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I think relativity is more helpful than you initially assume. The reason you may postpone a decision is twofold. First, it may not be your optimal decision. Sure, it may be an above average decision for someone else, but it still may not be the decision you are best capable of. [1] Second, “good” decisions are somewhat subjective. After all, most of the time life is about what is optimal for you rather than what is optimal objectively (the latter is often impossible to determine). Thus, the delay of important decisions may be in order to remain with consistent with yourself rather than to create optimal decisions.
In terms of competency threshold there is actually a long and confusing legal precedent concerning mental illness. My own knowledge largely comes from the “right to refuse” treatment but I think that qualifies as a major life decision. Both Rogers v. Okin and Rennie v. Klein uphold the right of the patient to be assumed competent to refuse treatment for mental illness. [2][3] A court may find the patient incompetent, but that is fairly rare and extreme. Both address more extreme cases than somewhat severe depression; I think it’s safe to say you are qualified to make decisions. It is instead a question of whether that is what’s best for you.
Interestingly, the entire premise of this post could be incorrect on society’s part. It turns out depression might not even hurt our ability to reason. In fact it could even help [4]. However, even if that is true, a decision made while depressed may not be consistent with what we will want later. After all, just because a decision is better reasoned does not mean it the one we will desire later. Another side note is that depression could have benefits besides increased reasoning capacity: it could also provide valuable insight. This is not to say depression is good or positive; rather I am suggesting how it interacts with our normal decision making process is vast and complex. Someone may have realizations through depression that she could not have had were she "normal" [5].
[1] http://www.medicalnewstoday.com/articles/242676.php
[2] http://law.justia.com/cases/federal/appellate-courts/F2/720/266/425748/
[3] http://www.treatmentadvocacycenter.org/component/content/article/343
[4] http://www.livescience.com/14036-upside-depression-decision-making.html
[5] http://www.nytimes.com/2010/02/28/magazine/28depression-t.html?_r=1&pagewanted=all
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There's an entire theory on thought that postulates that all decisions are made by instinct alone and that rational thought doesn't kick in until after we make a decision.
To be fair, this was something Dogbert said this morning, and I have no idea whether or not it's real.
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On July 02 2012 04:08 Liquid`NonY wrote:
It is troublesome that a person can make the suggestion that a depressed person's ability to reason has diminished and that that can take away the depressed person's self-authority. Where are the measurements? Where are the arguments, supported by facts and evidence, about the level of ability and amount of effort that a decision requires? How can a line of thinking so thinly logical and so fucking irrational be used to take away someone else's logic and rationality?
Do anyone like being depressed? I don't think so, otherwise you wouldn't call it a depression. Yet depressed people continue to make decisions which reinforce said depression. If they hadn't the sadness would never have developed into a real depression. Are you depressed? Then you are making the wrong decisions in some areas of your life yet you yourself are adamant in your opinion that they are the correct decisions.
On July 02 2012 04:08 Liquid`NonY wrote:
I would like to know psychology's best attempts at measuring a person's ability to reason. When someone tells me my ability is compromised, I'd like to know who is going to make the decision instead of me. And then we can take some tests and see who is really better qualified, a compromised me or a regular them. I'd like to know how much effort they'll put into their decision. There's no way it'll match mine. I'd like to know their arguments why my subjective experience is not valuable enough evidence to weigh in on the decision. I can't imagine a definitive one.
Did you know that most of the decisions you make are already decided by you before you even start to reason? And the only point of reasoning then is to affirm your already chosen path? So most of your hard thinking just goes into cementing this belief, which could be good if the decision was correct, but could also be disastrous if the decision was the wrong one. Anyway, no matter if it was right or wrong the thing we know is that it will be hell to try to change your opinion on the matter and that your own view is so strongly reinforced that it is impossible for you to see if there is any wrong in it. This makes depressions a really tough nut to crack, since when you think about all your problems that much you create mental bastions immune to all but the most fervent approaches.
This is fairly blunt and a depressed person would just scoff at the nonsense I am spouting, I know I would during my years where I barely even talked to people, but I hope that at least a seed of it gets through. I got out of my depression by hurling myself at my mental walls. Sure some of them were solid and it did hurt a lot hitting them but not as much as I though it would. But many others were just imaginary walls that were stopping me from having a good life and getting rid of those was the best thing I have ever done. These professionals are probably trying to get you to do things that helps most depressed persons, doesn't mean that it can work on you. However the fact that you are sure that it wont work doesn't mean much really, since the way out is beyond a path you didn't think would work.
