If you’re in treatment for depression and have ever mentioned a desire to die, you’ve probably heard these questions: How would you commit suicide? Have you make a plan to commit suicide? And others. So a commenter recently mentioned that this is just a way of “covering their backs,” and “. . . if I were serious about killing myself and had made a plan, why on earth would I tell them?” This is a logical question, but an uninformed one. In studies, we know that people who attempt suicide do reach out for help and do not really want to die.

In my last article on the biological evidence for depression I discussed evidence in genes, hormones, monoamines (like serotonin) and neuroimaging. Today I’ll finish off the research areas for the biological evidence of depression and suggest what I think all this biological evidence means.

Common messages spread by certain special interest groups are that “mental illness doesn’t exist” and “there is no biological evidence for mental illness.” It’s not surprising I take great exception with these claims. So do most doctors. But the brain is an extremely complex organ and refuting the above notions is hard. It’s not a two-word response. So, I’m going to attempt to give a two-part overview, in plain English, of some of the research around the biology of major depressive disorder according to a meta-analysis done in 2010 (see below).

The area of diet and mental illness is a contentious one. I suspect that’s for several reasons: 1. Many alternative practitioners make their living telling people what to eat and they want to believe this will help. 2. Individuals want to believe the treatment is simple, drug-free and something they can control. 3. The placebo effect leads to dramatic anecdotes. Here's what we know about diet and bipolar disorder.

It's tempting to think that because we read a list of symptoms for a mental illness, we can diagnose ourselves. We might think that taking a self-test online indicates the presence of an illness, or lack thereof. These things, however, are simply not the case.

Some people believe that being crazy makes you creative (perhaps brilliant) and being creative makes you crazy. Similarly, along this line of logic is that taking medication makes you uncreative and perhaps, un-brilliant. Well, pish-tosh I say.

I know this seems like an odd question, but I was considering it this morning (in my shower). It is a common problem for people with a mental illness. I have a tendency to avoid showering (really) and I know of others with a mental illness have gone weeks without showering. So, if all we’re talking about is standing in some warm water, why don’t we want to shower?

People throw around the word “depression” as if that word means only one thing. This is far from the case, therapeutically speaking. I would suggest there are mild, moderate or severe, relapsing/remitting or chronic depressions. Doing the basic math, that’s six types right there and we haven’t even taken into account treatment-resistant depression, or the depression subtypes noted in the DSM. Depression is not a disease; it’s a cluster of diseases.

I’m not known for my cheery everything’s-going-to-be-OK-puppies-rainbows-lollipops perspective. In fact, I’m against such perspectives. I find them disingenuous, phony, or seriously ill-informed. Save the rose-colored glasses for Sir Elton John, thank-you. I find smiling, being positive and telling people how great everything is to be just another chore on my list of things to do today when I’m already busy just trying to keep breathing and possibly pay rent.

Women are classic “I’m sorry” – ers. We’re taught to say “I’m sorry” from the time we can utter the words. We are the peacekeepers, claiming fault so no one else has to. We have to apologize for emotions because we’re “overemotional.” We have to apologize for our needs because we’re “clingy.” We’re sorry for our behavior, our significant other’s behavior and our children’s behavior. We are simply, sorry. And most women in 2011 realize this habit is one borne of the past and is no longer relevant in our everyday world. We realize we are not “sorry” at the drop of a hat or a glass of wine spilled by a drunken significant other. We realize there is a time to be sorry and there are times not to be. Unfortunately for me, I feel like I have to be sorry all the time, for every tear, for every thought, because if I’m not, people will leave.