Let's talk about depression. I don't mean the depression you see in movies. You know, the depression where your thoughts have a beautifully dark undertone to them; the depression where you're a passive perceiver, with an acute sense of individuation. No, not the depression you associate with things like hoodies with thumb-holes, rainy days and cigarettes that never seem to burn-out. Certainly, I don't mean to discuss depression as the opposite of happiness. I mean the empty, numb and isolating depression. The type of depression that no one sees; and the depression that leaves us wondering "why?".
For those living with depression, the word means something completely different. It means going days without showering just because; it means sleepless nights and fatigued days; it means having close friends, a career and a loving partner, yet being unable to shake off an overwhelming emptiness; and sometimes it means going years without ever really crying. Individuals can feel this way for a long while before the signs become obvious to either themselves or others. Frequent drug or alcohol use for short-sighted relief, angry outbursts to seemingly mild issues or over indulgence in hedonistic pleasures such as sex or food are just some of the ways that depression does not always look like depression.
Throughout recent years, I have seen a more frequent push to raise awareness in mental health issues, and being aware helps us in identify things like depression in ourselves and in others. Despite all efforts however, awareness itself is only the first step. One can be aware of having diabetes, and continue to eat foods hazardous to their health. So, where does someone go after they have taken the first step of acknowledging their depression? The purpose of this blog is not meant to assume all depression looks the same, nor is it meant to champion one method as a means to combat depression. As a therapist, it's my experience that when clients walk through the door they have some idea of what their problems are, but are not so clear as to what the solution might be.
The hope is that we have to keep walking in order to help either lift or cope better with depression, and luckily we have many ways to move forward. Some common tools include the usage of medication, others include nutrient rich diets and exercise. Speaking as a therapist, there are also many ways that one depression can be addressed in therapy. One way is to examine the role of the rational mind and work to adjust unhelpful beliefs about the world. We often have little control over what happens to us, however we can control our belief about the situation and how we judge it. Oftentimes we see in depressed individuals some inflexible beliefs about the world. These beliefs can be traced back to childhood or learned throughout life. Common unhelpful beliefs may include a rigid pessimism towards human nature or helplessness towards having their needs met. The flow in this cycle involves strong negative and inflexible thoughts, which create irrational beliefs about the world and ultimately lead to uncomfortable emotions resulting in unhelpful behaviors. In order to break the cycle, therapist and clients work to adjust their thoughts, create rational beliefs and follow through with helpful behaviors. This is not to say that if we were continuously slapped in the face for 24-hours a day we should simply smile, however it reminds the individual that they are truly the agents of how they choose to react to even the most extreme events, and ultimately can choose whether or not to smile, cry or walk away.
Other areas that can be addressed in therapy also include a focus on the purpose and meaning that we create in our lives. Depression often involves a sense of worthlessness or lack of hope towards the future and spending time examining and refocusing values can often provide some sense of meaning. For others, the depression may be so strong that the focus of therapy becomes about learning how to manage depression, rather than alleviating it entirely. Learning to sit with a sense of meaninglessness and not turn to unhelpful coping mechanisms which only make things worse.
So if you are feeling stuck and hopeless, at least experiment with therapy. It might just help.