News

Undoing Depression

November 1st, 2007

Monthly column for www.rasaspa.com written by Anne Marie Cummings.

Rasa Talks with Richard O'Connor, Ph.D.

Author of Undoing Depression: What Therapy Doesn’t Teach You And Medication Can't Give You

Everyone feels depressed at some point in their life. Some people are depressed for a few days, some for a few weeks, and some for years. In Undoing Depression, Dr. Richard O’Connor not only talks about the suicide of his mother and how his own depression affected him, but he guides his readers into understanding what depression is, what is isn’t, how some of his patients have dealt with it and what he suggests his readers do to help themselves to find relief.

According to Dr. O’Connor, we haven’t learned, as a society, how we can handle depression when it strikes. Instead, most of us do what’s comfortable. We do what we already know or have done our whole lives. We don’t seek advice and try out new kinds of behavior. And this is how Dr. O’Connor helps his readers. By pointing out new ways of thinking and feeling that bring depressives the awareness they need so they can feel joy and happiness in their lives.

Yes, it does take work, and sometimes depressives cannot do that work alone, but with a desire to change and rebuild oneself comes a great reward – freedom from pain, freedom from suffering.

What made you choose the word ‘undoing’ for the title of your book Undoing Depression?

The idea behind it is that people, without realizing it, get good at doing depression. We learn various ways of behaving and thinking that keep us stuck. I wanted it to be called Undoing Perpetual Stress or Where Does It Hurt is another title I had in mind because my book is really about the stress of modern times.

Why haven’t we learned how to productively stop self destructive behavior?

Because we learned it in situations where it was helpful to learn it. Self destructive behavior in certain circumstances served a purpose for us. If you take the most obvious examples such as cutting, mutilating, or purging – they are relief from stress. There’s such a build up of tension that to actually hurt yourself focuses the pain and gives you something real and concrete to deal with as opposed to an overwhelming vague sense of panic and dread. Every self-destructive behavior serves a purpose that relieves tension.

You write that achievement doesn’t mean happiness. Instead, it’s how we live rather than what we do that leads to peace. Please explain the difference between how we live and what we do.

Actually this gets into the book I just finished writing about happiness. I think there’s a lot of research now that shows that money doesn’t make us happy, and that success doesn’t make us happy. Happiness is much more about the attitude that we bring to our life. It’s about what we do, not necessarily about achieving our goals. Having goals is a good thing, but human beings are wonderfully adaptable, and having goals gives us a sense of purpose and direction and let’s us make decisions more easily. But the research says that even if we don’t achieve our goals, pretty soon we’ll get over that disappointment and be on to something else.

You write that repeated stress is the factor that separates the depressed and non-depressed person. Does it have to be repeated?

There is a line between trauma and stress that’s pretty vague. It’s very well established that post traumatic stress disorder is a very real thing. It can leave people unable to act, continually vulnerable to stress, and it can cause brain damage. It causes nightmares, and hyper-vigilance, among many other things. In Judith Herman’s book, Trauma and Recovery, she makes the point that repeated instances of victimization add up to trauma, so if you’re a woman in an abusive marriage you develop the equivalent of post traumatic stress disorder, or if you’re a child where there is alcohol abuse, you come out with a vulnerability that’s very much like post traumatic stress disorder. When I look at my own son who works with eight different bosses, has eleven hour work days where he’s exploited, no recognition from his employers, with five other people waiting for his job, I can see that this has a cumulative effect on his mind and brain. If you read the financial pages of any newspaper you’ll see that everyone’s proud of how the United States increases productivity per worker, but that means that the individual worker feels more pressure. When I started working thirty-five years ago, I went to work at nine and I got off at five. In addition, generally one worker in the family was enough, now both people in a family have to work to get by. The eight hour work day is a thing of the past.

We can either fight or flee, but if you’re stuck in a situation that’s unpleasant, you’ll get muscle damage, nerve damage, damage to the immune system – in fact that’s behind a lot of what we’re seeing in the increase of autoimmune diseases.

Many people seem to have qualities that set themselves up for depression, for example, wanting very much to be loved, but being afraid to trust. Why is this?

It’s not just depression. It’s human tragedy. Wanting to be loved, but being afraid to trust seems to be an increasing picture these days. If you’ve been raised in a family where your parents don’t behave consistently for you and the love is conditional, if you’ve been let down, or if you feel like you’ve been used or exploited, you’re afraid to trust. The depression part is you thinking that there’s something wrong with you. In fact there’s nothing wrong with you at all, it’s just bad luck, and then we internalize it. This is when it becomes depression.

What is your definition of happiness?

There are four components of happiness. One is less misery. As we were discussing, there’s a lot of self destructive behavior out there so there’s a lot we can do to reduce the pain and suffering we experience. The second is more joy. That is being able to appreciate the sun and the day for example. Being able to say, “I’m very fortunate to experience this moment.” The third is life satisfaction – are you okay with where you are in life? Some of this has to do with achievement and some of this has to do with realistic goals. Some people only believe they’ll be happy if they’re better than their neighbors. But you can actually get more satisfaction by wanting less than by getting more. The fourth is about meaning. Belonging to a community, or passing on your life through a generation.

Can we cure ourselves of depression?

There are lots of little quizzes on the web about depression – you can take one of those, but basically if you feel lousy most of the time, more days than not, if you feel hopeless, if you feel without purpose, if you feel a lot of self-blame and guilt – that sounds like depression. It’s probably a good idea to get help if you need it. Don’t expect that simply taking an anti-depressant will do the job for you.

