I believe there is a type of depression that is a result of exhaustion. We have in our bodies a store of hormones and nutrients that are there to handle stressful situations, whether they are good or bad. People who are driven, fearful, excitable and the like, may call on their stress response too often, depleting the hormones and nutrients. Trying to hype yourself up and pushing yourself to keep going, only depletes you further. It’s hard to be happy and optimistic when you’re weak and depleted. Fighting, being fearful, trying to run away only depletes the exhausted person even more. You must accept the situation and rest, allowing your body time to replenish itself.
Excellent point. And what makes this even more critical is that exhaustion is not a linear process – we reach a point where there is something like a cracked reservoir effect with that store of hormones and nutrients, etc. At that point, rest is needed not simply to replenish but first to repair.
In human-direction mapping, this is referred to as our functional reservoir, and it is too easy to forget just how important it is, which includes all of its components: hormones and nutrients, energy stores, fitness and flexibility, breathing habits, habits of physical posture, and, of course, mental state (including any unresolved psychological turmoil, anger, resentment, etc.).
I think you have a good point here (and not one I’ve seen stated before).
To add to it, I’ve found many modern jobs are much narrower and more repetitive than people realise. I’m talking specifically about office type jobs here and not factory ones. Anything involving customer support and problem solving can be quite demanding and stressful. The problem I see is that managers never seem to rotate people out of the “front line” to give them any rest or recovery (as the military used to do). So you get a build up of fatigue and eventually burnout. People working in this environment become to worn out to recognise what’s happening. Managers may care, but are likely so wrapped up in the same sort of pressures that they don’t notice. I suspect this is quite common.
I guess frontline and a real front have something in common. In the frontline you are even alone with the “adversary”. A frontline communication, say with a customer, is often less than authentic, Underlying is often a game by which the customer exploit the politeness of the service person, and/or the service (sales) person tries to trap the customer into some acceptance.
Lack of authentic contact, which normally also generates energy, may be the cause of exhaustion as well as depression.
Much depression is rooted in grief. This is not just grief for people who have died, but for places, relationships and lost opportunities. People have always felt grief but, in previous generations, it was allowed and respected. Melancholy was normal. Now, no emotion besides mindless ‘happiness’, probably involving shopping or holidays, is considered ‘normal’. People who are experiencing entirely understandable emotions are convinced that they ‘have got mental health’.
This is so very true. Two years ago, my beloved husband of 34 years passed away. I’m still deep in the throes of the most devastating grief, a pain so all consuming I would never have imagined possible. And what makes it worse is the utter indifference of former friends and even family (with the exception of my wonderful mom). They have moved on and don’t understand why I haven’t, so they conclude that I’m damaged goods and no longer worthy of their attention. I’ve done grief counseling for a year, followed by trauma therapy for another, but nothing seems to help. The only thing that gives me some comfort is reading the accounts of other people suffering from what the mental health industry labels ‘prolonged grief’. Knowing that there are many others out there suffering just like I am and yearning for their loved one ‘on the other side’ at least makes me feel a little less alone.
Some things such as the grief you describe can only be understood by those who share the experience. To try tohave them understand how you feel can be like trying to describe the colour of an orange to a blind person.
In 1987 one of my children died. Some people said, ‘I know how you feel,’ but I soon realise that, with one exception, they didn’t and couldn’t.
As a psychiatrist with 20 years of clinical experience, I’ve come to see what we call “depression” as several different things. I’ve certainly seen people who have what seems to be a clear cut brain disease–in some cases almost to the point of catatonia–but these are relatively rare. Far more common are people who are having some sort of existential or spiritual crisis and who wish to take a pill to avoid the suffering they need to go through. The latter would have been considered “just part of life” a generation or two ago. But our instant gratification pharma-tech-consumerist culture has created the expectation that no one should ever be unhappy, leading people (especially young people) to say they are “depressed” (i.e. they have a disease) when they are merely unhappy with their lives or disconnected from themselves and their communities. It takes away all agency–but is tempting because it also relieves us of the burden of responsibility.
An interesting and thoughtful essay. I am glad I read it. But one sentence raised a tiny hackle. ‘There is comfort here for the post-modern reader.’ Who the hell is a post-modern reader? How do I tell him apart from a modern reader or indeed a reader? Or is the phrase ‘post-modern’ a sort of verbal tic that we have to drop into our sentences now and again?
If verbal tics are a form of laziness, then yes!
Another form of laziness is having an essay titled “Can depression be cured?” under the strapline “Summer reads”. Yes, the author might have read her Melancholy tome on the beach, but…
Tragically, depression is the new autism (or maybe the old autism) . It’s become fashionable to have a mental illness, so many people without mental illness are claiming to have one. Their voices tend to be elevated over those of people who are truly suffering (perhaps because the whole point of their claiming mental illness is to elevate themselves).
