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Depression

Gaining insights into depression

Many people said that they had not always understood how their own thinking and circumstances contributed to their depression. It was usually only after many years that people gained insight into their depression in the ways that they describe below. What is clear is that gaining insight took much time and consideration. Counselling and therapy in particular often helped people become more aware.

Some people we talked to felt that, as they recovered, they moved from 'not knowing' to becoming more aware of themselves and their place in the world. This has been called 'cluing in' (Schreiber 1996). People became 'clued in' in all manner of ways, and this 'cluing in' actually helped them to be more positive about themselves.

As part of this process, people often realised that the messages they picked up as children could be contributing to their suffering, and such messages needed to be challenged. For instance, to start recovering, one older man had to undo the message he received from his parents that joyfulness was somehow wrong. Some became more aware that their families were limited or even quite wrong. For instance, one woman came to see how her family had failed her, rather than she herself being a failure in the family.

 

He was taught as a child that pleasure was wrong, but later found out that life is about pleasure...

He was taught as a child that pleasure was wrong, but later found out that life is about pleasure...

Age at interview: 69
Sex: Male
Age at diagnosis: 39
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Well my mother was very keen on the Catholic religion and her interpretation of it was that people were meant to suffer in this life, and it was God's will you should suffer. And it was almost a feeling, certainly I got from her the feeling, that if I was really doing things that I really enjoyed doing-that was selfish, it went against Jesus' teaching.

Because of all the unpleasant experiences I've had psychologically, I've realised that that is a travesty of the truth, that what a person should be doing in life is what gives them the most pleasure, and if they don't, they're actually denying their life's purpose, and it's not surprising they start showing some symptoms of mental imbalance.

My father was a very melancholy character, and he had a very strong influence on me because I... I was aware very early on that if I was cheerful around him he didn't like it, in fact he really couldn't bear it. And so I got into the... into the way of sort of feeling sort of slightly sad when I was in his company so I wouldn't show any signs of exuberance, because I knew that then the atmosphere would get so painful.

 

Therapy helped her to better understand that her family had failed her, rather than being a...

Therapy helped her to better understand that her family had failed her, rather than being a...

Age at interview: 50
Sex: Female
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But I think therapy gave me permission to say yeah I was right, rather than just somehow still thinking as a child I was failing because I felt very stressed with my parents. And I.... because I think when you are a child anyway, you tend to think your parents have, or are this fount of wisdom, and they are right and you are wrong. And, you know... to sort of to think yeah I was right when I thought Mum shouldn't have said that, or done that, or that wasn't very wise or whatever. Because I was brought... I was ruled entirely by manipulation. That I guess again is just a different generation I guess. I can be quite magnanimous about it now. I could have killed at the time, but I was ruled entirely by manipulation and controlled that way. Very down trodden kid, only child of parents who were in their late thirties when they had me, which was very old for then. I know it is more of a norm now but very old-fashioned parents. I was an only child so I'd not got any moral support from siblings.

One man in his early 30s learned that he was not so weird and different from everyone in the world as he had thought in his teens. Among other things, as part of his recovery, another man came to the conclusion that the world was not going to tell him what was important in life, so he had to work it out himself. A woman described her depression as a necessary part of breaking down the rigid way that she had approached life.

 

For him overcoming depression involved the realisation he was not as different as he thought, and...

For him overcoming depression involved the realisation he was not as different as he thought, and...

Age at interview: 31
Sex: Male
Age at diagnosis: 17
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I mean getting over depression is about discovering that, I mean discovering I could have decent relationships was the same kind of.... Again it's about that thing of joining the rest of the human race, thinking actually I'm not different. That's, I know that makes me sound like a natural conformist, I don't think I am, that's not what I mean. It's just like yeah, you can also have access to the same bank or pool or account of experience that everyone else can draw on, and that's... as I've grown up 

I've discovered that I'm not that weird, not that different and things that I thought were denied to me, you know if you'd said to me in my mid twenties, even in my happiest time I would've said to you, "Yeah, I'm a happy guy, I'll probably never manage a relationship, a long term relationship or get married to anyone but that's absolutely fine."

About two weeks before I met my wife I remember going to a wedding and looking at these people and thinking, "How does anyone do that, how does anyone think they're that secure with anyone?" And just thinking, "Well, that's denied to me, and that's okay. That's fine, I can live with that. You know some people never, I don't know visit you know visit Africa or something, I just won't be doing that." And then sure enough, I discovered that I could do it, and it worked, and it was a shock to me and a wonderful surprise.

 

Realised that he would need to have his own values, since the world was fallible. (Played by an...

Realised that he would need to have his own values, since the world was fallible. (Played by an...

