Like earthquakes and volcanic eruptions, the current international monetary crisis—bank failures and a collapse of markets worldwide—was not sufficiently predictable to preempt with defensive action. One would think that history's experiences with sudden breakdowns in global economics would have taught the modern world enough lessons to assure that economic intelligence would have tightened the reins of investors and speculators over the last decade of runaway optimism. But history has never been a good teacher—better said, people have rarely been good students (...) of history's lessons in cause and effect. Still, it makes sense, as with this essay, that we look back on such financial follies of the past, as epitomized by Holland's tulipmania, and take comfort in finding that our follies are just enough different from historical ones to at least claim them as our very own. (shrink)

Objective Manic and depressive phases of bipolar disorder (BD) show opposite psychomotor symptoms. Neuronally, these may depend on altered relationships between sensorimotor network (SMN) and subcortical structures. The study aimed to investigate the functional relationships of SMN with substantia nigra (SN) and raphe nuclei (RN) via subcortical-cortical loops, and their alteration in bipolar mania and depression, as characterized by psychomotor excitation and inhibition. -/- Method In this resting-state functional magnetic resonance imaging (fMRI) study on healthy (n = 67) and (...) BD patients (n = 100), (1) functional connectivity (FC) between thalamus and SMN was calculated and correlated with FC from SN or RN to basal ganglia (BG)/thalamus in healthy; (2) using an a-priori-driven approach, thalamus-SMN FC, SN-BG/thalamus FC, and RN-BG/thalamus FC were compared between healthy and BD, focusing on manic (n = 34) and inhibited depressed (n = 21) patients. -/- Results (1) In healthy, the thalamus-SMN FC showed a quadratic correlation with SN-BG/thalamus FC and a linear negative correlation with RN-BG/thalamus FC. Accordingly, the SN-related FC appears to enable the thalamus-SMN coupling, while the RN-related FC affects it favoring anti-correlation. (2) In BD, mania showed an increase in thalamus-SMN FC toward positive values (ie, thalamus-SMN abnormal coupling) paralleled by reduction of RN-BG/thalamus FC. By contrast, inhibited depression showed a decrease in thalamus-SMN FC toward around-zero values (ie, thalamus-SMN disconnection) paralleled by reduction of SN-BG/thalamus FC (and RN-BG/thalamus FC). The results were replicated in independent HC and BD datasets. -/- Conclusions These findings suggest an abnormal relationship of SMN with neurotransmitters-related areas via subcortical-cortical loops in mania and inhibited depression, finally resulting in psychomotor alterations. (shrink)

��This experiment found that the speed of thought affects mood. Thought speed was manipulated via participants’ paced reading of statements designed to induce either an elated or a depressed mood. Participants not only experienced more positive mood in response to elation than in response to depression statements, but also experienced an independent increase in positive mood when they had been thinking fast rather than slow—for both elation and depression statements. This effect of thought speed extended beyond mood to other experiences (...) often associated with mania (i.e., feelings of power, feelings of creativity, a heightened sense of energy, and inflated self-esteem or grandiosity). (shrink)

This discussion is about the moods characteristic of depressive and manic states. Moods are distinguished from the emotions they often accompany, and the relationship between these less and more cognitive, and seemingly less and more intentional, states is provided preliminary clarification. Epistemic deficiencies identified here, when combined with differences of quality and quantity in the moods and motivations that beset the depression and mania sufferer, seem likely to hinder self-knowledge and self-integration. These deficiencies, it is argued, may help explain (...) why the extreme moods found in states of depression and mania contribute to our inclination to regard these conditions as disorder. (shrink)

In this paper, I examine recent phenomenological research on both depressive and manic episodes, with the intention of showing how phenomenologically oriented studies can help us overcome the apparently paradoxical nature of mixed states. First, I argue that some of the symptoms included in the diagnostic criteria for depressive and manic episodes in the DSM-5 are not actually essential features of these episodes. Second, I reconsider the category of major depressive disorder (MDD) from the perspective of phenomenological psychopathology, (...) arguing that severe depressive episodes should not be characterized by any particular moods (such as sadness, hopelessness, or guilt), and should instead be characterized by a diminished capacity for finding ourselves situated in and attuned to the world at all. In other words, the affective dimension of depression should be characterized as a change in the way we have moods, not as a change from one kind of mood to another. Third, I turn to mania, arguing that manic episodes, taken as the opposite of depressive episodes, should be characterized not by any particular moods (such as euphoria, grandiosity, or even irritability), but should instead be characterized by an enhanced or heightened capacity for finding ourselves situated in and attuned to the world. In other words, the affective dimension of mania, like the affective dimension of depression, should be understood as a change in the way we have moods, not as a change from one kind of mood to another. Fourth, I return to the phenomenon of mixed states and argue that the affective dimension of depression and mania, when conceived along the phenomenological lines I set forth in the previous sections, dissolves the paradox of mixed states by showing that the essential characteristics of depression and mania cannot and do not coincide. Many cases of mixed states are diagnosed because moods that we take to be essential features of either depression or mania arise within the context of what is considered to be the opposite kind of episode (e.g. dysphoria, typically associated with depression, often arises in what is otherwise considered a manic state). However, if we conceive of the affective dimension of depression as a decrease in the degree to which one is situated in and attune to the world through moods, and the affective dimension of mania as an increase in the degree to which one is situated in and attuned to the world through moods, then the particular mood one finds oneself in is simply irrelevant to the diagnosis of either depression or mania. As a result, the manifestation of any particular moods in what otherwise seems to be a pure manic or depressive episode does not constitute a mixed state. (shrink)

In The Rules of Insanity, Carl Elliott draws on philosophy and psychiatry to develop a conceptual framework for judging the moral responsibility of mentally ill offenders. Arguing that there is little useful that can be said about the responsibility of mentally ill offenders in general, Elliott looks at specific mental illnesses in detail; among them schizophrenia, manic-depressive disorders, psychosexual disorders such as exhibitionism and voyeurism, personality disorders, and impulse control disorders such as kleptomania and pyromania. He takes a particularly (...) hard look at the psychopath or sociopath, who many have argued is incapable of understanding morality. Making extensive use of psychiatric case histories, Elliott explores the various ways in which mental illness can affect a person's intentions and thus excuse him or her from moral responsibility. (shrink)

Recent longitudinal observations show that human menstrual cycles, sleep‐wake cycles and manic‐depressive cycles can become synchronized with lunar cycles, but do so in uniquely complex and heterogeneous ways that are unlikely to have been detected by past studies. Past studies’ negative results have given rise to a scientific consensus that human biology and behavior are unaffected by lunar cycles. The recent observations show that synchrony can be temporary, and can occur with more than one type of lunar cycle, more (...) than one phase of a lunar cycle and more than one resonant frequency of a lunar cycle. Given the variability of human responses to lunar cycles, aggregate analyses used in almost all previous studies would likely have cancelled out individuals’ responses and led to false negative results. In light of these observations, the question of lunar influence should be investigated further, with longitudinal observations and case‐by‐case analyses of individuals’ data. (shrink)

