Taking the disease out of depression

Depression Dialogues is an attempt to start a discourse about the meaning of depression

Depression Dialogues is an attempt to start a discourse about the meaning of depression. If it's seen as an emotion, just like any other, everything changes, writes Dr Michael Corry

In any psychiatric practice, depression, along with its travelling companion anxiety, is the commonest complaint. Along the spectrum of depression, symptoms vary from mild disillusionment and lack of drive, to the black hole of despair, self-loathing and hopelessness. No one is immune.

Few states touch so many aspects of the self as depression, undermining body, mind, heart and spirit. In its most severe forms, depression can devitalise a person's soul to the point where they are unable to work, love or find meaning in life. It can lead to serious alterations in personality, sapping an individual's self-confidence, undermining independence and severing their ties to the world and the people who care for them. Depression can turn fatal.

Depression is best seen as an emotion, just like any other strong feeling such as fear, anger or love. Seen as such, it represents a legitimate response to life's difficulties, rather than a disease reflected by a change in one's brain chemistry, and unrelated to personality, belief systems, relationships, socio-economic factors or coping skills.

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I have yet to sit in front of one single depressed patient who did not have a symptom logic, sometimes even tracing back as far as intra-uterine rejection. The roots of depression can be found in any of life's losses, hurts and disappointments: sexual and physical abuse, the death of a loved one, the pain of a broken heart, the experience of being bullied, and the terrible feelings of loneliness and desolation associated with exclusion from the peer group.

The treadmill, be it at school, college or on the career ladder, can dampen the spirit and take its toll. In schedules deprived of downtime, energy bankruptcy is common, with substance misuse often the most easily available relief. For many "getting out of my head" is the main aim. The ensuing collateral damage is the price paid: exams failed, jobs lost, relationship breakdowns, all further triggers for depression.

Depression could be considered a valid and normal response to the poverty trap, given its own inherent set of problems - living from hand to mouth, overcrowded housing, insufficient heat, food and clothing, and a wilderness of inadequate resources.

Depression cannot be isolated from the frantic juggling required to keep family life afloat - night feeds, school drop-offs, homework, packed lunches and child minders, side by side with long working hours, excessive deadlines, demanding bosses, all to fund mortgage repayments, school fees, etc.

The ideas and beliefs that we hold ultimately dictate our state of mind. In the words of the great poet Milton: "The mind is a place which of itself, can make a heaven of hell or a hell of heaven."

The standards by which we judge our success or failure in the world are learned through years of conditioning, in our families, schools, church and the wider culture. Our sense of dis-illusionment or hopelessness emanates directly from our failure to meet these very standards.

The dominant approach in psychiatry, which sees chemical imbalance as the primary cause of depression and medication its cure, pathologises sufferers, turning them into damaged goods or victims of flawed chemistry and defective genes. Such a view places the problem within the person's brain matter, rather than in their thoughts, feelings and behaviours, and the ways in which they respond to the problems of living.

This stringently mechanistic approach marginalises personal consciousness, viewing the unfathomable depths of human passion, individuality, creativity, curiosity, reason, intuition, will, compassion and spiritual insight as mere secretions of the brain, akin to the way the kidney secretes urine.

The moment depression is classified as a disease, like all diseases it then calls for a cure. In this way it becomes a defining straight-jacket in which individual depressed people have to function. Diseases do not have meanings, therefore none is sought. Diseases "should not" be happening. Diseases separate the ill from the well. This classification defines the experience, limiting it to a form which society relates to in prescribed ways. By placing it solely within the realm of pharmacology, we distance it from problems of living and lack of resources.

The aim of Depression Dialogues is to create a safe forum in which depression can be discussed and understood as part of the human condition. Participants may ask questions, share their experience or merely listen, as they wish. The meetings adopt a liberation perspective, allowing the individual sufferer to stand at the centre of their story, and make sense of why they are depressed.