Hi everyone, I'm Dr. Dan Bochner. I'm a psychologist and author of two books, the latest of which is printed in its entirety on my website,
http://www.DrBochner.com. I hope the following article helps in your general understanding of depression. If you visit my website, perhaps you will find a variety of artilces to help get you through hard times.
Depression
by Dr. Dan Bochner
Depression touches us all at one time or another. When a person is depressed, they typically experience several of the following symptoms: poor sleep (including too much), poor appetite (including too big), decreased interest in life or activities, worry and/or guilt, low energy, poor concentration, and thoughts about death or even suicide. The experience of these symptoms is often associated with anxiety and tension as well, although such symptoms can lead to a completely separate diagnosis of anxiety disorder if they are relatively disabling.
All kinds of depression have similar symptoms, and all kinds have similar dynamics, but there are two basic causes of depression. These two separate causes can often occur simultaneously. Depression can come from a basic lack of internalized love and/or it can come from feelings of helplessness, hopelessness, or loss in the face of bad circumstances. By “lack of internalized love” I mean that some people have never experienced enough consistently positive feedback and affection to become confident about positive feedback or affection continuing into the future. Such people devise various personality strategies aimed at securing love which are typically controlling, manipulative, or desperate but can seem powerful, self-assured, and seductive. When such people do not get what they want, at first they might become more aggressive in their style. If that does not work, however, they become depressed, with relentless feelings of emptiness and dread as well as the typical feelings of helplessness, hopelessness or loss that are commonly experienced during depression. These feelings of helplessness, hopelessness, or loss, on the other hand, can be a primary cause of depression in themselves, even when they occur in the life of someone who is relatively healthy. When a person has experienced consistent love in their upbringing, circumstances that cause feelings of helplessness, hopelessness or loss, bring about depression in spite of the substantial emotional resources such a person’s good experiences have helped them develop.
Mentally healthy people feel responsible for those close to them, and struggle to balance that responsibility with taking good care of themselves. When something horrible happens to such people, whether that horrible thing involves a traumatic experience in the life of a loved one or to themselves, they can become depressed as they struggle with feelings of guilt or wonder about how they could deserve such experience. Such people feel the need to care for those they love, and when others are suffering or when others leave, they feel at fault and typically associate the cause to their own selfishness which then leads to guilt. On the other hand, when bad things happen, relatively healthy people often feel like they have been cheated or betrayed, since they think of themselves as deserving happiness in return for the good they have done for others, and because they have tried as hard as possible to be good. They simply cannot understand how they could deserve such heartbreaking and agonizing circumstances.
Regardless of the cause of depression, the dynamics and symptoms are typically quite similar in all cases. The depressed person undergoes a transformation from a state of relative emotional freedom and ability to withstand the daily pressures of life, to a state in which all of their energy goes into squashing their emotions as though all emotions are “bad.” A person afflicted with depression wallows in feelings of inferiority, weakness, and guilt, but they try to control the expression of these feelings for fear of hurting others or burdening others. They often feel that the world is caving in on them, that responsibilities are overwhelming, and that if anyone knew how they were truly feeling, they would lose all positive affection and love from others and be rejected. Thus, depressed people tend to feel extremely lonely and isolated since they feel no one is connected with them or in touch with how they feel.
Paradoxically, depressed people typically do the opposite of what is necessary for them to recover. Since depression is so related to being accepted by others (even in cases of loss), an afflicted person needs to share feelings and be active in exposing their experience to others. Unfortunately, and most typically, depressed people isolate their feelings and themselves, and quite often their activity level decreases due to how hard it is to tolerate the vulnerability of feeling exposed. However, if the depressed person does expose their true feelings to loved one's with whom they can feel safe, they typically start to feel better relatively quickly.
This process allows their assumptions about how unacceptable their feelings are to be contradicted both in the real world and in their minds. The need for reassurance and a non-judgmental attitude from those who could be close to the depressed person is therefore crucial. All too often, depressed behavior results in rejection from others who are afraid of being “brought down” or who feel vulnerable themselves when they don't know what to do. However, if the depressed person can see that they are still acceptable and loved, even when they have terrible feelings, a big part of their depression lifts since such a big part of depression is the feeling of being unacceptable, unlovable, and worthless. Activity itself can help create greater exposure. If a person is active, doing things, and getting things done, feelings of worthlessness are contradicted by that activity. Thus activity results in exposure and likely a feeling that one is acceptable even when the depressed person is not revealing their true feelings.
Psychotherapy works in a similar way. Although most patients do not feel that their therapist is a “loved one” as mentioned above, they do hopefully feel that the therapist is a relatively non-judgmental and open-minded person who is not directly involved in their lives, and who is professional. When emotions are exposed within the context of psychotherapy, the same kind of process occurs as was discussed above. When the depressed person exposes their true feelings to the therapist, and the therapist does an adequate job of making them feel that their feelings are acceptable, the depressed person can generalize that feeling to their experience outside of therapy. They can start to feel that their emotions are okay, and they can start to regain some semblance of spontaneity in their lives.
The question of chemistry is also important. No one really knows whether or not depression is caused by chemical changes in the brain or whether the brain’s chemistry changes when someone becomes depressed. Really, that question should not be very important to the depressed person who, typically, is simply desperate to feel better. The fact of the matter is that brain chemistry does change with depression, regardless of whether the changed chemistry or the depression occurs first. The dynamics and precursors of depression as outlined above are also a matter of fact, whether or not chemistry is involved. The human emotional system works by certain rules that make the depressed person react and think as has been discussed above. The truth of the matter is probably that some people are more prone to depression at the chemical/physiological level, and thus are more likely to see the world in the ways outlined.
Finally, there are two things I always recommend to depressed clients. The first is, be really, really good to yourself (please see article, Be Your Own Best Friend). The second is, tell that nasty, nagging, critical voice inside your head to “SHUT THE HECK UP!!!” Most people say things to themselves that exacerbate their depression. They tell themselves they are not strong enough, that other people will think horrible things about them, that they are not worthy, or that they are worthless. Being kind to yourself, however, means to treat yourself like you think a kind and loving mother should treat a small child who is hurt or scared. Would you scream at, or criticize, a poor vulnerable child? I don't think so. So, don’t do that to yourself. Tell that voice to SHUT UP!!! Defend yourself against it fiercely. At the same time, tell yourself it is okay to be hurt, give yourself an emotional hug, and do anything you can to comfort yourself.
If you are feeling depressed, open up to loved one's, get active, be kind to yourself and, if you are having trouble beating it on your own, go see a psychotherapist. Research indicates that you will benefit most from a combination of medical intervention and psychotherapy. Understanding the patterns that get you thinking in negative and self-defeating ways is important, but do not underestimate the importance of simply feeling better, even if you need to alter your brain chemistry to do it. Sometimes, feeling better in itself, regardless of how you do it, is necessary in getting you growing in new and healthy ways. No matter how you view it, however, you cannot recover from depression unless you see that you are an important and worthwhile person who, it should be quite obvious, deserves to be loved.
Topic: Depression from a Psychologist's View (Read 554 times)
August 11, 2008, 04:01:54 AM
