So much of the world is mourning Robin Williams, and quite rightly people are encouraging those experiencing depression to seek help, rather than take their lives. Naturally I concur with this, but it seems to me that the commentary has often treated depression as a single condition.
In fact, one of the major obstacle to successful treatment is that depression is almost certainly a complex of different conditions, which are best treated in different ways, and one of the great challenges is to identify the particular form a person has.
There is a theory held by a substantial, albeit still minority, group of health professionals, that says that a large portion of people diagnosed with simple “depression” are actually suffering from type 2 bipolar disorder. In Williams’ case his manic side was so obvious that bipolar was probably the first, rather than the last, thing considered, but the majority of coverage I have seen has failed to specify that he had been diagnosed with bipolar, a missed opportunity to increase awareness.
I’m only marginally more qualified to discuss this than your average anti-vaxer or climate change denier is to speak on the topics on which they hold forth so readily. So I can’t really say if the theory is right.
Nevertheless, it is clear that it is true for at least some people. One of my closest friends spent years being fruitlessly treated for depression with SSRIs and various other treatments. Then he encountered one of the advocates of this theory, was put on medication for bipolar and experienced an almost immediate turnaround in his life. Even before this I was sympathetic to the idea, having heard it from Professor Jack Pettigrew, who developed a theory to explain the causes of bipolar that I find utterly fascinating.
I’m certainly aware of the dangers of extrapolating from the experience of those I happen to know, while being influenced by the elegance of a relatively untested theory.
Nevertheless, whether you accept the claims of widespread misdiagnosis or not, the general lesson I would draw is that if a treatment is not working, look around for others. If the therapist you are seeing is unwilling to consider other options, get a second opinion. I know that is easier said than done. When depressed the effort to reach out once can be enormous, to reach out a second time may seem impossible, particularly if, like so many depressed people, you feel that you are unworthy of any support that may be offered. All I can do is encourage everyone to do so.
While on sad topics, I want to pay tribute to Chris Mardon. Chris died on Saturday, but I only found out today. Chris was a founding member of the Victorian Greens, one of the original 17 who formed the party. I didn’t know him well – we tended to operate in different parts of the organization, but his efforts were hard to miss. It was only recently that I learned of his impressive achievements outside the party, both as an engineer and as one of the first to bring climate change to public attention in Australia.
So on a sorrowful day it was good to bring some beauty to quite a lot of people’s attention. I don’t have the figures on how many people have viewed this article, since the bitly link that sometimes provides me with data was not created in this case, but 21 hours after it was posted 80,000 people have liked it.
The phenomenon of bioluminescent surf got quite a run a few months ago when Will Ho’s pictures made it to Gizmodo, but I think Phil Hart‘s work is even better. I hope lots of people have clicked through to his page to see his amazing astrophotography as well.
George Monbiot recently posted a column about how the environment movement needs to focus on promises, not fears. I haven’t yet really digested this, so I’m not sure to what extent I agree. And I’m even less sure how we go about achieveing such a shift most of the time. But I think photos like this probably have a part to play.