Depression: The Gloomy Chamber
In the present time, depression isn’t so unusual anymore. Not only have the adults fallen victim to this mental disorder, but also teenagers. People often overlook the signs of depression because they feel like it’s only a temporary kind of sadness. Everyone should keep in mind that a depressed person isn’t someone who can feel happy in just a matter of seconds, minutes, or hours for that matter and no one can force them to be one. But then, what do we actually mean when we say depression? What are the effects of being diagnosed by this kind of mental illness? How can we help these people who are experiencing depression?
What do we mean by depression? This is a difficult question to answer, because a lot depends on who you ask. The word itself can be used to describe a type of weather, a fall in the stock market, a hollow in the ground and, of course, our moods. It comes from the Latin deprimere, meaning to ‘press down’. The term was first applied to a mood state in the seventeenth century.
If you suffer from depression, one thing you will know is that it is far more than just feeling ‘down’. In fact, depression affects not only how we feel, but how we think about things, our energy levels, our concentration, our sleep, even our interest in sex. Depression has an effect on many aspects of our lives. Some of these are: motivation, emotions, thinking, images or imaginations, behaviors, physiology, social relationships, and brain states.
Clinical depression goes by many names – depression, "the blues," biological depression, major depression. But it all refers to the same thing: feeling sad and depressed for weeks or months on end – not just a passing blue mood of a day or two. This feeling is most often accompanied by feelings of hopelessness, a lack of energy (or feeling "weighed down"), and taking little or no pleasure in things that once gave a person joy in the past.
Depression symptoms take many forms, and no two people's depression are exactly alike. A person who's depressed may not seem sad to others. They may instead complain about how they just "can't get moving," or are feeling completely unmotivated to do just about anything. Even simple things – like getting dressed in the morning or eating – become large obstacles in daily life. People around them – their friends and family – notice the change too. Often they want to help, but just don't know how.
Depression is different from normal sadness, just like when you lose a loved one – as it envelops a person in their day-to-day living. It doesn't stop after just a day or two, it will continue on for weeks on end, interfering with the person's work or school, their relationships with others, and their ability to enjoy life and just have. Some people feel like a huge hole of emptiness when experiencing depression.
If you suffer from depression, you are, sadly, far from being alone. In fact, it has been estimated that there may be over 350 million people in the world today who have it. Depression has afflicted humans for as long as records have been kept. Depression has always been a health problem for human beings. Historical documents written by healers, philosophers, and writers throughout the ages point to the long-standing existence of depression as a health problem, and the continuous and sometimes ingenious struggles people have made to find effective ways to treat this illness.
Depression was initially called "melancholia". The earliest accounts of melancholia appeared in ancient Mesopotamian texts in the second millennium B.C. At this time, all mental illnesses were attributed to demonic possession, and were attended to by priests. In contrast, a separate class of "physicians" treated physical injuries (but not conditions like depression). The first historical understanding of depression was thus that depression was a spiritual (or mental) illness rather than a physical one.
Hippocrates, a Greek physician, suggested that personality traits and mental illnesses were related to balanced or imbalanced body fluids called humours. There were four of these humours: yellow bile, black bile, phlegm and blood. Hippocrates classified mental illnesses into categories that included mania, melancholia (depression), and phrenitis (brain fever). Hippocrates thought that melancholia was caused by too much black bile in the spleen. He used bloodletting (a supposedly therapeutic technique which removed blood from the body), bathing, exercise, and dieting to treat depression. In contrast to Hippocrates' view, the famous Roman philosopher and statesman Cicero argued that melancholia was caused by violent rage, fear and grief; a mental explanation rather than a physical one.
In the last years before Christ, the influence of Hippocrates faded, and the predominant view among educated Romans was that mental illnesses like depression were caused by demons and by the anger of the gods. For instance, Cornelius Celsus (25BC-50 AD) recommended starvation, shackles (leg irons), and beating as "treatments." In contrast, Persian physicians such as Rhazes (865-925), the chief doctor at Baghdad hospital, continued to view the brain as the seat of mental illness and melancholia. Treatments for mental illness often involved hydrotherapy (baths) and early forms of behavior therapy (positive rewards for appropriate behavior).
After the fall of the Roman empire in the 5th century, scientific thinking about the causes of mental illness and depression again regressed. During the Middle Ages, religious beliefs, specifically Christianity, dominated popular European explanations of mental illness. Most people thought that mentally ill people were possessed by the devil, demons, or witches and were capable of infecting others with their madness. Treatments of choice included exorcisms, and other more barbaric strategies such as drowning and burning. A small minority of doctors continued to believe that mental illness was caused by imbalanced bodily humors, poor diet, and grief. Some depressed people were tied up or locked away in "lunatic asylums".
