THE VALUE OF DEPRESSION

There is a problem with the conventional wisdom about mental illness.  The conventional wisdom is that mental illnesses are caused by chemical imbalances, genetic dynamics and brain abnormalities.  That belief encourages people to ignore the meaning of the symptoms and deprives people of an opportunity to learn valuable lessons about themselves, lessons that can help them live more the way they want to live.

If you accept the conventional wisdom, you have no interest in exploring the meaning of the symptoms or listening to what they may have to tell you.  Rather, you are encouraged to get rid of the symptoms as quickly as possible and pay no further attention to them.

But what if those symptoms had important information for people, information they need in order to lead healthy, fulfilling lives?

If you believe in evolution and natural selection you would conclude that the symptoms must have some survival value, must be useful in some ways.  Were they not useful, they would have been wiped away by natural selection a long time ago.  After all, human beings have been evolving for about 30 million years, the estimated time since humans split off from the other members of the primate family.  Any human faculty which has lasted for 30 million years must be useful to our survival and well-being in some way.

If that is true, let’s look at some of the symptoms of mental illness and see how they might be useful to us.

Here are the symptoms that are used to diagnose the most common mental illness – depression.  (Yes folks, the symptoms that are listed below, and nothing else, are used by doctors, psychologists and psychiatrists to diagnose clinical depression).  You would think – considering the conventional wisdom about mental illness – that there was a more “medical” way of diagnosing depression, a blood test or brain scan.  But no, the way it is diagnosed is the doctor, psychiatrist or other mental health professional asks the patient to give a self report on the following questions:

Have you felt sad or empty most of the day, nearly every day for the past two weeks?

Have you experienced a markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day for the past two weeks?

Have you experienced significant weight loss when not dieting or weight gain (a change of more than 5 % of body weight in a month) or increase or decrease in appetite nearly every day for the past two weeks?

Have you experienced insomnia or hypersomnia (excessive sleep) nearly every day for the past two weeks? 

Have you experienced psychomotor agitation (jittery, jerky, jumpy stomach) or retardation (slowed down, sluggish, groggy) nearly every day for the past two weeks?

Have you felt fatigue or loss of energy nearly every day for the past two weeks?

Have you experienced feelings of worthlessness or excessive or inappropriate guilt nearly every day for the past two weeks?

Have you experienced diminished ability to think or concentrate, or indecisiveness, nearly every day for the past two weeks?

Have you experienced recurrent thoughts of death, recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide?

If the patient responds “Yes” to five or more of those questions and if those symptoms are causing significant distress or impairment in social, occupational or other important areas of functioning, the patient is diagnosed with clinical depression.

So if we assume that these symptoms must have some survival value, how might they be useful?  What might be going on with a person who is experiencing these symptoms?  It sounds as if s/he is very upset about something.  Something is not going right in her life.  Something is threatening her ability to live the way she wants to live, to love the way she wants to love, to work (express herself) the way she wants to work.  Something precious has been lost.  He is concerned about his life, where it is going.  Is it the job, the relationship, the kids, the demands of parenting, his social status?  He’s not going to live forever.  Maybe he needs to do something about it.

It sounds as if s/he’s under a lot of stress or, perhaps shutting down after being under a lot of stress for a long time.  Perhaps this is the body’s way of protecting itself from prolonged stress.  There are worse things that could happen – a heart attack, a stroke, cancer.  In fact, research has found a strong link between high levels of stress and depression.

This sounds like a wake-up call, a message that something is not right and something needs to be done about it.  The bodymind is saying:  “Stop doing what you’re doing.  Stop focusing on the outer world, on other people, on your spouse, your clients.  It’s time to quiet down, go inside, take a serious look at your life, get in touch with what is going on.  Stop avoiding this by drinking, drugging, working, playing, sexing, competing, winning.  You need to make some important decisions or, perhaps, accept what is true about you and your life and become more comfortable with it.  You need to do some inner work.”

Perhaps this is a reaction to the loss of something that is very precious to us.  It wouldn’t have to be the loss of a person, a job, financial security or a relationship.  It might be the loss of youth, or certainty or a sense of comfort.  If something precious has been lost, perhaps it would be healthy to spend some time experiencing the pain of that loss.

