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SCENARIO COUNSELING
Dealing with Depression

A lot has been said about dealing with depression. The two main points I would like to address are 1) the difference between depression and Depression with a capital “D”; and 2) how we think about its effect on us. Both of these will help us understand dealing with Depression, and what you can do about it.
Depression and depression
There is a difference between depressed feelings and clinical Depression. The line that separate the two are not always clear. Robert Fancher, when writing about this distinction, pointed out that “depression nests within a semantic web of other words” such as “discouraged, dismayed, disconsolate, demoralized, despairing, disheartened, dispirited, defeated, downtrodden, heartsick, unhinged, bereft, [and] enervated.” These terms are not in and of themselves grounds for saying a person has clinical Depression. To be clear, Fancher uses “downcast” to describe the entire group of words that describe depressed-like feelings. I will do the same here.
Clinical Depression, with a capital “D”, is when someone is formally diagnosed by a qualified professional with a depression-related mental health disorder, such as Major Depressive Disorder, Persistent Depressive Disorder, Cyclothymic Disorder, and/or the Bipolar disorders (which are not officially depression disorders, but rather carry with them debilitating depressed episodes).
So what is the difference between depression and Depression? There really is none because the former has been replaced by the latter. So what?
How We Think about its Effect on Us
Well, the problem arises when we look at what Depression come to be understood as. Among several things, it has come to be understood as permanent (with affected individuals only ever achieving “remission”), beyond our control (indeed, we learn to think of it as merely manageable), a separate immaterial entity (e.g., “My depression is very bad today.”), and an alibis (e.g. “I can’t because I am too depressed.”). We think of it as occurring in a vacuum. When we combine all of this into our overall thinking about what depression is and how it affects us, we are left with a devastating view akin to something like this: It’s not my fault. My depression made me do it and I can’t control my depression. It’s never going away; and I am sick of dealing with it. Forget it, I give up!
Putting aside how futile such thinking is for a person, this way of thinking about Depression is completely false! It is an understanding that has been socially constructed (i.e., made up by members of society) between researchers, psychologists, theorists, practicing therapists, doctors, the pharmacy industry, commercial advertising, sufferers of Depression, and overall public awareness campaigns (including those who do not suffer from it, but who experience family members and loved ones who do). Although entirely innocent, it is a cultural misunderstanding with profound effects on those who suffer it.
I want to be absolutely clear that I am not blaming or criticizing anyone here. It was just an unintended consequence of how we as a culture have tried to address it through our understanding of science and medicine. For example, an infection is an unwanted foreign entity in our body that we treat with an antibiotic, and has control over certain aspects of our mood and physiology. It only made sense then that the condition called Major Depressive Disorder, which we treat with anti-depressants, would come to be understood the same way: as an unwanted foreign entity within our body that has control over certain aspects of our mood and physiology.
However, this is not the case. We can put bacteria and viruses under a microscope. We cannot do that with Depression. Sure, we can observe a chemical imbalance. However, the chemical imbalance is not itself Depression. Furthermore, we know that infections and viruses come first, then the symptoms of being and feeling sick. We do not know what comes first: the chemical imbalance or the Depression. Sure, some genetic studies help us approximate and speculate; but we still cannot escape the problem that depression is not a material entity that can be put under a microscope; and we still have not determined conclusively what comes first.
So what does this mean for you?
Dealing with Depression
To cut to the chase, it means that you have more control over dealing with Depression than you may currently feel. It means there is more hope than you currently sense.
What we call Depression is really just emotional experiences of downcast moods and states of being that do not occur in a vacuum, but rather as a response to life circumstances and decisions we make. Regardless of intensity and impairment, depression is a natural part of life. Of course, people have different levels and thresholds; but that is no different than physical pain. While some report a higher pain tolerance than others, pain is still a natural part of life.
Some may say, “Yeah, but we try to avoid pain.” I am not entirely sure that is true across the board. How often do we endure pain for the greater good? We do so when we endure painful medical procedures, or push our physical limits during exercise. We tend to avoid it when the cost/benefit ratio does not favor us; but that does not mean pain is not a natural part of life. It does mean that we try to understand what pain tells us: that something is not good—to one degree of another—for our body, or that our body is currently recovering from something. This means that pain is source of information that is helpful to us.
As it is with pain so is it with depression. It is a source of information that is helpful to us. How it is helpful to us depends on which word in the overall vernacular of feeling downcast most appropriately applies. Feelings of discouragement arise from a different set of circumstance than feeling defeated. We can feel defeated without feeling discouraged. Which means that each word in the various related experiences of downcast feelings gives us a different understanding of how we are affected and how to respond. However, Depression does not afford these deeper understandings. So our dealings with depression—what has replaced with Depression—end up being very dismal and feeding the problem. We begin to feel depressed because of our Depression without any real understanding of what that exactly means, or what to do about it.
What You can Do about It
The first thing you can do is identify precisely what we are feeling. Do not allow yourself to limit your understanding of what you are feeling to just a socially-constructed concept because it may not be the correct label for or complete understanding of your feelings. Even recent neuroscience studies are revealing that our attempts to identify and label our feelings are often wrong and/or incomplete. Obviously, you are mad, you’re mad. That is obvious. But downcast feelings are often more complex than just being mad at something specific. Do not be surprised if you have to identify your feeling with more of a statement or explanation rather than just a single word.
Once you correctly identify what it is you are feeling, you can determine how to respond to it. If you feel defeated, ask what defeated you and what you can do better next time. If you are discouraged over a life circumstance beyond your control, try to focus on the things within your control that can make you and others around you happier. The list of examples goes on.
If you are feeling downcast in some way due to irrational beliefs and distorted thoughts about yourself, others, and/or your future, then this is a good time use cognitive-behavioral therapy (CBT) techniques to reframe your thinking. This does happen and CBT has great skills for helping with this.
Finally, I would like to share my experience with individuals experiencing depression or other related emotions. They typically occur because something about how you are living your life is not congruent with what you know/believe/sense to be right. This is where our moral and ethical values can be very helpful, and is precisely why I help individual examine them.
The right combination of moral values exploration with basic coping skills and proper awareness can go a very long way in helping you deal with depression, including other related downcast feelings.
Counseling can help with this.
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