Sunday 27 March 2016

Learning from Depression: understand your symptoms

We reach for metaphors to describe the workings and dysfunctions of the mind. For Plato, the mind was a chariot: driver and horses. Reason steers a course while the animal passions, both noble and ignoble, pull us toward our aspirations and desires. Freud likened our mind to an iceberg, concealing below the surface of our awareness all our memories and instincts, as well as our repressed fears and desires. And for Cognitive Behavioural Therapists, the mind is a computer, programmed and reprogrammable, processing emotions and experience to our benefit, and sometimes to our disadvantage.

Depression too has been the target of some famous and infamous metaphors, from demonic possession to Churchill's symbolic 'black dog'. Recognising abstract and potentially threatening emotions, rendering them concrete and discrete through reference to a metaphorical source, is a fundamental means of gaining some control over them, and hence some meagre relief. For me, the conceptualisation I have of my own depression only took form when I was swallowed up by darkness at my own desk.

For me, depression is like being dead in the midst of life. It is like waking one morning to find that you are lying in your own grave with nothing but the stifling pressure of darkness and distance separating you from the rest of the world. Your body may act and react to the events around you, but you remain cut off, and nothing you can do or say will ever reach another, nor add a letter to the story of the world.

Dozens of classic poems, plays and novels reference this same deep metaphor: DEPRESSION is ISOLATION. In J.D. Salinger's Catcher in the Rye, Holden Caulfield's psychological dissolution is heralded by a sense that he is slipping away, even in the midst of a populated cityscape:
I kept walking and walking up Fifth Avenue, without any tie on or anything. Then all of a sudden, something very spooky started happening. Every time I came to the end of a block and stepped off the goddam curb, I had this feeling that I'd never get to the other side of the street. I thought I'd just go down, down, down, and nobody'd ever see me again.
In Sylvia Plath's The Bell Jar, in addition to placing her troubled protagonist under a metaphorical bell jar, Plath also uses immersion in water as an alternative source mapping attributes of isolation.

We have to believe that all experience is valuable, that setbacks are feedback, and that even an experience as nightmarish as slipping into a depressive coma, is, in the final reckoning, an opportunity to learn. When I finally stabilised that evening, and cycled slowly home with the sun still in my eyes, I strongly suspected that my core symptoms - the dissociation, the brain fog and the fatigue - were one in the same as the absolute isolation which had claimed me at my desk. The difference was only one of degree. If I felt dissociated from the world, it was because I was already experiencing it from behind a dark veil; my brain fog was only a thin layer of the same pressure I felt wrapping round my forehead and crown as I went under; and the terrible listlessness and lack of energy that had plagued me for weeks were in fact my body's way of folding me in on myself and preventing further interaction with the world.

I did not know it at the time, but in reaching for this metaphor of isolation, I had taken my first tiny step toward recovery; for only now did I realise that depression without sadness is in fact no paradox at all. This bout of depression was like no other that I had experienced because in place of sadness I had become numb. It made sense. In the past year I had bought a house, travelled to the far East on university business, designed highly innovative educational programmes, climbed mountains and run across Mediterranean islands, and every time someone asked me Aren't you happy to own our own home? Are you looking forward to your trip? I would look into my heart and realise that very often I wasn't. Instead, there was sometimes a sense of unreality and very slight discomfort, as if these pleasures and opportunities should be happening to someone else. And a great deal of indifference. I thought I was simply growing up. But now it seemed more like I was colluding in pulling myself down.

That night I slept for twelve hours and woke to a morning off work, my first since this whole episode began. I fully intended that morning to visit the doctor's surgery, to camp in their reception if need be till someone saw me and prescribed me the medication which I only hoped could deliver me some relief. But in the end, I did not go. Not because of pride, but because of an experiment.

If setbacks are feedback, then they warrant the formation of a new hypothesis, as well as an experiment to gauge the validity of your hunch. Sentient creatures have been making progress by following this simple paradigm since consciousness developed, and humans have been systematically exploiting its awesome ameliorative power to better their lot through the scientific method since the Enlightenment. It is also an incredibly positive and empowering way to look at adversity. Setbacks are an opportunity to learn, and you are in control.

Of course, you are only able to make this reframe as a depressed individual if you can get past your negative thinking, short-circuit your anxiety long enough to think clearly and create a hypothesis, and believe sufficiently in your own potential to make a difference to act. And this is the depressive bind. But, and here is what I cannot emphasise enough: you break this bind if you are mindful. It doesn't last long, the negativity, anxiety and listlessness return as soon as your focus shifts, but by practising mindfulness techniques like meditation, you can stand outside yourself long enough to see more clearly how things are and how they ought to be. And the more you do it, the better you become at controlling your own mind. 

I was now four weeks into my depression, and had been meditating briefly every morning for a couple of weeks. That morning had been no exception, and now I was ready to experiment.


To be continued...





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