What Depression Feels Like
From the Depressed Person's Viewpoint (Not the Clinician's) (Vol. 6; Issue 18)
If you or someone you love fall into a depressive state, where do you turn for solace? Scholarly literature and diagnostic systems like the DSM-V characterize depression as a “mood disorder” involving a depressed mood or anhedonia* daily for at least two weeks, as well as feelings of worthlessness, hopelessness or suicidal ideation. But these approaches understandably fail to account for the experience of depression, for what it “feels” like. They also fail to account for the individual differences in how depression presents: One depressed person may weep uncontrollably for hours and suffer from severe insomnia; another might feel emotionally flat and sleep all day.
The causes of depression are as complex as the varieties of ways it manifests. Some people who enjoyed loving, supportive childhoods and encountered no serious life stressors can be subject to depression; others who suffered childhood abuse, poverty, discrimination and other injuries can also suffer depression, but not necessarily. In a hundred years, scientific progress will likely yield a better understanding of cancer. But I wouldn’t bet on the same future for depression because of its complicated nature.
The complexity of depression is staggering. Abuse, loss, injury or aging, the effects of economic, historical and cultural shifts and the impact of alcohol and substance abuse mixed with genetics and biology, contribute to depression. These combine, still more evilly, with the disease, famines and wars that history has wrought.
Artists who have written of their experiences of depression offer some of the best portrayals. A striking account comes from William Styron’s (1990) book, Darkness Visible, in which he vividly describes his own bouts of depression. (Styron penned such well-known books as Sophie’s Choice [1992]). Validating my point about how clinical categories differ from personal experiences, Styron writes that depression:
remains nearly incomprehensible to those who have not experienced it,
Adding that:
the pain is unrelenting, and what makes it intolerable is the foreknowledge.
Winston Churchill (Roberts, 2018) suffered depressive episodes, telling his friends of his “black dog days.” He, too, lamented the unpredictability of them.
Sylvia Plath (1963/2005), the oft-depressed 20th-century novelist whose life ended by suicide, depicted her depression as a suffocating, isolating “bell jar” that descended upon her. She felt it trapped her in “sour air” caused by her “gray, dull, flat, empty” existence.
Neither an artist nor a depressive himself, the psychoanalyst and philosopher Jacques Lacan (1978, 2002) offers one of the clearest ways to account for the feeling of depression. He conceives of it as a state where the afflicted person a. completely loses the desire for anything or anyone and b. cannot imagine themselves as an object of desire. In other words, depressed persons cannot imagine anything desirable, and they cannot conceive of themselves as desirable to anyone else.
In an effort to provide my own description of the feeling of depression, I offer a fictionalized account based on an amalgam of my patients over the past four decades:
Sally, a 60-year-old woman, has felt consistently depressed since her husband’s death two years ago. She is “constantly lost in memories” of the early months of her relationship with her husband, Tom. She says these thoughts repeat themselves, “like the skipping of an old record,” unable to escape its “grooves.” Ironically, her emotional pain cannot be traced solely to the loss of her husband. Theirs was a conflicted relationship.
Her husband’s “moodiness” contributed to their alienation from their two sons, who moved from New York to the West Coast 20 years earlier. They call her occasionally, but they visit her rarely. The family gathered “only every few Thanksgivings.” But Sally denies feeling lonely and isolated. If asked how she feels physically, Sally declares, “Just pain.”
Sally does not report a loss of identity due to never having worked outside the home. She had an “enthralling” career, having entered the software business when writing code was “still new and brilliant.” She’d met Tom earlier, in college. Somehow, their falling in love bafflingly remains the forever-defining moment of her life. She doesn’t reflect on her occupational successes; she doesn’t reflect on the alienation from her sons. In a sense, she doesn’t “reflect” on anything save these romantic reminiscences, which seem to torture her.
In terms of her sensory experiences, Sally speaks of viewing the world in “endless blurs of gray.” She doesn’t really taste anymore, or smell, she says, adding that she hears “only the roar of pain.” She cannot imagine feeling anything positive. When willing to discuss her emotions, uncommon for her, she reports feeling as if her mind “is in a vise.” She passively wishes for death but lacks the energy to even gather up suicidal thoughts.
This fictional Sally displays just one variation on the sad theme of this mysterious condition. Unless you’ve been cursed with Black Dog Days yourself, it is essentially impossible to fully grasp the experience. But one thing’s for sure: Those who would still view depression as some sort of weakness, as cowardice, or as a defect of character are sorely misinformed.
Depression is a deadly serious state of being. Those who’ve felt the bell jar descend upon them, who feel suffocated and starved of the basic energy of life itself, deserve not only professional help but also efforts by loved ones to understand their painful worlds. Metaphorically walking alongside a depressed person often provides at least some breaks in their unbearable discomfort.
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*Seeking a catchy title for his 1977 film, Woody Allen proposed the word, anhedonia. The producers, Charles H. Joffe and Jack Rollins, objected, leading Allen to agree to the title Annie Hall. You can see the tonal relationship. Annie Hall won Academy Awards that year, including for Best Picture, Best Director, and Best Actress , hardly a depressing achievement.
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And check out my book, Lover, Exorcist, Critic: Understanding Depth Psychotherapy, available on Amazon.
References
American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed., text rev.). https://doi.org/10.1176/appi.books.9780890425787.
Lacan, J. (1978). The Seminar of Jacques Lacan, Book XI: The Four Fundamental Concepts of Psychoanalysis. J. Miller (Ed.). Trans. A. Sheriden. New York: Norton.
Lacan, J. (2002). Ecrits. Trans. B. Fink. New York, NY: Norton.
Plath, S. (2005). The bell jar. New York: Harper. (Originally published in 1963).
Roberts, A. (2018). Churchill: Walking with Destiny. London: Penguin.
Styron, W. (1990). Darkness visible: A memoir of madness. New York: Random House.
Styron, W. (1992). Sophie's choice. New York: Vintage Books.