It’s been a convenient distinction for a long time between reactive depression and endogenous depression. Apart from convenience, the distinction is far too crude to have much practical or theoretical use. Since it should be fairly clear that the term ‘depression’ itself covers such a huge universe of meanings, so many different states, so many different profiles of individual sufferers, perhaps one should indeed treat each case as unique and assume a co-existent matrix of factors at work in a dynamic flux that won’t stay still for neat classificatory boxes. In practice, of course, history shows firstly that even at the greatest economic costs, over the greatest period of time, delivered by the most gifted of psychiatrists or other therapists, depression often remains intractable; secondly, in practice, for most of us the interventions made professionally sometimes involve, in my case for instance, nothing but a medication programme which is barely monitored.
There is a stupendous documentary made by the then young film maker, Nick Broomfield, about the dreadful housing and social conditions facing the people of Kirkby , a huge new Liverpool overspill estate built, like so many ‘new towns’ from the late 1950s onwards. You can watch the relevant portion here. It speaks more than I can of the absurdity of throwing pills at somebody in the grip of a totally understandable situational depression.
Of course, there are many instances of situational depression which can be isolated from the general narrative of a person’s life; cases where the problems can be and are solved or ar time limited, as in most cases of grief and bereavement; where among necessary support may be counselling, talking therapies and medication.
However, depression has its own momentum. It seems to follow the patterns of growth from small factors to intractable large and overwhelming tyranny that is ever growing. A famous writer such as Tolstoy in the previous post, or myself to some degree, can give voice ‘intelligently’ to personal history and feelings. Countless others must be worn down, ground down bit by bit over the years by concurrent situtions and depression spiralling out of control. Situation and feelings feed from each other. Decision making, perception, relationship, memory, motivation, everything are affected by the mutual circling of situation and feelings. While depression reaches epidemic proportions among the long term unemployed (although, hopefully obviously, not everybody in any class of population is similarly affected), and such depression may not receive the attention of established medical paradigms, its silent grip tightens too at all levels of a society characterised by insecurity and fear. The creator of the detective series, Wallander, Henning Mankell, whose stories are dark and meancing while set in the clean, prosperous modern Sweden, has suggested that ‘people do not build homes anymore; they build hiding places.’
Depression feeds upon itself. It is impossible to disentangle depression from the concept of anxiety, and as difficult to come to close to understanding anxiety as it is to understanding depression. Fear and powerlessness seem central. Self-medication through drug or alcohol abuse, risk taking, inordinate pleasure seeking, diversions, denials, he list is endless: society itself and its members, whether formally diagnosed or not, share many of the attributes of the individual who is diagnosed.
These cultural, social and economic factors stand alone for the sake of clarity. One is overwhelmed by their complexity. Add to them the individual’s genetic predispositions. Add the particular life traumas of a particular individual. Spice it with the ‘epistemological quagmire’ of even being able to begin a clear conceptualisation of depression. It must be expressed, not conceptualised, and that obliquely, always failing. But to all these factors add too the existential. I will doubtless at some point refer to the existential aspects of depression. Also, I’ll refer to those severe critics of ‘existential therapy’. But that is later.
Now, I just want to rest a bit on the island of my own ‘situation’. I am pretty certain that there are factors in my life which are part of the erosion of my power, hence correlates with the growth of the increasing pessimism over depression.
I am poor by any standards, when all is taken into account I receive less than somebody on state benefits. Even with a small income from a job, my annual income is £4,000 less than what a recent report stated was the minimal annual income for a single person to live a basically secure life. I have to pay for dental treatment, spectacles, and prescriptions. I used to be richer than the median.
My accomommodation is stress inducing. A former council flat, now part of a major housing trust (social housing), it is physically very well kept and I can’t fault the reasonably low rent, the improvements made recently such as a new roof and central heating, or the fact that I am lucky to live near parks and other lovely places. But I am anxious all the time with some of the social problems. Ironically I am one of the problems, which is why I got the flat; many people here are near the end of their tether, coping as best they can, and I am so much better off, but still I feel tense, anxious, apprehensive.
My job is probably going to come to an end soon. So here, certainly in a mild form (I’m not in debt, have no responsibilities) are some immediate stressors: accommodation, income and job insecurity. The more insidious stressor is the long term unemployment from a professional career. Almost twenty years now. Sometimes the days are very long and empty, sometimes I know I’m ‘depressed’ because I have nothing to do, am bored, am not using a tenth of my intelligence or other capacities, living with a sense of shame for the past, for not being good eough as a human being, for being ‘redundant’ and – you can work out the rest.
All of this is modulated, moderated, attenuated in its final impact. I have things many in the same social, economic and employment categories don’t have. My education so that I find riches in things that cost nothing, a peculiar tendency I have always had to attract a few close and dear friends, and the love of a good woman. It may, you might well feel, be two different people writing here. In a way it is. Even my depressed self, which I believe my ‘core’ self, can be split and made unconscious. All I know is that when I feel my relatively precise negative situations (and relatively minor contrasted with many others) I do sometimes feel overwhelmed and triggered into an episode of undifferentiated depression. Dangerously, I have found in these negative situational contexts episodes of alarming anger in myself that threatens to spill onto another or others, and even to turn the anger precisely upon myself.
FeelingFeelings 