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Page 1 of 5 The Mechanisms That Make A Depressive
Why do some people stay "blue" and "down" for a long time after something bad happens to them, whereas others snap out of it quickly? Why do some people frequently fall into a blue funk whereas others suffer sad moods only infrequently?
Chapter 3 presented the general framework for the understanding of depression. Now this chapter proceeds to discuss why a particular person is more predisposed to depression than are other people who are closer to "normal".
Figure 3 presents an overview of the depression system. It shows the main elements that influence whether a person is sad or happy at a given moment, and whether one does or does not descend into the prolonged gloom of depression. Starting at the left, these numbered elements are as follows: 1) Experiences in childhood, both the general pattern of childhood as well as traumatic experiences, if any. 2) The person's adult history: the recent experiences have the greatest weight. 3) The actual conditions of the individual's present life--relationships with people as well as such objective factors as health, job, finances, and so on. 4) The person's habitual mental states, plus her view of the world and herself. This includes her goals, hopes, values, demands upon herself, and ideas about herself, including whether she is effective or ineffective and important or unimportant. 5) Physical influences such as whether she is tired or rested, and anti-depression drugs she is taking, if any. 6) The machinery of thought which processes the material coming in from the other elements and produces an evaluation of how the person stands with respect to the hypothetical situation taken for comparison. (7) A sense of helplessness.
Figure 3
The main lines of influence from one element-set to another are also shown in Figure 3. The question we ask is: how may a person, alone or with a counselor, alter these elements or their effects to produce fewer negative self-comparisons and a greater sense of competence--hence less sadness--and by that means pull the person out of depression?
Now we proceed in greater detail, considering the elements within these various element-sets and how they influence one another. Those who want still more details on the relationships between these various elements may wish to consult Appendix A, where all these specific ideas are linked graphically.
The Normal Person
A few definitions to start with: A "normal" person is someone who has never suffered from serious depression, and whom we have little reason to think will suffer serious depression in the future. A "depressed" person is someone now suffering from serious depression. A "depressive" is someone who is now depressed or in the past has suffered serious depression, and is subject to depression again unless it is prevented. A depressive who is not now depressed is like an alcoholic who does not now drink, that is, he is a person with a dangerous propensity that requires careful control.
A normal person has "realistic" expectations, goals, values, and beliefs that "normally" keep him feeling good. That is, the normal person's view of the world and himself interacts with his actual state in such a way that the comparisons he makes between actual and hypothetical are usually positive, on balance. Normal people may also have a higher tolerance for negative self- comparisons when they do occur, compared to depressives.
Bad fortune may befall the normal person--perhaps death in the family, injury, marriage breakdown, money problems, loss of job, or a disaster to the community. The person's actual situation then is worse than before, and the comparison between actual and benchmark-hypothetical becomes more negative than before. The unfortunate event must be understood and interpreted in the context of the person's entire life situation. The normal person eventually perceives and interprets the event without distorting it or misinterpreting it to make it seem more terrible or permanent than it really is. And the normal person may suffer less pain and "accept" the event more easily than the depressive.
What then happens? There are several possibilities including: a) Circumstances may change of themselves. Bad health may improve or the individual may purposely alter the circumstances--find a new job, or another spouse or friend. b) The person may "get used to" his health disability or being without the loved one. That is, the person's expectations may change. This affects the hypothetical situation to which he compares his actual situation. And after the expectations of the normal person change in response to the change in circumstances, the hypothetical-comparison state again comes into balance with the actual state in such fashion that the comparison is not negative, and sadness no longer occurs. c) The normal person's goals may change. A basketball player who aimed to make the college team may suffer a spinal injury and be confined to a wheelchair. A "healthy" person's reaction is, after a time, to shift his goal to being a star on the wheelchair basketball team. This restores the balance between the hypothetical state and the actual state, and removes sadness.
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