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Is everything you think you know about depression wrong? | Society | The Guardian
"So, what is really going on? When I interviewed social scientists all over the world – from São Paulo to Sydney, from Los Angeles to London – I started to see an unexpected picture emerge. We all know that every human being has basic physical needs: for food, for water, for shelter, for clean air. It turns out that, in the same way, all humans have certain basic psychological needs. We need to feel we belong. We need to feel valued. We need to feel we’re good at something. We need to feel we have a secure future. And there is growing evidence that our culture isn’t meeting those psychological needs for many – perhaps most – people. I kept learning that, in very different ways, we have become disconnected from things we really need, and this deep disconnection is driving this epidemic of depression and anxiety all around us.

Let’s look at one of those causes, and one of the solutions we can begin to see if we understand it differently. There is strong evidence that human beings need to feel their lives are meaningful – that they are doing something with purpose that makes a difference. It’s a natural psychological need. But between 2011 and 2012, the polling company Gallup conducted the most detailed study ever carried out of how people feel about the thing we spend most of our waking lives doing – our paid work. They found that 13% of people say they are “engaged” in their work – they find it meaningful and look forward to it. Some 63% say they are “not engaged”, which is defined as “sleepwalking through their workday”. And 24% are “actively disengaged”: they hate it.

Most of the depressed and anxious people I know, I realised, are in the 87% who don’t like their work. I started to dig around to see if there is any evidence that this might be related to depression. It turned out that a breakthrough had been made in answering this question in the 1970s, by an Australian scientist called Michael Marmot. He wanted to investigate what causes stress in the workplace and believed he’d found the perfect lab in which to discover the answer: the British civil service, based in Whitehall. This small army of bureaucrats was divided into 19 different layers, from the permanent secretary at the top, down to the typists. What he wanted to know, at first, was: who’s more likely to have a stress-related heart attack – the big boss at the top, or somebody below him?

Everybody told him: you’re wasting your time. Obviously, the boss is going to be more stressed because he’s got more responsibility. But when Marmot published his results, he revealed the truth to be the exact opposite. The lower an employee ranked in the hierarchy, the higher their stress levels and likelihood of having a heart attack. Now he wanted to know: why?

And that’s when, after two more years studying civil servants, he discovered the biggest factor. It turns out if you have no control over your work, you are far more likely to become stressed – and, crucially, depressed. Humans have an innate need to feel that what we are doing, day-to-day, is meaningful. When you are controlled, you can’t create meaning out of your work.

Suddenly, the depression of many of my friends, even those in fancy jobs – who spend most of their waking hours feeling controlled and unappreciated – started to look not like a problem with their brains, but a problem with their environments. There are, I discovered, many causes of depression like this. However, my journey was not simply about finding the reasons why we feel so bad. The core was about finding out how we can feel better – how we can find real and lasting antidepressants that work for most of us, beyond only the packs of pills we have been offered as often the sole item on the menu for the depressed and anxious. I kept thinking about what Dr Cacciatore had taught me – we have to deal with the deeper problems that are causing all this distress.

I found the beginnings of an answer to the epidemic of meaningless work – in Baltimore. Meredith Mitchell used to wake up every morning with her heart racing with anxiety. She dreaded her office job. So she took a bold step – one that lots of people thought was crazy. Her husband, Josh, and their friends had worked for years in a bike store, where they were ordered around and constantly felt insecure, Most of them were depressed. One day, they decided to set up their own bike store, but they wanted to run it differently. Instead of having one guy at the top giving orders, they would run it as a democratic co-operative. This meant they would make decisions collectively, they would share out the best and worst jobs and they would all, together, be the boss. It would be like a busy democratic tribe. When I went to their store – Baltimore Bicycle Works – the staff explained how, in this different environment, their persistent depression and anxiety had largely lifted.

It’s not that their individual tasks had changed much. They fixed bikes before; they fix bikes now. But they had dealt with the unmet psychological needs that were making them feel so bad – by giving themselves autonomy and control over their work. Josh had seen for himself that depressions are very often, as he put it, “rational reactions to the situation, not some kind of biological break”. He told me there is no need to run businesses anywhere in the old humiliating, depressing way – we could move together, as a culture, to workers controlling their own workplaces."



