Experiences of Depression: Low Joy, Self-Medicating, and Purely Brain Chemistry

Family sitting around table talkingThis article is part of a series that explores the ways that specific “clusters” of depression symptoms manifest to create different experiences of depression. The previous article in this series discussed the irritable and angry experience.

I want to mention three more types of depression experiences in this series: the low joy, low satisfaction experience; the self-medicating experience; and the experience of depression caused purely by brain chemistry.

The Low Joy, Low Satisfaction Experience

People say things like, “Stop and smell the roses,” and “It’s the small joys that make life wonderful.” These are people who are blessed with an abundant capacity to feel joy. However, there are other people who just don’t have, I believe, the brain chemistry or the permission for this. People who don’t have the capacity for much joy have to plan the ultimate Saturday night, vacation, or weekend: filled with guaranteed pleasure after pleasure. This is what it takes for them to feel the same kind of joy or sense of satisfaction that others feel from simple things like a full stomach or watching a sunset.

Those without much capacity for joy know that one movie won’t do it. Two movies, an amazing dinner out, some chocolate, and sex might. To people around them, this is a great deal of pressure and demand. When people with low joy don’t get what they need to feel some pleasure or satisfaction, they are disappointed and depressed, and others can feel like they failed, or guilty for feeling good. Sometimes people with low joy are seen as negative or critical because of their inability to be satisfied. Without adequate brain chemistry, people can actually physiologically lack the ability to feel the emotion of satisfaction.

So imagine: if you cannot feel satisfied, how would that affect your life? You might not feel satisfied, no matter what you eat, so you are driven to eat more and more, trying to get that feeling of satisfaction we all expect from eating. You might not feel satisfied sexually, no matter how hard your partner tries to satisfy you, so you might need sex to last much longer and happen much more often than your partner needs. You might turn to addictive chemicals or activities to try to feel the pleasure and satisfaction you can’t find any other way.

When people ask you if you enjoyed a movie or a meal or an adventure, your response might honestly be, “Not really.” Your mind might turn to ways it could have been better, but then all you would have to say is criticism, and that’s not usually what people want to hear when they’ve enjoyed something. So the lack of ability to feel much joy and satisfaction can have very destructive and far-reaching effects for a person experiencing this.

The Self-Medicating Experience

This experience includes anyone who uses a substance or activity to boost their low mood, low pleasure, or low motivation. Sometimes self-medicating becomes an addiction and the benefit is outweighed by the negative consequences. People can use anything that positively boosts the availability of the “pleasure chemicals” in the brain, such as serotonin, dopamine, beta-endorphins, nor-epinephrine, and more. Of course, antidepressant medications do this without causing addiction, but people often try their own methods, using food, especially sugar and chocolate, alcohol, street drugs, prescription opiates, gambling, shopping, sex, falling in love, video games, Facebook, other internet activities, and many others.

Usually self-medicating works in the beginning, and may even obscure that fact that depression exists. Usually, though, self-medicating causes highs and lows. The lows stimulate the need to do more self-medicating, and over time, more and more of the favored self-medication is needed to create the same effect. As people self-medicate more and more, negative consequences pile up. They get into debt; damage their health; have affairs and damage relationships; disengage with the world to lose themselves in video games or internet activities; steal to maintain drug supply; or lose jobs.

The point is, self-medicating experiences of depression may look and feel like—and indeed be—addiction, but may have started as unrecognized depression that undoubtedly still lurks underneath the self-medicating methods or addictions. Underneath the self-medicating type is often low joy, or excessive pain types—or any of the other types, but it can be impossible to tell what’s going on under addiction until it’s no longer active. Then another type or types may emerge.

Purely Brain Chemistry

There are people who get depressed despite having had loving, responsive parents, or who have healed their emotional wounds. Most of the time they can feel powerful, joyful, self-accepting, energetic, and hopeful, but periodically episodes of depression strike for seemingly no reason from events in their lives or internal emotional conflicts. It just hits like the flu hits. This is probably a relatively small group, but it does seem to exist.

