Working through depression

Depression is in the news quite a lot these days. Medical and psychological researchers (and news outlets) are focusing a great deal of attention on depression, and it seems that every week brings a new story about what does and doesn’t work for depression.

This is great; it’s a positive movement that is helping to make depression more of an everyday topic (instead of a hidden shame). However, many media figures report on research they don’t understand very well, and many lump all depression into one category, as if mild depression and bipolar depression are similar things. Or as if major depression can be treated in the same way atypical depression or postpartum depression should be. A great deal of the current news about the ineffectiveness of antidepressants isn’t taking into account the different forms of depression and the different treatments required.

In The Language of Emotions, I focus on situational depression, which is the situation-related low mood most of us have experienced. It’s not a disease state, as the more serious forms of depression are, and it’s usually amenable to all manner of intervention (including placebo) if you catch it early; however, if left untreated, situational depression can lead to more serious depressive disorders.

What I don’t see in this media flurry is people asking questions about why so many of us are situationally depressed. Last month, I retweeted this important public health message from Twitter user Where We At (@picklefight):

Before you diagnose yourself with depression and low self esteem, first make sure you are not, in fact, just surrounded by assholes.

Hah!

Where We At is silly and arch, but she’s got a serous point: When we’re depressed, we often turn inward and blame ourselves, but depression is not simply a low mood that arises from within. Sometimes, depression is a perfectly reasonable response to trouble in your life; depression is often an important signal about real issues that impede or disturb you. In my book, I call depression Ingenious Stagnation:

Situational depression is not a single emotion, but a constellation of emotions, postures, decisions, and health issues that erect what I call the “brilliant stop sign of the soul.” Depression is an ingenious (albeit overwhelming) movement in the psyche that takes you out of commission for crucial reasons…. Depression arises in response to exterior and interior conflicts that destabilize you, and while it can be crushingly disruptive, situational depression has a vital purpose.

Though depression can and does spin out of control and destabilize bodily systems, emotions, and mental functions, there is often an inception point at which the depression arose in a manageable way as a response to trouble or injustice that was already occurring. Treating the depression as a separate disease entity without addressing the very real situations it points to is an incomplete way to manage it – because depression is a natural protective response to disheartening or destabilizing stimuli.

The practice for depression is not to launch yourself toward happiness for the sole (and ultimately joyless) sake of happiness, but to understand what has occurred – inside and outside of you – to disturb you. Your first task is not to erase your depression, but to focus upon yourself with empathy so that you may view your depression not as a negative comment about your intrinsic value, but as a vital message about the specific (though often obscured) issues you face.

Depression is, as every emotion is, a message about and a reaction to things that are going on inside or around you. It’s important to pay attention to that message and deal with whatever is going on. Current research is suggesting that untreated depressions, especially major depressions (see this Mayo Clinic description of major depression), can teach your brain how to fall into depression more easily the next time. Untreated depressions can wear a path in your brain, so it’s very important to address depression with whatever therapy best suits your particular situation.

If you are feeling continually low, please see your doctor or visit the Helpguide.org depression page to understand more about your symptoms and your options.

Remember, too, that cycling rages often mask an underlying depressive condition (especially in men). If you flare up with rage and righteous indignation a great deal of the time, please check in with your doctor or Helpguide.org. While anger can feel empowering when you’re depressed, too much anger can destabilize your health and ruin your relationships, so please get yourself checked out. The fact is that we all feel depressed every now and then, and it’s nothing to be ashamed of or angered about. Help is everywhere.

So, you’re depressed. What’s next?

We all experience depression for many reasons, yet in most cases, the cures that are offered to us focus primarily on us: on our behaviors, our chemistry, or our habits of thought.  But depression isn’t merely an internally-generated emotion; often, depression is a response to external trouble.

