Depression:  A Different Perspective

I have recently come across an interesting paper:  How to Understand and then Escape from Depression.  It’s written by Saul Youssef, a professor of physics at Boston University.

The central theme of the paper is that persistent or chronic depression is caused by “…an unconscious withdrawal of participation in a person’s own internal decision making processes.”

Here are some quotes:

“I have been depressed for most of my life, and, at various times, I have tried most of the recommended treatments for depression. I have tried Saint John’s Wort, exercise, Yoga, talk therapy, SSRIs, thyroid supplements and Cognitive Behavioral Therapy. In my case, I would say that thyroid supplements, exercise and Yoga helped the most and all of them helped at least a little bit.  Unfortunately, none of these treatments helped dramatically. Then, however, in late 2013 and early 2014, I finally figured it out. I came to understand what was happening in my own head and why it was causing my own depression and I was able to figure out a way to escape. I don’t mean that I am now successfully managing my depression. I mean it’s gone. I am writing up what I think is going on and what I did to escape because I don’t think that my case is unusual. I think that exactly the same thing will work for many people.”

“A depressed person continues to live, but they do not continue to decide.”

“A depressed person is mainly on autopilot without realizing that they are mainly on autopilot. A depressed person will do what they always do, say what they always say, feel what they always feel and think what they always think.”

“If a depressed person actually has to do something, and they don’t decide anything, how do they do it? The answer is that they wait until an unconscious process forces them to do it. If a depressed person has to do their taxes, for instance, they will not decide at some moment to do their taxes. Instead, they will wait until the fear of the consequences of not doing their taxes forces them into doing their taxes. Depressed people will procrastinate about almost anything that they do not habitually do. The process of doing almost any necessary task is then necessarily emotional, stressful and unpleasant, because each necessity of life brings with it a rising tide of negative emotions, which only recede when the action is eventually forced.”

“It has often been observed that a depressed person will suffer from compulsive, selfdefeating negative thoughts and feelings…The major problem is that negative thoughts, beliefs and ‘depressogenic assumptions’ are, once again, only symptoms of the underlying problem.”

“I am not an expert on depression, but, after all, it is happening in my own head and who knows more about what’s happening in my own head than I do?”

Dr. Youssef goes on to describe some very simple techniques that helped him break the autopilot habit, take charge of his life, and resolve his long-standing depression.

Dr. Youssef’s concepts resonated with me for three reasons.  Firstly, in both my personal and professional endeavors, I have always emphasized the need to take charge of one’s life vs. drifting along with the tide.  Secondly, Dr. Youssef’s ideas are a form of self-help, and represent an excellent counterpoint to the inherently dependence-inducing medical model.  Thirdly, psychiatry often confuses cause and effect.  It is psychiatry’s position that extreme depression causes indecisiveness; Dr. Youssef’s contention is that extreme indecisiveness causes depression.

Anyway, please take a look.  It’s a simple program with no costs, adverse effects, or downsides.  I would be interested in any feedback.

  • cledwyn bulbs

    Whilst I wouldn’t reject this perspective in toto, I think it has extremely limited applicability. This might have worked for him; it hasn’t and won’t for a large percentage of miserable people. He seems to have fallen prey to the fallacy of particularism.

    It might help perhaps if there was an agreed upon typology of depression that reflected the true phenomenological and etiological diversity of this so-called unified phenomenon.

    I’m a bit uncomfortable with this voluntarist orientation as concerns the emotional pain or despondency that depression entails. This belief in the supremacy of the human will in relation to such feelings, and more specifically, that we can either rid ourselves of it through sheer willpower, or at least modulate its intensity, is eminently serviceable to the demands of a society that seeks to locate the source of human suffering within the sufferer himself, making him the focal figure of our attention, and obscuring the role of the proximal and distal origins of much temporary and chronic psychic pain, and thus the role of society and culture at large.

