Patterico's Pontifications

8/11/2014

Robin Williams, RIP

Filed under: General — Patterico @ 8:19 pm

Robin Williams has died. Preliminary reports indicate suicide by asphyxiation, due to depression.

He made everyone laugh, but apparently his despair was too much to overcome.

I firmly believe depression is an illness. It’s like contracting a virus. It’s not your fault. You don’t do it to yourself. It happens to you.

I can’t improve upon the words of Ken White, who had a long series of connected entries on Twitter about this. Read them below.

130 Responses to “Robin Williams, RIP”

  1. Theoretically it should be easier for the rich and famous to get treatment for depression, but I wonder if in many ways the very circumstances of their fame actually make it harder. Think of how many times we hear of a celebrity who is struggling with various ailments — many of them probably exacerbated by depression — but who continues to appear in movies or go on concert tours or make the requisite public appearances. Once you are part of the giant money machine it’s probably pretty hard to step away for anything other than a little while. You get your six weeks to try to heal yourself, but then you have to be right back doing what you are expected to do.

    JVW (638245)

  2. > You get your six weeks to try to heal yourself, but then you have to be right back doing what you are expected to do.

    That’s kind of true for anyone who struggles with these sort of things but who has to work to pay the bills.

    aphrael (69561e)

  3. I firmly believe depression is an illness.

    Of course it is. And we live in a golden age of pharmaceutical aids for this sort of thing. Mr. Williams was self-medicating for a long time; God bless him and his family.

    carlitos (c24ed5)

  4. Excellent advice.

    Those of us who sense someone is in a fragile state should trust our instincts. We may not have the training or the answers needed, but we can offer assistance like helping them connect with professional help, arranging transportation, and the like.

    AZ_Langer (a65cb5)

  5. that’s all just way way way too deterministic

    it helps you

    i swear to pikachu god

    it helps you

    to grow up in an era with a plethora of john hughes movies for to see

    plus, wilson phillips

    though, “steal my sunshine” by len will more than do in a pinch

    pro tip: a-teens with puppies

    whatever you have to do

    get it together, pika

    happyfeet (8ce051)

  6. Depression is like Catch 22.

    It makes you feel so bad you don’t want to help yourself.

    daleyrocks (bf33e9)

  7. Hard to distinguish from just plain shiftlessness, too. That cannot be said about Williams. What the hell made life so painful to him?

    nk (dbc370)

  8. nk:

    Depression, that’s what.

    Patterico (caf1cd)

  9. The fact you can’t see or name a reason why you feel as you do just makes it worse, it adds guilt and shame to that one’s failures already have piled on. His attempts to escape through drugs and alcohol would already make that a formidable pile. It is hard enough when you have avoided that trap and are just burdened by the hidden chains you make for yourself.

    machinist (313c6a)

  10. It’s the paradox. He was successful with a capital S.

    nk (dbc370)

  11. During my first year in college, someone one my dorm floor hung himself. I was the second person to see the body. It’s with me every day, and well it should be: it was quite an image. The poor guy had not been doing well in his classes, and the note he left (I was told later) stated that he couldn’t bear to shame his parents and disappoint them and waste their money.

    Being a parent myself, I am aghast. I was aghast as an 18 year old, hearing that.

    The problem with depression (and I have had bouts of it throughout my life) is that it plays terrible games with internal awareness. Bad things are magnified, and good things diminished. People are often driven to withdraw or hide from friends and family. There is resistance to any effort to bring perspective to the situation. Winston Churchill used to suffer from it, and called it his “Black Dog.”

    The fact is, we are all valuable. To a depressed person, this is an unbelievable notion. And the mind spins out of control, reinforcing negativity to lower and lower levels. Sometimes, it ends up in the place that Robin Williams arrived today.

    That is why Ken at Popehat’s “twitter advice” is so valuable.

    Most of all, this kind of thing is a reminder: tell the people you find valuable that they matter…and not just to you personally. We are all in this together, and even small bits of kindness can help others.

    Sorry for the sermon, but this is an important topic to me. RIP to Robin Williams and condolences to his family which is in such pain now.

    Simon Jester (74a50a)

  12. None of that matters much when you feel like a failure as a man and as a human being. It is an overwhelming load of guilt, shame and self loathing. You don’t deserve help or comfort.

    machinist (313c6a)

  13. Any time a person takes their own life its sad and when it someone you know, or feel like you know, its that much sadder. However…..

    No one has the right to take their life and no one should be excused for the horrible choice suicide represents on the basis that they were “sick”. Pedophiles and serial killers are “sick” but that is no excuse for their heinous perversions.

    Hearing that Williams was dead was like a kick in the stomach, hearing that he killed himself was like a betrayal. The man had a wife and children and he stole himself from them and left them with a blight that will never completely lift and the resultant guilt that survivors of suicides almost inevitably feel.

    I’m all for helping the living who are depressed to find a way out of their private hell, but I can’t join in the celebration of Robin Williams’ life and I can’t excuse the terrible wrong he committed.

    Mark Johnson (61d0de)

  14. Many public observers are openly discussing the tragedy of Robin Williams’ depression, but no one seems willing to acknowledge the roll hyper activity had on his comedy.

    Williams was a wonderful comic and a talented actor, but he was also the poster child for Bipolar Disorder. His alternations between hyper activity and deep depression usually accompanied by drug and alcohol abuse along with a growing tendency to suicide associated with advancing age are consistent with standard textbook descriptions of what was previously called manic-depression.

    Many people suffer to varying degrees from the effects of Bipolar Disorder, but they and their friends and families suffer in relative obscurity. Williams’ abundant talent allowed him to display the effects of his disease on TV and in movie theaters.

    It doesn’t diminish Williams’ stature as a comic to acknowledge he was driven, in part, by the manic alternation of his disorder.

    ropelight (2a9e05)

  15. nk (dbc370) — 8/11/2014 @ 10:39 pm

    What the hell made life so painful to him?

    Probably nothing. “Depression” is a feeling of gloom that has no outside cause.

    But we don’t know this was “depression” It could be some other kind of feeling, like a permanent hangover.

    Sammy Finkelman (4a5b32)

  16. I firmly believe depression is an illness. It’s like contracting a virus. It’s not your fault. You don’t do it to yourself. It happens to you.

    No.

    Art Deco (ee8de5)

  17. Williams was a wonderful comic and a talented actor, but he was also the poster child for Bipolar Disorder. His alternations between hyper activity and deep depression usually accompanied by drug and alcohol abuse along with a growing tendency to suicide associated with advancing age are consistent with standard textbook descriptions of what was previously called manic-depression.

    And he had also just come out of a drying tank — no, I won’t call it rehabilitation — where they had messed with his brain, his body, his mind, and his emotions in several ways. That had happened to Phillip Seymour Hoffman, too.

    nk (dbc370)

  18. Like many things, depression is more complicated than “is it this?” or “is it that?”.
    Clearly there is a physical component to mental conditions. People who have never been depressed can become depressed (or what looks identical) after having dengue fever. There is a curious disorder, usually in children, where a person can suddenly develop obsessive-compulsive disorder after having a strep infection http://www.nimh.nih.gov/health/publications/pandas/index.shtml .

    Thought patterns, value systems, circumstances all can interact with genetic and acquired medical issues. Medications can help and are a useful tool (but not “the answer”), as are different types of “talk” therapy.
    It would seem that at times suicide is the result of being utterly hopeless and despairing in life and one is virtually incapable (what do I mean by that? I’m not sure) of thinking about anyone or anything else.
    At times it can seem to be a violent and angry form of “Goodbye and ^%** you”.

