Appreciating Depression?

appreciating depressionWe are indebted to Tom Wootton for his observation that the key to living creatively with bipolar is accepting and making use of depression.

Tom wrote a book about depression (The Depression Advantage) that was one of the first things he wrote about bipolar (for more, see his website, Bipolar Advantage). He noted that it was a difficult book to sell.

People with bipolar tend not to want to have anything to do with depression. In fact, in our clinical experience, the most common reason someone with bipolar comes in for treatment is to get rid of their depression.

Of course, this makes sense to all of us. Who would want depression?

What Tom pointed out was that if you were able to accept and even see the value in depression, it unlocked a different way of relating to bipolar and to your moods. This alternative way was, in his view, much more creative and successful.

There are a number of authors who have written about depression, and why it exists, where it comes from.

For instance, this New York Times article about Andy Thomson at the University of Virginia and his theory that depressive rumination may serve essential purposes.

Our focus here is on why accepting depression might make any sense at all.

Depression is a mood which, when manageable, tends to create a stronger sense of awareness of the other person. And which forces you to confront in depth a problem or set of problems. The challenge is not being overwhelmed by this awareness, and by anxiety about it.

Another way of thinking about depression is considering its opposite – hypomania (mild mania). We often joke with people we work with that we would be rich if we could reliably induce a sustainable hypomania.

But often hypomania or mania takes a toll on relationships. The driven quality of action and the tendency to make quick decisions, as well as the loss of awareness of the other person, is one of the reasons why many partners will bring their spouse in to get the hypomania taken care of. (This is often the only reason someone with hypomania seeks help).

In his book A Blue Fire, the famous Jungian analyst, James Hillman, writes about the richness of awareness, spirituality, and depth that may accompany depression.

It is perhaps for this reason that so many of the greatest poets in the world have suffered from depression.

Elsewhere, we wrote about the notion of a fallow field. The idea is that these periods that may seem so bleak are actually laying the foundation for creativity.

We don’t know if any of these ideas make sense to you. Certainly we also know that depression is terribly, terribly hard and painful. What William Styron famously described as “Darkness VIsible.”

What we are suggesting is that the ability to accept depression, just as the ability to accept pain may actually lead to an unlocking of potential and better moods in the future.

To illustrate, we have been working with a wonderful gentleman with bipolar for a couple of years. It quickly became clear, after we met for the first time, that the challenge in working with him was going to be that he had absolutely no tolerance for even the slightest bit of depression. In fact, just a whiff of that mood would send him into extreme anxiety and, ultimately, drive him into a deeper depression. (The other challenge was that his wife had absolutely no ability to tolerate even a hint of hypomania).

For the last couple of years we have been trying to convince him that mindfulness (mindful acceptance) during depressions might help him. He was very reluctant to consider this notion… did it really only to humor us… And, as is often the case, left us feeling that by even suggesting this approach we were acknowledging that we were poor clinicians.

However, we have seen that the more he does this the less severe his drop into depression is, and the more successful he is coping with the mood. He hasn’t seen the value of depression yet, but accepting it has helped him to live better with his moods.

Now for the paradox – while we advocate acceptance, we don’t suggest that that acceptance extend to doing nothing about severe depression. Acceptance of the mood and its possible benefits can be accompanied by a thoughtful approach to minimizing its extremes… At least we think so.