    The only all-encompassing explanation of depression is that people are depressed because they are born. Happiness, that is, as an abiding state of tranquility, bliss, and contentment, free from the lacerations of others and of our frustrated desires, appetites and longings, isn’t possible in this world. Whether you define it as a positive state or a negative one, that is, of intense pleasure or simply freedom from pain and misery, it matters not, it just isn’t possible outside of the alternation between pain and pleasure, over which the former always preponderates in intensity and duration, which is why life can be said to be valued well over its true worth by those who confer upon it the status of a gift, which it can only be said to be so insofar as it is a gift no-one in their right mind would want.

    I”m not buying into the idea that the writer has rid himself of depression.

    Truth is, there is no such thing as a human being who lives without misery and suffering, free from the pains and frustrations which regularly convulse us.

    You show me a man who is truly happy, and I’ll show you a corpse.

    So why do people claim they are happy?

    Well, this has manifold origins. For one, there’s just the thoughtless use of language, the parroting of cliches. Most of what people say, it would seem, is said thoughtlessly, without reflection.

    Yet one of the main reasons why people claim to be happy (when they are not), is because acknowledgement of our pain and vulnerability which, as I will show, are ineliminable features of the human condition (although both admit of degrees, obviously), and inalienably bound up with our daily existence; acknowledgement thereof is deemed within the current cultural framework to be a sign of weakness.

    One shouldn’t expose one’s soft underbelly in the company of wolves. People take great pains to project an image of themselves as invulnerable, as unassailably self-confident and fearless, as being of granite inner substance, but this is a big fat lie, told as much for our own benefit as others.

    People will play their little games.

    Of course, psychiatry has helped to usher in a climate inhospitable to the acknowledgement of misery. There is a cricketer in our country called Jonathan Trott who underwent an episode of severe depression and who denied that he was miserable, saying “I’m not a nut!”.

    Few people want to be designated mentally ill, to be assigned a position in the social order that degrades and demeans its occupant, and no-one wants to face the kind of social and moral exclusion often resulting therefrom. Basically, those of us so-labelled are a group of culturally and legally designated inferiors degraded as inferior beings. Any transient feelings of pleasure we experience in this miserable life are largely contingent upon how we define ourselves in relation to others, which is shaped and colored by the opinions others have of us, so that self-loathing, and a degree of emotional pain that falls outside of the norm, is inevitable for those a spoiled social identity, which is not to forget the many disadvantages membership in such a group puts you at socially, interpersonally and economically.

    As for why happiness is impossible, well, put simply, it is because the idea of a man free from the torments of others, and those of his frustrated desires and appetites, is absurd. Even if life could be said, for a few lucky individuals, to furnish the conditions conducive to happiness, nothing can alter the fundamentally unalterable limitations of our nature, our kaleidoscopic moods, and our inability to rest content with what we have got. Indeed, living under such conditions would simply lead to chronic boredom, itself leading to that taedium vitae in which a nostalgia for nothingness is ever-present.

    The problem is, the sources of emotional pain in life are so numerous that it exists almost as a constant reality.

    One source of pain is, of course, the pain people inflict upon each other, so that the following rule obtains; the larger one’s circle of acquaintances, and the more densely populated the circumambient environment wherein the individual resides, the more pain of this sort we are subjected to, leading often to withdrawal and a desire to escape the hell of other people, an escape which itself leads to more pain and suffering, confirming my conviction that any road embarked upon to escape therefrom, ultimately leads back to it (in life, all roads lead to misery and pain).

    As philosophers of pain point out, people inflict pain to escape their own, hence why men prey upon each like wolves.

    We can only take pleasure in ourselves by making others suffer or by defining ourselves as superior to them.

    This explains why men are so competitive; it is to escape the pain of being the loser. When we come off unfavorably, or feel we come off unfavorably, in our comparisons with others, a sense of our inferiority sets in which excites emotional pain and feelings of insignificance. In modern society, feelings of pain and suffering preponderate so greatly over those of tranquility and contentment because everywhere we go we are tormented by examples of our inferiority in some regards, be it when we leave our houses and go for a walk (assuming one lives in a densely populated area), or when we turn our televisions on, and are bombarded with images of people happier than us, more beautiful than us, fitter than us, richer than us, more admired than us etc. etc.

    Nevertheless, many claim they are happy, that they have attained to some sort of state Nirvana-like state of selflessness, of freedom from worry, frustration, desire, and pain. Such people are always found to be liars, with an avid contempt for the truth.

