This is how Rethinking Depression by Dr. Eric Maisel begins: “I have a beautiful story to tell you about how you can take a stand, make personal meaning, and positively influence your moods. It is not a new story. For thousands of years existential thinkers have pressed us to get a grip on our minds and make strong choices about our relationship to life. They have advised us to seek mature happiness and make ourselves proud by boldly facing the inequities and exigencies of life. Their message: Decide to live until death wrests away your freedom.
“You can lead this life of personal fulfillment, but first you must get out from under the shadow of the mental disorder model of life. Today tens of millions of people believe that they have the ‘mental disorder’ of ‘depression.’ Maybe you are one of them. In addition, virtually everyone is convinced that, whether or not they have the disorder, it surely exists—apparently in epidemic proportions. In this book I will ask you to think through what the term mental disorder means, how the term is employed, and the implications of its definition. My question to you: Does the mental disorder called depression really exist?
“Never – not once – am I going to say that you are not experiencing whatever it is that you may be experiencing. Never —not once—am I going to say, ‘Just cheer up!’ Never—not once am I going to imply that nothing biological is going on. What I do hope to demonstrate is that there is something profoundly wrong with the way we name and treat certain human phenomena. When you call something a ‘mental disease’ or a ‘mental disorder,’ you imply a great deal about its origins, its treatment, its intractability, and its locus of control. The mental health industry has its reasons for calling life’s challenges ‘disorders,’ but we have few good reasons to collude with them.”
Rethinking Depression is a book about hope: hope that as an individual and a society we can rid ourselves of the myth that depression is a mental disorder; that it’s okay to be sad or unhappy because that is a part of life, and we can live a life of meaning because we are the sole arbiters of our life. When we become the advocates for our happiness instead of the powerful mental health and pharmaceutical industries, we don’t have to sit idly by waiting and wishing our life would be different. When we seize the opportunities to create a life rich in meaning, being true to our hopes and dreams because they matter, then perhaps we will embody what the existentialists have been telling us all along. How can depression rule my life if I greet each new day and each new moment authentically, empowered with the knowing that I am the sole arbiter of my life? To wrestle with the universe and find my place in it is not an easy path to follow, but it is certainly a more honorable and meaningful one than succumbing to the alternative.
Dr. Maisel writes: “Human beings experience unhappiness. The typical person experiences unhappiness not only for all the usual reasons—that his teeth sometimes ache, that his job is relentlessly stressful, that his family life is no white-picket-fence heaven, and so on—but also because, as a modern person, he can’t maintain the illusion that his place in the universe is particularly exalted. His life produces unhappiness, and his understanding of his place in the universe is its own poignant unhappiness.
“The former (unhappiness) he is taught to call ‘depression,’ and the latter (non-exalted place in the universe), if he knows the lingo, he calls ‘existential depression.’ Society’s widespread willingness to believe that the ‘mental disorder of depression’ exists produces a new set of expectations.”
I wanted to know why Dr. Maisel wrote Rethinking Depression, even though he knew it would bring a lot of heat and anger his way. So, I asked him. His answer: “When I first began my training as a therapist, I had the immediate feeling that the standard method used to ‘diagnose and treat mental disordersʻ made no sense. I would raise my hand and ask questions but everyone, teachers and my fellow students alike, were completely incurious. It seemed that using checklists of so-called ‘symptom pictures’ rather than being provided with any real explanations or any rationale for the checklist method was perfectly fine with them. So I’ve wanted to write this book for a long time but I’ve been engaged with other subjects, one after another, between now and then. Finally—and especially because the manual that therapists use to ʻdiagnose and treatʻ was being revised and a slew of new mental disorders will be perpetrated on us in 2013—I decided that now was the time.”
It might be a good time for us as a society to stop, take a deep breath, and look carefully and honestly at what we are perpetuating. It is as if we have taken the easy route and have been addressing the effect of why we are “depressed,” instead of doing the real work and revealing the root causes for our unhappiness.
