DEPRESSION, IN A NUTSHELL

A brief look at depression as an "Everything Problem"

Depression, In a Nutshell

A brief look at depression as an "Everything Problem"

Article by LiveReal Agents Grace and Thomas

Understanding depression can be a challenge.

It’s a complex topic.

It can be difficult to even talk about, for several reasons.

One thing is clear. Lack of data isn’t the problem. There’s a flood of information about depression.

Making sense of all of that data, though, and figuring out what it all actually means, is a different story.

Information about depression often comes in random, fragmented jumbles of facts, scattered all over the place. A statistic here, a study there, a few theories way over there, a good answer to a bad question over here, a history tour way over there.

The result, all too often, is an avalanche of impersonal, jumbled perspectives that never seem to fit together into some kind of coherent picture. As with many topics in psychology, it lacks a greater context. It has a hole at the center. It’s not grounded in a larger view of human nature, emotional health, inner strength, or life itself.

All of this can make sorting through piles of conflicting information on depression a depressing experience. (The irony there isn’t lost on us.)

That’s the reason for this article.

Our aim here is to briefly highlight a few key ideas that will lay a strong foundation for understanding depression with accuracy and depth.

We’ve been sorting through this information avalanche for a while now. We’ve been working to seek out the best nuggets, gather them in one place, present them simply and clearly, and talk about it.

In that spirit, in the words below, we briefly explore why even talking about depression can be so difficult. Then we'll try to let the air out of a few popular myths that obscure a clear understanding of the situation. Then we'll address what remains after those myths have been corrected. Finally, we'll offer just a few brief recommendations for the “what to do now?” question.

An important note: everything here is humbly offered in the spirit of a conversation with a friend over a beer. We aren’t on the clock. We aren’t pretending to be Final Words or The Authorities on the matter. If the perspectives here don’t ring true, leave them. They should stand or fall on their own.

That said, we did search for someone with genuine insight on the matter.

While genuine experts in these areas can be hard to come by, we wanted to find someone who had delved deeply into these matters, and who could earn our trust. We searched far and wide for someone who could pass three tests:

1) sees the Big Picture, but avoids getting lost in too much complexity

2) has decades of on-the-ground clinical experience, but also talks general theory

3) is smart, but also has common sense

It took some digging. But in time, we were able to find a few folks in this field who passed these tests. We eventually landed on a single individual: Michael, D. Yapko, Ph.D. author of Breaking the Patterns of Depression, Keys to Understanding Depression, and many others.

Before diving in, a few words about the problem itself.

Communicating about depression leads us into paradoxical territory.

Why?

Part of the problem is living in the age of Information Overload. The other part is that, again, depression is a complex topic. These can combine to multiply challenges exponentially.

In this setting, efforts to summarize complex topics often lead to a dilemma of “accuracy verses popularity.” The effort is either:

1) A focus on what many people, in general, want and are able to hear. This apparently means boiling down vast amounts of information into tiny, bite-sized nuggets. (This isn’t due solely to short attention spans. Shortcuts and simplification are necessary strategies for coping with today’s information overload on steroids.) This approach could be described as popular, but not accurate. Or,

2) A focus on orienting toward explaining the full scope of the complexity of it all. This is accurate, but not popular.

There are hazards with both approaches.

In regards to #1 above (not complex, and popular), the risk is oversimplification.

This can paint a picture of depression that’s easy to understand, but runs the risk of being a gross caricature, sometimes to the point of becoming inaccurate and misleading. This creates problems. It can lead us to think we understand something when we don’t. We can think our overly-simplified maps tell the entire story, when the reality is actually much more complex.

In regards to #2, the risk is getting snowed by complexity.

The #2 approach tries to tell the entire story. It’s more accurate, but overwhelming. No matter how well-written, bullet-pointed, and precise, it can still result in a sprawling, messy affair. In some cases, it’s like a mechanic trying to explain how a car works, instead of just fixing the car.

We’re hoping to avoid both hazards here.

Exploring complex problems, and trying to be thorough about it, can sometimes be like parachuting into a foreign country and then trying to learn the territory by just walking around.

