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 I am quite intrigued by our discussion of whether low energy and motivation, which we commonly view as hallmark symptoms of depression, could in fact be the causative agents of depression (at least in our productivity driven culture). I'd like to know whether in careers or micro-cultures that are high powered and competitive, is the etiology of depression the same or different as it is in less stressful situations? Does low motivation and energy experienced in an environment where high energy and drive is the norm contribute more to depression than low motivation in other situations? Furthermore, if depression is in fact more common amongst people in these competitive micro-cultures, is it because these cultures are more likely to contribute to the onset of depression, or is it that these cultures simply attract people who are more prone to depression? Perhaps the reason why so many doctors and CEOs are depressed is that depressed individuals have intrinsically more motivation and drive for success, but then a higher proclivity towards depression when they experience minor set-backs or dips in motivation. 

In terms of labeling depression as an illness or a mood "difference," I am conflicted. Perhaps the categorization of people as depressed leads them to feel isolated and alone; but could it also influence them to seek treatment? Although depression may in fact be productive in some cases, I think its important to recognize that this productivity comes with a price of patient discomfort and unhappiness. Where do we draw the line? I wonder if labeling depression as a "mood difference" will make it harder for those patients who want help to receive it, especially as insurance companies are looking to cut costs in any way they can.