Why Am I Depressed?
While this question is simple and honest, it can also be extremely confusing and complicated. Be careful not to oversimplify it. To say that a car motor runs because there is gas in the tank and you turned the key would be a true statement. However, it doesn’t account for all the other factors necessary for the motor to run. Likewise, pinpointing the cause of your depression may be confusing because you are overlooking some of the contributing factors. You might identify a contributing factor that would result in sorrow but does not warrant the depth of depression you feel. If this is your experience, it is very likely that you are overlooking some deeper contributing factors. It is widely believed and taught that one’s social, physical, nutritional and sleep behaviors need to be assessed. Each of these four areas will be individually addressed in the respective “What Can I Do?” sections. Following are some thoughts about grief and loss you may want to consider when evaluating the cause of your depression.
Loss Related Depression
Elisabeth Kubler Ross (1926-2004) was a Swiss nurse. She worked extensively with dying individuals and their families (now called hospice) during WWII and throughout her life. From this work, she noticed and named fairly specific and predictable stages these individuals and their loved ones experienced in the dying process. Her theory was more fully developed throughout her career and is known today as grief and loss theory. The stages Ross identified are:
Denial – This can’t be happening to us. It’s not possible. Not me…
Anger – Why is this happening to me? How dare this happen! It isn’t fair.
Bargaining – This is some form of “deal striking,” usually with a higher power, to right the situation.
Depression – Depression occurs when one recognizes the reality of the situation and realizes nothing will change the circumstance.
Acceptance – When one comes to terms with, and is at peace regarding the loss of a loved one, the person has finally reached the acceptance stage.
Although Ross originally developed her theory about the stages of grieving through death-related loss, it has since been applied as a template for many types of loss which can contribute to depression:
1) Loss of hopes and dreams – A child born with a disorder who challenges the hopes of its parents, family members dealing with addiction who can’t see their own potential, or teenage parents who had to forfeit an education
2) Loss of significant relationships – Death, divorce, break up, a falling out, breaking a trust, or any form of abuse that violates a relationship
3) Loss of quality of life – Health restrictions that deprive one from recreational activity, a terminal illness that renders one housebound, or loss of social life because of caring for a loved one
4) Financial loss – Not getting an anticipated promotion, losing a job due to budget cuts, or losing a house during the recession
5) Loss of security and predictability – Moving so children have to attend a different school or a new boss making unwelcome changes
6) Loss of innocence or virtue – sexual abuse, rape, or sexual transgression
7) Loss of freedom – anything from being grounded to incarceration
Some simple examples illustrate how any of these losses can induce the stages Ross identified. These examples are not meant minimize the severity of your losses but are merely intended to illustrate how the stages play out.
My son was asked more than once not to leave his bicycle in the yard. The next morning, he could not believe it when I told him it had been stolen. He had to look for himself, but he still didn’t believe me. For the rest of the day he thought I was hiding it to teach him a lesson (Denial). When he finally realized the truth, he yelled and screamed about the stupid thief who had taken it (Anger). He then tried to get a new bicycle by promising to do jobs and chores or making a payment plan if I would buy him a new one (Bargaining). When he realized his efforts were in vain, he sadly withdrew to his room and was quiet for the next day or two (Depression). Only then was he finally able to accept that choosing not to put his bike away had resulted in it being stolen. Today it is something he can talk about with little emotion, recognizing the lesson learned (Acceptance).
A depressed client of mine suffered from the effects of a devastating affair her husband hid for over seven years. For a long time she suspected his infidelity, but she found ways to erase her fears. She could not believe her husband would do this to her (Denial).
He eventually took responsibility for his behavior and filed for divorce. She was upset and embarrassed that he would make their personal life public to others. She worried about what others would think (Anger).
She tried desperately to reconcile the marriage by offering all kinds of solutions to maintain the image she wanted to portray (Bargaining).
When this didn’t work, she entered the depression stage. She has been divorced for 2 years and still carries the fantasy of someday reuniting with her husband even though he is married to someone else. She expends her energy re-living the “what if’s” and thinking about what could have been. She focuses on the past, trying to create an unachievable future. In short, by not allowing herself to enter the acceptance stage, she remains stuck with her anger and depression.
It is important to understand that these stages are very normal and natural when experiencing any kind of loss. Although these stages are presented in a linear way, a person can bounce back and forth between these stages at any time. They are not a checklist.
Moving past anger does not mean a person won’t experience that stage again at some point. However, when a stage is revisited, it is typically with less emotion or an increased ability to cope with the emotion. One thing will ultimately determine how successfully a person moves through these stages of grief and loss.
The key lies in the acceptance stage! There is a direct correlation between depression and resistance to what is, or the inability to accept things as they are (see Healthy Living: “Saying Yes to What Is”). A person who is unable to accept loss will stay stuck in the whirlpool of anger and depression. Though one might recognize the reality of the loss, eliminating the stages of denial and bargaining (cognitive and behavioral factors), anger and depression (emotional factors) will continue without acceptance. Acceptance is the golden key to being depression free after a significant loss.
Taking advantage of the Empowered Life Solutions sections specific to Acceptance ( Anxiety – Working Within Your Situation) will be of great benefit in helping you overcome any type of loss-related depression.