DEPRESSION AND MANIA
While major depression is a horrifying illness, the mood spectrum that includes extreme sadness is essential to our capacity to love. For some people, low or high mood may represent a gift from the psyche that signals the release of creative powers, a transformation in consciousness, or a significant change in one’s outlook in life. There is the possibility that in some mood disorders, there may be a silver lining that represents a hidden strength that come to the aid of the personality and fortify it on its journey toward wholeness.
Anatomy of Mood Disorders
Like other features of self, mood exists along a continuum that runs from major psychotic depression on one side to extreme psychotic mania on the other. Between is a gradation of milder disorders, temperaments – chronic depression, hypomania, melancholic temperament, and normal forms of sadness to a healthy exuberance on the manic side. Severe bipolar disorder moves between the extreme poles. Sometimes, external events induce the change but at other times they occur without obvious causes (e.g. endogenous depression).
The biology is complex and still largely to be explored, but a major cause is a dysregulation of the limbic system, or “emotional brain” (the amygdala, thalamus, hippocampus and hypothalamus) with the frontal lobes of the neocortex or “thinking brain”. The frontal lobes serve to modulate the emotions of the limbic system. A disturbance in the flow of neurotransmitters between the two, the neocortex is not able to modulate the ups and downs of the limbic system and engages in dysfunctional thinking processes (recrimination, guilt and negative rumination). Three neurotransmitters (serotonin, dopamine, and norepinephrine) are involved. Antidepressants like Prozac, Zoloft, Paxil and Luvox (SSRIs – serotonin reuptake inhibitors) work by inhibiting the reuptake of serotonin. Lithium, used to treat bipooar disorder, has an impact in the way that neurotransmitters are passed along from one neuron to the next.
Another cause can be how the endocrine system processes stress. Under normal stress conditions, the hypothalamus secretes corticotropin-releasing hormone (CRH), which stimulates the pituitary gland to secrete adrenocorticotropic hormone (ACTH) that in turn stimulates the adrenal gland to produce the stress hormone, cortisol. Cortisol activates the “flight or fight” response to provide the energy needed to cope with a legitimate threat. It then stops the secretion of CRH and ACTH. In depression, however, there is no tiger or intruder, and this feedback loop is disturbed, allowing cortisol to build up in the blood and giving rise to some of the chronic stress symptoms that characterize depression.
In the Eye of the Beholder
Major depressive disorder (low mood, negativity, insomnia and other symptoms for at least two weeks) occurs in 13% of Americans over the course of their lifetime, while bipolar disorder affects only 2-3%.
Different cultures have fundamentally different ways of viewing depression. Depression or paranoia in one culture may be perfectly normal in another. The Coast Salish group of Native Americans in British Columbia, Washington and Oregon have 75% of the community identifying themselves as being depressed. However, they have integrated the experience of depression into their own self-identity as a people by transforming one’s sadness into compassion for others. It doesn’t get rid of the depression but makes them more useful members of their families and communities. They think that the depressed people make the best guides and teachers.
Buddhists of Sri Lanka see hopelessness, meaningfulness, and sorrow as part of a recognized philosophy of live, not as a disorder. The keeners of Ireland have a labile emotional life that is an asset in mourning the dead. The berserkers of Scandinavia have a fierce manic behavior regarded as a positive sign of a true warrior.
In our own culture, many depressed people are simply experiencing normal sadness as a result of specific losses or traumas in their lives (death of a spouse, losing one’s job). Depression “with cause” and “without cause” was removed from the 1980 DSM-III.
Productive and Nonproductive Depression
There is no model of normal depression due to an adequately functioning human to get depressed or what function which this emotional response and its symptoms may serve. This healthy course may produce productive insight, growth, and reorientation. Productive depression may have some useful learning or maturation occurring, some behavior reorganized or some plan revised allowing the depressed person to function more effectively in the attainment of some goal, or become more realistic in setting our goal. Unproductive depression has no maturation, development is arrested, personality or health deteriorates, and perhaps death is the final outcome.
In 1796, Ludwig von Beethoven began do develop hearing loss but over the next 6 years, only worsened. A love interest was prevented and he entered a depressive period of isolation. After writing what was essentially a will, he entered into one of the more productive periods in his life. Underlying processes of transformation served to work out the inner conflicts that ultimately led to a resolution to continue developing his creative inner self.
The soul presents itself in a variety of colours, including all the shades of gray, blue, and black. To care for the soul, we must observe the full range of all its colorings, and resislt the temptation to approve only of white, red, and orange. Melancholy gives the soul and opportunity to express a side of its nature that is a valid as any other, but is hidden out of our distaste for its darkness and bitterness. In the Middle Ages, depression was known as the “old man”, the experience of time and experience. A sense of heaviness deepened the personality and gives the wisdom of old age. Melancholy maybe as valid a way of being rather than a problem that needs to be eradicated.