So at least you can try to listen to others from time to time even though their advice sounds completely outrageous and impossible. If they were wrong you are still depressed and have learned something about yourself but if they were right you just cleared a major hurdle on the way out of your depression. Another thing is that it isn't wrong to get happy over silly and small things. Every time you find a glimmer of happiness savor the moment as long as possible instead of scoffing it away.
Edit: Of course it is possible for these to dissolve over time but that doesn't always happen and is a very slow process so it is dumb sitting out waiting for it since then you could miss out on large parts of your life.
Edit edit: Or is this about them wanting you to try out some medical drugs? My post isn't about that, so it might not apply. I wouldn't advice you to take drugs but neither would I advice against it. Drugs can make it easier to clear roadblocks and thus aren't necessarily permanent but it could help to use them for a year or two and then go back. Drugs effect your mental abilities but it is mostly temporary, I used some drugs for a while and my mind was kinda foggy during that time but now it is back to my old normal sharp self.
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On July 03 2012 22:03 Zorkmid wrote:
There's an entire theory on thought that postulates that all decisions are made by instinct alone and that rational thought doesn't kick in until after we make a decision.
I would argue such a theory that such a theory only relates to those with either A) lower IQ(can't process the required information efficiently) or B) lack of self-control(succumbs to peer pressure, or any other variety of pressure related instances, so in turn they fall back on there instinctive nature which surpasses the logic/rational thought).
To be frank, the entire notion of actions based on "instincts" before rational thought implies that humans as a species has yet to even evolve past the basic animal on a logic based equivalent. I know, that before every decision I make, I rationally choose which is right. Now you could argue, that a mother would choose her child over the lives of a thousand other children, and perhaps you are right, but n that sense instincts > logic and rationalization, furthermore that circumstance is subjective and not an everyday life choice. If the argument by this "theory" is that the human, under immense pressure and strain, reacts in an instinctive way then I would personally agree that on average, most people would. But to continue, if it implies that the person always chooses the instinct before the rational/logical decision then I would simply say that is not the case.
On July 03 2012 15:23 DarkPlasmaBall wrote:
Replying to the first point critique:
I agree with you that there can definitely come a point where the level of instruction or advice that anyone gives a person can become too invasive or no longer helpful. Obviously, there are two scenarios here:
1. The patient is mentally capable of making his own decisions at the end of the day
2. The patient is not mentally capable of making his own decisions at the end of the day
And Nony (and others in the thread) have brought up good points about how it's quite hard to assess such things, and I'm quite fine with just focusing on situation #1 and not assuming a catch-22 of any sort.
And with such a case, I think it's in the patient's best interest (if he ever asks for help) to merely be made aware of all his options (something that a professional can help him do, as medical and psychological treatments can be alternatives to trying to live with the disorder), and then allow that patient to make the final choice after he's been made aware of all possible risks and rewards and every other factor and variable that could possibly be known. And again, there's almost no way that he could know everything without professional help. And keep in mind that the doctors can't force pills down his throat.
And just to be clear, I don't assume that there is one special drug that can cure depression at the cost of something else (e.g. mental capacity). Sometimes it comes down to figuring out the lesser of two (or more) evils. And this is actually something I can relate to... not because I have clinical depression, but because I have mild Tourette's syndrome and so I have a neurologist and have decided to take medicine to help control (not cure- unfortunately) my tics. The worst side-effect is the occasional slowing down of mental capacity, which makes me want to ditch the pills from time to time... but there aren't many alternative treatments that are as effective, and not using anything at all brings back more (and more severe) compulsions that distract from daily life anyway. And as an educator, intelligence is one of the things I value most highly above everything else, so it's an incredibly hard decision. There's no nice, neat answer. So based on circumstances, you weigh your options (after first learning about them from an expert), and make an informed decision. And then maybe you switch and try something else if Option A didn't work out as planned. Sometimes you just get dealt an imperfect deck of genetic or environmental cards, and you work with what you've got. It's certainly easier said than done, but that's what you've got to do.
So if Nony has to choose between depression and something he values more than his depression, that will be the difference between treatments. But he definitely has the final word on whether or not to take whatever pills he's prescribed or general advice he's offered. Sacrifices are probably going to be made either way; nearly everything comes with side-effects and possible risks. Hopefully he finds something that works well with fewest losses to his general well-being.
I have nothing more to add to this, I agree with the following points you've made--though they may be a bit vague--and I would agree sacrifices will be made.