    From a distance (and even up close, I imagine) it is difficult to say how much of his comic genius was related to mania, hypomania, or ADD, or some combination.

    I’ve read where Foxworthy states his comedy did develop out of coping with his ADD and being the “class clown” because he couldn’t keep still.

    MD in Philly (f9371b)

  19. The Philly MD’s advice is sound.

    Let’s be sure not conflate ordinary sadness, the blues, or temporary bouts of self-criticism, regret, or remorse with clinical depression, which is exponentially more serious. Clinical or major depression is both a mental and a medical disorder that affects the mind, behavior, and physical health. Although it can seem to suddenly arise, apparently spontaneously, bouts of clinical depression can and often recur over a lifetime (the disorder is usually hereditary but exacerbated by environment) which manifest as periods of normal activity alternating with recurrences of deep depression so debilitating as to challenge description (you have to see it for yourself).

    Major depression usually arises in late adolescence or early adulthood and affects about 6-8% of US adults across all racial, ethnic, educational, geographical, and economic lines, although it does seem to concentrate in areas with extended periods of adverse weather or where ongoing economic decline is prevalent. Estimates run about 25 million episodes of major depression each year, with only about half that number seeking treatment, which leads to correspondingly increased frequency and greater severity of symptoms (which tend to deepen and persist over time).

    Many professionals contend depression is often an element in suicide, which is among the top 10 causes of premature death, and may be a recurring factor in the lives of up to half the number of those who take their own lives.

    ropelight (2a9e05)

  20. I, Pagliacci, indeed.

    CrustyB (69f730)

  21. Mark Johnson;

    It isn’t just to say of somebody driven to suicide by depression that they committed a wrong. They weren’t strong enough. That’s tragic. I didn’t like Williams. I thought his body of work was severely overpraised. I still think it is. But I have lived with somebody subject to depression for three decades. We have been very, very lucky in out therapists and medicating physicians, and have evolved a number of protocols that seem to be working for us, but it is horribly exhausting FOR ME, and I’m not even the one suffering from rogue brain chemistry.

    I’m sorry that Mr. Williams didn’t get the help he needed. He did not fail us any more than we failed him. Nor any less.

    C. S. P. Schofield (e8b801)

  22. “Depression” is a feeling of gloom that has no outside cause.

    Rubbish.

    Art Deco (ee8de5)

  23. Excellent article from Cracked.com on this subject.

    Chuck Bartowski (11fb31)

  24. A permanent solution to a temporary problem, sadly. Also, a cowardly way out. He had a family and responsibilities.

    Gazzer (e04ef7)

  25. Richard Jeni, another talented comedian, went from diagnosed depression to suicide in 6 weeks.

    Gazzer (e04ef7)

  26. Goddamnit, it isn’t cowardly. Tragic, yes. But the man waded through his slough of despond for years. Just living WITH somebody doing that is debilitating. It’s like saying that somebody who suffers from chronic pain and commits suicide is a coward; unless you have suffered as much for as long, just shut your goddamned hubristic yap.

    I hope that wherever he is, the imbalance that made his life hell cannot follow him. I hope that he is somewhere where he can heal. I didn’t like the man, his politics, or his work. Nevertheless, lay the fuck off him.

    C. S. P. Schofield (e8b801)

  27. He had a family and responsibilities.

    His children are between the ages of 22 and 32; they’re not that dependent. A post-adolescent or young adult son can benefit a great deal from his father’s counsel (provided, of course, that his father is not dreadfully pre-occupied, which Williams may have been).

    He did have a wife (3d of 3). She’s likely well-fixed.

    Cowardly? It’s hard to see what he was running away from other than his disordered inner life.

    He has a history with street drugs, adultery, and serial divorce. He’s been troubled and troublesome for those around him for quite some time. Some people are that way…

    Art Deco (ee8de5)

  28. But I have lived with somebody subject to depression for three decades. We have been very, very lucky in out therapists and medicating physicians, and have evolved a number of protocols that seem to be working for us, but it is horribly exhausting FOR ME, and I’m not even the one suffering from rogue brain chemistry.

    Hoping you’re well.

    I read tales like yours and I recall Ivan Ilich’s Medical Nemesis: iatrogenesis, dysfunction as a role and identity, and, in some cases, steps in a danse macabre.

    Art Deco (ee8de5)

  29. With all due respect, responsibility to one’s family extends beyond mere financial assistance.

    Gazzer (e04ef7)

  30. I’d be more impressed with Freud’s descendants, and their pill-peddling cohorts in Pharma, pathologizing the human condition, if depression diagnoses did not follow wallet biopsies. It seems to be a disease of affluence. If you, or your family, or your welfare state, can afford your moods and shiftlessness, you’re depressed. If not, you might have to get off your butt, wash your face, talk to people, and try to earn your daily bread. In most cases. Maybe 5-7% out of the 6-8%, leaving 1-2%. I know there’s real mental illness that makes people unhappy enough to want to die. But there’s no way I agree with the numbers.

    nk (dbc370)

  31. I am grateful that clinical depression does not seem to be in my family’s biology or gene pool. I was therefore utterly inexperienced with it until I had a good young female employee fall apart from clinical depression, and then a few years later found out that an accomplished professional associate (now a very close personal friend) had suffered from–and hidden– depression for years. The explanation which I still struggle to fully comprehend is that someone in that condition feels pain, a deep, unrelenting, physical, debilitating, actual pain, like a severe migraine or enormous kidney stone– but a pain that involves and encompasses the entire mind, body, and spirit. People like Robin do what is necessary to stop the unbearable pain.

    Medication that is taken regularly and continually helps a great deal and keeps many clinical depressives alive and functioning and fairly happy. But sometimes for no reason, even with meds, the pain and despair creeps up and washes up over them again such that they are not even capable to remember to take the medication or consciously able to ask for help.

    RIP Robin

    elissa (836749)

  32. “I read tales like yours and I recall Ivan Ilich’s Medical Nemesis: iatrogenesis, dysfunction as a role and identity, and, in some cases, steps in a danse macabre.”

    Art Deco – Rubbish

    daleyrocks (bf33e9)

  33. Gazzer is right. The toll suicide takes on family is so tremendous that in cases where the suicide was not intended to hurt the family, the poor soul who took his life was apparently confused about the big picture. I’m thinking of examples like Simon’s, where some student realizes his dreams of success encountered a snag like a bad semester of grades or even realizing that a career decision was a mistake. The idea that the disappointment this creates is insurmountable can only be confusion. Who here hasn’t had to change their mind about what they are doing with the rest of their life? Very very few of us. And these changes are usually good for us! Compared against the horror of losing your brother or son to suicide, this fear of disappointment is so trivial. But the stakes are not. That’s why getting help can work and should work. That’s why I get angry now when someone stigmatizes mental illness.

    It’s also why we should all realize the key to happiness is not any outside force or event in the world. It’s a matter of accepting our lives and adjusting our expectations. Dissatisfaction with life is simply the difference between where we see ourselves and where we are. And we can reduce that difference and actually create happiness, often by forgiving ourselves for being mere humans. And actually accomplish more to be proud of, in one of life’s good ironies.

