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What is depression? And I am not asking about the symptoms; they describe depression and these are easy enough to ascertain, especially if you have experienced depression. The question now is: what is to account for these symptoms? Unfortunately, the prevailing view is that it is a biochemical imbalance in the brain. I’m not saying that this is not a factor in the equation. I’m saying that this is simplistic. I mentioned this in a previous post and stated that it is a combination of biochemical, genetic and environmental factors that interact in a really complex system. I’d like to offer another angle on this, which I got from Jungian analyst and author, James Hollis. He contends that there are three types of depression:
1. reactive or environmental
2. endogenous
3. intrapsychic
Reactive depression is a normal response to a loss or disappointment. When it becomes a problem and considered “pathological” is when it lasts an abnormally long time and interferes significantly with one’s normal functioning. Now, what is an “abnormal” length of time is a subjective thing. And obviously, if someone suffers a great loss, say the loss of a spouse, we might expect this to be a long time and for it to really impact their functioning. Some contend that we rush things like this in our culture, that we are so fixated on happiness all the time that we avoid the healthy arising of the sadness and grief of reactive depression. And what happens is we jump on the “your pathologically depressed bandwagon,” which may lead too quickly to medication when some talk therapy could help someone get through a particularly difficult time.
The word “endogenous” means, having an internal cause or origin. So endogenous depression is presumably the result of some physiological deficiency or imbalance, the most prominent theory being the imbalance of neurotransmitters in the brain. But an endogenous depression is also identified in terms of one’s family history. If you have symptoms of depression and there is a history of depression in your family, then it may very well be that this kind of depression is in your equation, which is to say that these different kinds of depressions can occur together. You may be genetically predisposed to depression and therefore more vulnerable to the impact of the other two types of depression.
The third kind of depression is called “intrapsychic.” The word psychic here is derived from psyche, which refers to the human soul, mind, or spirit depending upon your metaphysical orientation. The prefix, “intra” means, on the inside; so the intrapsychic depression is seen as arising from within one’s inner most being. Put simply, you might say we have “issues” or internal conflict(s), which need resolution. This is the stuff of talk therapy - bringing into consciousness the conflicts which run beneath our awareness. A word of caution - trying to figure out our issues alone while in a depression is often rumination, which is not helpful. We have big blind spots in our awareness and need help.
As mentioned above, these different forms of depression can occur together, which can make identification and treatment more complex. But with the help of someone with training and experience, it can be quite comforting just getting a better sense of what is going on. This is really important in terms of treatment because there are type-specific strategies. For instance, you could medicate a reactive depression and get rid of symptoms, but having not dealt with the cause of the grief, those symptoms may reappear once one comes off the medication. Also, it’s not uncommon for someone to reject medication on principle and work years on all of their “issues,” getting to know them inside and out, but still suffer chronic depression. Then, they finally give in, take a med and two weeks later have a dramatic shift of mood and perspective on their issues.
So the purpose of this entry was to highlight the complexity of the depression equation so that we can proceed with right action. Knowing what kind of depression we are dealing with can be very helpful in terms of treatment. I’d also like to note that some things are just good no matter what kind of depression you are dealing with and these things should be the baseline for any form of treatment in my opinion. These are things like diet, exercise and social support, to name a few.
I hope this was helpful and please feel free to comment or ask any questions. Thanks for reading.
Devin
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