Is It Okay To Be Deeply Sad For 20 Years And Not Call It Depression?
Question: Is it okay to be deeply sad for 20 years and not call it depression?
Answer (1) Some losses are irreparable and some grieving is without end. Some lives too swiftly taken for a complete goodbye and some loves too brief to fully mend a broken heart. I think of parents who miscarry, of children lost to illness. I think of whole communities, dispossessed. Of those who act out childhood wounds whom we abandon, unforgiven. I think of this world we cling to and us, not able or not willingly to be vulnerable to those with whom we share our lives. It is appropriate and healthy to feel deep sadness about these very human conditions and for a long time because that is the tender core, which compassion chases. It calls us to our fearless, tender heart; draws us closer to this huge life; toward embracing all that is dealt us, not just toward the next hit of retail therapy. Compassion moves us to welcome it all. To label that chest opening pain 'depression' pathologises a right minded movement to connection or a lengthy mourning of the loss of it.
True, mainstream culture hides or treats any emotional pain or grief lasting longer than a week, but clinical depression is on another trajectory. It can be described as 'fragility, brittleness, lack of resilience, a failure to heal, with a loss of any emotion but guilt, of any desire but to stop.' Not in that definition is melancholy or deep sadness. Clinical depression carries the hopelessness of learned helplessness into a room without windows and doors, where inner light is engulfed and our support networks inacessable. Prolonged clinical depression digs pot holes into brain tissue and over a long time these are like the scaring seen in dementia brain scans. Clinical depression, however, can and ought to be treated. For example, The London Depression Intervention Trial found that couple therapy, whereby a clinically depressed person is counseled together with their non-depressed spouse, works much better than any other form of treatment including anti-depressants!
Meaningful relationships and appropriate exercise are effective and singles can do both. Sadness and depression are different again from chronic, undifferentiated unhappiness. That is the normal reaction to growing up in a dysfunctional family, especially where one or both parents suffered chronic chemical dependence (such as alcoholism) or a disabling mental disorder (such as Bi-polar) or both. However, that normal child's reaction can grow into a way of life for the adult child of those families. It doesn't eat brain tissue, it just rarely opens to joy. Sadness, depression and unhappiness are set in different attitudes and outlooks. Each require different ways of living alongside them, of joining and of awakening the resource asleep in their signal pain.
Our last freedom, said Viktor Frankl, is to 'choose one's attitude in any given set of circumstances.' Of his time in the Nazi concentration camps, he said, 'It did not really matter what we expected from life, but rather what life expected from us. We needed to stop asking about the meaning of life, and instead to think of ourselves as those who were being questioned by life -- daily and hourly. Our answer must consist, not of talk and meditation, but of right action and right conduct. Life ultimately means taking the responsibility to find the right answer to its problems and to fulfill the tasks that it constantly sets before each individual.' in Mans Search for Meaning. After 20 years of deep sadness I think you probably know, in the tender core of you, the attitude you greet your life. Is it time for a change of mind?
Answer provided by Peter Fox
Answer (2) Depression can be a bit of a scary word for some people. It sounds more like a "psychiatric diagnosis" than of a common and normal emotion. Some professionals now speak of someone as having "a depression", as though it was something they caught, or somehow arose spontaneously for no particular reason. We now have patients being given antidepressants as a first line treatment, for a natural reaction to a real, significant loss or trauma and explained away as just disturbed brain chemistry. Antidepressants can indeed play a useful role in reactive depression but only as a temporary adjunct to psychological treatment. However, being "very sad" for 20 years does sound like in some respects at least, you are stuck and have not been able to either mourn effectively, to let go of, or resolve whatever it was that caused the sadness in the first place. Because you are non-specific about what this long standing sadness is about, I can only make general comments.
Answer provided by David White