How could the painful experience of loss be helpful?  If I believe that all human faculties which have survived through the 30 million years of human evolution have to be useful, that is an obvious question.  And an answer that makes sense comes to me.  Loss is useful because it tells me what is precious to me.  It tells me in a visceral way what I want to protect and nurture and tells me in a very powerful way that I better do what I can to protect and nurture those precious things.  Valuable information indeed.

What if depression is a state of being that forces people to take a look at their social relationships and that gives them impetus to do something about changing them?  That is the hypothesis of Paul Watson, a behavioral ecologist at the University of New Mexico:

“It induces us to be attentive to the structure of our social network: Who has power? Who has what opinions? How do these opinions of different social partners interact to constrain or enable us to make changes in life?  Depression may have a social planning function which helps us to plan active negotiating strategies in a sober, ruminative state so we can go out and actively negotiate ourselves into a better social position with the people who have power to help or hinder us.”

Edward Hagen, an evolutionary biologist, has a similar idea.  In the ancestral situation, when humans lived in small hunter-gatherer tribes, depression may have had value in compelling other people in one’s life to make changes that were in one’s interest – to induce the members of one’s tribe to come to one’s aid.

In his book Care of the Soul, Thomas Moore has a chapter entitled “Gifts of Depression”.  Here is one of them:

“Depression grants the gift of experience not as a literal fact but as an attitude toward yourself.  You get a sense of having lived through something, of being older and wiser.  You know that life is suffering, and that knowledge makes a difference.  You can’t enjoy the bouncy, carefree innocence of youth any longer, a realization that entails both sadness because of the loss, and pleasure in a new sense of self-acceptance and self-knowledge.  This awareness of age has a halo of melancholy around it, but it also enjoys a measure of nobility.”   

Medical researcher Antonio Damascio found that people who couldn’t feel bad couldn’t make good use of their reasoning powers.  In his book Descarte’s Error, he describes his work with people who couldn’t process feelings because of lesions in the amygdalas of their brains.  Not being able to feel bad, they were unable to make good decisions about their finances, business practices, relationships, etc.  They might buy a stock and see that it was losing value.  But, not feeling bad about it, they wouldn’t take any corrective action.

So I am suggesting that, when we experience the symptoms of depression, we would do well to spend some time and effort wondering about what has brought them on?  Have I lost something that is valuable to me?  Am I concerned about my life, my love relationships, my work, my ability to enjoy life and live the way I want to live?  Am I concerned about myself, my ability to work effectively, to pursue a satisfying career, to maintain satisfying love relationships?  Have I been under stress for a long time?  If so, what is causing the stress response?

But wait a minute.  Let’s not get too sanguine about this.  Depression is associated with suicide.  It is a very debilitating disease.  Severe depression keeps people from doing any of the things that make life worth living – loving, working, playing, expressing, enjoying.  Let’s be careful not to make light of a debilitating and dangerous state of being.

Yes, we need some balance here.  Perhaps, depression is like many things which are good and useful in moderate amounts but dangerous and deathly in extreme amounts.  Included in that list would be the stress response, alcohol, strychnine and water, among others.  Perhaps what makes sense is to make a distinction between moderate depression and severe depression.  Perhaps, keeping severely depressed people from killing themselves, hurting others or falling into permanent disability calls for extreme measures – psychotropic drugs, treatment in psychiatric hospitals.

Balance makes sense.  But that’s not where we are today.  Today, more and more people respond to symptoms of moderate depression by ingesting antidepressant drugs, drugs which make it harder for them to experience the emotions and thoughts which might be valuable to them.  Antidepressants are among the five most heavily prescribed drugs in the United States.  People are going to psychiatrists and other doctors.  The doctor asks them the nine questions.  If they answer “Yes” to five or more of them, the doctor writes a prescription.  There is no time spent exploring what might be going on in the person’s life or how they are responding to their lives that might explain the symptoms.  

Most of us don’t have the luxury of taking off two or three days to spend in that kind of contemplation.  But we could find some time during every day to quietly allow ourselves to experience what is going on inside.  We could even take some vacation time or sick leave to spend several days on it, perhaps with the help of friends or a therapist.

If you decide to do that, here are some suggestions.