You’ve written that one of the ways to undue your depression is by building a reservoir of self esteem. How does one do this?

I think the problem is that many people have leaks in their reservoir so what would normally bring a person self-esteem in terms of their career success, healthy relationships, a good day at work, for the depressive, it’s not good enough. They may feel temporarily happy or satisfied, but it quickly dissipates.

What makes an individual depression-prone?

Childhood experiences have a lot to do with it. Some of it is chemical and genetic. I think depression does run in families, so chances are if you had a parent who suffered from major depression, you’re twice as likely to suffer from it also. If you’re raised in a household with divorce, or a depressed parent, that increases your risk. And then of course there are later life experiences as well. People who’ve been victimized through rape, crime, or combat experiences come out of it much more vulnerable to depression than the average person.

Why do you think people feel that honest feelings will tear us apart or cause others to reject us?

I think that’s part of the culture of our times. We get the idea somehow that our own feelings are something to be afraid of. That if we feel anger, hurt, or disappointment, we’re supposed to stuff that away. We do need to control how we express our feelings, but we get that confused with not feeling those feelings at all.

What is the step that has to happen before a person consciously decides to do things differently?

I can’t say there’s any one step. In my practice, people come seeking help as a result of all kinds of different experiences. Generally it’s because they realize that what they’ve been doing, hasn’t been working. At some point they realize they have to learn a different way of functioning. It requires stepping back and looking at yourself objectively. This is something most of us are not able to do. A therapist can really help you begin to look at yourself with a certain degree of detachment so you can see what you’re doing that’s effective, and what you’re doing that’s self-destructive.

Why is the depressive’s need for self-objects more desperate than the non-depressive’s?

Because of that lack of self-esteem. Depressives are more likely to look to other people to make them feel good about themselves. It’s an unfair expectation. As a depressive – we keep hoping that someone will make us feel worthy and cure our depression.

Depression is the loss of parts of the self, the gradual numbing of feelings and experiences that the child learns are unacceptable and banishes from experience. Why is depression gradual?

For most people, I believe it takes childhood, adolescence, and young adulthood to learn that certain aspects of your personality are not acceptable to important people in your life. It generally happens over time.

What does it feel like to be numb?

It’s the absence of energy. It’s waking up in the morning and feeling like it’s another day of nothing. It’s the absence of ambition and desire. For depression there are technical time periods – for example, feeling pretty bad for more days than not is a certain kind of depression, feeling terrible for two weeks is another kind of depression.

You write that the opposite of depression is vitality and that connecting with our pain frees us – why is that?

Because, if we don’t allow ourselves to connect, we’ll just keep on running. We’ll be in a fear-based stance. We’ll avoid feelings. It seems to be a fact of life for humans. You can’t turn off bad feelings, because if you do, you turn off good feelings at the same time.

You write about defense mechanisms such as denial, projection, and sublimation, but aren’t some defense mechanisms a good thing for a period of time?

Defenses are absolutely necessary and serve a useful purpose for us. But when we live our whole lives based on defenses, it’s not good for us. Some defenses, like acting out and passive aggression, can mask reality and expose us to real danger or blow up in our faces. Other defenses, like denial and projection, which can dramatically and perhaps permanently interfere with our ability to accept reality, are crippling when compared to those that allow us to perceive reality more correctly.

How do you describe false fronts?

A false self we present to the rest of the world. It’s not necessarily a terrible thing. Everybody goes into the office and some days you pretend to be better than you are, but when it gets carried to an extreme, when you feel that nobody can understand how you feel, when you feel that you have to paste a smile on your face all the time, that’s a destructive false front.

How do you spot a defense mechanism with someone and how do you deal with it without making them even more defensive?

I don’t think you want to spot defense mechanisms in people – you just want to spot when people aren’t being honest with you or someone else.

Another way to undue depression is by sustaining the emotions of happiness and joy. How does one do that?

I think it can be very difficult to change your behavior. It takes a lot of honesty with yourself, but the good news is, once you learn it, it’s a new habit, like riding your bicycle. Living a full life, living a happy life, living a life that’s really engaged with the world is very rewarding. It’s the opposite of a vicious circle. It keeps us engaged and happy and functioning. There’s no work to it once you’ve gotten over the resistance.

If someone close to you doesn’t open up, how do you find out what’s really going on with them – for instance a parent and a child – how can a parent see what’s underneath?

It’s very hard for parents and children, especially adolescents. You have to look at actions. Actions speak louder than words. If a child is becoming solemn and defiant, then you know something is going on. They may not be willing to tell you, so you need to be very willing to listen. You need to be around when your child is ready to talk.

What’s the basic message of your book?

That life affects our brains and stress really can cause brain damage, but if we make the right kinds of decisions, we can learn how to adapt and make ourselves much more resilient.

Richard O'Connor is the author of three books, Undoing Depression: What Therapy Doesn't Teach You and Medication Can't Give You, Active Treatment of Depression, and Undoing Perpetual Stress. For fourteen years he was Executive Director of the Northwest Center for Family Service and Mental Health, a private, nonprofit mental health clinic serving Litchfield County, Connecticut, overseeing the work of twenty mental health professionals in treating almost a thousand patients per year. He is a practicing psychotherapist, with offices in Canaan, Connecticut, and New York City. He currently is working on his fourth book — about happiness. www.undoingdepression.com.

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