Depression (was Mortgage Rates (was Momentarily Verbal)) ?

Q: I am aware of two major types of depression: (a) topical depression, which has an external cause that may or may not have a predictable life span (e.g., your husband is a drunk and your mother-in-law, who hates you, lives with the two of you, as was the case with one of my acquaintances), and (b) clinical depression, which is caused by some internal hormonal imbalance (that may or may not be chronic or cyclically acute and then non-existent) that adversely affects one's emotional balance.

A:I'm sure there are other types of depression. For example, just as some of us grew up thinking that the way to solve problems was by shouting at people, by expressing our anger about life's imperfections, there are people who learned that the best way to be consoled and pampered when they feel sad or otherwise unhappy is to act depressed (just as I act angry -- I'm not "acting" but acting out; and I would hold that some depressed people do the same). There is no panacea for real clinical depression, only a series of trials and errors with a variety of drugs: natural drugs like St John's wort, artifical drugs like fluoxetine (Prozac or Sarafem), and naturally-produced-in-one's-own-brain drugs like dopamine and norepinephrine, which come from doing things like running or otherwise exercising strenuously for 60 minutes or more. It is certainly possible for some individuals to "heal themselves" -- and that is the only interpretation one can put on "set aside everything you have been told about the condition" -- but it's not possible for all of us. Such a characterization also implies that what I as a life-long clinical depressive know about my psyche from years of reading about, talking about, and personally experiencing depression is useless and essentially false second-hand knowledge, i.e., not knowledge at all. Depression appears to be more of a symptom than a simple illness with a simple cause. Even when patients have very similar symptoms they may respond very differently to medication. This is why the old tricyclic antidepressants are still prescribed, for some people they are the best option available. Those two aren't mutually exclusive. Topical depression may respond to the same medication as clinical depression. Clinical depression may

respond to the same 'talking therapy' as topical depression. Manic depression is a completely different kettle of worms that may or may not respond in the same way to clinical depression, and also has its own preferred medications, which sometimes work on other forms of depression. One thing that I found annoying was a recent letter I saw in a nespaper lettere column this week. A women who, for obvious reasons, had suffered topical depression wrote in response to a letter from someone who had clinical depression. Her letter could be paraphrased as "I had real depression, yours isn't real because you haven't been through what I went through, pull yourself together."