How can we better understand and treat those suffering from schizophrenia and manic-depressive illnesses? This important new book takes us into the world of those suffering from such disorders. Using self descriptions, its emphasis is not on how mental health professionals view sufferers, but on how the patients themselves experience their disorder. A new volume in the International Perspectives in Philosophy and Psychiatry series, this book will be of great interest to all those working with sufferers from such disorders (...) - helping them to better understand their mental lives, and providing important insights into how best to treat them. (shrink)

In this paper I examine the ways in which our language and terminology predetermine how we approach, investigate and conceptualise mental illness. I address this issue from the standpoint of hermeneutic phenomenology, and my primary object of investigation is the phenomenon referred to as “mania”. Drawing on resources from classical phenomenology, I show how phenomenologists attempt to overcome their latent presuppositions and prejudices in order to approach “the matters themselves”. In other words, phenomenologists are committed to the idea that in (...) our everyday, natural attitude, we take for granted a number of prejudices and presuppositions that predetermine how we conceive of and understand what we experience. In order to properly approach the phenomena themselves, we need to find ways of neutralising our presuppositions and prejudices in order to develop new (and hopefully more accurate) accounts of the phenomena under investigation. One of the most popular examples of such an attempt at neutralisation is what Edmund Husserl calls the epoché, which is the practice of bracketing out or suspending presuppositions. However, later phenomenologists developed alternative approaches. Martin Heidegger, for instance, engaged in etymological analyses to discover latent meanings in our language and terminology. Hans-Georg Gadamer also engaged in historical analyses of how our traditions sediment into latent prejudices. After discussing the various ways in which phenomenologists have attempted to neutralise presuppositions and prejudices prior to engaging in their investigations, I apply some of these principles and methods to the domain of psychopathology, and discuss some of the prejudices inherent in contemporary discussions of the phenomenon of mania. I examine recent attempts to link the phenomenon that we today refer to as “mania” with the ancient Greek concept of “μανία” (mania), and argue that the practice of linking contemporary and historical concepts can be detrimental to attempts at reclassifying disorders. In addition, I consider the implications of the shift in terminology from “manic depressive illness” to “bipolar disorder” – especially how conceiving of mania as one of two “poles” predetermines its description by both clinicians and patients. Finally, I address the implications of the headings under which mania and bipolar disorder are discussed within diagnostic manuals. For example, I discuss the removal of the headings of affective and mood disorders in the DSM-5, and the explicit decision by the authors to place bipolar disorder between depressive disorders and schizophrenia. What I aim to accomplish in this paper is not so much a phenomenological investigation of mania as it is a pre-phenomenological investigation. In other words, I offer a preparatory investigation of the phenomenon (or phenomena) referred to as “mania” in contemporary discourse, with the intention of laying the groundwork for further phenomenological and psychological research. (shrink)

Over the last century, as Figure 1 graphically illustrates, scientific investigations have given us a detailed account of many natural phenomena, from molecules to manic depression, through so-called.

Charles S. Peirce, polymath, philosopher, logician, lived a life of often wild extremes and, when he died in 1914, had earned a vile reputation as a debauched genius. Yet he created a unified, profound and brilliant work, both published and unpublished, a fact difficult to explain. In my 1993 biography, I proposed three hypotheses to account for his Jekyll-Hyde character: his obsession with the puzzle of meaning, two neurological pathologies, trigeminal neuralgia and left-handedness, and the powerful influence of his father. (...) After publication, further research has led me to propose two additional hypotheses to explain his extraordinary life: manic-depressive illness and mystical experience, the last greatly influencing the development of his doctrine of semeiotic, of which his logic of science is a part. (shrink)

Lithium, despite its simple structure, has numerous biological effects. It also has a remarkable therapeutic effect in the prophylactic treatment of manic depression, and is finding a role in controlling aggressive and self‐mutilating behavior. The special feature of lithium is that it only acts on overactive systems to bring them back to normal, without affecting the stable system. The mechanisms of action of this simple cation are still largely unknown although the inositol depletion theory is the most widely accepted (...) model. A recent paper(1) described a different molecular mechanism for its effect on development, which may also explain its action in manic depression. (shrink)

