C=EA2: The Way Forward: A Discussion Of Approaches

[Note:  This post is the prepared text for a discussion given remotely on September 18, 2017.]

A Personal Introduction

I would like to thank you all for giving me the opportunity to speak to you all today.  Mr. Crant already introduced me and a little bit about my story in his part of the presentation but I would like to give a little bit more detail about my lengthy period of major depression and the way in which it ended.  Although I have struggled periodically with depression over the course of my life, starting from childhood, my most serious period of depression was between 2006 and 2011.  In late December 2005, my father had a massive stroke that caused serious left-side paralysis and six weeks later, in early February, he died of a heart attack.  After his death, I felt a great deal of depression due to a variety of factors, including the fact that he had died at 59, and I was 24 at the time, and it was the first time I came to grips with the fact that long life was something that I could not personally take for granted in light of some of the similarities between us and between our early childhood [1].

This period of depression lasted for the next five years, during which time there was a significant degree of immense gloominess, along with my first two periods of gout attacks, the first shortly after my twenty-fifth birthday and the next three and a half years later during the first few months of 2010.  By the time I came into contact with Mr. Crant I had moved to Thailand where I worked as a teacher and a missionary to hill tribes teens and young adults in the northeastern part of the country.  Through my discussions with Mr. Crant I reflected on the absurdity of life and the reality that my body had used the period of depression, including its darkest part in 2010, as a way of rest after a prolonged period of stress and difficulty where I had pushed myself to obtain two graduate degrees despite the state of my mental health.  Interestingly enough, my recovery was accompanied by several days of my kidneys passing a particularly foul-smelling urine that appeared to be entirely unrelated to my rather modest diet based on rice and chicken and vegetables.

C=EA2:  A Case Study Approach

The current state of research of this theory is largely based on self-reporting from people like myself that can be considered as a case study approach.  We have stories of depression, therapeutic conversations that help re-orient attention from depression as a crisis to it being a response to the absurdity and difficulty of life that provides a period of rest where recuperation can be undertaken for the stresses of life, and where recovery was accompanied by the body ridding itself of what appeared to be toxins that were associated with the depression, after which there was a restoration to generally neutral to positive feelings.  Since then, I have not had any prolonged period of major depression thus far, and recovery from somewhat low feelings lasting for several days at a time has also been associated by what appeared to be the body cleansing itself of certain toxins.  As of yet I have not been able to have these tested, but that is something that I believe would be worthwhile in the future.

Stories like my own, and that of others, have a certain power to them.  For example, a paper published in the Journal of Behavioral Health Services in April 2011 [2] found a positive role in self-reported mental health measures in predicting functional outcomes for veterans.  It should be noted that just as I have struggled with PTSD since early childhood, so veterans too are often found to struggle with it, and this particular struggle is often related to other mental health issues with anxiety and depression.  Placing one’s story in a context often helps to make it easier to cope with, and it also can provide therapeutic benefit for oneself and for others.  Although this approach is qualitative instead of quantitative, there are positive results from being able to express one’s story and share it with others and also to gain insights from the stories of others, especially where there are similar patterns that may be recognized between a variety of self-reported stories.

Nevertheless, there are some limitations in reliance upon self-reporting and the case study approach.  An oft-repeated truism is that correlation is not causation, and there are limits to the evidence that can be gathered when one is limited to the case-study approach.  Questions of mechanism as well as numerical data are difficult to determine, and there can be a certain vagueness that comes from only being able to express one’s experience in a story without there being any data that can be aggregated together and analyzed in detail as part of experimental research.  In that light, one could see the efforts at helping people who have prolonged and/or deep periods of major depression ought to take advantage of as many approaches as possible, both qualitative approaches that allow them to report on their own mental and emotional state as well as quantitative approaches that can provide a detailed and data-driven understanding of how the recovery from major depression appears in various measurements.

Suggestions For Future Research

With this in mind, I would like to briefly discuss some suggestions for future research to further integrate this paradigm regarding depression into existing studies.  As many of the cases so far in the body of research that Crant has developed so far in his studies of depression include what appears to be the passing of foul-smelling urine, urine analysis related to the recovery of major depression is an obvious area of potential research.  Such analysis would be able to help relate depression to physical causes related to the chemical contents of the body, and point to the importance of the body’s natural systems in helping to preserve mental health.  Likewise, the existing body of case studies, and further case studies that are undertaken, can be examined using correlational studies that seek to determine the common elements in the story.  If similar processes and events can be found to occur in a sizable body of people recovering from major depression, then it may be possible to find certain avenues of approach for further research that would help to point out the mechanisms by which the body seeks to rest and recover through depression and then is able to rid itself of that which is dragging it down.

On a less chemical and statistical level, we may view the therapeutic efforts of reframing thoughts and ideas about depression as an approach that shows some marked similarities to Cognitive Behavioral Therapy, a common approach undertaken in various mood disorders like depression and anxiety disorders that seeks to give the mind a greater amount of tools in order to better understand the absurdity of life and the need to be resilient in the face of life’s stresses and difficulties.  Finally, the coincidence of PTSD and depression in athletes and soldiers is something that has been noted in the groundbreaking research on CTE by Dr. Bennet Omalu, most famous for being the doctor who first discovered the problem with repeated brain trauma in sports.  His papers on Chronic Truamatic Encephalopathy in athletes and veterans has suggested that traumatic experiences can cause the development of tau proteins in the brain that are associated with depression and other mental illnesses, which may provide a physiological basis for a great deal of our understanding of PTSD and related mental illnesses.  These are all among the areas where future research may be very profitable.

I thank you all for your time, and I would like to open the discussion to any questions.

[1] See, for example:

https://edgeinducedcohesion.blog/2012/08/25/i-am-no-better-than-my-fathers/

https://edgeinducedcohesion.blog/2011/02/08/sometimes-i-think-im-the-only-cab-on-the-road/

https://edgeinducedcohesion.wordpress.com/2014/02/13/book-review-forgiving-our-fathers-and-mothers/

https://edgeinducedcohesion.wordpress.com/2015/02/08/why-should-i-cry-for-you/

[2] https://www.ncbi.nlm.nih.gov/pubmed/21191819

About nathanalbright

I'm a person with diverse interests who loves to read. If you want to know something about me, just ask.
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