There are people who cannot take the small steps necessary to improve their mood or their life without taking anti-depressants. No one who has suffered actual clinical depression would agree that simply taking a walk or indulging in “small pleasures” will make them “better”.
I’m no friend of Big Pharma, but taking an SSRI did vastly improve my quality of life after suffering from debilitating depression since age 13 (I’m surprised to this day that I survived it).
My concern is that people suffering from actual depression are discouraged from taking medication due to hearing that it does not help, or that they should just “take a walk”.
Many types of depression are medication resistant – but not all forms of depression are.
I’ve known people who decided to “tough it out” by stopping their medication and ended up losing everything – in some cases, even their lives.
Because depression can kill you, I suggest throwing everything at the wall (including meds) to see what works – take nothing off the table just because other people insist that “it’s all in your head” (which is the most dangerous place for it to be).
Thank you for this.
The problem is that the SSRIs have no science to support them. These drugs were originally discovered by a process based more on data mining than science.
When the drugs were found to have a psychological effect scientists developed a theory that depression was often due to a lack of serotonin, and that inhibiting reuptake of serotonin would help cure depression. That theory never had any scientific evidence to support it, and every indication is that serotonin levels have nothing to do with depression.
Clinical trials with first Prozac and then other SSRIs showed some positive effects. Later more rigorous studies did not, and reexamining the earlier studies showed no real lowering of depression.
The SSRIs do have a psychological effect, there’s little question about that. And they may help some people with depression, as you say they do you. But there is no science to support that. Those like me who believe in evidence-based medicine are very doubtful when after 35 years a drug has no scientific evidence to show that it works.
My own personal experience with an SSRI was not like yours. The drug, which I took on and off for almost 8 years, did a lot of harm and no good. I had high hopes for it, which it why I stuck with it for so long. But looking back I wish I had never touched it.
Completely agree. I was prescribed antidepressants for prolonged grief and they made me feel even more depressed and physically ill to boot.
Yes, Penny. Every time I have suffered it has felt more like a kidnapping than an existential crisis.
“12.7% of Americans had taken antidepressants in the past month (and nearly twice that percentage of women)”
This can not be accurate. 25.4% is twice the percentage given for all Americans. If 25.4% of American women are on anti-depressants, but only 12.7% of all Americans are, it would imply there are no men at all on the drugs. Just think about it: 1000 people, half women, half men. 25.4% of the women would be 127 women, which would be 12.7% of the total population of 1000, leaving no room for any depressed men. The numbers get bigger with 300M people, but the ratios don’t change.
Something’s wrong with this article’s numbers.
Excellent. Often pedantic comments are just that, your comment defies the norm (said with a broad smile), excellent, thank you.
Excellent point. All those exaggerated headlines would disappear if the % were turned round. For example the quote above, whether true or not, could state 87.3% of Americans had not taken antidepressants in the past month. This rather changes the gloomy picture being presented.
Yes, that statistic struck me as being bizarre. As we have learned in recent years, so-called journalists tend not to be very good with figures, particularly percentages.
If you go to the linked study it declares 8.6% men and 16.5% women which 50/50 averages close to the 12.7 number.
BUT — she didn’t actually say that.
What she said, was: “But in a 2017 survey, 12.7% of Americans had taken antidepressants in the past month (and nearly twice as many women as men)
She’s not saying twice as many women were taking anti-depressants as the rate seen in the general population. She’s saying twice as many women as men were taking anti-depressants. That gives us an equation of (X+2X)/2 = 12.7…. or X+2X = 25.4….or 1.5X = 12.7…..or X (the men’s rate) = 8.5%….and 17% rate for women (roughly).
You’re absolutely right to ask those questions…we just have to be careful how we read the Other’s summaries.
The best cure for depression is to stop smoking weed.
The author does not address her title, Can depression be cured? I was twice very close to suicide, the first spell ended when, ironically, I was run down by a car in 1965, aged 23, and my injuries were thought likely to be fatal. I got a lot of strength from how I dealt with the aftermath. The second time, in 1972, I could see no hope of future happiness, and planned as a virtual non-swimmer to go into the nearby Thames at night. I was pulled back from the brink by a girl who had learned a lot of value in India, leading me to go there, where I had the good fortune to learn Vipassana meditation, a non-sectarian technique taught by the Buddha, from a great teacher, S N Goenka. The course not only changed my life, it put suicide out of the question.
