We are not safe or immune from the ravages of this world. Some people consider this planet to be the cesspool of the universe. How do we deal with it? Wars, criminal brutality, suffering of the innocent, famine, disease, trauma, guilt, regret, destroyed relations, murdered, mangled romances and pulverized opportunities. The list is enormous. We curse our perfectly functioning cognitive capacities when we have to mentally relive the past ordeals. Incessantly, we have to experience the horror of hindsight , the ‘what ifs’.
There is a quote from the movie “The Wolfman” which puts into some perspective our predicament, “Never look back, the past is a wilderness of horrors”. It is easy to see how agonizing situations can propel a person into depression. The term “Depression” itself can mean many different things, from major depressive episodes. to loss and bereavement, and lack of motivation as a result of brain disease. It can also be categorized into clinical and situational with genetic and environmental factors contributing. Whatever the case, depression can be extremely debilitating.
We have all had feelings of sadness as a result of various situations, but sadness differs from depression. Sadness, often circumstantial, fades with time and is relatively brief. Depression is a longer-term mental illness. It impairs social, occupational, and other important areas of functioning. Left untreated, symptoms of depression may last for a long time and can reach crisis levels leading to suicide.
This disorder affects the whole person. In the emotional realm , a huge telltale sign is the loss of the ability to experience joy, even at the most exuberant of times. This is referred to as ANHEDONIA. Cognitive signs center around worthlessness, guilt, hopelessness, constantly dwelling on death and thoughts of suicide. Motivation is also drained and the depressed person will not pursue, initiate or persist in activities. Even physical symptoms such as changes in appetite and sleep can occur as well as fatigue, aches and pains.
An expression of this mental state reads “ Depression is living in a body that fights to survive with a mind that tries to die” – Unknown.
Depression being classified as clinical or situational can be confusing since their symptoms are quite similar. They are both just as real and the threats and challenges are evident. The differentiation may be in the labels themselves, with clinical seeming to come out of nowhere, with biological causes such as disturbances and imbalances of neurotransmitters. Mood disorders such as Bipolar Disorder fall into this category. There may also be genetic factors which have a significant influence on how an individual responds to major life events and experiences such as frustrations and disappointments. These can have links also to drug and alcohol abuse and dependency which can also exacerbate symptoms. Symptom persistence and effective treatment response with medication also indicate a clinical classification.
A situational detection often stems from coming to terms with harsh life changes. The possibility of recovery depends on accepting and resolving situations. Many times this requires cognitive and psychoanalytic support and treatment. This is especially true and necessary when a situation turns into a crisis. An example can be the loss of a career. A person with a defeatist perception can see this as the end of the world and with the lack of proper coping skills and situational support mechanisms, depression can turn to unresolved crisis and then murder / suicide. We see this a lot in the media.
We can understand why many sensitive people have such cynical outlooks on life. When we watch the bleak news, read all the horror stories in the press, and then combine with our own pains and regrets and trauma we conclude that all that exists out there are court cases and caskets.
One’s perspective and certain cognitive distortions, can also determine symptoms of depression. Sometimes we overgeneralize where we make a sweeping conclusion on the basis of a single event. An example might be:
After going on a job interview and finding out we didn’t get the job, we decide that we will never get a job (overgeneralizing) and feel hopeless about our career, leading to sadness and depression.
Another distortion is called selective abstraction where we magnify insignificant, unpleasant details while ignoring the important productive features of a situation. An instance of this would be a boss praising an employee’s overall performance but the employee only remembers the one trivial comment that could be construed as critical.
Magnification and minimization is another factor in depression. This is where we greatly enlarge small errors in performance while diminishing major proficiencies. They can be completely unrelated events affecting self esteem. A case of this can be seen with a person getting a small dent on his car and seeing it as a catastrophe [magnification], while the fact that he gave an excellent presentation at the office does nothing to boost his morale. [minimization].
Personalization is one of the cognitive distortions where you believe that things are connected to you and you are to blame even though you have nothing to do with the situation.
For example, if a family member’s diabetes worsened, and death ensues, someone who uses personalization might think that this could have been avoided if they took better care of their family member. People with anxiety-related disorders are prone to experiencing personalization. A study showed that depression symptoms in patients with social anxiety disorder contributed to personalization.
Arbitrary Inference can lead to melancholy as well. This is where one draws a conclusion where there is little evidence to support it. A man may conclude that the sad expression on his friend’s face is the result of disappointment in him, but actually it was the result of being distressed by the illness of a close blood relative.
In upcoming discussions we will take a look at the link between depression and post traumatic stress disorder, the biology of suicide, treatment options and some metaphysical thoughts.