During the Renaissance, which began in Italy in the 14th century and spread throughout Europe in the 16th and 17th centuries, thinking about mental illness was characterized by both forward progress and regression. On the one hand, witch-hunts and executions of the mentally ill were quite common throughout Europe. On the other hand, some doctors returned to the views of Hippocrates, asserting that mental illnesses were due to natural causes, and that witches were actually mentally disturbed people in need of humane medical treatment.
In 1621, Robert Burton published Anatomy of Melancholy, in which he described the psychological and social causes (such as poverty, fear and solitude) of depression. In this encyclopedic work, he recommended diet, exercise, distraction, travel, purgatives (cleansers that purge the body of toxins), bloodletting, herbal remedies, marriage, and even music therapy as treatments for depression.
During the beginning of the Age of Enlightenment (the 18th and early 19th centuries), it was thought that depression was an inherited, unchangeable weakness of temperament, which lead to the common thought that affected people should be shunned or locked up. As a result, most people with mental illnesses became homeless and poor, and some were committed to institutions.
Depression is no respecter of status or fortune. Indeed, many famous people throughout history have had it. King Solomon, Abraham Lincoln, Winston Churchill and the Finnish composer Jean Sibelius are well-known examples from history. What is important to remember is that depression is not about human weakness.
Here are some of the sample cases of depression:
Depression over breakup: Tommy, a 21-year-old college student, was referred to the university counseling center by his roommate, who noticed Tommy was sleeping most of the day, missing class, and skipping meals. Tommy goes to his first appointment reluctantly, but because he recognizes that he hasn't been the same lately, he agrees to keep meeting with his therapist. In therapy Tommy recognizes that his depression began immediately following a breakup with his college sweetheart, Lynn, who had feelings for another man. In future sessions, Tommy identifies feelings of grief, betrayal, and hidden feelings of inadequacy. Tommy has a breakthrough insight when he discovers that his depression has been helping him avoid these painful feelings. The recognition itself helps the depression begin to loosen its grip. Tommy continues therapy for about a dozen sessions in which he identifies and cares for parts of himself that have felt inadequate since childhood. This increases Tommy's confidence and self-esteem and causes his depression to lift entirely.
Feelings of inadequacy and depression: Rudy, 38, cries and cries during the first interview with his new therapist and cannot say why. His life is, on the surface, everything anyone could want. He is married, with two healthy children and a sufficient income, and he claims to love his job as a financial analyst, or at least, that he used to love it. Lately, he does not seem to enjoy anything. Sports, which once gave him pleasure, now seem empty and meaningless. He feels distant from his wife and family. His job feels pointless and tedious. He has also been drinking alcohol, secretly, to numb himself. Treatment reveals hidden feelings of guilt and shame about Rudy’s perceived inadequacy as a son and now as a husband and father. His rigidly punitive parents instilled in him a perfectionism impossible to fulfill. Rudy has long buried his anger about this, and it takes a good deal of work for him to begin challenging his own rigid beliefs. Quitting drinking turns out to be easier than Rudy thought it would be, once he is able to talk openly with both his wife and his therapist about his deep shame and fear. Rudy asks for medications and is given a referral to a psychiatrist who prescribes a selective serotonin reuptake inhibitor (SSRI). Rudy reports it helps him get through the work day, but after six months he decides the side effects are not worth it, and based on his strong progress, his therapist and psychiatrist agree stopping would be fine. Though his mood diminishes for a few weeks, he is soon feeling more optimistic, closer with his wife, and more motivated at work.
Grief, transitions, and depression: Mindy, age 63, is depressed to the point of near delirium, verbalizing confused thoughts and demonstrating a loss of focus and cognitive organization. She has no history of psychiatric treatment, but her partner reports she has always been somewhat gloomy and anxious. This episode is different, as she has been unable to work, is tearful most of the day, isolates herself, and feels lethargic—behaviors that are totally out of character. An interview reveals that retirement looms ahead, a new boss has replaced one that Mindy liked much better, and she has not fully grieved her mother’s recent death. Treatment includes normalizing feelings of grief and identifying life-stage changes that triggered the diminished mood. After eight sessions, Mindy is able to confront deeply held fears and beliefs, communicate more effectively with her partner—from whom Mindy desires more physical affection—and make a plan for her transition to retirement. Mindy’s depression begins to dissipate, and she returns to her job with more hope, if not enthusiasm.
Another case was Mrs. N’s depression. Mrs. N first suffered from depression in 1979 and at that time she felt that she was in a deep pit that she just couldn't get out of. She pushed family and friends away even when they tried to help. The only person who was of any help was her younger daughter who ignored the fact that she seemed ill and just treated her as normal which she very much appreciated.
