Taking
disease out of depression
Looking at depression
as an emotional state rather than as a disease is a far more fruitful
approach, both in empowering the sufferer and pointing to solutions. Michael
Corry explains why
In
any psychiatric practice,
depression — along with its travelling companion, anxiety —
predominates as the commonest complaint. Along the spectrum of
depression, symptoms vary from mild disillusionment and lack of drive,
to the black hole of despair, self-loathing and hopelessness. No one is
immune.
Few states
touch so many aspects of the self as depression, undermining body,
mind, heart and spirit. In its most severe forms depression can
devitalise a person's soul, to the point where they are unable to work,
love, or find meaning in life. It can lead to serious alterations in
personality, sapping an individual's self-confidence, undermining
independence and severing their ties to the world and the people who
care for them. Depression can turn fatal.
Depression
is best seen as an emotion, just like any other strong feeling such as
fear, anger or love. Seen as such, it represents a legitimate response
to life's difficulties, rather than a disease reflected by a change in
one's brain chemistry, and unrelated to personality, belief systems,
relationships, socio-economic factors or coping skills. I have yet to
sit in front of one single depressed patient who did not have a symptom
logic, sometimes even tracing back as far as intra-uterine rejection.
The roots of depression can be found in any of life's losses, hurts and
disappointments: sexual and physical abuse, the death of a loved one,
the pain of a broken heart, the experience of being bullied, and the
terrible feelings of loneliness and desolation associated with
exclusion from the peer group, young or old.
The treadmill, be it at school, college, or on the
career ladder, can dampen the spirit and take its toll. In schedules
deprived of downtime, energy bankruptcy is common, with substance
misuse often the most easily available relief. For many, 'getting out
of my head' is the main objective. The ensuing collateral damage is the
price paid: exams failed, jobs lost, relationship breakdown, all of
which are themselves further triggers for depression.
Depression
could be considered a valid and normal response to the poverty trap,
given its own inherent set of problems: living from hand to mouth,
overcrowded housing, insufficient heat, food and clothing, and a
wilderness of inadequate resources. Depression can't be isolated from
the frantic juggling required to keep family life afloat: the night
feeds, school drop-offs, homework, packed lunches, and child minders,
side by side with long working hours, inexorable deadlines, demanding
bosses - all to fund mortgage repayments, school fees, and so on.
The ideas and beliefs that we hold ultimately dictate
our state of mind. In the words of the great poet Milton, 'The mind is
a place which of itself, can make a heaven of hell or a hell of
heaven'. The standards by which we judge our success or failure in the
world are learned through years of conditioning, in our families,
schools, church, and the wider culture. Our sense of dis-illusionment
or hopelessness emanates directly from our failure to meet these very
standards.
The dominant approach in psychiatry, which sees
chemical imbalance as the primary cause of depression and medication as
its cure, pathologises sufferers, turning them into damaged goods or
victims of flawed chemistry and defective genes. Such a view places the
problem within the person's brain matter, rather than in their
thoughts, feelings and behaviours, and the ways in which they respond
to the problems of living. This stringently mechanistic approach
marginalises personal consciousness, viewing the unfathomable depths of
human passion, individuality, creativity, curiosity, reason, intuition,
will, compassion, and spiritual insight as mere secretions of the
brain, akin to the way the kidneys secrete urine.
The moment depression is classified as a disease, like
all diseases it then calls for a cure. In this way it becomes a
defining straitjacket in which individual depressed people have to
function. Diseases do not have meanings, therefore none are sought.
Diseases 'should not' be happening. Diseases separate the ill from the
well. This classification defines the experience, limiting it to a form
which society relates to in prescribed ways. By being placed solely
within the realm of pharmacology, it is distanced from problems of
living and lack of resources.
The aim of Depression Dialogues is to create a safe
forum in which depression can be discussed and understood as part of
the human condition. Participants may ask questions, share their
experience, or merely listen, as they wish. The meetings we hold, which
at present take place in Dublin each month, adopt a liberation
perspective, allowing the individual sufferer to stand at the centre of
their story, and make sense of why they are depressed.
