Understanding Depression

You are walking home one evening and suddenly you have a strange feeling of dread. You have a premonition that something bad is going to happen. You become more alert to your surroundings and start walking more quickly. You reach in your pocket to see whether you brought your pistol. You look to see if anyone can help you.

Your anxiety, in other words, is trying to tell you something. You might or might not heed its message, but it is not just a random sensation that welled up from the depths of your soul. But it is not just trying to tell you something. It is helping you to deal with the danger. The emotions connected with anxiety will cause you to take actions to reduce the threat.

Obviously, anxiety is not infallible. You might have seen a picture in a store window that recalled a prior threat. You might have seen a shadow that resembled someone lurking behind a car. Anxiety alerts you to threats, but the threats need not be present threats.

Given the option between deciding whether the threat is real or imagined, you do best to assume that the threat is real. If the threat is real you have something to gain. If it is not real you have little to lose. Thus, reacting to an imaginary threat seems to be a correct adaptive response.

Nothing about this should feel strange or new. When we come to depression, however, the situation feels more complicated and difficult. What is depression telling us? And what are its symptoms telling us to do.

Recent research has suggested that the complex of symptoms that accompany a depressive episode serve an evolutionary purpose. Of course, anyone who has ever been prey to such an episode will not see it that way. As much as we believe in Darwin we will hesitate before drawing such a conclusion.

Paul Andrews of McMaster University suggest that the symptoms want to pull us away from everyday life and to send us into our minds to find out what happened and what we should do.

Matthew Hutson reports on Andrews’s theory:

Andrews had noted that the physical and mental symptoms of depression appeared to form an organized system. There is anhedonia, the lack of pleasure or interest in most activities. There’s an increase in rumination, the obsessing over the source of one’s pain. There’s an increase in certain types of analytical ability. And there’s an uptick in REM sleep, a time when the brain consolidates memories.

Andrews sees these symptoms as a nonrandom assortment betraying evolutionary design. After all, why would a breakdown produce so synchronized a set of responses? And that design’s function, he argues, is to pull us away from the normal pursuits of life and focus us on understanding or solving the one underlying problem that triggered the depressive episode—say, a failed relationship. If something is broken in your life, you need to bear down and mend it. In this view, the disordered and extreme thinking that accompanies depression, which can leave you feeling worthless and make you catastrophize your circumstances, is needed to punch through everyday positive illusions and focus you on your problems. In a study of 61 depressed subjects, 4 out of 5 reported at least one upside to their rumination, including self-insight, problem solving, and the prevention of future mistakes.⁴

Notably, this theory does not tell us what produced the depression. It might be telling us that we have a problem, and it might want us to solve the problem. Yet, the feelings of worthlessness are telling us that we are not capable of solving it. They are telling us that it’s all hopeless.

As with anxiety, the depressive episode does not necessarily refer to a current problem. It might also have been triggered by something in the present that recalled a past defeat. If the feeling of depression is telling us to distinguish between past and present defeats, that is one thing. If it is telling us that we can do nothing to solve the problem, that is quite another.

But, what is the threat, what is the danger that the depression is signaling? It is not a threat to life and limb... as happens with anxiety. We understand that losing a loved one produces mourning, not depression. We do better to understand depression as a loss of face. 

This assumes that we understand what it means to lose face. Obviously, if depression involves losing face, then treatment involves taking actions that save face. Perhaps Andrews was dealing with the fact that it is not always easy to know how one has lost face, thus, why other people see us differently. In other situations—a relationship failure or public humiliation—we know very precisely what triggered the depression. Surely, we might not have done anything to lose face. The charge may be unjust. And, we do not always know what we should do to save face.

If depression sends you searching for meaning, or some such, it is tricking you into thinking that you can save face by changing the way you feel about yourself. Or, by taking a pill. Yet, if depression is depressing because it involves how you look to others, the feeling of hopelessness signals the difficulty you will have in changing the way others see you. Evidently, if you can figure out how to change how you look to others you will feel better about yourself. And if you always find such situations hopeless you might well profit from a treatment that offers—not hope—but different ways of dealing with the loss of face.

It becomes more complicated. As you know, the Chinese have two words for face. Neither refers to the state of your soul. In the first you have face because you belong to a group. In the second, you have face because you have status or standing within that group. You can therefore lose face in two ways: by being expelled from the group, being ostracized or shunned. This is clearly the worst way to lose face. Second, you can lose status or standing, by being passed over for a promotion, by being demoted or even by being disrespected.

By this theory depression signals a loss directed at your social being. The same is not true when you are mourning the loss of a loved one. It tells us why Dr. Richard Mollica was pointing in the right direction when he said: “The best antidepressant is a job.” A job offers structure; it offers belonging; it offers relationships; it offers a role and rules. It provides a social support system.

If you do not belong to a group, join one. Simple, isn’t it. Well, maybe not that simple. At times, there are no jobs. If so, join a religious group. Their job is to give you face, to give you a place and a home and a connection with other people. One understands that some people try to treat their depression by becoming a denizen of a local saloon. Obviously, this is not the best way to go.

Take the case where someone has insulted you. He has offended you. He has treated you with disrespect. Now, you need to figure out how to respond. If depression, by the Andrews theory, causes you to put aside your bodily appetites and your pursuit of pleasure, it is telling you to ruminate … but without considering how you feel or what you want. It suspends questions of pleasure and desire. And, it also tells you to think before you act.

When someone offends you your first impulse might be to strike out in anger, to show how enraged you are, to demonstrate publicly that you refuse to accept the disrespect. Might we not say that some people, having seen their candidate lose the last election are feeling that their social status and standing, their position as part of the management team-- the managerial elite that enjoys the greatest social prestige-- has been compromised. So they strike out blindly, in anger.

That is: they are not thinking about how best to restore their status. I have in different posts offered some suggestions, but still many of those who have found their status compromised by the Trump presidency are so enraged that they cannot control themselves. They come across looking like fools... thus, looking like people who deserved to lose status. This suggests that some forms of status might be illusory.

This shows us why depressive symptoms cause the offended individual to step back from the situation, to ignore desire and pleasure, to ignore what feels right in order to do right. When you have lost prestige in society you ought to show that you did not deserve to lose that prestige. If you go out in public and act like a raving maniac—all the while accusing your orange-haired adversary of being a raving maniac— you will be showing that you do not deserve a more exalted status. If people start thinking that your adversary is acting a part while you really mean what you are saying... you will have been lured into a trap.

Among other things, people who have higher status in society know how to control their emotions.  They do not allow themselves to be led around by their desires. They set a standard for good behavior, and good behavior does not involve making your emotions, no matter how authentic, a public spectacle.

The moral of the story is: depression is telling you to do something, but, as opposed to anxiety, it does not know what you should do.