Philosophy And Depression

A man of 35 years wakes up one day acutely aware of a vague anxiety, a feeling of uneasiness, perhaps melancholy. He attributes the mood to problems at work and to a broken relationship. Weeks, even months, pass, but the subversive and unsettling "feeling" remains. There are slight irregularities in his sleeping patterns and in his diet. He is less keen on participating in various activities he once enjoyed. He is more withdrawn, more subdued.

He looks out at the world and finds many things to detest: social injustice, the trivialization of modern culture, the apathy of fellow citizens, the slow pace at which society seems to reform itself. He wishes people cared more about issues and ideas, and less about how they look and how much money they have. He wonders, occasionally, if he isn't a crank, a weirdo, a malcontent. He reminds (and thus reassures) himself that he has a job, a 401k, a friend or two, and a family.

Another six or seven months pass, and this destabilizing feeling metamorphoses into profound despair. He sees nothing in life which is fulfilling or even mildly satisfying. His relationships, for the most part, are insubstantial and transient. He's nearly convinced that life has no real "meaning"; he even contemplates suicide.

Should this man be drugged up on Prozac or Zoloft? Should he spend years on a therapist's couch trying to figure out what's wrong? Should he expect mitigation to come from the wisdom of self-help gurus or from the counsel of pastors and priests?

Professionals would insist upon acknowledging the "problem" and getting it diagnosed. Questions about family propensity for depression or bipolar disorder, about changes in environment and in relationships would of course be of some avail to psychiatrists and psychologists.

There is no reason to dismiss pharmaceutical solutions out of hand. Medicines of all kinds pass intense scrutiny and have to meet various guidelines before ever making it to market. They're examined in peer review journals, tested in double-blind studies, and monitored ever carefully after their debut. The verdict on drugs like Prozac has long since been out, and many report dramatic improvement in lifestyle.

The life of a man who has tried to cut his wrists or poison himself could very well be saved by lithium or fluoxetine or MAO inhibitors. This brute fact seems to render all further discussion on the subject irrelevant. Why should the nuances of social pathology matter to the man who seeks merely to attenuate his own depression? If relief can be obtained by a monthly regimen of pills, why philosophize? Why lose oneself in a labyrinth of psychoanalytic interpretation? Why question society or seek to change that which cannot be changed? Why speak loosely of alternative treatments?

These questions have a force and a momentum all their own, but they do not anticipate the unlikeliest of reactions: that depression isn't some evil that needs to be extirpated from the mind or some disease that needs to be palliated by drugs; that it might be an embodiment of philosophical pessimism, a natural reaction to one's social surroundings and situation. Imagine if the term were defined non-pejoratively, even positively:

Such a definition would naturally be derided by professionals and experts everywhere, declared at once to be irresponsible and inaccurate. The statement above, however, humanizes the depressed state and rightly sees the question about life's meaning as possibly the most important a person can ask, and a negative answer to it as at least as plausible as any naively affirmative one. "In most of its manifestations" allows for the fact that some depressions may necessitate immediate pharmaceutical intervention; high risk of suicide may be the one case in which an intervention is justified, overriding the putative autonomy of the sufferer and postponing any other treatment.

There are two other advantages to the statement above. First, it supports the widely held view that depression can sometimes occupy the same intersection of the psyche as genius. Philosophers such as John Stuart Mill, William James, and Friedrich Nietzsche suffered the worst throes of depression. A host of other artists and writers suffered the same fate, including Edgar Allen Poe, William Blake, Mark Twain, Wolfgang Mozart, Charles Dickens, Vincent Van Gogh, T.S. Eliot, Ernest Hemingway, and Sylvia Plath.

Second, it begs reflective souls to consider the meaningfulness of experience and challenges them to let go of simplistic notions of depression. It also provokes them to consider whether a depressed state isn't to some extent rational and objectively warranted.

The two quotes that touch off this article are illustrative. Schopenhauer sees the very nature of existence as vain and meaningless, whereas Laing sees modern society as so. Laing's sentences contain a few references to "social reality" and one to "exiled truth"; this last would suggest that meaning is recoverable, given certain remediating social factors. Schopenhauer's views can be called pessimistic, even nihilistic, though unlike certain nihilists he thought the tormented human will could find repose in a rigorous spiritual discipline (he wrote approvingly of Buddhism). Laing, a radical psychotherapist, identified with various sects of existentialism, particularly those of Heidegger and Sartre and Ludwig Binswanger. He vehemently denounced electric shock treatments for schizophrenics, and with some success fought for a different methodology. The goal of psychotherapy, he thought, should not be to reconcile patients to norms which may themselves be unhealthy, but to blaze a path in the direction of transcendence:

Our environment can either open up or constrict possibilities for spiritual and intellectual growth. In The Politics of Experience Laing offers a fine passage from Erving Goffman's study Encounters:

Both perspectives, pessimism and existentialism, wouldn't necessarily see depression as a malady existing in a person's head. A pessimist and existentialist might, in fact, agree that the world itself is screwed up, that social norms are themselves pathological, that feelings of despair, anxiety, loss, and pointlessness may be typical in people who are exceptionally intelligent and observant. A person who is "depressed" may thus, on this view, see things others don't see, have keen insight into the waywardness of modern culture, have a refined sense of the good and the beautiful. Drugging a person would therefore dim his vision, desensitize his perception, kill the penchant to search for meanings.

What is the practical import of this? That the best and truest therapy may consist in examining the condition or state itself, with understanding being the chief goal, not any simple fixes or meliorative expediencies; in locating the etiology somewhere in the ebb and flow of social relationships, realizing that some of the most brilliant people who ever lived were depressed, and that no super drug is effective enough to eradicate the ills of culture and modern society.

Further Reading:

Depression & The Threat of Nonbeing

An Existential View of Loneliness

Who's Mad & Who Isn't?

A Diagnosis of Our Time

Reasons To Be Cheerless (The Guardian,3/1/04)

Books:

Viktor Frankl, Man's Search For Meaning (1963)

Erich Fromm, The Sane Society (1955)

R.D. Laing, The Politics of Experience (1967)

_________ The Divided Self (1969)

_________ Knots (1970)

Arthur Schopenhauer, Parerga and Paralipomena (Clarendon Press, 2000)

Paul Tillich, The Courage To Be (1952)

Alan Watts, Psychotherapy East & West (1961)