Depression is not just about what people feel and what they do. It changes the way they see themselves and breaks their belief in themselves. Here’s how.
Depression limits not only what we feel and what we do. Depression steals who we are. Millions of people suffer from depression and have a range of debilitating symptoms. Unfortunately, many people use the term loosely and talk about being depressed in the same way they talk about feeling “sad”. They see depression as a transient mood state – something that makes us temporarily unhappy and then goes away. This assumption may be reinforced because depression is referred to as the “cold” of mental illness.
You come out of depression alive, but changed
And just as we respond to a temporary mood state, we assume that the impact of depression is like that of a cold – we suffer when we are depressed, but we come out of our depression with our lives intact. No one ever says, “They had a cold, and it destroyed their lives.” In fact, clinical depression, whether it’s major depression, bipolar disorder, or dysthymia, can be a devastating mental illness.
Depression is not just a passing sadness – although most people with depression experience sadness. People with depression suffer a great deal and often cannot feel pleasure, have no energy, cannot concentrate, and have trouble sleeping or eating. This suffering can be both chronic and recurring. An episode of depression can last for years, and people who suffer from depression may experience several episodes over the course of their lives. As a result, people with depression often cannot work or take part easily in social interactions for long periods of time. As a result, the World Health Organization (WHO) considers depression to be the leading cause of disability worldwide. In the most severe cases, depression increases the risk of suicide. Yet many people assume once people recover from an episode of depression, their lives return to normal. And most times this is true. People with depression can lead long and fulfilling lives, especially if they seek treatment to manage the illness. However, depression can do more than just affect our lives. It can change the way we see ourselves as people. It can undermine who we are.
Our identity can change with depression
I thought about it after discussing with Dr. Michael Bishop of GWAR on the Hardcore Humanism podcast his research on the concept of identity. Bishop explained how music is part of a narrative about how we perceive and connect to our lives. In his case, it became associated with punk rock and its conflicting nature in such a way that it became part of Bishop’s identity. And he described how organic that process was – just by hearing about the Sex Pistols, seeing images of them, and listening to their music, he could feel a natural connection. And that connection became a dynamic and interactive process that not only provided Bishop with a vehicle to express how he wanted to challenge societal norms, but also an opportunity to become more open-minded and accepting of others.
What was so striking about Bishop’s experience was that it relied so strongly on the visceral connection we have with music or any other important element in our lives? And that’s often how we build our identity – by experiencing and discovering the things we connect within our lives. We may enjoy a particular brand or type of music. But when we invest time and energy in that music to make a connection, those connections form the basis of who we are and how we understand ourselves.
How do you connect to your identity if you are depressed?
Listening to her talk made me realize how difficult it is for depressed people to feel that connection when they are depressed. If we are anhedonic, don’t sleep, have no energy, and can’t concentrate, how connected can we be? Because depression can occur so often, it means that people who are depressed may have many times in their lives when they miss opportunities to feel those connections that can help develop their identity and self-image. Often, when we suffer from a depressive episode, we experience the frustration of not being able to experience things the way we want to. Or we feel helpless that we cannot adopt basic functional behaviors such as working and taking care of ourselves. This can lead to despair that we can never feel the way we really are.
In fact, research suggests depressed people carry cognitive vulnerabilities to negative thinking that persist after recovery. Unfortunately, our private fears are often echoed by others. Depression is often undiagnosed, so the people in our lives see only the symptoms. We seem less interested, irritable, withdrawn, and unable to engage in pleasurable activities. We often cannot carry out what would previously have been easy tasks such as basic personal care and organization.
Thus, depression can create significant problems in our closest relationships, especially in couples where our partners see us regularly and rely on us. Similarly, our work environment often crumbles because people cannot understand why our functioning has taken such a plunge. This issue is compounded by the stigma of mental illness, where people often blame depressed people for their suffering.
How does this manifest itself over time in terms of identity?
Depression is not something that disrupts our lives – it can change the way we see ourselves as people. Let’s start with experiences and resulting connections that never happen because of our depression. Maybe we don’t have the energy to see a new band when they play a show in our city – so we didn’t see what could have been a magical, life-changing experience of discovering our favorite band. And our identity also becomes linked to powerlessness. We rarely assume that we are someone who can “make things happen” and plan for the future because we can’t be sure that depression won’t seriously compromise our life goals.
We lose confidence in ourselves, and our identity becomes linked to depression. We see ourselves as a “depressed person” rather than as someone who is depressed. Add to this the fact that our social relationships and work performance suffer and we assume we are “not good at relationships” or “not a good performer”. And as we see hard evidence to support these conclusions, our misshaped self-concept takes deeper root as our identity and depression take away from who we are.
How can we build and maintain our identity in the face of depression?
- The first thing we absolutely must do is to get treatment. There are several forms of psychotherapy and antidepressant medications supported by empirical evidence that has been effective in treating depression. Getting effective treatment reduces the time we spend suffering and feeling dysfunctional. It allows us to connect and engage with the work, activities, and people we love and make tangible progress towards building our identity. By increasing our ability to deal with depression, we will have more hope of being able to “be ourselves”.
- Second, we need to remember that even if we are depressed and limited because of our depression, there are still ways to maintain our identity by staying connected to our lives. We live with depression. We suffer from depression. But depression doesn’t have to be part of our core identity. Even when we are in a depressive episode, we can remember that even though we are currently functioning in a limited way, we are still “us”. And we can let those closest to us know we are depressed so that there are no misunderstandings about our behavior and we can keep those connections.
- At the societal level, we need to work to reduce the stigma of depression. Much of what makes depression an identity thief is that we suffer from depression in the shadows because of the fear or shame of being judged. And so, instead of getting the help we need, we avoid treatment because of the stigma. In addition, because people often judge those with depression as “lazy” or “unmotivated,” the social impact of depression may seem more real at home and at work. Educating people about mental illness, how to cope with it, and how to treat those who suffer from it would go a long way to breaking the vicious cycle whereby depression destroys identity.
So let’s see if we can work together to stop the identity theft of depression.
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