Posts Tagged ‘unipolar depression’

Ultimate Pessimism

November 17, 2019

This title of this post is identical to the title of a chapter in a book by Martin Seligman, Ph.D., titled Learned Optimism: How to Change Your Mind and Your Life. This is the third post on this book. Ultimate pessimism is depression, which comes in three kinds. The first is called normal depression. It is the type each of us knows well. Seligman writes, “It springs from the pained losses that are inevitable parts of being members of a sapient species, creatures who think about the future. We don’t get the jobs we want, we get rejected by people we love, or our loved ones die. It is predictable when such things happen that we feel sad and helpless. We become passive and lethargic. We can believe that our prospects are bleak and that we lack the talent to make them brighter. We don’t do our work well, and might avoid work. Zest goes out of activities we used to enjoy, and we lose our interest in food, company, and sex. We can’t sleep.

But most of the time, by one of nature’s benevolent mysteries, we start to get better. Normal depression is the common cold of mental illness. Seligman writes that he has repeatedly found that at any given moment approximately 23% of us are going through an episode of normal depression, at least in mild form.

The two other kinds of depression are called depressive disorders: unipolar and bipolar depression. What determines the difference between unipolar and bipolar depression is whether or not mania is involved. Mania is a psychological conjoint with a set of symptoms that look like the opposite of depression: unwarranted euphoria, grandiosity, frenetic talk and action, and inflated self-esteem.

Bipolar depression always includes manic episodes, and is also called manic-depression (with mania at one pole and depression at the other). Unipolar depressives never have manic episodes. Another difference between the two is that bipolar depression is much more heritable. If one of two identical twins has bipolar depression, there is a 72% chance the other also has it. This is only 14% true of fraternal twins who are no more closely related than any other full siblings. Bipolar depression is treated with a “wonder drug, “lithium carbonate.” Seligman writes that in more than 80% of cases of bipolar depression, lithium will relieve the mania to a marked degree and, to a lesser extent, the depression. Unlike normal and unipolar depression, manic-depression is an illness, appropriately viewed as a disorder of the body and treated medically.

Seligman’s view differs radically from the prevailing medical opinion, which holds that unipolar depression is an illness and normal depression is just a passing demoralization of no clinical interest. He writes, “This view is the dominant one in spite of a complete absence of evidence that unipolar depression is anything more than just severe normal depression. No one has established the kind of distinction between them that has been established between dwarfs, for instance, and short normal people—a qualitative distinction.” Both normal and unipolar depression involve the same four types of negative change: in thought, mood, behavior, and physical responses.

The way you think when you are depressed differs from the way you think when you are not depressed. When you are depressed you have a dour picture of yourself, the world, and the future. When you’re depressed, small obstacles seem like insurmountable barriers. You believe everything you touch turns to ashes. You have an endless supply of reasons why each of your successes is really a failure.

The second way both unipolar and normal depression is recognized is a negative change in mood. When you’re depressed, you feel awful: sad, discouraged, sunk in a pit of despair. Jokes are no longer funny, but unbearably ironic.

The third symptom of depression concerns behavior. There are three behavioral symptoms: passivity, indecisiveness, and suicidal action.

Many depressed people think about and attempt suicide. They generally have one or both of two motives. The first is surcease: The prospect of going on as they are is intolerable, and they want to end it all. The other is manipulation: They want to get love back, or get revenge, or have the last word in an argument.

The final symptom of depression concerns the physical self. Depression is frequently accompanied by undesirable physical symptoms; the more severe the depression, the more symptoms. The appetites diminish. You can’t eat. You can’t make love. Sleeping becomes difficult.

Unfortunately, depression is increasing. Research has shown that there has been greater than a tenfold increase in depression over the course of the century.

Seligman concludes this chapter as follows: “When we now look at the upsurge of depression, we could view it as an epidemic of learned helplessness. We know the cause of learned helplessness, and now we can see it as the cause of depression: the belief that your actions will be futile. This belief was engineered by defeat and failure as well as uncontrollable situations. Depression could be caused by defeat, failure, and loss of the consequent belief that any actions taken will be futile.

I think this belief is at the heart of our national epidemic of depression. The modern self must be more susceptible to learned helplessness, to an ever-growing conviction that nothing one does matters. I think I know why, and I’ll discuss it in the final chapter.

This all sounds pretty bleak. Yet there is also a hopeful side, and this is where explanatory style becomes important.”