The new research presents itself as an adjunct to the current ways to treat depression. It does not tell us very much about the current ways, which sometimes involve medication but more often consider depression to be a disease, a chemical imbalance or a disturbance of the soul.
Aside from the use of medication, about which I have no competence, current practice sees depression as an inner mental disturbance. It promotes certain kinds of psychological treatments, from cognitive exercises to introspection.
I have some confidence in cognitive therapy, but still, the nation is awash in depression. Young people, in particular, are depressed and anxious at levels we have rarely seen. As Abigail Shrier argues in her new book, Bad Therapy, it appears that the therapy industrial complex has gotten something grievously wrong.
And we should acknowledge, from the onset, that there are different kinds of depression. Some respond only to medication; some do not.
Anyway, the new study suggests that we can improve treatment if we consider depression as a signal, trying to tell the patient something. The researchers call it framing. I have no idea why they choose the concept of framing, which makes no real sense, but I heartily approve of the notion that depression is trying to tell us something.
Such thinking echoes the approach to anxiety and fear. It assumes that anxiety is trying to tell us something, specifically, that we are under some level of threat and that we ought to do something to mitigate the danger.
Note that all of it rejects the old Freudian notion that people who are suffering anxiety have nothing to feel anxious about, and therefore are reliving unprocessed castration anxiety.
Such thinking makes depression a psychic phenomenon, to be dealt with through introspection and analysis, that is, by putting it in a narrative.
Some modern theories emphasize that depression is a chemical imbalance. This relieves you of any sense that you have done anything to feel depressed, but it also tells you that you cannot do anything to resolve it.
Eric Dolan summarizes the new research at PsyPost:
Traditionally, depression has been viewed through a disease-based lens, attributed to genetic, biological, or chemical imbalances. This biogenetic explanation, while reducing self-blame, has also led to unintended negative consequences like increased stigma and reduced hope for recovery.
The researchers proposed a new way of looking at depression: as a signal indicating that something in one’s life needs more attention. This approach draws from evolutionary psychiatry and suggests that, like fear or sadness, depression could have an adaptive function.
Dolan quotes Hans S. Schroder, a clinical assistant professor of psychiatry at the University of Michigan Medical School.
“So we’re testing out different explanations of depression beyond this disease-centered framework. I’ve been interested in the idea that depression actually has a purpose in one’s life – that it’s trying to tell you something isn’t working for you right now and you can get curious about your life in order to address the depression.”
And also,
This finding suggests that viewing depression as a functional signal, rather than a disease, could help alleviate some of the negative self-perceptions associated with mental health issues.
Rather than see yourself as suffering from a disease, this approach says that depression is telling you to repair your relationships, to reconnect with other people.
The PsyPost report does not show us what to do, but if depression involves feeling detached, forlorn and bereft, you do well to learn how to repair and to conduct relationships. And not just love relationships.
Given that therapy has not seen depression as a signal, it has not offered any theorizing or any practicum about how to reconstruct relationships. For that reason I am writing a book about how to get along with other people and why you should get along with other people.
Obviously, this should begin with the establishment of a constructive relationship with a counselor. If you are depressed and if you do not connect with your counselor, you will have little chance of resolving your depression.
Second, I emphasize specificity. If you are going to reconnect with society you will need to be able to distinguish different types of relationships with different people. Do not imagine that they all reduce to a narrative about love and aggression.
Far too many depressed people imagine that they are going to overcome their condition by falling in love. They are grievously wrong.
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When depressed, the language of the ordinary is of no use. It cannot be communicated. It is, then, from the outside, viewed from the normal, a state of isolation.
ReplyDeleteReal depression turns one into a zombie. (The popularity of zombies in popular culture is probably a testament to this condition.)
My suspicion is that the higher rates of reported depression amongst the young is the result of their waiting for permission. Waiting for permission to act in some way.
A growing cohort of youth that has always been told what to do is not a cohort that can act independently. Waiting is a state of depression. Conservation of energy, if nothing else.
Increasingly, youth finds relief from the waiting by joining with the mob, the trend, the fashion. But then 'the thing' changes. Waiting again.
I don't remember much about George Lucas' first film (based on his film school thesis, as I recall), WD-40, or whatever; but I do remember that it was set in a controlling future and that the people in it were the most depressed people I had ever seen. I think that he went on to make films that a great many people are devoted to. How is that?
I think this 2024 PsyPost article and Stuart’s comments on it present a brilliant and helpful way to view depression. Interestingly, though, the 2024 PsyPost article links to an earlier 2022 PsyPost article that presents a sort of inverse view. The 2022 article posits that the depressive symptoms displayed by a depressed person (such as “reduced effort, fatigue, … poor personal hygiene [ ] and suicide attempt”) can be deemed adaptive functions in that they prompt other people to take action to help the depressed person.
ReplyDeleteI think this is exactly wrong. In my experience, friends of depressed persons often cut ties with their depressed friend, or, at the very least, avoid him or her until the depression passes. Moreover, as desperately as the depressed person may want to be “saved” by others, one symptom of the depression is that it makes him or her unlikely to accept help offered by others.
So I believe that the first step towards improvement for the depressed person has to come from within; and that viewing one’s depression as a “signal” to fix social isolation is the best way to that first step.