Suppose a woman can carry to term only one of two viable embryos. One has the genetic potential to become a normal child. The other has a gene that gives it the potential for both the artistic genius and the severe manic-depression of the painter Vincent Van Gogh. I think it would be permissible to select either embryo. But I also believe that it would be impermissible to intervene to turn an embryo that has the potential to be normal (...) into a potential Van Gogh, and vice versa. The paper aims to resolve the tension between these beliefs. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Desire is Mimetic: A Clinical Approach Jean-Michel Oughourlian Université de Besançon, American Hospital ofParis What is the clinical expression ofmimetic desire? Rivalry. What I see every day in my practice is not mimicking, nor copying, nor learning; it is rivalry. Rivalry is recurrent, it repeats itself. The repetition syndrome identified by psychoanalysis is mimetic for two reasons: 1) because it is always the clinical expression of a rivalry and (...) that rivalry is always mimetic; 2) because it reproduces itself, duplicates itself, imitating the circumstances of the first rivalry and always looking for an impossible victory. That victory is impossible, since it stems from a situation which mimics the circumstances of defeat. But those circumstances are the only ones of interest, since the only battle worth winning is the one that has every chance to be lost. Mimetic rivalry (as I have tried to show elsewhere1) is always rooted in one ofthe two following claims: the claim ofthe selffor the ownership of its own desire; and the claim of desire for its anteriority, its seniority over the other's desire, the other desire that has generated it, on which it is modeled. Clinically, the self and the desire are going to develop various strategies to ascertain those two claims. The interdividual psychotherapy has to diagnose the nodal points of the mimetic conflict. It has to see ' See Jean-Michel Oughourlian, The Puppet ofDesire: The Psychology ofHysteria, Possession, and Hypnosis, trans. Eugene Webb (Stanford: Stanford University Press, 1991). Ed. 44Jean-Michel Oughourlian through the clinical variety of strategies and symptoms to the essential unity ofthe two claims underlying it. Let me give a few examples. Vengeance As we know, violence is mimetic. When violence cannot be immediately retaliated, imitated, duplicated, the energy for that retaliation is saved for later use. The more humiliating the violence, the greater the stored-up energy. Humiliation, in turn, stems from weakness: the humiliation of a child raped by an adult, ofa civilian beaten up by soldiers, ofa poor person insulted by a rich one, or, generally speaking, ofthe weak overpowered by the strong. Ifa weak person is the perpetrator ofthe first violence, it does not generate humiliation and, most ofthe time, does not entail vengeance. When an angered child kicks an adult, for example, this usually produces laughter rather than violence precisely because the child is smaller and weaker. As time goes by, the energy of postponed or deferred violence accumulates and increases. Clinically, it manifests itself in two ways: as a feeling ofhatred; and as a strength, a drive, a compulsive desire to destroy which will animate the offended and organize all his efforts in view ofthe vengeance that will set him free. The mimetic retaliation ofviolence will drive him until that retaliation is accomplished. In my experience, all the young girls who were raped by their fathers could not restore their mental health and psychological balance unless they were able, in one way or another, to avenge themselves. In the absence of such revenge, the enormous energy built up throughout their childhood and adolescence produced psychological symptoms which last for a lifetime. One such example is a patient, Miss L., 35 years old, who seeks treatment for alcoholism. It is a strange type ofalcoholism: each time, she must enter a meeting and speak before a group of people—and especially if her boss is in the group—she goes to the bathroom and drinks white rum from a hidden bottle. She has been in psychoanalysis for the past 12 years with no significant results. The history of her malady shows that she has wide mood swings, ups and downs often labeled as manic-depressive. Very quickly I see that she has stored within herself an enormous amount of violence which is fairly well controlled, but which manifests itselfthrough different types of aggressive behavior, especially towards men. A few sessions later, she finally tells me that she had been raped by her father and, as a consequence, that her parents had divorced. She was then obliged to remain with her father and take care ofhim. Psychoanalysis, of course, has Desire is Mimetic: A Clinical Approach45 commented extensively on the actual achievement ofher oedipal... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Commentary on “Spiritual Experience and Psychopathology”Anthony Storr (bio)Many psychiatrists, including myself, are deeply dissatisfied with current psychiatric taxonomy. Grossly abnormal people like multiple murderers are often deemed sane in law, because they do not happen to exhibit the symptoms of recognized mental illnesses like schizophrenia or manic-depressive psychosis. In contrast, some of those who do exhibit such symptoms, and who therefore risk being labeled psychotic, cannot be considered (...) to be “ill,” and are in fact mentally robust. There is considerable overlap between experiences which psychiatrists call psychotic, and experiences which are generally called spiritual by those who have them.In order to illustrate this overlap, the authors quote three cases of people describing a variety of delusions and hallucinations which would certainly prompt the diagnosis of psychosis—usually some variety of schizophrenia—were it not for the fact that all three claimed that their experiences had been of considerable benefit to them.It is noteworthy that, in each case, the psychotic/spiritual experiences followed a period of stress. The first subject was threatened by legal action; the second had surmounted an episode of depression, but was questioning whether she could continue her career in business; the third was unemployed, in debt, and suspected that he had multiple sclerosis. The first subject developed both grandiose and religious delusions; but the revelations which he claimed were a sign of God’s special grace toward him enabled him to win his law case and set up a charitable institution. The second heard the voice of Jesus summoning her to work for him. She became convinced that she was specially gifted in various parapsychological fields, and became a religious counselor. As the authors point out, “Her experiences, if delusional and hallucinatory, were overwhelmingly positive in their content and fruits.” The third subject also experienced hallucinatory voices which were intensely reassuring, gave him new insight into the nature of reality, and guided his further progress. As a result, he believed that he had such support that “nothing in this world can worry me.” In each case, the psychotic experience proved to be a solution to the subject’s problem, rather than a breakdown ending in admission to a mental hospital. This raises a variety of intellectual problems.The authors suggest that psychotic phenomena may be good or bad, and label the good phenomena “spiritual” and the bad phenomena “pathological.” According to this point of view, psychotic experience need not be considered pathological, especially if consideration is given to the structure of values and beliefs professed by the individual concerned. [End Page 83]I am not happy with this distinction. I entirely agree that psychotic experience may be a solution to a subject’s problems; but whether it is considered spiritual or pathological depends partly upon the nature of the experience, and even more upon the social setting in which it occurs. A grandiose delusion that one is especially selected and addressed by God may cure the depression of someone who has so far considered himself a nonentity if it is accepted by others. In my study of gurus, Feet of Clay (1996), I make the point that a guru seeks disciples because they reinforce his delusions and may, in some instances, keep him out of hospital. Of the three cases described in this paper, the first told “various friends and ministers about them.” The second confided in her priest and was told that her experiences were authentic within their shared Christian belief system. The third did not apparently share his hallucinatory experience with friends; but, when he responded to the invitation to write to the Alister Hardy Research Centre, wrote, “It is fascinating to find I’m not on my own in this. I have naturally queried my own sanity, and generally don’t discuss it....”Medical diagnosis and psychiatric diagnosis are not strictly comparable. If I as a doctor find that X is suffering from diabetes, I can treat X as an isolated entity displaying symptoms and signs of a well-known disease. I cannot do this when X is displaying “psychotic” symptoms; for whether or not those symptoms are regarded as pathological depends upon the social setting in which they... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:EugenicsMary Carrington Coutts (bio) and Pat Milmoe McCarrick (bio)The word eugenics (from the Greek eugenes or well-born) was coined in 1883 by Francis Galton, an Englishman and cousin of Charles Darwin, who applied Darwinian science to develop theories about heredity and good or noble birth (I, Kevles 1985, p. x).The entry under "eugenics" in the Encyclopedia of Bioethics notes that the term has had different meanings in different eras: (...) "a science that investigates methods to ameliorate the genetic composition of the human race; a program to foster such betterment; a social movement; and in its perverted form, a pseudo-scientific retreat for bigots and racists" (V, Ludmerer 1978, p. 457). Kevles, who places a stronger emphasis than Ludmerer on the degeneration of eugenics, says that by 1935 it "had become 'hopelessly perverted' into a pseudoscientific facade for 'advocates of race and class prejudice, defenders of vested interests of church and state, Fascists, Hitlerites, and reactionaries generally'" (I, Kevles 1985, p. 164).Phrases such as "survival of the fittest" and "struggle for existence" came into use at the end of the nineteenth century when eugenics societies were created throughout the world to popularize genetic science. "Negative eugenics" utilized marriage restriction, sterilization, or custodial commitment of those thought to have unwanted characteristics. "Positive eugenics" tried to encourage the population perceived as "superior" to have more offspring (V, Ludmerer 1978, p. 459).In the United States, after World War I, new information, such as the importance of environmental influences and the more complex concept of multi-gene effects in inheritance, diminished the scientific justification for eugenics, but this knowledge did not decrease the pressure for legislation, judicial action, or immigration controls. The U.S. Immigration Restriction Act of 1924 favored immigration from northern Europe and greatly restricted the entry of persons from other areas referred to as "biologically inferior." Between 1907 and 1937, 32 [End Page 163] states required sterilization of various citizens viewed as undesirable: the mentally ill or handicapped; those convicted of sexual, drug, or alcohol crimes; and others viewed as "degenerate" (V, Larson 1991).In Germany, interest in eugenics flourished after the turn of the century when Dr. Alfred Ploetz founded the Archives of Race-Theory and Social Biology in 1904 and the German Society of Racial Hygiene in 1905. The German term Rassenhygiene or race hygiene encompassed more than the word "eugenics;" it included all attempts to improve hereditary qualities as well as measures directed at population increase (III, Weiss 1987). By the 1920s, various German textbooks incorporated ideas of heredity and racial hygiene, and German professors were participating in the international eugenics movement. The Kaiser Wilhelm Institute of Anthropology, Human Heredity, and Eugenics was founded in 1927; by 1933 a sterilization law, the Law for the Prevention of Congenitally Ill Progeny, which originally was entitled "Eugenics in the Service of Public Welfare," indicated compulsory sterilization "for the prevention of progeny with hereditary defects" in cases of "congenital mental defects, schizophrenia, manic-depressive psychosis, hereditary epilepsy... and severe alcoholism." (III, Müller-Hill 1988, p. 10).The co-mingling of science, politics, and Weltanschauung (ideological or religious world view) caused the darkest period for eugenics when Nazi Germans embarked on their "final solution" to the Jewish "problem", or the Holocaust. The Nazi racial-hygiene program began with involuntary sterilizations and ended with genocide. Beginning with the 1933 Law for the Prevention of Congenitally Ill Progeny, 350,000 schizophrenic and other mentally ill persons were involuntarily sterilized, and marriage or sexual contact between Jews and other Germans was banned. Several hundred black children and 30,000 German Gypsies were sterilized. By 1945, when the allies liberated those remaining in Nazi concentration camps, six million Jews, 750,000 Gypsies, and 70,000 German psychiatric patients had been killed by the Nazis (III, Müller-Hill 1992, p. 47). As a result of the German experience, eugenic thought dropped to its nadir, and to the present day, the term "eugenics" invokes a sense of horror in some people.Great Britain, the United States, and Germany were the countries most involved with eugenic science in the first half of this century, but interest was present in Europe and other... (shrink)

