This 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, therapist in El Cerrito, California. 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.