In the beginning there was Freud and he was big. So big, in fact, that many people still confuse psychology with his brainchild, psychoanalysis. Freud's great insight was that if you ask patients about their mental health problems they often have good reasons for behaving the way they do. In some ways psychotherapy is still a working out of what this means in practice.
Freud had a lot to say about depression, or melancholia as it was known at the turn of the 20th century. The enduring ideas from psychoanalysis is that depression is anger turned in against oneself. The idea is that the depressed person is angry at the world and, for whatever reason, can't express their anger, so it is turned inward. For some people, this view of depression makes sense, but it does not capture everybody who gets down. In fact with many men the opposite is true. They get depressed but actually "act out" their depression as anger. As a man, if you are getting irritable and aggressive, you may well in fact be depressed.
A second wave of psychology threw out the Freudian ideas and decided that the only scientific way to study human beings was to look at their behaviour. On the "behaviourist" view whatever the individual was thinking or feeling was simply irrelevant to understanding their behaviour. This led to a lot of animal studies, particularly on how animals learn, and generalising from these to human beings.
One early influential theory of depression made just that these moves. In one study, a dog was placed in a cage with two compartments divided by a small wall. If the dog was given an electric shock in compartment A it naturally jumped into compartment B to escape the shock. Similarly if given an electric shock in compartment B, the dog jump back to compartment A. If the dog was given electric shocks in both compartments A and B and had no route of escape, the dog simply endured the shock and took on the manner of a depressed person. The dog looked forlorn and sorry for itself. If the paradigm changed and the dog could escape, the researchers found that the dog still remained immobile and sorry for itself and simply continued to endure the shock. The dog had learned that escape was futile, so gave up trying.
The theory of depression that evolved from these studies was known as "learned helplessness". The idea is that people, when faced with overwhelming stress, simply give up trying. People have learned to be helpless, they have “given up”, and become gripped with depression and a feeling of hopelessness. Furthermore, they remain depressed even when the objective circumstances of their lives move on and trying to bring about useful changes would be possible and helpful.
This model of depression has many advantages to the psychodynamic view not least because it is more widely applicable, but also because it accounts for the cynicism, pessimism and hostility to living that many depressed people experience. It also accounts for why "behavioural activation", gently encouraging depressed people to re-engage with life, is so successful.
Is learned helplessness enough to explain depression? Well clearly not. It does not account for why some people retreat into depression as a first line of defence against stress, and why other people can endure even the most evil of circumstances, like the concentration camps, with some degree of good cheer.
What it does tell us, however, is that at a profoundly deep level, you can escape depression by opening up to the choice to be different – to re-engage with life. Of course when you feel so down this is an extremely difficult choice to make, but even the most profoundly depressed person can make it if they want to. They will need support to start re-engaging with life, and a therapist is a good person to help you start to do that. If you want to try on your own I can recommend "Overcoming Depression One Step at a Time" by Christopher Martel and Michael Addis.
Dr Phil Tyson is a Men's Psychotherapist based in Manchester in the UK. He offers:
- Cognitive behavioural therapy (cbt) for men in Manchester
- Counselling for men in Manchester
- Psychotherapy for men in Manchester
- Telephone and online counselling for men wherever you live
- Supervision and consultative support for therapists in Manchester
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