Monday 23 July 2018

Seizing Control of Depression

The Man at the Tiller 1892 | Theo van Rysselbergh
Posted by Simon Thomas
We know the symptoms of depression well. We read of them everywhere: sleeplessness, weight loss, reckless behaviour—and so on. Yet we tend to miss the fact that the foremost of these symptoms is deeply philosophical. 
The philosopher Tim Ruggerio defines depression, above all, as ‘the healthy suspicion that there may not be an aim or point to existence’. This broadly agrees with a symptom which stands at the top of many lists of symptoms: ‘Feelings of helplessness and hopelessness. A bleak outlook.’

Of course, depression does not exist purely on a philosophical plane. It is deeply felt. The symptoms one reads about do not begin to describe the darkness one feels in the throes of a depressive episode. It may be hard to see a way out when, frayed and tattered, one’s feelings start spiralling—and it seems no amount of positive talk can help.

Yet even then, there is one steady pole at the centre. My feelings belong to me. Only I can do something about them. This, too, is deeply philosophical. It is too easy to doubt or despair about something, without recognising that one is despairing over oneself. One needs to own it—and such ownership, in turn, forms the basis for a rational way forward.

The philosopher-theologian Paul Tillich wrote, ‘The acceptance of despair is in itself faith and on the boundary line of the courage to be ... The act of accepting meaninglessness in itself is a meaningful act.’ Here, then, is how this simple philosophical insight helps us further:
When we recognise that we are dealing with a philosophical struggle, our orientation to the problem may change. The acceptance of depression as my own, far from acceptance in the sense of surrender, becomes the source of the resolve to face the real issue. It is about the search for an all-embracing meaning of life.

When I see that depression is a philosophical problem, it stands to reason that I shall engage in activities which strengthen me philosophically—which enhance the mind and focus on the good.  Conversely, I shall as far as possible remove myself from the company of those who engage in negativity.

When I understand that it is too easy to doubt or despair about something, without recognising that I am despairing over myself, I know to set aside some of those thoughts and activities which are merely avoidant, which serve to continue a once-removed despair.

Knowing that the solution is philosophical, it stands to reason that it does not merely take a day off to apply it. It is a long-term process, and there are no quick fixes. One develops realistic expectations. Similarly, one does not let down one’s guard. Depression is a bit like the devil in Christian belief. It does not take time off. It is not the time for peace until one walks free.

The ownership of depression represents an acceptance of one's own weakness. Socrates was an avid proponent of the dictum ‘Know thyself.’ To know one's weakness in times of distress is of great help, because if one knows what causes one to fall, one can take steps to stop the downward spiral of one’s mindset.

Philosophy in all its fullness includes the spiritual and artistic aspects of our personality. Therefore it is valuable to have an appreciation for the spiritual and aesthetic inclinations of the human ‘soul’, and to exercise and expand on them.
Of course, prevention is always better than cure. ‘Guard your heart, for out of it comes the issues of life,’ wrote the wise King Solomon. Watch your life and be careful what and who you allow in your heart. We are always under the influence of something or someone, at some stage of our life. It is sensible to guard what one allows oneself to be influenced by.

This is not intended to diminish the help that medication gives, or wise counsel. Yet philosophy plays a central role in depression, and may present a definitive anchor for the soul, which enables us to find the way back to a place of reason and not to spiral into despair.


Keith said...

Much of interest, Simon, to think about here. To Ruggerio’s point, I concur that a person might experience ‘the healthy suspicion that there may not be an aim or point to existence’. Pointlessness or aimlessness — even the ‘helplessness’ and ‘hopelessness’ that Ruggerio lists as symptoms — aren’t necessarily hard-and-fast signals of depression, as long as the person is (genuinely) at ease with such ‘suspicions’ about life. Which is certainly within the realm of possibility, as a philosophical matter — all very much apart from questions of mental illness. However, I gather from what’s said here that Ruggerio expressly folds these ‘suspicions’ about perceived pointlessness into his definition of ‘depression’, seemingly to correlate the two. I’m somewhat struggling, however, with how Ruggerio squares that circle: that is, whereas ‘medical depression’ is an illness and typically involves suffering — hence patients’ resort to medication to quash the funk — how does Ruggerio (logically) juxtapose the incompatible notions of ‘depression’ and what he characterizes as a ‘healthy’ suspicion that existence is pointless? Does Ruggerio go on to explain?

docmartincohen said...

There are convincing studies of the therapeutical effects of homeopathic remedies versus conventional anti-depressant drugs. These remedies seem to work by the change in attitude they encourage in those who take them, rather than any chemical effect, setting aside the optimistic alternative physics of some of homepathy's supporters.

