In the public mind there is a tendency to think of depression as a mere inability to experience pleasure or that depression is a blue mood taken to extremes. However, a great deal of nuance is missed when one confines themselves to thinking only in terms of a sad/happy mood.
(Taken From my Medium Article)
In this brief article I’m going to introduce a simile to help provoke an intutive understanding of depression.
A tool for thinking:
Let us imagine for a moment a long day ahead of you. Maybe you have to get your kids to school, go to the shops before work etc. To carry out the list of exhaustive tasks ahead, you rely on your ever faithful car. The car is nothing fancy, but it gets you from A to B and you know you’ve been lucky in the way that it doesn’t generally go wrong. You’ve had no expensive garage fees for fixing the car and on the whole you know that your car will work.
So you climb into the driver’s seat and attempt to start the ignition — click…nothing happens! You try again and still nothing. Four or five attempts are tried and still nothing.
There are two possible outcomes here, one being that the car stays put, or you manage by some miracle to get the engine to come to life although the experience leaves you a little shaken as to whether the car is going to do what you need it to do that day.
With relief you pull out of your driveway and take a left at the next junction ready to finally begin the day. But with mounting horror you begin to feel that the car isn’t responding as it should. The engine feels sluggish, the car can’t seem to step into the next gear and refuses to accelerate.
The car as mind in depression:
Depression in absence of other mental health issues:
In the first part of the simile, I stated that the car has worked pretty well in general and is fairly dependable. Here I am drawing a fine line between a mind that may suffer depression with comorbid mental health issues, or depression that stands in its own right. In this example we see that the mind we are dealing with has been fairly dependable without the need for prior ‘mechanic’ (doctor) to prescribe anything to regulate mood.
There is also the idea that the individual has in the past felt an equilibrium of mind.
Turning the key “click…nothing”
Now let’s move on to the idea of the ignition not working or the engine not even starting. This is our first deviation from the common idea of depression, we’re not even broaching mood yet. The engine not ticking over, may signify something of a complete loss of will or motivation. Personally, I know that this may exhibit as a sort of hypersomnia, an inability or desire to get out of bed.
I may awaken several times, shift and twist as if making the effort to arise (turning the key?) but find that the mind can’t bridge that last step of putting two feet on the ground. A profound sadness may be the cause, but one need not feel that profound sadness at the time for these effects to be present. All one truly need for inertia, is a curious apathy, more on this soon.
Along with this idea of inertia, or lack of will I want to discuss another subtle point and that is of suddenness. The onset of depression may be as sudden as this or it may be precipitated by a gradual breakdown of parts. But the important facet is that the individual need not be aware of the breakdown of parts so that the appearance of the depressive can seem acute and unexpected. The ‘causes’ if we want to describe them as such, may be lost to time and very difficult to analyse. Thus asking the depressed individual what made them depressed, can be akin to asking an individual who can’t start the engine what’s wrong with the car. Even a specialist would need time to look at the anatomy of the car to discover the root cause. And for the rest of us, it can seem like an exercise in futility to try and ascribe causes to something which is so acutely present.
The car moves but something is wrong:
So in the next part we explore what may happen even if the car is compelled to work. But in doing so, we see that the car is still not behaving as expected. To the depressed individual, the emotional disequilibrium occurring may mean that functionally the body is moving but the relation between experience and emotion is either inverted or not acting as one might expect.
An example might be of a previously enjoyable hobby or interest no longer evoking the same joy or passion as it once did. Communication one once found compelling may now feel more forced as if to whisper a single syllable taxes the vehicle of thought more than it ought. While we may still drive the vehicle of the mind into any number of familiar experiences, those experiences do not elicit from us the usual emotive responses.
Driving this vehicle suddenly become an alien experience, devoid of anything familiar.
Depression and symptomology:
We have introduced a couple of ways of thinking about depression through the simile of a non-functioning vehicle, these include:
Loss of will or a feeling of inertia Extreme apathy Suddenness of onset with a lack of insight into prior causes
But of course we cannot ignore profound sadness, and the aim of this article is not to ignore symptoms of depression, but to provide a more nuanced view and one that may not be appreciable to the common notions of what depression is.
In fact the DSM — 5 outlines 9 total symptoms 5 of which have to be present throughout a 2-week period.
Sadness is one of these, but it is no mere sadness, it is often a sadness accompanied by a sense of hopelessness. It’s not just sadness but irritability which may be the aberrant emotion to an experience one has encountered thousands of time before.
Conclusion:
Using a simile such as a non-functioning car can help provoke thoughts or insight into the nature of a disorder which while widespread, is inherently, an individual experience. One may in fact deviate from the simile in several ways, but to a lesser or greater extent these feelings will no doubt be familiar to the individual in the throes of a depressive episode.
For the sufferer:
There should be a willingness to let go of the tremendous guilt one may feel when suffering from depression. After all, your vehicle has gone awry and you’re not expected to immediately understand how to get the damned thing moving again. What has happened is that your day will not go the way you had expected it to, so now is the time to seek help, let somebody else pick up the kids, let somebody else go to the shops. I’m more than aware that this is far from possible in every circumstance, and all too often we are greeted with stigmatisation.
For the observer (husband, wife, child etc):
It’s time to recognise the signs of a depressive episode. The role here is to step up and take a few of the responsibilities away from the individual who is unable, through no fault of their own, to fulfil their usual daily quota of activity. It would be useful to inquire whether anything needs doing, whilst staying away from inquisition or assigning blame for the situation. Whatever happens, the vehicle has stalled and is not functioning as it usually does, but this is the situation and no amount of judgement, blame or throwing solutions is going to help.
Questions to think about:
1. Under what conditions does the simile break down? 2. Is there any way that thinking about your depression in this way, helps alleviate the guilt? 3. Did the engine light come on prior to the car breaking down? In other words, would is possible next time to anticipate the onset of a stall (depressive episode)? 4. Ap part of owning a car, one often owns a user manual which will cover a variety of tips and tricks should the car break down, how can we develop this idea for depression? 5. It’s a crime to drive under the influence of alcohol, what may we learn from thinking about the dangers of DUID or driving under the influence of depression?