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I have a question for everyone:

Do you think staying in a situation that makes you clinically depressed for years could make it more likely that you'll suffer depression later on without the situation? Or do you think that if you're depressed out of that situation, you were probably depressed regardless of the situation back then - and it's just a continuation? If you don't know, you can hazard a guess.

There is also a family history, and a 6 month break between episodes. This break may or may not have been caused by a sense of relief and there were further triggers after this break that may have contributed to the second.

Also, if there was adequate treatment of the first episode would it have had an impact on the second episode in any way?

All opinions welcomed.

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Guest Vapourware

I don't think there's a clear-cut answer to this question, because it depends on both the person and the situation.

You can get two people and put them in the same situation, and one can get depressed while the other one is okay. I think some people are more vulnerable to depression than others and therefore situations can exacerbate this vulnerability.

It also depends on what you mean by treatment. I think a combination of medication and therapy [to help with coping skills] can help with how someone is impacted by the situation and their degree of depression.

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I think that situational depression is completely different than endogenous depression in that situational depression responds more to therapy and when the stressors go away, the depression is likely to lift. Now, does that instance of situational depression increase the chance of getting a later depression? Maybe. Or maybe the situational depression had an element where the person was already prone to get depression and so the person is already vulnerable to a relapse later in life.

Tough call, but I think people with endogenous depression often need meds for life whereas people with situational depression usually can get off meds and lead a completely normal life. But I do think that one episode of situational depression shows that you are vulnerable to depression.

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The first time I got depressed was when I was 18. I knew I was depressed, and I knew I was exactly the right age for my first episode. It happened when I was a freshman in college, and when I went to the Health Services for help, they dismissed me, even though I was fucking certain I was clinically depressed. In fact I told my closest friends I was certain I was bipolar, but I couldn't get anyone to see me.

But since the first 4 years of my illness were in college, I began to really believe when I left college, everything would get better. I had never been so miserable in my life, and of course being depressed, wasn't thinking clearly or wisely. My junior year I was hypo-manic, and I made dean's list both semesters. But I was put on academic probation 3 semesters at other points.

I totally bought into correlation being causation, because no one would help me, and I felt like my only hope was that when I left, I would feel better.

Then when I was 24, and living on my own, earning a living, and actually really enjoying my life, I suddenly got severely depressed. That was when I accepted it was not college, but me. And I finally got someone to believe I was depressed, but he was a sleazy and horrific psychiatrist, probably my worst experience outside of college. This was when I was a heavy LSD user, and he decided it was good for me, because I was always in such a good mood after I took it.

But anyway, the point is, even though I didn't get treatment right away, I knew something was up, and I got treatment as soon as I could.

On the one hand, I feel like college "trained" me in how to be depressed, because it was such a structureless environment. No attendance was even taken at most classes, except for tutorials in your major. I could stay in bed all day, not shower, stay totally indoors (our dorm had a tunnel system that even went to the next door dorm). Even some classes I took met in my dorm. And there was a lot of drug use; the joke was that everyone in our house was either a stoner or a physics major, because the physics majors liked how quiet the stoners were, and could study. So not a good environment.

On the other hand, I feel like I caught it really early, and am really lucky. I always feel shocked and terrible for the people joining the boards in their 40s who were just diagnosed. I couldn't imagine what it would be like going through so much of this life with no explanation for what was going wrong.

P.S. This was really rambly, but I think it did kind of address your question, so I am just going with it.

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Do you think staying in a situation that makes you clinically depressed for years could make it more likely that you'll suffer depression later on without the situation?

There definitely appears to be a connection. I watched that youtube lecture that was posted on this forum a few times (http://www.crazyboar...-on-depression/). Kudos for the person who discovered and posted it by the way. It's a really great and informative video.

In the video the professor says:

"What's very clear is, you get exposed to a lot of glucocorticoids [a type of stress hormone] and you're more at risk now for depression. You can see this epidemiologically, you get people and statistically before their first major depressive episode something awful stressful occurs. And that's where this happens [falling into depression], and this is the subset of people who stay down there far longer. Half one of those, first depressive episode due to some stressful event, they come out the other side eventually. You are no more at risk for depression than anybody else. Along comes the second major stressor, and you fall into depression and come out the other end. No more risk than anyone else for depression. Somewhere around the fourth or fifth stress-induced depression something happens, and things start cycling on their own there and you no longer need a major stressor to cause you to get depressed like that. That's when the clocks are off and running, that's the transition. Ok, so major stress can predispose you towards depression."

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I have been out of the situation which engendered my depression since October of last year, and the depression has still not lifted. In my case, I say yes to this; even after one is out of the trigger situation, the depression may conceivably remain. I'd guess that it also has to do with genetic/personality proclivity, life circumstances (academic, financial, etc.), and whatever treatments the person is taking.

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A conundrum for sure. I keep circling around "If you were in those circumstances of course you'd be depressed. But if you weren't prone to a more serious depression, you would feel well enough to change the circumtances." I don't think I said that quite right but I hope you know what I mean.

I don't know about the first bad one, but after that there's a fair amount of evidence for increased chance of repeat. It's not scientific, but I like to think of it as walking through the weeds in my brain. Once through and the weeds spring back up, but if you keep going that way a well-developed path develops.

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Hope I'm answering this as best I can. Not really taking in much information lately.

But what I gathered, this relates in some way to when I had depression. One event (for me this was when I thought I could control the time of day, but in reality I couldn't so I just ran myself into the ground, and the alcohol abuse that followed all this) triggered my depression. But when I was depressed, I ended up in some dodgy housing situations which definitely made the situation worse. People trying to hurt me, plus thought control, plus psychotic episodes, these all also added to my pre-existing depression. I do believe that if I had not lived through the ongoing circumstances, I would have come out of my depression much sooner than what I actually did.

Now I know what it was that caused my depression, I can put steps in place to stop it from coming back.

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