What is Depression?
You cannot separate subjective suffering from the subject of the suffering.
For all today's bluster about mental health awareness, I rarely see compelling or empathetic discussion of what mental illness is. Intuitively, we understand a broken bone is a thing, a damaged physical object, an injured part of a human body. A viral infection is at least a physical event, an infestation of minuscule packets of genetic information, propagated through a human body. The common story goes that depression is an imbalance of neurotransmitters, an issue with brain chemistry. While I don't think this story is entirely without merit—I don’t want to discourage anyone from seeing if medication-based treatment can help them—it doesn't satisfy me. It seems to sidestep the problem. I want to propose a different definition of depression, not as a physical issue with human body, but as a self-reinforcing pattern of subjective phenomenological experience—in my case, recursively-driven dissociative yearning.
The neurotransmitter story of depression differs from broken bones and viral infections on the grounds of diagnosis. The latter two afflictions are (or at least, can be) physically verified. A swab up the nose can physically detect a virus, an x-ray gives a picture of a shattered radius & ulna. This isn't the case with depression. No doctor is taking samples of brain tissue to check for neurotransmitter balance. The neurotransmitter theory comes later, a post-hoc explanation for the physical behavior and subjective phenomenological symptoms on which depression is actually diagnosed.
The latter category, subjective phenomenological symptoms, is of interest. Consider that a doctor might diagnose a patient with a viral infection by listening to them describe how they feel. But even if the patient feels fine, they could still be diagnosed with that same infection if a nose swab come back positive. The subjective phenomenological symptoms (how the patient feels) are secondary to the observable physical evidence of infection (presence of virus in the body). Depression, by comparison, has no observable physical evidence. Like other mental illnesses, it's diagnosed wholly on self-reported phenomenology and assessments of behavior. Even if we could easily sample an individual's neurotransmitter levels, and found them shockingly low, they wouldn't be considered eligible for a modern depression diagnosis off that alone. Diagnosis of depression requires the presence of one of the following two subjective phenomenological symptoms, as per the DSM-5: – (1) Depressed mood most of the day, nearly every day – (2) Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day
There's no way to write this piece without discussing my personal case. I personally suffer from (2). I've suffered from some variation or degree of (1) and (2) since early adolescence. Personal experience is no small part of why the neurotransmitter story doesn't interest me. It is so detached from my moment-to-moment experience as to mean nothing. Telling me that the neurotransmitter levels in my brain are what causes my (2) has no meaningful connection to my actual experience of (2). You may as well tell me my depression is caused by bad humors in my blood, curses from devious sprites, or karmic retribution for past-life sins. I don't particularly care what the 'cause' is, because any hypothetical cause is so unrelated to what my experience of (2) actually is—straightforward phenomenology.
I am depressed—I can use that term to describe myself—because I experience (2). This is our starting point. My specific, idiosyncratic experience of (2) is my depression. This is to say, the way a broken arm is the shattered bone or a viral infection is the presence of parasitically self-propagating packets of genetic material, my depression is my phenomenological experience of (2). Maybe that phenomenological experience could be explained by neurotransmitters in the same way a broken arm can be explained by jumping off a playground slide or a viral infection can be explained by eating bad food. But the cause is not the affliction itself. The depression is the phenomena.
Talking about phenomenology is difficult, because words don't map cleanly onto it. The purpose of language is to do compression on phenomena, make concessions, create a sizable map of discrete entities permitting some simulacrum of phenomena to be socially shared. The word “tree” is meaningful between Joe and Jill because Joe's phenomenological understanding of what “tree” means is close enough to Jill's such that no discrepancy is likely to arise when casually discussing the subject. Extending this, it becomes immediately clear that mental illness is difficult to talk about because it constitutes a phenomenological malady. An individual's experience of mental illness is not similar enough to common experience to be easily shared and discussed the way a “tree” can. In fact, the patient is defined as mentally ill because they are outside the realm of typical experience. Being mentally ill means suffering from a painful abnormal phenomenology, which by its very nature exists outside the realm of shared experience where language is comfortable and highly effective.
There is no way for the mentally ill to go to a psychologist and show them their mental illness as it is, as they experience it. Subjective phenomena is singular and private. The depressed patient can only bring that psychologist words which compress the (massive, fundamental, confusing, exceedingly painful) phenomena of their mental illness into generalized, socially-useful language-space—then they can only hope the nuances are accurately unpacked on the psychologist's end. In fairness, when it comes to mental illness, a psychologist is probably better at unpacking language than most. It's their job. But no matter how talented and empathetic the psychologist is, as soon as they respond, the patient becomes the party responsible unpacking language into phenomenological understanding—a task they have to accomplish in spite of the phenomenological malady which brought them to the psychologist in the first place.
It should go without saying that valid advice which makes perfect sense within the frame of the psychologist’s intuition often has no hope of being accurately unpacked by a depressed patient. Packing-unpacking-packing-unpacking—it easily slips into unnoticed circular patterns, failing to develop either party's understanding of the core topic, that being the patient’s depression and how to treat it. Trying to use talk therapy to resolve depression is like trying to explain Ulysses using facial expressions. There simply isn't enough available nuance.