"After I learned all this, and what it means for us all, I started to long for the power to go back in time and speak to my teenage self on the day he was told a story about his depression that was going to send him off in the wrong direction for so many years. I wanted to tell him: “This pain you are feeling is not a pathology. It’s not crazy. It is a signal that your natural psychological needs are not being met. It is a form of grief – for yourself, and for the culture you live in going so wrong. I know how much it hurts. I know how deeply it cuts you. But you need to listen to this signal. We all need to listen to the people around us sending out this signal. It is telling you what is going wrong. It is telling you that you need to be connected in so many deep and stirring ways that you aren’t yet – but you can be, one day.”

If you are depressed and anxious, you are not a machine with malfunctioning parts. You are a human being with unmet needs. The only real way out of our epidemic of despair is for all of us, together, to begin to meet those human needs – for deep connection, to the things that really matter in life."
depression  society  psychology  johannhari  2018  work  labo  hierarchy  meaning  purpose  belonging  competence  culture  medication  pharmaceuticals  anxiety  workplace  democracy  cooperation  sfsh  joannecacciatore  irvingkirsch  michaelmarmot  meredithmitchell  johncacioppo  vincentfelitti  aintidepressants  brain  serotonin 
january 2018 by robertogreco
The male suicides: how social perfectionism kills | Mosaic
"Impulsivity, brooding rumination, low serotonin, poor social problem-solving abilities – there are many vulnerabilities that can heighten the risk of suicide. Professor Rory O’Connor, President of the International Academy of Suicide Research, has been studying the psychological processes behind self-inflicted death for over 20 years.

“Did you see the news?” he asks when I meet him. The morning’s papers are carrying the latest numbers: 6,233 suicides were registered in the UK in 2013. While the female suicide rate has remained roughly constant since 2007, that for men is at its highest since 2001. Nearly eight in ten of all suicides are male – a figure that has been rising for over three decades. In 2013, if you were a man between the ages of 20 and 49 who’d died, the most likely cause was not assault nor car crash nor drug abuse nor heart attack, but a decision that you didn’t wish to live any more.

In every country in the world, male suicides outnumber female. The mystery is why? What is it about being male that leads to this? Why, at least in the UK, are middle-aged men most at risk? And why is it getting worse?

Those who study suicide, or work for mental health charities, are keen to press upon the curious that there’s rarely, if ever, a single factor that leads to any self-inflicted death and that mental illness, most commonly depression, usually precedes such an event. “But the really important point is, most people with depression don’t kill themselves,” O’Connor tells me. “Less than 5 per cent do. So mental illness is not an explanation. For me, the decision to kill yourself is a psychological phenomenon. What we’re trying to do in the lab here is understand the psychology of the suicidal mind.”

We’re sitting in O’Connor’s office on the grounds of Gartnavel Royal Hospital. Through the window, the University of Glasgow’s spire rises into a dreich sky. Paintings by his two children are stuck to a corkboard – an orange monster, a red telephone. Hiding in the cupboard, a grim book collection: Comprehending Suicide; By Their Own Young Hands; Kay Redfield Jamison’s classic memoir of madness, An Unquiet Mind.

O’Connor’s Suicidal Behaviour Research Lab works with survivors in hospitals, assessing them within 24 hours of an attempt and tracking how they fare afterwards. It also carries out experimental studies, testing hypotheses on matters such as pain tolerance in suicidal people and changes in cognition following brief induced periods of stress.

After years of study, O’Connor found something about suicidal minds that surprised him. It’s called social perfectionism. And it might help us understand why men kill themselves in such numbers."



"If you’re a social perfectionist, you tend to identify closely with the roles and responsibilities you believe you have in life. “It’s not about what you expect of yourself,” O’Connor explains. “It’s what you think other people expect. You’ve let others down because you’ve failed to be a good father or a good brother – whatever it is.”

Because it’s a judgement on other people’s imagined judgements of you, it can be especially toxic. “It’s nothing to do with what those people actually think of you,” he says. “It’s what you think they expect. The reason it’s so problematic is that it’s outside your control.”

O’Connor first came across social perfectionism in studies of American university students. “I thought it wouldn’t be applicable in a UK context and that it certainly wouldn’t be applicable to people from really difficult backgrounds. Well, it is. It’s a remarkably robust effect. We’ve looked at it in the context of the most disadvantaged areas of Glasgow.” It began in 2003 with an initial study that looked at 22 people who had recently attempted suicide, as well as a control group, and assessed them using a 15-question quiz that measures agreement with statements such as “Success means that I must work even harder to please others” and “People expect nothing less than perfection from me”. “We’ve found this relationship between social perfectionism and suicidality in all populations where we’ve done the work,” says O’Connor, “including among the disadvantaged and the affluent.”

