Many people present to me with long-term, chronic experiences of being depressed or having depression. Often, they are taking antidepressants prescribed by their general practitioner, sometimes by a psychiatrist. Sometimes they have been taking such psychotropic medication for a long time.
Significantly, a number of people come to see me whilst they are being ‘treated’ for depression because despite the treatment they are still not happy (happiness as a state of mind and state of being is yet another significant debate).
They say this even though they say they are no longer depressed, because the medication does not work, or because the way I work significantly enhances the beneficial effects of medication.
The funny thing is that when we explore behind the scenes, when we enter the construction zone that is the personality structure of such people, I often find that a sense of hopelessness, meaninglessness, worthlessness, harsh self-judgement, a collapsed sense of self and poor or impossible conditions of worth.
This informs who they are and their way of being in the world. Sometimes that way of being in the world can be quite self-destructive and often results in chronically repeating patterns of living and relating such that they become self-fulfilling prophecies of failure.
For example, they just keep relating to the same type of person repeatedly and therefore repeating the same failure and reinforcing the implicit proposition that “see, I told you I was worthless!”. This can also lead to chronic experience of anxiety in which we chronically foreshadow our own impending failure to the extent that it becomes a self-fulfilling prophecy. This is why depression and anxiety are closely associated. Why and how do we do this to ourselves?
In my encounters with people, I often find that some of them lose the capacity to generate meaning in their lives, to find fulfilment and to satisfy the conditions they set for themselves that make them good people in their own experience.
Often, these conditions are so rigid, so high that they are impossible to meet. I have had periods in my life where I have felt profoundly sad and hopeless but I never considered that I was clinically depressed. Sometimes I have felt this way because I have ended up repeating past traumatic experience without realising it or sometimes because I felt very lonely.
When I have explored loneliness, I found that it was tied to a poor sense of self-worth that led me to implicitly believe that somehow I was not worth being a friend to anyone. Furthermore, in my own personal experience, the failures that I feel most profoundly are those in which I feel I have failed the cherished values and beliefs that define me as a person and as a man.
This is why I write “meaningless-ness” in the way that I do to convey a sense I encounter in some people that not only are they unable to construct hope or meaning in their lives but they have lost the capacity to do so.
We end up dehumanising ourselves because it is the capacity to create meaning of the lives that we live, to construct that meaningful life and to construct meaning of the situations in which we find ourselves that defines the human condition. Indeed, I would suggest that without the capacity to be fulfilled and to have meaning, humanity is a rotten deal. After all, we know we are going to die so why prolong the agony of meaninglessness?
The history of humanity is littered with examples of people surviving terrible and unimaginable traumas because there was a reason or a meaning for their continued existence.
It can be as simple as the hope that someone who loves you and whom you love is waiting for you at the end, a desire to witness to the rest the world the horrors inflicted upon us, or because we have children who are dependent upon us and we cannot violate the evolutionary trust placed in us.
So much for the theory, so why is it that so many people seem to own their depression as though they are inseparable from it? Isn’t it more useful to experience it as a maladaptive maladjusted aspect of themselves that interferes with the dominant personality structure? At least this way we have a chance of reconstructing and transforming that experience of ourselves.
We cannot do that if we cannot separate ourselves from it. This is why I suggest that depression is not about what you think, nor how you think it. It is more about how you construct how you think, how you construct the meaning to your lived experience that you then experience in thought. This is why I work with experience more than thinking.
Many of the people I work with who are depressed have in themselves a part of them that constantly judges them as a failure, sets conditions of worth either so low as to be not even human or so high that they cannot ever be met. Time and time again I have met people who have held themselves implicitly emotionally responsible for an imagined crime against someone significant in their lives that when tested in counselling and psychotherapy collapses like a bubble and they are no longer depressed!
Very often, rather than being guilty of a crime against a significant other, that significant other has been guilty of a crime of abuse against the person who then becomes chronically depressed about a crime they never committed!
Depression is almost too simple a word to convey complex human experience in which we render ourselves worthless and meaningless and beyond the capacity for our own redemption. The effect of depression is to remove us from our common humanity and to collapse upon us the cold dark world in which we consider ourselves unfit to live.
I do not have a miracle cure for depression. Nor do I offer one. What I offer is an opportunity to encounter the depression you have as separate part of you and to enquire into it; who it is about, how it got there, what is it asking of us and what we need from it.
At worst, people leave with a better relationship with an experience of depression but they may no longer consider themselves depressed. That, at least, is a transformation.