    I know I had some very wild ambitions for myself when I was a kid, and of course the real world never plays out smoothly. I was fortunate that those I depended on most love me regardless, and are even happy for me as I find my place in the world. And those who instead judge eachother… as Ken said above… F them. They don’t matter.

    I happen to work in a field where I frequently encounter suicide, suicide attempts, those at risk of suicide, and their loved ones coping with those who didn’t seek help, so those Popehat tweets really ring true to me. It is so frustrating for me to see some of these people suffer from the wrong perspective. Life is precious, and when it’s a correctable problem like depression, we all need to show compassion and take some initiative.

    I don’t have a lot of free time, and when I do I no longer really want to be around computers (as I am surrounded by them all day). One thing I know is that a lot of those who are having mental troubles are online all day, so there probably are a lot of people who read Popehat (I think Ken’s) advice and need to follow it. I hope they do.

    Dustin (7f67e8)

  34. “It seems to be a disease of affluence. If you, or your family, or your welfare state, can afford your moods and shiftlessness, you’re depressed.”

    nk – I don’t understand where this conclusion of shiftlessness stems from or the conclusion that it is a disease of affluence. I think you are outside your areas of understanding.

    daleyrocks (bf33e9)

  35. Simon Jester.
    ==The problem with depression ….. is that it plays terrible games with internal awareness. ….People are often driven to withdraw or hide from friends and family. There is resistance to any effort to bring perspective to the situation. Winston Churchill used to suffer from it, and called it his “Black Dog.”==

    Yes. This describes exactly the situation with my friend whom I wrote about above, and how closely one has to watch those with clinical depression–because they withdraw subtly and often will not/can not ask for help. If these people commit suicide I do not think it’s fair to call them selfish for wanting to stop the pain, though.

    elissa (836749)

  36. Let me try to be clearer, daleyrocks. It’s a natural thing for people to feel sad and lazy. Psychologists and makers of Prozac can’t make money off of that, though, so they call it depression. In places where there’s no money to spare for psychologists and Prozac, they call it sad and lazy.

    nk (dbc370)

  37. nk–this is just a guess—you have never known or had anyone close to you with true clinical depression. It really is different from the people and situations and casual pharmacology to cope with stress that you seem mostly to be describing here today. I hope you never do have anyone with clinical depression in your life. It is a horrible business.

    elissa (836749)

  38. I don’t disagree that it’s real, I say that it’s over-diagnosed and misdiagnosed.

    If it matters, it was the first stage of my mother’s Alzheimer’s. (Forgetfulness was the second.) Hers was real, and had an organic cause.

    nk (dbc370)

  39. nk, back in the day, perhaps we called people sad and lazy because we didn’t understand that our willpower isn’t an absolute force, and that the chemical processes in our brains can malfunction.

    Now, we can take what was once called ‘sad and lazy,’ and treat that person so that they contribute to society and do not result in a horrible tragedy. Or we could stigmatize them as lazy losers because they asked for help.

    We do have cultural problems in America. Some need to be a victim, some seek approval for stupid things, some live online and for the approval of others online, some pursue education not to become educated, but in a quixotic pursuit of careers that probably aren’t to be had. And other stuff. That contributes to a fog and a mis-perception. While our willpower determines a great deal for us, it has to be directed more wisely than just ‘decide to suck it up’ when you’re feeling depressed. Sometimes people need the willpower to ask for help.

    Dustin (7f67e8)

  40. NK: I get off my butt, wash my face, talk to people, and earn my daily bread.

    *Right now* I’m doing so while experiencing something which is akin to acute depression. I wake up overwhelmed by sadness and guilt and self-hatred; I go through the motions of my day telling myself that I have to do it even though I don’t actually think it’s going to matter and isn’t going to change anything. By mid-afternoon i’m distracted enough to be somewhat OK, as long as I don’t think about what I’m feeling. But I have to be *constantly distracted* or the world is crushing.

    It *sucks*, and it *hurts*, and your “disease of affluence” framing is highly, highly irritating – because it’s not just that affluent people *feel* it, and the offhanded dismissiveness of your tone suggests that it is.

    aphrael (c5786e)

  41. With all due respect, responsibility to one’s family extends beyond mere financial assistance.

    Two of his three children are over 25. The third is in that hazy area between dependence and independence (depends on the family). At this point, you’d speak more in somewhat crass terms of his ‘benefit to his family’ rather than his ‘responsibility’ to them. This death is emotionally jarring. However, you have to bury your father sooner or later (and, if you’re a married woman, your husband too). Responsibilities for a family with this configuration, unless one of the children was rendered disabled or had a disabled child, would generally be prospective and concern what the child needed to do to look after an addled and infirm parent.

    -

    It seems to be a disease of affluence.

    Maslow’s hierarchy of needs, yes. There is nothing at all novel about melancholia (and manic-depression was first described in Ancient Greece, in contrast with schizophrenia, which was unknown until the early modern period). However, the prevalence of it and the tendency to describe it in medical terms is (arguably).

    Art Deco (ee8de5)

  42. Art Deco – Rubbish

    Not rubbish, just not altogether universal. Seen it up close and personal.

    Art Deco (ee8de5)

  43. aphrael, if you need to talk sometime, Patterico knows my number and email and could facilitate.

    Dustin (7f67e8)

  44. This link contains a map of world consumption of anti-depressants a little bit down the page. http://www.theguardian.com/news/2013/nov/20/mental-health-antidepressants-global-trends

    nk (dbc370)

  45. Maybe, it’s not affluence? Maybe it’s the English language?

    nk (dbc370)

  46. Not meaning to pick a fight over this, or step on anyone’s toes.

    I’ve been looking through some of Robin’s recent history.
    First thing I notice, while Popehat’s advice is well thought out and received, Robin Williams was swimming in therapists, both officially designated, and “amature” friends, acquaintances, colleagues, to talk to.

    For crying out loud, he was parading his drinking habit on Good Morning America. He had Oprah on speed dial. Dr. Phil would have paid to make that housecall.
    If you will forgive the foray into pop psychology, William’s schtikt, the free flow uninhibited stream of conscious might be exacerbated by the company, in that if people are around he would be under the pressure to be “on”, in performance mode as it were. That could be a problem if you are running low on bulsh1t.

    Another thing I notice, William’s had/has a bunch of pricy assets up for sale. There’s a wine villa in Napa county for sale. Asking price $29 mil.
    There’s a cliffside SF brwnstone, Del Mar (That’s the part of SF too expensive for you and me to even pass by on the sidewalk). Asking price $5,400,000.

    Williams had just jumped back into series television, which was recently canceled by CBS.

    My understanding of the thing is that series television is some of the least attractive, most grueling work that an actor can take.

    Is it possible that Williams, rather than being irrational or dispondent, was instead verging on insolvency?

    papertiger (c2d6da)

  47. However, you have to bury your father sooner or later

    You’re right. Might as well get it over with. Next!

    Gazzer (e04ef7)

  48. I find that, sometimes, people are really talking about something different than it might appear. Usually, they are referring to their own experience when opining on what has happened to someone else.

    None of us actually knew the late Mr. Williams. I certainly don’t think any celebrity is what I read in the tabloids. Still, I watched people—right after Williams’ suicide—sort of going off about which movies of his were bad and which were okay. Seemed a little callous to do so, at that particular time.

    People process tragedy—even remote tragedy—differently.

    Some folks place their own viewpoint on the subject of depression, or mental illness in general. None of us can really know the path that another person takes.