It’s accurate, but it requires a lot of work, takes a long time, and can be exhausting. It’s like making your way through a forest, one tree at a time.

The alternative approach is to stay in the airplane and fly over. The view isn’t detailed, but broad and general. Specialists sometimes criticize it for lack of nuance and for making broad, sweeping statements. They’ve often spent decades studying every grain of tree bark on every tree.

But there’s a need for a ten-thousand-foot perspective. Few of us are specialists, or want to be. We need to see the bigger picture. It provides context. Once that higher vantage point is established, it’s much easier to delve into more detail, but only when necessary. There’s a greater sense of the whole and the parts, the forest and each individual tree. There’s a proper sense of perspective.

This might sound obvious, but it doesn’t always come easy. Much of what’s out there is either overly simple or overly complex. Hitting the sweet spot here can be surprisingly difficult.

With that said, here we go.

What is depression, in a nutshell?

We’ll briefly define “depression” here as a range of experiences in life that can include hopelessness, sadness, numbness, self-loathing, lack of energy or motivation, lack of interest in life, a sense of meaninglessness, and more. It can range from mild to severe, temporary to chronic, and hidden to obvious.

Many of us have experienced at least touches of all of these. Which is to say, most of us have tasted depression, however briefly.

A few hours of hopelessness or numbness can be simply that: a few hours of hopelessness or numbness. But when those experiences linger, become a "new normal," or begin to dominate an increasing amount of our experience, we tend to call it by a different word: "depression."

That’s as far as we’ll go here in regards to defining it.

It doesn’t need to become overly complex. Specialists have more extensive and elaborate definitions and tests and so on, but those aren’t necessarily helpful to us here. Common sense can be a guide.

It might also be helpful to point out that this entire realm isn’t one of mathematical precision. And it probably never will be.

At what point, exactly, do whiskers become a beard? At what exact point does a “balding” man become a “bald” man?

There is no exact point. And that’s fine. Mathematical precision here isn’t necessary. A goal of absolute certainty here is likely misguided. This isn't math. Complex legalistic jargon is often an unnecessary burden. Broad brush-strokes can work just fine. We “muddle through” when we dance, play sports, or have conversations with friends. We can do the same here.

We don't “see” an external "thing" called “depression” the way that we see an apple, a tree, or a dog. At least in some ways, it's a private, personal, subjective experience. The word "depression” is simply a helpful label that tries to describe a certain aspect of our experience in life.

The “I know it when I see it” approach works fine here. What’s more important is understanding it. And overcoming it.

So, how do we understand it?

Here’s our take on it.

Depression is an “Everything Problem.”

That’s a nutshell definition, in two words.

An “Everything Problem” is a difficult problem that’s interconnected with other difficult problems. These problems ultimately lead to the Big Questions of life.

That might sound vague and unhelpful. It might even seem to be, in a way, cheating.

Fair enough. Despite appearances, that definition can be incredibly helpful in some circumstances, but less so in others.

That said, at this point, we’ll refer to Dr. Yapko in Breaking the Patterns of Depression.

Depression in fourteen words.

“…depression is not a single problem
with a single cause
and a single treatment.”

That’s how Dr. Yapko describes it.

Those fourteen words above also might not sound exactly mind-blowing. Elaborating on them might seem even more vague:

“…depression is a complex disorder. There is no single cause; there are many. There is no single solution; there are many.” (3)

But if these answers are so vague, why, then, are we giving them so much attention?

Answer: because, they’re antidotes to "easy answers that don’t work."

“For every complex problem
there is an answer
that is clear, simple, and wrong.”
- H. L. Mencken

The fourteen words above undermine several popular myths about depression.

And that’s a good thing. These popular myths about depression can make the entire matter much more difficult than it needs to be.

As the cliché goes, you need to clear out weeds before you can plant roses. To make room for good ideas, we first need to get rid of bad ones. The descriptions above help us undermine some bad ideas. They can widen our view of the situation. For a more complex and nuanced understanding of depression, first we need to break the spell of the overly simplistic.

And some ideas are overly simplistic.