    The roots of a lot of the pain severely depressed experience extends back into their earliest years, I would surmise, and has burgeoned and blossomed into a chronic inability to take pleasure in oneself and the world, which would likely take a period of time to uproot commensurate with the duration over which, strengthened by dint of repetition, their negative habits of thought, feeling and behavior (and I’m not referring to bad behaviors here) have grown. And it would seem “anti-depressants” aren’t helping.

  • all too easy

    Becoming aware of our jealousy of others’ happiness can be a positive step to becoming free of it. Admitting to ourselves how such jealousy is painful could be another move in the right direction. Becoming sick and tired of our pain caused by jealousy, in part, is key on the road to our own happiness.

    Once we begin to take the focus off ourselves and onto the less fortunate, a feeling of happiness moves within us. Service to others indeed is profoundly rewarding just as the ancients proclaimed. Love, reaching out to others, helping our fellow man are the path to happiness that alluded us for so long.

    It is so simple, we couldn’t see it. We had sought the answers to life’s most perplexing dilemmas in scholarly works and at the bottom of a bottle or in an empty needle, even as all along that small still voice repeated the theme, love your neighbor.

    Remember, just as important, is our health. If our brains are sick, we may be unable to reach out to anyone, even when we hold the secret to living a meaningful, happy life. We cannot run a one hundred yard dash with an ankle void of working ligaments.

    “…in 2005, (Mike) Wallace made news of his own when he acknowledged his longtime war with depression – a fight that nearly caused him to take his own life.

    “I came perilously close to committing suicide,” Wallace wrote in his memoir “Between You and Me.”

    He described in dramatic detail how he was crushed by a devastating depression fueled by stress from a $120 million libel suit over a 1982 CBS documentary about the Vietnam War. The subsequent trial, he wrote, pushed him “more deeply into a dark and devastating malaise, which was crushing my spirit and even sapping my will to live.”

    “Prozac also has coaxed people out of the depression closet. Since there’s a medication that helps them by altering their brain chemistry, depressed people are more secure in the belief that what they have is an illness – not weak character.

    Hard-bitten types like Mike Wallace and Art Buchwald have told the world they’re on anti-depressants. This fall, 60 readers responded to a California newspaper’s request for stories from longtime Prozac users – and they didn’t mind having their names published in the newspaper.”

  • Saul Youssef

    Thank you for the blog entry Dr. Hickey. For those who are interested, there are some additional notes here

    http://egg.bu.edu/~youssef/SNAP_CLUB/20150330164151576.pdf

    including more of an explanation of how and why the particular features of depression follow from the proposed core problem, and depression’s one big trick that keeps people from understanding what’s happening to them. Only a few others have tried this so far, but almost all who have tried it see positive results and some see dramatic and rapid positive results ( http://egg.bu.edu/~youssef/SNAP_CLUB/ ).

    Best regards, – Saul Youssef

  • Rob Bishop

    I have no aspirations to become “happy”. My journey has been to reduce my suffering. If I had to put a number on it (100 being near suicide and 0 being total peace of mind), I’d say over the last 5 years I’ve been able to reduce my suffering from about 80 to 20 (without meds). It’s been a massive change. Over the decades I became very comfortable with my misery, and since so much of it is gone now, it’s sometimes a little difficult getting used to. Misery fuels the ego, and I almost feel a sense of loss for my former life of anguish. For twenty years I accepted the Disease Model I was taught. I believed my addiction, depression, and anxiety were defects, rooted in genes and “neurochemical imbalances”. Turns out, I am fine. My parents and university never taught me how to navigate the cognitive waters and deal with my thoughts and feelings, but I’ve learned how now.

    “Nevertheless, many claim they are happy, that they have attained to some sort of state Nirvana-like state of selflessness, of freedom from worry, frustration, desire, and pain. Such people are always found to be liars, with an avid contempt for the truth.”

