Epidemiology of Multiple Somatic Symptoms in the community, and its association with illness related cognitions,2018,Jones et al

The depression you have when you're not feeling depressed!

To me, severe depression (major depressive disorder) is the worst thing in the world to have, so this would seem to me to be a rather good strategy, and we should learn how to encourage more MDD people to learn the technique.

 

A doctor once told me that there exists a pure bodily depression, i.e. you don't feel depressed, you have just bodily symptoms. I guess this was the time where I changed my opinion about him for good.

 

I just imagine these guys wearing tin-foil hats and spending their off-time consumed with proving that margarine is actually conspiracy butter.

 

I think one would need to be cautious about criticism. He was clearly trying to describe something other than "depression" and having to resort to metaphor.

There was a time many years ago when asked if I thought I was depressed would say: not in the conventional use of the term, but felt it to be a sort of systemic metabolic depression.

It is very difficult to convey meanings in these areas where the language to do so accurately is not available. He may have meant well. On the other hand, he may not.

 

Yes, I understood that. I think he steered more into the psychosomatic direction. But he definitely was not trying to put something into words he can't explain better.
And no, he didn't mean well.

Besides, I don't care much anymore if people "mean well". That's nice. But if they kill me (or discriminate me or harm me otherwise) with their good intentions, what it's worth? It's so easy to see what would really help me/us, it's not that I'm keeping this as a secret.

 

But then its not depression, is it? Do bears go into depression in the winter? I don't think anyone would say that.

 

It depends what you mean by "is".

ETA I am not convinced that banning metaphor as a means of linguistic communication would necessarily be helpful.

 

Yes, I have it on my list to write them a letter. It will be sent from Emerge. And I know a couple of others have contacted them as individuals, not through any of the orgs.

 

Fair enough. I guess if you feel depression is a good metaphor for your bodily state, then it could be useful to express that. As long as you're really clear you're using it in a metaphoric sense.

I do get a physical sensation I like to describe as being "pressed beneath a concrete slab" (this is the very worst symptom I have). That seems a better way to convey it than anything else I can think of.

 

Words are very difficult. "Depression" seems to be even more difficult than "fatigue". I doubt if even the most ardent BPSer would consider treating the Qattara depression or that weather system, that will be coming in off the Atlantic, with anti-depressants or CBT. I don't mean to be flippant, just that the word is used to describe the lowering of all sorts of things, and is readily understood in such cases. It is always necessary to tease out what is meant in the less obvious cases.

I think that my original point was that rather than just dismiss the views of a doctor who describes a physical depression, one has to cross examine him as to his meaning. There are, of course, some who have said all they need to to enable views to be formed.

Wittgenstein has interesting thoughts on this sort of subject in The Blue Book where he considers "unconscious toothache" as a means of addressing the tenets of psychoanalysis and talk of unconscious thoughts, acts of volition etc. I know. I should get a life.

Sorry to hear of that symptom. Hope things are improving under the new regimen.

 

One of the most irritating things about some doctors is how they refuse to understand you if you don’t use the correct medical terms for your symptoms (like it should be expected that all patients get a medical degree before seeing a doctor so they can understand us), so I try to be open to others attempts at describing symptoms we don’t have an adequate vocabulary for.

 

I contacted patient organisations about their response: Emerge won’t be contacting Macquarie Uni but the Allergy and Environmental Sensitivity Support and Research Association Inc, the Australian National Register of Environmental Sensitivities both wrote and lodged complaints.

 

As I said in my post, it is on my list to write a letter to be sent from Emerge. Emerge will be writing about this study, it’s just taken me a while to get to it.

 

Glad that writing this article prompted some action!