Seiten

Tuesday 30 November 2010

Depression Reloaded

Was ist der Mensch - die Nacht vielleicht geschlafen, 
doch vom Rasieren wieder schon so müd, 
noch eh ihn Post und Telefone trafen, 
ist die Substanz schon leer und ausgeglüht, 
ein höheres, ein allgemeines Wirken, 
von dem man hört und manches Mal auch ahnt, 
versagt sich vielen leiblichen Bezirken, 
verfehlte Kräfte, tragisch angebahnt, 
Man sage nicht, der Geist kann es erreichen, 
er gibt nur manchmal kurzbelichtet Zeichen.

For what are you – maybe you could sleep last night,
But now already so exhausted just from shaving,
Before the postman comes and the first ringing of the phone,
Your essence is empty, the embers burnt out.
A higher, more general type of force,
Of which you’ve heard, whose presence you’ve sometimes even felt,
Abjures so many bodily regions,
Futile energy, tragically prepared,
You can’t even say, the spirit can attain this,
It only gives occasional, briefly illuminated hints.

(Gottfried Benn, Melancholie 1954)

At the end of the nineties, when I was struggling with depression, a good friend gave me this poem to read. Even in my inner landscape of hopelessness (or perhaps because of it) at the time, the work struck a chord in me – I felt that Benn had been where I found myself, and had found words to describe it.

Describing what this strange, sombre inner world is like is not easy, at least not for me. People who have never really been there tend to think of depression as being a state of complete and continual sadness but this, in my opinion, doesn’t really get to it. In German the English couplet, easy and hard, can be translated as leicht and schwer, light and heavy – when you suffer from depression everything is schwer, heavy. Just moving yourself takes more energy than you feel you have at your disposal. There are a lot of negative feedback loops here, drained psychic energy leads mostly to reduced physical energy (although there are often phases of agitation which are exceptions) which in turn leads to a reduction in endorphins whose lack reinforces an imbalance in cerebral neurotransmitters responsible for mood. Mind influencing matter, matter determining mind.

Medical science has moved away in recent years from a rigid diagnostic separation of endogenous and reactive depression. There are definitely tendencies towards neuro-chemical imbalance (which give rise to serious depressive and bi-polar as well as other mental disorders) which probably have a genetic component. But the formation of our particular personalities in our childhood and the concrete experiences we make in life all play important roles. The roots and reasons for any particular depression are as individual as the person suffering from it.

From Aristotle onwards the purpose of life has been seen by many thinkers as the pursuit of happiness, though what exactly this means is itself the object of much deep reflection and questioning. We can perhaps state that depression is the opposite or absence of happiness, though there may be occasions on which it is a sensible reaction, for various reasons. Evolutionary psychologists speculate about possible positive effects of depressive reactions – there may be something in the thought that a depressive rather than aggressive reaction in particular circumstances, e.g. where resistance increases the chances of being killed, has a positive result for individuals. While I tend to see the complex logical chains in many arguments claiming to be based on evolutionary psychology as being highly speculative, there is one aspect to this kind of thinking that I find interesting.

One model which is used, particularly in some therapeutic contexts, to approach depression is to see it as suppressed, or inwardly transferred aggression. The basic idea is that we are faced with all sorts of situations in our daily life which are potentially threatening. A basic, animal reaction to this kind of stimulus is the fight/flight response. But often, the fight instinct (aggression) cannot be acted upon – for all sorts of reasons. The aggressive energy must be directed somewhere; failing its proper target, we can tend (on the subconscious level) to suppress it by directing it inwards against ourselves. In particular situations, where such a response is repeated and reinforced it can become a general strategy of activity. Like a thorn which is not removed, such misdirected aggression works inward, infecting and poisoning whole areas of the psyche.

 Anyone who has taken the therapeutic road of coming to terms with depression has probably made the acquaintance of this model of seeing things, and there is a lot of value and truth in it – for many people at least. We should, however, remember that it is a model. Now, the great thing about models is that they don’t claim to be complete pictures or explanations of everything that’s going on. Moreover, they are not exclusive – rather they can complement each other, even if they also contradict each other on some levels. This is, in my view, very important when we are dealing with such deep, complex and wonderful realities as that which is called the human soul.

With this in mind, I’d like to suggest another model. Like a coin, which always has two sides, or a tree, which in sunlight will always cast a shadow, I think that those parts of our personalities which cause us suffering or pain are frequently the inevitable shadows of our most positive and cherished aptitudes. And this is also the case for depression. This chronic pain as a reaction to the senselessness, the heaviness of life, the deadening dulling in the face of the merciless intensity of cruelty and suffering (as personally experienced) is the shadow side of an openness and sensitivity for others, the other side of the coin known as empathy.

This has consequences for the strategies those who suffer from depression may choose for dealing with it. (Apart, of course, from professional help and – should it be considered necessary – medication. What I am talking of here should not in any way be considered as an alternative to the basic ways those much wiser than me have developed over years for dealing with something which has to be seen as a debilitating illness and a source of deep suffering for millions. And it also does not obviate the necessity of changing negative concrete factors in one’s life which have been identified as such and are changeable.) We tend to quickly resort to the language and imagery of warfare in our descriptions of dealing with illness; so people “struggle with”, or “fight” depression. Some may claim that this is only figurative language but language defines thinking – particularly when we are dealing with things which are difficult (if not impossible) to quantify such as feelings or mood.

