Breaking the Bonds. Dorothy Rowe

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СКАЧАТЬ being told that all you are experiencing is nothing but the effect of a gene dismisses all you have experienced and know as being trivial and unimportant. It doesn’t just dismiss your experience and knowledge, it dismisses you. It says that you are nothing but a defective body, carrying a defective gene, passed on to you by an equally defective ancestor, and that you are likely to pass this gene on to your children. You cannot be cleansed of this gene, but must strive to keep it in check by a daily ingestion of drugs which affect the operation of your brain.

      If you are depressed, such a diagnosis does nothing to help you, for it simply makes you feel even more intrinsically bad, useless and worthless. Such a diagnosis does nothing to help the relatives of a depressed person, or indeed, any one of us, for we can all worry that at any time we shall produce the depression handed on to us by some ancestor, or that we have already, unwittingly, passed this dread disease on to our children.

      However, some of you in your search to learn about depression may have read something which many psychiatrists and psychologists fail to read, namely, the actual research reports by scientists working on the problem of the biological basis of depression. Perhaps you do read the monthly issues of the American Journal of Psychiatry and the British Journal of Psychiatry, or the heavy tomes of the American Psychiatric Review.

      If you do, you will know that the sentence ‘Depression is a genetic illness’ is a statement of a wish, not a fact. A hundred years ago the German doctor Kraepelin attributed the behaviour of some of his patients to the illness ‘manic-depression’, and since then psychiatrists have been searching for the cause of this illness. They talk of the ‘gene for depression’ and the ‘gene for mania’, and some of them even say that such genes have been found. They talk, too, of ‘chemical imbalance’, and of physical tests for depression, and some say that the precise chemistry of the imbalance and the tests is known. However, what is described as fact is actually speculation. An enormous amount of research needs to be done before any genetic factor can be shown for certain to play a part in depression, and, from the results of the research, it seems that, if there is a genetic factor, it is one which requires the presence of many other factors – physical, psychological and social – for it to be activated.¹

      One of the great difficulties of this research is that, even after a hundred years, psychiatrists still cannot agree on how many kinds of ‘depressive illnesses’ there are.² You will probably have come across terms like ‘clinical depression’, ‘endogenous depression’, ‘reactive depression’, ‘neurotic depression’, ‘bipolar and unipolar depression’, ‘major depressive episode’, and so on. If so, you are certain to be confused, particularly when you discover that different psychiatrists give different diagnoses. One might tell you that you are ‘clinically depressed’, another that you have ‘endogenous depression’, yet another that you have a ‘schizo-affective disorder’. What you are not told is that all these words are just labels used in an attempt to put the people who get depressed into different categories. However, it does seem that, while there are certain things that depressed people do have in common, each of us gets depressed in our own individual way.

      If you have read the research literature, you will be saddened and worried to find that what researchers call ‘outcome studies’ show that depressed people treated only with drugs and electroconvulsive therapy do not do well. Most find that the depression recurs. Many remain depressed, but cease to seek any kind of professional help. Many die, not just by their own hand, but through illnesses. Being depressed is physically debilitating.³

      This is very troubling, because while psychiatrists talk complacently of ‘managing depression’ by using long-term medication in the way that doctors ‘manage diabetes’ using long-term insulin injections, we know that a person with chronic diabetes can lead an ordinary life, but a person with chronic depression cannot. To be told that you have inherited depression in the way that another person has inherited diabetes is of no help at all. It just makes you more despairing and confused.

      If you are a woman and are depressed, no doubt you have been told that it has been caused not just by a chemical imbalance but that this imbalance relates to the functioning of the feminine hormones. This is puzzling, because you can see how the malfunctioning of a hormone could lead you to think, ‘I feel sick’, but how can a hormone, however it functions, cause you to think, ‘I am a bad mother’? Nevertheless, many women discover that from puberty to after the menopause their own real, lived experience is dismissed with the words, ‘It’s your hormones, my dear’.

      However, there is a genetic factor in depression. In that double helix of DNA there is a special strand which separates us from all other animals and marks us out as human beings. That special strand of genes not only determines our human shape, it gives us language, and with that the ability to conceive of the past and the future. Using these abilities we can look to the future with hope and courage, or fear and despair; we can remember the past in happiness or mourning, in gratitude or envy, in thankfulness or resentment. Using these abilities we conceive not just of ‘is’ but of ‘ought’, and create for ourselves two worlds of meaning – the world as it is and the world as it ought to be. Now we can trap ourselves in a tangle of ises and oughts. Now we can say to ourselves, ‘I do not accept myself as I am. I ought to be a better person’, and so lay the cornerstone of the prison of depression.

      You might, in your search for an understanding of depression, have tried to make sense of it in terms of ises and oughts by reading books by cognitive or behavioural therapists. In many ways these books can be extremely helpful, for they can make you aware of how easy it is to think in extremes (like, ‘Nobody cares about me’, instead of, ‘Some people don’t care about me, but some do’), and they suggest some practical ways of re-organizing your life. But, when they tell you you are thinking and acting ‘irrationally’ or ‘dysfunctionally’, you can hear this as yet another put-down and feel that ever so familiar stab to the heart.⁴

      Even if you can put this aside, you soon discover that these cognitive and behavioural therapists slide over, or ignore, the implacable truths and dilemmas of our lives. For instance, one such author chides his client for being so illogical as to say, ‘I’ll never find another friend like that again’, and asks her to estimate just how many people she could meet and how many of these could become friends. He ignores the fact that we do have relationships which are irreplaceable, like those with a parent who gave us unconditional love, or with someone with whom we shared the greatest joys and tragedies of our lives, and when such relationships end we can do nothing but mourn their loss. When we do suffer such losses what we need are not people who tell us to ‘look on the bright side’, but people who can acknowledge and share our pain.

      Cognitive and behavioural therapists ignore, too, the major questions which face us all: ‘Why am I here?’, ‘What is the purpose of life?’, ‘What happens when I die?’ They assume that all of us are concerned solely with making the most of our lives, when in fact many of us are chiefly concerned with the question, ‘How can I be a good person?’

      In your search for an understanding of depression, and in your concern about the great questions of life, you might have read some of the books on depression which give a religious or spiritual answer to the problem. Some of these books might just heighten your sense of badness and inadequacy, but others do offer consolation. However, most of them advise you to put your trust in God or some spiritual power, and this is precisely what a depressed person cannot do. When we have been repeatedly and deeply hurt by the people we trusted, we learn to be very careful about where we place our trust, and if we cannot trust the people whom we can see and know, how can we trust an unknown, unknowable God? Moreover, if you believe in God, then when you become depressed you find that God, like everyone else, seems far away, and, worse, СКАЧАТЬ