Nietzsche’s cardinal ideas - God is Dead, Übermensch and Eternal Return of the Same - are approached here from the perspective of psychiatric phenomenology rather than that of philosophy. A revised diagnosis of the philosopher’s mental illness as manic-depressive psychosis forms the premise for discussion. Nietzsche conceived the above thoughts in close proximity to his first manic psychotic episode, in the summer of 1881, while staying in Sils-Maria (Swiss Alps). It was the anniversary of his father’s death, and (...) also of the break-up of his friendship with Wagner, the most important relationship in his life. Despite having been acquainted with these ideas from reading philosophy and literature, Nietzsche created them de novo and imbued them with very personal meaning. Surprisingly, he never defined or explained his cardinal thoughts in his published writings, perhaps because rationally he could not. A resultant hermeneutic vacuum provoked an avalanche of interpretations in secondary literature. But could these ideas be delusions? A current definition of delusion is challenged, and an attempt is made at a limited comparison between delusion, scientific/philosophical doctrine and poetic creation. It is also argued that psychosis is a way of re-living trauma, and delusions can therefore be seen as a form of reasoning that helps to make sense of the world in a state of psychotic disintegration. Far from being false beliefs, delusions are a true expression of one’s innermost feelings and pain, albeit indirectly. The relationship between early parental loss and repeated trauma, psychosis and creativity is also explored. Indo-Pacific Journal of Phenomenology , Volume 8, Edition 1 May 2008. (shrink)

Jonas, sixty-four, had never had a problem with the police and was reputed to be polite and calm. How then to explain the sudden outburst of violence when, on a given night, he shot a rifle at police officers? No one was harmed, but the perpetrator was arrested. It was in prison, a few hours after the incident, that Englebert, at the time a prison psychologist, met him. Englebert was also able to interview some of Jonas's family and friends, all (...) of whom were astonished by the event. This book, written by Englebert in collaboration with philosopher Grégory Cormann, analyzes the case not so much to find an ultimate explanation for Jonas's act as to show the variety of ways in which one can frame the man and his actions.The most common way of framing the event, the one most of Jonas's acquaintances have employed, is to link the violence with madness, but temporary insanity is not really an explanation. To say that Jonas went mad is no more than saying that his violence was incomprehensible. Still, to assert that he was mad when he fired the rifle qualifies as an interpretation in that it splits the act from the rest of the man's life. By insisting on that separation, kin and friends unburden themselves of any feelings of guilt they may experience at not having been able to prevent the act.Jonas's wife has another version of the event. She connects it with the recent death of his mother. Jonas was very close to his mother: he had dined with her every night of his life, even after his marriage thirty years before she died. Indeed even after her death, a month before the episode with the police, he had continued to go every night to her house. He wanted to carry on his lifelong habit, without change. A dispute about the house with his twenty-year-old son led to the encounter with the police: Jonas had added to his will a provision that his son would inherit the house but would be prohibited from ever selling it. The son found this prohibition unacceptable, and their argument came rapidly to blows. Out of fear, Jonas's wife called the police. Jonas went to the attic and brought down his late father's rifle. The son fled, but Jonas remained on the doorstep, waiting for the police.All the data presented in this book appear to confirm that Jonas suffered from a “major depressive disorder with melancholic features,” characterized by strong attachment to order and regularity. In this interpretation, the shot was a desperate act, aimed somehow at precluding change. Hence the act marked not a break in the man's life but signaled continuation of a long-term disorder.Englebert and Cormann, however, advance a third version—the most audacious, the most original. They compare the shot (a moment of high excitation) to the electroconvulsive therapy sometimes used to treat manic depression. It seems that electroshock produces a temporary disruption in the brain that is followed by a higher neuroplasticity that can help patients to recover. By putting himself in a perilous situation, Jonas produced an excitation that could disrupt his neural circuitry. In the authors’ interpretation, the act suggests neither temporary insanity nor the symptom of a long-term illness, but a first step toward recovery. The rifle was an improvised instrument for self-treatment.The book reflects Jean-Paul Sartre's claim according to which “it is perhaps sufficient to seek the explanation for a crime in the social situation and the criminal's psychopathic makeup, but only a poet can elucidate its human meaning.” Englebert and Cormann prove to be poets by showing how Jonas could free himself from self-bondage. (shrink)

In 1980, the late French Marxist philosopher Louis Althusser, a long-time sufferer of manic-depressive illness, murdered his wife and was committed to a psychiatric hospital. Never allowed to stand trial, he was eventually released and spent the years until his 1990 death in fitful obscurity. The posthumous publication of his autobiography, especially when taken in tandem with the first volume of the biography by his friend Yann Moulier Boutang, allows his readers hitherto unavailable insights into the man, and even (...) into the possible interpenetration of the man and his philosophy.Contrary to the claims of his editors, however, Althusser's autobiography is far from a portrait of madness from the inside. The author's attempt at an "objective" self-portrait, even with its objective mistakes and ellipses, is at a very far remove from the depiction of madness as experienced by the madman. The entire thrust of Althusser's self-interpretation, moreover, with its psychoanalytic excavation of neurotic determinants, appears to aim at the reduction of psychosis to more readily comprehensible mental turbulence. A similar reduction is at work in the author's seeming inability, or unwillingness, to trace the links between the institutional and political contexts of his life and the more intimate, personal sphere--and that remains the case even when he seems to be tracing those very connections.The question remains--and it is the overriding question of this article--whether any relationship can be traced between Althusser's interpretation of Marxist philosophy and his selfinterpretation. The answer lies in Althusser's ultimately fissured and fragmented account of the social "whole" as a "structure of structures," in which psychic factors are irrelevant to historical understanding and vice-versa.The limitations of Althusser's self-understanding are thus seen to parallel the limitations of his conception of Marxism. (shrink)