On a course two years later, I recovered a memory from 1944 (aged 2), when with a family break-up and the birth of my brother, I felt rejected by both parents; I saw that for over 30 years I ha been seeking acceptance by trying to be “good” etc (it doesn’t work). (I later verified my memory with my mother and sister). There have been times since beginning Vipassana when I have been very depressed, notably when I had two serious long-term illness and was driven out of work with the Queensland government because, I learned, they felt threatened by my “honesty, integrity, intellect and analytical rigour,” which got in the way of bad, self-serving policy. But for many years I have gone through life with a smile on my face, to which other people respond; I lead a happy, harmonious life, good for me and good for others. So depression can be real and can be dealt with, but not by anything the author knows of.
Infantilisation of the populous via feminist doctrines that just happen to fit the needs of big pharma is one problem.
Men are far more likely to commit suicide than women, and less likely to take anti-depressants. Obsessing about the big bad feminists does nothing to help men to improve their own lives.
Yes, it does!
Men are just as vulnerable to the “feminization” of our culture as women, although I don’t think we can pin all the blame on “the feminists.” There are many forces at work–cultural and economic–that have made us “soft” — or to put it in more clinical language, that have caused us to lack resiliency. I do think that our obsession with “safety” and our culture’s normalization of the avoidance of struggle and conflict have had a profoundly negative impact on everyone’s mental health.
I have a copy of Burton: A Folio Society hardback that cost me a pretty penny. I dip into it occasionally. It’s one of my small collection of strange books that I have never read all the way through from beginning to end, but which I “consult” when I feel the need. They don’t cure anything (sorry to tell!) but they distract my mind when it needs distracting, or perhaps just occupying. I think that people used to read The Bible in this way, but it seems to have fallen out of fashion.
Human Givens understands depression as a rem sleep disorder, caused by dreaming too much in an attempt to clear away excessive ruminations and an overstimulated imagination. The primary cause of the excess rumination is a life not well met – where essential human needs (around work, relationships, safety, and meaning etc) are not being well met. The main symptom of depression is exhaustion, a direct feature of over dreaming, which then unravels. Depression, according to this approach is very much a great unravelling – or what I call a depression vicious cycle.
Perhaps I should express an interest here. I am a human givens therapist and I deal with depressed individuals all the time. Most depressions can be lifted pretty easily, without medication and without a spurious medicalisation.
Thank You for saying “most” depressions and not all depressions.The rem sleep disorder definitely fits with my own experience of depression, but medication still helped me.
Where does insomnia fit in?
Wow – I was just beginning to learn about this.
I dream intensely almost all night – which I recently confirmed with a sleep monitor. I wake up just as exhausted as when I went to sleep. I have certainly suffered from a form of depression.
What is the ‘pretty easy’ way to improve this?
The best way would be to see a human givens therapist. You could begin by looking at my website. https://andrewmrichardson.co.uk/
Just watched Ivan Tyrall on Human Givens. Absolutely fascinating.
Thank you for guiding me to this.
“The Myth of Mental Illness” by Thomas Szasz, written over 50 years ago, foresaw the nonsensical plethora of “mental illness” that we have now.
I have a decidedly different take on this. I survived Serotonin Syndrome, having been in an 8 day coma. Upon release from the hospital, as part of the sequelae, I experienced clinical depression. I did recover from that after a couple of years, with the help of a good psychiatrist who experimented with different antidepressants to ameliorate the discombobulation of my neurotransmitter balance.
I am left (fortunately not depressed) today with the inescapable conclusion that depression can result from a physical, neurological cause. And that antidepressants can help with that. It is also my personal experience that this is not the only cause or solution to depression and that work on one’s circumstances and attitudes is another route to mental health.
Did you go back on antidepressant?
I do not understand the virtue of any melancholy that borders on suicide. Lived with that for 42 years, and without for the last 4 on an SSRI. No one is a statistic, mental illness is real, and at least for me the meds work. Life changing, really.
Do lots of exercise, drink more water and less alcohol, and never smoke weed.
Work with your hands. It engages the mind and body, and distracts from melancholic thoughts.
Transcendental Meditation cures depression. Studies have shown this to be the case, and it was my experience as well.
I heard that TM improved mental health. I received the instruction from a qualified TM teacher. On purpose I didn’t change anything about my daily routine other than doing the meditation as instructed for 20 minutes twice a day morning and evening.
I had been depressed for years. After 60 days of doing the meditation I began to think that maybe things were improving. After 90 days I was sure the depression was lifting. And it did. That was many years ago.
Life goes on, there are still ups and downs, including some very hard times, but I don’t get depressed anymore.