Rather than distress and frustrate one, depression can be viewed as a valuable time for introspection and deep thinking about life. It gives time out to be an observer of things that are happening around one and to one. Accept is as part of your personality. When one is up, it is a time to be productive and when down, it’s time for taking things more slowly and thinking. Be grateful for theat.
This has a strong element of realism – an individual who has seen events come and seen them go and is not fooled by the illusions woven by societal customs and habit. People who are depressed see the world more realistically. Depressed people appear wiser. The epidemic of depression in our culture may have more to do with a realistic appraisal of world events and a refusal to sugar coat life than with an abnormal propensity towards gloominess. With all the negative things happening in the world today, if you are not in mourning, you’re cut off from the soul of the world. In that sense, one might think an underlying depression is a kind of adaption to the reality of the world.
The Downside of Happiness
As a culture, we’re fixated on the happiness: the happy face, the happy meal, the how-to-be-happy self-help books. A 2013 Pew poll indicated that 85% of Americans believed they are happy. After Donald Trump, in 2022, I think that number may be much lower. America has now become a divided country and has little to envy.
The experience of depression could be a certain revolt against core American values, a protest against a busy society, where the individual is bargaining for some time off to look at life and its complex problems and find a way to cope with it all. This may be why depression evolved in the first place.
On the other hand, the manic pole of mood disorders may have evolved as a way of increasing one’s energy to a peak level so that one could engage in sexual or aggressive activities that ultimately would have advanced one’s genetic cause and lead to the passing of one’s genes to future generations.
It may be that these deeper evolutionary reasons behind depression and bipolar disorder help explain the link between mood disorders and creativity. When 1000 eminent individuals of the 20th century were surveyed, 77% of poets, 54% of fiction writers, 50% of visual artists, and 46% of composers had undergone at least one significant depressive episode in their lives. This compared with 16% of sports figures, 5% of military leaders, and 0% of explorers. When 30 writers from the prestigious Iowa Writer’s Workshop were interviewed, 80% had experienced at least one episode of an affective disorder compared with 30% of a control group. Two-thirds had had psychiatric treatment for their disorder.
Important links between creativity and bipolar disorder reveal that elevated and expansive mood, inflated self-esteem, abundance of energy led to unusually creative thinking and increased productivity.
Mood Disorders and Niche Construction
Depression and bipolar disorders remain devastating conditions for millions. Antiderpessants and cognitive-behavioral therapy are vitally important to live normal or close-to-normal lives. SSRI’s increase the proliferation of glial cells in limbic system structures.
One niche construction may be depression being used to eliminate stressors and eventually be able to live a productive life by structuring the environment to reduce stress as much as possible. Working at home, setting one’s own schedule and working for oneself may help avoid tension that can come from office politics, authority issues with bosses, and the stress of having to fit into someone else’s timetable. It may give flexibility to engage in additional stress-reducing activities such a yoga, meditation, and exercise.
Other strategies include eating a healthy diet, engaging in simple activities you enjoy such as a walk in nature, time spent with pets, volunteering, keeping a journal, getting enough sleep, and joining support groups. Studying the lives of eminent people to see what kind of components went into their niche construction. Many used creative work to provide real relief. For many comedians, If one isn’t depressed, something’s wrong.
Good careers for those with mood disorders include: writer, entertainer, clinical psychologist, marriage, child and family counselor, theologian, philosopher, chaplain, journalist, musician, dancer, sculptor, painter or life coach. One needs talent and aptitude for engaging in any one of these professions.
High-stress jobs may not be the best match. Humanities rather than sciences are a more hospitable ecosystem for sensitive minds and hearts.
It is important to create and strengthen positive relationships with family, friends, and professionals. Infants need positive emotional attachments to their mother in the first two years of life to provide a buffer against stressful events in later life. Trauma in early childhood is more easily overcome – of being resilient – if they have a supportive relationship with at least one family member or friend in the family in later childhood. Depression in adulthood is helped by mental health professionals. They can pinpoint frustrated goals, assist in problem solving and suggest a more suitable niche to develop.
Most important is the building the context of meaning. Loss of coherence in our culture – the pace of life, the technological chaos, the alienation from one another, the breakdown of traditional family structures, loneliness, the failure of belief systems (religious, moral, political and social) can be catastrophic. The experience of depression itself can sometimes supply the deeper meaning. Depression may have redemptive power. Whatever else, whatever it brings, it is one’s life that has to be dealt with.