Mrs. N visited her GP who referred her to the psychiatric department of the nearby general hospital where she saw a psychiatrist. He diagnosed her as having manic depression and prescribed Lithium which is a mood stabilizing drug. However she only took it for 5 days as she describes that it made her feel like a "zombie". She went back to see the psychiatrist after 2 weeks who told her to go away and get better on her own as she obviously wasn't manic depressive. She gradually felt better over time but since then Mrs. N has visited her GP several times with depression and was prescribed various antidepressants.
Depression, even the most severe cases, can be treated. The earlier the treatment can begin, the more effective it is. Depression is usually treated with medications, psychotherapy, or a combination of the two. If these treatments do not reduce symptoms, electroconvulsive therapy (ECT) and other brain stimulation therapies may be options to explore.
Antidepressants are medicines that treat depression. They may help improve the way your brain uses certain chemicals that control mood or stress. You may need to try several different antidepressant medicines before finding the one that improves your symptoms and has manageable side effects. A medication that has helped you or a close family member in the past will often be considered.
Antidepressants take time – usually 2 to 4 weeks – to work, and often, symptoms such as sleep, appetite, and concentration problems improve before mood lifts, so it is important to give medication a chance before reaching a conclusion about its effectiveness. If you begin taking antidepressants, do not stop taking them without the help of a doctor. Sometimes people taking antidepressants feel better and then stop taking the medication on their own, and the depression returns. When you and your doctor have decided it is time to stop the medication, usually after a course of 6 to 12 months, the doctor will help you slowly and safely decrease your dose. Stopping them abruptly can cause withdrawal symptoms.
How can we help these people? First of all, before helping them, we must be sure that we won’t be carried away with our emotions. There’s a natural impulse to want to fix the problems of people we love, but you can’t control a loved one’s depression. You can, however, control how well you take care of yourself. It’s just as important for you to stay healthy as it is for the depressed person to get treatment, so make your own well-being a priority.
Remember the advice of airline flight attendants: put on your own oxygen mask before you assist anyone else. In other words, make sure your own health and happiness are solid before you try to help someone who is depressed. You won’t do your friend or family member any good if you collapse under the pressure of trying to help. When your own needs are taken care of, you’ll have the energy you need to lend a helping hand.
Sometimes it is hard to know what to say when speaking to a loved one about depression. You might fear that if you bring up your worries he or she will get angry, feel insulted, or ignore your concerns. You may be unsure what questions to ask or how to be supportive. Remember that being a compassionate listener is much more important than giving advice. You don’t have to try to “fix” the person; you just have to be a good listener. Often, the simple act of talking to someone face to face can be an enormous help to someone suffering from depression. Encourage the depressed person to talk about his or her feelings, and be willing to listen without judgment.
Don’t expect a single conversation to be the end of it. Depressed people tend to withdraw from others and isolate themselves. You may need to express your concern and willingness to listen over and over again. Be gentle, yet persistent.
Conclusively, depression is a serious condition. Depression isn’t something that we must ignore because as time goes by, more people experience this mental disorder without seeking for professional help. We can always offer help to these people but we must always remember that we can never fix that person. It’s up to them to fix themselves, recovery is in the hands of the depressed person. We cannot force them to just stop being depressed since it’s not that easy. Depression can be treated. Depressed people are just locked up in a gloomy chamber – that’s how I’ll call it. It’s dark and it seems like there’s no way out, but once these people search for the light, then they’ll surely get out.
Works Cited
Depression. (2015, December 2). Retrieved March 13, 2016, from GoodTherapy.org: http://www.goodtherapy.org/learn-about-therapy/issues/depression
Gilbert, P. (2009). Understanding Depression. In P. Gilbert, Overcoming Depression (Vol. 3). London: Robinson.
Grohol, J. (n.d.). Depression. Retrieved March 12, 2016, from PsychCentral: psychcentral.com/disorders/depression
Harrison, M. (n.d.). DEPRESSION - A case history. Retrieved March 13, 2016, from London College of Clinical Hypnosis: http://www.lcch.co.uk/hypnosisarticles/hypnosis_depression.htm
Nemade, R., Reiss, N., & Dombeck, M. (2007, September 19). Historical Understandings Of Depression. Retrieved March 13, 2016, from MentalHelp.net: https://www.mentalhelp.net/articles/historical-understandings-of-depression/
Smith, M., Barston, S., & Segal, J. (2016, March). Helping a Depressed Person. Retrieved March 14, 2016, from HelpGuide.org: http://www.helpguide.org/articles/depression/helping-a-depressed-person.htm
Treatment and Therapies. (2016, March). Retrieved March 13, 2016, from National Institute of Mental Health: https://www.nimh.nih.gov/health/topics/depression/index.shtml#part_145399