What’s not yet known is why. “Our hypothesis is that people who are social perfectionist are much more sensitive to signals of failure in the environment,” he says.

I ask if this is about perceived failure to fulfil roles, and what roles men feel they should fill? Father? Bread-winner?

“Now there’s this change in society,” O’Connor replies, “you have to be Mr Metrosexual too. There are all these greater expectations – more opportunities for men to feel like failures.”"



"If you’re a social perfectionist, you’ll have unusually high expectations of yourself. Your self-esteem will be dangerously dependent on maintaining a sometimes impossible level of success. When you’re defeated, you’ll collapse.

But social perfectionists aren’t unique in identifying closely with their goals, roles and aspirations. Psychology professor Brian Little, of the University of Cambridge, is well known for his research on ‘personal projects’. He believes we can identify so closely with them that they become part of our very sense of self. “You are your personal projects,” he used to tell his Harvard class.

According to Little, there are different kinds of projects, which carry different loads of value. Walking the dog is a personal project but so is becoming a headteacher in a lovely village, and so is being a successful father and husband. Surprisingly, how meaningful our projects are is thought to contribute to our wellbeing only slightly. What makes the crucial difference to how happy they make us is whether or not they’re accomplishable.

But what happens when our personal projects begin to fall apart? How do we cope? And is there a gender difference that might give a clue to why so many men kill themselves?

There is. It’s generally assumed that men, to their detriment, often find it hard to talk about their emotional difficulties. This has also been found to be true when it comes to discussing their faltering projects. “Women benefit from making visible their projects and their challenges in pursuing them,” Little writes, in his book Me, Myself and Us, “whereas men benefit from keeping that to themselves.”

In a study of people in senior management positions, Little uncovered another salient gender difference. “A clear differentiator is that, for men, the most important thing is to not confront impedance,” he tells me. “They’re primarily motivated to charge ahead. It’s a clear-the-decks kind of mentality. The women are more concerned about an organisational climate in which they’re connected with others. You can extrapolate that, I think, to areas of life beyond the office. I don’t want to perpetrate stereotypes but the data here seem pretty clear.”

Additional support for this comes from a highly influential 2000 paper, by a team lead by Professor Shelley Taylor at UCLA, that looked at bio-behavioural responses to stress. They found that while men tend to exhibit the well-known ‘fight or flight’ response, women are more likely to use ‘tend and befriend’. “Although women might think about suicide very seriously,” says Little, “because of their social connectedness, they may also think, ‘My God, what will my kids do? What will my mum think?’ So there’s forbearance from completing the act.” As for the men, death could be seen as the ultimate form of ‘flight’.

But that deadly form of flight takes determination. Dr Thomas Joiner, of Florida State University, has studied differences between people who think about suicide and those who actually act on their desire for death. “You can’t act unless you also develop a fearlessness of death,” he says. “And that’s the part I think is relevant to gender differences.” Joiner describes his large collection of security footage and police videos showing people who “desperately want to kill themselves and then, at the last minute, they flinch because it’s so scary. The flinch ends up saving their lives.” So is the idea men are less likely to flinch? “Exactly.”

But it’s also true, in most Western countries, that more women attempt suicide than men. One reason a higher number of males actually die is their choice of method. While men tend towards hanging or guns, women more often reach for pills. Martin Seager, a clinical psychologist and consultant to the Samaritans, believes this fact demonstrates that men have greater suicidal intent. “The method reflects the psychology,” he says. Daniel Freeman, of the University of Oxford’s department of psychiatry, has pointed to a study of 4,415 patients who had been at hospital following an episode of self-harm; it found significantly higher suicidal intent in the men than the women. But the hypothesis remains largely uninvestigated. “I don’t think it’s been shown definitively at all,” he says. “But then it would be incredibly difficult to show.”

For O’Connor, too, the intent question remains open. “I’m unaware of any decent studies that have looked at it because it’s really difficult to do,” he says. But Seager is convinced. “For men, I think of suicide as an execution,” he says. “A man is removing himself from the world. It’s a sense of enormous failure and shame. The masculine gender feels they’re responsible for providing and protecting others and for being successful. When a woman becomes unemployed, it’s painful, but she doesn’t feel like she’s lost her sense of identity or femininity. When a man loses his work he feels he’s not a man.”