Some approaches reduce depression down to a single problem with a single cause and a single treatment.

They’re reductionistic.

They’re also depressing. Those ideas can reduce humans down to dehumanized, depersonalized things. They can define, directly or indirectly, us as being puppets of genes, brain chemistry, past traumas, external environmental conditions, and so on. These definitions, intentionally or not, define us as being at the mercy of impersonal, indifferent, uncaring forces that we have no control over.

And that’s depressing.

Of course, these approaches often contain some grains of truth, as rumors, caricatures, propaganda, conspiracy theories, and single puzzle pieces often do.

Genes, brain chemistry, traumas and so on do play roles in the human experience. Yet there’s a great deal of debate surround how, exactly, these affect us. Yet many of these are overblown academic speculations that have bled out into the culture-at-large. They're theories are still being widely debated. Experts disagree on many critical points, and at nearly every turn. (In some cases, none of this seems to prevent some of them from declaring, with utmost certainty, their opinions on the matter, as they ignore scores of other, equally qualified experts, who hold contrary opinions.)

A few examples of these: “depression is like a bad mood.” Depression is an “illness.” It’s simply a matter of “genetics” or “brain chemistry.” There are others, but those are some of the big ones.

Let’s approach these one at a time.

Depression isn’t merely a “bad mood.”

Some see depression as a form of self-pity, or even a character defect or moral weakness. It’s seen as something like a bad mood that you can just “snap yourself out of” by willpower alone.

As Dr. Yapko states:

(There’s a) “…damning suggestion that depression is a product of self-indulgent self-pity by weak people who may complain but don’t really want to change. This tendency to blame the victim permeates our culture in a variety of ways…far too many people hold the outdated and incorrect view of depression as a problem stemming from a person’s character defects or moral weaknesses…Those individuals…may well have been given such ‘helpful’ advice as ‘Pull yourself together’ or ‘Be tough and quit complaining.’” (3)

This holier-than-thou, blame-the-victim approach is adopted by some individuals with little or no experience or understanding of actual depression. “The wind is easy to deal with, so tornados shouldn’t be a problem” is the kind of logic being targeted here. Some individuals emphasize personal responsibility and non-victimhood to a great extent. Personal responsibility and non-victimhood can be great things. But like all great things, they can become inaccurate and even toxic when taken too far, or applied in the wrong conditions.

Some types of depression can be caused, for example, not by doing too little, but by seeing too much. Some varieties (existential depression) can be fueled by genuine, legitimate, and accurate – yet disturbing – insights into the human condition.

Hamlet, Nietzsche, Solomon, Tolstoy and others, if they were alive today, might very well be scolded, given antidepressants, or told to “buck up.” Yet in each of these cases and many others, the “scolders” would likely understand less than the “scolded.” Each made profound insights into the human condition that have lasted centuries. The situation is often more complicated than it seems.

Some games in life, for example, might not lead to perfect happiness. In some cases, this means discovering a bitter truth. For example, a person who had based his life on the idea that becoming famous was the secret to happiness might get depressed when he actually becomes famous, and then realizes that he still isn’t happy. The problem, in this case, originated with bad ideas - specifically, misguided expectations for what fame can actually deliver. It’s part of a larger, very legitimate, existential riddle. Yet merely “bucking up” or "being positive" would mean bypassing the genuine insights offered by this kind of disillusionment. Lessons like these can be painful, but they can also mature us. If we’re heading the wrong way, it’s better to realize it sooner rather than later. They’re nothing to willpower our way out of.

In regards to this dynamic, a classic parallel here could be made to the story of Job. For reasons that were not his fault, a guy suffered through a series of terrible, traumatic misfortunes. He spoke with some of his buddies about it. Their response was to blame him for his suffering. The idea was that he must have done something wrong that made him deserve it.

As it turned out, his friends were profoundly mistaken.

That anecdote doesn’t scientifically disprove the “bad mood” model of depression. But it works to dissipate a common myth: depression isn’t just self-pity. It’s more complicated. Blaming the victim here isn’t helpful. Models of human behavior that focus exclusively on the moral dimension of life can be too narrow. They don’t apply across all situations. Depression seems to be one of those.

