Clinical Depression, Separation Anxiety: Allan Schwartz, Ph.D.

This is a comment that one of our readers recently posted in reaction to an article titled, "Loneliness, A Deadly Disease"

"The facts are these:
We live in a society that places utterly no value on human interaction. The overwhelming attitude of most people is rampant consumption and fostering an unquenchable thirst for more. The one avenue that most of us have in the pursuit of this is work. Lots and lots and lots of work. For good or for bad or for worse, that is the sole avenue of self-worth for many people; dare I even say most people?
And so that is to where I restrict my social outlet. I have long since given up on relationships because they have become the definition of filling other people's needs with no expectation of any kind that mine will be filled in turn..."

The person who posted this comment makes some valid observations about the pursuit of consumption and work. However, his premise that the root of the problem is that this society does not value human interaction is one with which I disagree.

From my perspective as a therapist and as a reader of fiction and philosophy, the root of the problem is human and universal. If you will permit me to become biblical for a moment, Adam and Eve's real punishment for biting the apple of knowledge in the Garden of Eden, was not only becoming aware of sexuality, but of the fact that life is finite and limited. Unlike all other living creatures, we are aware of death.

What is an existential crisis? It is the realization that each of us will one day die. It is understanding that life is not endless and that our days on this planet are numbered.

From the beginning of time, people have asked themselves the existential question, "If I am doomed to die, what is the point of my life?" It is a terrifying question and different people have attempted to answer it in different ways.

Those who are deeply religious deny there is an existential crisis because faith brings with it the achievement of an after-life. For these people, life is not limited but continues for all eternity. This is common to all the major world religions: Judaism, Catholicism, Christianity and Islam.

According to the author Ernest Becker, in his book The Denial of Death, most people put the notion of death out of their awareness and go about living their lives without thinking about their mortality. However, there are times when the fact of death breaks through to their conscious minds. When that happens they become temporarily terrified until the crisis passes and they achieve a new balance. What causes mortality to break through to consciouness? The death of friends, relatives and loved ones confronts even the greatest deniers of the fact that life is finite.

There are those who seem to have greater difficulty denying the fact of death. Among these are individuals who struggle with panic and anxiety disorders and various types of depression. Today, we are able to look at many of the causes of these disorders and find such factors as chemical imbalances in the brain, traumatizing childhoods and adulthoods, and such problems as neglect, abuse and addictions.

As a result of better understanding the causes of emotional disorders, we have greatly improved treatments with medications and more precise types of psychotherapies.

Yet, we tend to overlook the importance and even reality of each person's existential crisis. It is this crisis that I believe lies at the roots of depression and anxiety, in addition to those factors already mentioned. If this true, then what can we do about it in addition to medication and psychotherapy?

We each need to find meaning in our lives. Meaning is found through interpersonal relationships. This is also pointed out by the brilliant psychiatrist and psychotherapist, Irvin Yalom, MD. I highly recommend his many wonderful books, both fiction and non fiction.

As Yalom points out, it is the realization and knowledge that we influence others in ways that are positive that can provide a sense of meaning in our lives. That is why loneliness is so deadly. However, many people fail to realize that they have enormous influence on the lives of others. Whether they are friends or family, they are important to us and we are important to them. There are also the relationships with those at work and those we casually meet while walking in the street, riding the bus or train, and shopping in the supermarket and clothing store.

The pursuit of material items can be temporarily exciting but ends in a return to feelings of emptiness. The real "unquenchable thirst," the commentator mentioned, comes from meaninglessness.

In addition to acknowledging our importantance to others, it is also important to know that each of us is unique and individual. To put it another way, "No one else is quite like me. No one else had the specific events of childhood that happened to me and in the specific ways they happened." This is why you, me and each one of us is unique and special.

"No man is an island, entire of itself...any man's death diminishes me, because I am involved in mankind; and therefore never send to know for whom the bell tolls; it tolls for thee."

