Is depression a defence against grief?
Our Psychotherapist Gary Herrington explores this delicate topic below as part of mental health awareness month
Depression is one of those many terms that, in recent times, has become familiar with the concept of mental ill health. It is seen very much as a mental disease to be treated directly. This is often the case and can be treated effectively by both talking therapies and/or anti-depression medication.
However, ask any therapist who’s been practising for any length of time, and they will likely be able to tell you of clients who presented with depression (often paired with feelings of anxiety, stress and anger) but were seemingly impervious to any form of traditional depression treatment, whether medical or psychological.
In fact, many of these clients present the very worst version of themselves to their doctor or therapist with stories of their failures in life, their inability to cope with even moderate daily difficulties and, in extreme cases, active thoughts of self-harm or suicide.
Often these thoughts and feelings will appear disproportionate to any story that the client will tell that might try to explain or understand the symptoms that are being presented.
1) Depression and the unconscious mind; a help or a hindrance?
It has been suggested that what is diagnosed as generalised anxiety is in actuality an overpowering fear where the source of the fear is unknown, at least, to the sufferer.
In such cases, it is often surprising just how much of that anxiety stops once the source of that fear is identified. This is because at that point the fear can be addressed directly and the scale of the fear reduces as the cause becomes known.
In a similar way, depression can, in some cases, be thought of as a persistent sadness where the cause of the sadness is unknown to the conscious mind of the sufferer.
The concept of the human unconscious was originally proposed by Freud over a century ago but this concept has been shown to be correct by modern science with our more recent technical abilities, such as functional MRI (fMRI) scans that can observe the activity of the brain whilst thoughts and feelings are being had.
What is often misunderstood about the unconscious is that it isn’t just a passive process of our brains that keeps our hearts beating, our digestion working or allows us to drive safely to work and not be able to remember exactly how we got there. This also acts as an active agent of our psyche protecting us from emotional experiences that, at the time they occurred, were simply too much for us to deal with.
These defensive mechanisms are actually essential to our normal healthy mental functioning. The problem, as so often in life, is their over use or re-use in situations where the original cause is no longer a real threat.
This is where a standard psychological defence can become the body’s own worst enemy. When a significant loss occurs, some of the sadness (and anger) are felt but the cause can be denied because that would just be too painful for the mind at that time.
The result is a level of sadness and even despair that can be felt but for which no logical explanation is possible and that makes working through the grief of the loss so very much more difficult. Sufferers may then turn their sadness and anger inwards, blaming themselves for feeling this way but never being able to resolve the loss in a way that would allow them to move on with life as best they can.
It may seem from the description above that this form of depression might be unable to be resolved or, at least, may be very difficult to make better. This can be the case but not always.
In my own experience, these forms of depression have most often fallen to the extreme in that they can either be resolved quite quickly, where the actual loss is identified and accepted and genuine grief can follow. Or the cause, even when identified, simply cannot be accepted and the depression continues.
2) Depression and hidden loss
You might expect that grief would be because of traumatic experiences of personal loss, such as the death of a parent, a sibling, a child or a loved one. These experiences are generally more obvious and tend to lead to help being offered either at the time or once symptoms of depression begin.
It seems that often the more difficult losses are those that involve the loss of an ideal or a fundamental expectation of the world, because these don’t include the catastrophic events more easily identified in circumstances that include death or serious injury.
We need look no further than those situations that occur when families split due to parents separating. In this situation, children may well feel that one or other of the parents has changed in such a way as their ideal and expectation of that parent is damaged forever.
The loss of that ideal is felt so deeply but cannot be identified and this makes it an intolerably scary situation for the child. They can see the parent in front of them and yet, to them, they are no longer the parent they once had.
If this situation is not understood by a close adult, and often it isn’t because of things going on between the adults, then the trauma of that loss is buried deep inside and responsibility for the pain is felt by the child.
Their anger builds up inside and, in an effort to keep whatever they feel they have left from the image of their parents, they turn the anger inward on themselves in order to protect that remaining image. If they make themselves bad, then they don’t have to accept a damaged version of their parents.
If you have depression that seems resistant to treatment coupled with any of the other experiences and feelings described above, it may well be worth thinking about the losses you’ve had in your life and especially the ones that somehow linger and yet seem to defy rational consideration.
In these cases, counselling and psychotherapy can be a huge help in helping you identify and work through those experiences for a long-term improvement in how you feel and even how you experience life in the future.
By Gary Herrington, Psychotherapist