You can’t fight depression. Fighting it only makes it worse, since one of the mechanisms which makes it function is to take every tiny failure and every setback in that “fight” as something which strengthens the condition enormously. The way forward is different; you have to accept your depression as part of yourself, an aspect of your personality which is the shadow side of positive attributes which you possess. If you really want to excise this tendency to depression from your personality then you’re also going to have to distance yourself from other things like empathy or sensitivity. And I don’t think that most of us (even in the depths of depression) would really want this, it is, after all, nothing less than a spiritual lobotomy.

Instead, you can embrace your depression as part of yourself, the necessary consequence of other parts of yourself which are unquestionably positive. And what is part of yourself is not the whole of what you are. There is much more to you than your depression, even if that can be difficult to believe when that black dog is hanging from your back. One of the most dangerous tendencies of depression is increasing tunnel-vision, an inability to see many of the options always available until, in the end, you can only see two – unbearable suffering or suicide. But there are always more options and depression need not define your whole personality. One way to realise this for yourself is to stop trying to deny it and instead acknowledge it as a part – but only a part of you. And a necessary part of you, an aspect of other attributes which define you at your best.

The strange thing is that, treated in this way, as just one attribute among many, depression tends to weaken and shrink. It is a darkness which thrives on the inner limelight; forced to share it, it withdraws more and more, muttering vague threats, into the shadows. Which is where it belongs.

This post is a continuation of a previous one: http://francishunt.blogspot.com/2010/11/depression.html
I decided to write it as a response to the many courageous and honest comments which my first essay occasioned and feel thankful and honoured by those who revealed something of their own inner life here.

My present musings on the subject were initiated by a chance telephone conversation I had recently with an old friend who has had to bear with many difficult and extended visits from the black dog over a long period of years. G., I admire and am humbled by your endurance and courage. I love you, man.

7 comments:

  1. A translation such as „for what are you“ instead of „(for) what is man“ causes me a lot of pain - and my son Noah will have to suffer it in the form of some extra exercises on the usage of personal pronouns this afternoon (in French though, but the principle behind it is the same).

    German Weltschmerz that is. ;-)

    ReplyDelete
  2. This is a clear and elevating view of depression, Francis. Thanks for offering it at such an important time of the year, the beginning of hibernation season for many of us as the days grow shorter and cool weather sets in. The holidays too, can be a source of depression for anyone having experienced a recent loss. I love your conclusion that includes acceptance of self and empathy as part of the palliative care. Your article itself soothes the soul. Many thanks.

    ReplyDelete
  3. Traduttore - traditore, say the italians, Gabby, not without reason. Translating poetry is always a risky business; decisions and revisions which a minute will reverse, as T.S. Eliot said (who put an untranslated verse from Dante at the beginning of Prufrock).

    The decision to use the indefinite "you" was conscious, had I translated "Mensch" as "man," I would have been open to accusations of verbal sexism and there's too much of the pc feminist in me to want that! :-)

    The indefinite "man" in German is much more common than the use of "one" in English. We Irish hardly use it at all, which is probably the reason the country is broke now. If I had used "one", I'd have felt like Prince Charles (one does, doesn't one?).

    Eeh, Alte, isch wollte dir keine voll krasse Schmerzen zufügen, weisst du?

    ReplyDelete
  4. "This chronic pain as a reaction to the senselessness, the heaviness of life, the deadening dulling in the face of the merciless intensity of cruelty and suffering (as personally experienced) is the shadow side of an openness and sensitivity for others, the other side of the coin known as empathy. "

    ...Also, the Anger Repression along intense flight/fight chronic anxiety....

    You seem to know this beast very well. I have been in treatment for almost 12 years.

    I steadily saw a therapist for almost 10 years. Now, just my psychiatrist.

    My biological family also has a history of manic/depression and anxiety. This coupled with an extremely abusive childhood led me finally to medication.

    I am also Agoraphobic and suffer frightening intense panic attacks. After years of therapy and different medications my DR. finally found one that helps.

    But, it only helps, it does not cure!

    Thank you for addressing this issue. So many people truly do not understand. Many people are ashamed to even talk about it.

    They are afraid of how people will view them. I don't care if society is still stuck somewhere in the 18th century when it comes to understanding mental illness.

    I speak out. If we never speak out and share then how can we help each other and also help society in general have a better understanding?

    Another moving post...I am in tears as I type!

    Thank you Francis.
    Jackie

    ReplyDelete
  5. This is a great post about a very important subject. I was talking to another friend today about depression and a situation she was unable to resolve in her life. We tend to compartmentalise various aspects of our lives into things that make us happy and things that make us sad often without realizing that the wholeness of our beings is a work in progress.

    I do tend to suffer bouts of depression that when I was young led me close to those depths of despair where there seem to be only two choices. I never chose suicide because I always knew how that would hurt the people who loved me. Thank God there are people who love us even when we don't feel loveable.

    Ultimately, life is a mystery and heartache deepens our ability to feel compassion - a much more fulfilling emotion than happiness.

    In other words, I agree with you.

    ReplyDelete
  6. This is a superb post about a subject that affexts me too. Well done

    ReplyDelete
  7. Jackie: Your comments and the wonderful artistry and optimism of your blog are a testimony to your courage and strength - shine on!

    Susan: You speak of a matter I've been considering for a long time; compassion as a basis for organising society and the way we live with and relate to each other. I don't describe myself as a Buddhist, yet I think the basic Buddhist approach of compassion and right action may be a much better template for society than the Christian one, which claims to base itself on love. Love is a sublime and most powerful emotion, it can move mountains and I would never want to be without it. But it can also be destructive and cause desperate harm, particularly when it is warped, which frequently happens.

    ReplyDelete

Your comments are, of course, welcome. I've had to reinstall captchas recently as - like most other bloggers - I was being plagued by spambots.

LinkWithin

Related Posts Plugin for WordPress, Blogger...