The term depression is batted about very freely by the population at large and the media. In fact, many clinical terms of psychology and mental health have made their way into peoples’ everyday use and thus changing the meaning of those words from what they represent clinically. Depression is one of them, but others include anxiety, bi-polar, schizo or schizophrenia, manic or mania, psychopath and so on.
When talking about depression it is important to understand and differentiate exactly what a person is experiencing. Many times people use depression to mean sad, blue, and unhappy. It may include bouts of crying, loss of appetite or increased appetite, increased or decreased sleep. However, from a clinical point of view, there are specific criteria that need to be met in order for clinical depression to be diagnosed.
Beyond the Label: Getting Help
Diagnosis of depression is not necessary to treat whatever the person is experiencing. Having a diagnosis isn’t the same as having a solution or getting better. It is simple a label, and can often prevent people from getting better. Some people hide behind their diagnosis and can use it as an excuse to maintain their current state or get out of responsibilities.
Often people's preoccupation with the diagnosis can derail them from getting help. There is a lot of confusion about depression is and what causes it.
Different Views on “Causes” of Depression
From a pharmaceutical and medical point of view, these industries make it sound that depression is something that attacks you or comes from the outside of the person. They talk about and market very effectively the idea of a chemical imbalance.
However, this hypothesis, “chemical imbalance” has not been proven and therefore is not a totally accurate way to view depression. “Chemical imbalance” is not a FACT but rather a hypothesis to explain symptoms.
Depression is not like malaria that you catch or get from something else. You cannot go to the hospital and get your chemicals tested to see if you are imbalanced. Try it. Ask your doctor for a chemical test to see if you are imbalanced and have depression. You cannot. There are no blood tests for depression. It is simply a way of marketing and conceptualizing depression.
This hypothesis, which is medical and problem oriented, uses drug to alter a person's chemistry. But sometimes the drugs work to increase or decrease. It is very much a trial and error and creates may effects that need additional drugs.
If anyone has seen a psychiatrist for depression, they'll know that it is largely guess work and trial error with prescribing drugs. They are told that the drugs will take 4 to 6 weeks to take effect; they will have effects, some of them serious like causing suicide ideation to increase. Often they'll need other drugs to make the current drugs work.
All this drugging of depression is based on the fact that perhaps something in the brain isn't working. Though there is nothing physically or biologically wrong with the brain. Research shows that over a period of time, even if the drugs worked, they stop working if the person with depression doesn't learn more effective thinking and problem solving skills.
A mental health view of depression which is different than the pharmacological one or medical view is that depression is a RESULT (not a CAUSE) from a person reacting to something in their life like relationships or dilemmas that they do not know what to do or how to solve.
When working with a counsellor to address depression, the therapist is looking at the entire 360 degree view of the person’s life, not just the symptoms or problems as a medical doctor does. The medical doctor asks about the depression symptoms and treats those. A mental health counsellor sees depression as the symptom and looks to address the core root of the problem.
Another way to put this is, the client with depression is using their creative mind to solve a problem in their life and depression is the best choice they have come up with. Choosing depression is not a conscious choice, but often a purposeful and practical one because the client doesn’t know any better solution to choose.
I have many examples where depression was a purposeful choice to get the person what s/he wants.
All the following examples are cases of people choosing depression: For example a mother who learns that her son has been diagnosed with Autism and has serious behavioral problems that prevent the child from attending mainstream school and doesn’t allow her to parent or have the family she has always imaged.
A husband whose wife has committed suicide and left him to be a single parent to their children is likely to choose depression, or as people say "become depressed." Depression may be a way of asking for help without being responsible. It can also be away of delaying the enormous responsibility of being both a mom and a dad to his son.
A person whose relationship ended with their partner against his/her wishes and s/he does not want to let go of this relationship. Depression or even threat of suicide will get the attention (at least for a while) of the departing spouse and stave off the end of the relationship…for a while…
An expat wife who moved to Singapore and is living away from friends and family in a new country with a different culture and very different resources available to them. Being depressed may communicate to her husband how miserable Singapore is making her and that the best “cure” is to move back (instead of build a life in Singapore, which is a lot harder in the short term).
A man who was up for partnership in a law firm and then was passed over and told he would never get it. Depression is a way of coping with or avoiding dealing with the fact that his idea view of his life and his reality do not match and he’ll need to make choices as what to do next.
In each one of these cases, the person is responding to the situation with depression. In Choice Psychology we would say the person is choosing depression, not consciously but as their best attempt to get what they think they want.
Depression makes a lot of sense but is not helpful to relationships or the individual in the mid to long term. In each case, the person with depression has a quality world picture in their head of their ideal life whether that is of their child, their spouse, their work or their daily life. When the person is unable to match their ideal quality world picture to their real world and they do not know what to do, people may creatively and unconsciously choose depression.
PURPOSE OF DEPRESSION
Many people reading this would say why anyone would choose depression!? Of course our mind is very creative. It is sort of like the Genie in the bottle that you ask a wish. You ask the genie for all the money in the world and the genie grants this to you by dropping literally all the money in the world on you and killing you. The brain is always doing things to help us. The brain is trying to keep us alive and comes up with the best solution. But often these solutions are developing outside of our conscious mind, so we cannot really evaluate their effectiveness or impact.
Depression can do many things for people:
-When a person depresses, they are sending out messages to people around them that may be a way for asking for help. Some people will not ask for help. Being depressed allows them to get help without asking for it.
-Depression allows people to avoid making a choice between two or more unappealing options. Often people are presented with choices in life that really not ideal or down right horrible. When people do want to make a choice or cannot find a win in their choices, they may choose to depress. Depressing allows them to stall or put of making a decision or choice.
-Depression is a way to send a message to someone whose behavior you do not like and want to change. Depression can send a message "see how sad your choices and behaviors are making me. If you stop doing that behavior or choice I can stop being depressed" Again this sounds a bit manipulative, it is often not conscious but the person's best attempt to get what they want.
Depression can get people out of obligations they do not want. People can become so depressed that they can get out of mandatory army duty or they may get out of going on trial for a crime they committed. Being depressed can get people out of a life they don't want, i.e. if they are working a job they don't or parenting in a family environment they can't stand or being married to spouse they no longer love. Depression shuts a person down and can be an unconscious way of getting out of something
Depression is a solution or a person's best, often unconscious, attempt to solve a problem in their life.
In treating depression one must look beyond the symptoms or diagnosis and look at the entire life and relationships of the person choosing depression. It is important to understand how depression may be helping this person and see if there are better ways to solve the person's problems
This may be a pretty radically new way to look at depression, but the research supports that people who are depressed need to change their thinking and problem solving skills and often change what they want. Pills will not solve bad relationships or make people want the things they do want in their life. Pills do not give us our quality world picture. Pills allows us to avoid doing something different in our life. Pills do have a purpose but they are not a total solution. They need to be paired with skills and thinking solutions.
Other considerations with depression are that you need to distinguish it from the following:
- Regret: Regret is about something that happened in the past that you cannot rectify and may still be affecting you in the future. There is great remorse over a choice or action or inaction that is still preoccupying the person. Sometimes regret gets confused with depression
Grief: People may confuse depression with grief. They are similar but the treatment and approaches are different. Sometimes the two occur at the same time.
Masking Anger: Depression is wonderful to cover up extreme anger at one's self or others. Often the more depressed the person is the angrier they are at something in their life. It is not appropriate for people to very angry or acts out on it. Our brain will depress us to prevent us from hurting ourselves (suicide) or others (aggression or murder).
If you are struggling with depression, consider seeking profession help to find better choices and solutions to your problem. We can help you.