That said, it’s also possible to err on the opposite side of the matter.

Depression isn’t an “illness.”

As Dr. Yapko states:

“Depression is not a fixed “thing.” And despite the oversell of drug companies, treatment centers, talk shows, and books that suggest you think of depression as an illness ‘just like diabetes,’ the best evidence to date states that for most people depression is not a biologically based disease. The ‘disease model’ of depression and the value of antidepressant medications have been exaggerated. Biology is only part of the depression story…” (xvii)

Let’s unpack this a bit.

Is there any advantage to seeing depression as an “illness”?

Yes. Unfortunately, as we explored above, some view depression as something that isn’t “real.” In this way, they invalidate, reduce, and dismiss the experience of someone struggling with depression.

The model of depression is an illness counters this.

Illnesses are “real,” of course. If illnesses are real, and if depression is an illness, then depression is also “real.” By this logic, it can’t be negated or dismissed as merely some sort of imaginary condition, as described above.

Depression is real. It doesn't need to be an “illness” like diabetes, malaria or Lou Gehrig’s disease to be "real." Yapko continues:

“Lauren’s depression wasn’t an “illness”; it was a clear and valuable sign that something was wrong. It was a call to examine more closely what too many people seem unaware of: how expectations, thoughts, feelings, relationships, and all the other aspects of experience that can drift off course can lead you to erroneously believe you’ll never have a happy or fulfilling life.” (xvi)

On the optimistic and empowering side, the idea that depression isn’t an illness can – and should – be interpreted as good news. Some illnesses seem to suddenly appear truly randomly, with no apparent reason, cause, or explanation. There's no treatment for something truly arbitrary. If depression isn’t arbitrary, then at least in some cases, there are logical and understandable reasons behind it. This means there can be a way out.

Depression isn’t merely “genetic” or “brain chemistry.”

The ideas that depression is “genetic” or a function of “brain chemistry” are often bread-and-butter staples of mainstream approaches.

Again, like most rumors, there are aspects of truth to them. Yet in other ways, they’re spectacularly unhelpful, and even counterproductive, for someone actually struggling to overcome depression.

How are they unhelpful?

For starters, they aren’t accurate. In his book The Undiscovered Mind, Scientific American writer John Horgan speaks bluntly: “…so far none of the claims linking specific genes to specific, complex behavioral traits and disorders – not one – has been unambiguously confirmed.” (141)

We don’t have clear confirmation linking specific genes to a single specific, complex behavior.

Stephen J. Gould described geneticist R. C. Lewontin as “the most brilliant scientist I know." In an argument that ranges through several books (Biology as Ideology and Not In Our Genes, and others) Lewontin bemoans the overstatements surrounding the situation, and argues against “this tidy and showmanlike packaging of science as the panacea to global problems.”

Question: what human behaviors don’t involve genetics, or "brain chemistry"?

Answer: Basically, none.

How, then, does that really help us in understanding depression, and overcoming it?

Maybe it doesn’t. At all.

Every behavior can be described as involving both genetics and brain chemistry. Happiness, joy, anger, love, and plenty of other experiences involve genetics and brain chemistry. Why reduce these experiences to brain chemistry or genetics, but not others? Genetics and brain chemistry as present in everything we do, in the same way that blood cells and carbon are present in everything we do. But this doesn’t point to them as causal factors. Why don’t we say “I did that because of my carbon”?

For anyone who is depressed, does hearing the universally-repeated phrase that “depression is a combination of genetics and environment” actually help them overcome it? In any way, whatsoever?

This gets at why the answer is so spectacularly unhelpful. “Why do we do what we do?” “Genetics.” “Brain chemistry.” If these are used as universal, one-size-fits-all explanation of everything, they don’t really explain anything.

If genetic therapy eventually produces genuine solutions to depression at some point in the future, we’re happy to be proven wrong here. That said, certain problems – family dynamics, for example (which can also form a basis for depression, as described here) – will always exist. If we’re waiting on a pill that will solve “family dynamics,” we shouldn't hold our breath.

