On ease and happiness: What history can teach us about therapy and depression

On Christmas morning I happened to catch CNN's Fareed Zakaria interviewing historian David McCullough, loosely on the topic of a McCullough's new book about the wave of 19th Century American emigrants to Paris and more broadly on the topic of what we can, at our present moment, learn from history. I was not expecting a lesson on depression and therapy, but I found one.

This of McCullough's remarks struck me:

One of the themes that I realized is a theme, as I was about halfway through this project, is work. We receive such ballyhoo constantly about ease and happiness being synonymous. Again and again, people were saying, on paper, in their diaries and letters, I've never worked harder in my life and this is the happiest time of my life.

How well spoken, McCullough's critique of the pairing of "ease and happiness." Surely, I'm not the first to remark on the tendency of those who are depressed (and those therapists who treat that depression) to make use of a pill (an anti-depressant) to feel better. That's a tired argument, and one I think misses McCullough's point. If an anti-depressant can make you feel better, and it's a move you want to make, go for it. But don't mistake that for being a shortcut around work.

Why? Because depression isn't just a feeling; it's a set of activities that, when played out over time, organizes our lives around the habits and tendencies we've fallen into while being depressed. Friendships get more and more distant (or aren't cultivated at all).  Work lives get more and more precarious. Even if an anti-depressant can help us feel better, we still have ahead of us the tremendous task of getting those parts of our life in shape.

With or without anti-depressants, in order to feel better (and kick depression's butt) we must engage the insidious pairing of ease and happiness.

Depression is a sneaky bastard

When a new therapy patient who's depressed comes to see me, I hear of how difficult it is to do the most basic life-building tasks. Parties are a chore, one gets behind at work, family is neglected. It's obvious to see why: Depression makes doing all of these things feel utterly painful. When you're depressed, the last thing you feel like doing is calling your friends, or going to the gym (and even going to therapy).

My recommendation?

Inevitably, I'm told in therapy from someone who is depressed that they want help to make things feel better so they can "get back to their lives." We have to flip that on it's head.

We have to step outside of feelings. That's a somewhat unusual sentiment in therapy: How you feel, when you're seriously depressed and when it feels as though there's no way out, isn't the most important thing. Yes, your pain matters. But we need to draw on something unrelated to feelings to help us do the work McCullough speaks of. If you're depressed, this will likely be the last thing you feel like doing. In fact, building your life while you're depressed might really hurt for a while.

How we feel and what we need to do often don't line up neatly. Sometimes, they're miles apart. It is in our darkest times that we most need to draw upon our remarkable capacity to work in spite of how it feels.

A bit later in the interview, McCullough returns to the notion of work, speaking of a later moment in history:

I think maybe the darkest time was right after Pearl Harbor. We had no army. Half our navy had been destroyed. The Russians - the Germans were nearly to Moscow. Britain was about finished. And Churchill came across the Atlantic and he gave a speech and he said, "We haven't gone this far because we're made of sugar candy."

You are not "made of sugar candy!"

I imagine many people in the world felt like crawling under the covers in those dark days following the attack on Pearl Harbor. Churchill's American counterpart, at that same moment, said, of course, "The only thing we have to fear is fear itself."

What Roosevelt was saying was that, in that dark and terrifying moment, the most dangerous sentiment was fear; we feel one way, but we must act another.

Both men were engaging, by necessity, in quite remarkable therapy. They said to the world, in a moment of intense, painful feeling, that those very feelings were the things we needed to move beyond. What we needed to do instead (and what ultimately won the war) was work. (A process which, incidentally, helped the world get over a rather prolonged depression of another--economic--sort.)

That's the tough love we need when we're depressed, from a therapist and from ourselves: It may, at this moment, feel as though the most painful thing in the world would be to attend to the work of building your life: call up an old friend, say yes to this or that invitation, get to the gym. But that's exactly what's needed. Happiness will not come with ease. History has taught us that.