"I am profoundly unhappy"-Medicalization of Sadness

emotional pain Rethinking Depression
by Eric Maisel
If we move from the “depression is a mental disorder” model to the idea that we must deal more effectively with the realities of sadness, we’ll take a giant step toward lives lived with renewed purpose.
Why is it that so many lottery winners, after a brief period of euphoria, become unhappier than they were before winning the lottery?
This happens because there is no lottery to win with regard to life. If you were an alcoholic before you won the lottery, you are still an alcoholic — albeit with a better-stocked liquor cabinet. If you were a cranky, critical, angry young man with a hefty sense of grandiosity and no willingness to do any real work, you are still that narcissist — probably even more so. Where is the change or improvement in any of that? This is what many lottery winners experience. If you weren’t living an authentic life before you won the lottery, an influx of money will provide you with the perfect opportunity to live just as inauthentically.
If you haven’t created yourself in your own best image, if you haven’t demanded of yourself that you strive to understand what matters to you, if you haven’t aligned your thoughts and behaviors with your intentions, an influx of money is just an opportunity to further refrain from stepping up to the plate.

So is a regimen of antidepressants. Even if you believe that there is a “mental disorder” called “depression” and that certain treatments work to minimize it or “cure” it, you must agree that you will not have cured life once you have cured your depression.
You might cure your depression and still not be able to conjure up a single reason to go to the office, your paycheck excepted, or a way to reconcile your mate’s protestations of loyalty with his affairs. Don’t your human challenges remain, even if you have cured your depression? And mustn’t you dream up solutions for them?
Human beings experience unhappiness. The typical person experiences unhappiness not only for all the usual reasons — that his teeth sometimes ache, that his job is relentlessly stressful, that his family life is no white-picket-fence heaven, and so on — but also because, as a modern person, he can’t maintain the illusion that his place in the universe is particularly exalted. His life produces unhappiness, and his understanding of his place in the universe produces its own poignant unhappiness.
The former he is taught to call “depression,” and the latter, if he knows the lingo, he calls “existential depression.” Society’s widespread willingness to believe that the “mental disorder of depression” exists produces a new set of expectations.
Medicalization of Sadness
People have come to believe that unhappiness is an aberration and that if they are experiencing it they have somehow “caught something” almost embarrassing to catch, like an STD. Who should be unhappy nowadays, what with malls and television? So, rather than admit that they are unhappy, they opt to treat their feelings like a disease. This enormously pleases Big Doctor, who welcomes each “depressive” with open arms.
Big Doctor and his ideas are everywhere, providing tremendous cover for inauthenticity. David Karp argues in Speaking of Sadness: “A necessary condition for widespread depressive illness is a culturally induced readiness to view emotional pain as a disease requiring medical intervention. The grounds for interpreting pain as an abnormal medical condition have been largely established through the increasing incursion of medical and other therapeutic experts into literally every aspect of our lives.”
This new belief that life shouldn’t hurt, a belief fostered by Big Doctor at every turn, is very strange. It is very strange that, having been sexually molested as a child, you should somehow believe that you will not experience that harm as hurtful, injurious, even ruinous.
Shame a child, scare a child, belittle a child, dismiss a child, lie to a child, and what do you imagine you will produce? Happiness? It is as if we have come to be surprised by our feelings of unhappiness, so surprised that we involuntarily exclaim, “Wow, something must be going on. This isn’t natural.”
Accepting Unhappiness
Nothing could be more natural. What sort of creature do we think we are? A kind of wishful thinking has washed over the developed world that life has become simple and settled. Aside from the occasional economic downturn, natural disaster and unfortunate “disorder,” modern life is like a good supermarket: abundant, orderly, unblemished and brought to you with a smile.
Your child would be as happy as a clam if only it weren’t for her pesky attention deficit disorder and childhood depression. Your mother would be a happy old lady if only she didn’t suffer from “nursing home syndrome” and “seasonal affective disorder.” If only we could shed the rough coat of this or that disorder, this new story goes, we would find ourselves wearing silk pajamas.
This is a false view of life. Life is a project. The moment they are born, people are dropped into a world that makes many demands and certain allowances. Either you equip yourself to deal with human unhappiness and the rigors of living, or you will find yourself dealing with them in ways that make you even unhappier.
Get-Happy Treatments
Chemicals have effects and they can alter a human being’s experience of life. That a chemical called an antidepressant can change your mood in no way constitutes proof that you have a mental disorder called depression. All that it proves is that chemicals can have an effect on mood. There is a fundamental difference between taking a drug because it is the appropriate treatment for a medical illness and taking a drug because it can have an effect. This core distinction is regularly obscured in the world of treating depression.
Psychotherapy, too, can help remediate sadness for the simple reason that talking about your problems can help reduce your experience of distress. Psychotherapy works, when it works, because the right kind of talk can help reduce a person’s experience of unhappiness.
To put it simply, chemicals have effects and you may want those effects. Talk can help and you may want that help. Antidepressants and psychotherapy can help not because they are the “treatment for the mental disorder of depression” but because chemical have effects and talk can help.
Creating Meaning
By taking the common human experience of unhappiness out of the shadows and acknowledging its existence, we begin to reduce its power. At first it is nothing but painful to say, “I am profoundly unhappy.” The words cut to the quick. They seem to come with a life sentence and allow no room for anything sweet or hopeful.
But the gloom can lift. It may lift of its own accord — or it may lift because you have a strong existential program in place whereby you pay more attention to your intentions than to your mood.
What is an existential program? It is people taking as much control as possible of their thoughts, their attitudes, their moods, their behaviors, and their very orientation toward life and turning their innate freedom into a virtue and a blessing.
Even if people decide to take antidepressants or engage in psychotherapy to get help with their unhappiness, they will still have to find ways of dealing with their meaning needs, the shadows of their personality, their consciousness of mortality and the facts of existence.
Living authentically means organizing your life around your answers to three fundamental questions. The first is, “What matters to you?” The second is, “Are your thoughts aligned with what matters to you?” The third is, “Are your behaviors aligned with what matters to you?”
You accept and embrace the fact that you are the final arbiter of your life’s meaning. With this approach to life, each day is a project requiring existential engineering skills as you bridge your way from one meaningful experience to the next. By accepting the realities of life and by asserting that you are the sole arbiter of the meaning in your life, you provide yourself sure footing as you actively make meaning.
If we can begin to move from the “depression is a mental disorder” model to the idea that human beings must deal more effectively with the realities of human existence, including the realities of sadness, despair and grief, we will have taken a giant step away from “medicalizing everything” and toward lives lived with renewed passion, power and purpose.
Eric Maisel, Ph.D., is a licensed psychotherapist and the author of  Rethinking Depression. Visit www.ericmaisel.com. Excerpted with permission by New World Library.



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