Focus: Depression

Depression is the most common of all disorders in our western society. According to the American Psychological Association (APA), National Institute for Mental Health (NIMH) and comparable institutions, depression in the US is prevalent approximately in 1/5th to 1/3rd of the general population at some point in life. Those statistics only include major depression though, and only those getting diagnosed by a mental health practitioner, each year. I personally think that the “dark-number” of people who do not seek for a diagnosis (due to stigma, anxiety and other reasons), and are still perceiving themselves as (mild-, or major) depressed, might be much higher. When believing the estimates of statistical institutions, women are twice times more likely to develop depression. Its first onset is most likely during the mid 20s, but could happen at any time in life, especially when facing a perceived highly-negative experience.

Depression, no matter its severity, is thus a major health-concern for us humans living in a western world, which becomes evermore focussed on performance and functionality.

What is Depression?

There is barely an exception to people who will experience episodes of sadness and sorrow in their life. Almost everyone experiences those feelings and they are a normal way for us to cope with tough situations like losing a loved one or a job. Expressing and accepting these emotions is important because they are necessary for us to deal with harsh environments and fate.

Depression, on the other hand, is more than just feeling down for a bit. It’s a condition where these sad feelings last a long time and seriously impact our lives. It’s different from the regular ups and downs we experience. Depression can literally de-press, attenuate or dampen, our motivation, satisfaction with life, and overall outlook on us, others and the world, for an extended and debilitating period.

Depression is often not as clear-cut and many times accompanied by other complaints or special types of depression. Psychodiagnostics differentiates further subtypes of depression such as seasonal depression (occurring only during specific times, mostly winter-times), Dysthymic disorder (less severe but very long-lasting depression), Cyclothymic disorder (switching between emotional “ups” and “downs” which are less intense than Bipolar disorders) and many other subtle distinctions. Moreover, a distinction can be drawn between depressive disorders and depressive episodes.

Humans who are seeing themselves as being depressed to the extent of being a disorder, can have major life- & well-being limitations over a long period of time, and most of the time, if not daily and always. When these depressed feelings become persistent, often through a kind of learned helplessness, they can significantly affect our daily life and well-being. It’s essential to talk to family, friends, or mental health professionals if you think you might be experiencing depression. Seeking help is crucial for managing and overcoming these challenges.

Personally, I like to refrain from using diagnostic terms from manuals and criteria such as the DSM or ICD. Moreover, the labelling of human individuals as being something (no matter how we call it), is often perceived as stigmatizing and categorizing, leading to self-fulfilling prophecies and further suffering from the act of labelling itself.

What is causing Depression?

Depression can be caused by a variety of factors, mostly accumulating many adversities, while some of them are seemingly unrelated and unthought of. Different schools of psychotherapies and medical trainings see depression through different lenses, and all of them have their fair share on the truth.

Traumatic Experiences

Experiences which are perceived as traumatic (no matter what the society holds as acceptable for traumatic experiences, but what the person perceives as traumatic!) can be a deep-lying cause of depression and long-lasting depressive symptoms. One not has to be raped or experience the death of a dear one to experience depressive symptoms, although they are among the common causes of depression. Being bullied (as adult or child), not having one’s biopsychosocial needs met, or having made bad decisions in one’s life can be as much of a risk-factor for depression, as any other adverse situation. There is no “absolute scale” to which we should compare our adverse experiences to, to decide if they are “worthy” of being depressed of. The person who experiences depression should not need to worry that the cause of its loss of well-being is seen as too mild or too less intense. In fact, the perception and evaluation of each individual differs heavily in response to adverse situations. Hence, any adverse situation which is perceived as traumatic could potentially be a cause of depression.

Diet and Physical Health

Poor diet, hormonal imbalance, metabolic dysfunction and unregulated gut-bacteria are major risk-factors for depression and depressive symptoms. Yes, as in any physical or mental disorder, the condition of our body plays a major role. Although often overseen, even by renowned mental health practitioners, our physical health is the foundation for a healthy mind. Not many know, that about 95% (!) of our serotonin (commonly referred to as “happy-hormone”, although being involved in various other functions in the body) is sitting in the lining of our gut and is produced and managed by our gut-bacteria. Without having those roughly 2 kg of bacteria sitting in our gut and managing our inner life on a microscale, we are just not able to produce the chemical compounds which make us happy. Moreover, when our mitochondria (the powerhouse in each and every cell of our body) are malfunctioning, mostly due to poor diet and lifestyle, a multitude of symptoms, both physically and mentally, can and will at some point appear. We need to remind ourselves that we are not just one living being, but a collection of billions of little organisms and bacteria, working together as a collective, to keep us healthy, alive and running. If those tiny creatures in our body are unhappy, we ourselves will be unhappy as well. That is, the body and mind are one system, the bodymind.

