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Dear Dr. Debug:
The short answer is that there are belief systems and styles of thinking that can set us up for clinical depression. However, these are not what I would call "choices" until we become aware of what we are doing and gain knowledge about alternatives. The power of our programming cannot be consciously understood or dealt with until we have adequate self-knowledge.
We all have had learning experiences that have set us up primarily for happiness or depression. For those of us who may have gained beliefs and styles that set us up primarily for happiness, until we are aware of the dynamics of our happiness, we cannot say we are "choosing" happiness. We can only say we are happy, but we may not fully understand why.
Depressions range from mild to severe. What most professionals call "clinical depression" has certain neurobiological characteristics that have lasted longer than two continuous weeks, such as early morning awakening with difficulty returning to sleep or fragmented sleep, significant loss of motivation, energy, or interest in life (suicidal feelings, ideas or plans, constant sadness), and, often, loss of appetite.
Although it is possible, in some exceptional circumstances, to "think our way out" of a clinical depression, it takes a huge restructuring of our lives, learning how to effectively reduce our emotional baggage, and a lot of support. For most of us, the most efficient way to fix the neurobiological elements is with an appropriate anti-depressant. However, anti-depressants only help the neurobiology. The particular stresses, belief systems, and environmental factors that may significantly contribute to a clinical depression are not fixed by anti-depressants.
What are the psychological factors that can set us up for clinical depression? On a simple level, the answer is "stress." However, stress comes in all sizes and flavors -- what is stress to you is not stress to me. And, stress does not always come from external sources. We all have what I call "background noise" in our brains. The burden that background noise places on our brain is based on how much unfinished emotional business has built up in our lives and upon how much "negative" programming we have endured.
"Unfinished business" is an easy concept to understand, but taking care of emotional business as it happens can be a skill that is difficult to learn. Stress-inducing belief systems consist of any beliefs that produce more stress than necessary, such as a belief that "we will always be criticized for what we do." If we grew up in a situation where we received a lot of put-downs and criticism, we may learn to expect them. When we expect that a bad thing will happen, we automatically switch into a state of fear that sets off fight-or-flight responses. Relatively constant switched-on fears often lead to clinical depression.
Another word I use to describe the end-product of stress is "burnout." Severe burnout is essentially clinical depression. We now know that stress increases neurochemicals related to cortisol that damage nerve cells, especially in an area of the brain called the hippocampus. That is, certain nerve cells actually get "burned." We also know that stress decreases certain neuroprotective chemicals. To read more about these findings, please go to www.hippocampus.us.
The word "programming" is more popularly known in this age of technology to mean "creating machine-readable coded instructions that allow a machine to perform a function." It can also mean "to train to perform automatically in a desired way" which is something like brainwashing.
Transactional analysts, such as Claude Steiner, use the word programming to describe a process: (1) we have an experience; (2) the experience teaches us something; (3) if we have the same experience many times, we begin to develop a theory; and (4) once we have a theory about life, relationships, or ourselves, we attempt to keep the theory, even if the theory may be mostly incorrect. One of the most important things to remember about human beings is that our theories always interfere with the correct assessment of reality. That is why scientists conduct double-blind studies. We all tend to bias data to keep our theories, rather than suspending, re-examining or questioning our beliefs. For instance, if we believe that we are not loveable, we will set things up to prove that we are not. In some circles, this is called a "self-fulfilling prophecy."
We each have our own sets of programming -- what we have been taught to believe about ourselves, life, and relationships. If we take the time to contemplate or consult with someone about our programming, we can learn what controls our stress levels and get to a place where we can make more conscious choices about happiness.
I hope this is helpful. For more information about programming, please visit www.AllAboutPsychotherapy.org. -- Best wishes, Dr. Debug.
Ron Sterling, M.D. (Dr. Debug) is an award-winning psychiatrist in Seattle, Washington. He has been writing for newspapers and magazines since 1998 on subjects ranging from good manners to senior mental health. He hosts and maintains the well-known Internet mental health center, DearShrink.com. The Doctor Debug column is dedicated to assisting with the "debugging of malfunctioning elements in our own personal programming."
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