Depression, A Symptom of the Age - 3

By Kevin Murphy, M.Sc.,
Psychoanalytic Psychotherapist,
Dublin, Ireland.

I wrote last week and the week before about depression being linked to a sense of loss. You could say that the classical psychoanalytical position posits an ego (the conscious part of our mind mediating between our internal and external world) that is so weak and so depressed, it has almost disappeared. It is the ego, the part of us that gives us the sense of ourselves, of who we are, that has become lost. The basic condition for depression, therefore, is this loss of ego with all the symptoms that are so similar to the state of mourning.
More modern psychoanalytic thinking moves this on somewhat. While the notion of loss, and the mourning for some intangible thing that is lost, remains part of the theory of depression it has more recently come to be understood as a tumbling out of a fundamental fantasy in which we situate ourselves in relation to significant others in our lives. This fundamental fantasy is an elaborate and necessary fiction by which we construct our identity in accordance with the desire or desires of others.
In depression we fall out of this desire of the other. We become un-desired, unable to cause desire, unable to re-ignite desire and our view of ourselves suffers detrimentally as a result. In short, we lose that vital sense of meaning, of who we are, the inner thing that supports us and allows us face the ups and downs of life with, not immunity to pain, but a sense of being securely anchored within ourselves in terms of facing it.
As I said last week, if depression is a sign of the times then we have to look closely at the times we are in. Yes, depression results in sadness, inability to function, unwillingness to engage with others, poor self esteem, a sense of isolation, lack of sleep, negative thoughts, irritability/aggression, and so on, but with changing times new depressive symptoms have been steadily emerging. Most if not all therapists working in clinical practice will be familiar with this phenomenon.

By new depressive symptoms I mean things like borderline personality disorder – this includes intense bouts of anger and anxiety that may last only hours, or at most a day and can be associated with episodes of impulsive aggression, self-injury, drug, or alcohol abuse. We also see symptoms like self harm, eating disorders, aggressive and sexual acting out.
This new evolution of depressive symptoms is driven by the need to sustain the weakening self in the face of an aching, unnameable loss. And, unlike the more classical symptoms that centre around the psychical concept of ‘feeling’ bad, the new symptoms are centered as actual and real events on the body. Self inflicted pain, bodily discomfort, as well as physically and often impulsive actings out are physical, bodily solutions to the underlying emptiness of depression. They are a forced way of feeling alive, a shock that brings us back from the void, a physical and destructive response to the emptiness of depression and the fear that this sense of emptiness engenders.
A further characteristic of these symptoms is that they avoid language, or symbolization through speech, or communicative sharing with others, or any attempt to put into words what is going on for the sufferer. They are pure action; immediate and direct administrations of negatively charged pleasures.
Professor Paul Verhaeghe of Ghent University sees depression as a possibility for every person because it is rooted in the process of identification, which is essentially dependant on our ability to inter-relate with others. This process of identification is central to everyone’s formation as a person. If this process of identifying with significant others – allowing us form our own identity – is hampered or weakened in any way, we risk tumbling out of the fantasy I spoke of earlier.
Dublin psychoanalyst Rik Loose, on the other hand, believes depression is due to anxiety and the latter’s prevalence in modern times. As an expert on addiction, he refers to drugs as externally situated products of negative pleasure with which users administer their own compensatory internal pleasures in order to avoid depression.
But he makes an interesting point. Anxiety comes first since it is part of the human condition and is laid down very early in all our lives, to a greater or lesser extent. But anxiety is not something that is acceptable in ‘modernist’, progressive society. This unacceptability leads us to deny it and repress it and this is where the problem of depression comes in, he says.
While it is a new take on depression, it also harks back to an idea of Freud (1926) that anxiety is the thing that drives us to bury and repress and deny certain wishes and desires and thoughts. So, in this light, depression arises from a denial of anxiety. This then leads us to seek out artificial means to deal with depression itself, in effect a second denial.
Other writers have agreed with this idea and have further suggested that depression is a giving up of one’s place in the world of ideas, words and satisfying relationships and retreating instead to a more silent, secretive, personally isolated world where artificial ‘comforts’ are sought by way of compensation. However, these ‘comforts’ – alcohol, drugs, sex, masturbation, aggression, food, self-harm, etc., – only add to the depressive experience in the long term.

I mentioned the notion of falling out of the desire of the other and it can have one other consequence. It can lead a person to feeling as if they are a mere puppet at the mercy of an omnipresent significant other or others. In this case depression acts as a defence – albeit not a very effective one - against being crushed under the weight of this oppressive other or others by effectively putting oneself out of the service. The job of therapy in this instance becomes that of carefully rebuilding the person’s ability to trust, love and enter into relationships without fear of being overwhelmed.

In summary, psychoanalysis stands against the vague generality of the term ‘depression’, a stance that today has greater urgency when you consider the attempts to transform sufferers into consumers of ‘happy pills’. The term is, as one writer put it, a ‘non-differentiating cloak’ that seeks to describe the ‘symptoms of the discontent’ in our modern age.
It has become an overused concept as a result of two main forces. One is pharmacology, which is at times indispensable but which leads us to believe that there is a pill that can ‘cure’ it. It can certainly alleviate but it cannot cure.
And, secondly, the human condition means we are complicit too because, in our own way, we like to believe that there are artificial means of administering pleasure that will offer a form of cure.
Psychoanalysis, in contrast, is always looking for a cause, and this is to be found in the particularity of each individual’s real and human situation. It is to be found in the totality of their lived experience. That’s where we look to find the answers.