    I had a former student on Facebook just rail about Williams’ “selfish” act. He really got into it…not knowing anything about Williams or his life. I can only think that that student lost someone dear to him, and was processing through that set of eyeglasses.

    I guess we all do that.

    But I hope that we can all agree, no matter what, that this is a tragedy for Mr. Williams’ friends and family. And maybe, just maybe, hug our own friends and loved ones a little closer. Even tell them how much they are valued.

    Because you never know.

    Simon Jester (c8876d)

  49. “Depression” is a feeling of gloom that has no outside cause.

    Art Deco (ee8de5) — 8/12/2014 @ 10:25 am

    Rubbish.

    OK, it probably actually does have causes too, but usually there are things that lift your sprirts and there are things that make it go down. Someone can be in situation where they easily go down, and nothing much can get them up.

    Sammy Finkelman (d22d64)

  50. I say to lift the darkness and disension, we all rent a Robin Williams contributed to bit of entertainment. I’ll try to get the Bicentenial Man based on Robert Heinlein’s book.

    Nanu, Nanu!

    Shazbot! don’t get all down. Robin doesn’t want anyone to copy his final act.

    PCD (39058b)

  51. NK, it is certainly exploited I am sure but I can say quite confidently it strikes those without means. The people afflicted either find a way to function enough to get by or they die. There are treatments but there are reasons why they are not acceptable to everyone.
    It can be very hard to trust a stranger in such an intimate way and drugs can make you feel like a zombie who can’t remember or think clearly. There are other ways some can deal with it. The guilt and shame associated with the personal failures resulting from it are some of the more destructive aspects, causing a terrible feedback effect and downward spiral. This makes the escape of addictive drugs and alcohol an especially deadly trap that must be avoided. One way to deal with this and remain productive in a job calling for responsibility and reliability is to bind yourself in a very rigid set of personal standards and rules or moral code that keeps you meeting your responsibilities and avoiding the guilt as much as possible. It constrains your life and makes you come across as an a**hole to many because you seem so rigid, uncompromising, and stilted, but it keeps you functional. It makes for a lonely life, especially when young, but it allows one to carry on and if you are lucky enough to meet the right person who can see through it you can be even be happy.

    I have always found Richard Cory easy to understand.

    machinist (313c6a)

  52. 45. …Is it possible that Williams, rather than being irrational or dispondent, was instead verging on insolvency?

    papertiger (c2d6da) — 8/12/2014 @ 12:37 pm

    It’s entirely possible that he wasn’t verging on insolvency. But rather he was facing financial difficulties that could have been solved, if he had been able to approach his problems objectively. But his depression warped his perspective.

    That he was convinced his problems were insurmountable, but they really weren’t.

    Steve57 (34b0af)

  53. I didn’t know that Robert Silverberg had expande dthe story, nor tht it had been made into a movie.

    Sammy Finkelman (d22d64)

  54. Just saying, suicide is not a rational response to insolvency.

    Steve57 (34b0af)

  55. Maybe not, but it’s still a popular response.

    I think Don McLean has a healthy attitude toward the fleeting nature of show business, fame, and the money which drops on a person in buckets one year, dries up the next, leaving the recipient with a narrow set of ‘dignified’ options when something goes wrong.

    When asked what “American Pie” meant, McLean replied, “It means I don’t ever have to work again if I don’t want to.”

    papertiger (c2d6da)

  56. the whole alimony dealio needs to be reformed

    happyfeet (8ce051)

  57. You’re right. Might as well get it over with. Next!

    No, that’s not my point. My point, for the umpteenth time, is that speaking of the man’s ‘responsibility to his family’ is misplaced in the circumstances of most men with children the age he has. If his estate is left with a mess of debts a la Sammy Davis Jr’s, then your remarks would have more merit.

    Art Deco (ee8de5)

  58. “Not rubbish, just not altogether universal. Seen it up close and personal.”

    Art Deco – So have I and in my opinion you are full of shlt.

    daleyrocks (bf33e9)

  59. Art Deco – You said Depression is not a disease. Do you believe it is a mass delusion, an artificial construct made up by the medical profession to make money or do you deny it even exists? Please explain yourself.

    daleyrocks (bf33e9)

  60. “Let me try to be clearer, daleyrocks. It’s a natural thing for people to feel sad and lazy.”

    nk – What I take issue with is your use of the word shiftless which I would agree is synonym for the word lazy. I would consider somebody lazy who consciously chooses to do nothing productive all day, instead watching TV, playing video games, hanging around with his her buddies. That is not the way people with depression act in my experience. They isolate. They want to be left alone, go into a cave, lock the door, pull down the blinds, turn off the lights and not be bothered. They can wake up with a sense of impending doom and that can be the high point of the day. They don’t want to live that way. They want to act normal, but their mind is telling them to do something different. They have to force themselves to talk to other people, to leave their apartments or houses even for walks. Going to work can be an incredible effort. Calling them shiftless is flat out insulting.

    daleyrocks (bf33e9)

  61. what else is a disease is that one where you can’t eat gluten

    happyfeet (8ce051)

  62. 55. …I think Don McLean has a healthy attitude toward the fleeting nature of show business, fame, and the money which drops on a person in buckets one year, dries up the next, leaving the recipient with a narrow set of ‘dignified’ options when something goes wrong.

    When asked what “American Pie” meant, McLean replied, “It means I don’t ever have to work again if I don’t want to.”

    papertiger (c2d6da) — 8/12/2014 @ 2:01 pm

    I agree. Often I haven’t understood show biz types, or others, who seem to be driven by something other than what others would reasonably call success.

    But the fact I don’t understand it doesn’t make it any less real. I came across this Guardian interview dated 19 September 2010. Clearly it’s revealing.

    http://www.theguardian.com/film/2010/sep/20/robin-williams-worlds-greatest-dad-alcohol-drugs

    The headline and subtitle.

    Robin Williams: ‘I was shameful, did stuff that caused disgust – that’s hard to recover from’
    His new film, World’s Greatest Dad, is a glorious return to form. But a mournful Robin Williams would rather talk about his battle with drugs and alcohol – and recovering from heart surgery

    This I thought was particularly telling.

    …My worry beforehand had been that Williams would be too wildly manic to make much sense. When he appeared on the Jonathan Ross show earlier this summer, he’d been vintage Williams – hyperactive to the point of deranged, ricocheting between voices, riffing off his internal dialogues. Off-camera, however, he is a different kettle of fish. His bearing is intensely Zen and almost mournful, and when he’s not putting on voices he speaks in a low, tremulous baritone – as if on the verge of tears – that would work very well if he were delivering a funeral eulogy. He seems gentle and kind – even tender – but the overwhelming impression is one of sadness…

    Maybe there are other things besides drugs and alcohol you need to quite if you’re going to live. Things that aren’t recognized as addictions, like the pursuit of adulation and fame.

    Also, and I realize this is blasphemy, maybe he shouldn’t have quit self-medicating. He might have eked out a few more years. Again, I realize this is secular heresy, but I recall listening to Dr. Dean Edell a few years back talking about the trade-offs of banning smoking. The fiction the anti-smoking zealots were advancing was/is that there were/are no trade-offs.
    Banning smoking would be 100% good with no downside. Which isn’t true. Smoking helped many people deal with anxiety, for instance. The trade-offs might be worth it, but first one must acknowledge the trade-offs exist.

