How To Cope With Depression...
There
are, on the surface, some notable similarities between those who are sad and
those who are depressed. Both groups cry; both withdraw from the world; both
complain of listlessness
and
a sense of alienation from their normal lives. But there is one categorical
difference between depression and sadness. The sad person knows what they are
sad about; the depressed person doesn’t. Sad people can, without difficulty,
tell us what is troubling them. I am sad that my grandmother
has
died. Or that I lost my job. Or that my friends are being unkind to me. And -
though
it
might sound strange - this is precisely what the depressed person is not
capable of doing. They may be tearful and at a very low ebb, but they can’t
conclusively put a finger on what has drained life of meaning for them: they
simply say it has no meaning per se.
They
aren’t depressed about x or y as one might be sad about x or y. They are, first
and foremost simply depressed.
The
inability of the depressed person to account concretely for their mood can lay
them open to unwarranted charges of faking, malingering or exaggerating.
Friends who begin in a well-meaning search for a soluble problem can end up
frustrated by the lack of progress. When pushed, the depressed person may latch
on to rather odd or minor-sounding issues to account for their state: they
might complain that there is no point going to work because the earth is due to
be absorbed by the sun in 7.5 billion years. Or they might insist that life
lacks all meaning
because
they’ve just dropped a glass on the floor and everything is now completely hopeless.
At
this stage, one can hear it said that if depression doesn’t have any any
sensible
psychological
causes, the problem must be bound up with some kind of imbalance in brain
chemistry,
which it would be kinder and more effective to treat with pills - an idea of
great
appeal to the pharmaceutical industry first and foremost, but also to worried
families
and
schools and employers who crave rapid and cost-effective solutions.
But
there is another approach to depression which, though slower and more arduous,
may
be
a great deal more effective in the long-term. This stems from insights drawn
from psychotherapy,
the
discipline that has - arguably - been able to understand depression better than
any
other. The basic premise of psychotherapy is that the depressed person isn’t
depressed
-
as they suggest - for no reason. There is a reason. They are very distressed
about something
but
that something is proving extremely difficult to take on board, and has
therefore been pushed
into
the outer zones of consciousness - from where it wreaks havoc on the whole
person,
prompting
boundless feelings of nihilism. For depressives, realising what they are
concretely
upset
about would be too devastating, so they unconsciously choose to remain dead to
everything,
as
opposed to very distraught about something. Depression is sadness that has
forgotten its
true
causes - forgotten because remembering may generate overwhelming, untenable
feelings
of
pain and loss.
What
might these true causes be? Perhaps that we have married the very wrong person.
Or
that
our sexuality isn’t what we once believed. Or that we are furious with a parent
for their
lack
of care in childhood. In order to preserve a fragile peace of mind, one then
‘chooses’
-
though that may sound more willed than it is in reality - to be depressed
rather than
to
have a realisation. We pick unceasing numbness as protection against dreadful
insight.
To
make things yet more difficult, the depressed person doesn’t typically
consciously feel
that
they are in fact lacking insight. They are not aware of a gap in their
self-understanding.
Furthermore,
they are nowadays often taught to assume that they are ‘just depressed’,
as
one might be physically ill - a verdict that can be of appeal as much to the
pharmaceutical
industry
as to certain people close to the patient with an interest in insights
remaining buried.
There’s
another key difference to note between sadness and depression. Sad people are
grief-stricken
about
something out in the world but they aren’t necessarily sad about themselves,
their
self-esteem is unaffected by their grief, whereas depressed people will
characteristically
feel
wretched about themselves and be full of self-recrimination, guilt, shame and
self-loathing
paranoia
that may, at tragic extremes, culminate in suicidal thoughts.
For
psychotherapy, the origins of these violent moods of self-hatred lie in anger
due for,
but
unable to be directed towards, someone else in the world - that has then turned
against
the
sufferer. Wrathful feelings that should have gone outwards, towards a partner
who
is
relentlessly defensive and denies one sex or a parent who humiliated one in
childhood,
are
instead driven back onto the sufferer and starts to attack them. The feeling:
‘X
has
horribly let me down’ turns into a very unpleasant but in some ways more
bearable
‘I’m
an unworthy and unbearable wretch.’ One becomes self-hating as a defence
against
the
risks of hating someone else.
Also
worth noting in all this is that, in many cases, depression is associated with
an
apparently opposite mood, a kind euphoric state termed mania, hence the term
‘manic-depressive’.
The
mania in question looks, from a distance, a bit like happiness, just like
depression
can
look like sadness. But in one area in particular, the relationship between
mania
and
happiness is identical to that between depression and sadness. The common
element
is
a disavowed self-knowledge. In mania, one is euphoric, but cannot go into one’s
own
deep
mind and discover its bitter truths. Which explains one of the leading
characteristics
of
manic people: their habit of being in flight from themselves, talking too fast
about nothing,
over-exercising,
working continuously or spending too much - all as an escape from a submerged
grief,
rage and loss.
It
is from this kind of diagnosis that a suggested cure emerges. What people in
depression need
above
all is a chance to arrive at insight. For this, they will tend to need a hugely
supportive
and patient listener. They may also - used appropriately - benefit from
temporary
use
of medication to lift their mood just enough so that they can endure a
conversation.
But
the assumption isn’t that brain chemistry is where the problem either begins or
ends;
the
despair is caused by an undigested, unknown and unresolved trauma. Far from
needing to
be
taken through reasons to trust that life is beautiful, depressives must be
allowed
to
feel and to remember specific damage - and to be granted a fundamental sense of
the legitimacy
of
their emotions. They need to be allowed to be angry, and for the anger to
settle on
the
right, awkward targets.
The
goal in treating depression is to move a sufferer from feeling limitlessly
despairing
to
mourning the loss of something in particular: the last twenty years, a
marriage, a hope
one would be loved by one’s father, a career... However agonising the insight and mourning might be, these must always be preferable to allowing loss to contaminate the totality of one’s perspective. There are plenty of dreadful things in every life - which is why
it
is wholly normal to feel sad on a regular basis. But there are also always a
sufficient number of things that remain beautiful and hopeful, so long as one
has been allowed to understand and known one’s pain and anger - and adequately
mourn one’s losses.
Thank you…
Comments
Post a Comment