DSM-III and its revisions have provided little in the way of explicit historical or philosophical foundations. The logical empiricism embedded in its operational criteria and its external approach to validation are inadequate to account for the presumption of nosological regularities or the specific categories endorsed by the taxonomy. The nosologic operation that Jaspers referred to as the "synthesis of disease entities" is explored in connection with the central distinction in DSM-IV between mood disorders and schizophrenic disorders. This synthetic operation is (...) analyzed in terms of the paradigmatic shift from the mania-melancholia matrix of pre-modern psychiatry to the manic-depression/dementia praecox model defined by the work of Kraepelin. In the context of this analysis the self-evidence of these regularities is questioned. Keywords: DSM-III, DSM-IV, mood disorders, nosology, schizophrenic disorders CiteULike Connotea Del.icio.us What's this? (shrink)

This article explores the role of affect in the disorganized language and thought that can manifest itself in bipolar disorder. Bipolar disorder, or as it was previously known, manic-depressive illness, can produce psychotic language and thought in its more extreme forms. During the production of discourse in bipolar disorder, there is a strong correlation between the underlying affective state, i.e., depression, euthymia, hypomania, and mania, and linguistic and cognitive performance. A psycholinguistic model of the dynamics between language, thought, and (...) affect in bipolar disorder based on McNeill¿s concept of a ¿Growth Point¿ is proposed. In particular, the poetic structural phases of discourse production in bipolar disorder, which vary according to the underlying affective state, provide a phenomenological bridge between the psychotic discourse of mania and normal language production. (shrink)

The reorganization of psychiatric knowledge at the turn of the twentieth century derived from Emil Kraepelin’s clinical classification of psychoses. Surprisingly, within just few years, Kraepelin’s simple dichotomy between dementia praecox (schizophrenias) and manic-depressive psychosis (bipolar disorders) succeeded in giving psychiatry a new framework that is still used until the present day. Unexpectedly, Kraepelin’s simple clinical scheme based on the dichotomy replaced the significantly more differentiated nosography that dominated psychiatric research in the last three decades of the nineteenth century (...) (Janzarik in Themen und Tendenzen der deutschsprachigen Psychiatrie. Springer, Berlin, 1974 ). Moreover, although all the components of the future development were already available shortly after 1868, the real course, which led to Kraepelin’s dichotomy, was unpredictable then. This paper explores the ways in which the unpredictability of psychiatric knowledge and the postulate of a rationality underlying psychopathological phenomena interacted in the debates regarding the classification of psychoses. It examines the “natural antagonism” between the practical aspirations of an increasingly specialized medical nosology and unitary conceptions, which, in a psychopathological countermovement, emphasized that no somatic criteria can be specified for the majority of psychic abnormalities and that all nosological distinctions are not binding (Janzarik 1974, 20). In this context, this paper investigates the revival of unitary theories of psychosis in postwar German psychiatry and seeks to understand why the forms of thinking that dominated nineteenth-century psychiatry have proved to be very lasting. Furthermore, this paper emphasizes the perspectivity underlying psychiatric research on psychoses and explores the ways in which writing the history of the schizophrenia concept involves inevitably writing the history of the entire psychiatry. (shrink)

A debate persists over how to distinguish manic states from non-manic ones (such as depressions). A lacuna exists amongst these efforts, where a specifically agentive account of mania would sit. An agentive account centers the manic person’s view of practical reasons, rationalizing their actions in the same way that sympathetic understandings rationalize the actions of more neurotypical agents. In this paper, I argue that mania restructures our agency by creating a pervasive sense of urgency. This urgency changes (...) the kind of handling that our practical reasons seem to call out for. Whilst this can make us less reliable as agents, I argue that this does not undermine the basic capacities on which personal autonomy is founded. The greater threat to manic agents’ autonomy is nonrecognition of this restructured agency, undermining autonomy in its social dimensions. Without an agentive account, we will fail to recognize distinctly manic agency when we see it, limiting our understanding of autonomy, and withholding recognition, fundamental to autonomy in its social dimensions, from manic agents. (shrink)

There is a strong presumption that mental disorder injures a person's autonomy, understood as a set of capacities and as an ideal condition of agency which is worth striving for. However, recent multidimensional approaches to autonomy have revealed a greater diversity in ways of being autonomous than has previously been appreciated. This presumption, then, risks wrongly dismissing variant, neuro-atypical sorts of autonomy as non-autonomy. This is both an epistemic error, which impairs our understanding of autonomy as a phenomenon, and a (...) moral error, which withholds recognition and respect that autonomous agents are due. I argue that careful attention to the different 'shapes' of agent's autonomy reveals that there are indeed distinctive kinds of neuro-atypical autonomy that are widely mistaken for non-autonomy. This project argues for two propositions. First, that there is a kind of autonomy, with a distinctive shape and texture, available to bipolar agents. This is a variant sort of autonomy, but not a defective or deficient sort. It is the ideal of autonomy that it is worth bipolar agents striving for, given the range and intensity of experiences that they will have to confront. Whilst bipolar autonomy will look unlike more neurotypical kinds of autonomy, it continues to be owed recognition. The second proposition is that we should understand the ideal of autonomy to be both pluralist and highly context sensitive. Given the range of starting points from which agents will strive to an ideal of autonomy, there will be some variation in the ideals worth striving for. The variation in ideals will reflect the existential realities they are local to. Theory of autonomy must be adapted to recognise bipolar, and other neuro-atypical, kinds of autonomy, and to reflect this wider pluralism. These propositions will be argued for with careful attention to the experiences and agency of people living with bipolar, or related, disorders. Understanding the ways that manic or depressive episodes, and the shifts between them, alter and apply pressure to our agency will inform an account of the distinctively bipolar autonomy that can be built on top of it. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:diacritics 35.1 (2005) 8-21MuseSearchJournalsThis JournalContents[Access article in PDF]Klossowski's Reading of Nietzsche Impulses, Phantasms, Simulacra, StereotypesDaniel W. SmithIn his writings on Nietzsche, Pierre Klossowski makes use of various concepts—such as intensities, phantasms, simulacra and stereotypes, resemblance and dissemblance, gregariousness and singularity—that have no place in Nietzsche's own oeuvre. These concepts are Klossowski's own creations, his own contributions to thought. Although Klossowski consistently refused to characterize himself as a philosopher ("Je (...) suis une 'maniaque,'" he once said, "Un point, c'est tout!"),1 his work in its entirety was marked by an extraordinary conceptual creation. From this point of view, his Nietzsche and the Vicious Circle can be read as a work in philosophy—at least in the idiosyncratic sense given to this term by Gilles Deleuze, who defined philosophy as the creation or invention of concepts [Deleuze and Guattari 2]. No doubt, Klossowski remains an almost unclassifiable figure—philosopher, novelist, essayist, translator, artist—and attempting to analyze his work through the prism of philosophy may seem to be a reductive approach that belies the complexity of his exceptional oeuvre. Reading Klossowski as a conceptual innovator, however, at least has the advantage of allowing us to chart a consistent trajectory through his difficult and often labyrinthine text, without denying its other dimensions (affective, perceptive, literary, and so on). In what follows, then, I would like to examine three of Klossowski's most characteristic and important concepts—impulses and their intensities, phantasms, and simulacra and their stereotypes—as well as the precise interrelations he establishes among them. Taken together, these three concepts describe what Klossowski terms the tripartite economy of soul, which constitutes the implicit model through which he interprets Nietzsche's thought.1Impulses as Fluctuating IntensitiesKlossowski describes his books on both Nietzsche and Sade as "essays devoted not to ideologies but to the physiognomies of problematic thinkers who differ greatly from each other" ["Postface" 137, emphasis added]. This emphasis on the "physiognomy" of thinkers reflects Nietzsche's insistence on taking the body rather than the mind as a guide for philosophy since the body is a more accessible phenomenon, less surrounded by myth and superstition. "The body and physiology as the starting point," Nietzsche wrote. "Why?... The phenomenon of the body is the richer, clearer, more tangible [End Page 8] phenomenon.... Belief in the body is more fundamental than belief in the soul" [WP §§492, 489, 491]. Klossowski himself, however, when writing of the intensive status of the impulses, frequently makes use of the term "soul" (âme), owing in part, no doubt, to his interest in the theological literature of the mystics, such as Meister Eckhardt and Teresa of Avila. For the mystics, the depth of the soul is something irreducible and uncreated: it eludes the exercise of the created intellect, and can only be grasped negatively.2 Nonetheless, if one can find a similar apophaticism (or "negative theology") in Klossowski, it is related exclusively to the immanent and chaotic movements of the soul's intensive affects, and not to the transcendence of God. What is incommunicable in the soul (or body) are its "impulses"—their fluctuations of intensity, their rises and falls, their manic elations and depressive descents, which are in constant variation.Nietzsche himself had recourse to a highly varied vocabulary to describe what Klossowski summarizes in the term "impulse": "drive" (Triebe), "desire" (Begierden), "instinct" (Instinke), "power" (Mächte), "force" (Kräfte), "impulse" (Reize, Impulse), "passion" (Leidenschaften), "feeling" (Gefülen), "affect" (Affekte), "pathos" (Pathos), and so on.3 Klossowski frequently employs the musical term tonalité to describe these states of the soul's fluctuating intensities—their diverse tones, timbres, and changing amplitudes—which can take on various forms ("aggressiveness, tolerance, intimidation, anguish, the need for solitude, the forgetting of oneself" [NVC 6]). At bottom, what these impulses express are what Klossowski calls the "obstinate singularity" of the human soul, which is by nature noncommunicable; they constitute "the unexchangeable depth" (le fond inéchangeable) or "the unintelligible depth" (le fond unintelligible) of the soul. What makes every individual... (shrink)

