"I don't know who discovered water but I don't think it was a fish." --Marshall MacLuhan
Since the time of Hamlet -- "But two months dead, nay, not so much, not two" -- our culture has deemed that the bereavement period should last approximately two months. After that time, according to the Diagnostic and Statistical Manual of Mental Disorders, eight of the nine symptoms that characterize bereavement now characterize depression.
On my DVD "Mindfulness for Urban Depression," I make a temporal distinction that helps me differentiate pain, grief, and depression:
Pain is immediate and often overwhelming. It informs you that there is a precise situation that demands attention. For example, a broken nose or arm is painful because it needs to be addressed urgently.
Grief is the period of time it takes to process a loss, any loss, irrespective of whether it is your mother, your son, your job, your 401K, your home, your car keys, or your favorite pen -- anything that is a part of your life is something that you may have to learn to live without.
And then I ponder the putative distinction(s) between grief and depression according to the DSM.
For are we not continuously processing losses? Doesn't change -- and thus simply being alive, since everything is constantly changing -- inherently imply loss? Lost hopes, lost dreams, lost aspirations, lost expectations, lost friendships, lost loved ones...
So then, what exactly does it mean to be diagnosed with depression and why are there 100 million prescriptions for antidepressants written every year in America?
I would like to explore the possibility that our scientific and capitalistic paradigm has an aversion to heightened emotions (crying, screaming, etc.) and doesn't allow sufficient bereavement time because grieving can hinder productivity, busyness and business.
Babies cry because they are not getting their immediate needs met. They cannot articulate which need isn't being met -- food, safety, cleanliness, or affection -- and the situation requires a caretaker to interpret what the non-specific cry refers to. Adults need the same basic things as babies need to survive, but to thrive in our advanced society an adult also needs a sense of self, a sense of belonging, a sense of purpose, a sense of accomplishment, the space to process emotions, some means of attaining whatever peace of mind he or she can muster... and maybe a little sex, although I would argue that it is far easier to live without sex than it is to live without affection. (Maslow adds "self-actualization" to the top his hierarchy of needs, but I feel that this ability to overcome and transcend oneself is problematic for spiritual reasons that I am not going to address here.)
Let's explore for a moment the possibility that the symptoms the DSM identifies as constituting depression are analogous to the non-specific crying of babies, that depression is a blunt tool people subconsciously learn to use in order to try to get their needs met. Crying does not solve the baby's problem, but it does draw other people's attention to the situation. Similarly, depression doesn't solve any problems (although there could be secondary gains such as avoiding work); viewed as a tool, depression is obviously maladaptive, but it does draw attention to a potentially problematic situation.
And when we interpret these situations, when we "read" the symptoms, we often find that the depressed person does not feel as if he or she has the space or time to process losses and disappointments, and/or he or she doesn't have the loving and trustworthy connections that would facilitate the sympathy and empathy needed to work through the natural traumas of being alive and experiencing perpetual change.
I doubt you ever heard anyone say, "I feel completely lovable, and I feel loved, supported, and appreciated by my family, friends and colleagues, and I'm depressed."
All of us will experience terrible traumas and tragedies. It is those of us with real community who will be able to process our resentments and negative emotions and move forward in a positive light.
I guess it comes as no surprise then when we learn of recent studies demonstrating that placebos, exercise, and meditation are more effective than antidepressants in the long run.
Which is a more empowering position, to believe that you have a certain gene or brain chemistry that causes a disease as defined by a book that changes every 15-20 years, or to analyze your way of being, your relationships, your needs and your tools for getting them met, and then make adjustments that bode more favorably for your overall well-being and happiness?
If it will help you decide, just read Lisa Cosgrove and Sheldon Krimsky's article from the Safra Center for Ethics at Harvard University, wherein they state, "The revised Diagnostic and Statistical Manual of Mental Disorders ... has created a firestorm of controversy because of questions about undue (pharmaceutical) industry influence."
It is clear that as a society we are tolerant of a relatively thin bandwidth of human emotions. Curing the supposed depression epidemic is not contingent upon altering brain chemistry with billions of dollars of pharmaceuticals. Treating this dis-ease would first entail reframing our cultural paradigm and changing our priorities to create the time and space needed for people to express and process a wider range of emotions. Secondly, it would entail teaching people skills for cultivating loving relationships and community so that they don't feel alienated, isolated, and disconnected. Thirdly, it would entail providing people with healthy tools like meditation and yoga that are specifically designed to help cultivate personal equanimity, peace of mind, and ease.
For more by Ira Israel, click here.
For more on mental health, click here.