The Essence and Nature of Depression

Depression is giving up. This is the essence or nature of depression. When we give up we are depressed and when we are depressed there is something in our life upon which we have given up.When I write “when we give up we are depressed” I do not mean that we are necessarily experiencing the emotions that are associated with depression. I was talking to someone recently who had abandoned his goal of diet and exercise. He had completely abandoned this goal and he had no immediate plans to resume work toward this goal. He had given up. I asked him how he was feeling and he indicated he was feeling fine. His face and demeanor however did not indicate that he was fine. He had a depressed affect and he had depressed eyes but he was not aware of it. This means that it is possible to give up on something which is important to us and not experience the feelings associated with depression. There are many possible reasons for this. A man might suppress his feelings and therefore avoid the experience. A woman might deny her feelings to herself and to others and avoid the experience. A person might give up to a degree which is not sufficient to produce noticeable or recognizable feelings. In other words that person might only be mildly depressed and therefore the feelings might escape their notice. Nevertheless I am suggesting that when we give up on some goal in life that is important to us we are depressed regardless of the degree to which we experience such feelings.

The corollary to the above concept is that when we feel depressed we have given up on something. It is not uncommon for patients to come to me and to complain that they are depressed. It is also not uncommon for a patient to be unaware of the cause of the depression. I usually ask how long he has been depressed and then ask what has happened to him in that period of time. I am trying to discover upon what they have given up. It is usually not hard to find. A depressed person might have given up on a relationship or on work or on a personal goal in his or her life and this giving up behavior will precipitate depression. If I point it out to them they can make the connection and the way out of the depression becomes clearer.

If depression is giving up then resolution of depression will involve a change in our behavior. If we have given up we have to overcome our inertia and start once again. Inevitably once we start once again we feel better and the depression is reduced.

This definition of depression is useful because it is clear and because it gives us a direction in which to go in order to resolve our depression. The actual experience of depression is much less clear. It consists not only of a behavior change but also of a change in our way of thinking and a change in our feelings. The full force of all these changes complicates the experience and makes it seem all that much more overwhelming. But in the end it is still true that depression is giving up or stopping and overcoming depression involved starting once again.The anecdotes that follow will illustrate and address some of the complexities of the experience of depression.