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Depression and embodiment: phenomenological reflections on motility, affectivity, and transcendence

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Abstract

This paper integrates personal narratives with the methods of phenomenology in order to draw some general conclusions about ‘what it means’ and ‘what it feels like’ to be depressed. The analysis has three parts. First, it explores the ways in which depression disrupts everyday experiences of spatial orientation and motility. This disruption makes it difficult for the person to move and perform basic functional tasks, resulting in a collapse or contraction of the life-world. Second, it illustrates how depression creates a situational atmosphere of emotional indifference that reduces the person’s ability to qualitatively distinguish what matters in his or her life because nothing stands out as significant or important anymore. In this regard, depression is distinct from other feelings because it is not directed towards particular objects or situations but to the world as a whole. Finally, the paper examines how depression diminishes the possibility for ‘self-creation’ or ‘self-making’. Restricted by the illness, depression becomes something of a destiny, preventing the person from being open and free to access a range of alternative self-interpretations, identities, and possible ways of being-in-the-world.

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Notes

  1. To make her case, Angell points to a 35 fold increase in mental disorders among children from 1987 to 2007 and the fact that nearly half of all Americans met the criteria for a psychiatric disorder as established by the American Psychiatric Association (APA) (Angell 2011a). Contributing to this epidemic is the ever-increasing number of diagnostic categories in the Diagnostic and Statistical Manual of Mental Disorders (DSM), the current edition of which contains 365 different psychiatric diagnoses. Angell also cites the fact that of the 170 contributors to the current DSM, over half had financial ties to drug companies, “including all of the contributors to the sections on mood disorders and schizophrenia” (Angell 2011b; Cosgrove 2006).

  2. The result, according to Angell, is that since the introduction of Prozac in 1987, “the number of people treated for depression [has] tripled… and about 10 percent of Americans over age six now take antidepressants” (2011a). Angell goes on to point out that despite its cultural pervasiveness as a causal explanation, the chemical imbalance theory has never been empirically demonstrated. Moreover, studies have repeatedly shown that the medications used to treat depression are only marginally better than placebos in double blind clinical trials and that drug companies tend to only publish positive results in medical journals, while the negative results usually remain unpublished (2011a). Angell goes on to suggest that long-term use of the most popular antidepressants (selective serotonin reuptake inhibitors or SSRIs such as Prozac, Zoloft, and Celexa) may even cause a type of iatrogenic or medically induced brain damage by fundamentally altering neural functioning, making it exceedingly difficult to get off the medications (2011a).

  3. Kramer, Oldham, and Carlat agreed with a number of Angell’s points, for instance, that psychiatrists are often too quick to medicalize ordinary feelings of grief, sadness, and anxiety with little or no biological evidence for these diagnoses; that psychiatric medications are overprescribed as the first line of treatment; and that clinicians and research psychiatrists are too ready to accept money from the drug industry resulting in increasing conflicts of interest. Kramer (2011), however, criticized Angell’s reticence in accepting the medical legitimacy of depression and highlighted the long-term efficacy and health promoting benefits of antidepressants. Oldman (2011)argued that whether or not “chemical imbalances are causes of mental disorders or symptoms of them” is not the point. “The bottom line is that medications often relieve the patient’s suffering, and this is why doctors prescribe them.” And Carlat (2011) claimed that regardless of the evidence provided by Angell regarding the scientific validity of the chemical imbalance theory, the “unequivocal if perplexing truth about psychiatric drugs—on the whole, [is that] they work.”

  4. Shenk (2001) describes the difficulty of capturing in words the experience of depersonalization. “Words—unhappy, anxious, lonely—seemed plainly inadequate, as did modifiers: all the time, without relief. Ordinary phrases such as I feel bad or I am unhappy seemed pallid. Evocative metaphors—My soul is burned skin, aching at any touch. I have the emotional equivalent of a dislocated limb—were garish. Though this language hinted at how bad I felt, it could not express what it felt like to be me” (pp. 248–49).

  5. But regardless of the identity I happen to choose, I am also not that person because I can always question myself and choose to assign different meanings and values to my experiences in the future. In short, there is no pre-given nature or essence that ultimately determines or defines me as a human being because my identity is always penetrated by a ‘not’ (Sartre 1946/2000, 293).

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Acknowledgments

A draft of this paper was originally presented at the ‘Bodies Knowing Bodies’ Symposium in Uppsala, Sweden in November of 2011. I am thankful to Linda Martín Alcoff, Lisa Kall, Carrie Paechter and especially Fredrik Svenaeus for their thoughtful comments. I am also thankful to three anonymous referees who offered helpful suggestions to sharpen the paper.

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Correspondence to Kevin A. Aho.

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Aho, K.A. Depression and embodiment: phenomenological reflections on motility, affectivity, and transcendence. Med Health Care and Philos 16, 751–759 (2013). https://doi.org/10.1007/s11019-013-9470-8

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