Today’s focus will be on ways of looking at depression, both as a problem and as a gift. Depression hurts–it hurts all over, inside and out. It darkens the rooms of the mind and the soul, shuts down the personality. It takes us down into hell, and forces us to wander there for some indefinite period of time. Actually, that time is generally limited to about 6 months, a time when depression will often resolve on its own, without intervention (assuming we live through it.) However, I would not recommend being sad for that length without trying to improve one’s mood and energy level. One way to look at depression is that it is a luxury. People in less developed parts of the world, and people from past times did not have time to be depressed because they were working so hard to stay alive–that illustrates Abraham Maslow’s pyramidal Hierarchy of Needs theory that says we cannot deal with our social needs and esteem needs until our basic survival and safety needs are met. Of course, that not mean that people who struggle are not depressed, and that brings us to Japanese thinker (Shoma Morita 1874-1938.) Morita was a psychiatrist and a contemporary of Sigmund Freud. His model urged people to accept things as they are, not to try to fix thoughts and emotions, just to acknowledge them and then do what needs to be done. In Western thought, a person might say, “I’m too depressed to go to work today.” Morita’s approach was to separate those two ideas into “OK, I’m depressed today, and I’m going to work.” The assumption is that action (doing something regardless of feelings) works better than just thinking about the misery. In a clinical context, people who are depressed are very good at talking, and talking, and talking about depression, at being stuck in their own story, inwardly focused and “can’t see the light at the end of the tunnel.” I have been on both sides of the desk (personally and professionally,) so I understand major depression from both sides. I know that this is the reason I am so keen on happiness and gratitude. Although it has been many years since I was treated for depression, I realize it could come back unless I work to prevent it; I am, therefore, grateful for every day that I wake up not depressed, and I celebrate that day with happiness. My idea of a good life is to be happy more often than not!
We can look at depression as a season–like winter, when the ground is frozen. Nothing grows above the frozen ground, but life goes on being generative beneath the soil. The farmers cannot grow crops, but they have time to repair the farm, plan for spring planting, maintain livestock–they know it is a season, a natural cycle of the earth, and that sunlight, energy, new growth, and productivity will flower in the spring. Similar to a depressive episode, surviving between harvest and planting requires about 6 months also. Depression has been addressed or studied by numerous disciplines–myth (Persephone and Demeter), psychology, philosophy, genetics, research, neurology to name some; the concept is also used in economics, geology, sociology. Definitions include feelings of severe despondency and dejection, a long and severe recession in an economy, a slump, decline, downturn, standstill, stagnation (Oxford Dictionary,) and that pretty much sums it up. Depression can take us down, as Persephone was taken down to the underworld, for part of each year.
All well and good to look at depression intellectually, but suffering from an episode or recurrent episodes of major depression can be seemingly unbearable. It is both treatable and manageable; in my opinion, depression is not a disorder or a disease. It is a symptom that something in our lives need to be addressed. Your physician may not agree with my opinion, of course. Physiologically, depression may mean the need for sunlight or bright, full spectrum light. It may be calling for a healthier diet; psychologically, it may speak to the need to remove toxic people from your life, or spiritual/religious renewal or re-commitment, the practice of gratitude and forgiveness, letting go of the past and allowing ourselves to experience joy and happiness, or getting more exercise. Physical exercise has been shown to decrease/resolve depression as well and as quickly as antidepressants without the side effects. Exercise addresses both the physical and the emotional needs of the body. Before referring a non-suicidal client for possible medications, I suggest that he or she try several of the ideas mentioned above–adequate hydration, fruits and vegetables, sleep hygiene, being outside in nature, connecting with other people, working on changing thought/behaviors through talk therapy, or experiential therapies (body work, yoga, meditation, sand tray, art or music therapy) for a few weeks instead of taking medications. Medicines can always be used if there is no positive change in the level of depressed mood. Keep in mind, however, that it is very important for your medical doctor to rule out any illnesses or physical causes of depression before assuming that mental health treatment is needed.
Having said all of that, I want to also include symptoms that signal a potential diagnosis of major depression; symptoms, or manifestations, may differ in children and in older adults. Information is abundantly available on the internet; a partial list of more serious symptoms below are listed on the Mayo Clinic website.
Symptoms occur most of the day, nearly every day, and may include:
* Feelings of sadness, tearfulness, emptiness or hopelessness
* Angry outbursts, irritability or frustration, even over small matters
* Loss of interest or pleasure in most or all normal activities, such as sex, hobbies or sports
* Sleep disturbances, including insomnia or sleeping too much; fatigue/low energy
* Feelings of worthlessness or guilt, fixating on past failures or blaming/shaming yourself for things
* Trouble thinking, concentrating, making decisions and remembering things
* Frequent or recurrent thoughts of death, suicidal thoughts, or suicide attempts
WHEN TO GET EMERGENCY HELP
If you think you may hurt yourself or attempt suicide, call 911 or your local emergency number immediately.
If you have some/most of the symptoms listed above, talk with someone you trust, schedule an appointment with your doctor or minister, call your local mental health facility, particularly if the symptoms have lasted two weeks or longer, or have gotten worse in the past two weeks.
I will conclude with one major suggestion, (and a few small ones); Take responsibility for your body and healthcare. Get professional help when you need it, but do your own research, know as much as you can about whatever condition you may have. Do not be intimidated by health professionals; you live in your body, and you know (or should) know your body and its needs. If you decide to take recommended medications, do some research, particularly on side effects, and know other medications that should not be take at the same time.
Some of us have to walk through colder winters than others, but I believe that gives us a sharper, clearer sense of tragedy and a greater experience of joy than those who live in eternal sunshine. That is the gift.