Before We Hurry to Silence It, We Should Listen to What It Has to Say
If depression is a journey, recovery cannot always mean returning to the starting place.
By Dr Neel Burton — Psychiatrist, philosopher, and wine writer; Fellow of Green Templeton College, University of Oxford; author of over twenty books.
Grief knows its object. Depression often does not. But that does not mean that depression is always meaningless suffering. Often, it is suffering whose meaning is asking to be discovered.
Still, we must be careful not to romanticise depression. Depression can be a disabling, even deadly, illness. Such depression requires urgent and intensive treatment. But neither should the most severe cases determine how we understand all depression.
Diagnosis
Today, in England, around one person in six is prescribed antidepressants. Numbers on this scale should make us ask: is this all mental illness, that is, a biological disorder of the brain, or is it also a problem with modern life?
If at least some depression arises from a problem of living, then the depression is pointing straight at the problem. By treating it as a biological disorder of the brain, we are hiding the problem and prolonging the pain. Our depression may be telling us, look, something here is seriously wrong, something here has to change, you can’t go on like this.
Treatment
Treatment cannot simply aim at silencing it. If a fire alarm is sounding, disabling the alarm may bring relief—but it does not put out the fire.
Instead, treatment should be more like an exploration and journey. Already in the thirteenth century, Dante gave us the right image. At the beginning of Inferno, he finds himself alone in a dark forest, having lost the straight path. The forest is dark and dangerous. Yet the only way out is through it.
If depression is a journey, recovery cannot always mean returning to the starting place. Because the starting place may have been the problem.
Depression can be an illness, but it can also be a form of intelligence. Before we hurry to silence it, we should listen to what it has to say.
He who has a why to live for can bear almost any how. —Nietzsche & Frankl
By Dr Neel Burton — Psychiatrist, philosopher, and wine writer; Fellow of Green Templeton College, University of Oxford; author of over twenty books.
Viktor Frankl (1905–1997) was an Austrian psychiatrist and neurologist, the founder of logotherapy. His experiences in Nazi concentration camps profoundly shaped his outlook, which found its fullest expression in Man’s Search for Meaning, one of the most influential books of the twentieth century.
Viktor Emil Frankl was born in Vienna in 1905. As a schoolboy, he attended evening lectures in philosophy and psychology. While still in his teens, he sent one of his papers to Sigmund Freud, who arranged to have it published in an international psychoanalytic journal. Frankl later joined Alfred Adler’s rival circle, only to break away after concluding that both Freud and Adler had got it wrong.
Freud argued that we are driven primarily by the pursuit of pleasure. Adler emphasised power, mastery, and the overcoming of inferiority. Frankl proposed a third possibility: meaning.
From 1928 to 1930, Frankl organised counselling programmes for suicidal students, which supported his growing belief that people needed reasons to live as well as reasons not to die. After qualifying in medicine in 1930, he specialised in neurology and psychiatry, treating patients with depression and suicidal thoughts.
The Decision
In 1941, Frankl obtained a visa to emigrate to the United States. Then one evening, he returned home to find his father holding a fragment of marble salvaged from a synagogue that had been destroyed by the Nazis. The fragment bore part of the Fifth Commandment: Honour thy father and thy mother. Frankl chose to remain by his parents in Vienna, tearing up his passage to safety.
The following year, Frankl and his family were deported. His parents, brother, and pregnant wife all perished. On arriving at Auschwitz, the guards confiscated the manuscript that he had been working on for years.
Stripped of his possessions, his profession, and even his name, he found himself wondering what remained of his former self.
He later recalled:
We who lived in concentration camps can remember the men who walked through the huts comforting others, giving away their last piece of bread. They may have been few in number, but they offer sufficient proof that everything can be taken from a man but one thing: the last of human freedoms—to choose one’s own attitude in any given set of circumstances—to choose one’s own way.
Frankl’s conclusion echoes that of the Stoics: while our circumstances may be taken from us, our response remains our own. Instead of sinking into despair, Frankl found purpose in imagining the future. He pictured himself lecturing to students about the psychology of the camps, subliming his suffering into knowledge that might help others or illuminate the human condition. He silently reconstructed the manuscript in his mind and, after the war, painstakingly rewrote it from memory.
