Breathe
By Valeria Villa
One of the topics that have interested me most in my professional life are the different manifestations of what we know as depression. Personally, I find two approaches useful to understand it: the psychiatric and the psychoanalytical. I think that it is not possible to work with only one of them and that the best thing for those who suffer is to have alternatives to heal from the medical perspective and from the analytical understanding that can be reached in therapy.
This mood disorder manifests itself with sadness but also with anger (which is often covert) and is provoked by causes that are sometimes identifiable and sometimes difficult to locate. Thus, there are two ways to treat it: drugs and discovering the unconscious causes.
The depressive illness can last from 4 to 6 months and in some cases it subsides spontaneously. It is decided to treat it because it is necessary to avoid useless suffering, to avoid relapses and to stop, if it exists, the suicidal intention and melancholy, which we have misunderstood as something light and even romantic, when in factit is a pathological mourning of psychotic cut, that is to say, of absolute indifference for the self and for the external world.
From a medical perspective, depression is defined as a set of characteristic clinical signs that must be identified: chronic fatigue (nowadays it is fashionable to describe it as burn out), oversleeping, slowness in daily activities, lack of concentration, inability to plan for the future, fleeting or repetitive suicidal ideas, changes in appetite (anorexia or bulimia), disturbed sleep with difficulty falling asleep, difficulty staying asleep or inability to sleep for more than 3 or 4 hours. The tendency is to withdraw into oneself and self-criticize.
As for the analytical understanding, the dominant affection is a sadness out of the normal, that is to say, very intense, insidious, described as a fog that overshadows, mixed with anxiety, tormented mood, bitterness, irritability, with easy tendency to anger and complaint. Susceptibility, anger, complaints to close people, resentment for past hurts. There is in the sadness of the depressive an old hatred and rage turned towards himself. It is a permanent state that not only reduces but inhibits all action.
There is an obsessive withdrawal into oneself, self-devaluation and rumination of misfortunes, of unforgivable mistakes, masochistic need to enjoy (not enjoy) the guilt, called by Freud moral masochism, due to all failures, imperfections and personal mistakes. The guilt of the depressed person is monstrous.
Desire is lost, there is no taste for anything, neither for love, nor for sex and does not want to see anyone. Boredom, little will to live, the will and the drive for life are numb.
For psychoanalysis , depression is the symptom of the decomposition of a neurosis. This means that there is a prevailing mood of spite, disappointment, disenchantment and the conviction that nothing is worthwhile, including therapy. Neurosis is the cause of depression.
What exactly is a neurotic state? The fragility of a person vulnerable to separations or losses. The neurotic faces misfortunes as inadmissible, unjust, as amputations of vital parts of himself. He experiences losses as unthinkable: of objects of love, of a feeling destroyed by a betrayal, of health, of youth, of material possessions, of work, of youthful ideals.
Depression then has to do with the subject's vulnerability to loss, with intense feelings of frustration, which is defined as the lack of a real object in the imaginary. It is the expected, requested, dreamed object, which the neurotic is certain to obtain, or the other has to give it to him, because he deserves it, he owes it to him. When he does not obtain what he fantasizes, disappointment appears, the promise disappears, the illusion disappears and its place is taken by rage.
It is not the loss that causes depression but the way of living it, because one can learn to live with the wound, because one can preserve the capacity to love and because it is possible to continue loving oneself, but if there is a pathological dependence on the loved object, the collapse of the being and the subsequent depression occur.
The depressive sustains pathological dependencies with his world of affections. He experiences an exacerbated narcissism, an idealized love of self, which needs the fusion with a loved one to nourish a childish illusion, of the child who does not want anyone to touch his dreams of being forever the most loved, the most admired, the most recognized. The depressive does not love the other for what he is but because he is the vital source of his idealized self. The most precious object is not the loved person or love but his hyper-ideal self.
To be cured of depression we must deal with the childish illusion of omnipotence. Accept that you cannot do everything, nor can you do everything perfectly. Not to deal with sadness but to locate what is the lost illusion. Also to work with the repressed rage, which has been trapped in the self. It is necessary to work on the distinction between the possible and the impossible and to locate to correct the obsessive and compulsive character of the negative thoughts.
Depression is not an invention of the bourgeoisie and it is an emotional life disease that needs treatment, sometimes dual, with antidepressants and therapy, and sometimes exclusively therapeutic. No one should wait until it becomes serious, the best thing to do is to talk about it with our support network and seek professional help as soon as possible.
The opinions expressed are the responsibility of the authors and are absolutely independent of the position and editorial line of Opinion 51.
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