Thinking of depression as stuck anger

In your column of 9/7, you refer to depression as "stuck anger." I think I understand what you mean, but wonder if it would be possible to pursue that idea at some point, with some more depth on the meaning of the expression. As you can probably guess, I have been dealing with depression for many years without much success. I often wonder has much is me (just think positive and get over it), as opposed to chemical issues in the brain. Thought exploration of your term might be helpful. R.F., Las Vegas

First, I want to take a shot at extracting you from the pointed end of an unhelpful dichotomy:  Is this chemical?  Or can I just will myself to think positively and get over it?

I'm a big believer in the 'power of positive thinking,' R.F., as long as we can agree that the power of positive thinking is relative, and not absolute. I mean to say that I don't put a lot of stock in therapeutic models whose essential message is "buck up," or "snap out of it," or, "...if you really belieeeeve." In some cases, such nonsense (sold as science) actually adds to the burden of depression.

Here's the paradox that heals the dichotomy: Human moods cause changes in brain chemistry, and changes in brain chemistry invite a lot of variations of mood, not all of which are happy. It's both. At once.  Almost always.

I'm saying give yourself a break, and turn your energy to other, more useful questions.

Now, to the metaphor of "stuck anger" ...

My point in the column was my passionate prejudice that healthy access to healthy anger is a HUGE part of human vitality -- our ability to feel energetic, creative and alive. Anger is 'life force.' Without this healthy access to healthy anger, the energies of our vitality slow down. They don't flow. They get, well, stuck.

Let me risk a bit of crass so as to make the point provocatively and powerfully: My frequent experience of depressed people, both clinically and personally, is that they are royally and righteously pissed, and perhaps have been so for a long, long time. But in the case of depressed people, they are often the last to know they are angry. The anger was too painful. Perhaps where they grew up, too risky. Perhaps their religion made anger taboo. But one way or another, they don't have access to this vital and important part of being human.

In therapy, the goal, by hook or by crook, is to slowly find a 'crack' in the depressed, well-defended self. Some contradiction of "how much I just LOOOVE my mother," etc. Some behavior that speaks to agitation, aggression, or even veiled fascination with violence. Wanna know how my therapist first introduced me to my anger? -- By noticing the way I bit, mutilated, and simply trashed my fingernails and cuticles. I'm not kidding. That began a long journey for me; a journey that ended with me getting aquainted with a deeper, more vital, more honest, albeit often unsettling and sometimes frightening version of myself.

When patients surrender to an authentic embrace of anger, they, in that moment, aren't complaining of depression. I'll sometimes interrupt the demonstration of anger with a dramatic question: "In this very moment, right there on that couch, where is your depression?" They often look befuddled. Their eyes dart, as if to look for misplaced car keys. "It's gone," they'll mutter, with no little incredulity.

This phenomenon (authentic emotional flow as antidote for depression) is also observable during the catharsis of acute, heretofore "stuck grief."

I'm not saying it's an end-all cure-all. But depressed patients frequently report improvement as a result of therapeutic models helping them to access anger and grief. Add regular exercise and healthy diet to this prescription, and certainly medication when necessary, and the suffering of many, many depressed patients can be greatly decreased and in some cases ameliorated.