I’ve had several moments in recovery when I realized that things I assumed to be true were really delusions of depression. Some were long-held beliefs about myself, others were briefly held convictions that were too far from reality to maintain for long. Psychiatrists probably wouldn’t call these delusions of the sort linked to psychosis, but when I recall how often they dominated my mind, I need a strong word to capture their chilling effect on my life.
From childhood on, I believed I was being watched and judged. I didn’t bother to think about that much since it seemed so self-evident. The stress of being under someone’s eye never left me, and their judgment was always negative. Long after I realized that this wasn’t true, I kept having to remind myself that there was no one looking my way. Sometimes I had to scan the nearby houses just to be sure.
I also believed, as do most people with depression, that I wasn’t worth much, couldn’t do anything of value and didn’t deserve to succeed. This felt like fact, not open to questioning. Anyone who tried to convince me otherwise was either naive or trying to be polite.
At times, I was convinced that I was being betrayed by close friends who were planning to take things from me. One time this belief was so strong that I confronted a group of colleagues at work with my accusations. Their puzzled reactions made it instantly clear that I had imagined the whole thing, but for four days I had been obsessed with every detail of their plot.
For an extended period, I believed that people close to me were the cause of the inner pain I felt. I was angry, often raging, in response (as I saw it) to their actions. Only after months of feeling tortured and acting destructively did it become apparent that I was deeply depressed and needed treatment and that no one else was doing me any harm.
What ties these beliefs together for me was my certainty that they were true. I didn’t think of them as distortions caused by depression, and I often based my actions on these delusions and others like them.
Believing yourself, knowing that what you feel is true when you’re in depression is like seeing an image that’s been through Photoshop. One believable layer is superimposed on another, each one part of a real scene, but the composite is something utterly fantastic.
How can you tell when the combination of simple truths and self-evident perceptions merge into distortion and unreality?
It’s hard because we start with the assumption that what we think and feel about things is accurate. We tend to believe ourselves and have many ways of dismissing any evidence that might contradict what we think.
When your beliefs about yourself are driven by depression, you’re convinced that you are making conscious choices based on accurate perceptions when you really aren’t. As long as you believe the delusions, you can’t imagine that you might have it wrong and won’t seek the help you need to challenge your beliefs.
Looking for Causes
One thing that held me back for a long time was cause-and-effect thinking. We have a deeply embedded habit of trying to explain things by finding a unique cause so that we see the linear sequence that gives rise to a problem. If you start by assuming that you can’t be the cause, then you need to look elsewhere.
Looking for causes can become the central concern when you are afraid of what is happening to you and trying to block out the fear with the control of rational thinking. A cause is something you can isolate and point to. It wraps up the hurt in an explanation that is outside you at a safe distance. I can point and put the blame on that without having to look within. Everything is simplified.
Getting better is simplified because you only have to separate yourself from the cause and try to get rid of it. But if you give up the cause-effect model, you have to look instead at the fullness of what you feel and the connections you have to others. You live in an ecosystem of relationships, influences and shared needs, but it’s hard to see that when you’re depressed. Your field of vision narrows.
Learning to Doubt
I think there is always an element of doubt mixed into the delusive beliefs. The doubt comes from fear, however hidden, that there is something missing from your seemingly airtight explanations. Things don’t quite add up.
You can’t see what it is, but you remain disturbed deep down, uncertain, anxious. What is happening to me? Depression likes to keep things simple. Limiting your search to simple causes helps you screen out a lot of your life.
You know intuitively that there is more to it, but fear drives you to look for a simple cause. It is either out there – someone else – or it’s in here – me.
If I’m the cause, then everything is my fault. I’m the wrong thing in the picture and need to be erased. It’s the trend of delusive thinking that follows a logic of self-destruction.
The paradox of the explanation is that you imagine you are using your rational mind to reassert control over your life, but in fact you have lost control to the illness.
But if you can accept the fear, it can become a force for change, a signal for survival. It was one of many turning points for me that helped me get back into treatment. But delusions die hard, and the need to explain what you feel and what you are in terms of isolated causes keeps returning.
Have you had delusive beliefs about yourself in depression, as well as those moments of doubt? Have you felt the fear that your explanation of who you were didn’t quite add up?