One way to understand depression is to see it as a problem that has to do with courage. It develops in people who have, most often by necessity, become afraid of the unavoidable dangers of life. People who have had to give up on their independent development because they have had to become immersed in what others do, think, or need. People who suffer from depression will usually have lived a life having to restrict themselves. The result being that the less they do the less they can do, and the more helpless they become.
The more someone is forced to shrink back from the difficulties and challenges of life, the more they naturally begin to feel inadequate. It is inevitable. If someone’s life has been a series of “silent retreat’s” they end up wedged into a corner and have nowhere else to hide. The depressive person has learned that, no matter what they do, “it makes no difference”. This is why depression is sometimes referred to as ‘learned helplessness’ – i.e. that the person has learned that being helpless brings the least amount of pain.
Therefore, the fear of the consequences of living a full life leads to an excessive sense of failure, impotence, inadequacy, and rejection. Finally, the individual does not dare to move. The depressed person may lie in bed for days, letting the housework pile up, plugged into the small corner of their life.
Life itself demands the willingness to risk oneself on a daily basis. Every day life asks us to arise and face the unknown, to prove ourselves again. Every one of us has to find courage to face this uncertainty. “Will I be good enough today?” “Will I be adequate enough as a parent today?” “Can I still prove myself at my job?” “Is my life secure today?” “Will my husband still love me today?” If the truth were known, each day requires courage and self-belief.
The depressed person, for genetic, family, or circumstantial reasons, begins to retreat from life’s unpredictability. Life demands independence and self-responsibility and the courage to face into it. In trying to not put a foot wrong, in trying so hard to not let others down, the depressed person begins to sink deeper into their shell.
Most people find it hard to understand depression because they are in denial of their own fears and dreads. So entrenched are they in their security defining rituals and status confirming routines that they find it hard to understand the anguish and terror of the depressive. They prefer to label depression as some form of selfishness or self-pity. They label the depressed person as someone who refuses to grow up.
However, they forget and deny the real fear that influences their own life. The fear of difference, isolation, loss of support, loss of power, is within everyone. People can protect themselves from the terrors of life by getting a spouse, a job, a family, success, substance-enhanced good feeling, and by building a security-fence of social status.
However, when these things fail and he or she is threatened with the loss of any of these things, how logical it is that he or she gives way to some form of depressive withdrawal.
The loss comes because of a physical illness, the death of a family member, the infidelity of a spouse, the breakup of a marriage, the mental health of a child, or just chronic stress. In fact chronic stress illustrates how one cannot spend everyday of one’s life trying to prove oneself. One cannot pretend to be in control and supremely competent when deep down one is unavoidably average. At these times he or she discovers that all the status and securities do not protect them from life itself.
In many ways depressive withdrawal from life into helplessness and dependency is the last and most natural defense available to any creature. Dependence on others is a basic survival mechanism. When someone gives up hope in his or her ability to cope he/she is reduced to a state of depression.
The guilt of the depressed person is understandable because they feel the sense of failure in not being able to fully live their lives. They feel guilty because they know very well that they have, until now, failed to live up to their potential because they have twisted and turned in their efforts to be “good” in the eyes of others.
The truth is that we are not in this world to please others, nor are others there to please us. If we can but grasp the truth, we are in life to be heroic in facing the challenge of everyday life and to be fearless in our pursuit of happiness, regardless of what anybody thinks. The integrity of the self is more important than anything. Don’t give up!
Are you anxious or are you depressed? In the world of mental health care, anxiety and depression are regarded as two distinct disorders. But in the world of real people, many suffer from both conditions. In fact, most mood disorders are a combination of anxiety and depression. Surveys show that 60-70% of those with depression also have anxiety. And half of those with chronic anxiety also have clinically significant symptoms of depression.
The coexistence of anxiety and depression carries some serious repercussions. It makes them more chronic, it impairs functioning at work and in relationships more, and it substantially raises suicide risk.
In truth, depression and anxiety are two sides of the same coin. Researchers suggest that what goes on in the brain and body are very similar. It just seems that some people with the vulnerability to mood problems react with anxiety and some people, in addition, go beyond that to become depressed.
People with depression tend to close down - it is a form of shutdown. Anxiety, on the other hand, is a kind of looking to the future, seeing dangerous things that might happen in the next hour, day, or weeks. Depression is all of that with the addition of 'I really don't think I'm going to be able to cope with this, maybe I'll just give up. It's shutdown with mental or physical slowing.
Research suggests that the stress response over-reacts to situations causing anxiety and depressiveness. Negative things then tend to cause a disproportionate impact and response.
You may identify with this inability to have a proportional response to situations. You may be awake at night worrying about the smallest of things, or you may feel very downcast because some small thing did not go your way. When something makes you anxious you may worry about it for a while but then begin to feel despondent that things are ever going to change.
Psychologists often have difficulty distinguishing anxiety from depression. The things that work best for depression also combat anxiety.
Who is at risk for combined anxiety and depression? There's definitely a family component. Looking at what disorders show up in your family history provides a clue to whether you will end up with both. If you have a lot of depression or anxiety in your family tree chances are your susceptible yourself.
The nature of the anxiety also has an influence on how depressed you feel. Obsessive-compulsiveness, panic attacks, and social anxiety are particularly associated with depression as there is often no relief from the worry.
Age plays a role, too. A person who develops anxiety for the first time after age 40 is likely also to have depression. Someone who develops panic attacks for the first time at age 50 often has a history of depression or is experiencing depression at the same time.
Usually, anxiety precedes depression, typically by several years. Currently, the average age of onset of anxiety is late childhood/early adolescence. This actually presents an opportunity for the prevention of depression, as the average age of first onset of depression is now mid-20s. A young person is not likely to outgrow anxiety unless he/she learns some mental skills. But dealing with anxiety when it first appears can prevent the subsequent development of depression.
The cornerstone of anxiety and depression is overestimating the risk in a situation and underestimating personal resources for coping. Those vulnerable see lots of risk in everyday things-applying for a job, asking for a favour, asking for a date. They also doubt that they have the abilities to deal with these situations and can withdraw.
Further, anxiety and depression share an avoidant coping style. Sufferers avoid what they fear instead of developing the skills to handle the kinds of situations that make them uncomfortable.
Often enough a lack of social skills is at the root. In fact the link between social phobia and depression is dramatic. It often affects young people who can't go out, can't date, don't have friends. They're very isolated, all alone, and feel cut off.
A simple question to ask yourself if you are suffering from anxiety/depression is “ What am I avoiding?” “What do I need to do with my life, my marriage, or my work that I have really been avoiding doing? What decision may I be avoiding that leaves me desperately worried or gloomy?”
Whatever the situation, the twin problems of anxiety and depression can become very debilitating as you feel increasingly helpless to do something about the problems you worry about. So you go around in circles and find it very difficult to create positive momentum with your life. The best thing you can do for now is to tell someone, to admit to your problem and to your helplessness. To give it a name. To get help. To help yourself.
Dr. Colm O'Connor is a Cork Psychologist. You can find more articles by Dr. O'Connor in the Evening Echo every Wednesday.