There are plenty of external situations that are in and of themselves depressing — such as conflicts, difficulties, injustice, illness, loss, and upheaval. These things should evoke some depression. In the face of troubles, something in us should stop moving blithely forward as if nothing is happening. Something in us should drop, lose energy, and experience a sense of despair or hopelessness every now and then. To not feel depressed about deep troubles may be a sign that we’re not really paying attention.

Depression can be very problematic, it’s true, and we should be vigilant about how long we maintain a depressive mood — but depression has a very important purpose, so it’s not something that should be avoided as if it’s the plague. Depression has a purpose, which is to tell us that something is wrong. Our job is to find out what that something is.

As a lifelong sufferer of depression (my form is Early-Onset Recurrent Major Depression with Dysthymia — and a side of fresh fruit!), I keep a pretty close watch on my depressive tendencies. I’ve found that by taking an inventory of what’s going on around me, I can pretty quickly pinpoint whether my depression is situational (which means I can make lifestyle changes) or more serious (which is a sign that I need to check in with my doctors).

This inventory is not merely personal, because depression can be a natural and healthy response to a rotten external environment. It’s important to be able to understand and articulate the difference between depression that is internally generated, depression that is externally generated, and depression that is a combination of both.  If you tend toward depression, this inventory (and your doctor’s guidance, of course) may be useful to you:

The Personal (Are you taking good care of yourself?)

Diet
Are you eating well, or often enough? Some depressed people become food-phobic or food-centered, and their meals aren’t regular or particularly nutritious. Low blood sugar or spikes in blood sugar from a sugary or irregular diet can exacerbate a tendency toward depression.

Exercise
Are you getting enough, or any? Exercise has been shown time and again to be an excellent mood elevator and a way to break a depressive cycle.  This article suggests ways to exercise when you’re so low that you can’t even muster the energy to get moving.

Sleep
Are you getting at least seven hours of restful sleep each night? In his book The Promise of Sleep, the father of sleep research, Dr. William Dement notes that of the three: diet, exercise, and sleep, only sleep is positively correlated with increased longevity and reduced prevalence of disease (here is excellent advice from Dr. Dement’s Stanford Sleep Camp: How to Sleep Well).

Very few of us treat our sleep as the most important aspect of our healthcare efforts, yet researchers are continually confirming Dr. Dement’s advice (most recently, it was found that you should keep your bedroom as dark as you possibly can make it, because light at night is being linked to depression).

The Relational (Are you surrounded by sweeties, or … ?)

Your mate or lack thereof
Is your relationship working? Do you feel loved, respected, and welcome in your relationship? If not, your depression may be trying to tell you something. Or are you alone and feeling isolated? Loneliness and a sense of disconnection can lead to depression.

Your family relationships
Is your family a healthy place to be, or is it full of unrelieved tension and unsaid words? Family conflicts can feel depressing and entrapping.

Your friends
Are your friends supportive and restful, funny and dear? Or do you have to tolerate a lot of “frenemy” conflict and turmoil from people who really don’t have your best interests at heart? This study suggests that frenemies are not just depressing, but actually harmful for your health.

Your colleagues
Is your work environment healthy and emotionally well-regulated? It has often been said that “People don’t quit their jobs; they quit their managers.” How well is your workplace managed? How are you treated? Do you look forward to getting to work each day, or do you dread it?

The Sociological (Is your social environment healthy?)

Your financial situation
Are you experiencing money worries, or are you concerned about friends and family who are? There’s a reason times like these are called “depressions.”

Your employment
Are you unemployed, or is your current employment unstable? Both can lead to depression.

The condition of your community
Are you engaged with and hopeful about the future of your community, your town, and your county? If not, social disenfranchisement can lead to depression.

Your political situation
Are you hopeful about where your town, county, state and country are headed? Do you feel comfortable with your political party and its direction? If not, political powerlessness can lead to depression (and for some people, to repetitive outbursts of frustration and rage).

