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.
