(I’ve changed the title of this post because I realize the earlier version sounded too sweeping. This post is focused on the way we can beat ourselves up for not being able to will or wish depression away at moments of greatest vulnerability to its onslaught. I didn’t mean to suggest that we can never gain any control over the problem at all through such means as cognitive therapy and meditation. Of course we can, and those methods have been critical for my own recovery. Hopefully, a new title at the top were make this clearer.)
When you’ve been in the midst of severe depression, have you groaned in exasperation: “Why can’t I control this? How can this keep happening? I should be able to will it away. Why can’t I?” I used to do that whenever I went under, and words like those are a sad refrain running through most of the discussions of depression I’ve heard.
About 15 years ago, one therapist I worked with – briefly – told me that feelings depended on the intention I brought to a situation. If I went into it expecting to be irritated, defeated or excited, that’s what I would feel. The general idea was that we could turn the experience of life in a positive direction, if only we brought the right intentions and thoughts to daily living.
Though he didn’t quite say it, he clearly believed that I could intend my way out of depression. Thinking bleak and hopeless guaranteed I would feel bleak and hopeless. So he gave me meditation exercises to help me think more positively and cultivate attitudes of loving kindness and forgiveness. He was certain that I could dispel depression by developing new mental habits for responding to life events. While meditation definitely helped and later became an important practice in my life, the positive intention approach didn’t solve the problem.
I had never experienced at that time – or since then – any intention or thought that could keep itself from drowning in depression. And depression never came because I thought about doom and gloom or interpreted events in negative ways. It was always the other way round. Depression came out of nowhere – no cause in sight. It was like a flash flood or a tsunami that was suddenly upon me. Only after a wave engulfed me did my mind interpret everything as hopeless.
With that experience as background, I’ve been deeply interested to read about research on how emotion relates to mental life, as summarized in Joseph LeDoux’s, The Emotional Brain
He describes the complicated – and unconscious – processes that take place across many systems of the brain to generate emotion. (The researchers, by the way, make a sharp distinction between emotion, involving all these brain functions working outside consciousness, and the conscious feeling you’re aware of.)
The action starts with some external stimulus – like suddenly finding a mugger or a loved one in front of you. There are bodily sensations, activation of arousal systems, flashing lights in primitive parts of the brain. Those basic arousal signals are translated by a number of intermediate systems and sent on to the parts of the brain’s cortex that are responsible for higher level interpretation.
There the working memory processes the signals in several ways, such as matching them with long term memory of similar situations and structuring them with language. The result allows you to recognize the mental commotion consciously as fear or anger or love. Then the brain can tell the body to get busy with appropriate behavior, like running from the mugger or embracing the loved one.
In this view, all the unconscious systems generate a powerful flow of emotional energy into awareness, but the flow back into those unconscious systems isn’t nearly so strong. That says a lot about the attempt to command depression.
This is how LeDoux summarizes two key points. (For emphasis, I’ve reversed the order in which he lists them.)
… [E]motions are things that happen to us rather than things we will to occur. … We have little direct control over our emotional reactions. … While conscious control over emotions is weak, emotions can flood consciousness. This is so because the wiring of the brain at this point in our evolutionary history is such that connections from the emotional systems to the cognitive systems are stronger than connections from the cognitive systems to the emotional systems.
… There is but one mechanism of consciousness and it can be occupied by mundane facts or highly charged emotions. Emotions easily bump mundane events out of awareness, but nonemotional events (like thoughts) do not so easily displace emotions from the mental spotlight — wishing that anxiety or depression would go away is usually not enough.
There it is – and perhaps that statement will help you the next time you’re beating yourself up for not being able to control depression. It’s also good to keep in mind when someone with Sympathy Deficit or Hateful Personality Disorder tells you to get a life or pull yourself together.
Have you had this problem of adding self-insult to injury by despairing about your lack of control over depression? Do you condemn yourself for not being able to will away other powerful feelings as well?
Image Credit: Some Rights Reserved by kennymatic at Flickr
Heather and John,
I think that illness, in whatever form, is often perceived as weakness for some families, and weakness is to be avoided at all costs. This is very true in my husband’s family. Everybody is supposed to be tough and stare down adversity. Individual family members are very contemptuous of each other’s mental or physical issues, my husband included. Few of them seek out medical assistance, but will complain constantly about physical symptoms or mental state. It’s very sad, and I suspect denial and disgust is perceived as an easier response than acceptance, treatment and understanding.