I would recommend that you find a psychotherapist to work with, somebody with whom you feel comfortable, who you sense will respect you and help you come up with your own answers.  There is something healthy about being able to say things to another human being that you have not said to anyone else, to let your hair down and expose yourself, knowing that nothing you say or do will go out of the room.  There is value in becoming more comfortable with the symptoms and looking for the meaning and potential usefulness in them.  Becoming more accepting of what is true about yourself is profoundly healing.  Therapists can help you do that.

I would recommend that you spend some time just sitting by yourself in quietness, perhaps using some of the simple relaxation or meditation exercises that you can find on the internet or in various books (my favorite is the mindfulness meditation of Jon Kabat-Zinn).  Just sitting and noticing whatever thoughts or feelings come up and paying some attention to them - not necessarily hanging onto them or doing anything with them – just noticing them.

I would recommend that you do some things that are enjoyable – perhaps reading books or articles that you want to read and definitely getting some good exercise – running, walking, bicycling, swimming, skiing.

The bottom line is that I urge you to regard the symptoms, no matter how painful and debilitating,  as a message of meaning, a message that contains valuable information that can help you live a healthier and more satisfying life.  And I encourage you to make an effort to understand the meaning of the symptoms and to use the information they offer to live more the way you want to live.

Submitted by:

Al Galves

TURNING NEGATIVE EMOTIONS INTO POSITIVES

What are the negative emotions?

Anger

Jealousy

Fear

Guilt

Sadness

Anxiety

Others?

Why do we think they are negative?

They aren’t comfortable.

It’s interesting to wonder about why these important feelings are uncomfortable.  Perhaps it is because we need to be motivated to do something about the concerns that are causing them.

They are associated with behavior that is dangerous.

It’s important to make a distinction between the emotion and behaviors that are associated with the emotion.  All emotions are valid, OK and potentially useful.  But the behavior that results from emotions can be either helpful or dangerous and hurtful.  

They can make us sick.

When these emotions are stuffed and repressed, they go inside, put a strain on the body, impair the immune system and cause sickness.

What evidence is there that these emotions are useful?

Evolution or Creation

Whether you believe in evolution or creation, there is evidence that the “negative” emotions are beneficial and useful.  If you believe in evolution, you understand that the human organism has been evolving over the past 30 million years.  Any faculty or state of being that wasn’t useful and didn’t have survival value would have been wiped out long ago by the process of natural selection.  If you believe in creationism, why would God have given us a faculty or state of being that wasn’t somehow useful?

Research

Antonio Damasio

In his book Descarte’s Error, Antonio Damasio describes his study of people who, due to lesions on their amygdalas, were unable to experience emotions.  He found that such persons were unable to make good use of their reasoning abilities. Unable to feel bad, they couldn’t learn from mistakes.  For example, they would see a stock they owned going down in value but wouldn’t feel bad about it so wouldn’t sell it.

James Pennebaker

People who write about the most traumatic experiences of their lives have better immune system functioning and are healthier than people who write about impersonal topics.

Method Actors

The immune systems of actors function better while they are experiencing emotions and it doesn’t make any difference if the emotions are “positive” or “negative”.

Medical students

Medical students included in the “Bland-No emotions” group were 16 times more likely to contract cancer than those in the “Acting out” group.

Joseph Ledoux

Signals that are received through the eyes, ears, nose and skin pass through the amygdala (the part of the brain which processes emotions) before they go to the neo-cortex (the part of the brain which processes thinking, problem solving and analyzing), evidence that the human organism is “designed” to enable the emotional processing and reasoning faculties to work together.

How are these “negative” emotions useful?

Five basic ways in which they are useful:

They tell us what’s important, what we care about, what we like, what we don’t like, what we are afraid of, what we want to get rid of.  

They help us get clear about our values.

The help us make decisions

They give us energy and motivation.

They help us understand other people and, therefore, to behave in better ways.

Following are some examples:

Anger:

Anger tells us what we don’t like, what we want to get rid of, what is threatening us, what we want to overcome.

Jealousy:

Jealousy tells us what we want and don’t have or what we have and don’t want to lose.

Fear:

Fear tells us what we want to avoid, what we want to be careful about, what can hurt us, what we must protect ourselves against.

Sadness:

Sadness tells us what is precious to us and what we want to nurture and protect in our lives.

