Shirah Vollmer MD

The Musings of Dr. Vollmer

Depression or Misery?

Posted by Dr. Vollmer on November 26, 2014

“Depression as a feature of mental illness is the misery of childhood translated into the present….” Charles Brenner MD

 

As we enter into the Thanksgiving holiday and remind ourselves of what we are grateful for, I am also reminded that relieving human suffering is the goal of my work as a clinician, and my work as a teacher. As such, understanding suffering is critical to a meaningful intervention. Children who suffer in childhood are likely to suffer as adults because those are the limited tools they are given to cope with a challenging and uncertain world. This understanding has multiple layers. One obvious layer is that we, as a society, need to do what we can to make sure that childhoods are supported by a rich infrastructure of nuturance, through schools, community clubs and religious organizations. Second, those who did suffer greatly as children, who grow to adulthood, need intensive intervention and understanding to create a new, more optimistic schema of their world. Third, mental health practitioners need to understand the connection from past to present in order to help the depressed adult. One cannot just look at the here and now, without thinking about what this current suffering hearkens back to.

Robyn, fifty-five, male, comes to mind. He dreads the Thanksgiving Holiday and so this time of year he retreats into his apartment and does not go out much, except for work. “What was Thanksgiving like as a kid?” I ask, trying to tie past with present. “Oh, I hated it. My family would get together and they would be mean to each other. My mother would tell my father that he was lazy and did not do any of the work. My brother and sister would fight, leading my brother to make holes in the wall, as that is how he discharged his anger. My mother would then praise my brother for hitting the wall and not a person. The more I think about those days, the more sad I am about the family I grew up in,” Robyn says, with deep feelings which make me feel both sad and interested in his past. “Do you think those memories have carried forward such that you are re-living them every year around this time?” I ask, wondering if he sees the connection between past and present. “Actually, I did not think about that, but as you say it, it sounds so obvious,” Robyn says with obvious excitement over this understanding. “Maybe you can layer over those memories by creating happy times for yourself around the holidays. Maybe you need to make an extra effort to do that, as a way of pushing down further the memories of your Thanksgiving table.” I say, not encouraging repression of memories, but layering over them, consciously, with times which create very different associations to the holiday. “Maybe you need to ask your friends for an invitation, so you won’t be alone?” I say, encouraging him to reach out to those who care about him. “Yes, of course that is what I should do, but I need to think about it, as I am afraid I will be a downer.” “Maybe if you are around people you care about, your mood will lift and people will enjoy your company,” I say, pushing him to interact over this sensitive time of year. “Maybe,” Robyn says, with extreme hesitation.

4 Responses to “Depression or Misery?”

  1. Jon said

    Your advice to Robyn seems quite good to me. One can (and should) examine one’s life to understand how that person got to where they are. However, the real question is, “Now that I know where I am, what do I do to make me happy and fulfilled?” For fictional Robyn (as for most of us), being around caring people (especially around a supposed time of celebration) cannot be a bad thing.

    • Yes, indeed, being around caring people cannot be a bad thing, but the complicated issue arises as holidays usually come with mixes of caring and non-caring people and so navigating those waters can be very challenging, even in the best of moods. Thanks.

  2. Shelly said

    It almost seems that in this post we go back to blaming the parents for the offspring’s depression. Not everyone who is depressed had a dysfunctional childhood. Not everyone who had a catastrophic life event (death in the family, lost their job, life-threatening illness) and fell into depression had trauma in young adulthood. If depression is the misery of childhood translated into the present, then what is mania?

    • Misery in childhood is not necessarily the fault of the parents, but childhood misery can carry into adulthood. Yes, indeed there are no simple formulas for happiness or unhappiness. Mania, is a lot of different things, but generally speaking it is a dis-inhibited state where the superego goes on vacation, and behavior is uncensored and unmonitored. Thanks.

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