Time is an essential feature in bipolar disorder (BP). Manic and depressed BP patients perceive the speed of time as either too fast or too slow. The present article combines theoretical and empirical approaches to integrate phenomenological, psychological, and neuroscientific accounts of abnormal time perception in BP. Phenomenology distinguishes between perception of inner time, ie, self-time, and outer time, ie, world-time, that desynchronize or dissociate from each other in BP: inner time speed is abnormally slow (as in depression) or (...) fast (as in mania) and, by taking on the role as default-mode function, impacts and modulates the perception of outer time speed in an opposite way, ie, as too fast in depression and too slow in mania. Complementing, psychological investigation show opposite results in time perception, ie, time estimation and reproduction, in manic and depressed BP. Neuronally, time speed can be indexed by neuronal variability, ie, SD. Our own empirical data show opposite changes in manic and depressed BP (and major depressive disorder [MDD]) with abnormal SD balance, ie, SD ratio, between somatomotor and sensory networks that can be associated with inner and outer time. Taken together, our combined theoretical-empirical approach demonstrates that desynchronization or dissociation between inner and outer time in BP can be traced to opposite neuronal variability patterns in somatomotor and sensory networks. This opens the door for individualized therapeutic “normalization” of neuronal variability pattern in somatomotor and sensory networks by stimulation with TMS and/or tDCS. (shrink)

This article explores negotiations over the humanistic versus mechanized components of care through an ethnographic account of digital phenotyping research. I focus on a US-based team of psychiatric and engineering professionals assembling a smartphone application that they hope will analyze minute changes in the sounds of speech during phone calls to predict when a user with bipolar disorder will have a manic or depressive episode. Contrary to conventional depictions of psychiatry as essentially humanistic, the discourse surrounding digital phenotyping positions (...) the machine as a necessary addition to mental health care precisely because of its more-than-human sensory, attentional capacities. The bipolar research team likewise portrays their app as capable of pinpointing sonic signs of mental illness that humans, too distracted by semantic meaning, otherwise ignore. Nevertheless, the team members tasked with processing the team’s data must craft and perform a selectively attentive machinic subject position, which they call “listening like a computer”: a paradoxical mode of attention and inattention. By tracing the team’s discursive and on-the-ground enactments of care and attention as both humanistic and machinic, I tune a critical ear to the posthuman promises of digital phenotyping. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy, Psychiatry, & Psychology 12.3 (2005) 235-237 [Access article in PDF] Determined by Chaos: The Nonlinear Dynamics of Free Will Jessica Wahman Keywords free will, chaos theory, determinism, materialism In "antidepressants and the Chaotic Brain: Implications for the Respectful Treatment of Selves," Douglas Heinrichs provides an intriguing justification of individuated and longer term therapy for depressive clients. He does not reject medication as a therapeutic strategy, nor does he (...) question the materialist basis of the traditional medical model. Rather, he offers a physically deterministic account of depression that is at the same time compatible with a sense of human agency and individuality. Heinrichs suggests that human physiology and its psychiatric disorders are better accounted for by the nonlinear dynamics of chaos theory than by the traditional account of neurotransmitter production and reuptake. Because the latter, microscopic, explanation suggests a direct cause-and-effect relationship between synaptic activity and subjective affect, it cannot account for the wide variation of responses to the same medications, nor can it satisfy the client's fears that her drug-induced well-being is not fully hers to control. Chaos theory, he asserts, can provide a better explanation by treating the human organism as a complex holistic system whose patterns resemble a topographical map of probability more than they do a unidirectional vector model of cause to effect. Like the weather, human affect and behavior are physically determined but difficult to predict, and so careful attention to both the individual history of the client and the uniqueness of responses to medication are a necessary part of any successful therapeutic program.Connected to this theory of nonlinear physiology is Heinrichs's account of autonomy and agency under this rubric. He notes that a psychology based on chaos theory is not only compatible with the notion of free will, it can better explain why the successful use of medication actually increases freedom and autonomy instead of limiting it. It is here that I wish to focus my comments, because his interpretation of free will may give us, to borrow a phrase from Daniel Dennett, a "variet[y] of free will worth wanting" (1984, title page). Free will, in this case, is not a metaphysical ability to act above and beyond our material causes, but is instead a property of the material system itself, namely when that system feels itself capable of greater psychic mobility around the topographical map of probabilistic patterns.According to this model, our ability to reason, plan, and act on the decisions we make is itself a [End Page 235] part of our chaotically determined neurologic system. When we are healthy, we are able to reason in our best interests and act on those reasons. This is modeled as an ability for the organism to metaphorically "move about" the map of its own possibilities, and more important, to both enter and escape certain states, known as chaotic attractors, into which it is likely to be drawn. "Where" we wind up, psychologically speaking, at any point in time is determined by our own system, and so we may say that in such a case we are autonomous and our choices are made freely. Depression, on the other hand, can be compared to a deep groove in the map, a chaotic attractor that is hard to escape, and so the system quite literally becomes "stuck in a rut." This is subjectively experienced as the tendency for thought processes and activities to fall into negative and self-defeating patterns despite the best efforts of the client to escape these habits. So long as the organism does not have a sense of being "trapped" in an attractor (whether a depressive or, for example, manic or compulsive state), then that organism may be said to be free. Medication and the therapy that accompanies it, so far as it facilitates our ability to escape deep chaotic attractors, promotes our own freedom of will. If a car cannot spin its way out of a ditch, does the tow truck hinder or promote its freedom by hauling it back onto solid pavement where it may again... (shrink)