Social contact

Few, or no social contact at all can be a major contributor to depression and its symptoms. We humans are not only emotional beings, but first and foremost social beings. Evolutionary, we are wired to live in groups, share experiences and communicate our concerns. If there is no possibility to share our inner life, our hard and joyful times with someone, we tend to feel depressed. The harmful cycle begins when feeling depressed makes it hard to connect with others, causing difficulties in making new social connections. Also, desiring a close relationship without having one can contribute significantly to depression symptoms. It’s not about being alone, which is good and healthy at times, but feeling lonely even when you want and try to be around people. Love, appreciation and respect from others is absolutely crucial for us to feel happy and fulfilled. So much so, that in a famous study with babies who received everything they may physically need (food, water, etc.) except of attention and love, most of them died (The Frederick Experiment). Follow-up studies by Bowlby (1944) found that this absence of attachment in children can result in unaffectionate and psychopathological adults later on. This phenomenon is often referred to as “failure to thrive” and relates to our basic and fundamental needs for love, affection and attention.

Limiting Thought-Patterns

Finite thinking and limiting thought-patterns or beliefs can create and maintain depressive symptoms, sometimes over decades. Phrases like “I am worthless,” “I am not enough,” or “I don’t deserve happiness, a specific job, or a certain life” are powerful thoughts that our mind comes up with to explain why things may not be going well. These limiting thoughts often originate from childhood experiences, where not meeting others’ expectations led to rejection, or from repeated unsuccessful attempts to please our caregivers, that damaged our self-esteem. The reasons behind these thoughts can be varied and complex.

Nevertheless, these drowning beliefs are often untrue and are based on the evaluation of an “earlier self” trying to make sense of the negative reactions received from others or the situation. In the context of depression, those thoughts are in most cases present and make the depression persevere over long periods of time. “Learned helplessness” is a term coined by early behaviouristic psychologists which describes the (perceived) uncontrollability over a situation, despite having multiple ways to step out of it. It plays a major role in many individuals displaying depressive symptoms over a long time, and stems from having literally “learned” to feel and act “helpless” in such situations. Those limiting beliefs and feelings can contribute to long-lasting depressive symptoms and are heavily created in the last point I want to talk about in the next paragraph: Social media.

Social Media

Social media had the purpose to connect people, but resulted in deep inner disconnection and envy for some of us. Its presence and prevalence in our life, especially of younger generations which grew up with it, becomes increasingly problematic. The extent to which we become dependent, nearly addicted, to the “likes” we get, the “compliments” we earn for uploading pictures or short videos, relates back to our 3rd and 4th aspect of causes of depression just discussed here. As social beings, we want to be validated and gain attention, which we can get through social media presence. So far, so good. The real issue though is, that we often see an overly positive picture of the lives of others, which we may admire or envy. The thought that oneself is not having “such a beautiful body” or not living “such a wonderful life”, is not very far when being confronted with those overly positive depictions on a daily basis. Limiting thought-patterns can arise quickly, judgements made about others and oneself, which do not live in such an always positive fashion, give rise to the mind’s intriguing creativity of why that might be the case. On the other hand, the lack of being “liked” and superficially “complimented” on social media platforms might create such thoughts as, again, “not being enough” or “not worthy of being liked”. What many often forget is that the admired person we compare ourselves and our life to, are only showing their overly positive depicted upsides, and seldom their downsides. Moreover, the envied persons are themselves often dependent on the likes of others and draw their self-esteem from that, which seems to be a kind of “filling a hole” principle. Lastly, I want to make clear that social media is not a kind of devilish technology, but it most certainly contributes a lot of silent suffering and, to stay in the context of our focus-topic, symptoms of depression

Certainly, the five contributing factors described here are not the only ones, neither are they mutually exclusive. Rather, I wanted to depict a wide variety of aspects, of which some are often not spoken about or just not seen as a possible contributor. The important point here for me is to make clear, that any disorder, among which depression, should be seen holistically, not only relating to one aspect or psychological “disorder”. As multivariate those causes for depression can be, just as many different kinds of interventions, treatments and help can be offered to humans experiencing its sometimes devastating symptoms.

Help and Treatment

Helping and supporting humans with depressed well-being and decreased life-satisfaction can be as easy as giving the social support they needed for a long time, or as hard as year-long intensive therapy sessions within a small-win framework. As so often, there is no “one size fits all” or “do this one thing to cure depression”. Here at TRUE INNER WORK, people are not seen as wrong, depressed, or faulty in any way. I strongly believe that the key to healing and wholeness lies in respect and compassion towards all our parts, thoughts and emotions. We did not came to this world and decided to wake up depressed one day, so how can we make ourselves responsible for what was done to us at a time in which we did not know how better to cope. Nevertheless, it is on us to recover from our past wounds and take back the control which was locked away for so long.