- Depression can be understood as an existential shift in how the affected person experiences life, rather than a bundle of associated symptoms.
- Furthermore, depression may be considered to be a distinct global state of conscious, like waking, dreaming, and drug-induced states.
- Understanding depression in this way has numerous benefits for research, treatment, and basic understanding of the condition.
Researchers in psychology, psychiatry, and neuroscience have struggled for years to define, understand, and analyze depression, which torments untold millions of people around the globe. In clinical diagnosis, depression is understood as a collection of symptoms, which must be present together in sufficient number and for a certain length of time. But are these symptoms what depression is, or do they point to a common factor, the "true" depression, causing them all? (Think of it like pain: Pain often indicates a deeper problem, of which pain is a signal, but pain is also an issue in and of itself that merits its own treatment.)
Thinking About Depression in a New Way
Some philosophers have proposed a new way to understand depression based on what it actually feels like (or its phenomenology): not as a collection of disparate symptoms but rather as a general shift in how a depressed person experiences life. For instance, in his 2015 book Experiences of Depression: A Study in Phenomenology, philosopher Matthew Ratcliffe writes that people suffering from depression report that it is "qualitatively different from what many of us regard as 'everyday experience'" (p. 10). In other words, living with depression is distinctly and existentially different from living without it, which in turn demands a radically holistic way of looking at it.
Following in this vein, philosopher Cecily Whiteley draws from recent work in consciousness science in a paper forthcoming in the British Journal for the Philosophy of Science titled "Depression as a Disorder of Consciousness." (See also her article in Psyche titled "Depression Is More than a Low Mood—It's a Change of Consciousness.") There, she argues that depression might best be understood as a distinct "global state of consciousness," similar to states of wakefulness, dreaming, or being under the influence of psychedelic drugs. All of these states involve different combinations of capacities to think, feel, and interact with the world, as well as a unique overall experience of life.
Three Insights from This Conception of Depression
Whiteley proposes that "when an individual is depressed, she departs from a state of wakefulness to a distinctive depressive state of consciousness, a change which is reflected in an experience of an ‘existential shift' as described by Ratcliffe" (p. 13). Understanding depression this way has several benefits:
First, it explains why the experience of depression can be so difficult to describe to someone who has never been depressed: It changes the very context in which one lives, thinks, and expresses themselves. Just think of radical life changes that don't involve altered consciousness, like having children. It's often said that you can't explain being a parent to a non-parent because life with children is so different than life without them, and there's simply no way to express it to someone who hasn't experienced it. But whereas parenthood radically changes your life, depression affects the mind itself, making it much more difficult to communicate its unique characteristics to those not affected by it.
Second, framing depression as a state of consciousness helps to explain the ebb and flow of the symptoms of depression over time, in which sufferers feel like a different person in each stage. Depressed persons may experience alternating periods of depressive and "ordinary" consciousness (as well as dream states), much as a person who isn't depressed regularly passes from waking to dreaming and back again, or a psychedelic user transitions between states of being and not being under the influence. If each of these states of consciousness is associated with its own bundle of capacities to think, feel, and live, it is easier to identify them and study when and how the transitions happen, leading to better treatment.
Third, there are fascinating parallels between the self-reported experience of depression and being under the influence of psychedelics, particularly in terms of the "existential shift" one experiences in each. As Whiteley explains, "in both cases, individuals report robust phenomenological changes or alterations to their experiences of time, their sense of self, bodily experience, mental agency, concentration, and attention" (2021, p. 14). This observation would help explain the promising results regarding psychedelic treatment for depression, which may have a more direct impact on the core neurological basis for depressive states of consciousness than current antidepressant medications.
Working Together to Understand and Treat Depression
Whiteley concludes by emphasizing that this new way of understanding depression should not be taken as a challenge to traditional ones, but as a supplement to them, expanding and enriching the conceptual tools that researchers in all fields can use to better research and treat the condition.
What I appreciate most about her proposal is that it approaches depression as a unified experience—albeit different for every sufferer—rather than merely a handful of coincidentally "bundled" symptoms. It gives us a new way to think of depression as a thing unto itself, rather than the cumulative effect of the various symptoms, and one that has analogs in other, more common and less harmful life experiences. Perhaps it can also demystify the experience of depression and reduce the stigma around it, making it easier for more people affected by it to seek treatment, whatever form that may take.
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Matthew Ratcliffe (2015) Experiences of Depression: A Study in Phenomenology (Oxford: Oxford University Press).
Cecily Whiteley (forthcoming) "Depression as a Disorder of Consciousness." British Journal for the Philosophy of Science. (Pre-print available here.)