've not read the paper carefully, so no comment on it right now. Xasodfuih (talk) 20:44, 8 March 2009 (UTC)[reply]

Here are some other links:

• Sleep apnea, depression linked in Stanford study (2003)
• Depression and Obstructive Sleep Apnea (OSA) Study (2005)
• BBC News: Sleep disorder linked to depression (2002)
• Case Study: Rapid eye movement sleep behaviour disorder, depression and cognitive impairment (2000)
• The National Sleep Foundation page Depression and Sleep has links to more studys + some infos about the possible realationship. Hopefully, I just linked every study once.. Hope this is evidence enough for a section "Depression and sleep" Good Night!--Cyrus Grisham (talk) 21:37, 8 March 2009 (UTC)[reply]

• Regarding the comment above that the psychiatric community seeks to attribute medical conditions diseases to psychiatric disorders, the example give is peptic ulcer. My experience is the opposite, that is, the general medical community attributes to psychological disorders diseases for which the etiology is unclear e.g. currently Fibromyalgia and Chronic fatigue syndrome and often pain in general. —Mattisse (Talk) 22:15, 8 March 2009 (UTC)[reply]

Yup, including mine (DSPS) until quite recently. Progress is slow, but remember that homosexuality was a disorder to be treated according to the DSM. Now it's not, though transsexuality still is. Circadian rhythm disorders were mental disorders until recently. Now they're not, except for SAD which got left behind. There are certainly still a lot of unknowns. - Hordaland (talk) 01:25, 9 March 2009 (UTC)[reply]

All I am saying is that misinformation/misdiagnoisis is not a feature of the psychiatric/psychological community seeking to "cover" more diseases/disorders under their umbrella, but rather a reflection of the general medical consciousness of the times. —Mattisse (Talk) 02:21, 9 March 2009 (UTC)[reply]

Here are some more studys (some were from mentioned in the New Scientist article, but I couldn't find them all):

• Insomnia in Young Men and Subsequent Depression (1997)(Full Free study available + including links, who cite this study!)
• Longitudinal association of sleep-related breathing disorder and depression. (Study 2006)
• Sleep disturbance in bipolar disorder: therapeutic implications.(Review 2008) (Here because of the depression phase.)
• Sleep and youth suicidal behavior: a neglected field. (In, because of psychiatric disorders. Depression is not mentioned, however. This link is more about this.)
• Are sleep disturbances risk factors for anxiety, depressive and addictive disorders? (Reviw 1998)
• Insomnia and hypersomnia associated with depressive phenomenology and comorbidity in childhood depression. (Study 2007)
• Prevalence, course, and comorbidity of insomnia and depression in young adults. (study 2008)

By the way, there are far more studys out there between the connection sleep and depression/psychiatric disorders. Quite interesting... --Cyrus Grisham (talk) 12:12, 9 March 2009 (UTC) <-Here's a suggestion: I think a specific article on Role of sleep disturbances in mood disorders would be fully appropriate, and having such an article would make it easier to extract out the gist for the top-level article. If you would like to use your sources to start such an article, I would be supportive. Looie496 (talk) 16:47, 9 March 2009 (UTC)[reply]

Thanks Looie496, thats an good idea. I would even suggest an article like sleep and health (Maybe thats too general, and quite a lot of things are in other articles, but there is no article in wikipedia, which gives a quick overview, what might happen when someone has sleep disturbances). However, first I'd like to hear what others are thinking and then we can decide what to do. So I'll be back in this discussion in a few days, I have lots of work to do (and I'm not an expert in this area). Best regards! --Cyrus Grisham (talk) 21:22, 10 March 2009 (UTC)[reply]

• You might look through

• Sleep disorder (this lists some), Circadian rhythm sleep disorder, International Classification of Sleep Disorders, Shift work sleep disorder, Insomnia (redirected), Caffeine-induced sleep disorder, Category:Sleep disorders in general, Narcolepsy, Delayed sleep phase syndrome, Parasomnia, Sleep deprivation, Rapid eye movement behavior disorder, Sleep apnea, Non-24-hour sleep-wake syndrome, Sleep etc. Perhaps some of these can be combined or listed or something. Quite a plethora. —Mattisse (Talk) 00:20, 11 March 2009 (UTC)[reply]

For sure :-)

One approach might be Sleep disorder as a list, showing a hierarchy. F.ex. shift work, DSPS and Non-24 are all circadian rhythm sleep disorders, as are ASPS and even Jet lag. One section of Sleep disorder is already in list form. As is:

This almost should be a project. In fact, I think I proposed it as a task force once upon a time!

(This whole discussion should be moved someplace more appropriate.) - Hordaland (talk) 00:55, 11 March 2009 (UTC)[reply]

Until then: There is an article on sleep medicine, which could be of use.--Garrondo (talk) 08:33, 11 March 2009 (UTC)[reply]

Task force: found it! I did indeed suggest a task force for Sleep medicine here last June. (That was before I wrote the article Sleep medicine referred to above.) Only one other person (user:Medicellis) ever expressed an interest. As this discussion shows, some clean-up and reorganizing is needed. Might there be enough interest now for a Task Force? - Hordaland (talk) 12:22, 11 March 2009 (UTC)[reply]

Insomnia got redirected to Sleep medicine (from my point of view, an annoying redirect.) I don't know much about wikipedia projects, but I wonder if "Sleep" could be a "Topic", or is that what it is in the template above? Not sure. Does a project deal with a topic? How does a task force operate? I agree that the subject of sleep is very important and has relevance to many issues/subjects/conditions. —Mattisse (Talk) 12:59, 11 March 2009 (UTC)[reply]

There seems to be an focus on psychological and biological causes of depression which definitely should be included in the article and are relevant but there is zero mention of drug induced depression, which is a common cause of depressive disorder, such as chronic alcohol misuse, chronic sedative hypnotic use and also adverse drug reactions. I am not saying that we need a huge section on this but even just a short paragraph or two would do. I can't see why these factors have been totally excluded but a huge amount of text is used on the biological/genetic/chemical imbalance and social factors but nothing on chemical induced depressive disorder. Here is one paper, a 25 year follow-up study.[1] Certain drugs can cause chemical imbalances in serotonin, dopamine etc which leads to depression.--Literaturegeek | T@1k? 21:22, 11 March 2009 (UTC)[reply]