    What evidence do you have for this claim? I’m fairly cynical and skeptical, but wow, that’s over the top. The ego loves misery and suffering (note how popular it is in our “entertainment” …the ego loves pain and anguish!) and this the primary roadblock to reducing suffering. The ego is the reason so many people scoff at the idea of experiencing peace of mind. The ego says, “That’s not true. It’s all BS. How stupid. They are faking being happy.” I’ve heard many people scoff at the idea of reducing misery. Our ego clings to misery like a possessive lover. Your comment below is an example of this.

    “I’m not buying into the idea that the writer has rid himself of depression.”

    Who are you to call him a liar?

    I’m interested in yours or others thoughts about this subject.

    Respectfully,

    Rob

  • Rob Bishop

    Your Mike Wallace remarks made me remember, there was once a billionaire who committed suicide by jumping off a building because he lost 20 million dollars in a business venture. The depression he experienced before he killed himself was not due to an illness, but due to the humiliation he felt, and his self hatred for making a poor decision, both rooted in a bruised ego. People who kill their spouse for cheating are motivated by revenge, which is, at it’s core, a similar issue.

  • Rob Bishop

    I enjoyed reading your paper. I like the concept of The Snap Club and will try this method. I use similar types of cognitive tools… some I create. For example, I have a small black pail on my desk that has a label that says, “The Negativity Bucket”. Like everyone, my thought stream contains many (mostly) negative thoughts, so when I get one, I flick it (with my thumb and index finger, like a kid flicks a booger) pantomime into the bucket. Doing this exercise snaps me out of my unconsciousness trance of thought. Of course they never all go away, but the awareness of my negative thoughts has a significant effect on reducing their frequency, intensity, and duration. It is a method to cut off the repetitive loop that often occurs with negative thoughts.

  • Saul Youssef

    Thanks Rob. I love that bucket idea! I think that the apparent silliness of your bucket or “Snap Club” is hiding something very powerful and important. For me, Snap Club was far more powerful for depression than anything else I tried, and I tried a lot of things including antidepressants.

  • cledwyn goodpuddings

    “It’s a simple program with no costs, adverse effects, or downsides.”

    “For every complex problem there is an answer that is clear, simple, and wrong.”

    H.L. Mencken

  • cledwyn “corpse in the making”

    I think monotony plays a huge part in the depression of which we all partake. Every day I go into Sainsbury’s and all I see is people seemingly suicidal with the crippling, soul-deadening monotony of their tragi-tedious, absurd lives. True, one often encounters some seeming aberration who by some dispensation of Fate and Nature seems genuinely happy, as unaffected by the grinding tedium and monotony of their existence as they are by the undulating patterns a man’s moods trace, and the torments of frustrated passion, appetite and desire; yet such people don’t fool me.

    You can almost see the life visibly ebbing away from such people, cascading out of every pore, carrying with it its silt of shattered illusions and destroyed hopes, their faces ravaged by the flow of time and the griefs, preoccupations, humiliations and disappointments borne on its currents, in the lines, lineaments and contours of which, this river, which nothing can arrest the flow of, deposits its alluvial sediment, betraying the despair, frustration, disillusionment, heartache and tedium that men, with a nod to the obligatory optimism of every age, endeavor to conceal; faces that in the trajectory they trace invite comparison with a body progressively devastated by metastatic disease, so that if one takes photographs of the human face at regular intervals and in correct chronological sequence, starting from youth, when illusions are in full bloom, it is a like succession of x-ray images so arranged to record the inexorable advance of a cancer, each successive photo detailing evidence of of a further spread, documenting some fresh stigmata of the disease of life.

    Variety is all important. Men should seek to live like the birds, flying from place to place, nourished by the novelty of the surroundings, which novelty excites a lively impression and appreciation of the few beauties a place may have to offer, then moving on to another before the effects of habit take hold.

    Yet, alas, this is a luxury few can afford, due to the obligations which anchors man firmly in the particular urban space whose few visible beauties repetition has dulled and within which the movement of his body and soul is circumscribed, and in routines from which he never derived any pleasure in the first place.

    So we must go on, and on, like Sisyphus, pushing the same sodding boulder up the same sodding hill in the same sodding Tartarus to which we have all been condemned.

