If you have read the research literature, you will be saddened and worried to find that what researchers call ‘outcome studies’ show that depressed people treated only with drugs and electroconvulsive therapy do not do well. Most find that the depression recurs. Many remain depressed, but cease to seek any kind of professional help. Many die, not just by their own hand, but through illnesses. Being depressed is physically debilitating.3
This is very troubling, because while psychiatrists talk complacently of ‘managing depression’ by using long-term medication in the way that doctors ‘manage diabetes’ using long-term insulin injections, we know that a person with chronic diabetes can lead an ordinary life, but a person with chronic depression cannot. To be told that you have inherited depression in the way that another person has inherited diabetes is of no help at all. It just makes you more despairing and confused.
If you are a woman and are depressed, no doubt you have been told that it has been caused not just by a chemical imbalance but that this imbalance relates to the functioning of the feminine hormones. This is puzzling, because you can see how the malfunctioning of a hormone could lead you to think, ‘I feel sick’, but how can a hormone, however it functions, cause you to think, ‘I am a bad mother’? Nevertheless, many women discover that from puberty to after the menopause their own real, lived experience is dismissed with the words, ‘It’s your hormones, my dear’.
However, there is a genetic factor in depression. In that double helix of DNA there is a special strand which separates us from all other animals and marks us out as human beings. That special strand of genes not only determines our human shape, it gives us language, and with that the ability to conceive of the past and the future. Using these abilities we can look to the future with hope and courage, or fear and despair; we can remember the past in happiness or mourning, in gratitude or envy, in thankfulness or resentment. Using these abilities we conceive not just of ‘is’ but of ‘ought’, and create for ourselves two worlds of meaning – the world as it is and the world as it ought to be. Now we can trap ourselves in a tangle of ises and oughts. Now we can say to ourselves, ‘I do not accept myself as I am. I ought to be a better person’, and so lay the cornerstone of the prison of depression.
You might, in your search for an understanding of depression, have tried to make sense of it in terms of ises and oughts by reading books by cognitive or behavioural therapists. In many ways these books can be extremely helpful, for they can make you aware of how easy it is to think in extremes (like, ‘Nobody cares about me’, instead of, ‘Some people don’t care about me, but some do’), and they suggest some practical ways of re-organizing your life. But, when they tell you you are thinking and acting ‘irrationally’ or ‘dysfunctionally’, you can hear this as yet another put-down and feel that ever so familiar stab to the heart.4
Even if you can put this aside, you soon discover that these cognitive and behavioural therapists slide over, or ignore, the implacable truths and dilemmas of our lives. For instance, one such author chides his client for being so illogical as to say, ‘I’ll never find another friend like that again’, and asks her to estimate just how many people she could meet and how many of these could become friends. He ignores the fact that we do have relationships which are irreplaceable, like those with a parent who gave us unconditional love, or with someone with whom we shared the greatest joys and tragedies of our lives, and when such relationships end we can do nothing but mourn their loss. When we do suffer such losses what we need are not people who tell us to ‘look on the bright side’, but people who can acknowledge and share our pain.
Cognitive and behavioural therapists ignore, too, the major questions which face us all: ‘Why am I here?’, ‘What is the purpose of life?’, ‘What happens when I die?’ They assume that all of us are concerned solely with making the most of our lives, when in fact many of us are chiefly concerned with the question, ‘How can I be a good person?’
In your search for an understanding of depression, and in your concern about the great questions of life, you might have read some of the books on depression which give a religious or spiritual answer to the problem. Some of these books might just heighten your sense of badness and inadequacy, but others do offer consolation. However, most of them advise you to put your trust in God or some spiritual power, and this is precisely what a depressed person cannot do. When we have been repeatedly and deeply hurt by the people we trusted, we learn to be very careful about where we place our trust, and if we cannot trust the people whom we can see and know, how can we trust an unknown, unknowable God? Moreover, if you believe in God, then when you become depressed you find that God, like everyone else, seems far away, and, worse, the more you hate yourself, the more you feel that God will never forgive you.
Whenever we come across an author, or a therapist or counsellor, or a preacher who says to us, ‘Believe as I do and all will be well’, it is very tempting to say, ‘Right, I’ll do that’. However, we cannot change our beliefs about the purpose of life and the nature of death in the way we can our beliefs about the best breakfast cereal. Our beliefs about the purpose of life and the nature of death relate to our own inner truth, and even though we may hide or deny our own inner truth, it never disappears, and it speaks to us clearly. You will know this if ever you have been in analysis and your psychoanalyst has given an interpretation which your inner truth knows is wrong. The respectful, fee-paying part of you can be saying, ‘Yes, I see what you mean’, while your inner truth is saying, ‘No’.
This is where therapists can be dangerous. They can use their position, power and mystique to persuade us that what we know as truth is mere fantasy and that because we are anxious and depressed and having difficulty in coping with our lives we are intrinsically inadequate. If you have read any of the psychoanalytic texts on depression you will have discovered how little respect psychoanalysts have for a person’s own experience and how belittling to the client the psychoanalytic jargon is.
So, whatever you have done to try to discover what depression is and how you might bring it to an end, all that has happened is that you have become more and more confused, and when we are confused we feel powerless and helpless.
The aim of this book is to help you sort out your confusion and regain that which is rightly yours, the power to understand yourself and the society in which you live, so that you can make the best decisions about how you should live your life. With such power we can not only understand the causes and the purposes of depression but, more importantly, free ourselves from its prison and live life joyously, hopefully and freely.
To do this, we begin by understanding our own real, lived experience.
It is our own real, lived experience which leads us into the prison of depression. It is not a gene, or our hormones, or our dysfunctional and illogical thinking, our lack of faith, or our complexes and inadequacies which have brought depression upon us, it is what has happened to us and, most importantly, what we have made of what has happened to us; it is the conclusions we drew from our experience.
That set of conclusions which leads us, finally, into the prison of depression was not drawn illogically, or fantastically, or crazily, but were the correct conclusions to draw, given the information we had at the time.
If, when you were a child, all the adults whom you loved and trusted were telling you that