Thursday, August 27, 2009

Spring Cleaning

Well, we made it through January and February, and for many of us, the hope of spring does at last begin to stir the heart. For others, though, hope barely flutters, because the winter months have been painfully SAD - which stands for Seasonal Affective Disorder. For some, this time of year is excruciating. Rather than bringing hope, the end of winter is marked by shutdown, numbness, irritability, a sense of disconnection, apathy, and worst, despair.

Depression, seasonal, situational, or chronic, is a grim illness, because it convinces you that you are not ill, but rather that you are simply weak, lazy, and unworthy. If that's the cruel way that you've been thinking of yourself, then that is the depressed part of you talking. Depression is not a moral failure - though it does lead one to feel self-loathing. Most of us can get somewhat depressed from time to time, but chrnic depression is a powerful disease that eats at the soul and sucks the joy out of life.

The late writer William Styron used the phrase "darkness visible" to refer to his lifelong episodes of depression (it was also the title of his extraordinary memoir on the subject of depression). Styron, and many other highly accomplished, productive people who have spoken publicly of their struggles with depression, have shown exceptional courage to do so. Even in this confessional age of Oprah, many people consider their depression, or the depression of a loved one, as something to be hidden, a secret shame they hope will go away if it is ignored.

More recently, people go to their family doctor and ask for Prozac, or the latest anti-depressant they've heard of. Sometimes with medication, they experience enough relief from the worst of their depressive symptoms so that they carry on. But to attempt to get rid of depression solely in this way is an error, in my view. Yes, depression can be biological, but rarely is it purely a matter of genes. In all my years of practicing psychotherapy, I have never met a depressed person who didn't have significant cause for depression - usually, unrecognized, untreated trauma of one kind or another. Trauma can ensue from a discrete episode, such as an assault, a rape, the witnessing of a horror. But trauma can also be cumulative - examples might be growing up feeling unseen and unloved; or feeling that one never lives up to others' expectations, no matter how unreasonable those expectations may be; or being systematically dominated, controlled or belittled in a relationship. Untreated trauma, discrete or cumulative, is at the heart of depressive illness, and there is still no better way of treating it than through talk therapy, or therapy combined with medication prescribed by a qualified mental health professional.

With good psychotherapy, the root causes of depression can be unearthed. A therapist can be a compassionate witness to your personal history, a history that you may have tried to forget, or get rid of, or render meaningless. Therapy can help you put your history in perspective; learn to live with and bear the losses you need to mourn; and find the courage to make new choices, seek new opportunities. Many people know this, and yet refuse to seek help, believing they can change themselves. Certainly some can, but on the other hand, I've known people who bounced in and out of depression for 50 years before they really got serious and sought help.

Victor Frankl survived the Nazi concentration camps, and went on to become a renowned psychoanalyst. He wrote: "When we are no longer able to change a situation - we are challenged to change ourselves." For those who make good use of it, psychotherapy is still one of the most effective ways of changing oneself. If this has been one more depressed winter for you, begin your spring cleaning by getting help from a licensed mental health professional. If someone you know is depressed, tell them to get help. Getting help is a sign of strength, not of weakness; the decision to get help for depression is a sign that you can find the strength to overcome it.Daniel Shaw, LCSW, practices psychotherapy in Nyack, New York, and in New York City. He can be reached at in Nyack at (845) 548-256; and in New York City at (212) 581-6658.www.danielshawlcsw.com shawdan@aol.com© Daniel Shaw, LCSW, 2007

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