    Steve57 (34b0af)

  63. smoking is also key to the prevention of weight gain pursuant to smoking cessation

    happyfeet (8ce051)

  64. They protest too much, don’t they?

    ropelight (2a9e05)

  65. 63. smoking is also key to the prevention of weight gain pursuant to smoking cessation
    happyfeet (8ce051) — 8/12/2014 @ 2:55 pm

    That’ll teach you to quit, fatso.

    Steve57 (34b0af)

  66. It is so, sooo, morally superior to die of complications of diabetes or arteriosclerosis than lung cancer.

    Steve57 (34b0af)

  67. i’m drinking nespresso right now for to help boost my metabolisms

    I’m supposed to drink a couple these then slam some grapefruit juice

    there’s some theory behind it but I don’t understand it I just do it

    happyfeet (8ce051)

  68. aphrael- as others have said, I hope you are getting help of some kind. It is common as you describe it, depression is often worse in the morning and slightly “lifts” as the day progresses. (The opposite of anxiety, which usually gets worse as the day goes on.) Patterico has my email as well if you want, but certainly you need to have someone you can see face to face.

    Maybe depression is more common in affluent societies, but that alone does not make it less real, just like heart attacks are more common in affluent societies. I have read where PTSD is highly dependent not so much on the traumatic event itself as the person’s perception and general expectation. If one grew up in a culture where violence and death was commonplace a person is less likely to get PTSD, as opposed to someone who grew up in suburbia with a quite and healthy family. That said, I think we would all vote to grow up in quiet suburbia than Gaza if we had the choice.

    The heart has it’s reasons that reason knows not thereof.

    MD in Philly (f9371b)

  69. I wonder if Williams felt any guilt from Belushi’s death?
    They were partying hard that night.

    mg (31009b)

  70. nk, Art Deco … I’m going to try very hard to forget your posts in this thread. That there can be such pride in concentrated ignorance is just revolting.

    Yes, I can have blue days, and depressing days, and I recover just fine. Then the black dog bites and if it wasn’t for the support of family and friends NOTICING, THEN, I would have been dead maybe a half-dozen times. I wasn’t in the mood to call anyone, I wanted an end to the damned spiral down into nothingness.

    I hope it never happens again … and I hope you never have to deal with it. And that you never have family or friend who does.

    happyfeet — I will, however, wish you gluten intolerance. Have fun with the fecal incontinence!

    htom (412a17)

  71. aphrael, you matter to people you have never met. It was you and you alone that changed my mind about same sex marriage. It was you that changed me. I thank you for it and look forward to your thoughts on any topic. You matter to me more than you can ever imagine.

    highpockets (d74597)

  72. Dustin, MD in Philly: thank you for your kindness. :)

    I am getting help, and I have a number of friends who I can share this with, and both are a great comfort to me; and yet it is also comforting to hear such support from friends like you. :)

    I mostly brought it up because nk’s flippancy was irritating me and I couldn’t explain why without doing so. :)

    Highpockets – thank you, as well. :) I am happy to hear that I have made a difference to you; at the end of the day, making a positive difference in the lives of those around is is the most we can hope for. :)

    aphrael (69561e)

  73. [and, lest a sudden absence cause unneeded worry - i'll be offline until next week, because i have a long-scheduled trip to Gencon which, even if I'm unexcited about, I don't want to flake on; I have friends depending on me to be there. :)]

    aphrael (69561e)

  74. Art Deco – So have I and in my opinion you are full of shlt.

    Your opinion isn’t worth squat.

    Art Deco (ee8de5)

  75. Art Deco – You said Depression is not a disease. Do you believe it is a mass delusion, an artificial construct made up by the medical profession to make money or do you deny it even exists? Please explain yourself.

    I think the medical discourse a sales pitch by the mental health trade, as is referring to alcoholism as a ‘disease’. See Thomas Szasz, Fuller Torrey, and even Paul McHugh on some of the troublesome aspects of psychiatry and clinical psychology. (They each have a different and somewhat antagonistic take).

    Certain emotional states are real enough, though only experienced subjectively.

    Art Deco (ee8de5)

  76. There have been reports for quite awhile now about people in the banking industry committing suicide, and, in effect, reactivating a scenario that dates back to the Great Depression of the 1930s. Or the urban myth — but presumably actually the urban reality — of bankers on Wall Street jumping off tall buildings in New York.

    Williams reportedly had problems with depression, possibly due to biochemical imbalances in his brain. But the final trigger may not been so much that alone as much as what’s behind, again, the people in the world of high finance who’ve also been choosing the ultimate final solution.

    nydailynews.com: [Robin] Williams was preoccupied with his money woes prior to his suicide — and was frustrated at taking parts just for the cash, RadarOnline reported Tuesday. The comedian, after two pricey divorces, was upset that he needed work to insure his family’s future financial security, a family friend told RadarOnline.

    “All he could talk about were serious money troubles,” the friend told the website about a recent chat with Williams. “There were clearly other issues going on and Robin sounded distant during the telephone conversation.

    Bloomberg.com, March 2014: Coroners in London are preparing to investigate two apparent suicides as unexpected deaths by finance workers around the world have raised concerns about mental health and stress levels in the industry. The suicides were followed by others around the world, including at JPMorgan in Hong Kong, as well as Mike Dueker, the chief economist at Seattle-based Russell Investment Management Co.

    The ongoing series of gloomy, glum stories throughout the US and the world seem somehow quite fitting in this Age of Insanity, in this Age of Obama. It’s as though we Americans chose the dark option — starting back in November 2008 — when we (like George Bailey in “It’s a Wonderful Life”) decided to jump in the frigid river. But there may be no angel of salvation if this reality, no Clarence to save us from ourselves, and we conceivably could truly end up as one giant Potterville. Or Obamaville. Or Hillaryville.

    Mark (5758a9)

  77. nk, Art Deco … I’m going to try very hard to forget your posts in this thread. That there can be such pride in concentrated ignorance is just revolting.

    What pride? And what ‘ignorance’ that would not be manifested by any layman? He has his take (I see some merit in it, just not in his diction) and I have mind. They’re alike in rejecting a disease paradigm. Don’t know why you find that gruesome.

    Art Deco (ee8de5)

  78. aphrael,

    Call Dustin, or any helpline, go volunteer at a orphanage, there are many outlets to combat depression – best wishes

    EPWJ (775325)

  79. Ok, now I’m depressed.

    nk (dbc370)

  80. Limited to my being a finite human and unable to get out of myself to look objectively back on myself, and years of medical practice and discussions with psychologists and theologians,
    I can tell you with certainty that the mysteries of the interaction between the physical/emotional/spiritual aspects of a human being can be understood in part only.

    IMO, to try to say whether depression and/or addiction fit a medical model “or not” is a bit like asking whether light is composed of waves or particles, it depends on just what aspect you are looking at
    which is why I said previously that medications can be a very useful tool, but only a tool.

    The brain is the source of signals that move the body, problems in the brain can cause trouble with movement such as seizures, Parkinson’s disease, and Sydenham’s Chorea;
    why would it make sense to say that the thought processes and emotional states of the brain are not subject to physical injury and malfunction as well??

    Would some physicians, other professionals, and laypeople like to claim more certainty about a process than warranted? Of course,
    but that doesn’t mean there is some truth to it.

    MD in Philly (f9371b)

  81. It is most comforting to witness the unselfish display of love on this thread! If only I deserved to be in their company.

    felipe (40f0f0)

  82. nk, some say that coexistence with the Cubs makes one immune to feelings of hopelessness, hence immune to depression,
    so cheer up ;-)

    MD in Philly (f9371b)

  83. aphrael, that’s good to hear.

    nk is a great commenter because he challenges preconceptions. I remember before I appreciated that I would get irritated about it, but now I expect it and enjoy it (though often disagree).