The psychology of belief in the paranormal has often been used to stigmatize believers but it has also been used with a more open-minded approach. This paper describes some research of this kind in which believers were found to report more mystical experience, have more creative personalities, report more manic and depressive experience, and more magical ideation, unwittingly suggesting a link with bipolar disorder and schizotypal personality. In addition, however, these six variables were all found to correlate positively and (...) significantly with each other. The positive manifold suggested a single underlying factor, which indeed emerged from principal components analysis. It was speculated that the underlying factor was “transliminality”—a gating mechanism modulating the flow of information and affect from subliminal levels into supraliminal. Later studies have not as clearly confirmed the existence of the positive manifold but nevertheless the concept of transliminality may be a useful one for understanding paranormal experience and hence paranormal belief. (shrink)

Strategic Environmental Assessment, as a support to strategic planning, is a starting point in the creation of a sustainable concept of managing waste that is based on the principles of a circular economy. The role of SEA is to guide the planning process towards the goal of securing the best effects in relation to the quality of the living environment and the socio-economic aspects of development. SEA is also an instrument that can be used when making optimal decisions about spatial (...) development, which further contributes to its importance and role in the planning process. The implementation of SEA allows developers to establish the benefits and implications of the proposed spatial changes, taking into account the capacity of the space to sustain the planned development, and to determine the degree of acceptability of the proposed spatial changes. This paper presents a specific method used for impact assessment in SEA for the Agro-Waste Management Plan for Oplenac Vineyard. The specificity of this method is that it combines specific goals, indicators and criteria for assessing the effect of planning solutions formulated in the simulated AWMP for Oplenac Vineyard using a semi-quantitative expert method. The results of the paper indicate the possibility of using GIS tools to increase objectivity in the expert evaluation of planning solutions, particularly in relation to a group of criteria for assessing the spatial dispersion of the impacts. This reduces the subjectivity that is characteristic of all expert methods. The graphical presentation of the results in GIS technology and the use of matrices and graphs to present the results makes them easier to understand and creates a good basis for making optimal decisions on future activities concerning the elimination of waste from wineries and viticulture. The research was carried out within the framework of the NoAW project, which is supported by the European Commission through the Horizon2020 research and innovation program. (shrink)

Background: Recent research has demonstrated that depressed individuals show impairments in inhibiting irrelevant emotional material, and that these impairments are linked to rumination. Cognitive inhibition, however, is not a unitary construct but consists of several components which operate at different stages of information processing. The present study was designed to assess two components of inhibition and examine their relation to depression and rumination in a sample of clinically depressed and healthy control participants. Methods: Twenty-two individuals diagnosed with a current depressive (...) episode and 27 never-disordered control participants completed an Emotional Flanker Task to assess individual differences in interference control and a modification of the Working Memory Selection Task to assess individual differences in the ability to discard no longer relevant emotional material from working memory. Participants completed self-report measures to assess depressive symptoms and rumination. Results: Clinically depressed compared to control participants showed significantly reduced interference control of irrelevant negative information. The groups, however, did not differ in their ability to discard no longer relevant negative information from working memory. In contrast, rumination was associated with difficulty removing no longer relevant negative material from working memory but not with deficits in interference control. Conclusions: Results highlight the importance of differentiating among components of inhibition to gain a better understanding of cognitive mechanisms underlying depression and rumination. (shrink)

ABSTRACTTime-consciousness has long been a focus of research in phenomenology and phenomenological psychology. We advance and extend this tradition of research by focusing on the character of temporal experience under conditions of mania. Symptom scales and diagnostic criteria for mania are peppered with temporally inflected language: increased rate of speech, racing thoughts, flight-of-ideas, hyperactivity. But what is the underlying structure of temporal experience in manic episodes? We tackle this question using a strategically hybrid approach. We recover and reconstruct three (...) hypotheses regarding manic temporality that were advanced and modeled by two pioneers of clinical phenomenology: Eugène Minkowski and Ludwig Binswanger. We then test, critique, and refine these hypotheses using heterophenomenological methods in an interview-based study of persons with a history of bipolar and a current diagnosis of acute mania. Our conclusions support a central hypothesis due to Minkowski... (shrink)

In this article, I examine stigmatizing and especially patronizing attitudes towards others’ depression that people who are well-intentioned produce. The strategy of the article is to consider the social experience of depression through two separate subfields of philosophy: epistemic injustice and phenomenology. The solution that I propose is a phenomenological account of empathy. The empathetic attitude that I argue for involves actively listening to the depressed individual and taking their depression testimony as direct evidence. The article has been written both (...) for those who seek to better support neurodiverse people in their lives and for depressives (and other neurodivergents) themselves in order to provide them with a better account for advocating for themselves against social stigma. (shrink)

First-person reports of Major Depressive Disorder reveal that when an individual becomes depressed a profound change or ‘shift’ to one’s conscious experience occurs. The depressed person reports that something fundamental to their experience has been disturbed or shifted; a change associated with the common but elusive claim that when depressed one finds oneself in a ‘different world’ detached from reality and other people. Existing attempts to utilise these phenomenological observations in a psychiatric context are challenged by the fact that this (...) experiential ‘shift’ characteristic of depression appears mysterious and resists analysis in scientific terms. This paper offers a way out of this predicament. The hypothesis proposed is that when an individual becomes depressed, the individual departs from a state of ordinary wakeful consciousness and enters a distinctive global state of consciousness akin to dreaming and the psychedelic state. After unpacking and motivating this hypothesis in the context of research in consciousness science, I outline two of its important implications for the neurobiology of depression and psychedelic psychiatry. The upshot is a promising and conceptually well-motivated hypothesis about depression which is apt for empirical uptake and development. (shrink)

I argue that consideration of certain cases of severe depression reveals a problem for desire-based theories of welfare. I first show that depression can result in a person losing her desires and then identify a case wherein it seems right to think that, as a result of very severe depression, the individuals described no longer have any desires whatsoever. I argue that the state these people are in is a state of profound ill-being: their lives are going very poorly for (...) them. Yet desire theories get this case wrong. Because no desires are being frustrated, the desire theorist has no grounds for ascribing ill-being; indeed, because the individuals described seem utterly without desire, the desire theorist has no grounds for treating these people as subjects of welfare ascription at all. I argue that these results are unacceptable; therefore, we should reject desire-based theories of well-being and ill-being. (shrink)

