I am working with a patient who claims to be severely depressed. Yet he exhibits no vegetative changes: no change in appetite, sleep, or energy level. He does not have crying spells. When he is interviewed, he laughs, and smirks, and is otherwise upbeat. He does not express any sense of hopelessness, helplessness or loss of self worth. He is not forgetful, not confused, or otherwise does not have thought or memory problems.
He is, however, very dissatisfied with his current circumstances in life. He is hoping to get something that he will probably not get. And he is angry about that.
I had the thought, the last time I interviewed him, that he was not depressed. That he was disappointed, angry, unhappy, but not depressed.
I won a book: Finding My Way by John Schneider, http://www.survivorresources.org/?page_id=70 about grief and loss, a few weeks ago as a door prize at a seminar. I have it at work, and I am slowly reading it as I have a few minutes, here and there.
It starts with talking about the medicalization of grief and loss, but that these are natural emotions and feeling that have to be experienced, not avoided, that have to be gotten through. The premise is that medication provides avoidance, delay, but not resolve. I believe this wholeheartedly, and I try to teach it to my patients. It is normal, usual and typical to feel bad about bad things. That we cannot and should not medicate away bad feelings when we are experiencing bad things. That we need to go through the experience and get beyond it. That the bad feeling will be always with us, but will not always be debilitating, and we will move on to a new place in life where we accept that loss and we live on.
It is interesting to me that the confluence of these two experiences and ideas are so close in my life. These are not new ideas to me, but they are being re-enforced at this time. Hmmm.
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