contradictory, pointless, bearing very little relationship to reality

On the heels of Robin Williams’ death, some writers are sharing their experiences with depression.

The theme I find interesting are the themes around sufferer’s thoughts and beliefs. Therapists almost universally discuss cognitive distortions. I’ve been wondering if, in the case of very severe depression, framing these thoughts as distortions fails to capture the power of these thoughts and beliefs.

“Cognitive distortions” implies that a person is taking something real and selecting the negative, framing things in a negative light or intensifying the negative aspects/possibilities.

These are more like delusions that are firmly maintained with very little relationship to reality.

First, John Tabin:

To me a lot of the thinking in severe depression is more like a delusional system than distortions. They are not grounded in reality. When you’re that depressed, others seem blind and deluded–you’re the only one who sees things as they really are.

Depression is a skilled liar, using what you know is true as basis for a massive fraud. You know you’ll always be wrestling with your demons, and depression convinces you that you’ll always be in as much pain as you are right now. The kind of pain that’s so unbearable that you’d die to end it is not a permanent part of your life, no matter how much it feels that way.

Next, David Weigel:

If I’d imagined a dream job, it’d likely be the one I have now. But success doesn’t change the patterns of depression. These are the ways it hits me:

One: You earned none of what you have. You’re a fraud. People are going to find out. Everything your critics have said about you, from the guy who lobbed dodgeballs at your head to the hate-mailer who hated your Iowa story, is completely right.

Two: All that other stuff you feel, the negativity and the screw-ups? You definitely earned that, because you’re meant to fail. You’ve succeeded, and you still feel this way? Why, that’s proof that you won’t possibly feel better.

Three: Nobody truly likes you. They can desert you at any moment. They’re succeeding, and you’re not.

It’s contradictory, and pointless, and bears very little relationship to the reality of what you’re going through.

(hat tip: Elizabeth Nolan Brown)