He also wrote Man’s Search for Meaning, which he draftedin little more than a week. Intended as a brief account of his experiences, it went on to sell many millions of copies.
The ideas he had carried through the camps became the foundation of an entirely new approach to psychotherapy.
The Will to Meaning
Frankl’s message is ultimately one of hope. Even in the most absurd, painful, and dispiriting of circumstances, life can be given meaning—and so too can suffering. Life in the camps confirmed his conviction that our deepest motivation is neither pleasure, as Freud had believed, nor power, as Adler had believed, but meaning. Pleasure and success matter, but they cannot satisfy us for long unless they serve a larger purpose. As Frankl wrote, ‘Happiness cannot be pursued, but must ensue.’
These ideas became the foundation of logotherapy (from the Greek logos, meaning ‘word’, ‘reason’, or ‘principle’), which is often described as the ‘Third Viennese School of Psychotherapy’ for coming after those of Freud and Adler. Part philosophy and part psychotherapy, logotherapy belongs to the existential tradition—but differs from its mainstream in holding that meaning is discovered as well as created.
Logotherapy seeks not merely to relieve symptoms but to help people discover meaning in their lives. According to Frankl, meaning can be found in three principal ways: through creating or contributing something of value; through our relationships, especially the loving ones; and through the attitude we adopt in the face of unavoidable suffering.
Depression and Meaning
Frankl coined the term ‘Sunday neurosis’ to refer to the dejection that many people feel at the end of the working week when they finally have time to realise how empty and meaningless their lives have become. This existential vacuum can lead to all manner of distractions and compensations: anxiety, avoidance, binge eating, drinking, overworking, and overspending. In the short term, these distractions carpet over the existential vacuum, but in the longer term, they prevent action from being taken and meaning from being found.
For Frankl, depression results when the gap between what a person is and what they ought to be, or once wished to be, becomes so large that it can no longer be carpeted over. The person’s goals seem far out of reach and they can no longer envisage a future. As in Psalm 41, abyssus abyssum invocat—’hell brings forth hell,’ or, in an alternative translation, ‘the deep calls unto the deep.’
Thus, depression is our way of telling ourselves that something is seriously wrong and needs working through and changing.
Unless change can be made, there will continue to be a mismatch between our lived experience and our desired experience, between the meaninglessness of everyday life and the innate drive to find meaning, to self-actualise, to be all that we can be.
From an existential standpoint, the experience of depression obliges us to become aware of our mortality and freedom, and challenges us to exercise the latter within the framework of the former.
By meeting this ultimate challenge, we can break out of the cast that has been imposed upon us, discover who we truly are, and, in so doing, begin to give deep meaning to our lives.
After the War
After the war, Frankl returned to Vienna, where he rebuilt both his life and his career. In 1947, he married Eleonore Schwindt, with whom he had a daughter, Gabriele. He became head of neurology at the Vienna Polyclinic Hospital and lectured at universities around the world. He refused to let himself be defined by his wartime experiences. He remained an enthusiastic mountaineer into old age and, in his sixties, fulfilled a lifelong ambition of earning a pilot’s licence.
By the time of his death in 1997, Man’s Search for Meaning had sold millions of copies in dozens of languages. It continues to inspire psychologists, philosophers, doctors, teachers, clergy, and countless ordinary readers searching for purpose amid suffering, loss, and uncertainty. He helped broaden psychology beyond pathology, arguing that resilience depends not merely on optimism or self-esteem but on having a reason to get up in the morning.
His message has become more relevant than ever. Many people today enjoy unprecedented freedom and prosperity, while struggling with loneliness, anxiety, and a pervasive sense of emptiness. Technology offers endless distraction, consumerism endless temptation, and social media endless comparison. Yet none can answer the question that mattered most to Frankl: What is my life for?
In the middle of our life’s walk, I found myself alone in a dark forest… —Dante Alighieri
By Dr Neel Burton — Psychiatrist, philosopher, and wine writer; Fellow of Green Templeton College, University of Oxford; author of over twenty books.
Like heart disease or diabetes, depression can be highly debilitating, even fatal. But unlike heart disease or diabetes, depression is poorly understood and heavily stigmatised. People with depression are often seen as ‘failures’ or ‘losers’, too weak or lazy to pick themselves up or pull themselves together.