Age at interview: 35
Sex: Male
Age at diagnosis: 17
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Yes, the universe is pointless and the only meaning comes from us. Somebody in [self-help group] once wrote that depression was his own idiosyncratic response to living in a flawed world, I think. I thought that was quite a difficult concept to get across to people, but I think it's important. And you know, it's a question of whether you can.... what you do, in the face of that universal meaninglessness, I think.... I learned that, you know, we're not perfect. We're fallible human beings. That life isn't fair, as was pointed out to me, but that doesn't mean that we can't try to make life fair when we possibly can. And I learned that you can go very, very low. I learned, I suppose, I learned what was important. What I was missing then, I've now subsequently rediscovered, or discovered for the first time, really, because I'd never had it in the first place.

What's important?

It's important to be good to each other, and be compassionate to each other, and it's important to let yourself have a good time and look after yourself.

 

Understands depression as a 'breakthrough' because it helped her to become less rigid in her...

Understands depression as a 'breakthrough' because it helped her to become less rigid in her...

Age at interview: 58
Sex: Female
Age at diagnosis: 20
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What have I learned? I've learned that the only thing that matters in life is love and peace. That, sort of, strict discipline is not important. It's balance that really matters. I've learnt that a breakdown can also be a breakthrough. I'm one of these people that's obviously had to be broken down in order to grow enough. I'm not saying that everybody needs to do that, they don't, in the severe way I have, but...

So what was the breakthrough..... the rigidity was breaking down?

The rigidity had to be broken down. I mean, after the first depression, my the religious binding, as it were, and I think religious, religion means that which is bound, but that had to be completely.... that was completely knocked out of me. Whether I liked it or not, and of course I felt, that, during that first depression, I was going about saying, "But what happens if there's no life after death?" All the doubts that I'd squashed in my teens were of course coming out now and I had to deal with them. They just hit me in the face. And I thought the end of the world had come. If this wasn't true, supposing it weren't true, life after death, you know.

The other insight people were gaining was about recovery - that they could not only move beyond the limits of depression (e.g. negative thinking, low confidence), but they could start seeing life differently (e.g. enjoying life, developing better relationships). With long-term therapy, one woman (who had had dysthymia and bouts of severe depression all her life) feels she is now stepping out of the 'prison of depression' into the unknown. Although the prospect is scary, she wants to get more out of life beyond her familiar depression.

 

Therapy can lead to stepping out of the 'prison of depression' into the unknown, which can be...

Therapy can lead to stepping out of the 'prison of depression' into the unknown, which can be...

Age at interview: 40
Sex: Female
Age at diagnosis: 37
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You know, I can actually see that there might be a third way, of me moving forward in life, but it's been a very long process. I didn't imagine that two and a half years later I would still be having weekly therapy, to get better. It is, but it's scary, if you're used to living in a very constrained band in your life, then the actual idea that you can take charge of your life... The bigger world is very scary. I think it's something to do with when you live with depression the way that I have, you are limiting your life. You don't necessarily know why you are limiting your life, but through your thought processes and the way you are as a person, you concentrate on surviving life. 

You know, you're getting through life but you don't necessarily get any pleasure from it. There may be the odd day here and there that are great, but you're surviving, and you don't really have any sense of why you are doing that. But if I choose to live differently, if I choose to, and can, set aside the depression, and think, right, I'm going to live life as other people seem to live it, that's really scary because that's been so much part of my life. And to actually live life without worrying every minute about what's going to happen next, about what people think of me, about what, am I doing a good enough job, you know to actually take life as it is, and to take knocks on the chin, and you know, dust myself off, and not worry about it, it's just a completely different way of living. And it's scary because I've never done that before, and I clearly need a lot of help to get to that point. But I do know that I want to live life and be more happy, and be more settled, and have a point to my life, you know, have a purpose, other than just getting through it.

People also often talked about how important it has been for them to take responsibility for sorting themselves out. Medication and other people could only be helpful tools. Taking responsibility was related to the notion of being your own expert, as discussed elsewhere on this website (see 'Help with depression: General Practice' and see Expert Patient Programme).

 

Says that while medication helps you to function, people still need to work on themselves and...

Says that while medication helps you to function, people still need to work on themselves and...

Age at interview: 73
Sex: Male
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Now the early part of medication you feel you're getting nowhere. And then after a while you do sort of... be able to cope in a fashion, but that's because you're totally dependent on the, on the medication. And the medication keeps you stable, keeps.... you're able to go to work, you're able to do your job, able to enjoy quite a few things. But it doesn't get rid of the fears and whatnot because that's a sort of a different, different area, your thinking processes... They're yours and that's where it's got to come from you, you've got to get there yourself, I don't think there's a miracle cure. They'll give you the tools for you to do it, but you end up, you've got to do it, there's a... I'm convinced of that. No one is actually going to make you better but they're going to help you get better.

Last reveiwed September 2017.

Last updated October 2010.

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