It’s well documented that depression will afflict almost half of us at some point in our lives. And yet our understanding of the illness is often confused with sadness. The Book Of Life argues that a number of assumptions that are made about sadness have been inappropriately applied to depression, and this can lead to people with depression suffering more than they need to.
While on the surface, a sad person may present similar characteristics to a depressed one, there is one fundamental difference. The sad person knows what they are sad about, the depressed person doesn’t. Unlike a sad person, a depressed person usually has difficulty articulating what they are sad about. They may simply feel that life has been drained of all meaning.
This can leave them open to unwarranted charges of faking, malingering or exaggerating. Friends may end up feeling frustrated at the lack of progress in their attempts to help. A sad person usually doesn’t feel that life has lost all meaning. A depressed person may totally disintegrate as a result of a minor accident such as breaking a glass.
For decades now, the idea has been promulgated that depression is a result of a chemical imbalance in the brain, a concept very attractive to pharmaceutical companies who are more than willing to flood the market with their miracle cures. But for many patients, so-called antidepressants have only resulted in weight gain.
Psychotherapy has brought some sufferers some relief because it starts from the premise that the depressed aren’t feeling that way for no reason - there is a reason. “They are very distressed about something but that something is proving extremely difficult to take on board, and has therefore been pushed into the outer zones of consciousness.“ Rather than being able to confront what really distresses them, they remain dead to everything. Often, the depressed aren’t aware that they lack insight into what’s really troubling them.
There is another key difference between been sad and being depressed. The sad my feel grief stricken by something out there in the world, but they are not usually sad about themselves - their self esteem remains unaffected. “Whereas depressed people will characteristically feel wretched about themselves and be full of self-recrimination, guilt, shame and self-loathing.” In extreme cases, this can lead to suicidal thoughts.
The Book Of Life suggests that a sufferer can become self-hating as a defense against the risks of hating someone else , a parent who humiliated them when they were a child for example. Despair can be caused by “undigested, unknown and unresolved trauma”.
Psychotherapy can open the door to greater insight, but this can take time and require courage in the sufferer and patience in the care-giver.
This brings me to the use of psychedelics in the treatment of depression. This is nothing new. In the 1950’s and 60’s much knowledge was gained and progress made in the use of psilocybin found in magic mushrooms on patients whose depression seemed treatment resistant. Unfortunately, the reputation of psychedelics was tarnished by their use (abuse) recreationally; this and the linking of the psychedelic movement with the anti-Vietnam War movement led to the banning of these substances by the end of the 60’s.
But in recent years there has been a renewal in interest in psychedelic treatments in the USA, the UK and many other countries. The benefits of these treatments is far too lengthy a topic to be covered here. It seems the use of psilocybin in conjunction with psychotherapy is bringing benefits to many sufferers. But I recommend Johann Hari’s book “Lost Connections” as a good starting point for anyone interested in the topic. It was quite an eye opener for me.