Aversive experiences have been thought to provoke or exacerbate clinical depression. The present review provides a brief survey of the stress-depression literature and suggests that the effects of stressful experiences on affective state may be related to depletion of several neurotransmitters, including norepinephrine, dopamine, and serotonin. A major element in determining the neurochemical changes is the organism's ability to cope with the aversive stimuli through behavioral means. Aversive experiences give rise to behavioral attempts to cope with the stressor, coupled with (...) increased utilization and synthesis of brain amines to contend with environmental demands. When behavioral coping is possible, neurochemical systems are not overly taxed, and behavioral pathology will not ensue. However, when there can be no behavioral control over the stressful stimuli, or when the aversive experience is perceived as uncontrollable, increased emphasis is placed on coping through endogenous neurochemical mechanisms. Amine utilization increases appreciably and may exceed synthesis, resulting in a net reduction of amine stores, which in turn promotes or exacerbates affective disorder. The processes governing the depletions may be subject to sensitization or conditioning, such that exposure to traumatic experiences may have long-term repercussions when the organism subsequently encounters related stressful stimuli. With continued uncontrollable stimulation, adaptation occurs in the form of increased activity of synthetic enzymes, and levels of amines approach basal values. It is suggested that either the initial amine depletion provoked by aversive experiences or a dysfunction of the adaptive processes, resulting in persistent amine depletion, contributes to behavioral depression. Aside from the contribution of behavioral coping, several organismic, experiential, and environmental variables will influence the effects of aversive experiences on neurochemical activity, and may thus influence vulnerability to depression. (shrink)

Experiences of Depression is a philosophical exploration of what it is like to be depressed. In this important new book, Matthew Ratcliffe develops a detailed account of depression experiences by drawing on work in phenomenology, philosophy of mind and psychology, and several other disciplines.

In this paper I offer an alternative phenomenological account of depression as consisting of a degradation of the degree to which one is situated in and attuned to the world. This account contrasts with recent accounts of depression offered by Matthew Ratcliffe and others. Ratcliffe develops an account in which depression is understood in terms of deep moods, or existential feelings, such as guilt or hopelessness. Such moods are capable of limiting the kinds of significance and meaning that one can (...) come across in the world. I argue that Ratcliffe’s account is unnecessarily constrained, making sense of the experience of depression by appealing only to changes in the mode of human existence. Drawing on Merleau-Ponty’s critique of traditional transcendental phenomenology, I show that many cases of severe psychiatric disorders are best understood as changes in the very structure of human existence, rather than changes in the mode of human existence. Working in this vein, I argue that we can make better sense of many first-person reports of the experience of depression by appealing to a loss or degradation of the degree to which one is situated in and attuned to the world, rather than attempting to make sense of depression as a particular mode of being situated and attuned. Finally, I argue that drawing distinctions between disorders of structure and mode will allow us to improve upon the currently heterogeneous categories of disorder offered in the DSM-5. (shrink)

Despite the relevance of silence in several psychopathologies, first-person perspectives on silence have been largely neglected in the phenomenological scholarship on those conditions. This paper proposes a phenomenological framework for addressing this neglect and demonstrates its usefulness through a case study of empty silence, an experience which can be found in many first-person accounts of depression. The paper begins by surveying research on silence in depression in mental health research and phenomenological psychopathology. Drawing on the thought of Merleau-Ponty, it then (...) outlines a phenomenological framework for explicating the structure of silence experiences in psychopathology. Finally, it applies this framework to articulate the experiential structure and implications of empty silence, with a particular emphasis on the bodily doubt that can flow from repeated experiences of empty silence. (shrink)

According to current opinion in western psychopathology, depression is regarded as a disorder of mood and affect on the one hand, and as a distortion of cognition on the other. Disturbances of bodily experience and of social relations are regarded as secondary to the primarily 'inner'and individual disorder. However, quite different concepts can be found in cultures whose members do not experience themselves as much as separate individuals but rather as parts of social communities. Disorders of mood or well-being are (...) then conceived less as intra-psychic, but rather as bodily, interpersonal, or atmospheric processes. On this background, the paper describes depression as a disorder of intercorporeality and interaffectivity. After developing these phenomenological concepts, it analyses depression as a 'detunement' of the resonant body that mediates our participation in a shared affective space. Instead of expressing the self, the body is turned into a barrier to all impulses directed to the environment. This impairs particularly the patient's interaction with others, resulting in a general sense of detachment, separation, or even segregation. Moreover, the restriction of the lived body also corresponds to the triggering situations of depression, namely experiences of a disruption of social bonds. Thus, intercorporeality and interaffectivity are presented as crucial dimensions for an ecological and non-reductionist view of depression. (shrink)

Motivational internalism (MI) holds that, necessarily, if an agent judges that she is morally obligated to ø, then, that agent is, to at least some minimal extent, motivated to ø. Opponents of MI sometimes invoke depression as a counterexample on the grounds that depressed individuals appear to sincerely affirm moral judgments but are ‘listless’ and unmotivated by such judgments. Such listlessness is a credible counterexample to MI, I argue, only if the actual clinical disorder of depression, rather than a merely (...) hypothetical example of such listlessness, is the source of this listlessness. However, empirical evidence concerning depression shows that, to the extent that the depressed are motivationally listless at all, they are abnormally listless only with respect to an important class of non-moral judgments, namely, their prudential normative judgments (i.e., those concerning their own happiness and well-being), not their moral judgments. Hence, depressed individuals do not constitute a counterexample to MI. This conclusion has important methodological implications concerning how supporters and opponents of MI can best defend their respective theses. (shrink)

Postpartum depression is a major maternal health problem after childbirth. It can start at any time within the first year after delivery and continue for several years. It is characterized by an inability to experience pleasure, anxiety symptoms, panic attacks, spontaneous crying and depressed mood. Some women with postpartum depression even have thoughts of harming their child and self-harm. This study aims to find out the status of postpartum depression and the associated factors among postnatal mothers at the first, fourth (...) and sixth month. This study is a prospective descriptive study, carried out in three major health facilities in Misurata. This study consists of a three-part questionnaire. Part 1 covers the demographic characteristics of the participants, while Part 2 explores the associated risk factors according to the variables used. Part 3 consists of the psychological evaluation of the participants. A hundred mothers (ages between 15 and 43 years) were enrolled in this study. The findings revealed that the prevalence of depression is 60.0% and 22.0% are suffering from borderline depression. Development of depression was strongly correlated with sleeping disturbances, the state of the neonate after birth, excess consumption of stimulants, less weight acceptance by mothers during pregnancy and infant illness. There was a weak relation between depression and delivery state, maternal admission to the hospital during the current pregnancy, and infant gender dissatisfaction. No correlation was found with the development of depression regarding miscarriage, maternal medical problems after delivery, previous child sex, maternal age, education, parity or neonate weight. Thus, this study shows that the chance of having a miscarriage and an unhealthy neonate increases with advanced maternal age. It also shows that caesarean section is associated with bad neonatal outcomes, more weight gain and having gestational diabetes or preeclampsia during pregnancy. Maternal sleeping problems are more pronounced in the first month, attributed to the baby's care, compared with the fourth and sixth months. The study indicates that depression is a common state of psychiatric disorders among Libyan women and should have appropriate attention by physicians and gynecologists. (shrink)