It’s a notion echoed by the celebrated psychologist Professor Roy Baumeister, whose theory of suicide as ‘escape from the self’ has been an important influence on O’Connor. “A… [more]
suicide  men  via:anne  2015  perfectionism  roryo'connor  middleage  behavior  impulsivity  rumination  serotonin  socialperfectionism  responsibility  responsibilities  society  failure  judgement  urbanization  success  self-esteem  socialesteem  pressure  stress  gender  manhood  roybaumeister  martinseager  thomasjoiner  shelleytaylor  brianlittle  self-concept  korea  china  us  uk  kayredfieldjamison 
may 2015 by robertogreco
The Reinvention of the Self § SEEDMAGAZINE.COM
"Marmosets are the ideal experimental animal: a primate brain trapped inside the body of a rat."

"The structure of our brain, from the details of our dendrites to the density of our hippocampus, is incredibly influenced by our surroundings. Put a primate under stressful conditions, and its brain begins to starve. It stops creating new cells. The cells it already has retreat inwards. The mind is disfigured.

The social implications of this research are staggering. If boring environments, stressful noises, and the primate’s particular slot in the dominance hierarchy all shape the architecture of the brain—and Gould’s team has shown that they do—then the playing field isn’t level. Poverty and stress aren’t just an idea: they are an anatomy. Some brains never even have a chance."

"The genius of the scientific method, however, is that it accepts no permanent solution. Skepticism is its solvent, for every theory is imperfect. Scientific facts are meaningful precisely because they are ephemeral, because a new observation, a more honest observation, can always alter them. This is what happened to Rakic’s theory of the fixed brain. It was, to use Karl Popper’s verb, falsified."

"Neurogenesis is an optimistic idea. Though Gould’s lab has thoroughly demonstrated the long-term consequences of deprivation and stress, the brain, like skin, can heal itself, as Gould is now beginning to document, finding hopeful antidotes to neurogenesis-inhibiting injuries. “My hunch is that a lot of these abnormalities [caused by stress] can be fixed in adulthood,” she says. “I think that there’s a lot of evidence for the resiliency of the brain.”"

"The mind is like a muscle: it swells with exercise. Gould’s and Kozorovitskiy’s work reminds us not only how easy it is to hurt a brain, but how little it takes for that brain to heal. Give a primate just a few extra playthings, and its neurons are capable of escaping the downward cycle of stress."

"Neurogenesis is a field that doubts itself. Because it has been scorned from the start, its proponents talk most emphatically about what they don’t know, about all the essential questions that remain unanswered. Their modesty is accurate: The purpose of all of our new cells remains obscure. No one knows how experiments done in rodents will relate to humans, or whether neurogenesis is just a small part of our mind’s essential plasticity."
uncertainty  trophins  childhoodstress  children  childhood  lizgould  biology  geniakozorovitskiy  resilience  resiliency  neuronova  jonasfrisén  fernandonottebohm  robertsapolsky  serotonin  prozac  antidepressants  depression  pharmacology  psychiatry  psychology  ronaldduman  michaelkaplan  josephaltman  paskorakic  brucemcewen  christianmirescu  neurogenesis  howwelearn  science  permanence  adaptability  change  ephemeral  observation  scientificmethod  research  stress  poverty  surroundings  environment  primates  marmosets  brain  neuroscience  elizabethgould  via:litherland  2006  ephemerality 
july 2012 by robertogreco
The Atlantic Online | December 2009 | The Science of Success | David Dobbs
"Most of us have genes that make us as hardy as dandelions: able to take root and survive almost anywhere. A few of us, however, are more like the orchid: fragile and fickle, but capable of blooming spectacularly if given greenhouse care. So holds a provocative new theory of genetics, which asserts that the very genes that give us the most trouble as a species, causing behaviors that are self-destructive and antisocial, also underlie humankind’s phenomenal adaptability and evolutionary success. With a bad environment and poor parenting, orchid children can end up depressed, drug-addicted, or in jail—but with the right environment and good parenting, they can grow up to be society’s most creative, successful, and happy people."
nature  nurture  evolution  society  genetics  animals  biology  behavior  genes  creativity  psychology  science  children  success  dandelions  orchids  depression  serotonin  life  toread 
december 2009 by robertogreco

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