The good news is that depression is relatively treatable, and it is my belief that a move away from the way of life the civilized consumer economy has created for us will ultimately reduce the occurrence of depression by a whole lot (and yes, that is an official measurement). But this isn't a chicken or egg scenario - to move forward we first need to deal with our health, because healthy people produce healthy communities and ultimately, that's what we're striving for.
What is Depression?
I think this question is easiest to deal with by answering the question "what depression isn’t." Depression isn’t having a bad day or being a little down. Depression isn’t feeling a little lethargic or melancholy. Depression is a long-term feeling of uselessness, anger, mental and physical pain, fatigue, sadness, hopelessness, and overwhelming negativity. It is marked by irrationality; not only in how you act but also in how you interpret the world. It’s important to note that not all people who suffer from depression exhibit these signs – depression manifests itself differently in different people. For me personally, my depression was marked by anger – the smallest thing set me off and at times I felt I would explode with rage. Others lie in bed for days and don’t move. Others sob uncontrollably. Whatever the case, depression is incapacitating and ultimately, destructive to the person themselves and the people around them and without help, there is little they can do about it.
What Causes Depression?
The truth is that we don’t really know what causes depression, but the general consensus seems to be that it is a mixture of things that can cause a person to have a depressive episode. Certainty heredity plays a part – if someone in your family has had a depressive episode, you are probably more susceptible. Life events, whether being molested or abused as a child, the death of a loved one, or daily stressful interactions, can also play a role and in many cases, trigger an episode. Drugs and alcohol are also commonly involved – whether it is as a cause or, more likely, as a coping mechanism for depression itself. More recently, evolutionary biologists like Randolph Nesse have argued that depression and depressive symptoms serve the adaptive function of stopping humans from engaging in activities that are harmful to them or of little benefit. In a 2000 article entitled “
Is Depression an Adaptation?”, Nesse argued that
Some negative and passive aspects of depression may be useful because they inhibit dangerous and wasteful actions in situations characterized by committed pursuit of an unreachable goal, temptations to challenge authority, insufficient internal reserves to allow action without damage, or lack of a viable life strategy.
In a 2006 study with Matthew Keller, Nesse also found that certain negative situations aroused particular depressive symptoms. They found that people who were engaged in “failing efforts” were stricken with depressive symptoms such as “guilt, rumination, pessimism, and fatigue,” leading them to conclude that these reactions “may have been shaped by natural selection to minimize wasted effort and to re-assess failing strategies.”
My theory? Rising rates of depression are the result of engaging in an unhealthy way of life. Authors such as
Tim Kasser and
Juliet Schor have shown that those who are more materialistic are more susceptible to depression because they engage in activities that are of no physical or mental benefit to them – watching TV, shopping, and worrying whether you measure up to the image advertisers portray. Not only that, but the modern consumer lifestyle precludes us from doing things that we need to be healthy – spending time with others, exercise, and community service. I’ve argued that if depression really is a biological adaptation as Nesse and other suggest, that perhaps what we are seeing today with the rapid rise in rates of depression is our bodies telling us to stop engaging in a way of life that is unhealthy and harmful. Materialism as a way of life doesn't provide us with what we need as humans - in fact, it harms us physically, mentally and spiritually. Rising rates of depression are a sign that our bodies are screaming out at us to stop the madness and to try and find a new way to live, one that provides us with what us humans need.
What do I do if I’m depressed or know someone who is depressed.
Here’s the thing – most people who are in the middle of a depressive episode cannot get out of it by themselves. They need help. The dangerous thing about depression is that when people are in an episode they likely don’t know that they are in a depression, especially if they have never been diagnosed or had a previous episode. They know they feel terrible. They feel angry. They hate themselves. Some may even feel like ending it all – and the thing is that to them, all these feelings are completely rational and justified. Of course the reality is that they aren’t rational feelings, but there is nothing rational about depression. In fact, at its core, people with depression interpret the world and themselves in a completely irrational way. I’ve known people with depression who when they’ve thought about engaging in any activity, whether it is as mundane as leaving the house for milk or applying for a job, it will end up in disaster. Others believe that when they leave a room full of people, all those they left behind begin talking about how much they hate them. For me, if I saw a cup or plate not put away, I took it as a personal slight and a grandiose statement about how my partner felt about me. Rational people don’t act like this – depressed people do. And that’s why if you know someone who is in the middle of a depressive episode, you need to help them get help. I’ve known people who have literally dragged their partners into doctor’s offices and begged for help. My partner told me that she couldn’t live with me anymore if things continued as is – my depression not only affected me, it affected her, badly. And much like an addict, you can’t make excuses for someone in a depression – you can’t enable their behavior. They need help. Get them to a doctor anyway you can. Their life may depend on it.
