The legacy of depression

Depression is perhaps the most unexpected source of suffering in an affluent society.   People who are no longer living on the edge, who have reliable sources of food and shelter, sometimes with almost boundless spending capacity and social status, are often screaming with the psychic pain of depression.

Why?

The causes of depression are many.  Unlike great scourges like the plague or polio or small pox or malaria, depression is not caused by a single identifiable organism that is potentially halted by vaccines.  Depression is partly genetic, partly learned;  it is partly bio-chemical, partly psychological.

Depression tends to run in families.  Many characteristics which are not genetically influenced are generational — the language we speak, for instance – but in the case of depression, there is a genetic loading.  Not an absolute determination.  But some bio-chemistries are more prone to depression than others, and bio-chemistry is partly inherited.

But it is only partly inherited through our genes.  We know now that our bio-chemistry is influenced by environmental factors beginning in the womb.  The chances of my being depressed in adulthood are increased from day one if my mother is stressed during her pregnancy.  The stress may not be of her choosing or her responsibility – it may be due to famine, war, marital discord, financial difficulties – but a study of epigenetics has shown that  the anxiety felt by the mother actually influences the gene regulation of the embryo.

Unfortunately the causes of depression are not limited to the first nine months of our lives.  Studies of tens of thousands of children in the States and in Britain show that children who are abused, neglected or rejected are more than twice as likely to experience recurring depression as adults.   People prone to depression are far more likely to be thrown into long periods – months or even years – of anguish by life’s inevitable challenges – bullying at work, death of a loved one, the break-up of a significant relationship, worries about money, or the life changes that might come with retirement and subsequent feelings of uselessness and abandonment.

Depressive people are often exceptionally intelligent, but depression is not rational.  The black cloud that engulfs a person is not something that is dispelled by reason or logical arguments.  It can’t be fixed by replacing the worn out part, by throwing money at it, by buying things, even by giving the depressed person what they think at the moment they desperately want.

It is not, though, completely hopeless.  In fact, depression is amazingly treatable.  The biggest obstacle is often convincing the depressed person of that.  The very nature of depression often leads the person to argue that there’s no use trying.  They believe the causes of their depression are due to factors outside themselves – the economy, their spouse, the world’s suffering, their own failures.

Drugs can and do help bring some people back even from the edge, even of suicide.

Exercise is an immensely useful tool in keeping depression under control.

Interestingly, cognitive therapy, learning to think differently,  has as good a record for many people who are depressed as medication.  Learning new thought patterns can often , with effort and patience, lead to significant permanent change.

One can learn not to take ones depression at face value – to recognize that depression distorts.  One can learn not always to assume that the negative interpretation is inevitably right — the depressed can learn that they are loved for themselves, not merely for their usefulness or money or as a result of some neurotic need by the person who seems to care for them.  One can learn that bad news can often be turned into an opportunity rather than failure.

In my experience, this kind of change doesn’t always require therapy.

But it does always require courage.  And time.  And love.