Of course, nothing could be further from the truth. If you feel the way you do, it is most likely because you tried too hard or took on too much—so hard and so much that you made yourself ill with depression. In other words, if you feel the way you do, it is because your world was simply not good enough for you. You wanted more, you wanted better, and you wanted different, not just for yourself but for all those around you.
So if you’re a ‘failure’ or a ‘loser’, that’s only because you set the bar far too high. You could have swept everything under the carpet and pretended, as many people do, that all is for the best in the best of all possible worlds. Instead, you had the honesty and the courage to recognize that something was amiss, that something was not quite right.
Rather than being a failure or a loser, you are all the opposite: you are ambitious, you are truthful, and you are courageous. And that’s precisely why you got ‘ill’.
Depression as a Signal
But here’s the good news. Unlike heart disease or diabetes, depression can also have a silver lining.
Crushing though it may be, depression can present a precious opportunity to identify, acknowledge, and address deep-seated problems.
Just as physical pain evolved to signal injury and prevent further injury, so depression may have evolved to remove us from distressing, damaging, or futile situations—situations that do not serve us well as human beings.
The time and space and solitude afforded by depression can enable us to reassess our needs, reframe our perspectives, and round up the resolve to break with established patterns.
In other words, depression, or the depressive position, may have evolved as a signal that something is seriously wrong and needs working through and changing—or, at the very least, processing and understanding.
In the normal run of things, we become so immersed in our day-to-day that we no longer have the opportunity or perspective to think and feel about ourselves. The adoption of the depressive position invites—or compels—us to shed our defences, stand back at a distance, reassess our needs and priorities, and formulate a modest but realistic plan for fulfilling them.
At a deeper level, the depressive position can enable us to develop a clearer understanding and appreciation of ourselves, our lives, and life in general. From an existential standpoint, it obliges us to become aware of our mortality and freedom, and challenges us to exercise the latter within the framework of the former. By meeting this ultimate challenge, we are able to break out of the mould that has been imposed upon us, discover who we truly are, and begin to give deep meaning to our lives.
The Gift of the Dark Wood
It can be no coincidence that so many of history’s most creative and insightful people suffered from depression, or from a state that might today be diagnosed as depression. They include Winston Churchill, Abraham Lincoln, Emily Dickinson, Sylvia Plath, Friedrich Nietzsche, Arthur Schopenhauer, Leo Tolstoy, and many others.
To quote Marcel Proust, who himself suffered from depression, ‘Happiness is good for the body, but it is grief which develops the strengths of the mind.’
The concept of depression as a mental disorder may be helpful for the more severe and intractable cases treated by hospital psychiatrists, but probably not for the majority of cases, which, for the most part, are mild and short-lived and more readily understood in terms of life circumstances, human nature, or the human condition.
Thinking of our distress or protest or withdrawal in terms of a mental disorder or chemical imbalance in the brain can be counterproductive, insofar as it can prevent us from identifying and addressing the important life problems or psychological issues that lie at the root of our distress, and that are, almost literally, crying out for our care and attention.
Maybe all this is more common sense than philosophy, but I do think it merits saying.
In the middle of our life’s walk I found myself alone in a dark forest Where my path was confused.
Ah how hard it is to retell How dense, dark, and dangerous The thought of it alone fills me with fear!
So bitter that death is scarcely worse; But to speak of the good I found there, I shall tell of the other things that I saw.
If you’re struggling with depression, or know someone who is, I’d like you to have this book—free of charge.
What if depression were a blessing as well as a curse? This is a book about how depression can have benefits as well as costs, and how to reap those benefits while making yourself feel better—better, in fact, than ever before.
Drawing on psychiatry, psychology, philosophy, and literature, Dr Neel Burton explores depression not only as an illness to be treated, but also as an opportunity for insight, growth, and transformation.
🏆Semi-finalist, the BookLife Prize
🏆Highly Commended, the BMA Book Awards
A comprehensive, sympathetic, and thought-provoking guide for those who want to explore their depression in more depth.—The British Journal of Psychiatry
Neel is an incredibly insightful and elegant writer, with a deep knowledge of all he surveys.—Dr James Davies, psychotherapist, author of Cracked
I have read most of Dr. Neel Burton’s books and have enjoyed them immensely … All in all, I found this to be a very insightful and engaging book on depression.—Jamie Bee, Amazon.com Top 50 Reviewer
Three ancient mind exercises for processing and subliming bad news.
