Depression:
Defining the 'Black Dog'
Ask five different health professionals for a definition
of depression, and you are likely to get five different
answers. To a physician it is a disease, something
you can treat with medication. To the pharmacy industry,
it is an opportunity to make lots of money and some
psychiatrists will define it as a physical brain
disorder.
Depression is a term for a complex set of processes
but is not necessarily a 'thing'. It is a useful
label, but telling someone that they are depressed
could be seen as permission to adopt a certain way
of thinking and reacting. This is not to deny that
to experience depression is a real and debilitating
event and should always be taken seriously by any
therapist, but it may be more useful for the person
suffering, to acknowledge that people can be involved
in the process of depressing themselves. That is,
it is not an outside force that attacks them, but
a process that they have the power to turn around
and change. A therapist can help their patients or
clients to realize that they have control over their
own fate and do not have to be passive victims of
a disease. |
People describe their
'depression' in many ways and the words used are symbolic
representations of complex facts and feelings. Expressions
such 'falling endlessly into a black hole', 'locked
inside a cage', 'silently screaming and knowing that
no one will hear' are only some of the phrase used.
Everybody 'does' depression in different ways but the
pain is the same. In some people, depression is denied
and unrecognized because they control it by acting
out in self harmful ways, such as eating disorders,
alcohol or drug abuse or aggressive behaviour.
As a psychotherapist I have a duty of care when
a client presents to me with depressive ideation,
to ensure that they do not have suicidal thoughts
and plans. In such cases, I will always recommend
that they see a GP to discuss anti depressant medication
as well as continuing therapy. In most other situations
I do not suggest pharmaceutical medication because
I do not see depression as an illness but as a way
of coping with overwhelming circumstances. These
may be past traumas that have not been dealt with,
current issues such as loss of a loved one or most
often, a build up over time of many losses, griefs
and causes to be sad. Depression can then be seen
as a coping mechanism which can help to numb the
overburdened person from life's pain and opt out
of dealing with unwanted issues. This should not
be seen as a sign of weakness but as a survival skill.
If depression is a way to deal with unbearable pain,
how then does someone learn to change their way of
thinking to move into a non depressed state? This fascinating
question is dealt with in part
2 of this article.
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