Antidepressants

Any dialogue about the warp and woof of depression should include something about its value in our lives. That sounds like a bugged out thing for me to say; all the more so when you consider that much of the national dialogue has been dominated by main stream medicine that tells us that depression is an illness – just like diabetes or heart disease.  I have, in fact, been part of this choir at different times.

Leading this charge is psychiatrist, Peter Kramer.  He’s the author the best-seller, Listening to Prozac and followed up recently with, Against Depression.  His conclusion is that we need an all out war, a full fledged armada, against depression which he maintains is “brain damage” which we must stop from occurring in the first place or progressing once it has gotten a foot-hold.  

I think Kramer’s arguments oversimplify the complex malady that is depression.  More than just a biological illness, depression is also a dying of one’s soul.  Indeed, one’s inner self – that which is most vital and true about us – is a casualty of depression.

What if by medicating our depression, or replacing its jagged thoughts with “clearer” or “more constructive thinking habits” (As defined by whom?), we are moved in the wrong direction?   What if medication doesn’t so much result in full remission (i.e. the goal of psychiatry) of depression as a “draw” with the gun-slinging opponent that our melancholy can seem like?

What if we’re not supposed to mute our depression with medication or straighten out our uneven thoughts with a flat iron?  What if we are killing the messenger?

In his book, The Swampland of the Soul, psychologist, James Hollis, sees depression less as a biological phenomenon, than as a psychological one.  Here’s his description of its causes:

“Depression can feel like a well with no bottom, but is a well with a bottom, though we may have to dive very deeply to find it.  Think of what the word means literally, to de-press, to press down.  What is “pressed down”?  Life’s energy, life’s intentionality, life’s teleology is pressed down, thwarted, denied, violated.  While the etiology of such pressing down may or may not be discernible, something in us colludes with it.  We might even say that the quantity and quality of the depression is a function of the quantity and quality of the life force which is being pressed down.  Life is warring against life, and we are the unwilling host.”

What is pushing down our life force as attorneys with depression?  Is it just the long hours, stress and adversarial nature of our craft?  No doubt such factors play a role, just like our biology and genetics. But clearly much of the foundation of adult onset depression has been layered, brick by brick, in our childhood experiences for it is here where we learn how much to value ourselves and others.  If we learn to value ourselves in a healthy way early on in life’s journey, there are fewer impediments in the future to de-press our life’s energy which is trying to express itself.

If we have grown up in a dysfunctional home, as the majority of adults with depression have, it will be much harder to feel good about ourselves and build a healthy life without depression.  This is so because we have learned to devalue our inner experiences and give too much weight to what others expect and think about our life’s value and future course.  After all, all parents are giants to small children.  In a child’s world of magical thinking, there is no way of filtering out parents’ toxic messages about a child; no way of seeing these voices as a reflection of the parent and not a child’s fledging sense of identity.

This was certainly the case with me.  My alcoholic father, who had gaping holes in his psyche and soul, couldn’t nurture himself let alone his five children.  The eldest of five children himself in an era of WWII veterans, his feelings were alien to him.  As time went by, he crumbled under the weight of his disease and growing awareness, on some level, that he was a failure at work and home.  My mother, an equally damaged person who grew up with an alcoholic father, never learned the basic law of reciprocity in love and nurturance. 

No wonder I ended up as a young man after a successful undergraduate career; without an internal sense of who I was or what I wanted to be.  Like many others without a deep relationship to self and my feelings, I “chose” the law because of one thing I could be sure of – it was a chance to serve others, be a professional and make money.  This is, to be sure, why many young people go into this strange business we call the legal profession.

I was estranged from something essential in me for many years, so powerful was the pushing down of my own inner instincts and life force.  I felt defined and limited by who I had been in my rocky childhood, whether I was aware of it or not.  I always felt a gnawing sense that something was missing – that piece turned out to be nothing less than my essential self. 

Dr. Hollis frames the developmental task before us after we have come to sense this elemental truth:

“The task implicit in this particular swampland is to become conscious enough to discern the difference between what has happened to us in the past and who we are in the present.  No one can move forward, psychologically, who cannot say, “I am not what happened to me: I am what I choose to become.”  Such a person can come to recognize that the early deficit was not inherent in the child, but the result of circumstances beyond the child’s control.  One can then begin to tap the energy for life that was previously walled off.”

And so begins the journey out of the well of depression for all of us.  We must learn to regain our inner authority – regardless of our biology.  This doesn’t mean one needs to quit the law – though some may need to do so to follow their true path.  It may be a more modest shift in perspective or a reshuffling of our life’s deck. 

Hollis has a great analogy that captures the value of modest changes.  He writes that steering our lives is like a pilot using his navigation instruments while flying.  A one degree shift here or there will determine where he ends up landing; in Africa or in Europe.  

In Listening to Depression, psychologist, Lara Honos-Webb writes that depression is trying to tell us something: that we are on the wrong track in life.  In this sense, depression can be a teacher if we would only listen to it. In one interview, she summarizes the five greatest gifts as follows:

–         It propels you on a search for the meaning of life

–         It’s nature way of pushing you out of your comfort zone. Depression reminds you that you are losing your life while not risking

–         It’s a breakdown in the service of offering you an opportunity for a breakthrough

–         It means it’s time to reclaim your power to author your own life

–         It alerts you when you have gotten off course and guides you towards self-healing.

How do we come to see these truths?  Honos-Webb says:

“Depression can be seen as a break-down in the service of offering the person an opportunity for a break-through.  In this way, depression can be a corrective feedback to a life with little reflection.  We only reflect on those things that break down in life.  For example, if life is going along smoothly you won’t spend time thinking about the meaning of life.  We tend to think deeply about life when something is not working.  When we identify a problem, we begin to reflect on what caused the problem and how to fix the problem.  If you are disconnected from your deepest feelings and impulses you may still manage to get through life without realizing it.”

I admit that it’s hard to see depression’s value when in the thick of it, the swamp through which we slog without relief.  But there’s much to be said for seeing depression not just as a disease, but as a diminishment of self which makes our world too small.  We don’t have to keep colluding in our own victimization.  And remember this:

You are not what happened to you – You are what you choose to become.