Imagine: Your house has been burgled. You’ve been fired. Your partner cheated or walked out on you. You’ve been diagnosed with a life-changing condition…
Bad news can leave us in a state of dread and despair. It seems like our whole world is falling apart, almost as if we’re being driven into the ground. We fear the very worst and cannot get it out of our mind, or gut. Often, there are other emotions mangled in, like anger, guilt, despair, betrayal, and love.
Bad news: we’ve all had it, and the worst is yet to come.
So, how best to cope?
I’m going to give you three cognitive strategies, or mind exercises, that I picked up from the Stoic philosophers—who, in the second century, could count the Roman Emperor, Marcus Aurelius, among their followers.
All three strategies aim, in one way or another, at generating perspective. While reading, hold a recent piece of bad news in the front of your mind, and consider how the strategies might or might not apply to your bad news.
Contextualization
Try to frame the bad news, to put it into its proper context. Think about all the good things in your life, including those that have been and those that are yet to come. Remind yourself of all the strengths and resources—the friends, facilities, and faculties—that you can draw upon in your time of need. Imagine how things could be much, much worse—and how for some people they actually are. Your house may have been burgled. Yes, you lost some valuables and it’s all such a huge hassle. But you still have your health, your job, your partner… Bad things are bound to hit us now and then, and it can only be a matter of time before they hit us again. In many cases, they are just the flip side of the good things that we enjoy. You got burgled, because you had a house and valuables. You lost a great relationship, because you had one in the first place. In that much, many a bad thing is no more than the removal or reversal of a good one.
Negative visualization
Now focus on the bad news itself. What’s the worst that could happen, and is that really all that bad? Now that you’ve got the worst out of the way, what’s the best possible outcome? And what’s the most likely outcome? Imagine that someone is threatening to sue you. The worst possible outcome is that you lose the case and suffer all the entailing cost, stress, and emotional and reputational hurt. Though it’s unlikely, you might even do time in prison (it has happened to some, and a few, like Bertrand Russell, did rather well out of it). But the most likely outcome is that you reach some sort of out-of-court settlement. And the best possible outcome is that you win the case, or better still, it gets dropped.
Transformation
Finally, try to transform your bad news into something positive, or into something that has positive aspects. Your bad news may represent a learning or strengthening experience, or act as a wake-up call, or force you to reassess your priorities. At the very least, it offers a window into the human condition and an opportunity to exercise dignity and self-control. Maybe you lost your job: time for a holiday and a promotion, or a career change, or the freedom and fulfilment of self-employment. Maybe your partner cheated on you. Even so, you feel sure that he or she still loves you, that there is still something there. Perhaps you can even bring yourself to look at it from his or her perspective. Yes, of course it’s painful, but it may also be an opportunity to forgive, to build a closer intimacy, to re-launch your relationship—or to go out and find a more fulfilling one. You’ve been diagnosed with a serious medical condition. Though it’s terrible news, it’s also the chance to get the support and treatment that you need, to take control, to fight back, to look at life and your relationships from another, richer perspective.
A Taoist story for the road
There’s a Taoist story about an old farmer whose only horse ran away. “Such terrible news!” said a neighbour. “Maybe it is, maybe it isn’t,” replied the farmer. The next day, the horse returned with six wild horses. “Such wonderful news!” exclaimed the neighbour. “Maybe it is, maybe it isn’t,” replied the farmer. The day after that, the farmer’s son tried to tame one of the wild horses but got thrown off and broke a leg. “Such terrible news!” cried the neighbour. “Maybe it is, maybe it isn’t,” replied the farmer, biting into a peach. A week later, war broke out: thanks to his broken leg, the farmer’s son managed to escape military conscription. “It all worked out really well in the end,” said the neighbour, “such great luck!”
“Maybe it is, maybe it isn’t,” replied the farmer, rolling his eyes.
Neel Burton is author of Growing from Depression, which is currently free to download from his website bookstore.
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