DEPRESSION
A clinical illness or simply a passing state?
Depression often reflects a profound lack in our lives. It can affect our body, our brain and our mind. How does it act on each of these dimensions, and what can we do at each level?
The main forms of depression
1. Neurotic depression versus psychotic depression
○ Neurotic: less intense; contact with reality remains broadly preserved.
○ Psychotic: a serious disorder involving delusions and a break with reality.
2. Psychogenic depression versus endogenous depression
○ Psychogenic: triggered by psychological factors (stress, trauma, inner conflict).
○ Endogenous: attributed to biological causes (chemical imbalance), without a clear emotional trigger.
3. Reactive depression versus autonomous depression
○ Reactive: occurs in response to a specific event (loss, a break-up, failure).
○ Autonomous: develops without an identifiable external cause.
Complementary approaches
In addition to medical care (antidepressants, anxiolytics, etc.), one can adopt a holistic, Ayurvedic or herbal-medicine perspective.
● ‘Circular’ depression:
This is not strictly speaking a mental dysfunction, but a ‘state of mind’ in which one goes round in circles: excessive guilt, self-accusation, fixed ideas… These thoughts maintain the depressed mood and can become delusional (without necessarily developing into psychosis).
The effects of depression
● On the brain and body: fatigue, lack of motivation, sleep and appetite disturbances.
● On the mind: a pessimistic view of the future, a sense of constant suffering.
Freeing oneself from suffering involves meaning: finding a purpose, a responsibility to take on, a clear direction. In the Indian tradition, Dharma (doing one's duty in the service of others) is considered a universal antidote to suffering.
Medication and dependencies
Psychotropic treatments (neuroleptics, sleeping pills, anxiolytics) can shut down the dopamine reward system: no more effort, no more pleasure, and a loss of inspiration. A long withdrawal period, from six months to several years, without addictive substances, may be needed to restore balance. Plant extracts (griffonia, St John's wort, etc.) can accompany this withdrawal, provided one has a life plan to stay motivated.
Five thought mechanisms that feed depression
1. Conditional self-love
Self-esteem depends on performance: simply doubting one's abilities makes self-esteem drop and triggers a feeling of worthlessness.
2. Misunderstood despair
Hitting rock bottom should protect us and encourage us to bounce back. But we often see it as a problem in itself, when it can sometimes be a driving force for finding solutions and rediscovering hope.
3. Incessant projections
Imagining that ‘tomorrow everything will be better’ or endlessly dwelling on the past wastes precious cognitive energy and traps us in a repetitive pattern.
4. Inability to forgive
Anger at oneself and resentment towards others create an inner state of frustration and aggression that is conducive to depression.
5. An accumulating backlog
Faced with a growing to-do list, we feel overwhelmed and powerless. The thought of never catching up paralyses action and plunges us into inactivity.
Moving out of depression: building a personal roadmap
1. Meditation and breathing: finding an inner anchor.
2. Self-knowledge: exploring one's motivations and values and giving meaning to one's life.
3. Neuroscience and the microbiota: combining scientific learning and bodily practices to strengthen the brain–gut connection.
4. Goals and a life plan: defining small steps and a realistic, motivating action plan.
If depression stems from an unsatisfying life (lack of meaning, blockages, a stifling routine), it can continue indefinitely. You are not ‘ill’ in the strict sense, but functioning poorly in relation to your life. It is up to you, through your will and action, to break this cycle: psychiatry can help relieve symptoms, but real change comes from you.