Tuesday, September 16, 2014

Prejudice vs. Discrimination

Yes, it's time for a long-overdue post. I know I mentioned that I was going to cover this topic on at least two psychology posts and on another of my blogs, so here it finally is.

This is not mere semantics. This is not nitpicking about the way terms are used. This is informing readers about the real difference between prejudice and discrimination. This is also to inform readers that it is possible to have one without the other.

Prejudice: an attitude held about an individual and/or group of individuals based on perceived characteristics believed to be shared by the group. Prejudice is an attitude. I've already written about the different components of attitudes here. Remember, attitudes 1) are learned; 2) have three components (emotion, behavior, thoughts); and 3) are poor predictors of behavior. Notice, also, that a prejudice is simply an attitude. Although even college textbooks will throw in the words "primarily negative" before "attitude" in their definition, the truth of the matter is that prejudices can be positive as often as they can be negative. What makes a prejudice unique as opposed to other attitudes? Honestly, not a whole lot, except they do seem to be applied primarily toward perceived characteristics of other people, and not so much toward objects, though sometimes a prejudice may be formed about certain ways of thinking (like political ideologies). When we assume that people like us are favorable, we display a positive prejudice. When we decide we don't care for someone because they are "one of those people," then we display a negative prejudice. Prejudices are heavily influenced by stereotypes, which are in turn influenced by all the other circumstances--direct exposure, learning, second-hand hearsay, media, etc.--that lead to other attitudes. A prejudice can be changed, for good or ill, from positive to negative and vice versa.

Discrimination: differential treatment of individuals. Discrimination is an act. We are talking about overt behaviors (see a previous post of mine on what is considered a behavior). Notice again that there is not any sort of emotional attachment to the definition, although many text books include terms such as "negative" or "harmful" in their use of the term. On the surface, discrimination happens all the time. When you choose chicken over fish, you discriminate between the dishes, putting them into different categories and then making a decision based on the qualities of the categories and what you desire at the time. The same occurs, without violating civil rights laws, in employment when a company sorts candidates into "piles" based on their education, experiences, and skills and then select candidates who they feel fit the requirements of the job. Problems arise when discrimination, or differentiation, of individuals occurs based on stereotyped beliefs that have very little to do with necessity. Judging a person's honesty (this is a prejudice, by the way) based only on superficial things like their skin color or age and then treating them differently from others not in this perceived group (this is a discrimination) because of this judgment, is when things go wrong and fairness gets thrown out the window. It is possible to show "positive" discrimination. This is usually called favoritism, nepotism, or even reverse discrimination. It's still a form of differential treatment.

Can you be prejudiced without discriminating? Absolutely! Many people hold positive and/or negative attitudes about certain classifications of individuals and still choose to treat everyone as fairly as possible, to not let their preconceived ideas influence their choices. Unfortunately, our society has moved to a point that we want to control the thoughts and opinions of others. We now have a collective negative prejudice toward individuals who have prejudices. We stereotype anyone who uses a stereotype, even if said classification is honest or accurate. We assume that anyone who believes in a positive or negative stereotype is automatically going to unfairly mistreat others based on those thoughts. That's unfair treatment and stereotyping in itself.

Can you discriminate without having a prejudice? Sure thing! In fact, this is what is expected of us all the time. If you didn't discriminate, then you would date anyone who came along or hired any person who applied to the job even if they weren't qualified, or eat any food that was presented to you, or watch any movie that played at a theater. We differentiate between people and things all the time and it's not always tied to a stereotype-driven attitude about them. The intent and the thought process used are the key factors in determining unlawful or harmful discrimination or not. We also look for larger patterns to determine if a harmful discrimination occurred. Two is a coincidence, three is a pattern, four or more is a potential conspiracy.

It is okay to hold beliefs, positive or negative. That is your right, especially in countries like the United States that value individual freedoms. It is your actions and your intent with those actions that are subject to judgment to maintain as a fair a society as we can achieve.

Tuesday, September 9, 2014

Just How Many People Are Actually Depressed?

Unfortunately, this is another topic that everyone thinks they know and most people don't care about unless it affects them personally or it comes to media attention, such as with the relatively recent death of Robin Williams. Honestly, I become rather irritated when someone who is feeling "blue" claims that they are depressed or when someone else accuses a person of having depression, as if it is an excuse for certain behaviors (or lack of behaviors) and then proceeds to "cheer them up" with quick fixes like alcohol or sex. True depression is not easily fixed in a few hours or even overnight. True depression is not an excuse or an emotion. It is a complex mood disorder that is still being studied because, honestly, very few people are ever truly "cured" in any permanent way. Psychology and psychiatry are working on it. We've got a long way to go. Let's shed some light on the reality of the disorder.

Mood disorder: a category of psychological disorders affecting an individual's mood or affect. As I mentioned in an earlier post, an emotion such as sadness is a quick, short, instantaneous physiological and cognitive response to a stimulus. Once the emotion subsides, we are left with a milder mood that lasts for hours or as long as days. Mood disorders are classified when an individual's mood appears to be abnormal to their customary behavior or personality pattern or abnormal (i.e. unexpected) to a particular stimulus, outside of the society's expected norms of behavior. Someone laughing hysterically at a tragedy and staying in a positive (NOTE: not optimistic) mood in the aftermath would certainly raise some eyebrows. In order to determine if an individual suffers from a mood disorder, the abnormal behavior has to persist for a significant amount of time. This is to rule out other possible explanations. I am going to focus only on the depressive disorders for this week's post. Mania, cyclothymia, and bipolar disorder are a different side of the coin. The other thing to keep in mind with most mood disorders is that even without treatment, an individual may experience periods of the disorder between periods of normalcy. A depressed individual isn’t necessarily always suffering from depression all day, every day. They may experience joy between episodes. Treatment helps to increase the length of those “normal” moments and reduce the abnormal periods.