If you feel depressed and anxious, it is important that you enter psychotherapy. The therapy could be Cognitive Behavioral, Psychoanaytic, Jungian, Dialectical or some other. However, the treatment should include a search for ways to define life and its personal meanings through interaction with others and the removal of blocks to successful and intimate interacting. By "intimate" I do not mean sex as much as closeness, warmth and honesty. Let's not leave out your uniqueness and specialness as a human being.

Mainly wanted to give a positive response to Allan Schwartz article on what I believe is an MHMR blog located in Peacan Valley. I wanted the 'impacted folks' to be aware more than anyone else. All Dr. Schwartz says concerning TMS is right on the mark. However, we are considerable past that stage now. As one may have noticed over the past week or so, a number of universities as well as private science enterprises have come out with a bit of fan fair relating to the 'fact' that they have discovered that certain power stratas of ultrasound can be utilized for the treatment of mental illness. AND. . .if you conjoin electromagnetism to the mix you have what is referred to as the 'magical duo'.

The fact of the matter is. . .this is all true and good and the process is called 'electromagnetic brain animation'. An EBA generator was designed and [invented] by the Behavior Research Institute way back in 2003. To this date, following 22 successful clinical trials, a completely finished working model will be introduced to the mental health field in early 2010. Also, this may be a little dismaying to those making all these 'fan fair' announcements; BRI along with its medical director, William Rogers, own all patent use rights and accessory allowances required by all governmental bodies overseeing such instrumentation. That fact needs to be known but it is secondary right now as far as importance is concerned. They will be made aware soon enough. However, the great thing is there is now coming to the fore an ability to help those with crushing mental difficulties that is truly seminal in scope. Help is on the way and it will be here shortly.

I believe that there is a great Divinity in the Universe, but am agnostic on the question of whether there is some sort of "intelligent design" behind it, at least to the extent that "intelligent" implies some sort of will, or "plan". As to an individual afterlife - let us say that I am prepared to be pleasantly surprised.

I suppose that this should mean I am a candidate for a really nasty existential crisis. Indeed, perhaps I did have one, of sorts, some considerable time ago. These days, while I have moments of worrying whether it is worth being here, and whether it is worth going on, this has generally passed. The view that it is not worth proceeding in the face of inevitable death seems, not only rather egocentric, but human-centric, if I may put it that way. We humans - like all creatures, everywhere - are (it seems to me) natural expressions of the great Universal Divinity, whether that Divinity has will, or a plan, or not. It is natural for us to be here. True, we are aware of death, which is a bit of a drawback to humanity when compared to the state of other creatures. On the other hand, perhaps it is best to view as part of the price we pay for the huge blessings of being human - including the ability to apprehend, however dimly, the beauty of the great, if sometimes terrifying reality that gave us rise.

Part of the price of our coming is our going. This is sad - but it seems a price worth paying, however brief our passage through "this transitory life" (in the words of an anonymous Old English poet put it) may prove. My penultimate word is from Marcus Aurelius -

"Mortal man, you have lived as a citizen in this great city. What matter if that life is five or fifty years ? The laws of the city apply equally to all. So what is there to fear in your dismissal from the city ? This is no tyrant or corrupt judge who dismisses you, but the very same nature that brought you in. It is like the officer who engaged a comic actor dismissing him from the stage. 'But I have not played my five acts, only three.' 'True, but in life three acts can be the whole play.' Completion is determined by that being who caused first your composition and now your dissolution. You have no part in either causation. Go then in peace: the god who lets you go is at peace with you". ("Meditations" 12.36, trans. Martin Hammond).

If, as Shakespeare put it, "we are the stuff that dreams are made of, and our little lives are rounded with a sleep", well, so be it. The dream, while it lasts, can be beautiful.

Hope I have not been writing nonsense - it would not be the first time, as I am sure you know ...

The Existential Crisis, Depression, Anxiety and Mortality