With all the conflict about defining depression, it’s not surprising if you’re confused about what it is, where it comes from and how best to treat it. There may not be much disagreement or confusion about what it does to you. But there is a difference of opinion about whether those impacts are a good or bad influence in your life.
You may not worry about definitions at all but simply be content to have a name for what you’re living through. Life isn’t collapsing around you because of anything you’ve done. Your experience is shared by millions, and now you know what it’s called.
At last, you begin to believe that you can deal with it. Who cares about causes and theories? Leave all that to doctors and take the treatment they recommend.
There will be Choices
You should be aware, however, that in doing this you’re making one choice among many possibilities. You’re adopting a definition of depression that can not only set the course of treatment but also the way you think about yourself and, perhaps, your future.
Depression has a way of recurring with increasing likelihood after each bout you come through. If you live with it for many years, you may change your view of the condition several times.
You may come to think of it as permanent, something you’ll have to adapt to and live with forever. You may even change your response to depression so completely that you stop trying to get rid of it and embrace it as a positive dimension of life.
I’ve been through so many phases of trying to understand depression that I thought it would be helpful to start writing them all down. Looking at depression from a dozen angles – or 13 or whatever the number – has turned out to be another aid in my recovery.
This exercise is one of many that has helped me keep a distance from the illness. It reminds me that depression is a thing, whatever its nature might be. It’s like a spell of bad weather that I have to live through. However I might define depression, it doesn’t define me.
13 Views of Depression
- Disease: When I first heard about neurotransmitters and the idea that depression was a brain disease, I took comfort in accepting my condition as a chronic illness like diabetes. No wonder I couldn’t fix it on my own. The whole thing is a matter of biological mix-ups, and medications would correct the problem. I didn’t have to feel ashamed of who I was or doomed because I so often succumbed to depression. There was hope for the future.
Condition: After a while, especially as I failed to get much help from medication, I became disillusioned with the idea that depression was all about neurochemical processes in my brain. I came to think of depression as a condition rather than an illness like diabetes. It was always there in the background of my life, ready to come out of hiding and grab me every so often. I just had to accept it and adapt as well I could.
Disability: As depression gradually ate away at my ability to work effectively, I considered another view of the illness – as a disability. I learned that I had a right to ask for an accommodation in handling my work. I negotiated a new schedule with my employer but could never bring myself to get a ruling that would formally label me as disabled. I couldn’t see myself in those terms. For a lot of people, it’s a lifesaver, but I felt it would bury me deeper in a life dominated by depression.
Spiritual Crisis: There were times when I looked at depression as a step toward spiritual enlightenment of some kind. It was the resistance and despair that had to be lived through to achieve a deeper awakening of soul. I was looking for a sense of connection to life in a larger sense, a profoundly peaceful union with a universal presence. These were powerful experiences, but depression turned out to be a trap rather than a step toward enlightenment. Whatever spiritual life I had disintegrated when severe depression took hold.
- Normal: For a while, I wondered if depression could be a mood and state of mind on the downside of normal. Had a life experience been medicalized by psychiatry’s diagnostic categories and the pharmaceutical companies? A lot of people believe this to be so, but I’ve never been able to put severe and recurrent depression into that category. Perhaps psychiatry had gone overboard with the milder forms of depression, but there was no way I could imagine what I went through as anything like “normal.”
- Weakness: Despite all I learned over the years about depression, it was hard to avoid the inner belief that it was all a problem of will. There was a false echo in my mind each time I talked about the illness. Wasn’t I just making this up, trying to hide from life? It was the classic mindset of seeing a stain (that’s what stigma means) in my character, worsening the contempt and self-hatred that depression brings. When you feel worthless through depression anyway, it’s easy to buy into the stigma and prejudice that so many non-depressed people have.
- Behavioral Problem:> I’ve spent a long time looking at depression strictly as a here and now problem. It’s about what I do every day and how I do it. This gives me something concrete to work with. I can track what I do and spot the triggers that send me into a downward spiral. I can look back at what I did in those moments and see what came out of each one. Then I can recognize the moments when I need to stop myself before doing something that will only worsen depression.
- Personality: At times, I’ve believed that I had a depressive personality, streaked through with behaviors and attitudes that put me on the downside of every day. Personality doesn’t change very easily, but I worked a lot with psychoanalytic therapists to do just that. One psychiatrist brought out a problem with this approach. Entering and untangling the past can only help after you’ve shaken up your awareness of what you’re doing in the present and found possibilities of future change. Without a future, the past can too easily look like an endless replay of problems that will never stop.
- Family Inheritance: I’ve thought of myself as the offspring of depression through my mother and generations of her family history. It wasn’t just a genetic inheritance but a way of living that was an open invitation to join the party. It was the only sort of party I never missed.
- Trauma: The more I learned about the varieties of trauma, the more I realized how powerful an influence it had been in my life. It wasn’t a matter of extreme forms of abuse but the subtler ones of emotional absence, belittling comparisons and icy responses, repeated in patterns year after year. Depression became the typical response, a way of filling in the blanks of emotional life.
- Cognitive Problem: It was another revelation to find how active a partner my way of thinking was in locking me into depression. My mind had always been my greatest asset in navigating life, but now I found it to be the prime suspect in my own unraveling. My way of interpreting things skewed them into dangerous shapes. I turned my life into a mindscape of depression that stretched endlessly in all directions.
- Creativity: Depression was so deeply marbled into my nature that it seemed at times to be essential to the creative work I was doing through writing. I resisted medication for a while partly because I was afraid I’d lose the edge, the pain I considered necessary to the creative process. The facts didn’t support this belief. I couldn’t think straight let alone get creative while depressed, but that didn’t change my view for a long time. Inspiration and depression seemed inseparable.
- Life Advantage: Most recently, I’ve come to look at depression through the eyes of Thomas Moore and Tom Wooton. They both see the condition as an experience to be embraced as thoroughly as any other rather than eradicated. Despite its obvious pain – or perhaps because of that pain – your life can be enriched by accepting another side of the fullness of living. Given all the losses I’ve put up with because of depression, I can’t go as far as they do in embracing the condition as a positive. But I’ve learned a lot from the idea that you can expand your awareness and comfort zone, as Wooton puts it, to include even so difficult an experience as depression.
I keep finding new ways of looking at depression, and each view reveals its own surprises. Whatever misery it has caused, living with it seems to pry open one part of my life after another. Each view of depression is another way of looking at myself and understanding a little more of what being alive is all about.
Have you cycled through many ideas about your depression? Is there one view that holds true more than others? Or do you think of depression as combining all these dimensions?