I agree with you, Heather, that repackaging mental illness as a brain disease might go a long way in helping people accept it is not a chosen state of existence, but like other illnesses, something thrust upon an individual.
MK
John,
I just found your blog and I really appreciated this post. Everybody experiences feelings of sadness from time to time, and people who’ve never suffered from depression CAN, to a large part, control those thoughts. Of course they can’t understand why someone else isn’t able to do the same thing. It’s similar with addiction. People who are moderate drinkers don’t understand why an alcoholic can’t just stop. It doesn’t make sense to them.
The weird thing is that with physical illnesses like heart disease, no one would dare say you can wish it away. (Or I suppose there are a few who do, but society in general looks at them as crackpots.) There are actions you can take to help yourself guard against the symptoms (as there are for depression, addiction, and other mental illnesses), but nobody thinks that positive thinking will get you out of cancer or a heart attack.
I think people’s perception of mental illness might shift if it were relabeled a “brain” disease rather than a “mental” one. There’s something different about the brain chemistry of the mentally ill that makes us susceptible to persistently negative thoughts. Again, there are definitely actions we can take to help ourselves, but we shouldn’t–as you say–condemn ourselves for having these thoughts in the first place.
Best,
Heather
Hello, Heather –
I’m delighted you found the site – and that this post makes sense to you. It is hard to put up with so much insensitivity about all types of mental illness. It’s seems odd to me that many people get angry or contemptuous when they meet someone with a condition like this. Those comments don’t get to me so much these days, I guess because I’ve been around and around on the issue for so long. Part of the attitude about emotional control is pure social and family conditioning – it always seems to me that folks who’ve been raised to keep everything in can’t stand to see someone “get away with” losing emotional stability. Maybe it’s a kind of threat – I don’t know, but it’s important to try to educate everyone as much as possible.
Thanks for your comment – hope to hear from you again.
JOhn
John,
Forgive me. This line of discussion generally only leads to hurt feelings all around. It’s an old argument with me; I don’t mean to drag you into it. I recognize you as an authority on depression and its dynamics, and so I deeply mirrored your suggestion that we don’t have control over our depression. I reject my own authority in these matters, because the truths I’ve found are so painful and isolating, but those truths are, by and large, socially unnecessary as well. I do have a valid point, but it’s me who needs to recognize that, not you. As a result, I’ve gone far off topic in pursuit of validation and I’m sorry.
Hi, Will –
There’s nothing at all to forgive, and I don’t think you’ve taken things off topic. I learn a lot from what you write here, and I’m sure others do too.
All the best –
JOhn
Hi, John,
I found the idea presented in this post to be a very interesting way to approach depression. My husband of 19 years moved out this summer, and I believe he suffers from depression. He is in denial over it, and I think a big part of the denial stems from his belief that one can wish away dark thoughts and feelings of dissociation, and when he is not able to do it he feels even worse about himself and us. Having started to look into depression, I am of the belief that there is not one method which can help all sufferers of depression. It seems those who are successful in managing depression look at this disease honestly and part of the honest look requires accepting the human brain often does things unexpected and is difficult to control — and that goes for everyone, not just persons suffering from depression. I wish my husband would learn this, as I think his interpretation of depression is someone who stays in bed with the blinds drawn and the windows closed and the only solution is to take a pill. As he is functioning very well at his job he can tell himself that he does not have depression. And, I do not believe medication would help him at all.
Your insights, John, I hope will resonate with him and help him to look at his depression in a different way, one that does not require complete shedding of his past life to achieve happiness. That is, if I can get him to read your posts.
Thanks for your discussion. Your posts are helpful to me in managing my anger with my husband and his choices; it’s easier to tolerate the extreme change when I accept it comes from a suffering man and not a cruel and unfeeling man.
Hope you’re having a good day!
Mary Kay
Hi, MK –
I’m sorry you’re having this kind of experience with your husband. My wife had to live with a lot of denial and abuse from me for a long time, and I can only hope that he’ll be able to turn things around, as I finally could. Everyone moves through this in their own way and discovering what they can. Hopefully, they can grasp the full scope of the illness and the need for a strong response before too much damage is done.
I wish you both my best.