The reason for discussing this at such length here is that these ideas can make depression worse.

Genes and brain chemistry aren’t usually seen as things are within our control. Let’s imagine the unlikely event that one day we even discover a “depression gene.” (We haven’t yet, and quite likely, never will.) So what? A depressed person could then think, “OK, I have a ‘depression gene.’ That’s depressing news. Now, what should I do about it?”

Why not go ahead and ask that question now?

Antidepressants aren’t panaceas.

The attractions to antidepressants aren’t mysterious. They’re fairly uncomplicated, they’re easy to swallow, they’re blame-free, relatively easy to measure, and most importantly, sometimes, for some individuals, they seem to help.

When they work, that’s a good thing. But it’s definitely worth mentioning that if they don’t work, there are other potential answers available.

There are also downsides to the antidepressant approach. Being overhyped, overprescribed, and oversold are a few.

As Dr. Yapko says this:

While it is certainly appealing to think that ‘a capsule a day will forever keep the depression away,” it simply isn’t true, not is it ever likely to be.

…antidepressant medications, although they can be effective allies in treatment, are not a total solution in most cases. They can provide symptom relief, help ease distress, and even lessen other symptoms that may co-exist with depression and further complicate an already complex clinical picture. What they can’t do is magically transform most personalities (despite the optimistic excesses of some drug advocates), teach vital coping and problem-solving skills, resolve associated personal and interpersonal issues, or erect strong protection against the recurrence of episodes. The clinical research and evidence is perfectly clear on this point: psychotherapy that emphasize skill-building and problem resolution is not only desirable but necessary.

So, where does this leave us?

If the above ideas are unhelpful, what are helpful ones?

One definitely deserves a mention.

This is the idea that sometimes, depression can be a normal, healthy reaction.

“Depression can be a completely normal response to painful circumstances…” (xvi)

How is this helpful?

One way the worst ways psychology and psychiatry can drive us crazy is by pathologizing normal human behavior. It can convert life itself into a disorder that needs treatment. Life and everything in it becomes one big “symptom” indicating that something, somewhere, is wrong.

To describe it in the most cynical way possible, we could describe the following business model: 1) take any normal human behavior; 2) label it as some sort of “disorder;” and 3) offer some sort of “treatment” for it. Whoever provided “treatment” would be seen as essential, and would even get paid for it.

The model described above, isn't entirely fair, isn't the full picture, and doesn't do justice to the positive accomplishments of psychology and psychiatry. That said, it warrants a mention.

It’s one thing to be depressed. It’s another thing to be depressed, and then, on top of that, to be defined in some vague way as fundamentally flawed. The “disorder” model implies this, perhaps accidentally. The implicit or explicit message is that “something is wrong with you.” This can add a layer of guilt and worry on top of the depression. It carries moral weight. As G. K. Chesterton famously quipped, “Psychoanalysis is confession without absolution.” All the guilt, none of the forgiveness.

The view of depression as, on some level, a normal and even healthy response in some cases, reverses the above. Sometimes, as Richard Rose said, a negative reaction to a negative situation can actually be quite positive. A sane reaction to an insane situation might appear to be insane. “Feeling screwed up at a screwed up time, in a screwed up place, does not necessarily make you screwed up!” said Allan Moyle in Pump Up the Volume. Maybe in some cases, underneath it all, a sense of being “fundamentally flawed” is an illusion, generated by the way we talk about things like depression.

Sometimes the issue isn’t us, necessarily. Sometimes the real issue is life.

In this sense, every depression can be as unique as every human.

This doesn't mean that there aren't common denominators, or that everyone is completely on their own.

But untangling the various threads of causes can be like solving a unique puzzle that exists within every individual. Depression can be caused by traumatic events, or a lack of drama in life. It can be caused by dysfunctional dynamics involving family, friends, or coworkers, or by a lack of genuine relationships. It can happen while someone is surrounded by jerks, or while someone is surrounded by loving and supportive friends and family. It can be caused by the difficult existential realities we all wrestle with. It can be caused lots of things.

It’s an Everything Problem.

