Depression
Last week, 11-17 May, was mental health awareness week and
in the USA it is a whole month of awareness. It is necessary because of the
stigma attached to mental ill health. Also, I find that there are ‘sunny’
people, Christians and others, who can’t see what it is all about. I have come
across folk who are very dismissive of the mentally unwell or who cannot see
that inward pain is a very real and profound affliction which afflicts the
sufferer and those near and dear to them.
I usually find the winter most difficult but depression, for
example, can strike out of the blue. At such times I find it helpful to take
walks, read, generally slow down and avoid potentially stressful situations at
least for the time being. I also get myself ticking along by making to-do lists
with simple tasks as well as bigger ones. At one time the antidepressant fluoxetine
helped to numb emotional pain. On Sunday, 11 January, 2015, there was an
interesting programme on R4 about 'Mindfulness' which seems to be a recent
development and is being promoted this year by the Mental Health Foundation. It
was said that CBT (cognitive behavioural therapy) helps people with depression
but ‘mindfulness’ enables better functioning afterwards. When I asked a
psychologist friend about mindfulness he said it was a very good thing so it’s
worth following up but he pointed out that it helps some people more than others.
In 1975 I came across a book, Overcoming Depression by Paul Hauck. I must have given it away
because I can’t find it anywhere now. He traced depression to three main causes
and fortunately I have his later book, How
to be your own Best Friend (1988), which outlines them briefly.
[1] Self-pity. We
may well feel sorry for ourselves at times and justifiably so but obsession
with self-pity will most likely end in depression. Hauck says we should
challenge the idea that it is awful that life doesn’t treat us as we want it
to. It’s time to count our blessings.
[2] Other-pity. Compassion
is an excellent trait but being incessantly involved in other people’s troubles
can be overwhelming and result in burnout and depression. People in need may require
our help but if we break down emotionally over them we will not be able help
them. So the motto is to do what we can.
[3] Self-blame
which Hauck later called self-hate. Whereas self-pity often involves blaming
other people for our troubles the opposite, self-blame, is a potent source of
depression. Again it is good to be self-aware and to put our hands up when we
are wrong but when the whole thing becomes obsessive or out of proportion the
spiral of depression can begin and swallow us up. Hauck says that we should
learn to forgive ourselves for falling short over things we are not really
gifted at anyway, for not getting everything right first time (parents need to
accept that they are on a learning curve) or things we do when highly
disturbed, ‘there is no way we can be fully rational when very upset.’ [Best Friend p. 42]. And it’s worth
basking in the realisation that there are people who really value us.
It’s all a form of cognitive behavioural therapy that was
refined by Albert Ellis who called it rational emotive therapy. Basically it
involves straightening out irrational thinking so that the sources of
depression don’t get out of hand or even get a foothold.
In my opinion there is plenty of good, practical, common
sense in this and clearly thoughts can affect emotions and sometimes a lot of
straightening out is needed but I’m not entirely convinced. It seems to me, for
example, that conflict over equally balanced alternatives can spin into
depression. Furthermore, I’m not sure that it recognises the sheer depth of the
black hole of despair involved in this affliction. Also, our varied temperaments
and personalities pitch in to varying degrees so ‘depression stories’ and their
outcomes are likely to be diverse. Finally, brain chemistry seems to contribute
as well which is where antidepressants play a part.
A few years ago I attended a lecture by Professor Lewis
Wolpert, a medical biologist, who was struck down by depression to the extent
of being suicidal. He wrote a book about it. Perhaps not surprisingly for a
biologist he brought in such factors as genetics and concluded that a mixture of
drug and cognitive therapies is the best treatment at the moment. It’s
complicated, there are seldom quick fixes and I am very suspicious of some
treatments but that’s another story. Sometimes we just have to grind our way through
depression.
