A Conversation about Depression
A thirty minute conversation on depression.
Posted November 5, 2018
Here is a 30-minute video conversation that offers folks an overview of depression. It is not high tech, but I think it offers an easy to follow discussion that lays out some key features associated with depression. It was initiated by my brother, Tim Henriques, a physical fitness guru who frequently encounters folks who are depressed and wanted a way to help them understand the condition. He was a fan of my formulation, so he interviewed me with the goal of making it more accessible.
Here are some key take home messages from the conversation:
What is depression?
It is a state of behavioral shutdown. It can be caused by many different things, but the logic is that the state of depression is a shift in an individual’s emotion-mood system, such that the positive emotion-mood system is depressed, and the negative emotion-mood system is elevated.
What does depression look like?
Depression is a negative mood state marked by feelings like numbness, sadness, frustration, agitation, anxiety, irritability, shame or guilt, and a diminished feeling of desire, excitement, and interest in pleasure. There is a continuum of depressed mood states, ranging from a mild “down” feeling that might last a few hours (which almost everyone sometimes experiences) to clinically depressed states (that last weeks or months) where folks are feeling lousy most of the time, but still are able to work and function to chronic and severe “melancholic” states that are so profound that the individual cannot function at all in areas like work or school and might need to be hospitalized.
Is depression a disease?
Clinical depression is a serious health issue. And it is a biological issue, in that individuals in a depressed state cannot just “snap out of it” any more than someone who is exhausted because they have not slept for 24 hours can “snap out” of feeling tired. However, diseases are usually defined by biological malfunctions. It is not clear that depression involves biological malfunctions. The most common or popular idea is that depression is caused by a chemical imbalance, but that idea has many, many holes in it. In addition, there is a clear logic to shutting down and often the shutdown is directly connected to major life problems and feeling trapped and overwhelmed with no escape. So, first and foremost, depressive feelings should be considered as symptoms associated with shutting down because someone feels trapped or is having inner struggles they cannot resolve. That said, extreme cases of severe-chronic depression are so intense and pervasive that these are probably best considered developmental disease states.
How common is clinical depression?
Clinical depression is a major world health problem. It is significantly more common in women, with lifetime prevalence rates of 20-30 percent in women, and 10-15 percent in men. There is evidence that the prevalence of depression (and especially anxiety) are increasing in younger populations (young adults and adolescents).
What should someone do if they are depressed?
Let’s start by saying what people should not do. Depression sucks and many people hate both feeling depressed and the fact that they “let” themselves get depressed. So many people “turn against themselves” and become very critical and try to control their feelings. This is a recipe for the depressive shutdown to get much worse. The second thing is to be aware that folks cannot just snap out of a depression.
There are strategies that can be helpful. One basic notion is called behavioral activation. This is the opposite of things that lead to behavioral shutdown and includes making an intentional effort to increase activities, especially those that afford pleasure or mastery. In addition, learning how to engage in helpful or adaptive self-talk, learning social skills, learning to deal with old, emotional wounds, and developing lifestyles that are more psychologically nourishing.
Here are some resources to guide folks on understanding depression and various approaches for dealing with it.
Good Self-Help Books:
Some Blogs I have Done on Depression:
Some Blogs on Adaptive Ways of Relating to Thoughts and Feelings