Shirah Vollmer MD

The Musings of Dr. Vollmer

Archive for December 11th, 2013

Depression as a Whole in the “Self”

Posted by Dr. Vollmer on December 11, 2013

I struggle with this concept of depression, as I struggle to define it, to treat it, and to clump it into a category, as it means such different things to different people. As per my last post, there is no certainty in “knowing”. A disease versus a symptom, a subject of a previous post, puts me in the symptom camp, where depression is a state of mind, indicating deeper issues and conflicts. As a symptom, it is a window into a deficiency of one’s identity and hope for oneself.

Gaby, fifty-one, jumps to mind. Her daughter, Sari did not get into her first choice law school, throwing Gaby into a mental state of despair. Gaby was angry at her estimation of injustice, and she was sad that Sari had to cope with disappointment, given how hard Sari has worked her entire life. “Yes, but this rejection has gotten to you in such a deep way. I would like to understand that better,” I say, hoping to clarify why this rejection letter has sent Gaby into a very dark place. “Sari deserves better,” she insists, with a tone of bitterness, making me wonder if Gaby had disappointments in her life, which this letter has now triggered. “When I was her age, I did not get the job I wanted, even though I deserved it, and I do not think I have gotten past that,”

Gaby spontaneously reads my mind, as she brings up her previous disappointments. “So Sari’s news is bringing up a very sensitive, and raw part of your past,” I say, thinking, once again, how the past lives in the present. “The fact that you did not get the job promotion seems to have been your symbol of unfairness, and it seems like you have focused on that event as the pivotal experience which caused you to be less successful than you imagined you would be and now you project that experience on to Sari’s future.” I say, outlining how Gaby has organized her life around not getting this promotion, such that experiences which smell of unfairness, brings her back to this bitter and angry place. “Yes, I know Sari will have her own experience and I also know that getting passed over for a promotion did not define my entire professional life, but it did feel to me, at the time, that I was very limited in my career and I felt painfully stuck and angry.” Gaby says, with frankness, and understandable frustration. “I could not move for a better job because I had a family. My kids were in school and my husband liked his job.” She says, anticipating my question that she could have searched for a new job by casting a wider net. “Accepting that limitation has been very hard for you, ” I say, thinking about her necessary journey of acceptance and self-love. “Yes, indeed. I guess I am not over it,” she says, as she looks at me with a sense of knowing that she has work to do.

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