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Working through depression

August 10, 2011

photo of exhausted catDepression 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 disabling state, as the more serious forms of depression can be, 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 cognitive 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 can be 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 commentary 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 depressive (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 starchy 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
Cover for The Promise of SleepAre 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, 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.

31 Comments

Joan August 11, 2011 at 10:17 pm

Your articles are priceless. I especially appreciated this one because it describes how I traverse those difficult times. Currently, at a comfortable place, I can see how your ideas all worked to get me here. Your summary is most profound, left me with a big grin. Thanks again.

Karla August 12, 2011 at 1:02 am

Thanks so much, Joan. As a professional artist, you’ve got a leg up in the self-care and creating-sacredness department!

Here’s a post by mythologist Michael Meade, who always seems to be able to bring sacredness and transcendence to even the most rotten situations. The Hidden Hope of the World.

Emily August 19, 2011 at 4:20 pm

I love how you address all the aspects of depression and all the possible causes because through my own experience depression can be related to any number of things and perhaps all of the reasons that you listed. For a long time, I struggled with depression, and I thought my mother would understand because she struggles with it herself. I soon learned that, because I did not come from a bad family life or have any traumatic experiences (like she did), she did not understand why I would have depression.

Thank you for the thouroughness of this article. I especially enjoyed all your suggestions for treating depression. Good stuff!

Katrina September 18, 2011 at 8:08 am

I have been reading the book “Acedia and Me” by Kathleen Norris over the course of the last several weeks. I found Norris’ description of acedia — as something often labeled nowadays as depression but, as she notes, actually very different from depression — fascinating. There is one person I know of in particular who has been diagnosed with depression — but after reading Norris’ book, I’d say that acedia more accurately describes his state of being.

Intriguing.

Jen December 5, 2011 at 4:57 pm

This is awesome, and brought me comfort, and sort of validated some things I’m going through, and some thoughts I have been having about my own depression. I realized recently that it’s not so much that I have given up on life- I have had to just pause everything, even some contact with certain people, so that I can come out of this stronger, and hopefully cultivate some healthier relationships. It has been necessary for me to be very protective of myself- it feels like a survival thing. I just wanted to say thank you so much for posting this.

Karla December 5, 2011 at 6:59 pm

Thanks Jen — I’m glad this is useful to you. But also, are you getting any good medical or counseling support? Please remember that depression isn’t a character flaw; in some cases it’s a disease, and a treatable one at that. Take care!

Jen December 5, 2011 at 7:57 pm

Yes, I see a therapist, as well as a psychiatrist who is treating me with thyroid medication. I had wanted to mention in my previous comment that I do suffer from low thyroid. I wanted to mention that because some people who may have ‘treatment resistant’ depression might want to get tested for hypothyroidism.

I tried to deal with this on my own, and could not. I hope that anyone who is suffering will seek out help also.

Jen December 5, 2011 at 8:01 pm

Oops, and, to add: Thanks for your response & happy holidays! I’m following you now on Twitter, and look forward to reading through your other posts :)

Karla December 5, 2011 at 8:07 pm

Jen, awesome! I am also being treated for depression with Cytomel (I was finally diagnosed with autoimmune hypothyroiditis a few years ago). Getting my thyroid right has been a life saver — literally. And you know what else? It has helped me become less hypersensitive emotionally. Two for one!

I just took a person who is suffering from refractory atypical depression to my endocrinologist at UCSF. The thyroid is a huge culprit, but you sort of have to find this out through sheer luck. I’m glad you did!

Jen December 5, 2011 at 9:01 pm

Karla, that makes me happy to hear- that someone else is being helped from Cytomel! You just gave me so much hope, since I only just began taking it a few weeks ago! I’m so happy you have found relief.

Joan January 10, 2012 at 12:30 am

Funny thing… I just reread this on FB and saw it as “Walking through Depression”. Kind of telling, isn’t it. Because of you I do walk through depression and other emotions. Like a walk through the forest…. , “Look there, isn’t that interesting the way I reacted, I wonder why I said that, Today I see that tree differently, it’s growling at me, yesterday it was smiling. or That sky has been great to me, maybe today it’s just having a bad day, I won’t rely on it.” You know what I mean … it’s not work anymore, it’s a walk through the park. (most of the time)

Karla January 10, 2012 at 4:16 am

Joan, what a wonderful way to look at it. Thank you for saying that!

Nancy April 4, 2012 at 6:31 am

What an EXCELLENT article!!! I really appreciate the way you can share insights that don’t come from textbooks or pharmaceutical pamphlets!!, but from experience and from the heart. I’ve blamed myself for feeling the despair, but see that some of the external situations that were going on in my life would make almost anyone else fall into a pit as well. Somehow, there is a comfort in realizing that – and I can just shine more empathy on my own heart. Great stuff, Karla – thank you!

Karla April 4, 2012 at 5:36 pm

Thanks Nancy!

Simon February 25, 2013 at 7:18 pm

Great article!

I’m glad you included masturbation as healthy entertainment. That made my day.

Thank you!

Karla February 26, 2013 at 9:18 am

Yay masturbation!