People with this kind of depression can often be helped with medication or electroconvulsive therapy (ECT), but psychotherapy has minimal effectiveness, because it’s not the person’s problems, childhood, traumas, or self that needs to be healed. It’s simply their brain. Well,  not “simple,” but not complicated so much by life as other experiences of depression are—that is, until the depression itself affects the person’s life by disabling them and creating problems in their lives.

Understanding Different Experiences of Depression

When people have several of these experiences of depression at the same time, they can be diagnosed with depression. When they only have one of these experiences, they may not meet the medical criteria for depression, but may still be suffering tremendously.

Most depression is treatable. If you recognize yourself in any of these experiences, find a good therapist to help you figure out where your experience of depression is coming from and what you need to get relief.

© Copyright 2011 by Cynthia W. Lubow, MS, MFT. All Rights Reserved. Permission to publish granted to GoodTherapy.org.

The preceding article was solely written by the author named above. Any views and opinions expressed are not necessarily shared by GoodTherapy.org. Questions or concerns about the preceding article can be directed to the author or posted as a comment below.

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  • benita

    November 8th, 2011 at 5:16 PM

    I read the description of the self medicater and I realize that this is me. I have been through food and credit cards, alcohol and even some drugs, always looking for those things that I think will make me feel better. It is not a pretty life and at various times in life I have had it all and lost it all.

  • AJ

    November 8th, 2011 at 11:39 PM

    I think there are combination types as well. I have constant low-level depression which I’m pretty sure is linked to low self-esteem, I used to self-medicate with alcohol (now I let meds do the work), and I still get occasional periods of intense depression that don’t seem to have a cause other than brain chemistry. I’m not sure I can tick only one box…

  • kendrick

    November 9th, 2011 at 1:03 PM

    the first type describes me pretty well and I dont really think it is a problem.maybe I have a milder form of it but I never see it as a problem.if it requires more of things to impress me or make me happy thats just my taste and not necessarily a prob.

  • Larson Grogan

    November 9th, 2011 at 2:44 PM

    This was a real eye opener for me because I thought that depression was just depression, you know? That there were no variations other I can get up out of bed or I can’t. Thanks for always providing such valuable information that helps someone like me who always wants to see things as either black or white come to the awareness that there can be shades of gray in life as well.

  • Jennifer

    September 20th, 2012 at 7:22 PM

    I have the a mixture of all of these types of depression, but really, for me it is the third one. I do have a personality disorder plus PTSD, but therapy has not helped me. My self-esteem is low. I heard voices and suffer from Schizoaffective disorder. I was diagnosed with Major Depression, severe. I recently OD’ed and almost died. I had ECT before the OD but it did not kick in immediately. I think it takes awhile. Now, I no longer have the weepy, crippling depression or the constant suicidal ideation. My meds are finally balanced and things look pretty good for once.

  • Cynthia Lubow, MFT

    September 20th, 2012 at 9:27 PM

    Jennifer–I’m so glad ECT and meds are working for you finally! Kendrick–I’m glad low joy doesn’t seem like a problem to you, because some people suffer from this tremendously. AJ–no reason to tick just one box–you can have any or every form of depression I describe. Benita–yes, I know what you mean. Addictions are an attempt to feel better, and they work to some extent, but over time they are like mafia–extracting super high interest rates for the pleasure they provide. Larson–you’re welcome–this is information I’ve collected from 30 years of working with depressed people, plus my own experiences with depression, plus what I’ve read. I’m glad you find it helpful!

  • Nina

    October 28th, 2017 at 10:49 PM

    What a load of rubbish, any medication causes changes in the Body and addiction results in the nidys attempt to retain an equilibrium. The psych meds are addictive not because they help but because they dustiot the body’s own equilibrium.

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