In this sense, wrestling with depression is part of wrestling with being human. Human nature is complex. Life isn’t always the romp through Disneyland many seem to portray. More often, in fact, it’s a struggle. Sometimes it can be utter hell. We should be able to just tell the truth about all this. If there’s a genuine way out, it has to lie in the direction of brutal honesty.

In this sense, there are ways each of us can work to untangle the threads of our own inner knots and achieve clarity. This doesn’t mean we’re all alone in the effort – far from it. But the “inside out” approach, where an individual gropes their way out of their inner labyrinth, can work toward a solution from every side.

Armed with the understanding that depression isn’t simply a bad mood, an illness, a simple issue of genetics or brain chemistry with an easy pharmacological solution, we can briefly look at options that might help make things better.

Here are a few basic, general tips.

These "tips" (at the risk of being repetitious) are offered in the spirit of a conversation with a friend over a beer, not as someone on an hourly rate with diplomas on the wall. They're also most likely to be useful for mild to moderate depression, which seems to be the vast majority of cases. Most individuals who experience depression are still functional, in the sense of being able to at least “go through the motions.” Severe cases of depression would probably benefit most likely from consulting with a professional. A few suggestions are TalkSpace.com for general issues, Rehab.com for addictions, or Dr. Yapko’s own site that focuses on depression and hypnosis, Yapko.com. (These are not paid endorsements, by the way.)

As an Everything Problem, there are a number of ways to approach depression.

Some books, for example, can help.

Yapko’s Breaking the Patterns of Depression and Keys to Understanding Depression can be helpful. Mindfulness approaches, such as The Mindful Way Through Depression by Mark Williams, John Teasdale, Zindel Segal and Jon Kabat-Zinn offer other tools. For a strictly practical, scientifically research-based approach that deliberately steers clear of lofty ideas (such as existential approaches), The Depression Cure by Stephen S. Ilardi offers some good suggestions. Others can help as well.

That said, as with all Everything Problems, the issue is woven in with everything else in life, and can’t always necessarily be treated as an isolated, standalone symptom, separate from everything else. A depression that's a result of a dysfunctional relationship, for example, might entails dealing with some messy relationship dynamics.

With that said, a basic series of steps can help.

One way to move forward is with a scan of four basic arenas: body, heart, mind, and soul – or physical (body), relationships (heart), psychology (mind), and spiritual (existential, or soul.)

The approach offered here is practical. It starts with the relatively easy, and proceeds to the complex. It keeps going until something works. Eventually, it can become comprehensive, working on multiple levels at the same time, by way of “Existential Fitness.”

First, there’s the easy, low-hanging fruit.

These approaches require less effort.

Michael Greger, M.D., of NutritionFacts.org fame, has described how a better diet can relieve some depression. Food can affect mood, and energy level.

Stephen S. Ilardi, Ph.D., author of The Depression Cure, suggests exposing oneself to more light, and even buying a light box. He also suggests a focus on healthy sleep habits, as well as omega-3 fatty acids by way of vegetables, fruits, whole grains, seafood, and other sources.

Exercise, as many already know, can help. Granted, the hard part here is in the doing. Motivation doesn’t always come easy. But focusing on just taking one tiny step at a time – just stepping outside for two minutes, or walking around the block once – can help. Micro-steps can work wonder.

Taking a vacation from alcohol or drugs can help. (But safely. Going cold-turkey, in some cases, can carry risks.)

Taking a vacation from social media, television, and the computer can be like finding a second lease on life. Consuming certain types of media – especially social media – can be demoralizing and vitality-draining. All of it seems to affect us in ways that we still don’t fully understand. Based on what we know so far, it clearly isn’t always good for us.

In regards to bad habits, one strategy is to use bad habits against themselves. For example, we can embrace laziness by telling ourselves that we don’t want to bother with junk food, alcohol, drugs, bad television, or social media. A vacation from these can sometimes lead to a surprising surge of energy that suddenly becomes available for us to use. This strategy employ laziness to work for us instead of against us.

These are a few physical strategies.