Alicia February 26, 2013 at 10:47 am

All EXCELLENT information and advice – I learned most of it the hard way myself, so hopefully this blog will reach a lot of people! It would be great to see what you have to say, Karla, about when depression and anxiety are linked or combine to make one feel “crazy” – that’s been my most recent challenge. Meds help, sleep, exercise, diet, of course, but when working through these issues I find myself in a chicken and egg type situation: which came first and what caused it?
Love EVERYTHING you’ve written that I’ve read so far, BTW! Your book could have saved me LOTS of money on therapy had it been around 20 years ago!! Thank you SO much!!

Karla February 26, 2013 at 11:29 am

Hoowhee Alicia, I also wish this information had been around 20 years ago! Wouldn’t it be great to get into a time machine and deliver this knowledge to the person you were?

Here’s my hope that young people struggling with depression can use this hard-won information, address their depression in a way that works, and go forward to create wonderful lives for themselves. Yes!

Bill May 20, 2013 at 6:15 pm

Hi Karla
Checking in – I would love to hear your thoughts on loneliness – unpacking it. What is the feeling loneliness? Have you written about it?

I can “feel alone” while I’m in a crowded room, or if I’m physically by myself. So it must not be about being physically with or without people. I wonder if when I’m feeling alone, what I’m really feeling is sadness, maybe mixed with shame. Perhaps I’m feeling feeling disconnect or not fully present here and now. I’ve realized I’ve been dealing with that energy of loneliness and I choose to know what that is. And what message it is conveying to me.

Mucho thanks! I’ve had many conversations with friends/my lover recently about what you have shared. Thank you for sharing what you’ve learned. :)
Best
Bill

Karla May 21, 2013 at 9:50 am

Hello Bill,

I like your emotional sense of loneliness. It does seem to contain sadness and some shame. I also feel some grief in there, for the loss of a relationships that won’t come back, or that feels as if it will never arrive. And maybe some depression, which might be pointing to one or more situations that simply aren’t working.

There also seems to be some thinking process in loneliness that expects that the future will be like the past — such that the loneliness seems to be a forever state. It would also seem to be a state that would specifically suppress the forward-looking emotion of happiness, and the soul-expanding oneness of joy.

I would wonder, in loneliness, if it would be worthwhile to perform the rejuvenation practice from The Language of Emotions, which intentionally evokes joy and helps people breathe it into their bodies. This might help a person gently interrogate the sense of lonely isolation and see what else is underneath it.

I hope that’s helpful,
Karla

Tyler June 8, 2013 at 8:52 am

Huh. . . .yes all those things. I guess it is one of those feelings that other feelings sit underneath of. For me, reading this, loneliness is also about fear- living alone as I do now, I wake up and fear that I have suddenly grown old(i’m in my thirties!) and my life is over. Perhaps thats the “forever feeling” aspect of loneliness talking- it seems to contain an awful lot of things-
anyway this is a very helpful starting point for me, too, thank you!

Karla June 8, 2013 at 11:33 am

Thanks Tyler, for what you’ve added. I wonder, too, if there’s some depression in loneliness — which would make sense, because feeling alone and not liking it (we’ve all had times when we were happy to be alone, but that’s not loneliness) would be one of those situations that doesn’t work for us. The ingenious stagnation of depression might step in to say, “Hey, this isn’t workable.” The problem, of course, is that it’s so much harder to get out and meet people when you’re depressed. Sometimes, emotions can go on a bit of a bender and get in the way. Go home, depression, you’re drunk!

Tyler June 9, 2013 at 3:34 am

Ha ha ha. .. . .I like how you talk to depression. Loneliness then as sadness(or grief), shame, and some depression. And as a separation from its cause. The word “loneliness” is actually a sentence- “being alone AND not liking it”- a process. This is super helpful for me, thank you. And its an awesome book you’ve written, too. It contains the most constructive, insightful thinking I’ve ever found about dealing with empathy and emotions on an inner level. Thanks again!

Bill June 10, 2013 at 3:48 pm

Thanks, Karla and Tyler. I appreciate what you wrote.

Yes, “being alone and not liking it” and perhaps thinking “and this is how it will always be.” So, to listen to my loneliness energy – perhaps I can ask it what message it has for me.

Perhaps loneliness’s message is: “Go out and love. Connect with someone you love.”

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Megan August 18, 2014 at 6:36 pm

Your article was by far one of the best and most helpful I’ve read on this topic! You reminded me of my love of art and how expressing myself is a manner in which I cope with my depression! My goal for this week: dive in to an art project!!
Thanks!

Karla August 18, 2014 at 8:52 pm

Welcome Megan – and hooray for your art!

Bill August 19, 2014 at 3:54 pm

Thanks for this, Karla. The recent comments brought me to this page, and I re-read this. Very timely for me, only recently coming to terms with recent feelings of depression. Recognizing now it’s time I get support.

Karla McLaren August 19, 2014 at 7:26 pm

Hello Bill! I too have had to get some support this year; thank goodness there are workable and accessible solutions for depression, whew.

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