PhD student Cecily Whiteley and philosophy prof Jonathan Birch, both of the London School of Economics and Political Science, think that depression is often misunderstood. In this 2021 article, noted again at Psyche, they point out that it is not just “feeling low”; it is an altered form of consciousness:
The psychologist Andrew Solomon hints at some of these transformations in his memoir The Noonday Demon (2001): “When you are depressed, the past and future are absorbed entirely by the present moment, as in the world of a three-year-old. You cannot remember a time when you felt better, at least not clearly; and you certainly cannot imagine a future time when you will feel better. Being upset, even profoundly upset, is a temporal experience, while depression is atemporal. Breakdowns leave you with no point of view.”Cecily Whiteley, Jonathan Birch, “Depression is more than low mood – it’s a change of consciousness” at Psyche (November 8, 2021)
A term to describe such an experience that is gaining ground in neuroscience is global state of consciousness, which they describe as “the structural properties of experience that varies between ordinary wakefulness, dreaming, the psychedelic state and the minimally conscious state.” Depression, they argue is like that; the whole conscious experience is altered, not just one state.
Commenting on the current experimental use of psychedelics to treat depression, they note,
The idea is that psychedelics might work to reset or reboot a patient’s global state of consciousness. On this hypothesis, being depressed is like being stuck in a dream from which you cannot wake. Psychedelics are the jolt that finally wakes you up. As [journalist Sally] Brampton wrote in her memoir Shoot the Damn Dog (2008): ‘It is like living through a waking nightmare. What we most want is somebody to take our hand, to try to connect us back to the world.’Cecily Whiteley, Jonathan Birch, “Depression is more than low mood – it’s a change of consciousness” at Psyche (November 8, 2021)
At any rate, they hope that seeing depression that way will help sufferers make more sense of their experience in a world where those who don’t suffer from depression think that the depressed should just “look on the bright side” or “snap out of it.” As Andrew Solomon writes in The Noonday Demon, “Being upset, even profoundly upset, is a temporal experience, while depression is atemporal. Breakdowns leave you with no point of view.”
The causes of serious depression — which is said to affect approximately 17.6 million Americans each year — are many and varied (abuse, age, medication, loss, conflict, serious illness, possible genetic factors, and substance misuse.) Women are roughly twice as likely to suffer depression than men and “Nearly 30% of people with substance misuse problems also have major or clinical depression.” (WebMD) The fact that there is no one easily identified cause or small, specific group of sufferers would be consistent with depression as a global state of consciousness in which a broad variety of people may find themselves.
There are neural correlates (brain states associated with) of depression:
Depression is generally treated by antidepressants and psychotherapy, sometimes by electroconvulsive therapy (ECT or shock treatment) or transcranial magnetic stimulation (TMS). Helping a depressed friend regain a more connected state of consciousness can be a challenge:
Depression may cause a person to push away the friends that are trying to be supportive. Again, this is most likely the depression talking and not the friend’s actual feelings. Caroline Leaf, a clinical psychologist explains, “People can be difficult when they are depressed, but we should not take this personally, which often happens when one friend is depressed and tends to lash out at the other friend. This person may not be aware that what they are doing is wrong, or what is going on inside them, or they may not even care,” she says. “Or they may even be asking for help, but in a really roundabout and confusing way.”Randi Mazzella, “Friendship and Depression: How to Support a Friend Who’s in Emotional Pain” at Psy.com (October 17, 2022)
But it’s worth a best shot, of course, because serious depression, unattended, can lead to suicide:
New data on depression that has followed people over long periods of time suggests that about 2 percent of those people ever treated for depression in an outpatient setting will die by suicide. Among those ever treated for depression in an inpatient hospital setting, the rate of death by suicide is twice as high (4 percent). Those treated for depression as inpatients following suicide ideation or suicide attempts are about three times as likely to die by suicide (6 percent) as those who were only treated as outpatients. There are also dramatic gender differences in lifetime risk of suicide in depression. Whereas about 7 percent of men with a lifetime history of depression will die by suicide, only 1 percent of women with a lifetime history of depression will die by suicide.”Does depression increase the risk for suicide?” at Health and Human Services (September 16, 2014)
Anyway, seeing serious depression as not just a mood but a state of consciousness — one that no one wants to be in — may help us treat it with the seriousness it deserves.