Understanding depression

Along with anxiety, depression is probably one of most common mental health problems in this country. It is estimated that over 6 million people suffer from depression and/or anxiety in England.  However, these numbers tell us little about the true nature of depression. In other words, what it is to be depressed; how each individual experiences depression in their own way; the history of each person’s depression.

Of course, such questions may seem a lot less important than finding ways to get rid of depression, to feel happier.  And there are certainly plenty of treatments for depression, both pharmaceutical (based on medication) and psychological. It’s also true that many of these treatments can be quite effective, at least in terms of alleviating the symptoms of depression.

One of the problems about treating the symptoms of depression, however, is that, in fact, depression itself is a symptom. People feel depressed for a wide range of reasons. More critically, each person’s depression is unique to them. Therefore it makes little sense to treat depression in some ‘generic’ manner, e.g. by prescribing anti-depressants or even offering someone a course of cognitive behavioural therapy (CBT).  I’m generalising, of course, but the point is that in order to effectively treat depression it’s crucial to have an understanding of the history of each person’s depression. And this essentially means that it’s important to have an understanding of that person’s history.

For example, someone may come to a therapist saying that he is depressed because he has just broken up with a long term partner. At face value this seems relatively straightforward: the client has just suffered the break up of an important and close relationship, therefore it’s hardly surprising he feels depressed. So why not, in fact, simply help him work through these feelings, and perhaps encourage him to look to the future, to the possibility of a new and perhaps more rewarding relationship?

As a short term and immediate intervention this might well be effective. However, a bit more exploration may reveal that this particular individual has experienced a whole series of relationship break-ups in his life – dating back to his childhood when his parents split up and his mother went off with another man, leaving him with his father. In his late teens and twenties he became involved in a series of failed relationships, and every time it was the other person who left him. In fact, his whole life could be described as a history of broken relationships in which he is abandoned by various women.

Now, perhaps, things are not quite so straightforward in terms of how therapy might progress. Of course, it may still be possible to explore with the client how he behaves in relationships with women, whether perhaps he becomes too clinging, too dependent, and so consequently ends up driving the women away. And, of course, this can all be traced back to the original loss of his mother.  Again, this seems seem a perfectly reasonable strategy, and once again may be effective in the short term. However, at the end of the day this is not going to bring his mother back – and this may be where the real problem lies for this particular individual.

Now it’s perfectly clear that no amount of therapy is going to bring back this person’s mother. However, therapy could provide him with the opportunity to explore his relationship with his mother before she left; what it meant for him to lose her to another man; how he related to his father – before and after his mother left; how the loss of his mother in these particular circumstances has affected how he views women in general, and the particular women he has been involved with.

True, this still won’t bring his mother back, but it might well change how he feels and thinks about his mother, how he remembers her – and this in turn may well affect how he relates to women in the future.