The Art of Overcoming Depression - Letting Go
Why Causes Matter More Than Symptoms
With the advance of cognitive behaviour therapy (CBT) and anti-depressant medication, overcoming depression has largely become an exercise in technical engineering, overwriting the language of ‘living a good life’ with an aseptic vocabulary of mental hygiene. It may, though, be time to wonder whether alleviating chronic depression can ever truly be achieved by targeting symptoms. The painstaking work of letting go after a loss may be much more important.
Chronic Depression or Melancholia?
Human beings are inevitably faced, sooner or later, with loss. But in a culture which favours robust independence and individualism, the universal human vulnerability to loss is an awkwardly unwelcome fact which often gets ‘medicalised’ into a pseudo-biological malfunction.
In Freud’s day, what is now called ‘depression’ was usually termed ‘melancholia’ – an inconsolable and interminable misery. The word change has not necessarily produced greater enlightenment, however. Today, overcoming depression tends to mean relieving generic symptoms (persistent sleep disturbance, loss of concentration, dietary and weight fluctuations, low mood rated on a scale of 1 to 10). For Freud, it meant accepting – and ultimately consenting to – a specific loss.
In Darian Leader’s recent book The New Black: Mourning, Melancholia and Depression (2008, London: Hamish Hamilton/Penguin), Freud’s wisdom is resuscitated for modern times: if the work of mourning is refused, the misery of melancholia will descend. However many general symptoms appear, unless the precise details of what, or who, has been lost are identified (and how the patient has responded), the misery will persist, even if its overt manifestations – symptoms - change.
Why Coping with Depression Means Coping with Loss
Leader’s work invites a radical reconsideration of the notion that depression is a form of medical illness. Whilst chronic depression certainly produces effects which can be debilitating, it may be misleading to view it as a kind of disease. Psychoanalysis brings into focus the central issue which must be dealt with before recovery can occur: coping with loss.
Loss can take countless forms: a loved one, a career, a home, or more intangible ‘bereavements’ such as health, self-confidence, a friendship or love relationship (the person may still be around; it’s the attachment which has been lost). All can result in generic symptoms, but each ‘depression’ has a different underlying cause. It is the failure to consent to – to agree to relinquish -the specific loss which causes the problems.
Consent does not mean acquiescence, just going along with things whilst secretly resenting what has happened. It means, as Leader shows, fully letting go of an aspect of oneself: specifically, what one was for the lost object or person. This relinquishment cannot take place in a single bound and it certainly cannot be accomplished by medication. It has to occur over time, as each aspect of the self and the lost other comes to mind.
The Importance of Letting Go
Freud’s lesson is that a loss which is refused is psychologically absorbed. Instead of releasing one to move on in life, pathological absorption perpetuates inconsolable misery. The person emotionally fuses with the lost one and directs all the rage and resentment at being abandoned to his melancholically altered self instead. Melancholics endlessly bemoan their worthlessness and wretchedness, but the refrain of mea culpa is a disguised way of expressing hate, not remorse.
As Leader argues, resorting to medication may not only fail to address the specific cause of the misery, it may even be dangerous. As newspapers began to report that anti-depressants like Seroxat may increase the risk of suicide, demands for such medication to be refined emerged. But from a psychoanalytic point of view, the assumption that symptom removal equals ‘cure’ is likely to be the danger rather than the drug itself.
Some depressions have a protective function, dampening emotions down but safeguarding the individual from a massive collapse into unmollifiable despair. Rapidly removing essentially protective symptoms in the hurry to get the patient back on track is no substitute for the painstaking work of mourning – giving up not just the lost person or experience, in every particular, but the version of one’s self attached to the lost party.
Letting Go IS Overcoming Depression
If the human story of the particular loss afflicting the grieving individual is not acknowledged, psychoanalysis suggests, there is a danger of permanent suffering. A heavy price is to be paid by emotionally refusing loss: interminable misery. To overcome depression, one must be able to consent to the loss - of both self and other. Only then can life be fully resumed.
Depression: mourning or melancholia?
|
What do you think about this article?
Latest Articles