The only tiny argument I would have, is when comparing Tourette's syndrome (which is inherently a more severe case which almost requires medical attention) to depression, no matter the severity, is a bit of a non-comparable claim, I would argue that TS actually requires treatment for the individual to function properly in society, because it is actually a inherited neuropsychiatric disorder whereas depression can be so many other things.
So the point at which I am trying to get across, is that if the lesser of two evils for you is lowering mental abilities to function properly in society (which I do not condone, because I would personally be fine with TS as it is in society, I feel it's a maturity issue within people that makes it so people shy away from it) I believe the lesser for Tyler would not be equivalent, and if ridding himself of depression requires drugging himself, and by doing so lowering his critical thinking abilities, then it most certainly isn't the lesser of two evils. Like I stated earlier, to someone with a lower intelligence, ignorance is more often bliss and they would prefer it, but when someone with a rather high intelligence (note Tyler) is forced to choose between ignorance and depression... He will almost certainly choose depression because to be ignorant for a smart person, is depressing in its own stature.
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Postponing important decisions in that situation actually has very little to do with one's abilty to reason.
Even with the best decision making skills in the fkin world, you will make mistakes if your capacity to assess a particular situation is compromised, it's not about your intellectual capacities but about your emotional instability/bias that'll distort your perception of things.
For the same reasons, doctors are not supposed to treat people they are close to because they are too emotionally involved, it doesn't mean that they suddenly become terrible at their jobs, just that a warped perception makes things a lot tougher when an important decision has to be made.
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On July 03 2012 16:28 BuuurN wrote:
I know I'm not contributing anything to this thread but I just wanted to say that I love Nony and reading his posts.
that is all
Tyler is just an amazing guy.
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On July 03 2012 23:28 Recognizable wrote:Show nested quote +On July 03 2012 16:28 BuuurN wrote:
I know I'm not contributing anything to this thread but I just wanted to say that I love Nony and reading his posts.
that is all Tyler is just an amazing guy.
It's always the best of people who have depression, why! : D
offtopic:
Really mature response in the SOTG thread, and really well done during the episode, not getting involved in the "bantering" and making fun of Avilo.
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I may be misunderstanding the situation/circumstances, but it seems like you've gone a doctor/therapist to help you with a certain problem (depression) for a while now, and reached a point where he/she is saying you should not be making a decision about X at this point because your "ability to reason" is at a reduced state. Is it not up to you to decide whether you take this advice and/or continue seeing this doctor/psychiatrist or not? As in, if you don't like the direction this treatment is headed, you have the option of leaving this treatment and seeking help somewhere else. And if you trust this doctor, or trusted them up to this point, then you should probably continue trusting them even if they are giving you advice you don't particularly like right now.
Again, I may not be understanding the situation correctly, however.
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I believe people are told to postpone major decisions while depressed not because their ability to reason (logically) is necessarily impaired, but more because your brain is functioning different than normal, and it's believed that you will be happier long term with a decision made when you are in a normal state of mind.
Now, if you are suffering from long term depression and have been depressed for a long time, it might not apply - after all, being depressed might be because you need to make some changes in your life, and postponing it doesn't work ... so yeah, giving advice based on this is impossible obviously ...
But consider it akin to making a major life decision when you are drunk or on drugs ... your brain doesn't function normally, and so it might be a smart thing to just postpone the decision until you've returned to your normal state of mind.
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wow so many internet psychologists have come out of the woodwork for this blog..who knew TL had so many experts on the matter.
Great post Nony well written..I'm sure between you and your wife/family you will always be able to figure whats best. GL
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To Tyler, I sincerely hope that whatever you do, you do at least attempt to go along with a psychiatrist's treatment plan, as they do tend to know what they are doing having been to medical school and residency and had years of treating patients behind their belt. Please don't become a case study in the Dunning-Kruger effect.
As for depression, I have personal experience with clinical depression, and I can in fact say that healthy me far out-thinks and makes better decisions than depressed me. Yes, it obviously varies from person to person but the treatment and psychiatrist helped immensely. If you have a (seemingly) disrespectful psychiatrist there are plenty more out there, and what you are portraying as a person telling you to not make decisions I suspect is actually a person who is attempting to get you to delay any major life decisions while the chemical imbalance in your brain that is depression is still holding strong.
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On July 04 2012 01:27 Irre wrote:
wow so many internet psychologists have come out of the woodwork for this blog..who knew TL had so many experts on the matter.
