Before you say, “No, not me!” let me offer you a number. The National Institutes of Health estimates 17.3 million adults in this country experienced at least one major depressive episode in 2017; that's a little more than seven percent of the US population. It is not because 2017 was a particularly bad year for people; it is because depression is something that nearly every one of us will experience as we move through life.
Depression is part of some important experiences we all have, such as illness, losing a pet, losing a job, a dear friend moves away, or grieving the death of a loved one. All of these are a normal part of living. In the progression of life, this
type of depression is part of the mourning process and will pass with time.
However, we can't assume that all moments will pass with time. Depression is characterized by protracted feelings of sadness and hopelessness that can affect one’s sleeping, eating, social and work life. Often, there's a loss of interest in things that used to be enjoyable, loss of energy, feelings of worthlessness and guilt, difficulty concentrating, anxiety, and even thoughts of death or suicide. When those feelings linger, we should see it as a red flag; a messenger sent to tell us we need to look inside of ourselves to find the deeper meaning and significance of what is happening. This is the time for honesty with ourselves. A moment to acknowledge that the symptoms have gone on for too long and seek the deeper help that is available.
What is important to know about depression is that it is in most cases absolutely treatable; it does not have to cripple one’s life.
It's worth acknowledging here that medication is often necessary in cases of depression. While it treats the symptoms, you can do what author Emmy Gut calls “the work of depression” - create space to process what is happening, and address its causes in whatever ways are needed. You can find the messages your depression is sending from your inner self, and do the work of exploring hurt, fear and anger from the past and the present.
There is no simple solution for understanding and dealing with depression.
What drives the depression is as individual as the person it is afflicting. As a result, each episode has its own unique structure and meaning. What works to resolve one episode may not work on the same person a second time.
However, through the years researchers have assembled some common categories
to help us begin to understand what is underneath the depression and find the message it is bringing to us.
1. Anger Turned Inward:
This was the first cause of depression that was formulated. It is astounding how often a person will respond to being harmed or mistreated with depression rather than with rage. It is as if the anger cannot be felt and directed outward, but needs to be turned upon the self, leading to self-blame, deprecation and a feeling of being bad.
2. Harsh Inner Voice, The Harsh Inner Critic:
This is an internal voice of judgment and blame which attacks and punishes the self for perceived transgressions usually related to anger and aggression. Guilt and shame are generated by this voice which leads to turning the anger toward the self.
(If this sounds familiar, I have written quite a bit about the Harsh Inner Critic in this blog, and I invite you to read some of those posts as well)
3. Lack of Psychological Tools for Successful Functioning:
Some of these include the capacity for trust, the ability to be separate, lack of self esteem, the ability to tolerate frustration, inability to create connection with others and healthy entitlement. These deficits in development are linked to depressive episodes and lifelong depressions.
4. Underdeveloped Sense of Self:
This is the part of ourselves that defines who we are, giving us a sense of well-being and self esteem. In order for the self to develop, it is necessary to have a constant supply of affirming relational experiences as we grow up. When there is an underdeveloped sense of self, depression can be triggered. The self is hurt by frustration, a feeling of not measuring up to personal standards or from a failure.
Therapy can help in two ways in this case: first by discovering the areas of underdevelopment and understanding their origins, then by providing a safe and
meaningful relational experience where psychic growth can occur. This provides an opportunity for growth in underdeveloped areas.
5. Withdrawal of The True Self From Interacting With The World:
These people appear happy and successful from the outside, but inside they feel empty and often believe life is meaningless. That leads to apathy and futility. They feel as if they are going through the motions of life rather than feeling engaged in life. They interact with others and can be skilled at social engagement while keeping their lives superficial. They are not emotionally involved in life, and often do not feel that they are real.
Early experiences taught these people to withdraw to stay safe from being hurt and overwhelmed. As a result, they did not learn the necessary tools to be comfortable with emotional connectedness. It is necessary to have meaningful relationships with self and others to have the emotional energy to have a fulfilling life. This path of withdrawl leads to an impoverished, empty life resulting in chronic depression.
Therapy can help you to discover the unconscious hurt and fear that restrict
your life. It gives you a safe place to feel more authentic and emotional
Depression is not a life long sentence of pain and misery. Psychoanalytic therapy provides invaluable help to people willing to confront their challenges. In the process of overcoming depression, such treatment can also spark new and necessary growth. When used productively, author Donald Winnicott has said, “a person may come out of a depression stronger, wiser and more stable than before he or she went into it.”