Depression
From time to time we all experience a feeling of gloom and negativity, but usually this is usually short lived as we bounce back into our normal life style. This is just the up and down of everyday life. But not for everyone. Some people get stuck and can’t find a way out of their mood of sadness and self-reproach. The key to true depression is passivity where they feel life is so meaningless they cannot get out of bed or bother to wash and dress themselves. There is no question of friends and family jollying them out of it. But if they can find sufficient energy (which is really anger) inside themselves and maintain the security of some kind of daily routine, they have the key to unlock the door. The mobilised anger/energy will lead to action, choices and change.
Reactive depression
Some writers contrast clinical and reactive depression. Reactive depression indicates a response to a negative event, usually a significant loss, which demands adaptation to a new situation. This could range from the theft of a bicycle to loss of a close friend or relative. The healthy way of dealing with this is by actively engaging with the negative feelings so that they are processed through mourning.
The emotions which are most prevalent in mourning are sadness or grief, anger and guilt. Not everyone feels all these, and reactions to loss are not necessarily straightforward. Often the mourner has mixed feelings including relief, which is where guilt can arise. If mourning is engaged with actively and wholeheartedly the mourner will gradually emerge from that miserable, dark place to be able to think and talk about the loss without getting upset and tearful. It takes time and there is no time limit.
There is a problem for people who either won’t or can’t mourn because they get stuck in a melancholic depression and don’t experience any gradual lightening of mood. It may be they are frightened of the powerful feelings that take over in mourning and repress them, quickly getting back to work and announcing that all is well, or they have an especially ambivalent attitude to the loss which confuses the process. Some people feel ashamed of crying and often children are not allowed to, being told to cheer up and put a good face on things. Sometimes in the case of unexpected or traumatic death there may have to be an inquest or court case and either no body is recovered or it is left unburied for a long time, which delays the funeral and the restoration of a feeling of psychic balance. This can lead to people getting stuck in their depression and unable to actively mourn. In that case a prescription for antidepressants is worth considering to loosen feelings up. Together with talking therapy proper active mourning can begin which is the route back to a balanced state of mind. There is no short cut in coming to terms with loss.
Society offers a ‘rite of passage’ through a funeral service for death or in the case of a lesser loss e.g bicycle theft, an insurance claim or maybe just a police complaint, all of which are restorative processes which can help to counteract reactive depression. Traumatic loss may be more complicated and needs professional intervention.
Clinical depression
The other type of depression is clinical depression which may be thought of as endogenous or buried in the personality and so difficult to change. I see this sort as a response to very early poor maternal care which leaves a child fundamentally anxious and unsure about himself: how to relate to others and how to cope with the outside world. It is easier to be passive than active, to keep a low profile, not engage or expose oneself to any outside stimulation while inside you feel sad at not finding a way to lead a normal life-but you don’t know how to begin and if you begin you don’t know how to maintain it.
Luckier children are born into families which are stable and supportive. They are wanted children who are responded to with pleasure and enthusiasm. Their parents are available and attuned so when needed respond predictably and appropriately. Those children can leave home confidently relying on finding the same set-up when they return. And when a parent dies they mourn until they can carry around a memory of the deceased which continues to help and support them when they feel a need to draw on a reliable guide.
It is much harder for children who have not experienced warm, loving and attuned parenting and where they retain deep doubt as to whether they are truly wanted or good enough to have any value. The uncertainty about their own worth and place in the world and how other people regard them leaves them deeply sad and angry not for what they have lost but for what was never given. This unproductive anger can be felt as shame and self hatred sometimes leading to self-harm or suicide.
To come out of clinical depression usually takes longer than recovery from a specific loss but whether anti-depressant medication is advisable for a personality or developmental problem caused originally by a child being trapped in an unfavourable environment for which he will often blame himself, is debatable.
Freud talked about ‘frozen anger’ in relation to depression. By this he was indicating that the energy normally coming from aggression or anger, is unexpressed, leaving people feeling frighteningly stuck, passive and powerless without any idea how to help themselves. This is why mourning is important in reactive depression as an active process leading to restored mental health and talking therapy helpful for clinical depression in giving people the understanding and self awareness that their problem stems from early environment failure rather than their own inadequacies.
If you, or someone close to you, is suffering from depression please get in touch. Taking the first steps can be a challenge, but we can help you turn your life around. Take the first steps on a road where you no longer feel lost or powerless, become stronger and more positive.
