As I discussed in an earlier post, most people use the word “depression” to describe many separate and distinct experiences — grief, disappointment, mild forms of unhappiness, etc. When I use the word here, I mean clinical depression, the sort of mental and emotional suffering that sends people into therapy or to their physician for prescription-based relief. I’ve seen many depressed men and women over the years; from my experience, the roots of their suffering usually lie in three common areas. I’d like to offer some thoughts about these types of depression and their origins. I don’t view them as necessarily distinct; they often overlap and mingle in various ways.
1. Post-Apocalyptic Rage:
Beginning with Freud, psychotherapists have noted the frequent connection between anger and depression; you may heard depression described as “anger turned inward.” I’d take this a step further and say that explosive and violent rage often lies at the heart of certain severe forms of depression. I use the phrase “post-apocalyptic” because, with many severely depressed clients, I have felt almost as if a nuclear bomb has gone off inside them, devastating their minds and laying them waste. Such clients might make it to session but lie inert and mute on the couch; they might say they feel nothing, or describe their body as feeling numb, weighted down by a pressure that flattens all emotion. In the room with these clients, I often feels as if meaning has been completely destroyed and the emotional realm is void. Such clients might describe themselves as feeling no interest or motivation to do anything. They often mention intense pressure around their eyes or face.
Re-creating the emotional events that led to this state of devastation takes time and patience. The task is complicated by the fact that the rage is almost always unconscious: the client has no idea that he or she has been raging. Sometimes you might hear hints of it in the client’s material when he or she begins to speak; more often, you see it in dreams or simply feel it by intuition. The landscape of the apocalypse often appears in the dreams of depressed people: bleak ghettoes, vast lifeless deserts or scorched terrain borrowed from movies such as The Terminator. If you have a strong empathic link with your client, you may find feelings of rage rising inside you during the silence, for no reason you can understand.