Chronic Depression: What You See Depends on Where You Look

chronic depressionIt can be hard to sit with someone with depression, especially chronic depression. For me it is the fact that I am trained to try to enter a person’s world, and understand that world… but the visit to the world of someone who is depressed can be depressing. One of the reasons for this is that they describe lives where they have very little control over anything that happens to them.

Even when not depressed, this same trait can persist.

Asked to talk about why things are going better with her husband, a woman who has wrestled with depression for many years says that he is suddenly doing things that make her happy. She really enjoys it when he does work around the house. She remembers how she was attracted to him because he was so handy.

Later on in the conversation we are talking about how different she finds it working with her boss, who is very good at recognizing her unique abilities, as opposed to her husband, who tends to get frustrated that she can’t do things that he finds easy – for example, things involving spatial ability – seeing complicated drawings in 3 dimensions. She notes that he is “very good with people…” and again it seems to me, listening to her, that she is at the mercy of whether or not the person she is spending time with values her.

Ten minutes later, as she describes how she has been really recognizing her husband’s work around the house, and I can see from her smile and excited way of talking that this enthusiasm is really infectious, it occurs to me that she is actually pretty “good with people…” and in particular is usually very generous in recognizing each person’s unique contributions and strengths.

So I point out that probably some of the good feeling that she is experiencing because of her husband’s rekindled interest in working around the house is probably due to how she has expressed her appreciation for that effort. In other words, I point out how she has some influence or control over what happens to her.

She changes the subject to another topic which is along the same lines as her original observation – another way that she is benefiting from her husband’s changed behavior.

This tendency of depressed people to not notice the influence and control that they do have on the environment has been most articulately described by Jim McCullough in his books about the Cognitive Behavioral Analysis System of Psychotherapy.

Changing this pattern is hard work… but it is worth it. Because when someone starts to notice how the “glass if half full” (they do have some control) it leads to a pattern of behavior that prevents further depression.