Anxiety:

Anxiety gives us the energy, the mental acuity and the stamina to do things that we want to do but which are going to be difficult and scary.

Guilt:

Guilt tells us what we think is wrong, keeps us from doing things we think are wrong and enables us to make amends to persons we have wronged.  It enables us to act in accordance with our moral code.

What do we have to do in order to use them?

1.  Experience them.

We experience them in our bodies.  We first get in touch with them through bodily sensations.  What we have to do is let them in, sit with them, wait with them, let them work in us.  Many of us have been told that these emotions are bad, that they can’t be trusted, that they only lead to no good.  So, as soon as we begin to feel them, we find a way to avoid them.  We get busy, we act out, we take drugs and alcohol, we escape.  If we only would let them work in us for five minutes or so, we could take the first step to turning them into positives.

1. Find out what they are telling you. What is behind them? What are they about? What is the message?

This is easier said than done.  It may take some time to get the message from the emotion.  One thing that will help is to find a quiet place in which to sit.  Sit in a comfortable position.  Tell yourself that you are open to receiving whatever the message is.  Take some time to relax, let the tension out of your body and allow yourself to receive whatever messages come up from inside of yourself.

Here are some other rules of thumb that may be useful in taking this step.

• Anything which gets in the way of you loving the way you want to love and working - expressing yourself and using your abilities - the way you want to work is going to cause one of these “negative” emotions.

• Welcome whatever thoughts come up. Even if they don’t make sense or seem to be coming out of left field, they may be the start of a useful insight. If they seem weird, ask them what they are doing there and what they have to tell you. Be open to answers.

• It is not necessary to push yourself hard at this point. It works better to relax and allow things to come to you – all by themselves – without you making it happen.

1. Take some action based on what you have learned or decide not to take action.

This may be the hard part.  Since these emotions are usually about something which is bothering you or is in your way, something you want to get rid of or you want to confront, it may take some courage to take action.  And since action will often involve confronting other people you will have to learn how to confront without making them defensive.

Here are some rules of thumb for taking action.

• If you are confronting another person, use the rules of assertiveness:

Describe what is going on for you, what you are noticing, how you are feeling using “I” instead of “You”.

Tell the person that you are having a problem with what is going on, that you don’t know what the solution is and that you’d like her or him to join with you in finding a solution.

Take responsibility for your feelings, your thoughts and your desires.

Say what you want – calmly and directly.

Don’t take responsibility for the other person’s feelings.

• If you are afraid, ask yourself what you are afraid of. When you get the answer, see if it is a fear that you can walk with, that you can manage without letting it stop you.

• Ask yourself what is the worst thing that can happen and see if you could live with that or somehow mitigate it.

• Be aware of the ways in which you habitually stop yourself from taking action. We often stop ourselves by saying things like:

I don’t want to be petty.

I’m afraid if I say something or do something, things will get worse.

It’s not that important.

I’ll just let things ride and see what happens.

Who am I to think I should get what I want?

If I do what I want to do, they’re going to think I’m mean and nasty and not a nice person.

      Check these thoughts out to see if they really make sense and if you want to let them stop you or not.

What if I don’t want to take action?

After experiencing the emotion and getting its message, you may decide not to take any action.  If so, you need to find some way of discharging the energy that is in the emotion.  Examples of how some people use this energy effectively is exercise, sports, creative activity, talking to friends, writing, playing music, and helping other people.  Any activity which uses energy and is not harmful to self or others will work.  

So what is the bottom line?

These so-called “negative” emotions are valid, beneficial and potentially useful.  They tell you what is important to you and what you need to do in order to live more the way you want to live.  If you want to use them, take the following steps:

1. Experience them. Let them in and let them work on you.

1. Learn from them. What are they telling you?

1. Take action based on them. If you decide not to take action, find a way of using the energy in them that is helpful to you and/or others.

Al Galves, Ph.D.

agalves2003@comcast.net

www.algalves.com

Problems With the Biopsychiatric Belief System

WHAT YOU BELIEVE CAN HURT YOU

By

Al Galves

Keywords: Mental Illness, Biochemical Imbalances, Genetics Brain Scans, Psychotherapy

Summary:

The majority of Americans believe that mental illnesses are caused by chemical imbalances, genetic dynamics and brain disorders.  That is a cynical, harmful and erroneous belief.  It is a belief that hurts lots of people.