Perhaps this underlines what Simon Thomas is saying - I mean that the power of the mind is enhanced by this step of taking a philosophical approach to what is otherwised presented as a 'medical condition' that expert 'others' need to cure.

mylearningsimonthomas said...

yes, from my own experience I can attest to the fact of "mind over matter" does work since in many cases depression is not only partly and has more of an emotional base to it like when a person experiences some kind of trauma. Sometimes the right diet, plenty of rest and an art lesson will do the trick to lift the despondent spirt.

docmartincohen said...

You might be interested, Simon, in this book , we reviewed for The Philosopher a few years back: "Placebo Talks: Modern perspectives on placebos in society", edited by Amir Raz and Cory Harris. Published: 26 November 2015, Paperback 304 Pages
ISBN: 9780199680702

Sample point!

In 1978 it was found that giving people a placebo version of morphine or some of a supposed painkiller actually worked - not just in terms of self-reported effects but in terms of measured levels of endorphins. ‘In other words the subject created the biochemical conditions that allowed his or her expectation to come true.’

mylearningsimonthomas said...

Thank you Martin, I will have a look out for the book.

Tessa den Uyl said...

Dear gentlemen,

Depression is a nasty beast inside ourselves that in a way only shows the nasty beast that provoked the depression. The incoherence to a set of rules makes one doubt and shiver. But how can you ask something that is incoherent to become coherent? This is mainly where psychology has failed. You cannot put something ‘back’ once it sees through a structure. The depressed only notices the malfunctioning of 'the chain'. (This is often family, and families are power structures). What indeed is incoherent is 'the chain'. Laing and Bateson have clearly pointed out to these malfunctioning chains, but until today the problem is still put upon the depressed. Strangely the incoherent becomes the depressed.

Those who make the depressed feel as if the accused, (and from here I’ll quote Derrida, which somehow adheres) - understand the essential of what they claim not to understand, namely, that it is a matter first of all of putting into question a certain scene of reading and evaluation, with its familiar comforts, its interests, its programs of every kind. No one gets angry at a mathematician or a physicist whom he or she doesn't understand at all, or at someone who speaks a foreign language, but rather at someone who tampers with Your own language, with this "relation" precisely, which is yours. -

Keith said...

I agree that ‘mind over matter’ is a viable strategy for certain situations. Your point is well taken, Simon. Though let me offer that, in my opinion, there are potential downsides as well as potential upsides to the strategy, critically depending on the circumstances. Perhaps I’m being terribly obvious in this point, but let me go there anyway.

On the upside, the mind-over-matter strategy seems to work more often if an otherwise healthy person has allowed for a self-deprecating narrative to dominate in his or her head — that is, persistently negative, internal chatter about one’s lack of worth. It happens. Such behavior can be chalked up, however, as having succumbed to a ‘bad habit’ rather than as an illness. Psychologists say that even healthy people, without for now getting into the thorny matter of how one chooses to define 'healthy', can begin to believe the internalized chatter: ‘Oh, I’m a failure’. ‘I lack purpose’. ‘I always screw up’. And so on. Even to the point, sometimes, of (temporarily) feeling helpless and hopeless. I would argue that the mind-over-matter strategy can indeed be effective in this instance, where the individual deliberately changes the chatter, repeating more self-affirming messages almost mantra-like. The positive messages crowd out the dispiriting messages. Which may be all that needs to happen. By endorsing the new narrative, a person’s outlook on life can become more self-affirming.

On the downside, if someone is not merely vanilla-styled crestfallen but is diagnosed as, say, clinically depressed, because of neurophysiological misfiring or some such goings-on, the calculus can be very different. Specifically, if that person shoulders the belief (burden) that his or her illness is really just a mind-over-matter issue — that it’s a question of adjusting the dials on the internal narrative — such belief riskily puts the onus of recovery squarely on him or her. All happening at a juncture, I believe, when the person is the most fragile and vulnerable. In this scenario, if mind over matter doesn’t work, as may be the case with true clinical depression, it might prove counterproductive and further fuel the person’s gnawing sense of failure, bleakness, and inertia (non-engagement in life). He or she might well see the depressive state as one’s own fault — ‘I’m to blame!’ ‘If only I were stronger!’ — rather than the fault of conditions of the brain that, one might reasonably suppose, require a wholly different kind of intervention.

Meanwhile, I did read the philosopher Ruggerio’s short essay on depression, whose link Thomas helpfully provided, and found that it did fill in some gaps as to where his logic attempts to go on the subject.

Thomas O. Scarborough said...

My first reaction on reading this post, with regard to blame: depression may be helped, if it is about philosophy -- therefore not condemned. But it is not only about philosophy, as the post acknowledges.

With regard to Tessa's comments, I find that we inhabit a world of our own construction or imagining, and this is more fragile than we generally imagine. Its bonds can come apart, within oneself.

What I seem to read in the comments, too, is a point that theologians make. One comes to point where the human will is helpless, powerless. What then?

Tessa den Uyl said...

Agreeing Thomas that we make up our own world, depression is a language problem, isn't it?

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