In regards to relationships, there are few easy answers that aren’t already apparent. Here, the challenge isn’t in the knowing, but the doing. Becoming more aware of toxic relationships and their effects, and then taking whatever measures are possible to either eject from or change the dynamics of them can make a tremendous difference.

Then there’s the psychological.

The psychological level involves becoming more away of how we think and feel. This can involve "making the unconscious, conscious." It gets into the area of becoming more aware of our thoughts, our emotions, and the interactions between them. If we become more aware of our own thinking, which helps change it, the rest can follow naturally. Sometimes, becoming more aware of our thinking means popping out of our usual routines of thought – “breaking the pattern” of our thought loops – that imbue us with a fresh perspective on ourselves.

“Learned optimism” (and its evil twin – learned helplessness) is an incredibly practical, science-based approach that can make a tremendous difference. It’s formed no small part of the basis of modern cognitive-behavioral therapy. It takes some practice, effort and time to adopt new thinking habits, but the results can be well worth it. Some of this is discussed here.

This can is also enhanced by some of the “inner strength” techniques discussed here. Writing down one’s life story, for example, is another research-based technique that can be surprisingly effective. (Experts don’t necessarily understand why it works, but there's a great deal of evidence that it works.)

The common denominator underlying much of this is becoming more aware of oneself in an objective way. As Dr. Yapko describes:

The most important point I can make at the outset, the point that succinctly represents all I have written here, is that people become absorbed in ways of being (thinking, feeling, doing) that they mistake for “real” or “true.” They lose sight of the fact that much of life experience is not clearly “this” or “that,” but is instead a product of personal beliefs. So when people tell themselves, and then actually believe, “I’m a terrible person” or “Life is just no damn good,” depression is a predictable consequence. The worthy skill to develop is how to step outside your personal beliefs. Only then can you determine whether they are accurate and serve you well, or whether they are distorted and the cause of unnecessary pain. (xvii)

In two words, a key ingredient of this approach is self-knowledge.

The basic dynamic is that you use your mind, instead of your mind using you. That might sound hokey, but it points toward a shift in our inner center of gravity.

We don’t often think of our mind as a tool. We often think of our mind as “ourselves.” But when we learn the flexibility and perspective Yapko is referring to in the quote above, we can learn to see our own beliefs and perceptions as something elastic and flexible. This can help us realize that we have more resources than we might ordinarily think.

Simply paying attention to everything in our lives, and really noticing what inspires us and especially what demoralizes us, what invigorates us and what drains us, can yield incredibly helpful insights. Some friends, for example, might affect us like junk food: they’re fun, but bad for us. Other habits, relationships, and even ideas can work the same way.

This can also help us clarify more about who we are, and who we aren’t. “I feel depressed” is very different from “I am depressed.” That “I am not my depression” can sometimes be a liberating insight.

That said, as powerful as the above practical and psychological approaches can be, it still might not clear up the entire matter.

This brings us to the next level.

Finally, there's “Existential Fitness.”

This could also be described as working on the existential or spiritual level.

Your thinking might be as optimistic and realistic as possible. Your habits might be healthy and life-affirming. Your relationships might be just fine. Yet if you see yourself as a mere player in a game in life, and that game is pointless, and has no apparent meaning or aim, then it won’t matter how optimistic your thinking is. It could mean being a great player in a pointless game.

This is a different level beyond the psychological. It delves into our core ideas about life.

We’re all faced with existential riddles in life. Part of our task in life means coming up with answers to these riddles, also known as “The Big Questions” of life. Along with the question of happiness, our search for antifragile happiness, and questions about why we suffer, one of the most critical of these is the question of meaning in life. The question of “the meaning of life” as it’s depicted here isn’t an abstract philosophical exercise, but an answer to “why get out of bed in the morning?” The answer to this is crucial. If life is seen as ultimately going nowhere (and unpleasantly, to boot), depression is fully – to use Yapko’s word – “predictable.” But on the other side of the matter, different answers to meaning in life can make depression almost impossible.

All of this means working on our life philosophy. Our life philosophy is like our source code for understanding the world. It’s the basis of our existential immune-system.

