In an earlier post I suggested some differences between unhappiness and depression. I now think that I confused the terms "unhappiness" and "grief" by compounding them. At the time it seemed important to me to avoid confusing depression with grief/unhappiness. People generally confuse depression and unhappiness, not realizing that depression is a treatable (and curable) illness.
Grief is not a part of unhappiness, I believe. Grief is a natural healing process that provides relief from losses occurring in all of our lives. It is possible to have a happy and satisfying life even though it is visited by grief at times. Unhappiness is a different emotion, resembling depression more than grief in that it is generally not time-limited, as grief normally is. However, depression is an illness that is characterized by anger or hopelessness directed at the self, while unhappiness is the result of life problems and circumstances that are not suitable for the individual experiencing them.
We can understand grief and depression fairly easily. Unhappiness, however, can result from either circumstances beyond our control (life in a concentration camp, for instance) or from circumstances that could be changed but at a price the person believes may be too high. When our lives are unsuitable for us, we become unhappy, and the unhappiness can endure as long as conditions remain the same. However, I am also aware that many individuals have achieved a happy life in spite of terribly unsuitable and difficult life situations, and that most of us have experienced periods of happiness even during difficult times. Obviously the condition of unhappiness is not solely conditioned by external circumstances.
Unhappiness, then, is composed at the least of our awareness that our life situation is not what we need it to be. One patient described his chronic unhappiness very well: "It's like wearing your shoes on the wrong feet. You can do it, you can even walk in them, but nothing feels right and everything seems to hurt."
Sometimes it seems to me that people choose to remain in unhappy circumstances rather than face the uncertainty and risk of change. This is especially true with those who have never really been happy. When we know no other way to survive than through an unhappy life-style, we tend to avoid chance-taking. For example, I think of the many abused spouses who elect to remain in their marriage rather than risk the uncertainty of trying to survive alone, or to risk the moral judgment of one's religion, or whatever. People get "stuck" in bad jobs and bad relationships, unwilling to risk alternatives or change. Sometimes they even get stuck in lifestyles that they believe are "right" but which result in chronic dissatisfaction and unhappiness.
People can (and should) get treatment for depression. While they sometimes ask for treatment for grief, little beyond support (or supportive treatment) is necessary. In fact, psychotherapeutic intervention for grief may even be harmful in that it treats a normal human response to loss as if it were some sort of pathology.
What about unhappiness? Should we treat that in psychotherapy? In general, I believe it is useful to use psychotherapy as a tool in treating someone who is unhappy over a longer period of time. The therapeutic issue that immediately arises is whether the situation and circumstances that give rise to the unhappiness are chosen by the patient or imposed on the patient. To what degree does the person consent to the circumstances of their life? Can they find their current situation livable if they change their attitude and values? Sometimes the answer is yes. Sometimes, however, the answer is no, and the patient must decide to live with their unhappiness or to change their circumstances. The latter choice is rarely welcomed by partners and family members.
Frequently, if not invariably, the unhappy person has to examine their values and the choices arising from those values. Changing values and associated behaviors is not an easy task, but then neither is living with unhappiness.
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Hullo Harry, I found your blog while searching for an article in the UK Daily Express which I read two days ago, on the subject of whether unhappiness should be treated as depression. It is something I am struggling with myself at the moment, and have been writing about on my blog. Having told my GP that I was depressed, and filled in the appropriate questionnaire, on which I rated high enough to need treatment, she then suggested that many of my symptoms were caused by old age (I am 81) so did not rank as symptoms of depression. That is something I was not sure I agreed with, but I was reluctant to add another pill to what I take already so I decided against treatment.
ReplyDeleteThen I found various articles in the media and have been having a good think about this whole issue. As a result, I have decided that I am not depressed, because I am still in control and can take steps to improve my mood.
But I am undoubtedly sad/unhappy, and that is because I am old, have heart disease, and feel that death is no longer following me at a distance but is walking at my shoulder. This sense of the shortening of the distance has come upon me so suddenly that it scares me.
I am also trying to manage feelings of grief and guilt for the loss of a husband 2 years ago, from whom I had been separated for more than 20 years. I cannot change the circumstances of my age, nor, alas of my relationship with my husband. The latter is, I think, a grief that I simply have to bear, but perhaps I can work on a change of attitude towards my mortality.
Does this look as though I am asking for therapy via your blog? Sorry if so. It started off just as a comment, as I try to untangle the differences between depression and unhappiness, but not being a professional I can only comment from my own experience.