I suspect most people who claim to be depressed have no idea what actual clinical depression is like. It’s not melancholy, it’s not sadness or desperation. Situations may trigger it in those that truly have it, but they’re not the “cause”. Depression is an all encompassing heavy weight on the soul ( for lack of a better term – I’m an atheist and don’t believe in “souls” ). I suspect it’s a genetic predisposition, which doesn’t always manifest in everyone with the genes.
It’s really impossible to explain to anyone that hasn’t experienced it, in the same way mania is truly beyond my comprehension. I’ve experienced friends in a manic state with delusions of grandeur, belief in all sorts of what can only be described as “magic”, a seemingly psychotic state wherein reality and fantasy are conjoined. I can’t really wrap my head around that, but I understand the heaviness, the overwhelming ennui, the inability to move, of major depression even while simultaneously my rational mind clearly understands the whys, hows, and answers to “fix” it to no avail.
Thankfully Bupropion which is an NDRI not an SSRI keeps me from that deep void. SSRIs did nothing for me at all, beside some ugly side effects. And I still experience profound sadness, melancholy, etc. from time to time but it never progresses to the major depressive disorder level. It doesn’t “dull” me at all. I just feel normal which is by comparison pretty great. I don’t experience any side effects either thankfully. I’d prefer not to have to take it, however having deliberately experienced life without it a few times I know it’s necessary. Again, I firmly believe most people will never understand, and that’s a good thing really.
It is interesting how this author is subconsciously aware that the way our modern medicine thinks is mostly defied by the industry aimed at treating illness. But like most in the medical business, one is not aware that one does not know that the modern medicine narrative is the consequence of the needs of the industry of illness (which makes the rules and provides the investment and the questions for research)
The emerging definition of health is: the ability to adapt and self-manage in the face of social, physical and emotional challenges.
Once one accepts this definition, this article would have been written from a different angle, research in medicine will start asking question related to how can we make people healthy (rather how can we make them feel better: the difference is subtle by the angle very different and the outcomes will be radically different) Such a change will be too much restricted by financial interests and hence we shall struggle along with a view on health and illness that is skewed and health narrative that serves the industry rather than humanity (and animals and farming etc).
There are a few voices promoting change but they are still drowned out by the press from popular to professional outlets that keep the same ‘modern’ narrative going avoiding change, even when the population cries out for it (shown in the gaining of popularity of other medical approaches despite resistance of the medical establishment that wishes to keep a status quo which suits them better…)
“The Anatomy of Melancholy won’t cure depression.”
We might as well say it won’t cure life.
For to live, most fully, invested fully in the world, its people, this time & place with any sense at all of what has preceded and what may follow — to do that as mortal man whose life is the blink of time sitting between Before & After is to wrestle Depression (for lack of a better term)…to wrestle life.
” Twilight and evening bell… And after that the dark!”
To find the inevitability of our ending, somber, is to be human. To recognize and anticipate the closing of the circle, to mourn the lost, to wander solitary beside a lake of tears — yeah, I can see how we might get depressed.
But why does such a state require endless handfuls of drugs and quiet hours, in dim rooms, with soft-voiced therapists asking, “And how did that make you feel?” It made me feel bad, of course, but so what?
When I walk in rain I feel wet. When the wind howls in December, I feel cold; in August I feel hot.
It’s natural, in other words, that sad things make us sad.
But like the man in mid-plunge…asked, halfway down the cliffside, “How ya doing?”…we answer, “So far so good!” We grin!
So far, so good, indeed.
There is an end, but it is not here; not now.
Eventually we lose, but right now we win, this moment, passing, still — we win..
Can depression be cured? Of course not. We might as well ask if breathing can be cured, or eating, or having our belly growl, or our feet hurt, or knees ache. Can having our heart break, can that be cured? God no. Please no! Not here; not now — all these things are life.
And imagine a life without them. No hunger; no thirst; no fear; no pain; no grief; no regret; nothing lost or gained…
“The grave’s a fine and private place,…”
So be depressed or not. Choose as you will and recognize that each choice is life. So why inure yourself to it? Why insulate yourself from it? Why seek to escape what you’re already, by nature, ineluctably abandoning?
Rather embrace it; hold it close; squeeze hard and refuse to let go! Refuse absolutely.
Now therefore, while the youthful hue
Sits on thy skin like morning dew,
And while thy willing soul transpires
At every pore with instant fires,
Now let us sport us while we may,
And now, like amorous birds of prey,
Rather at once our time devour
Than languish in his slow-chapped power.
Let us roll all our strength and all
Our sweetness up into one ball,
And tear our pleasures with rough strife
Through the iron gates of life:
Thus, though we cannot make our sun
Stand still, yet we will make him run.
And this, too, we choose!
I think a lot of people have identified as depression what is actually boredom.