Rethinking Depression: How to Shed Mental Health Labels and Create Personal Meaning

More Praise for Rethinking Depression

This book helps us to understand how and why sadness and suffering have been transformed into a medical or psychological disorder called ‘depression,’ and why that transformation has left us all ‘sicker and weaker’ than we might otherwise be. The suggested remedy to our modern alienation, the injunction to abandon the search for happiness and to live according to our principles, stands as a challenge and an inspiration to us all. I would recommend this book to sufferers and professionals and anyone who is interested in a deeper understanding of mental health issues.

— Joanna Moncrieff, author of The Myth of the Chemical Cure and senior lecturer in social and community psychiatry,

University College London

The world is shrinking and the American model of mental illness is being sold globally. Soon there will be billions of ‘depressed people’ worldwide taking antidepressants to medicate away their unhappiness. Eric Maisel’s brilliant new book explains this phenomenon with awesome clarity and simplicity and goes the next step by proposing what people can do to sidestep mental health labeling and create their own sensible program for healthy living.

— Nancy Pine, author of Educating Young Giants

From Reviews of Eric Maisel’s Previous Books

Eric Maisel’s psychological approach sets his work apart.

— Library Journal

Eric Maisel has made a career out of helping artists cope with the traumas and troubles that are the price of admission to a creative life.

— Intuition magazine

Eric Maisel’s books should be required reading for anyone involved in the arts, especially students and their teachers. Maisel demystifies the process of creating art.

— Theatre Design and Technology Journal

Maisel is a meticulous guide who knows the psychological landscape that artists inhabit.

— The Writer magazine

Praise for Brainstorm by Eric Maisel and Ann Maisel

Presents a new way of thinking about how to turn brain potential into passion, energy, and genuine accomplishments.

— Camille Minichino, physicist and author of the

Periodic Table Mysteries

All too often people overlook the basics of a productive life, distracted by multitasking, marketing, and information overload. With this provocative departure from the usual lifestyle manual, the Maisels are out to break us of those tendencies.

— Publishers Weekly

"[Brainstorm] is a book that should be read by all who want to live their life in a way that is vital and leaves some kind of legacy. It’s not about fame and fortune, but rather, about ensuring that this brief span that we have on Earth is one that has value — where we leave some kind of impression. There’s nothing that matters more."

— Seattle Post-Intelligencer

RETHINKING

DEPRESSION

ALSO BY ERIC MAISEL

NONFICTION

Affirmations for Artists

The Art of the Book Proposal

The Atheist’s Way

Become a Creativity Coach Now!

Brainstorm

Coaching the Artist Within

Creative Recovery

The Creativity Book

Creativity for Life

Deep Writing

Everyday You

Fearless Creating

A Life in the Arts

Living the Writer’s Life

Mastering Creative Anxiety

Performance Anxiety

The Power of Sleep Thinking

Sleep Thinking

Ten Zen Seconds

Toxic Criticism

20 Communication Tips at Work

20 Communication Tips for Families

The Van Gogh Blues

What Would Your Character Do?

Write Mind

A Writer’s Paris

A Writer’s San Francisco

A Writer’s Space

Your Best Life in the Arts

FICTION

Aster Lynn

The Blackbirds of Mulhouse

The Black Narc

Dismay

The Fretful Dancer

The Kingston Papers

Murder in Berlin

JOURNALS

Artists Speak

Writers and Artists on Devotion

Writers and Artists on Love

MEDITATION DECKS

Everyday Calm

Everyday Creative

Everyday Smart

HOME STUDY COURSE

The Meaning Solution

RETHINKING

DEPRESSION

HOW TO SHED

MENTAL HEALTH LABELS

AND CREATE

PERSONAL MEANING

ERIC MAISEL

Copyright © 2012 by Eric Maisel

All rights reserved. This book may not be reproduced in whole or in part, stored in a retrieval system, or transmitted in any form or by any means — electronic, mechanical, or other — without written permission from the publisher, except by a reviewer, who may quote brief passages in a review.

Portions of chapter 7 from The Van Gogh Blues by Eric Maisel. Copyright © 2002 by Eric Maisel. Reprinted by permission of Rodale Inc., Emmaus, PA 18098.

Portions of chapter 8 first appeared in The Atheist’s Way by Eric Maisel. Copyright © 2009 by Eric Maisel. Reprinted by permission of New World Library.

