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Why Coping with Depression Means Coping with Loss
Leader’s work invites a radical reconsideration of the notion that depression is a form of medical illness. Whilst chronic depression certainly produces effects which can be debilitating, it may be misleading to view it as a kind of disease. Psychoanalysis brings into focus the central issue which must be dealt with before recovery can occur: coping with loss.
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In Freud’s day, what is now called ‘depression’ was usually termed ‘melancholia’ – an inconsolable and interminable misery. The word change has not necessarily produced greater enlightenment, however. Today, overcoming depression tends to mean relieving generic symptoms (persistent sleep disturbance, loss of concentration [link widoczny dla zalogowanych], dietary and weight fluctuations, low mood rated on a scale of 1 to 10). For Freud, it meant accepting – and ultimately consenting to – a specific loss.
Chronic Depression or Melancholia?
With the advance of cognitive behaviour therapy (CBT) and anti-depressant medication, overcoming depression has largely become an exercise in technical engineering, overwriting the language of ‘living a good life’ with an aseptic vocabulary of mental hygiene. It may, though, be time to wonder whether alleviating chronic depression can ever truly be achieved by targeting symptoms. The painstaking work of letting go after a loss may be much more important.
Loss can take countless forms: a loved one [link widoczny dla zalogowanych], a career, a home, or more intangible ‘bereavements’ such as health, self-confidence, a friendship or love relationship (the person may still be around; it’s the attachment which has been lost). All can result in generic symptoms, but each ‘depression’ has a different underlying cause. It is the failure to consent to – to agree to relinquish -the specific loss which causes the problems.
In Darian Leader’s recent book The New Black: Mourning, Melancholia and Depression (2008 [link widoczny dla zalogowanych], London: Hamish Hamilton/Penguin), Freud’s wisdom is resuscitated for modern times: if the work of mourning is refused, the misery of melancholia will descend. However many general symptoms appear, unless the precise details of what, or who, has been lost are identified (and how the patient has responded), the misery will persist, even if its overt manifestations – symptoms - change.
Human beings are inevitably faced, sooner or later, with loss. But in a culture which favours robust independence and individualism, the universal human vulnerability to loss is an awkwardly unwelcome fact which often gets ‘medicalised’ into a pseudo-biological malfunction.
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