Dr. Maisel continues: “People have come to believe that unhappiness is an aberration and that if they are experiencing it they somehow ‘caught something’ almost embarrassing to catch, like an STD. Who should be unhappy nowadays, what with malls and television? So, rather than admit that they are unhappy, they opt to treat their feelings like a disease. This enormously pleases Big Doctor, who welcomes each ‘depressive’ with open arms.”
Antidepressants may help and psychotherapy may help because pills and talk can help. But they won’t solve life’s problems. They won’t make the unhappiness go away, unhappiness that may have been caused by something harmful and injurious we have experienced. We can try to numb ourselves out of unhappiness or talk our way out of life’s problems, but the problems and sadness won’t disappear with a pill or talk. It’s not that easy nor should it be. Wouldn’t it be better to gain some tools for handling our sadness so we can stand tall and look at life squarely in the eye? Wouldn’t it be better take charge of our happiness and unhappiness instead of falling prey to the myth that something must be wrong with us if we are feeling sad or melancholy? Wouldn’t it be better to learn the fundamental difference between waiting for meaning to arrive and actively make meaning so we can live authentically like Dr. Maisel proposes?
Dr. Maisel states his premise thus: “By taking the common human experience of unhappiness out of the shadows and acknowledge its existence, we begin to reduce its power. At first it is nothing but painful to say, ‘I am profoundly unhappy.’ The words cut to the quick. They seem to come with a life sentence and allow no room for anything sweet or hopeful. But the gloom can lift. It may lift of its own accord—or it may lift because you have a strong existential program in place whereby you pay more attention to your intentions than to your mood.”
Dr. Maisel’s statement that an existential program may allow you “more attention to your intentions than to your mood” has profound significance for me because so much of my life has been dictated by mood rather than by making meaning. When I read the above statement, I suddenly understood that an existentially aware person decides to focus on making meaning rather than on monitoring moods. He writes, “If you pester yourself with the question, ‘How am I feeling?’ you create unhappiness. If the question you pose yourself instead is, ‘Where should I invest meaning next?’ you live more authentically.”
This giving in to moods or investing in our intentions is one of the elements of Dr. Maisel’s existential program, which he lays out in “Part Two: Your Existential Plan” of Rethinking Depression. Each chapter is dedicated to examining each of the twenty elements: You Look Life in the Eye; You Investigate Meaning; You Decide to Matter; You Accept Your Obligation to Make Meaning; You Decide to Matter; You Honor Your Wants, Needs, and Values; You Create a Life-Purpose Vision; You Use Your Existential Intelligence; You Focus on Meaning Rather Than Mood; You Snap Out of Trance; You Reckon with the Facts of Existence; You Personalize a Vocabulary of Meaning; You Incant Meaning; You Maintain a Morning Meaning Practice; You Negotiate Each Day; You Seize Meaning Opportunities; You Handle Meaning Crises; You Engage in Existential Self-Care; You Engage in Cognitive Self-Care; and You Engage in Behavioral Self-Care.
However much we want to live proudly and authentically, this kind of arduous existential program may prove too difficult for us to implement. But Dr. Maisel encourages us to try, because we might surprise ourselves that it is not impossible to achieve: “Maybe you’ll find authentic living suitable and doable. Let’s champion that hope!”
Dr. Maisel’s hope is that we stand tall, make ourselves proud by living authentically, and face life’s challenges, armed with the awareness to make meaning, seize meaning opportunities, and live with a purpose that is true to our beliefs and passions. We will experience unhappiness; we are human. It’s how we deal with it that matters. Do we hide? Do we shop? Do we fall into our addictions and maybe one day emerge from that darkness? Do we call ourselves “depressed” and let it go at that? Or do we live authentically and face life’s challenges, doing our best? Do we choose to make meaning in spite of, or because of, we have the courage to make meaning no matter what happens?
But where do we find the answers to these complex and challenging questions? And how do we make our lives meaningful when so much is pulling us toward the opposite direction?