The material in this book is intended for education. It is not meant to take the place of diagnosis and treatment by a qualified medical practitioner or therapist. No expressed or implied guarantee as to the effects of the use of the recommendations can be given nor liability taken.

Text design by Tracy Cunningham

Library of Congress Cataloging-in-Publication Data

Maisel, Eric, date.

  Rethinking depression : how to shed mental health labels and create personal meaning / Eric Maisel.

    p. cm.

  Includes bibliographical references and index.

  ISBN 978-1-60868-020-7 (pbk. : alk. paper)

1. Depression, Mental. 2. Mental illness. 3. Psychiatry—Philosophy. I. Title.

  RC537.M333 2012

  616.85’27—dc23

2011041631

First printing, February 2012

ISBN 978-1-60868-020-7

Printed in Canada on 100% postconsumer-waste recycled paper

10 9 8 7 6 5 4 3 2 1

For Ann,

thirty-five years into this adventure

CONTENTS

INTRODUCTION:  The Reality of Unhappiness

PART ONE: RETHINKING DEPRESSION

CHAPTER 1      Creating Mental Disorders

CHAPTER 2      What Do Treatments Really Do?

CHAPTER 3      Fifteen Reasons Why People Believe That Depression Exists

PART TWO: YOUR EXISTENTIAL PLAN

CHAPTER 4      The Existential Ideal — and Its Reality

CHAPTER 5      You Look Life in the Eye

CHAPTER 6      You Investigate Meaning

CHAPTER 7      You Decide to Matter

CHAPTER 8      You Accept Your Obligation to Make Meaning

CHAPTER 9      You Decide How to Matter

CHAPTER 10    You Honor Your Wants, Needs, and Values

CHAPTER 11    You Create a Life-Purpose Vision

CHAPTER 12    You Use Your Existential Intelligence

CHAPTER 13    You Focus on Meaning Rather Than Mood

CHAPTER 14    You Snap Out of Trance

CHAPTER 15    You Reckon with the Facts of Existence

CHAPTER 16    You Personalize a Vocabulary of Meaning

CHAPTER 17    You Incant Meaning

CHAPTER 18    You Maintain a Morning Meaning Practice

CHAPTER 19    You Negotiate Each Day

CHAPTER 20    You Seize Meaning Opportunities

CHAPTER 21    You Handle Meaning Crises

CHAPTER 22    You Engage in Existential Self-Care

CHAPTER 23    You Engage in Cognitive Self-Care

CHAPTER 24    You Engage in Behavioral Self-Care

CONCLUSION:   Cracking the Depression Code

NOTES

BIBLIOGRAPHY

INDEX

ABOUT THE AUTHOR

INTRODUCTION

THE REALITY OF UNHAPPINESS

I HAVE A BEAUTIFUL STORY to tell you about how you can take a stand, make personal meaning, and positively influence your moods. It is not a new story. For thousands of years existential thinkers have pressed us to get a grip on our minds and make strong choices about our relationship to life. They have advised us to seek mature happiness and make ourselves proud by boldly facing the inequities and exigencies of life. Their message: Decide to live until death wrests away your freedom.

You can lead this life of personal fulfillment, but first you must get out from under the shadow of the mental disorder model of life. Today tens of millions of people believe that they have the mental disorder of depression. Maybe you are one of them. In addition, virtually everyone is convinced that, whether or not they have the disorder, it surely exists — apparently in epidemic proportions. In this book I will ask you to think through what the term mental disorder means, how the term is employed, and the implications of its definition. My question to you: Does the mental disorder called depression really exist?

Never — not once — am I going to say that you are not experiencing whatever it is that you may be experiencing. Never — not once — am I going to say, Just cheer up! Never — not once — am I going to imply that nothing biological is going on. What I do hope to demonstrate is that there is something profoundly wrong with the way we name and treat certain human phenomena. When you call something a mental disease or a mental disorder you imply a great deal about its origins, its treatment, its intractability, and its locus of control. The mental health industry has its reasons for calling life’s challenges disorders, but we have few good reasons to collude with them.