Great post Nony well written..I'm sure between you and your wife/family you will always be able to figure whats best. GL
Everyone is an expert on their own experience. I personally love hearing people share their honest experiences. If you don't, that's fine, but I don't think anyone benefits from snide remarks 
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A person's faculty for reason is commensurate with their determination to 3 Gate Expand over FFE.
'Reasonable' behavior is relative to the context of the society that you exist in. It can be determined by cross-referencing the century you live in with your present longitude/latitude. No behavior is reasonable in the absolute sense. A psychiatrist's primary task is to get people to fall in line with the reasonable behavior of their society. If you announce that you plan to make a decision that runs counter to society's standards, your mental fitness may be called into question.
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For those who are interested in a treatment for depression that focuses solely on an individual’s reasoning check out Rational emotive therapy(RET). The main premise of RET is that whenever we become upset, it's not the events that upset us its our irrational beliefs about that event that upset us. By being able to acknowledge these irrational beliefs the professional can help the client deconstruct their current irrational thought process and replace with a new thought process based of thinking rationally.
I'm a human services student which involves a lot of therapy and counseling classes and this has been the most unique therapeutic approach I have encounter, its completely different from all of the other types of therapies because its based on a scientific model unlike many others where its merely left to the subjective opinion of the professional. This also differs from others because of the therapeutic relationship, in most types of therapy its important for the therapist to come off as supportive and to allow the client to direct where the therapy leads, but with RET it’s the opposite the professional directs where the therapy leads and is very confrontational with the client and directly challenges any irrational beliefs and insists on the clients using their critical thinking skills. Personally I think this type of therapy is perfect for those who believe they think rationally because they will be challenged by the professional.
Heres some more basic information if your interested http://www.rebtnetwork.org/whatis.html
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On July 03 2012 22:40 NeMeSiS3 wrote:
To be frank, the entire notion of actions based on "instincts" before rational thought implies that humans as a species has yet to even evolve past the basic animal on a logic based equivalent. I know, that before every decision I make, I rationally choose which is right. Now you could argue, that a mother would choose her child over the lives of a thousand other children, and perhaps you are right, but n that sense instincts > logic and rationalization, furthermore that circumstance is subjective and not an everyday life choice. If the argument by this "theory" is that the human, under immense pressure and strain, reacts in an instinctive way then I would personally agree that on average, most people would. But to continue, if it implies that the person always chooses the instinct before the rational/logical decision then I would simply say that is not the case.
I would recommend the book Blink, by Malcolm Gladwell, for an exploration of split-second "instinct" decisions. While we often think that we are making some thought-out, rational decisions as you describe, it is quite often not the case. "Instincts" are a bit more complex than they seem, though, and can in fact be more accurate in some cases than longer, rational, thought-out decisions/judgments. I can't really explain the whole book in a TL post, so I just recommend that you check it out if you are interested. It's some pretty cool stuff, and will change the way you think about decision making.
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I will mention Dunning-Kruger as well. As a victim of my own depression (I went to the very last step but failed, thank god), it is hard to conceptualize arguments against what you are feeling, mostly because you "feel" rather than "think" you are right, and if you've ever been in a relationship, you will know no emotion exists that has ever listened to reason.
This can best be described as being stuck in a dream and "feeling" that the way to go in a forest is west. The answer isn't west, nor is it any of the other 3 directions. The problem here is that it doesn't matter; the dream exists in a hypothetical realm that answers, once concluded and despite being correct, have no relevance to the superset reality. It's similar to being in a deep depressed state, except that making that decision has real-life consequences. That is why you really must be mature about it and take the advice of people removed from your dream to make decisions for you.
In the end, some people die, and some live, but over the years you realize that the outcome really is down to something akin to fate. If no reason can change a person's mind, and that person's personality is predisposed to or has an affinity for endless rationalizations for poor choices, then it seems as if they were destined for the "choice" they chose, like a monkey choosing a banana over a piece of string.
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I believe it is generally accepted in modern biomedical ethics that paternalistic actions are only justified when the patient's autonomy is significantly compromised. The fact that a patient's ability to reason is simply "diminished" is not an acceptable justification to override their autonomy - like you said, decision-making capacity can be altered to varying extents by myriad variables. So, in order to take away a depressed patient's ability to make autonomous decisions regarding his own treatment, the patient must exhibit a severe impairment that clearly indicates they are unable to make decisions for their own well-being. So, it seems to me that any medical professional that tried to override your decision-making is clearly in the wrong here.
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Nice and interesting with your perspective on this, psychology and philosophy are the two most interesting fields!
I would like to add a few things though.