John
John,
Yeah, I had a pretty strong, visceral, defensive reaction to this post. My father was a psychologist who used his powers for evil instead of good–or at least for every scrap of personal, political or financial gain he could manage. Pretty much, I find there is no position one can take that can’t be either supported or refuted by one psychological theory or another, as long as one is willing to subvert the relevant context enough. For twenty years I held onto every scrap of rational perception and confidence I could, in order to maintain a shred of self identity. I clung to suicidal depression as my happy place, because I knew why I felt that way, so I had confidence it was mine, and so I could at least see a glimer of reason and hope with that perspective. With that little ego, it was easy for me to reach for Eastern religious thought as an alternative to psychology, which helped me find enough perspective to endure, and eventually to find enough trust to allow counselling to work. But I still have fairly violent reactions to misapplication of psychological theory, or to feeling a misapprehension of my behaviors.
When I’m in the throes of a depressive bout, I have trouble even recognizing it as depression; I lived in that state for so long I’ve adapted to cope with its deficits. I don’t generally know I’m in trouble until suicide begins to make sense. Suicide, I long ago decided, is always wrong, and I can work my way back from there, stepping through my chain of reasoning until I can poke holes in the logic and find some cause for hope. Amazingly, although denying that sort of emotional tension and trying to be wholly rational about it forces that pressure into trying to express itself in other ways, like psychosis or catetonia, I find even a hint of those mindsets far, far easier to clarify and dismiss than depression.
So, I do this each and every time I get depressed; there seems no other way back for me. I take control of my thinking, distance myself from the worst of the emotional recriminations, and walk myself back from the brink of madness. My greatest trouble lies in identifying the depression to begin with; actually taking control and reversing the trend is comparatively easy for me, although painful. It may take me days or weeks to realize that I’ve slid into depression, because it seems to have such a consistent, even reasonable, world view, despite the fact that, ultimately, it includes my own worthlessness. In such a state, continuing to discount myself by *not* taking control seems entirely out of the question. Apparently this is at odds with your experiences, or at least vastly different.
Will –
I can well understand you’re having a visceral reaction with a background like that. Your experience with your father gives real depth to the term psychological abuse, and it’s hard to believe you were pushed so far as to find a happy place in suicidal depression. Recognizing those early signs took me a long time – there were many years of flat denial and lack of awareness – but I’ve made a lot of progress on that. Fortunately, I’m now able to catch them before getting to the extreme you describe.
But my experience is not quite so far from yours as you may think. In this post, I was talking about my experience with a therapist who didn’t have the tools to deal with severe depression. The idea that having positive thoughts and intentions all the time takes care of serious emotional problems – I think – is destructive because it tends to blame the depressed person for not thinking “properly.” To me, positive all the time is just as false as negative all the time. But cognitive therapy and meditation are obviously far different. I’ve learned a great deal from both about looking at the world with enough detachment to see things more realistically – as they are, not as my mood interprets them. Gaining detachment and control over the way the emotional flow is interpreted in my awareness is fundamental to the recovery I’ve experienced.
I’ve written about all this before, but I always forget that no one could possibly keep track of old posts, and this time I forgot to refer back to the ones that round out the picture of my experience with these methods.
You’ve had to live with some of the worst depression I’ve heard of, and your ability to gain some control over it is incredible. I hope I never sound like I’m challenging anyone’s experience – what works for each of us is what works – period.
John
I, too, struggle with accepting that I do not have total control over depression. When I used to view depression as an outside force, e.g. a Black Monster that engulfed me, I felt as though I allowed this Monster to take me over, that I was too weak to resist, that I wasn’t using my cognitive-behavioral strategies properly to withstand the takeover.
I now try to view depression as a brain disease, and chronic depression, with which I have suffered for 40 yrs, as a chronic brain disease. Thus it requires ongoing management with both medication + psychotherapy. I compare depression with other chronic diseases such as asthma, diabetes and hypertension.
Until last October I had 6 yrs of no serious depression, despite occasional dysthymia. I truly believed that I had depression under control, that I would never allow suicidal thoughts to take hold. Silly smug me. I was slammed hard with a 5 month, dark, energy-sapping, dangerous episode. I had never felt that suicidal for so long as I did during that episode. It was very difficult to be patient, to let it be, to not fight against it, to not give up.
That was a humbling learning experience. Still I fear another relapse, and the odds are that someday I will have another relapse.
