StayOnTop: Depression

Some months ago I promised a post about shame. Why? When talking about depression, shame is often recognized as something important, but it is not always well understood. Many professional therapists will tell you one thing first of all: “One of the symptoms of a really deep depression is that the patient in her bleak indifference is no longer inhibited by any feelings of shame.” And indeed it is true that in some instances of severe depression, you won’t care about anything anymore (or you won’t have the energy to do anything) – which means you may allow things to happen that you would normally be ashamed for.

    I once spent some time in the psychiatry ward of a hospital that was clearly understaffed – meaning that the few staff members always were busy and in a hurry. One day I found a very depressed patient sitting on the floor of a passageway: crouched against the wall, her head down, motionless. Like all others, I just walked around her. Ten minutes later I passed her again: she was still sitting at the same spot, crouched on the floor tiles, petrified. But this time I noticed something with her jeans: it looked like she had wet her pants.

    If you are curious to know what happened next, I still feel a bit… yes, ashamed. Ashamed because I did not have the courage to say something directly to her. I guess this was partly because I did not feel very well myself, and partly because I was not at all sure how she would react to me. But it was also because I could already imagine the shame and humiliation that she herself might feel when I would make her aware of what had happened. So instead I walked straight to the staff desk and told them that out there someone needed help.

    As illustrated by the wet pants of this sad woman-in-the-corridor, a deep depression can indeed make you forget (or ignore) your normal feelings of shame. But it is not just as simple as this. Depression does not nullify shame, but will only postpone it. As soon as you return to a slightly less depressed state-of-mind and you begin to realize what happened, your feelings of shame may get back to you with double force. Deeply-felt shame may even cause your depression to become worse again. The most extreme example I can think of for myself right now, is the horrible flood of shame-and-guilt-and-failure feelings that can knock you off your feet while recovering from a botched suicide attempt. But that particular situation is of course exceptional and really complicated; perhaps I will try to tell a little more about that some other time.

    For now, maybe it’s best to start with a closer look at what we mean with the simple word “shame”. And since “shame” seems to be pictured better in Japanese manga than in European or American cartoons, I’ve borrowed some manga illustrations here:

Usually, shame is not just one single clearly defined feeling. It is more like a complicated brew, the outcome of a recipe based on several negative feelings and conditions. Here are some of the most frequent ingredients for brewing a “shame” mix:

    • feelings of inadequacy,
    • feelings of guilt,
    • feelings of remorse,
    • feelings of embarrassment,
    • feelings of humiliation.

What do all such shame-components have in common? Well, in one way or another, each one of them has something to do with falling short: with not fulfilling expectations.

    Sometimes shame is a very social emotion: then it is about not fulfilling the expectations of the people around us. This is the kind of shame we may feel towards others. For example when we get an angry call because we forgot an important appointment. Or when someone exposes us as a liar in front of everyone. Or long ago when as a child on our very first day in a new school we somehow felt to be not properly dressed, different from the rest. I assume that anyone can fill in some well-remembered moments of shame here.

    But shame is not necessarily a social thing. It can also be a more personal, individual emotion: then it is about not fulfilling your own expectations of yourself. This is more the kind of shame we may feel towards ourself. Like when a few days after deciding to stop smoking, we cave in and buy cigarettes again. Or when at the last moment we don’t muster the courage to go to some party, staying home alone for a miserable evening instead. Again, I guess anyone can fill in his or her own examples here.

    In daily life, moments of shame are often a mixture of both social and individual elements. Take the quit-smoking example: if I had proudly announced to all my friends that this time I really and definitively stopped smoking, and the next day a friend catches me with a cigarette, then my shame will probably feel like I failed to meet both his expectations, and my own.

    Normally, feeling ashamed is an emotion that can actually serve a purpose. In some situations, experiencing acute shame can really strengthen your resolve to do things better (or at least in a different way) next time. Feeling a little shame can also serve as a gentle reminder that at least, you are still clinging to specific norms and values: for otherwise, like the unhappy manga girl below, you wouldn’t feel any shame.

    Unfortunately in the context of a depression, emotions of shame do not serve some useful purpose. On the contrary: when you already feel depressed, shame can intensify your feelings of utter worthlessness and total failure. And things may get even worse – much, much worse – when you start feeling ashamed for being depressed.

    A <snip> here. For while typing this, I see this post is growing too long and maybe also too dull. I want to tell much more about the special connections between shame and depression, because I really feel that in several ways they have to do with each other. But I will save that for another time. Just one more thing now.

    Whatever it is you feel ashamed for, shame nearly always is about something you cannot undo. Most times it is about something you did or said or looked-like recently. A day, an hour, a minute ago. Your shame tells you not only that you just did something wrong, but it also tells you that this cannot be undone. Because if that had been possible, then you would of course have undone your failure right away, and you would not need to feel ashamed now. But you cannot unsay your stupid gaffe; you cannot un-enter the party in your wrong dress; you cannot unforget that vital appointment. Shame may help you to do things better in the future, a next time, but the feeling of shame itself is often about something that happened – irrevocably. This is what I call the Finality of Shame.

    And whenever depression lurks around the corner, it is this “finality” that makes shame a dangerous emotion right from the start. <snip> <snip> <snip> OK, I promise, more about this another time.

• tip: If you are on the brink of depression and your mood gets tinged with feelings of shame for your own inadequacy, try not to mull over what other people may think of you. Also try to forget (if only for a second) how dissatisfied you are with yourself.
    The best way to accomplish this, is to take up something rewarding, something you know from experience you can do efficiently and well, something you can do right now – whether it is baking an apple pie, downloading MP3 songs, playing chess with your son, writing a limerick, solving a crossword puzzle, or trimming the hedge.

 
Author: Henk van Setten