Some ideas for working through depression

If you’re already exercising, eating well, sleeping well, getting treated medically for depression, and taking good care of yourself — but your situation is depressing you, it’s important to look outside yourself for support. Therapy, sure, but therapy is not the only answer.

When you’re surrounded by, well, assholes, or your financial or political situations are unsure and fraught with trouble, then your depression is probably trying to tell you that something is wrong. So how do you work through your depression when, honestly, things suck and your depression is actually the correct emotion to feel in the situation?

Entertainment!
Distractions like games, TV, movies, texting, web surfing, sports, even masturbation … all of these can give you a nice time out and, in many cases, excellent positive input and a sense of pleasure and peace. Distractions are awesome!

Keep an eye on the amount of time you spend on distractions each day, but don’t shame yourself about it; just take note. Sometimes, distractions are the only things that can keep you going when you’re surrounded by trouble.

If you notice yourself using distractions continually, be gentle with yourself and ask if the time you’re spending on distractions is actually keeping you from dealing directly with the depressing situations in your life. Maybe this is true, but maybe your distractions are keeping you afloat because you’ve got no real power, and it’s time to move on, but you can’t just yet. Distractions can be awesome! Love them, observe them, and treat yourself well around them.

Art
Expressing yourself artistically, or viewing the artistry and craftsmanship of others, is a special kind of healing activity. Something about writing, singing, painting, building, dancing, and creating can evoke a sense of timelessness, sacredness, and transcendence.

If you’re feeling totally awful, you can even channel those awful feelings into your art and see what your awfulness is trying to tell you. Doing art with emotions is actually the genesis of the empathic practices in my book, especially Burning Contracts and Conscious Complaining. Art can heal you when almost everything else fails. Art heals!

Connection
Connecting activities are especially important for people who are experiencing relational and sociological depression. Creating or joining an interest group, volunteering, caring for youth or animals, giving or receiving bodywork, having good sex … all of these can help you reconnect to the positive aspects of humanity and community.

In depression, we tend to withdraw, which can be a really good idea when our depression is a response to rotten relationships or miserable social environments. But it’s important, when you’ve identified that your depression is a response to your environment, to reach out for healthy relationships, healthy groups, and positive social engagement.

Good people, healthy groups, and hopeful civic action exist. Don’t allow your depression to color the entire world with the palette it created from your current rotten situation. Healthy community and healthy connections heal!

Sacredness and Transcendence
Depression can strip the meaning from life, and it can lead to a sense of nihilism and hopelessness. All of the positive suggestions above can address depression, but if you’ve come to a place of nihilism and existential ennui, you’ll need contact with something larger, older, and deeper than yourself so that you can engage with the sacred, soul-making work of wrestling with deep questions of purpose and meaning.

For many people, sacredness and transcendence live only in the realm of religion and spirituality. But the pull toward the sacred, the transcendent, the larger purpose, the deeper meaning — these live fully in the human heart and mind. Certainly, these qualities play out majestically (or horrifically) in religio-spiritual traditions, but these traditions don’t own sacredness, nor transcendence, nor purpose, nor deep meaning. These qualities belong to humans, and each of us has full access to them.

When you’ve lost your sense of purpose and meaning, reach behind and beyond yourself — to historical thinkers, to the grandeur and mystery of nature, to great writers, artists, and poets, to philosophers and dreamers, to beauty and to intensity — and take your place as a deeply feeling person in a world of  sacred, profound, absurd, and transcendent ideas and experiences.

Depression can lead you into the dark night of the soul — and art, connection, sacredness and transcendence can lead you through that night and into the dawn of new ideas, new possibilities, and a deeper understanding of human nature, conflict, beauty, injustice, trouble, love, meaning, and perhaps, even assholes.

Tags: Depression, Emotion Work, Emotional Hygiene, Empathy, Sociology

This entry was posted on Wednesday, August 10th, 2011 at 6:05 pm and is filed under Empathic Skills . You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.