Depression

In a culture such as ours where the goal of instant and total happiness is promoted, depression is a stigmatised condition; and is often viewed as a moral failure. Fluctuations of mood are normal and inevitable; when depression becomes disturbing and problematic, or threatens to overwhelm, then it is wise to seek help - even if you imagine there is no point.

Depression may be:

1. Reactive - a normal response to a loss or disappointment. Anniversary dates related to a loss, for example due to death of a loved one, are often accompanied by reactive depression; whether or not the loss is consciously remembered. Mid-life is often accompanied by depression, as is any time when the self is called upon to expand. The work at mid-life is the work of recognising what is no longer useful (beliefs about self, patterns of behaviour, relationships characterised more by toxicity than nurturance). Experiencing the loss of these is part of the journey as a person steps into a more expansive adult being.
2. Intrapsychic - basically the self is at war with the self; life energy is caught up in this process. The question here is "What is being depressed (kept out of awareness)?" Consider the example of an eight-year-old child who comes home from school to discover his/her parents have taken the family pet to the vet to be destroyed because it is "too old". Imagine this decision was made without consulting the child. After the shock of discovering his/her lifelong companion is dead and never returning, the first impulse of the child might be rage at the "murdering" parents. The child may want the parents to be dead. But such a response might be contrary to the child's belief system, part of which may say, "Your parents love you, they are always right, anger is not nice, you must love your parents". The conflict between the emotional reaction and the cognitive belief system can be resolved by depressing the emotion, by keeping it out of awareness. This pattern, learned early in life, may become habituated to the point that any feeling deemed "unacceptable" is routinely kept out of awareness and therefore denied expression. This form of intrapsychic conflict takes tremendous energy, leaving less available for other activities, and may result in a feeling of generalised depression.
3. Endogenous - theories of depression include this category, presumed to be biologically based, and thought to be inherited. The understanding is that some individuals simply experience life as a struggle, with little capacity for joy. The new antidepressant medication belonging to the class of "SSRI's" (selective serotonin reuptake inhibitors) have helped millions to adjust to this condition. The way they work is to allow greater amounts of serotonin (the neurotransmitter associated with elevated mood) to be present in the synapse (the space between neurons in the brain) by inhibiting the function of reuptake transporters that would take the serotonin back into the cell axon where it is not able to positively influence mood.

In my experience, such medication need not necessarily be an end in itself, but may help access the motivation to explore more deeply the underlying causes. A biological basis for depression may also be countered by taking supplements such as 5HTP along with essential vitamins and nutrients that can help restore the natural functioning of brain chemistry, often impaired in our culture by an inadequate diet.

It is part of the therapist's work to help determine which of the above apply.