Depression Dialogues III: If we feel peaceful inside, we are empowered and better able to combat worrying thoughts or a sense of helplessness and anxiety, advises Dr Michael Corry
Wave a wand, take away fear and its travelling companion helplessness, and depression would virtually disappear. The fight or flight response is the most primitive and ancient of all survival responses, dealing, as it does, with the matter of life and death. The degree to which this is aroused is dictated by the threats we face, and their severity places us along a spectrum between fear at one extreme, and safety on the other.
To spend extended periods of time at the fear end, teetering on the edge of panic, with no possibility of controlling it or disengaging from it, has to be one of the most dis-empowering and excruciating states a human being can experience.
Fear is the demon of peace, compassion, acceptance, spontaneity, love, happiness, health - life itself. Bertrand Russell, the philosopher and mathematician, described those who live in fear as "already three parts dead". Living in fear is lonely, energy-draining and depressing. It's a tortuous juggling act running parallel universes: trying to engage with the world of work, family and friends while grappling with frightening images and feelings. This adrenaline-driven state of arousal is recognisable to all of us in its milder forms as the butterflies in the tummy, sweaty palms, trembling and worrying thoughts.
It is difficult to imagine living with the more extreme versions of fear, on red alert, where the body and mind can at any moment be swept away by the adrenaline cascade which creates the symptoms of high anxiety or panic attacks - shortness of breath, pounding heart, dizziness, wobbly knees, nausea, feeling spaced out, and the catastrophic thoughts that predict death, madness and loss of control.
The aftershock of such an experience leaves one feeling wrecked, mentally and physically beaten up, terrified and feeling helpless to prevent the next attack. An added burden is the struggle to summon up the energy to re-engage with life. For many, this is a secret existence sealed by fear of ridicule and stigma. There is a profound sense of desperation and helplessness when our life feels taken over, and we feel powerless to stop it spinning out of control.
Living in this helpless, hopeless state, preoccupied and hyper-vigilant, mistrustful and paranoid, battling with poor concentration, memory lapses and burnt-out resources, renders the simplest of demands incredibly difficult.
Unable to help ourselves and disapproved of by others, feeling trapped, de-motivated, and weighed down by life, we withdraw into our shell, becoming defensive, emotionally unavailable and irritable. Misunderstandings flourish, fuelling further alienation. The formulation of the belief that "nothing I do makes any difference" ushers in the emotional state of depression.
What is not commonly realised is that people already living with high levels of fear become easy prey to the scare-mongering tactics of multinational vested interests shaping our personal and collective thinking. We are constantly being goaded by scarcity consciousness - there is not enough to go around; defend what you have; 'they' will take everything from you. Your only defence is to be vigilant at all times. With the terrorists now under the bed, that great global tribe of 'they' is ubiquitous.
We all know the localised version of 'they'. It comes in the form of how we are perceived by others. The public gaze. What people think of me. And it starts in childhood. There is possibly no greater power that shapes us than the pressure to conform - status anxiety. Everything has to look right. The camera is under the bed.
Your appearance, partner, career, car, house, holidays, all have to meet the standard. We are constantly looking over our shoulder.
Competition is the order of the day. We compete for college places, a place in the spotlight, our rung on the career ladder, relationships, money, power. The emphasis is on achieving, and surrounding ourselves with the objects and symbols of success. The food chain has been replaced by the status chain.
With such a prevailing dog-eat-dog mentality, there are winners and losers. The air of triumphalism is pervasive. "Look at me, I've made it, you haven't, you're a loser."
We are constantly bombarded by the parade of the successful and the celebrated. If you're not a winner, you have only two options. Either you try harder, which involves more fear, or you give up. This is the essence of depressio- "something I value has been taken from me, and I've been unable to prevent it, so what is the point in trying?".
Fear has many faces. There are those individuals who reflect a sensitivity, a delicacy of personality, a lack of certainty about their role in the greater scheme of things. In contrast to the competing group, their camera is in their own head. Their orientation is different. They are focused on existential meaning-of-life questions such as "Who am I? Why am I here? What's it all about? How does everyone else seem to know what they're doing and I don't?"
They feel they've landed on the wrong planet and the natives aren't friendly. They know they don't fit. There are few people with whom they can share their inner world. If they fail to meet like-minded fellow travellers, fear levels rise and, helpless to change things, they drift into a state of alienation, which can be experienced as depression.
The most vulnerable in society are those with serious physical disabilities (upwards of 70,000 in this country), and the population is growing as a result of road traffic and other accidents. Add to this the many suffering from chronic illness, both young and old, who are dependent on over-stretched services and home carers, and the numbers suffering daily levels of intense fear and helplessness becomes obvious.
If fear is the demon to a meaningful and engaged life, then safety is the antidote. Everything must be done to move ourselves to the safety end of the fear-safety spectrum. If we feel peaceful inside, we automatically feel empowered, authentic, non-critical, compassionate and giving.
The prerequisite of all change is acceptance of exactly the way things are. Wishing things were different changes nothing. Acceptance is the most radical position a human being can take as it creates a starting point; a new beginning. In the words of the Serenity Prayer:
God grant me the serenity to accept the things I cannot change, the courage to change the things I can, and the wisdom to know the difference.
Dr Corry is a consultant psychiatrist and co-author of Going Mad? (Gill and Macmillan) with Dr Aine Tubridy.
Depression Dialogues will be conducted as open meetings with all members of the public welcome. Each meeting will be facilitated by Dr Michael Corry, consultant psychiatrist, and will be held on the first Thursday of each month. The next meeting is scheduled for Thursday, October 7th, in the Research Centre, St Vincent's Hospital, Dublin, from 7.30 p.m. to 9 p.m. Donation €5. Inquiries 01-2800084.