Profiles of depression from my case book. I have tried to draw some common themes and circumstances that can fuel depression. It would perhaps be over egging it to say that these depression profiles are truly representative – but they will resonate with many of you.
Depression profiles: Who do you recognise?
The harassed mum
Modern life can impinge ruthlessly on many mothers and wives in their thirties or forties. They see themselves as strong and able to handle the pressures of elderly and failing parents, marriages maybe under stress, the daily challenges of young children and perhaps finally uncertainties and frustrations around work and money.
But then they find that they are not coping and they just can’t understand why which just adds to their problems by exacerbating unproductive worrying. In most cases, the trigger will be a very difficult experience, often a family tragedy or crisis which they cannot deal with. This then becomes an active traumatic memory which feeds on their new but unsettling experiences of not coping. This then becomes a depression vicious circle of worry and nervous exhaustion.
The young mum and her tiny baby
Often this is called post natal depression, but is no different in principle from any other depression. The stress and life change associated with a new baby can be impossible to deal with, especially if this means that important elements of the young mother’s life appear lost for good.
Relationships can be problematic, isolation can increase and with physical exhaustion rising, this then spreads into a mental exhaustion also. And then there appears no way out and inevitably the young mother will either blame herself or those around her.
Mother, either married or separated and juggling work, family and finance
The high pressures of modern life can find expression in debilitating anxieties (often linked to an apparent specific cause around work, family or financial pressures) or in an exhausting and increasingly overwhelming depression.
Often these women are very capable and have lived a life of achievement and success in school, university and work, but the life that they are now having to deal with seems just too much and the tools that they have always relied on, no longer seem up to the task.
It is also often the case that they can identify their current difficulties in issues and coping strategies that originated in their childhood. So the current crisis is one that seems to go the heart of something very important – either of their marriage or the relationship to the father of their children or the career they are pursuing.
The young career man or woman, wondering why
The competitive pressures at work are considerable and growing and the early upbringing has left him/her unprepared for what s(he) is now facing. Often emotional difficulties and inadequate coping strategies from earlier life become more evident and so insecurities increase.
And it is not just work – but a new life in London perhaps and new relationships and these are not exclusively sexual. This all can develop into a potent brew where thinking, rumination, collapsing self confidence and loneliness fuel a depression and then perhaps addictive behaviours also – such as coke or alcohol.
These are in essence, attempts at self medication.
Man in city job, succumbing to addictions and growing dissatisfaction and stress
The problems arise from the classic source – of pressures at work where a big reward/risk trade off is no longer attractive. In addition, there may well be problems at home.
The opportunity for expensive and secretive activities (cocaine, gambling, and/or prostitution) becomes increasingly attractive and hard to control. And so the consequence is even greater stress and alienation which then shifts into a classic depression.
The married businessman balancing work and home
The family unit is established, the mortgage is being paid off, the marriage is basically sound and work pressures are mounting.
There is a dissatisfaction that begins to evolve into a mild or moderate depression. And what exactly is the source is not clear, which adds to the exhaustion, over dreaming, unproductive worrying and perhaps growing marriage strains.
Something needs to change or does it? And there are memories and patterns and maybe even mild traumatic memories from the past that are becoming more and more problematic.
Newly retired and facing so many changes
Retirement is a massive life change and for many represents a natural evolution that works well as they have become a little wiser as they age and have developed the resources for a life that works.
But for others, the strains can become intolerable – if one’s spouse dies or becomes seriously ill or relationships with children or grandchildren need to change.
Again a depression will take its typical form, with unproductive worrying and exhausting over dreaming at its immediate core. But there may be serious practical questions to resolve in addition and the necessity to see themselves and their situation in new ways.
Single girl with partner problems
The source of her depression is a variant of most depressions – namely a life where the strain is great relative to the reward. A difficult relationship is at its centre and perhaps emotional memories from her parent’s relationship and her upbringing are compounding these difficulties. Rumination maybe further raised by difficulties to work or finding work that is right. What is quickly discovered in therapy is that she does not know where to turn to find solutions.
Serious life difficulties compounding and appearing insoluble
The life problems will have been around for many years. Often there is a fundamental issue at its core, namely an unhappy and unsatisfying career or deeply problematic relationships, often exacerbated by issues around sexuality or a profound dissatisfaction.
This adds to the problem and keeps the individual worried and exhausted and desperate. Another characteristic is that this person will have been resourceful and tried and failed to find any therapeutic or other means to heal.