What Is Depression?

What is it to be depressed?

Many of us, even those who experience it most deeply, actually have little idea. Sure, by now we all know that, according to the DSM, if you have five of nine certain symptoms, you “have” a depressive disorder. But what does that mean? What does it explain? Does it explain anything at all? Many people think it does: “Ah, I feel so terrible because I am depressed.” And yet such a sentence is a tautology. In truth the diagnosis explains very little. It mostly describes; at best it captures a snapshot of something. It provides shorthand for a set of symptoms. But symptoms of what?

When I ask people what they think depression is, often I’ll hear something about being really sad. This is a common understanding of depression: extreme sadness. In truth, not uncommonly, a depressed person isn’t feeling particularly sad; she’s more typically not feeling much at all. She’s stuck, stagnant, in a room with no exit.

I’ve come to best understand depression as a void, as an absence of experience where an emotional life should be. It is a profound alienation rooted in the negative space of disconnection – disconnection from other people, from a place in the world that offers authentic expression, disconnection from oneself, from one’s right to exist in harmony with other living things. In that sense, in it’s being characterized by a distancing of the self, I see depression as an unconscious defense – a defense against the painful emotions we fear we can’t bear to face, or we fear the world doesn’t want to receive.

By acknowledging small improvements in behaviour you make it easier for big improvements to follow.

Many of us believe we can choose what we feel. We can’t. However, we can in a sense choose whether to feel or not. I see depression as rooted in the largely unconscious choice not to feel.

Eric Jannazzo PhDSource: Eric Jannazzo PhD

For many of the depressed people I work with, then, the path is clear, if hugely difficult: We must begin to feel the truth of life. Many people are afraid to. At times, the truth really hurts. Or we don’t trust that the world will accommodate us if we come to face, and name, the truth we’ve been conditioned to bury.

And of course our culture gives us warped messaging about not only what our external appearance should be, but what our internal life should be as well. In short, I should be happy. Beyond happy, I should be joyful. And I should be grateful. I certainly shouldn’t be sad, jealous, or resentful. Maybe I can be privately afraid of death, but I sure as Hell can’t be afraid of life. And I shouldn’t be angry – especially if I’m a woman. A woman should be pleasant and easy to be with. Anger is neither pleasant nor easy.

I’ve found that disavowed, stagnant anger is often close to the core of the depressed life. Anger is a necessary emotion for the same reason it can be dangerous: It’s suffused with personal power. (This is in part why our society has “rewarded” women for being pleasant and pathologized their anger.) Healthy anger is rooted in a sense of self-worth; it informs the ways and means of protecting the self, of saying no to transgression, of feeling one’s own agency even in the face of life’s arrows. No doubt in its righteous deliciousness anger can be unskillfully overdeployed, obscuring more tender emotions rooted in vulnerability and connection. And yet so many of us have been taught that there’s no room for the healthy, appropriate experience and expression of anger in response to life’s transgressions. Utterly disconnected from this sense of power, we become more prone to a defeated collapse.

Set up a "gratitude circle" every night at dinner. Go around the table and take turns talking about the various people who were generous and kind to each of you that day. It may sound corny, but it makes everyone feel good.

So we must reset our emotional aspirations. Let us aspire to be human. Let us acknowledge what that is, and let us grant each other – and ourselves – permission to be exactly that, in all its complexity, and with all its attendant emotion. If we don’t, we are far more likely to find ourselves in that room with no exit, in the state of profound disconnection from our own aliveness, the state we call depression.