    Same reason I’ve always appreciated your participation here. Obviously it’s different… you do not seek to challenge preconceptions. You just come from a different point of view on some matters. But you’re among the most valuable voices to read because I have to question how I think.

    I’ll keep you in my thoughts, and I’m easy to reach if you ever want to.

    Dustin (7f67e8)

  84. i was struck by that one article what said Mr. Williams felt yoked to some not very fulfilling

    a certain sense of freedom is for me anyways absolutely crucial to keeping the old chin up

    happyfeet (8ce051)

  85. ?

    that was supposed to say felt yoked to some not very fulfilling work

    happyfeet (8ce051)

  86. It’s also why we should all realize the key to happiness is not any outside force or event in the world. It’s a matter of accepting our lives and adjusting our expectations. Dissatisfaction with life is simply the difference between where we see ourselves and where we are. And we can reduce that difference and actually create happiness, often by forgiving ourselves for being mere humans. And actually accomplish more to be proud of, in one of life’s good ironies.

    Can we not simply eliminate the capacity to feel any emotion except happiness?

    http://www.dailymail.co.uk/health/article-2389891/Always-smiling-stroke-patient-feel-sad-Condition-leaves-Grandfather-permanently-happy-prone-fits-giggles-inappropriate-times.html

    Think about it. If we could duplicate this process, we could have eternal paradise.

    Michael Ejercito (becea5)

  87. The frailty of the human condition is not to be underrated. It is an ugly world where some manage to navigate through it with a seeming ease, yet others labor intensely just to find enough meaning in life to get up out of bed in the morning – let alone make it through or 10 or 12 hours before curling up in a ball again at night. The hours between can be a private hell that torments and dares the soul to just try and move through the next five minutes with out thinking about how to numb the pain.

    For those who manage to not be “cowards” (/sarc) and ease through life and stay on top of the demons, that’s a wonderful gift you have been given. For those whose every day is filled with that struggle that spills out through the entire being, weaving its way through heart, mind and soul, attempting to claim you, my prayers. We’re all on the wire just trying to keep our balance. Even those who believe they don’t wobble.

    To lose so much hope, to have such self-loathing and to be just so utterly exhausted from trying to live this life that one would choose to hang themselves, is heartbreaking.

    There is always hope.

    Dana (4dbf62)

  88. 2010 The first year of drought restrictions = Williams’ Napa vineyard went up for sale. Still listed for sale at $29.9 million. Today.

    Later that year Williams listed the SF Del Mar property.

    Both of them still on the market. No takers. And can you blame people? Would you want to buy a place where you have to get permission from the ward boss to trim the bushes? Where the city gets a progressive percentage of your work product in the good years, cleans you out during the bad? Where a “bad year” is not defined by any objective view of water delivery, but rather on how deep the local government’s commitment to environmental politics runs?

    Then theres the house he was found in. Would you move to Sausalito on purpose?

    papertiger (c2d6da)

  89. There is always hope.

    There’s always shore, too, Dana. The problem is that some people can’t see it when they’re adrift in the ocean.

    Chuck Bartkowksi (ad54b9)

  90. R.I.P. Lauren Bacall.

    nk (dbc370)

  91. I agree, Chuck Bartkowski.

    Dana (4dbf62)

  92. yeah he had really stupid taste in real estate

    but he’s a product of a certain era

    happyfeet (8ce051)

  93. amazon has lots of great old movies you get with prime

    happyfeet (8ce051)

  94. Mark Steyn comments on Williams’ death:

    I don’t have much to say about Robin Williams that hasn’t been said better elsewhere. The manner of his death is too sad, and it colors for me the celebrations of his life – because it seems clear that, to one degree or another, what people loved about him is also, ultimately, what drove him to do what he did. Minnie Driver, a fine actress, issued a tribute recalling a lunch break during the filming of Good Will Hunting:

    “We sat around on the grass eating sandwiches,” Driver said in a statement to The Hollywood Reporter. “What began as a riff on something or other to make us and the crew laugh suddenly extended to office workers out on their lunch break, enjoying the sunshine, and pretty soon he stood up and his big beautiful voice, full of laughter, reached out to the people who were now hurrying down from the street and across the park to catch his impromptu stand-up. “There must have been 200 people listening and laughing by the time lunch was over. I just remember how broadly he smiled, patted me on the shoulder and said, ‘There, now that was GOOD.’”

    I know she means this to sound heartwarming and affectionate, but to me it rang rather bleak and empty: a man who seems to exist only when performing – even on a sandwich break. Very few friends and co-stars seem to have known that other Williams, the one alone on Sunday night, with no one to perform to.

    JVW (638245)

  95. Most men lead lives of quiet desperation and go to the grave with the song still in them. — Henry David Thoreau

    Mark (5758a9)

  96. Art Deco – You said Depression is not a disease. Do you believe it is a mass delusion, an artificial construct made up by the medical profession to make money or do you deny it even exists? Please explain yourself.

    I think the medical discourse a sales pitch by the mental health trade
    , as is referring to alcoholism as a ‘disease’. See Thomas Szasz, Fuller Torrey, and even Paul McHugh on some of the troublesome aspects of psychiatry and clinical psychology. (They each have a different and somewhat antagonistic take).

    Certain emotional states are real enough, though only experienced subjectively.

    Art Deco – Rubbish nonresponse. Medical sales pitches and real emotional states, the rest non germane. The conclusion is what, depression represents real emotional states which must be subjectively diagnosed by practitioners?

    daleyrocks (bf33e9)

  97. O Captain, my Captain.

    Sit down, Mr. Anderson. Do you hear me? Sit down!

    Robin Williams exiting the building from Dead Poets Society. Such a cool scene that seems superficially appropriate.

    But if I were to dedicate a song it would be Metallica’s Enter Sandman. Tonally appropriate, rather than topical. The lyric is a lullaby, believe it or not.

    papertiger (c2d6da)

  98. Art Deco – Rubbish nonresponse. Medical sales pitches and real emotional states, the rest non germane. The conclusion is what, depression represents real emotional states which must be subjectively diagnosed by practitioners?

    No. The conclusion is that it’s a phenomenon of life and a problem in living, not a disease.

    Art Deco (ee8de5)

  99. Then theres the house he was found in. Would you move to Sausalito on purpose?

    I would not move to anywhere in California on purpose.

    Art Deco (ee8de5)

  100. Dying is a phenomenon of life as well, yet we often do things to intervene when technically feasible.

    There is a fundamental difference between a sore arm and a broken arm,
    I would suggest there is a fundamental difference between being sad or having grief and having clinical major depression.

    (Though there is that situation of a sore arm with a cracked bone but no apparent fracture and where “normal” grief takes a more ominous course.)

    MD in Philly (f9371b)

  101. ==I would suggest there is a fundamental difference between being sad or having grief and having clinical major depression.==

    Of course, MD. Until reading some of the comments posted on this thread I thought almost everybody probably understood that. But apparently not.

    elissa (42a097)

  102. The fact Williams was facing major economic problems makes his suicide a bit more than a question of whether his depression was clinical or not, or a disease or not.

