“Imagine trying to enjoy a poolside party when you are drowning in the pool and all you can hear is people having a great time and laughing while completely oblivious to the way your body keeps submerging into the water and getting heavier by the water filling your lungs.” Anonymous.
Depression is like that.
Depression is usually defined as an illness characterised by prolonged low mood and a wide range symptoms, which vary from person to person and may include feeling helplessness, hopelessness, meaninglessness, low self-esteem, change in sleeping patterns, loss of appetite, decline in sexual functioning and low energy levels. Depression can develop quickly or gradually and it can strike anyone.
There is no single cause of depression. You can develop it for different reasons and it has many different triggers. Currently, there are three main hypotheses regarding the cause of depression, a biochemical one, an environmental one and one that combines the two. Of course, the distinction between the first and second is artificial, we are biological and we interact with, are part of and are influenced by our environment.
The biochemical approach claims changes in brain chemistry and lower levels of serotonin are the cause. Despite numerous experiments, this hypothesis is yet to be fully substantiated; many clinical studies indicate that it has less to do with brain chemistry and more with a placebo effect. In all instances, anti-depressants may control symptoms in some people, are only effective in conjunction with other treatments and do not seem to give sufferers a depression-free life. Other sufferers do not respond to anti-depressants and are seen as resistant to treatment which may leave them feeling helpless and thus maintain their suffering.
The environmental hypothesis considers depression as a defence mechanism that helps to escape from unbearable stress, real or imaginary, a way of hitting the brakes, as it were, when life gets too much. In some cases, it can be part of a grieving period or a form of anger directed towards the self for not having lived up to one’s expectations. According to this approach, we need to remove stressors from our environment in order to remove depression. It may be true in some cases, however, in my experience, many depressed people cannot make a direct link to a specific life event.
The increase in depression rates in the West (some statistics forecast depression to be the second most disabling condition in the West by 2020) suggests that it may have to do with social changes, such as individualistic culture, the breakdown of community life, the move from smaller communities to big city life, loss of faith (some studies suggest that religious people suffer less from depression) and loss of purpose and meaning in life.
As depression has no physical evidence, many depressed people report feeling misunderstood, judged, isolated and lonely and start to withdraw from any social engagement. The problem is that isolation and loneliness only perpetuate and maintain depression.
The sociobiologist E. O. Wilson writes that “to be kept in solitude is to be kept in pain and put on the road to madness”.
A relational approach follows the third hypothesis and whilst it cannot explain what makes some people depressed, it sees relationships as a physiological experience with physiological consequences. We know that other people, especially close ones, can make us feel sad, angry, elated, happy or in love. A relational approach is one that emphasises the vital importance of connection and context in determining how individuals identify resources and opportunities to flourish. From this perspective, depression is seen as meaningful transition process, rather than an event.
Such approach challenges the culturally dominant theory that individuals have issues because problems are inside them, instead, it stresses the importance of situations and social structures in determining human behaviour. Depression may be an appropriate response to inappropriate conditions –not so much an illness as a reaction.
When people recover from depression it is most likely through the help of and connecting with other people. They normally attribute recovery to a sense of belonging, learning skills and changes in their capacity to reach out and be reached by others.
A sustainable and enduring recovery from depression requires behavioural change. Whilst sleep, nutrition and physical activity contribute to this change, feeling acceptable and lovable and connecting with supportive others is no less crucial. When we feel part of a support group, we know that our individual concerns are group concerns, we also know that if we have a problem others will help us and we are expected to help when others need support. In modern Western society we seem to have lost this understanding.
Building a support network is something that can be learned and the first step in curing depression is curing loneliness.
End of part 1.