Treatment
The big issue with depression is whether or not medication should be used. Now again, I’m not a doctor so really, if you have depression talk to your doctor about this. They are much more knowledgeable about it than I am. But since this is my blog and my post, I will tell you what I think. It’s pretty clear that anti-depressants are being prescribed as solutions to depression and that's wrong. While some people may forever need anti-depressants in order to cope with their depression, most should be able to live a normal life without. This doesn’t mean that anti-depressants shouldn’t play a role in helping people deal with depression and ultimately, change their lives. I took anti-depressants as part of a larger program to help me - my belief is that anti-depressants are needed to A) get people out of their depression, and B) help them learn the techniques they need to combat their depression and hopefully, avoid future episodes. I saw anti-depressants as a tool – a means to an end, not an end in and of itself. If all your doctor does is prescribe anti-depressants then you probably need to find a new doctor.
While anti-depressants helped me get out of my depression, what really saved me was therapy. Talking with someone else who really has no history or attachment to you as a human being is an unbelievably liberating experience. And ultimately, it allows you to get to the bottom of why you are depressed in the first place. My therapist guided me through my unbelievably negative self-talk (which led to my anger which led to my depression) and my horrible self-image and helped me see that I wasn't quite as horrible as I thought I was. For me, I think my biggest problem was that I put a lot of pressure on myself to succeed in the traditional sense and I beat myself up relentlessly when it was clear that I wouldn't (yes, Mother Culture is a bitch). Add to this my feelings of inferiority as a result of a childhood marked by obesity and the scourge of all teenagers everywhere, pimples, and I had become my own worse enemy. Freud has been quoted as stating that depression is anger turned inwards, and that's exactly what my depression was - I hated myself for my perceived lack of success. Without therapy I would have never been able to recognize the destructive self-talk I had, or been able to, at the advice of my therapist, not to see my 13 year old self simply as a fat-pimply kid who I hated with all my being, but as a funny, kind-hearted kid who just wanted to make people laugh.
I've learned over the last 18 months what I need to do to be healthy - I workout more often and go to Yoga. I eat better and I try to go out with friends for coffee and walks more often (and it's important to note that people need to engage in healthy relationships - dysfunctional and unhealthy relationships only hurt depressed people). I watch less TV and read more. I've learned that I shouldn't base my aspirations on a sick society that in the end, wants you to feel bad about yourself so you'll buy more shit. And most importantly, I've learned to like myself again - to not be so hard on myself. And I'm not alone in believing that moving away from the way we are expected to live is good for depressed people. Stephen Ilardi, a University of Kansas psychologist, has shown that when people actually change their habits through a method he calls “therapeutic lifestyle change,” they have a better chance of treating their depression than those using medication and therapy. In a
February 12, 2007, Los Angeles Times article, Ilardi argued that human beings were not designed “for our sedentary, socially isolated, indoor, sleep-deprived, frenzied, poorly nourished lifestyle”—in short, the modern consumer world. His treatment method has people exercise more, sleep more, eat more Omega-3’s, and, finally, interact more with their fellow human beings. The results have been stunning: ‘in an on-going study of 79 patients, with two-thirds assigned to his therapy and the rest to a control group treated mainly with antidepressant medication or traditional psychotherapy, Ilardi reports a 74 percent favorable response, compared with 16 percent for the controls.”
Things can get better.
Depression is a terrible existence - while I never considered ending my life I could certainly understand why some people did. Depression is a trap that is very hard to get out of and one that is self-reinforcing. When in a depression, the vast majority of things you do and think only make the depression worse - its the ultimate negative feedback loop. My cycle would work somethings like this - be depressed --> do nothing all day --> feel shitty about yourself for not accomplishing more --> be more depressed --> get angry at nothing --> feel guilty about getting angry --> feel more depressed --> eat a box of chocolate chip cookies --> feel fat --> get mad at myself --> feel more depressed --> stay inside and don't go out for days --> feel useless, lonely, and more depressed. You get the idea.
I've always believed that while there are a lot of great reasons to stop living this way (the damage we are doing to the environment and our non-human neighbours, climate change, peak oil, etc...), the best reason is that the way we live makes us so dysfunctional. People are hurting, depressed, and lonely. A study cited in the Washington Post in 2006 said that
1/4 of all Americans have no-one to talk too in times of need. Just think about how fucking insane that is, especially in a day and age when we have more communication tools than ever before. Our culture is insane and its demands of us, both materially and aesthetically, are insane. And most importantly, it makes us insane. So please, if you or someone you know has depression - get help and change the way you live your life. You are not alone. We need you to be healthy - I can think of no better people to produce the changes we need for a more sustainable way of life than those of us who have fallen victim to civilization itself.
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