This can all become most apparent when our life philosophy gets undermined. When that happens, it typically results in an existential crisis. An existential crisis is what happens when our basic worldview or life philosophy either takes some hard knocks or even collapses. If it gets undermined with nothing to replace it, it can leave a kind of vacuum. This often results in a kind of “soft nihilism,” or a sense of meaninglessness. Life simply ceases to have any point. (For incredibly vivid descriptions of this, read Tolstoy’s A Confession or Ecclesiastes: “all is vanity,” or meaningless.)

This entire dynamic described above is becoming more popular, and even the norm these days. One shorthand way to describe all of this is to say that we’re living through “The Death of God,” which is what Nietzsche was trying to warn us about.

Even when our life philosophy doesn’t get undermined in any kind of dramatic way, there can be a general, underlying sense of angst. Angst is connected to our human nature – or more specifically, to our “human potential.” In a way, angst could be seen as the “dark side” of human potential. Angst, in a nutshell, can be the sense (the “dread”) that we aren’t fully realizing it. It could be pictured like a seed within us that hasn’t yet blossomed, or to wax poetic, a song in us that is yet unsung.

This might sound highly speculative. But the matter is practical, and natural, and in a way, even biological. A caterpillar has the “potential” to become a butterfly. An acorn has the potential to grow into an oak. A human being has the potential to grow into something greater as well.

If we aren’t on our way to becoming our own version of butterflies or oaks – or if the entire idea of it seems impossible, or absurd, or isn’t even on our radar – then this can translate into a deep sense of dissatisfaction.

The positive side of this, though, is the sense that it’s an invitation. Without merely sugar-coating it, if we truly understand and approach it correctly, we can see this as a guide to that leads us, by way of Ariadne’s thread, out of our inner labyrinth, to a greater sense of freedom.

All of this might ring true, and almost common sense – or not. If not, no problem. In these areas, it can often be prudent to just take what you like, and leave the rest.

“Making full use of our human potential” might sound like the epitome of a hokey, head-in-clouds impracticality. But what this points to is an inner transformation. It isn’t about becoming an astronaut or a billionaire. This doesn’t necessarily refer to any dramatic outer activity, such as becoming a banker instead of a lawyer, or a lawyer instead of a banker. It involves a deeply personal dynamic, or “Inner Work.” A sense of angst can sometimes be the result of a lack of a genuine spiritual life (or “spiritual repression.”) Spiritual repression creates angst. The solution lies in exploring, and finding, a valid spiritual path.

And what is a "valid spiritual path"? That’s what we explore here, in searching for an approach that is no-nonsense, that’s “satiberas,” or that holds up – and even thrives – under rigorous questioning and skepticism.

This obviously touches on a lot of issues.

It’s why we describe depression as an Everything Problem.

“For most people, depression is the product of a hurtful way of interpreting and responding to life experiences. Depression involves an intricate set of projections about yourself, life, the universe, everything.” (xvii)

So, where does this leave us?

Hopefully, the above provides a basic framework to build on.

The broad and rough sketches outlined above obviously aren’t exhaustive. The picture can become much more nuanced and detailed on all fronts. But hopefully, this can offer a brief but accurate ten-thousand foot view of the big picture.

At this point, Yapko offers what we’ll use as a final word for now.

(And not just a final word, but a “great secret.”)

“But here is the great secret about depression – it’s a sheep in wolf’s clothing.”

Depression as a “sheep in wolf’s clothing”?

That image might sound surprising. It contradicts ways we often seem to depict depression – as something so scary to talk about that it’s nearly taboo.

If that statement was coming from the ordinary “man on the street,” it might well mean that he didn’t really understand the complexity of it all, and was merely dismissing it the way so many do.

But this isn’t coming from that guy. It’s coming from someone who been fighting on the front lines of depression for decades.

He elaborates further:

“But here is the great secret about depression – it’s a sheep in wolf’s clothing. It can be treated effectively and the treatment’s effects can make a difference that will last a lifetime.”

He follows the statement above by describing the skills – learnable, practical, understandable skills – that can arm individuals who are fighting that same battle.

That should offer hope.