It definitely feels outrageous when you look at what kind of deprivation of "rights" and/or status we allow ourselves to perform, in the name of psychiatry, and depression is no exception.
Perhaps luckily, depression is much more accepted these days then just a few years ago and it definitely has something to do with how we generally relate to it as something everyone goes through, albeit in very different shapes and sizes, and in most peoples case, not pathological at all.
I see you call for a valid argument about peoples ability to "reason" while in such a state. But the definition of our ability to reason is still made on a case-by-case basis even today. It is impossibly hard to say what our reasoning really is, and we might speculate whether the answers we come up with for that question, will ever stop sounding like they are pulling themselves up by the bootstraps ever so slightly. After all, we are left to dry by modern philosophy on this matter, it seems for now we have to admit that there is no answer in classical philosophy that has the sort of incisive pin-pointing effect we want but (you spoke in such terms that i assume you have epistemology/knowledge study of some kind behind you, excuse me if i get too obscure) Hegels coherence, contextualism, and comprehensiveness seems to be the closest we can come recognizing objective truth, if we want it to have any kind of specifics but quite obviously that is still not objective in the sense you want. you can go more specific, and it will seem more and more subjective or you can go broader and it will seem vague and over-simplified, e.g. "i clearly and distinctly percieve it to be true"
I get the feeling the kind of reason you are talking about is a mix between Marilyn Vos Savant, and like... an Airforce pilot or something  (i am kidding of course but you get what i mean) and while the kind of intelligence we want and see in them, are definitely nice and neat and packaged, it's not proof enough for you and i, that someone is smart or even "reasonable", for us to give them full control of our lives.
Almost only when we feel we are completely lost (in mental or physical serious disease) do we trust in these people completely, and then it seems to be for lack of a better option.
the DSM is the most obvious example.(tyler will know this im sure, but for others the DSM is basically the compendium of all the mental pathologies recognized by contemporay psychiatry) Every psychotherapist or psychiatrist ive ever talked to, or heard give an opinion on the matter, recognizes it to be completely and utterly terrible, and describe it ONLY a neccesary evil, not at all something "we"(it spans in use over many countries) can be proud of.
I wan't to end on some personal opinon, before i write too much wall!
to me, it seems that we do at least want some kind of power of right-deprevation in psychiatry, at least for now general consensus seems to be that with many symptoms of mental disorder people should not retain the right to choose what to do with their body etc. But it gets interesting when we come to voting and and that kind of external decision making.
this is actually something ive discussed alot with friends in the field, and it is almost paradoxical where we land. It should be possible, i think, to say: "you are a danger to yourself, im going to restrain you and treat you", but it should NOT be possible to take from people their right to vote, or any other right we percieve as a nation to be, intrinsic to being a person and a part of a country, democratically speaking you are back to the non-mental illness reasoning-ability point if someone is on the border, has some very border-case downs syndrome for example it seems to me we can expect of eachother to say, this person needs these kinds of help (and this can include taking control over said persons body) but we cannot take away from them the right to be persons and participate in a democracy (ideologically speaking of course, since it's doubtful whether this kind of a utopian democracy exists anywhere today) because, if we do say "IQs lower then 130 should not be able to vote" it will end up being up to the higher IQ population to slowly raise and raise the bar... if you can see where im going, this is with respect to the apparent consensus across countries and rights-organizations to deal in philosophies only real human numerical value, "persons". If it is a person, it has the rights we attribute to a person, if we start dividing "persons" into qualitative subcategories we end in the kind of parts of history we would rather forget.
sorry for the wall
boris
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I think you’re too concerned with the exception to this generality rather than the wisdom of the statement itself that major decisions should not be made while suffering from depression. Of course it is true, as you point out, that a depressed person is can still make rational decisions. As is the case with any generality, there are always exceptions. No one would question the wisdom of the statement “seatbelts save lives” but it is also true that in some instances wearing a seatbelt can actually result in death when in a collision. The fact that an exception exists does not make the original statement incorrect.
The point is that depression literally alters your brain chemistry in a way which can result in irrational thinking (and in a way which is obviously more serious than caffeine, lack of rest, and nutrition) and thus you may be making decisions which would not be the same after your brain chemistry is back to normal. So because you literally may run into a scenario where when choosing A or B one week you would choose A and the next you would choose B, and this variation can be explained by a temporary medical condition, then of course it is logical to wait until the medical condition stops to be a factor. So I think you are just flat out wrong when you say that the statement is “very vague in its reasoning”.
Good luck with your decision.
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EPT