I understand that the great majority of Americans believe that mental illnesses are caused by chemical imbalances, genetic dynamics and brain disorders.  That is a cynical, harmful and erroneous belief.  Cynical because it turns human beings into helpless victims of physiological forces over which they have no control.  Harmful because it makes it less likely that people will participate wholeheartedly in psychotherapy, far and away the best treatment for mental illnesses.  Harmful also because it encourages people to focus on what is not important and ignore what is important.  Erroneous because it is not based on adequate scientific evidence.

There is a more hopeful, beneficial and accurate belief about the cause of mental illness.  It is a belief that is held by the great majority of people in the world and which was held by Americans fifty years ago.  Here it is:

The great majority of mental illnesses are essentially reactions to difficult, troubling and damaging life situations and to concerns that people have about their lives and themselves.  Mental illnesses are caused by life crises, emotional distress, spiritual emergencies, difficult dilemmas, inner conflicts and various forms of overwhelm.  Mental illnesses are essentially how people avoid emotional pain, protect themselves, feel more adequate and powerful, gain the illusion of control in a world in which the most dangerous things are outside of our control.  Mental illnesses are reactions to significant loss and to concerns about one’s ability to live the way one wants to live.  They are wake-up calls, signals that something is wrong and needs to be dealt with.  Mental illnesses are the painful, uncomfortable, dangerous and debilitating emotions, thoughts and behavior that people experience in the course of dealing with the problems of life.  Mental illnesses are reactions to difficult, scary, terrifying, rage-creating life situations. 

This is a more hopeful belief because people have the ability to learn how to deal more effectively with life crises, emotional distress, spiritual emergencies, difficult dilemmas and overwhelm.  They have the ability to learn how to manage their thoughts, emotions, intentions, perceptions and behavior in ways that will enable them to lead more satisfying lives.  They have the ability to heed the wake-up call and take a serious look at their lives and what it is going to take to love more the way they want to love, work (express themselves) more the way they want to work and enjoy life more they way they want to enjoy life.

This is a more beneficial belief because it will encourage people to participate whole-heartedly in all forms of psychotherapy: cognitive-behavioral therapy, hypnotherapy, body-centered therapy, trauma-informed therapy, narrative therapy, solution-focused therapy, group psychotherapy, art and music therapy, mindfulness meditation, yoga, nutrition, exercise, support groups, help with love relationships and family relationships, help with finding satisfying and rewarding work, help with finding enjoyable and healthy ways of expressing themselves.

But what about the scientific evidence?  Isn’t there evidence through brain scans that mental illnesses are caused by chemical imbalances and brain disorders?  Of course, all human behavior involves biochemistry and brain function.  But that doesn’t mean that the chemistry or the brain function causes anything.  From what we know about how the mind and body function together it is more likely that the biochemical and brain changes are reactions to what is happening to the person, what the person is perceiving, the difficulty the person is having, the concerns the person has.  That is what happens in the stress response, the most widely studied and best understood of the human mind-body dynamics.  The stress response is a profound biochemical dynamic which includes the secretion of neurotransmitters such as norepinephrine and noradrenaline.  But it doesn’t come out of the blue.  It doesn’t just happen.  Rather, it is a response by the person to some threat or to some demand that is placed upon her or him.  It is a reaction to something that has happened to the person.  This is in keeping with what we know about human beings.  Human beings are not random organisms.  They are meaning-making, desiring beings who live with a purpose.  States of being such as mental illnesses don’t just come on them out of the blue.  Rather, they are reactions to something that has happened, to some kind of concern, fear, need, desire, frustration.

If this clearly the case with the stress response, why wouldn’t we think it is true of depression, anxiety disorders, bipolar disorder, obsessive-compulsive disorders and psychotic disorders such as schizophrenia?

Human beings have believed things that turned out to be wrong for a long time.  There was a time when people thought the earth was flat, the sun revolved around the earth, illnesses were caused by humors and evil spirits, everything existed within an ether called phlogiston.  Some of these beliefs were harmful, some not so.  Time will tell the extent to which this cynical, harmful and erroneous belief about mental illness is harmful to human beings.