Dr. Maisel believes that to live without “depression” you begin by practicing an existential program. He writes, “What is an existential program? It is people taking as much control as possible of their thoughts, their attitudes, their moods, their behaviors, and their very orientation toward life and turning their innate freedom into a virtue and a blessing. Even if people decide to take antidepressants or engage in psychotherapy to get help with their unhappiness, they will still have to find ways of dealing with their meaning needs, the shadows of their personality, their consciousness of mortality, and the facts of existence.
“Living authentically means organizing your life around your answers to three fundamental questions. The first is, ‘What matters to you?’ The second is, ‘Are your thoughts aligned with what matters to you?’ The third is, ‘Are your behaviors aligned with what matters to you?’ You accept and embrace the fact that you are the final arbiter of your life’s meaning. With this approach to life, each day is a project requiring existential engineering skills as you bridge your way from one meaningful experience to the next. By accepting the realities of life and by asserting that you are the sole arbiter of the meaning in your life, you provide yourself sure footing as you actively make meaning.
“If we can begin to move from the ‘depression is a mental disorder’ model to the idea that human beings must deal more effectively with the realities of human existence, including the realities of sadness, despair, and grief, we will have taken a giant step away from ‘medicalizing everything’ and toward lives lived with renewed passion, power and purpose.”
How would my life have been different if, as a young woman, when I experienced the gravest existential crisis of my life, someone had helped me face my sadness so I could make meaning and move through the life-shattering grief until the healing began, instead of burying myself in self-destructive behavior, addictions and years of being lost? What different path would I have taken if I had held a morning meaning practice and strove to find meaning because I mattered, instead of falling into the hell of the darkest and deepest “depression”? And, yet, because I have changed my vocabulary to include words like “meaning opportunity,” “meaning investment,” and “meaning crisis,” and I do my best to make meaning now, the deep healing occurs and will continue to occur. Because I have decided what matters to me, because I align my thoughts with what matters to me, and because I align my behaviors with what matters to me, I am able to embrace all that my life has been, is, and will be. I can’t change what happened when I was a young woman, but I can change my relationship to it: I am the arbiter of my life. And I believe this is what Rethinking Depression is about: It’s a battle cry for me to take charge of my life, to be centered and whole, authentic and proud because I make meaning and don’t wait for meaning to appear. Because it won’t. And that’s okay, because I’m the one in charge of my happiness and unhappiness.
Life is a myriad of choices and experiences, and I choose to live like I matter. The more I clarify and bring to the forefront what matters to me, the more I am able to align my thoughts with what matters to me. And the more I align my thoughts with what matters to me, the more I am able to align my actions with what matters to me. When I am armed in this way, life can throw me any curve it wants; I will look it in the eye, and, with courage, make choices and take action based on my life’s purpose. I will experience all of life’s happy times and unhappy times and remain true to who I am. I will banish the word “depression” from my vocabulary because it doesn’t serve me. It never did.
Dr. Maisel ends Rethinking Depression with these words: “If, however, you experience the thing called ‘depression’ and feel like exploring an existential approach to climbing out of that hole, give my program a try. The word depression is a corruption of language, and the more society uses it, the further it will push us all toward unhappiness. Pathologizing unhappiness creates unhappiness. Reject the very idea of depression and make meaning instead.”
I hope you read this book so that you, too, can banish the word “depression” from your vocabulary—because it doesn’t serve you, either. I hope you begin to implement even a little of Dr. Maisel’s existential program and decide what matters to you, aligning your thoughts and behavior to what matters to you. I hope you live an authentic life, one that you are proud of, because you matter.
Dr. Maisel has given his permission to quote from his book, Rethinking Depression.
Eric Maisel, PhD, is a licensed psychotherapist and the author of over forty books including Coaching the Artist Within, The Van Gogh Blues, Mastering Creative Anxiety, Brainstorm, and A Writer’s San Francisco. He blogs for Psychology Today and the Huffington Post, and writes a regular column for Professional Artist Magazine. He is widely regarded as America’s foremost creativity coach (a new profession he began after leaving his private therapist practice). He trains creativity coaches nationally and internationally and provides core trainings for the Creativity Coaching Association. In addition, he is crafting a new psychology of meaning. You can visit Dr. Maisel online at ericmaisel.com.