    I recall an article several years ago about a person who due to financial trouble had to vacate his premises. I believe he had to forgo either his mortgage or his lease. On the day he was moving out he hung himself in one of the rooms of the home he was leaving. Some of what Williams was facing may have been triggered by a factor similar to that as much as anything else.

    Mark (5758a9)

  103. I read this in a book. There’s two hunters out in late fall looking to drygulch some poor defenseless deer. They’ve been at it for hours, crawling through their bellies on cold, wet, muddy ground, over sharp rocks, and through thorny brush. One is feeling pretty miserable but the other is bright-eyed as a baby in a topless bar. The first one turns to the second and says, “How can you be so cheerful?” The second one says, “What do you mean?” The first one says “Aren’t you cold?” The second answers “Yes”. “Aren’t you wet?” “Yes”. “Aren’t you tired?” “Yes.” “Aren’t you hungry?” “Yes”. “Then”, demands the first, “how come you’re so damned happy?” “Well”, answers the second, “it’s bad enough to be cold, wet, tired, and hungry, without being unhappy too.”

    nk (dbc370)

  104. Until reading some of the comments posted on this thread I thought almost everybody probably understood that.

    “Understood” what? What’s so blatantly obvious about the taxonomies you are offering (other than they are apparently convenient for psychiatrists)?

    Art Deco (ee8de5)

  105. Dying is a phenomenon of life as well, yet we often do things to intervene when technically feasible.

    You might ‘intervene’ when a crime is in progress. Crimes are not diseases either. (I trust cops a great deal more than I trust mental health tradesmen).

    Art Deco (ee8de5)

  106. I want to make it clear (for the fourth time on this thread) that I part company with Art Deco on the question of whether there is genuine clinical depression. I believe there is. A very famous case is that of Prince Rudolf, Crown Prince of Austria-Hungary. The perfect heir to Franz-Josef until he and his girlfriend committed suicide. My contention is that it’s grossly over-diagnosed.

    nk (dbc370)

  107. 73. …Highpockets – thank you, as well. :) I am happy to hear that I have made a difference to you; at the end of the day, making a positive difference in the lives of those around is is the most we can hope for. :)
    aphrael (69561e) — 8/12/2014 @ 6:42 pm

    I’ve been rolling this around my mind. Is it more kind to say nothing? I finally decided it is more kind to say something. Unlike highpockets, you haven’t changed my mind on gay marriage. I remain opposed.

    But that isn’t how you should define your worth as a human being. You’ve been an honest and sincere advocate for that cause. There are, I think, other ways to make a difference without making converts. You are a good man, and the world is a better place with you in it. Remember that.

    Steve57 (5f6c2a)

  108. “No. The conclusion is that it’s a phenomenon of life and a problem in living, not a disease.”

    Art Deco – Diseases are a phenomenon of life and a problem of living as well. Referring people to authors who have written about issues with psychology and psychology does nothing to explain your position nor does attempting to compare alcoholism with depression without explaining why they should be compared.

    Comparing normal moods and emotions to depression as MD in Philly attempts to point out is like comparing weather to climate. All you have to support your position is some ongoing rodomontade about the flaws of modern society and medecine complete with references to poorly written books by priests and others.

    daleyrocks (bf33e9)

  109. “My contention is that it’s grossly over-diagnosed.”

    nk – I would agree that mild depression appears to be over diagnosed.

    daleyrocks (bf33e9)

  110. Comparing normal moods and emotions to depression as MD in Philly attempts to point out is like comparing weather to climate. All you have to support your position is some ongoing rodomontade about the flaws of modern society and medecine complete with references to poorly written books by priests and others.

    The ‘others’ would be three prominent psychiatrists. You keep asserting a distinction between ‘normal’ moods and this ‘disease’ but not really giving much thought as to what would make that distinction compelling for anyone who did not care to use it. (Ultimately, you’d be making a normative evaluation of the subject’s emotional state).

    Please recall how this started: with the moderator saying ‘Depression’ is ‘like contracting a virus’. Uh huh.

    Art Deco (ee8de5)

  111. “Please recall how this started: with the moderator saying ‘Depression’ is ‘like contracting a virus’. Uh huh.”

    Art Deco – Please recall our host calling depression a disease and your expansive response of “No” followed by a extensive clarifying remarks of “Rubbish” and an internet diagnosis of a commenter’s situation by comparing it to a book by Ivan Ilich.

    An explanation for why you disagree with the disease model, which might be a productive discussion, nowhere in evidence unless I have missed it. Raising an argument and then not having the balls to defend it by telling people to read other authors is a cowardly commenting approach. If you have actually read the authors you cite you should be able to summarize their arguments.

    daleyrocks (bf33e9)

  112. I would certainly agree that depression can not be transmitted like a virus so in that since it may not be a disease, but a defect in brain chemistry. The depressive part is not just a bad mood in an otherwise happy life. The up or manic phase is just as out of control and irrational and just as destructive and damaging. It is not that you are in a good mood and happy, you act happy because you are out of touch with your limits or the constraints of reality. While for some artists or creative people this may lead to brilliant accomplishments because a person feels no limits to their ability or to any limits imposed from without and will push the envelope, it leads all people to make really bad and foolish choices. When a more rational state returns you can’t believe the things you did or understand your reasons. In the lower states this becomes shame and self loathing. You feel terror vat the commitments you made that you now must somehow meet even though you are terrified of what it requires in terms of interaction with people. The harm to your family and friend who count on you make the guilt all the more unbearable because you can’t understand why you did the things.

    The rigid constraints needed to control this must apply at all times, up and down. These prevent you from ever really opening up to even those you love and prevent you from ever giving yourself over to joy or happiness without heavy self scrutiny and control, and in the low periods it may force you to do things you would literally prefer to die than face. At times the only reason you continue to ace life is the code and rules you have imposed on yourself. It effects every part of your life, all of your life.

    This is really not just being moody or lazy or shiftless. Your circle of friends becomes quite limited when people think you are a preening moralist or worst. There can never be any relaxation of this as the one you must accommodate sees everything and will judge quite unmercifully in the times he takes the saddle.

    machinist (313c6a)

  113. I guess I would say that alcoholism is not a decease in that sense either, though I think it is physical, not just character weakness. Alcoholism would really be the normal state. Some cultures have bought a high resistance to this addictive and lethal toxin at the price of countless lives over thousands of years of exposure, just as we bought a high resistance to some deceases. I do make a distinction between alcoholics and drunks. A man who uses booze as an escape from reality is indeed a weak character while a true alcoholic must have tremendous strength of character to resist the addictive nature of it. I have known both.

    machinist (313c6a)

  114. internet diagnosis of a commenter’s situation by comparing it to a book by Ivan Ilich.

    I do not do ‘diagnoses’. I can say a story sounds familiar. No I did not compare it to a book by Ivan Ilich. Rather, I made an allusion to Ilich’s thinking about illness, disability, and medicine.

    Art Deco (ee8de5)

  115. If you have actually read the authors you cite you should be able to summarize their arguments.

    1. Ilich’s argument is that medical science and medical care generates a treadmill that does little to improve the general state of well being, as the treatment of illness is conjoined by the generation of iatrogenic illness. It’s a provocative (and overstated) argument, but interesting.

    2. Torrey’s complaint has long been that the psychiatric profession invested decades in sterile psychoanaltic thinking and also abandoned its proper clientele (schizophrenics and those adjacent, and inpatient populations) for office practice superintending the ‘worried well’. I think he’s more of a critic of psychotherapy than psychotropic use generally, but I have not read most of his oevre.