I have been told that people with what we commonly call depression are already reluctant to come forward to receive treatment and will be even more reluctant to receive it if they become persuaded that they are only profoundly unhappy. Should they agree that they are only profoundly unhappy, they will presume that the solution to what ails them must be to buck up, and they will feel too embarrassed to get help. I respect this argument and ask that readers who do feel depressed seek help. I hope that this book aids you in understanding what help to ask for from professionals and what help you should realize they can’t possibly offer you.

People have also angrily informed me that the amount of pain and difficulty they’re experiencing can’t possibly be attributed to anything ordinary and that to imply that it can is to insult them. But the experience of pain and difficulty, no matter how severe or long lasting, is not proof of a mental disease or mental disorder. Tremendous dental pain may signal with perfect accuracy the need for a root canal, but tremendous grief, which is as emotionally painful as anything under the sun, does not signal a mental disease or disorder. No amount of emotional pain is proof of these things.

Before I can paint that beautiful picture of your path to personal fulfillment, I’ll spend several chapters reviewing what many critics of the mental health field have observed. In book after book they’ve reported the sad news that tens of millions of people have bought a bill of goods sold them by the mental health industry: that profound unhappiness is a mental disorder rather than a human challenge. I wish I could skip this discussion and move on to solutions. But because the view that a mental disorder of depression exists is so widespread, most people are not primed to acknowledge and make use of their innate freedom. They need their freedom back — even their freedom to feel miserable.

One of the goals of this book is to help you remove the word depression from your vocabulary and, as a result, from your life. If depression were an actual disease, illness, or disorder, you wouldn’t be able to rid yourself of it just by removing it from your vocabulary. But since it isn’t a disease, illness, or disorder, you can dispense with it right this second. What I would love is for you to say, I can’t be depressed because there is no disease of depression! That stance would be a welcome change for millions of people. They would still have to deal with their profound and perhaps chronic and systemic unhappiness, but by dispensing with the depression label they would find themselves much better able to do so.

Family therapists like myself, who have no medical training, diagnose and treat mental disorders every day. That is what we do. I am licensed by the State of California to diagnose and treat your mental disorder of depression, even though I have no medical training. Isn’t that an inadvertent admission by the government that you have a life problem and not a medical illness or biological disorder? If your depression were really about your serotonin levels, your neural transmitters, or your genetic predisposition to depression, would state governments allow nonmedical personnel to diagnose and treat you?

If you actually had a medical illness or mental disorder, would state governments let psychologists, family therapists, clinical social workers, and other nonmedical mental health professionals diagnose you and treat you? Of course they wouldn’t. Governments somehow know that so-called depression is a life challenge and not a disease and that sitting down and talking about it can help you a lot. The State of California is perfectly right to let me chat with you because chronic and profound unhappiness is exactly the sort of thing that I know about. That they let me do so reveals volumes about the true nature of the thing we are discussing.

You already know what it feels like to hate work or to grow so angry with your mate that you feel you are being eaten away inside. You already know what it feels like to be blindsided by despair over the fact that you must pass away in a few years. You already know what it feels like to never lose those extra forty pounds and spend your whole life unhappy about your weight. And you already know enough to make an informed decision about whether you think the mental disease or mental disorder of depression does or doesn’t exist. My goal is to point you in the direction of your own knowing.

Am I alone in thinking that we’ve all been sold a bill of goods? Hardly. Many books have recently appeared making this same argument. Peter Conrad, for example, wrote in The Medicalization of Society, "‘Medicalization’ describes a process by which nonmedical problems become defined and treated as medical problems, usually in terms of illness and disorder. Some analysts have suggested that the growth of medical jurisdiction is ‘one of the most potent transformations of the last half of the twentieth century in the West.’"

Allan Horwitz explained in Creating Mental Illness, "Many of the conditions encompassed by the diagnoses in the DSM [the diagnostic manual used by psychiatrists, psychologists, and psychotherapists] are neither mental disorders nor discrete disease entities; instead they reflect expectable reactions to stressful conditions, culturally patterned forms of deviant behavior, and general human unhappiness and dissatisfaction."

You may be thinking, yes, I get what you’re saying; but depression must be something different from mere chronic or profound unhappiness. It just must be, because everybody says it is and because, well, it just must be. In the next several chapters we’ll look more closely at the ways in which you’ve been trained to think that profound unhappiness is a mental disease or disorder. For now, I would just ask you to keep an open mind and begin to wonder.

PART ONE

RETHINKING DEPRESSION