In the spring I shared with a friend the difficulty that I had just recovered from. Her response was, “I don’t have the time to be sad.” This is a reminder that people that have never experienced an episode of depression cannot understand the despair, the pain, the profound sadness + hopelessness.
Thanks, John.
Hi, Lynda –
My experience has been similar to yours in many ways, especially in blaming myself for not being able to control depression. I came to believe, as you say, that depression was an illness that would always be with me. It would recede to the background every so often, but I always felt deep down that it would come back in its own time. However, I found that I was wrong and that even after living with it for 50 years – in different forms and broken up by long periods of seeming recovery – I could end its dominance. It’s still hard to believe, and for the last couple of years I’ve devoted most of the writing on this blog to exploring and trying to understand what happened.
I’m so glad to hear that you were able to pull out of that recent relapse after such a long period of living without serious depression. Humbling is a good word for learning from an experience like that. Recovery is the hardest thing – and the recent research on emotions and the brain is showing another reason why that is so. It was only when I realized that my whole life was at stake that I could pull out all the stops – but as you know there’s still going to be a lot of disappointment no matter what you do. Of course it took forever to be able to think of it as disappointment instead of the sort of failure that pointed out my weakness and shortcomings. We usually have to measure progress in those little steps.
Thanks for sharing these insights about your experience.
John
Wow.
Huh.
Gee …
I couldn’t disagree more completely. Changing one’s emotional composition makes up the core of conquering any emotional problem, depression included. I can’t have control over my depression? Working to dispel depression with a positive outlook is a zero-sum game? Boy, I dunno. It sure isn’t as simplistic as trying not to feel bad when you’re depressed–if that’s what you’re saying, then you’re adrift in your emotional sea and need some basic rational grounding to begin with.
Honestly, I really want to say something harsh and cruel in return, just to defend myself. To me, you sound like the worst sort of troll I could ever fear to encounter on this kind of site, yet I have faith that you aren’t intending to be malicious.
But what you’re saying seems so destructive to my own confidence, with facts and studies to back it all up, that I feel entirely powerless to defend my own perceptions and experience. Really harsh and hurtful, disempowering, lacking in emotional support and empathy–totally uncalled for!
Jeez’, I just want to say something extremely rude.
Or maybe I just won’t patronize this site any more.
Hi, Will –
I’m so sorry that this has offended you. That’s never my intention and generally the opposite of what I hope to do with these posts. LeDoux’s book is by no means a destructive one, and I deeply regret if I’ve misrepresented the research to make it sound that way. I’m certainly not trying to sweep aside all attempts to empower us to control depression.
In this post, I’m urging people not to punish themselves in the midst of depression for not being able to control all their negative feelings. LeDoux is saying – and so am I – that you shouldn’t be so hard on yourself at that time of emotional pain because basic brain systems aren’t giving you much of a chance simply to tell depression to stop.
The research is showing that when your awareness is flooded with the powerful feelings of depression, those brain signals are drowning everything else out. I’m trying to emphasize a few major points LeDoux makes that are especially relevant to the experience of being in the throes of depression when the power of thinking seems lost. When I’m at that point I usually can’t even remember all the methods I’ve learned to fight back. That’s what I’m getting at – that groan of exasperation – why can’t I make this go away. Well, there are powerful reasons in the workings of the brain that make it hard for you to do that. This research seems helpful to me, but it doesn’t suggest that careful therapy isn’t effective.
That’s what I want to discuss in the next post based on this research. And I clearly should have talked about it in this one – there’s a lot that can be done through therapy that has the long term effect of helping people control depression. LeDoux points out that it takes a long time precisely for this reason – that your brain has to train itself to increase the power of thinking to have a stronger impact on the emotional systems.
Most types of therapy rely on talking about depression and changing ways of thinking and of course they can really work. Research on emotional mechanisms in the brain offers a different way of understanding what these therapies are accomplishing – and how they help restore areas of the brain that have been damaged by years of depression. It doesn’t refute them.
The last thing I would ever want is to attack the methods that have worked for you and many others. I’ve tried to make this site about hope and empowerment for recovery.
I’m really sorry that this post has backfired so badly. You’ve offered so many wonderful insights in many comments – I hope we don’t lose you.
If you’d like to talk about this by email too, I’m happy to do that.
John