    3. McHugh, who was the chief of psychiatry at Johns Hopkins, has offered an account of psychiatry which differentiates it from other branches of medicine and renders its methods more primitive inasmuch as it’s not grounded in locating dysfunctions in one of a discrete set of physiological systems. It has had long periods of non-development (essentially from the period running from 1935 to 1975, when it was addled by psychoanalysis).

    4. Szasz offers that authentic ailments, once they are identified as such, cease to be the province of psychiatry and are conveyed to neurology. Psychiatric ‘diagnoses’ are not delineations of illness, but reflections of the common assumptions of psychiatric practitioners about norms of human cognition, emotion, and behavior. (N.B. Szasz and Torrey were antagonists).

    An interesting article by Robert Wright appeared about 27 years ago in The New Republic (“Alcohol and Free Will”), debunking the ‘disease’ paradigm for discussing alcoholism which had grown quite prevalent from about 1975 onward.

    Human beings have problems. Nothing much you can do about that in general.

    Art Deco (ee8de5)

  116. machinist – Thank you for your comments. I think you and I are on the same page. While I would hesitate to speak for Patterico, I am fairly certain his reference to depression as a virus was not relative to any communicable properties, rather than just it represented some illness of the host.

    To me saying that depression is not a disease because it is part of life is circular logic at its finest. People get cancer, heart disease, ebola and other diseases and other afflictions sometimes from identifiable causes, sometimes not, all as part of life. Why would you consider any of them differently.

    There are psychologists and psychiatrists who object to using the disease model with depression, but so far I have not seen Art Deco advance their arguments and I have no plan to make his arguments for him.

    daleyrocks (bf33e9)

  117. 111. Art Deco (ee8de5) — 8/13/2014 @ 10:56 am

    You keep asserting a distinction between ‘normal’ moods and this ‘disease’ but not really giving much thought as to what would make that distinction compelling for anyone who did not care to use it.

    The difference is, it is persistent, and not related very well to what’s going on in someone’s like.

    On the radio, Ron Kuby said he had it, but when he had this depression it wasn’t something near as bad as what happened on other times when he didn’t.

    Do they (the people who want to treat this) know what they are doing? Of course not.

    It’s not diagnosed based on anything you would or could call medical criteria; what is diagnosed is some picture of a “disease” not too well related to reality (just coining a name doesn’t mean anything is being accurately described, or that many cases are similar because it has a name, or that it has an etiology); and the treatment is basically quackery, and very ad hoc.

    The whole thing is maybe like being able to move your muscles one way, but not the other way. A form of paralysis of thought, although it isn’t really thought that’s paralyzed, but mood. This can work in many ways, and last a short time or a long time. They have no idea what might trigger it, or how to stop it, and it often ends spontaneously.

    And we don’t know that was what was going on with Robin Williams.

    Please recall how this started: with the moderator saying ‘Depression’ is ‘like contracting a virus’. Uh huh.

    It’s conceivable an infection can start it. In #18 md in Philly mentioned dengue fever. And that strep might start obsessive compulsive syndrome. It coule easily be some more obscure viruses that don’t show other symptoms.

    This then, would be related to some form of brain damage, or an auto-immune disorder. And we know with auto-immune disorders, like allergies, they sometimes go away. Maybe often.

    Sammy Finkelman (b0c537)

  118. it’s important to get plenty of sunshine and if you’re prone to depression for sure you should eat more protein and avoid starchy foods and sugary crap

    also remember to treat yourself

    you are your own best friend

    smile and the world smiles with you

    fake it til you make it

    every day in every way you’re becoming a better and better lieutenant junior grade

    happyfeet (8ce051)

  119. Every part of the body other than the brain one can stick needles to take pieces to study and such while a person is alive, and the chemistry of the body outside of the blood-brain barrier is pretty much the same all over hence simple blood tests say a lot; inside the blood-brain barrier it is different. These facts should make it very clear why there is more known and specifically described about “diseases” that affect the body other than the mind/brain, without there being any fundamental difference between an illness “here” or an illness “there”. For someone to make that explicit and say psychiatry in some ways has lagged other fields of medicine is not a very astounding claim.
    Newer tools like SPECT scans and functional MRI’s and quantitative EEG’s may help to understand aspects of “psychiatric” disease, but how much is unclear AFAIK.

    There will remain mystery as to the interrelationship between the brain and it’s electrical and biochemical properties and the emotions, value making, and “the mind”.

    There is something to be said that medicine will never cure the world’s ills. Psalm 90, attributed to Moses, says a man’s life is 70 to 80 years long. It is true that one prevents death from childhood diseases by vaccination only so that people die of something else. One prevents many deaths from infectious diseases by sanitation and other means, only for people to then get cancer and heart disease, etc., etc.

    MD in Philly (f9371b)

  120. To me saying that depression is not a disease because it is part of life is circular logic at its finest.

    I gather to you the term ‘circular logic’ means anything you damn please.

    Art Deco (ee8de5)

  121. I have no plan to make his arguments for him.

    Or for your own position either.

    Art Deco (ee8de5)

  122. without there being any fundamental difference between an illness “here” or an illness “there”.

    I think if you rummage through DSM-IV you might just get the idea that the ‘fundamental’ difference for much of it is that coding what is described as ‘pathological’ is ultimately dependent on a conception of how people ought to think, act, and behave. Psychiatry and psychology are going to be parasitic on other branches of reason in this regard.

    Art Deco (ee8de5)

  123. just a sad, sad thing to happen. He was a very funny and – by all reports – a true gentleman in every sense of the word.

    Colonel Haiku (2601c0)

  124. as I’m sure others have said, he was the true heir to the genius Jonathan Winters… cut from the same bolt of cloth.

    Colonel Haiku (2601c0)

  125. Art Deco (ee8de5) — 8/13/2014 @ 4:56 pm

    I’m not going to argue with you.
    I’ll agree that it is easier to look at “physical” function and measurements with standard deviations from the norm and label something a “disease” than behavior that is outside of the norm that also causes great “dis-ease” for the person and others involved.
    And that much of the DSM classification is more opinion than you will find in a textbook on Neurology,

    but as I said before, to say that physical disorders of the brain, where thought processes and emotions are made and experienced, cannot be responsible for some emotional conditions seems to be a claim without logical basis.

    MD in Philly (f9371b)

  126. i feel like i’ve processed this Robin Williams thing pretty well

    happyfeet (8ce051)

  127. 127. i feel like i’ve processed this Robin Williams thing pretty well
    happyfeet (8ce051) — 8/13/2014 @ 6:48 pm

    kudos, mr. feets. bravo. well done. a hearty “huzzah.”

    Steve57 (5f6c2a)

  128. “Or for your own position either.”

    Art Deco – When you actually say something supporting your original comments, a discussion may be possible. So far all I have seen is generalized gripes about psychology and psychiatry, nothing specific about your original claim of why depression does not fit a disease model. I’m not holding my breath.

    daleyrocks (bf33e9)

  129. It’s been revealed that Robin Williams also had Parkinson’s disease.

    That can create cognitive problems (not much in the early sstages) The cogntive problem is not permanent – it is rather, that the brain gets tired (from thinking) It has to work much harder.

    There was a report that Robin Willisma was sleeping (or staying in bed) 20 hours a day and needed the room dark during the day. I think that sleep may have been on purpose, with the hope that things would be better when he woke up.

    Sammy Finkelman (b0c537)


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