Depression: Hopelessness and Self-loathing

Depression can be a disabling disorder that feels like a deep, dark hole from which there is no escape. Clinical depression is more than feeling "down" or "blue," which all of us experience at times. Rather, a clinically depressed person exhibits or experiences a variety of emotional, cognitive, physical, and behavioral symptoms such as sadness, tearfulness, fatigue, poor concentration, insomnia, over-sleeping, loss of appetite, over-eating, loss of interest in things previously enjoyed, irritability, anger, agitation, lethargy, suicidal thoughts, or feelings of guilt, hopelessness, or worthlessness for more than just a few days.

Depression is not difficult to diagnose, but determining the causes of depression can be tricky. Is it purely genetic or biochemical? Is it purely situational or reactive? Or is it a combination of genetic and situational factors?

Treatment may involve antidepressant medications, counseling, or both. A variety of antidepressant medications work to correct a chemical imbalance in the brain that affects mood. The chemical imbalance may have been caused by genetics, a medical illness that affects brain chemistry, head trauma, substance abuse, or chronic exposure to a depressing environment (such as growing up in an abusive household, living in an abusive marriage, or experiencing a succession of overwhelming losses), or any combination of the above. Antidepressant medications usually give some relief within a month, but the process may involve a trial-and-error period until your doctor determines the right medication and dosage.

Counseling for depression focuses on educating the client about depression and treatment options, facilitating grieving unresolved losses, healing past emotional traumas, correcting mistaken beliefs about self, others, and life, changing unhelpful patterns of thinking, and teaching coping and self-care skills. Interestingly, research has shown that successful counseling can help correct chemical imbalances in the brain much as antidepressant medications do, only more gradually.

Certain patterns of thinking seem to fuel depression. These patterns are often a reaction to chronic situational circumstances such as growing up in an alcoholic, abusive, or highly dysfunctional family environment or being in an abusive relationship. The most common patterns of thinking that fuel depression are hopelessness and self-loathing.

Hopelessness is a pattern of thinking where individuals believe they are trapped in misery with no expectation of things ever getting better.

Self-loathing is a pattern of thinking where individuals believe they are bad, worthless, evil, unsuccessful, unlovable, and/or incompetent.

Both patterns of thinking are common reactions to childhood abuse, trauma, neglect, or overwhelming loss where no substantial adult support was available to help these children deal with their painful situations. Thus, these children are forced to cope alone, as best as their immature minds can, sometimes with disastrous results, such as relying on drugs, alcohol, gangs, crime, promiscuous sex, and other self-destructive behaviors. Very often these children grow into adults who do not know how to take care of themselves emotionally, physically, spiritually, or in relationships. Thus, these patterns of thinking emerge as a reaction to the original pain (the childhood trauma or dysfunction) and then persevere into adulthood when these individuals struggle, often unsuccessfully, to find their places in relationships and in the world.

Interestingly, research has shown that individuals diagnosed with depression do not always exhibit these destructive patterns of thinking (that is, hopelessness and self-loathing). In fact, when persons who have a history of depression are not particularly depressed, their patterns of thinking are not significantly different from persons who have never been clinically depressed. So how can we explain this?

These destructive patterns of thinking seem to be connected to a "switch" in the mind of a person who struggles with depression. Certain "triggers" seem to "trip" the switch, causing a flood of hopeless and self-loathing thoughts, which then ignites the embers of depression into full-fledged flames. Triggers can be anything that trips the switch, such as being criticized, having an argument with a spouse, losing a job, flunking a test, making a mistake, becoming ill, being denied a promotion, feeling rejected, raising a difficult child, having a bad day, experiencing a loss or disappointment, having a financial setback, and so on.

When the switch is triggered, it's as if "audio tapes" in a depressed person's mind begin to blare, overwhelming the person with "stinking thinking" such as "I am a failure," "I can't do anything right," "No one could ever really love me," "Things will never get better," "I don't deserve to be here," "I'm bad," "I will always be alone," "No one cares about me," "I can't trust anyone," and so on until the person's own thinking pounds him or her into a deep, dark, depressive hole.

Learning to be aware of when this switch has been tripped and then learning how to reset the switch are valuable skills in managing depression. These skills can be learned in counseling.