  • cledwyn bulbs

    That should be “so arranged as to record…”

  • Saul Youssef

    Hi Phil, Rob, everyone;

    Check this out

    http://forums.psychcentral.com/4715237-post156.html

    – Saul

  • Rob Bishop

    That’s great Saul! Snapping helps to snap us out of the unconscious trance we easily fall into… the autopilot mode. It’s also helpful to snap when making a decision not to do something. Such as the decision to not buy a 12 pack of beer, or eat a pint of Ben and Jerry’s ice cream at 2:00AM.

  • Saul Youssef

    The amazing thing is that this seemingly superficial little trick was so powerful that it took someone from needing hospitalization to feeling fine in two days!

  • Saul Youssef

    Hi Rob, Phil,

    If the theory behind snap club is correct, then you would expect that areas of the brain used for decision making would be suppressed in depressed people. Guess what? There is an area of the brain called the dorsolateral prefrontal cortex which has been mainly associated with “executive function”, “intention formation”, “goal-directed action,” “attention control,” along with abstract reasoning and working memory. Sound familiar? And fMRIs, lesion studies and simulation studies all show that the dorsolateral prefrontal cortex is underactive in depressed people. In fact when depression or PTSD patients are treated with TMS (transcranial magnetic stimulation) and DBS (deep brain stimulation), the area that they are trying to stimulate is exactly the dorsolateral prefrontal cortex! This is exactly what would be expected if the theory behind snap club is actually correct. – Saul

  • Cledwyn’s Pus Poetry

    “I am not an expert on depression, but, after all, it is happening in my own head, and who knows more about what is happening in my head than I do?”

    Isn’t one of the most salient features of the human mind that we understand it far less than we think we do, that below the threshold of conscious awareness many forces are at play, insight whereinto is difficult owing to the limitations of our knowledge and the tendency of people to deceive themselves?

    The average person who is depressed – insofar as is understood by that someone apathetic to the point of abulia, which I stress because under the term “depression” a variety of qualitatively distinct states are subsumed that bear, for the most part, only a nominal similarity – would conceive of their problems differently. This being the case, couldn’t they easily appropriate the writer’s own language and retort that no-one knows their own head better than they do?

    The writer basically impoverishes his argument through the statement aforementioned, because if a man is the best judge of what is happening in his own head, then it necessarily follows from that that the individual who conceives of his problems otherwise must be correct also in his conception thereof, ergo invalidating the writer’s attempt to generalize from his own experience to others who struggle with the same problem but frame them differently.

    The writer is basically saying, “I’m the best judge of what goes on in my head, but not you in yours”.

    Another problem is, what came first? Sometimes people will withdraw from reality because the participation therein is what depresses them.

    Whence does a man derive this motivation to participate in things?

    For some people, reality is profoundly demotivating, for a number of reasons, one being the way they are treated and the messages conveyed to them, hence why it is so many kids do so poorly at school and bunk off.

    Another reason lies in our outlook on life, whose roots are to be found within the disposition of the individual, his personal history, and the education of the individual, all of which can conspire to bring uppermost in a man’s thoughts patterns of thinking that sap one’s vital energies.

    Some people frame our worldview as a matter of free-choice, and a degree of freedom may be conceded, but for the most part we are no more the masters of our inner world than we are our outer world, I would surmise.

    Nevertheless, it being impossible for any man to keep continually present in his mind the thought of himself as a marionette, we take refuge in the idea of autonomy, of anything that gives us an illusion of greater control over our lives than that which is actually exercised thereover.

    The way I see life is that we all have our boulders to push up life’s steep incline, yet the size differs from person to person. Up to a certain point, the increase thereof can be a good thing, in that in proportion as the resistance from life is great must a man exert himself, and in stretching our sinews – bodily and mental – we become stronger for it.

    Yet this is only up to a certain point, beyond which life stretches a man’s sinews to such a degree that they easily give away, whereupon he buckles under the weight of his burden. A lot of people understand this when it comes down to some of the proximal and distal environmental forces that oppress us and sap our motivation, but remain ignorant of many of these owing to the limitations of our knowledge. They also remain ignorant of the ways in which dispositional factors might variegate our lot.

