> about something that isn't really in the present
Or is it? Therapy, especially gestalt or existential, often makes people realise that something really is off with their outlook on life, relationships with other people or other things like this — something that they had paid no attention to and perceived as "normal", that really wasn't. And in the end, what started as their fight against depression ended up as work to fix the core reason for which that depression was only a symptom.
I know this to be the case with myself and some close friends of mine. I'm not a health professional, and this is anecdotal evidence, but from talking to other people and therapists, I hear about this quite often.
PTSD among combat vets, for example, can have a person chronically frightful while they live in a safe environment actively preventing them from properly apprehending their current environment. Most people who want to rid themselves of their mental illnesses aren't experiencing it as a signal that their outlook is wrong, their mental illness is actively hampering their ability to properly engage and function in their life.
And for illnesses with a stressor: sometimes a person is not empowered to resolve it.
You shouldn't have too much faith in your own biology, it is far from perfect.
Not the OP, but I'm in therapy personally, and just as a personal example, didn't realize that some current reactions and feelings were colored by past experiences. In particular, this has to do with patterns I hadn't noticed across different relationships and work. Like my pathological independence and general lack of trust in humanity.
Often the "answers" to why one is depressed can be hidden under many layers. It can be from a psychological source, a physiological/neurological source (an injury, etc), or a physiological source BROUGHT ON BY a psychological source, that may or may not continue to exist.
The last part is in my experience the thing people are missing that creates a lot of arguments, especially around medication. I have gone through lots of trauma growing up, and I only recently learned of the role of the interplay between the physical and the mental. I had always eschewed medication - and I still think it to be /mostly/ a first-aid treatment. There's nothing to say that someone has a long-term physiological imbalance, or one that we don't know how to treat. Therefore its valid if someone needs to be on a medication for the long term. The saying goes amongst people I know - "If you can't make your own neurochemicals, store bought is fine.".
For me, medication allowed the relative calm in order to directly tackle and address childhood trauma and patterns of thinking that ultimately result in acute depression and anxiety. Unawareness of those triggers or ways to deal with them leads that acute depression/anxiety to become chronic over time, where no trigger is necessary.
CBT (cognative behavioral therapy) is a very good way to identify patterns of thoughts or thinking that doesn't make sense, or create a reaction that is far outside of the range that a person would expect. You end up having this moments of unclear thoughts when digging into past events, or things that upset you, or thoughts about yourself. I have learned to relish those - that means I'm learning something or making a connection that I didn't have before.
Finally, approaching entirely from the psychological side does not always give results. Having gone through lots and lots of cognative behavioral therapy, I'm fully aware when I'm being irrational or have a stronger than expected emotional reaction to things. I even apologize while I'm doing it! But it wasn't until I dug into a different type of therapy, EMDR, that started to approach from the physical side of things. I started to learn to notice things that were making my hands ball up in anger, even though I didn't notice them before. I learned that I dissociate sometimes and don't form memories of when I'm upset, which severely hampers my ability to address the things. All of this to say, its complex. It all has underlying rational reasons behind it, and seeking out information and building your own mental model of, well, your mental model, is a very helpful way to go about it, though it takes a long time.
So try medication, try therapy, try different types of therapy. Its extremely difficult. Its sort of like performing surgery on yourself. But there is always another path and more things to learn about yourself.
For some people, these diseases (depression, anxiety, ADHD, bipolar, schizophrenia, OCD, intermittent explosive disorder, etc.) are lifelong maladies present from birth; where even if the disease only “showed up” later on, it is known from the person’s genetics/neuroanatomy/etc. that it was inevitable for this person to get them, eventually, regardless of environment or lifestyle.
Such cases are no more adaptive than Cystic Fibrosis is adaptive. They’re malfunctions.
I would hesitate before calling these conditions "lifelong maladies present from birth". It's much more accurate to call them predispositions that may or may not manifest. And even so, the degree of manifestation may depend on the degree of trauma, addiction, or other challenges the person happens to face in life. This variation is what makes me doubt any clean division into adaptive/maladaptive cases. Not everyone so predisposed is triggered into these mental reactions through their life experiences, and not everyone who is so diagnosed is a lost cause, and furthermore, those who can manage their conditions may take offence at being called "malfunctioning" when they did in fact "adapt".
> those who can manage their conditions may take offence at being called "malfunctioning" when they did in fact "adapt".
People don't malfunction; bodies do. People are (cybernetic) systems, composed of a mind and a body; but people's bodies specifically, when taken on their own—including their brains, when taken on their own as organs!—are just complex machines, that can have organic diseases. (In the case of the brain, we call these https://en.wikipedia.org/wiki/Organic_brain_syndrome s.)
If your computer spontaneously powers off whenever you open hit your keyboard's "A" key, that's a malfunction. Computers, as machines, aren't supposed to do that. If you avoid ever hitting the "A" key, you might have worked around the problem, but the problem itself is still present—the computer, considered as a standalone machine rather than a cybernetic operator-machine system, is still malfunctioning.
If you have an SNP in the gene DDC, causing https://en.wikipedia.org/wiki/Aromatic_L-amino_acid_decarbox..., that is a malfunction (or manufacturing defect) in your brain-as-machine. You — the mind-body system — might learn to adapt to/work around this malfunction; but that doesn't mean the brain-as-machine isn't continuing to malfunction. A working system can be constructed from unreliable components.
> who is so diagnosed is a lost cause
Who said anything about being a lost cause? For something to be maladaptive, it simply has to reduce inclusive genetic fitness, such that people with the condition reproduce less than people without the condition. That says nothing about whether you can live your life with the condition.
Whatever part of the human brain thinks getting a vasectomy is a good idea, is extremely maladaptive! But that's not to say that we don't prefer things that way. :)
Or is it? Therapy, especially gestalt or existential, often makes people realise that something really is off with their outlook on life, relationships with other people or other things like this — something that they had paid no attention to and perceived as "normal", that really wasn't. And in the end, what started as their fight against depression ended up as work to fix the core reason for which that depression was only a symptom.
I know this to be the case with myself and some close friends of mine. I'm not a health professional, and this is anecdotal evidence, but from talking to other people and therapists, I hear about this quite often.