What cuases it? And why is there a certain demographic that suffers from it? (to be general, it is mainly in the middle class demographic)
If we do not know what causes some types/forms severe depression, does it detract from the legitimacy of the disorder?
In my case, my depression was caused by despair and despondency, after battling the effects of undiagnosed narcolepsy for nearly a decade, and losing the battle rather handily, not knowing or understanding why every facet of my life was falling apart at the seems, seemingly beyond my control despite a heroic but futile effort to 'fix' what was wrong, with the [un]help of a lot of well-intentioned but completely WRONG advice, the lone exception being one person who recognized the classic symptoms of narcolepsy only because her brother had it, and suggested to me that I see a sleep disorder specialist. Sure nuff, she was correct.
I have likely been suffering from symptoms of narcolepsy since I was 17 or 18 years old, a typical age of onset. It certainly explains much; bouncing my head off the desk at school frequently; waking up in the opposite direction of traffic; suffering from horrible work performance, can't exactly do a good job when you're freaking asleep on your feet; difficulty waking in the morning; falling asleep on friends, family, and significant others at inappropriate times; waking up in the supermarket slumped over the canned goods or propped against a display rack in the same position I had been reaching for some item, a store clerk inquiring whether I was alright, getting to the checkout and not recognizing a single thing I put in my cart as items I preferred or liked; waking up with a spiffy keyboard impression across my face after falling asleep at the computer, or bouncing my head off the screen and slumping out of my chair onto the floor; and the hallucinations...oh those wonderful hallucinations.
Most of that wrong advice being that I needed to make lifestyle changes in order to get myself on a 'regular sleep schedule', or to 'stop partying so much' though I hadn't done any of that in years. Not a lot of partying to be had when just making it home from work without killing myself or anyone else required a measure of sheer will most people will never expend in a month. When sheer will didn't cut it, pain was a quick though temporary fix. I was a smoker so I always had a lighter handy.
My favorite 'advice' was the 'pull yourself up by the bootstraps' type, I just 'lacked discipline', or alternatively, I was lazy. If these 'bootstrap' advocates had to endure for one day what I lived for years, most of them would have thrown in the towel and blown their f-cking brains out. Bootstraps my ass.
So having tried every permutation of possible methods to heal myself, each several times just in case I hadn't given it a good go the last five tries, all proving futile and some only making things worse, I had essentially given up. I didn't know what else to do, so I did nothing, I just waited for the roof to cave in on me or something. I remember passing someone I hadn't seen in a few years, and when they inquired "Hey, what have you been doing with yourself?" my response was a quip "Waiting for death" and continued on my way.
Of course, there was one thing I hadn't tried, and that was asking for help, which was a big no-no.
Why was asking for help not an acceptable option? Because narcolepsy is a disorder, like many others, whose symptoms manifest BEHAVIORALLY. These behavioral symptoms are often, in our society, according to the 'conventional widsom' among a vastly uninformed and ignorant population who attempt to explain things they don't understand, viewed to be the signs of a character flaw or some other personality, discipline, maturity, or emotional failing.
But who am I to judge, I was the one suffering and still believed this. It was 'my fault', this was all somehow my own doing, and if I could just 'get my life together', my 'priorities straight', [insert other favorite 'bootstrap' cliche here], et. al. Other people can work 50 hours per week, take classes part time, find time to socialize, sleep 5 hours per night, and they don't fall asleep at the drive-through speaker, or in the shower, while eating, or taking the DMV test to renew their driver's license. If you can't do that, too, you're probably just lazier or not as ambitious as they. R-R-RIGHT!
For more than 70 years, narcolepsy almost exclusively fell within the scope of PSYCHIATRY because, well because that's where you're sent when 'regular' doctors can't find anything medically wrong with you. Narcolepsy was granted a reprieve from the stigma of psychiatry by a dog, who was observed to have symptoms remarkably similar to human narcolepsy. Dogs don't feign illness for attention, or because they're maladjusted, or lazy, or because they lack character, as it is supposed that humans do.
So when you have a highly observable animal model which mirror characteristics of human maladies, it must cause any thinking person to consider that this may not be purely psychological or mental. It just so happens there are depression models in animals and they are readily observable.
I shutter when I think of all the schizophrenics who were certainly committed to prisons, insane asylums, and mental institutions, when those places were only nominally different than hell, before it was learned that the brain isn't filled with some Magic 'Divine' Spirit and that the heart's sole function is pumping blood, not harboring compassion or 'feelings'.
That 'repository' would be the brain, which is made of billions of neurons. Those neurons and the dozens of known neurotransmitters (probably a fraction of what actually exist) are responsible for everything; memory, judgement, cognitive abilities, reasoning capacity, concentration, mood, personality traits, sleep tolerance, wakefulness, alertness, and all states of mind such as happiness, motivation, ambition, perception, everything. We exert influence over those things only to the extent that the infrastructure permits itself to be influenced.