June 2023

Is depression a mental health issue?

I have often been faced with the question when in discussion with depressed individuals as to whether they are mentally ill. I find this difficult to answer as even the expression mentally ill is, to me, loaded and presupposes a psychological state that is somehow false or wrong and one that needs to be cured. Often mental illness is defined by behaviour that somehow is at variance with a considered norm. People have be incarcerated or even worse – think of the witch burnings – when they present opinions and actions that don’t fit in with the rest of society. Are they ill or different?

There are of course, degrees of depression. When one looks at the world it is easy to be depressed or anxious about what we see. This is however understandable as a glance at the news will confirm. But what about a depression that does not have an apparent cause? A depression that comes from within and is somehow not capable of being understood. I believe that often this type of depression lies deeply buried in our unconscious. It makes its presence felt by worrying dreams, irrational thoughts and feelings. Something that is lost and cannot be mourned. To paraphrase Freud it is like a shadow falling across our consciousness.*

I believe that psychotherapy, especially longer term work (I know “he would say that wouldn’t he”) can enable people to bring deep seated buried and repressed fears into the safe container of a psychotherapy session where they can be recognised and be given a space.

*Try the original “Thus the shadow of the object fell upon the ego” (Mourning and Melancholia, 1917).