    Yet, outside of the intervals separating the successive spasms of the human heart, and in the lucid fatigue that follows upon one of our spells of megalomania or our fevers of fanaticism, these epistemological limitations whereof I spoke and that circumscribe our understanding of ourselves, of others, and the world, are lost all sight of; we often speak or act as if we were the god-like narrators on human existence, thundering forth opinions thereupon and almost everything that pertains to it with a grandiosely delusional sense of our own worth and power, the extent of our knowledge and insight, fulminating fanatically at all who disagree with us from the Olympian perches to which our madness and our lust for certainty conveys us, and from which imaginary vantage point the eye can survey all.

    This can be seen amongst those who judge others for their depression, as if they were privy to all the facts pertaining thereto, a delusion that grips a man all the more when we wish to judge him. An example of this is where men make comparisons between people in order to attack the man who seems to have buckled all too easily under stressors whereover the other triumphed, which, accepting the fact that sometimes our choices are to blame – though people often make bad choices that seemed good at the time and without the foreknowledge to know that they would turn out to be bad -, makes no allowance for the likelihood that the similarity is really a figment.

    Another reason for the lack of motivation amongst some to participate in reality is, of course, because of the psychiatric drugs some take, experience whereof has pressed it home to me just how profoundly demotivating they are, for they create a fatigue that, whilst productive of insight into the utter nullity of things, drains your resources of energy and enthusiasm.

  • Cledwyn’s Pus Poetry

    Anyway, why should people want to participate in life? Many of the world’s great thinkers and religions frame life as an epic nullity, and history as a lunatic procession of events, a fanatic’s orgy, and as if proceeding under a malign providence.

    Life really isn’t worth the activity we expend upon it. Your parents wrap up life in all this pretty packaging – as if it were a present – but when you tear it off, what are you left with? A big turd…. a gang rape, of which your arse is the unfortunate recipient… a big free for all.

    Life can feel good for a time, until one day – amidst the shattered remains of the illusions you once cherished, face down in a pool of your own drool, spreadeagled and taking an anal pounding, cluster-fucked by fate, fortune, man and circumstance alike – the realization dawns upon you that you’ve been duped; for life only raises us to the altitudes of bliss and content only to bring us crashing back down to the gutter, in bathetic descent.

  • Hankie

    According to Mr. Ego himself. Take whatever this narcissist gushes on and on about, the vile stream of vomit, from which his seemingly endless tails of horror and mistreatment by others flows eternally from the vast pit of unceasing self-pity upon which he lives to whine ceaselessly concerning the plethora of painful experiences to which he’s been subjected by the hordes of cruel enemies who have singled him out because of his despicable appearance and loathsome personality, with a grain of salt. Until he steps down from his lofty tower of self-worship, he has nothing useful to add.

  • Saul Youssef

    Greeting Phil. I’ve started a campaign to ramp up the use of this idea for depression. There are new materials here

    http://egg.bu.edu/SNAP_CLUB

    A facebook group http://facebook.com/mysnapclub

    I hope all’s well with you.

    Best regards, – Saul

  • Rob

    Hi Saul! There’s a strong relationship between despair and depression. Hopelessness (a common disturbed state) is often associated with a belief one can’t reduce their distress (and sometimes an unwillingness to examine the cause of their despair). Have you explored the ideas of Karen Horney and her views on the development of anxiety and depression? I’m fascinated that we are able to identify the deep roots of our neurosis. I’m also interest in the subject of, “Learned Helplessness”, a condition in which a person suffers from a sense of powerlessness.

  • Saul Youssef

    Hi Rob. Thanks for the comments! I don’t know Karen Horney’s views, but I’ll look her up. Learned helplessness is one of the oldest ideas about depression and IMHO it’s a pretty good idea. I think that there has been some confusion thinking why should a person with childhood trauma (say losing a parent) suddenly develop learned helplessness at age 40. Of course the medical interpretation increases the confusion a huge amount. I think I understand this now: Why it takes all those years and how it progresses over time. I think that the best way is to think of it as a two component process as explained in the notes where “unconscious withdrawal” is the thing that grows over time and eventually becomes the full blown thing called clinical depression. – Saul