Is Clinical Depression a Choice? An Alternative View

I wake up 4am in the cold morning. All I see is black, and all I feel is emptiness. I remember why I committed to waking up early, but I don’t seem to have the motivation to get up anymore. Life suddenly seems pleasureless and bland.

We all have experienced our bouts of depression at some point in our lives. It is even normal and appropriate to experience such, especially after the loss of a loved one.

Depression as an illness

This was a recent experience where I felt depressed. Depression is a term commonly used to describe a state of intense sadness or hopelessness. When one is depressed, the person usually experiences low energy, fatigue, and even thoughts of suicide. Lack of pleasure from once pleasurable activities are also common. This means eating good food or bonding with friends aren’t appealing anymore.

The Diagnostic and Statistical Manual of Mental Disorders (DSM 5) refers to a period of prolonged depressed mood as a major depressive episode. However, most people like me prefer to simply say “I’m depressed!”

Labeling depression as something that we’re victims of does have negative consequences though. Since mental illness is something beyond our control, we would have to rely on a rescuer or an expert to handle our problems. Fortunately, one can view unpleasant states such as clinical depression and anxiety at a different angle.

Depression as a choice

Psychiatrists concern themselves with diagnosing patients with mental disorders, and prescribing to them the right psychotropic drugs for the job.

William Glasser (1998) was an unusual psychiatrist. He argued against diagnosing people with mental disorders. Instead, he insisted that whenever someone is anxious, he is ‘anxious-ing’. Similarly, when someone is depressed, he is ‘depress-ing’. You’ve got an Obsessive Compulsive Disorder (OCD) you say? Share to me how you are OCD-ing!

Of course, his practical view of mental illnesses does not extend to cases of brain injury or deterioration, such as Alzheimer’s disease.

Dory had dementia, less controllable compared to depression
Sadly, Dory’s forgetfulness wasn’t her choice.

What does this funny form of wordplay of adding ‘-ing’ to mental illness mean? It means, whatever symptoms or ‘mental disorders’ we experience are actually our choice. Every behavior has a function, and depress-ing oneself is no exception.

Functional depression

I knew a girl named Mikaela (not her real name) who took a law course due to paternal pressure. Since law is definitely not an easy course, she depressed. She thought her studies hopeless. Mikaela badly wanted to transfer courses, but was repeatedly forced by her father to do otherwise. Consequently, she felt even more depressed. What was her alternative?

Instead of depress-ing, she could have been anger-ing towards her father, perhaps complain or scream at him for not understanding. That wouldn’t have end well for her though. Her depress-ing served a function, and allowed her to socially adapt as a form of coping. However, it was emotionally taxing, and not getting her what she really wanted in the end.

This is where Glasser’s Choice Theory and psychotherapy come into play.

A way past depress-ing: changing our total behavior

Glasser founded Choice Theory based on the principle that every behavior we carry is our choice. Behavior according to the pocket dictionary next to me defines behavior as “the way in which one conducts oneself”. Oftentimes, people mistake behavior as only the activities that we do. However, this is far from the truth.

When I think I of happy thoughts, or that I am good for nothing (thinking), that is my behavior. If I am feeling down or angry (feeling), that is my behavior. When my heart suddenly races a hundred beats per minute or sweat profusely in the arm pits (physiology), that is my behavior. Together, the components thinking, feeling, physiology, and activity constitute our total behavior. This means we choose how we behave, though we do the latter two indirectly.

One night, I swore I was depressed, so I went to the gym. By bench pressing on some higher-than-usual weights, my focus shifted fast. Instead of thinking repeatedly of the nasty things that happened that night, I felt intense strain on my body from my bench press. Boom, no more depress-ing for that moment! Also, the weights were too heavy and someone had to rescue me, so that was another distraction, albeit embarrassing. By altering my physical activity, I indirectly change my feeling and bodily state.

Exercise is good example of an area ‘depressed’ people have control over. A study (Johnsgard, 2004) suggests that sticking to a regular exercise program is just as effective as any medication program (or even better).

Implications for the ‘depressed’

Does it really help to label one’s depression as a choice? If I am depressed, would that mean I am intentionally making myself suffer?

