How To Cope With Depression

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almost half of us will suffer from

depression at some point in our lives

but the condition remains badly

misunderstood and therefore often poorly

treated at the heart of our collective

difficulty with depression is a

confusion about what it actually is and

in particular how it can be

distinguished from a state that all of

us know very well and with which it has

a distracting number of similarities

namely sadness it's because we

unwittingly tend to apply to cases of

depression a number of assumptions drawn

from and better suited to an

understanding of sadness that we end up

suffering far more than we should but

there are on the surface some notable

similarities between those who are sad

and those who are depressed

both groups cry both withdraw from the

world both complain of listlessness and

a sense of alienation from their normal


but there is one categorical difference

between depression and sadness the sad

person knows what they are sad about the

depressed person doesn't sad people can

without difficulty tell us what is

troubling them I'm sad that my

grandmother has died or that I lost my

job or that my friends are being unkind

to me and though it might sound strange

this is precisely what the depressed

person is not capable of doing they may

be tearful and at a very low ebb but

they can't conclusively put a finger on

what has drained life of meaning for

them they simply say it has no meaning

per se they aren't depressed about X or

Y as one might be sad about X or Y they

are first and foremost simply depressed

the inability of the depressed person to

account concretely for their mood can

lay them open to unwarranted charges of

faking malingering or exaggerating

friends who begin in a well-meaning

search for a soluble problem can end up

frustrated by the lack of

progress when pushed the depressed

person may latch on to rather odd or

minor sounding issues to account for

their state they might complain that

there's no point going to work because

the earth is due to be absorbed by the

Sun in seven and a half billion years or

they might insist that life lacks all

meaning because they've just dropped a

glass on the floor and everything is now

completely hopeless at this stage one

can hear it said that if depression

doesn't have any sensible psychological

causes the problem must be bound up with

some kind of imbalance in brain

chemistry which it would be kinder and

more effective to treat with pills an

idea of great appeal to the

pharmaceutical industry first and

foremost but also to worried families

and schools and employers who crave

rapid and cost-effective solutions but

there is another approach to depression

which those slower and more arduous may

be a great deal more effective in the

long term this stems from insights drawn

from psychotherapy the discipline that

has arguably been able to understand

depression better than any other the

basic premise of psychotherapy is that

the depressed person isn't depressed as

they suggest for no reason there is a

reason they are very distressed about

something but that something is proving

extremely difficult to take on board and

has therefore been pushed into the outer

zones of consciousness from where it

wreaks havoc on the whole person

prompting boundless feelings of nihilism

fir depressives realizing what they are

concretely upset about would be too

devastating so they unconsciously choose

to remain dead to everything as opposed

to very distraught about something

depression is sadness that has forgotten

its true causes forgotten because

remembering may generate overwhelming

untenable feelings of pain and loss what

might these true causes be perhaps that

we've married the very wrong person or

that our sexuality isn't what we once

believed or that with furious with a

parent for their lack of care in our

childhood in order to preserve a fragile

peace of mind one then chooses though

that may sound more willed than it is in


to be depressed rather than to have a

realization we pick unceasing numbness

as protection against dreadful insight

to make things yet more difficult the

depressed person doesn't typically

consciously feel that they are in fact

lacking insight they're not aware of a

gap in their self understanding

furthermore they are nowadays often

taught to assume that they are just

depressed as one might be physically ill

a verdict that can be of appeal as much

to the pharmaceutical industry as to

certain people close to the patient with

an interest in insights remaining buried

there's another key difference to note

between sadness and depression sad

people are grief-stricken about

something out in the world but they

aren't necessarily sad about themselves

their self-esteem is unaffected by their

grief whereas depressed people will

characteristically feel wretched about

themselves and be full of

self-recrimination guilt shame and

self-loathing paranoia that may a tragic

extremes culminate in suicidal thoughts

for psychotherapy the origins of these

violent moods of self-hatred line anger

do fall but unable to be directed

towards someone else in the world that

has then turned against the sufferer

wrathful feelings that should have gone

count words towards a partner whose

relentlessly defensive or denies one sex

or a parent who humiliated one in

childhood these feelings are instead

driven back onto the sufferer and starts

to attack them the feeling X is horribly

let me down turns into a very unpleasant

but in some ways more bearable I'm an

unworthy and unbearable wretch one

becomes self-hating as a defence against

the risks of hating someone else also

worth noting in all this is that in many

cases depression is associated with an

apparently opposite mood a kind of

euphoric state termed mania hence the

term manic depressive the mania in

question looks from a distance a bit

like happiness and just like depression

can look like sadness but in one area in

particular the relationship between

mania and happiness is identical to that

between depression and sadness

the common element is a disavowed

self-knowledge in mania one is euphoric

but cannot go into one's own deep mind

and discover its bitter truths which

explains one of the leading

characteristics of manic people the

habit of being in flight from themselves

talking too much about nothing over

exercising drinking working continuously

or spending too much all as an escape

from a submerged grief rage or loss it

is from this kind of diagnosis that has

suggested cure emerges what people in

depression need above all is a chance to

arrive at insight for this they will

tend to need a hugely supportive and

patient listener

they may also used appropriately benefit

from temporary use of medication to lift

their mood just enough so that they can

endure a conversation but the assumption

isn't that brain chemistry is where the

problem either begins or ends the

despair is caused by an undigested

unknown and unresolved

also far from needing to be taken

through reasons to trust that life is

beautiful depressives must be allowed to

feel and to remember specific damage and

to be granted a fundamental sense of the

legitimacy of their emotions they need

to be allowed to be angry and for the

anger to settle on the right awkward

targets the goal in treating depression

is to move a sufferer from feeling

limitlessly despairing to mourning the

loss of something in particular the last

20 years a marriage a hope one would be

loved by one's father a career however

agonizing the insight and mourning might

be these must always be preferable to

allowing loss to contaminate the

totality of one's perspective there were

plenty of dreadful things in every life

which is why it's wholly normal to feel

sad on a regular basis but there are

also always a sufficient number of

things that remain beautiful and hopeful

so long as one's been allowed to

understand and no one's pain and anger

and adequately mourn ones losses

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