Depression: Some Days You Feel Very Small

There are days when you just want to sit alone and suck your thumb.

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Lost your job? Your dog died? Partner left you? A cancer diagnosis? Nothing left in your bank account?

These events happen every day in the Western World, and victims can get really down. Depression, despair, feelings like giving up, even a regression into childhood…these results are more common than many people realize. And we also know that a family history of depression doubles or triples a person’s risk for a mood disorder, especially from studies of monozygotic twins (bipolar disorder) involving chromosome linkages.

The neural transmission of serotonin and norepinephrine have been implicated in both depression and bipolar disorder. “This makes neurobiological sense because these same neurotransmitters are involved in the capacity to be aroused or energized and in the control of other functions affected by depression such as sleep cycles and hunger. Drugs that alter the activity of these neurotransmitters decrease the symptoms of depression (and hence are called antidepressants)” (Drew Westen, Harvard University, Psychology: Mind, Brain & Culture, 2nd ed. 1999. John Wiley & Sons, Inc. New York. p. 701).

Environmental factors play a role, such as in early childhood and familial experiences. Factors that have been identified include:

  1. having been raised in disruptive, hostile, and negative home environments (Brown & Harris, 1989)
  2. family deaths and divorce (Nolen-Hoeksma et al., 1992)
  3. children of depressed mothers (Hammem et al., 1991)
  4. loss of a job or significant other (Brown et al., 1998)
  5. lack of an intimate relationship, particularly in women (Brown & Harris, 1989)

Depressed persons, remarkably, tend to “seek out partners who view them negatively, and they prefer negative to positive feedback” (Giesler et al., 1996), and who verify their self-concept of negativity.

Learned helplessness theory can “relate depression to expectations of helplessness in the face of unpleasant events” (Westen). Beck (1991) observed the negative triad, in which depressed individuals interpret events unfavourably, have a poor self-concept, and are pessimistic about the future. Such a person may ignore his/her past successes, continually doubts him/herself, and generalizes and overgeneralizes about things that “don’t fit the data”. And people whose depression focuses on interpersonal issues tend to develop depression in the face of rejection and loss, whereas people whose depression focuses on autonomy and achievement issues tend to become depressed by failure to meet standards (Peselow et al., 1992).

Anxiety disorders (phobias, panic attacks, agoraphobia, obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD) may develop alongside depression such that they are co-morbid in the life trajectory of the person. A reciprocal ’cause-effect’ relationship between anxiety disorders and depression has not been fully researched, but intuitively they appear to be linked.

Depressed persons, without proper treatment, may have their sexual, employment, socio-economic status and self-image, education, religious convictions, physical health and interpersonal relationships – all negatively affected. Family members and others who live with a depressed person for an extended period, may be ‘pulled down’ themselves, and experience guilt, frustration, lack of sleep, and even cynicism about the healthcare system that seems unable “to do its job”.

As conscious or unconscious defense mechanisms, depressed individuals may develop a ‘coat of armour’ of detachment, isolation, denial, rigidity, delusional thinking (grandiosity, unrealistic scenarios), fixed mental images and thought patterns, and may feel that all would be better if they could just “move away”. Their daily lives may become shallow and restricted to only a few routinized or compulsive behaviours. They may be unable to show ‘insight’ or to argue reasonably without becoming angry, frustrated or defensive. Regression into the ‘safe’, and happy mental images and experiences of their childhood, may be observable. They may reject reading novels and textbooks. They may be unable or unwilling to engage in a vigorous discussion with others about moral issues or politics. They may also regress to childhood activities, such as watching cartoons repeatedly. Or they may wander over to a theme park and sit in a big chair.

 

 

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