Again, depression is a form of coping, it allows one to adapt in an otherwise problematic situation. The situation may be as obvious as a punitive parent, or as subtle as a purposeless and lonely existence. Since one’s feelings of depression are a fraction of one’s total behavior (hence, depress-ing), it is a choice.

Psychological growth occurs when one finds more life-giving behavior to replace the depressing. Make no mistake, this might take as long as a few minutes (for the blessed few) to a couple years depending on the presence of an intervention or support.

Conclusion

I can’t directly change how depressed I am, however the next best thing is available. I’m able to seek behavioral alternatives through counseling, and slowly change my situation. I can change my physical activity and consequently affect how I feel. Or I can affect the way I think and feel better in the process, and so on.

Ultimately, it is our choice to see ourselves as mentally ill, or mentally ill-ing (forgive my repeated use of alien vocabulary). When I admit that I am responsible for my anxiety or depression (no matter how little that might be), I open myself to positive change.

For a more detailed account of Glasser’s concept of mental illness, read “Choice Theory: A New Psychology of Personal Freedom”.

Choice theory shows multiple cases where Glasser counsels depression

 

References:

Diagnostic and statistical manual of mental disorders: DSM-5. (2013).

Glasser, W. (1998). Choice theory: a new psychology of personal freedom. New York: HarperCollins.

Johnsgard, K. (2004). Conquering depression & anxiety through exercise. Amherst, NY: Prometheus Books.

 

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14 thoughts on “Is Clinical Depression a Choice? An Alternative View”

  • An interesting read but I think not all can change how they feel and think just to get out of depress-ing as some of them may not even have a specific trigger/cause. What’s important is to get support. And most importantly, be a support to someone who is going through it as it may be hard for them to open up.

    • Agreed. Oftentimes, what worsens the experience of depression is to have it denied or shunned. Once sufficient expression and opening up has taken place though, eventually it becomes the person’s role (along with the therapist if any) to seek more adaptive behaviors for him/herself. I think realizing we have a choice can be really important at a certain point 🙂

  • Interesting point. I never know what to say about depression as a choice and something you can’t handle. Like for me, there are times when I feel very depressed. And during those times, I really can’t do anything to change it. 🙁

    • I can relate to the experience of helplessness. I hope when the time comes, we focus on the things that we can control, such as finding a confidante, or enriching someone else’s life

  • very interesting look into depression.

    I know chemicals have a way with influencing how we feel but I also feel that there’s a very thin line between do and don’t and that will power is beyond emotions, it’s a sheer force coming from a person.

    I have yet to further understand depression in a deeper level, but I agree that somehow…. people who do not wish to be helped cannot be helped no matter what you do.

  • Depression is a tough battle. Personally, I had to physically move to a new city and get a taste of a new environment to slowly get rid of my anxiety and depression. It also helps to see posts like this and more awareness, despite how small, about mental illness. As for someone who’s never comfortable baring my soul to people out of fear that I might cause them sadness in the process, I think it also helps to find some sort of channel or vessel to pour emotions into like art, music or writing for example.

  • I totally feel you, bro! I have my own bouts with depression plus an utter lack of motivation. Honestly, I strongly believe that one can live it and function well. Being depressed thought me about perspectives and I believe that a person who can survive these bouts are more resilient and could actually become more successful than the ones who never felt it. The danger though is that depression could also be like the waves of the ocean, it can devour you if you do not ask for help. 😉 It’s too simplistic to say it is a choice because during those dark moments, you fell you have no choice. 😉

  • I don’t totally agree that depression is a choice, but I do believe how we react to it is our choice. I have recently added a rigorous exercise routine to my daily schedule. I have to say that I agree that exercise should be an everyday part of our lives. Not only is it solitude to hear your own thoughts, there are also numerous other health benefits. Those who have experienced depression can ultimately benefit from the schedule and the consistency of an exercise routine incorporated into daily life. I have felt every emotion associated with depression, so I know exactly how bad it can get. Getting one’s self out of a funk can be hard but it can be done. It does take dedication, will power, and serious determination…Thanks for the great read!

    • Thank you for dropping by Miranda! We cannot directly control our depression, but with rigorous exercise and commitment, we can indirectly influence it for the better! I think it matters a lot.

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