Dysthymia: a mild depressive mood disorder, usually caused by a stimulus outside the individual (loss of job, breakup, etc.), that lasts at least 2 years or more before diagnosis. Many cases of dysthymia go longer than 2 years before diagnosis occurs. Part of the idea is that this mild mood disruption will work itself out in most people; you're supposed to "get over" whatever the cause is long before the 2-year mark. Symptoms are also not as severe as other depressive disorders. People with dysthymia usually maintain their regular routines and social patterns, but with less vigor than before. They may feel like life is sometimes a big effort, but they haven't lost all their motivation to continue day-to-day activities. People who know them might take a while to grasp that something more serious is afoot, trying to be understanding until they lose patience with the sufferer. Cognitive therapy is often the most successful with this type of depression, as there is an actual root cause that can be dealt with.

Major depression (also known as clinical depression): severe depressive mood disorder that comes on suddenly, has no apparent outside stimulus, and lasts at least 6 months. This is the type of depression that presents the most danger to the individual and is the most difficult to treat with a blanket treatment. Symptoms are much more severe than with dysthymia, thus the shorter time frame for diagnostics. Many people suffering from clinical depression find it difficult to do much. They may lack the motivation to get out of bed, go to work or school, interact with friends or family, eat or drink, or take pleasure in their usual enjoyments.
A subset of major depression known as endogenous depression appears to have no single catalyst to its onset. It is believed by many therapists to be caused by some form of chemical imbalance in the brain. The primary suspects are serotonin, dopamine, and norepinephrine. It is believed that severe depression, another label for this mood disorder, is caused by an imbalance in one or more of these chemicals. Unfortunately, there is no test that I know of to determine an individual's neurotransmitter levels, so many physicians must experiment with various antidepressant mixes until the right one is found for each individual patient.
The worst cases of major depression occur when patients do not respond to any medication or alternative treatment. Psychotherapy may help, but not without a lot of work on the part of the patient and support (NOT coddling!) from the patient's social support network. Time is also a key factor in successful treatment. The ugly truth is, however, that even if a person is cured of their severe depression, they have a high risk of succumbing to the disorder once again. This is also the type of depressive disorder most associated with suicide. With no external cause and treatments that can be frustrating in their duration, many patients simply give up, looking for an escape from their problem. Sometimes a patient who appears to be on the mend may turn to suicide because the treatment has helped them regain just enough energy and motivation to end their life but not enough yet to keep fighting for it.

Postpartum depression: depressive disorder affecting some women after giving birth. A milder form of this is commonly known as "baby blues" and it may affect as many as two-thirds of women. Baby blues typically involves mild feelings of anxiety, despair, and depression in the first few weeks following childbirth. This does not necessarily involve bouts of uncontrollable mood swings, as shown in the movie Look Who's Talking. Many physicians believe that the hormonal turmoil resulting from pregnancy and delivery put extra emotional strain on the mother. Baby blues usually works itself out before the child's second month, sooner with proper medical treatment and support from friends and family.
For something like 15% of women giving birth, a more serious postpartum depression takes place. This severe depression has similar symptoms to major or clinical depression, but it coincides directly with childbirth. Mothers not only lack motivation to continue their regular routines, they also do not have any desire to care for their children. This can be especially detrimental to the infant, as the first few months are the most critical for bonding. Postpartum depression may last months following childbirth. The sooner the mother receives treatment, the healthier both herself and her baby will be. Again, familiar or other social support is critical for successful treatment.

Seasonal affective disorder: otherwise known as winter depression, a depressive disorder that affects individuals primarily during seasonal periods of lower sunlight, such as autumn and winter. Symptoms include: oversleeping and difficulty staying awake, fatigue, cravings, an inability to cope with day-to-day activities or unexpected experiences, and social withdrawal. The primary cause of SAD (yes, I’m aware of the irony of the acronym) seems to be a sensitivity to levels of sunlight. Individuals suffering from SAD will experience these symptoms during months of longer nights and shorter days. Once the days grow longer, the symptoms recede. Not surprisingly, a larger prevalence is found the further north of the equator one travels. The main mode of treatment is known as phototherapy, in which an individual is exposed to extra hours of sun-like light during the shorter days. I suppose a month-long vacation in the tropics would help too, but I don’t anticipate many insurance policies covering such treatment.

Overall, mood disorders are very serious, but too often misunderstood. We take it for granted that anyone can just flip a switch and get out of their funk. While it may be easy for one person to overcome a personal set-back or tragedy, others are wired such that they need more assistance to “bounce back.” Understanding, but not making excuses, and emotional support are the best things one can do for someone suffering a depressive disorder. Getting to psychotherapy as quickly as possible is also extremely important, even more than finding a magic pill to pop, as psychotherapy has been proven to as effective as, if not more so than, medication, especially when the two methods are combined.