Descriptions of people suffering from despondency, absence of energy/motivation and intense sadness go as far back as ancient Greece. Melancholia was a term used by Hippocrates over 2000 years ago, and the term melancholy was in fashion throughout medieval times and beyond. Throughout the mid-1800s, there began to appear references to depression (from the Latin verb deprimere – “to press down”) in the medical literature, which continued into the 20th century. In 1980, the American Psychiatric Association published the 4th edition of its bible of neuropsychiatric disorders – The Diagnostic and Statistical Manual, commonly referred to as the DSM; in it was the first official categorization of Major Depression.
There has been and continues to be much controversy around the contemporary ‘medical model’ perspective on depression. Some say it represents scientific advancement, while others say it is overly pathological and that it ‘medicalizes’ normal (though painful) aspects of human life. No one denies the very real suffering and loss of functioning that accompanies depression; what’s at issue is – what do we do about it?
While highly produced television and online commercials are increasingly encouraging people to seek one or more medications for relief from depression, I highly recommend that people first get to work on learning how to understand and transform their own moods and subjective experience – which is what psychotherapy is all about. In doing so, people can usually reverse their depressive patterns, and there’s a ton of research to support that. In cases of chronic and severe depression, medication can be a helpful adjunct in this process, but should not be seen as ‘a magic bullet.’
depression: robber of life
To state the obvious, it can be debilitating to be in the grips of horrible moods, acute irritability, chronic fear and endless fatigue. In less extreme situations like low grade depression (Dysthymia), people can function pretty well but regularly feel decidedly negative, easily frustrated, unmotivated and/or excessively sad for no particular reason. In both cases it is very common to numb the pain with alcohol or drugs, or other mood altering behaviors. It is also common to increasingly isolate oneself from social connection; each of these exacerbates the problem.
No matter what degree of depression we experience, it robs us of the experiences that make life meaningful. Depression clouds our judgment, makes us less available for relationships and creative projects and decreases our ability to love, laugh and have fun. Simply put, repeated moods characterized by negativity, restlessness, fatigue and frustration serve as huge obstacles to living life in the ways we want. So when we are visited by depression, it is incumbent upon us to do something about it.
The paradoxical thing about depression is that the very strategies human beings usually employ to get rid of depression often make it more entrenched and more severe. Why is this so? Because thinking, feeling and behaving are interrelated in ways that reinforce depression shortly after it makes its first appearance in our lives. If we do not learn how to neutralize depression in these early stages, a snowball effect takes place; negative thoughts, moods and actions begin to build upon each other – often to the point where we find ourselves in a minor or major crisis.
Beyond just not being depressed, effective psychotherapy helps people to go further; it helps them to maximize their abilities and potentials so that feeling comfortable and secure within oneself becomes a new norm. ‘Feeling good’ is not best achieved when it is sought as an end in itself, but instead when it is a by-product of living an actively engaged and meaningful life. As Viktor Frankl said, “Happiness cannot be pursued; it must ensue” as a result of living well.
Chris Kingman | Therapy
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