I think it's unfortunate how little grasp most people have on the concept of their own phenomenology. This might be the primary 'space' where helplessness in the face of mental illness exists. An individual obviously cannot debug issues with their phenomenology if they can't even meaningfully grasp what 'their phenomenology' is. At a minimum, I suspect it has to be understood—really understood—that emotions and feelings are not reducible to common-sense linguistic taxonomy. Consider descriptors like happy, sad, ambivalent, envious, loving. They're just words. They don't map onto clean-cut distinct phenomena, they just gesture toward broad, hazily-delineated fields within the greater continuum of possible phenomena. If you've lived, you've felt all of those things in a thousand different ways. Deeper than language, anyone can find that even simple feelings are multi-faceted textures of experience, constantly in flux, countless ineffable sensations arising and passing faster than they can be noticed—let alone rationally considered or narratively packaged. Trying to treat mental illness without increasing the fidelity of phenomenological perception is like trying to fix a car without recognizing the single engine under the hood as being made of many distinct parts.
In spite of these hurdles, I'm surprisingly optimistic about my grasp of of depression as a concept. Talking about phenomenology isn't impossible, just hard. I believe the perfect words can occasionally resonate, suddenly clarifying previously indescribable experiences. Such resonance is inherently personal—occurring on the fringes of language, in the ways it's experienced by an individual rather than the in role it serves as a social tool—but that doesn't mean there's zero utility in trying to share it. It would be a shame not to share something so meaningful. Most Zen koans are gibberish until they suddenly enlighten a disciple. The chance at conveying profound understanding is worth trying for.
A few months ago, amidst efforts to practice greater mindfulness, I began to notice a recurring phenomenological motif—the vast amount of time I spent with my consciousness fixated to the idea of an indistinct better future for myself. Fantasies about the next place I'll live, the next meal I'll eat, the next semester where I'll finally study every evening and have the marks to show for it. The feeling was deeply familiar, something I knew I'd been doing since childhood. I gave the habit a shorthand name (“future-tanha”)^{1} and casually noted as it occurred over the next few months.
Over that period, it became clear that “future-tanha” was only a subcategory, an acute instance of a more general feeling—a miserable yearning for an indistinct elsewhere, a yearning for the phenomena of elsewhere-itself^{2}. I recognized it everywhere, in childish daydreams and in suicidal ideation, in manic productivity and in mindless scrolling. Attempting to satiate it was why I used to smoke weed every night before bed, why I still pick up my phone to check the internet first thing almost every morning. So many of my reflexive actions are desperate sprints away from the present moment, toward a sedated, indeterminate elsewhere.
Then I realized, softly at first, but with increasing clarity, this is my depression.
The psychic discomfort that had haunted me since I was twelve, the perpetual internal suffering I've spent over a decade managing, is the presence of this feeling.
Coming to terms with this was an experience of profound resonance as discussed above, a moment of lucid conceptual collapse. It quickly became intuitively obvious that the signified 'my depression' pointed to was one-and-the-same as the signified 'my yearning for elsewhere' pointed to. This created immediate opportunities for new linguistic bootstrapping. Before, reflecting on the phenomena of my depression, I only had one direct-match word to play off it—'depression'. This insight gave me two more: 'yearning' and 'elsewhere', in conversation with one another. Suddenly, I could meaningfully recognize my depression not as a background tone, but as a happening—not as something external to my ego, but as something I do.
I began to recognize 'yearning for elsewhere' as a recursive process that had reinforced itself over the course of my entire life. When the moment is uncomfortable, the mind attaches to elsewhere—a fantasy, a distraction—to escape the discomfort. Maintaining such attachment to elsewhere is uncomfortable and taxing. The present gives itself freely—the future or the past must be constructed within the mind on the stage of the present. This is subtly taxing, subtly painful. Doing it continuously has the net effect of making the present continuously more painful, burdened by the pressure and stress of trying to always escape elsewhere. As the present grows painful, the need for escape becomes even greater—imagine a man dying of thirst, trying to drink more and more seawater. Over time, the mind becomes conditioned into a state of perpetual dissatisfaction with the moment of hand, wholly dependent on fantasies and distractions. Eventually, little or no pleasure exists in the present at all.
I'm not going to lay claim to having discovered the phenomenological mechanism by which depression occurs. I can only speak for myself. But this is a mechanism, a mental pattern, which can spiral into a full-blown clinical depression. It has in my case.
This is an unoriginal complaint, but the world we live in today offers more attention-colonizing 'elsewheres' than any other time in history. It's trivial to escape the moment by scrolling, browsing, ruminating on an endless flow of novel information. Any discomfort can be drowned out by quantity alone. It's all too easy to teach the mind to view an unadulterated present as a threat, something to be escaped. But as discussed, the effort of constructing past and future is painful. Once you've ruined your relationship to the present, there is nowhere comfortable left to go.
I haven't solved all my problems by recognizing my depression as yearning for elsewhere. There are still good and bad days, upswings and downswings that last weeks or months. It has, however, given me some faith back. It's exhausting to spend decades exploring your own mind, rotating through the same tired tropes, feeling broken, clinging to various stories and methodologies in hope of uncovering one that would explain it all. Stepping beyond language—depression as a 'sign'—and into phenomenology—depression as a 'happening', a pattern or motif in my phenomenology that occurs—has given me my first truly new lens on it. There's a part of me that's almost ashamed to write that, remembering all the times before where I convinced myself I'd finally figured it out. Perhaps this insight is just another example of that kind of self-delusion. But I won't talk myself out of a good thing. Words that emerge to describe a familiar, recognized phenomenology feel meaningfully distinct from words in search of a phenomenology to attach themselves to.
I suspect all of mental health care would be better if we started with phenomenology rather than language. You are not a language model, you are not a storybook, you are not a text. You are an embodied person. The complete experience that comes with that is your birthright—nothing is inconsequential or invalid. Every blank moment, every ineffable emotion, every intrusive thought, every hot flash, every half-dream, every weird tingle, every lump in your throat, every smile on your face—none of it is disposable. Depression isn't a lack of neurotransmitters, depression is a distortion of all that, a painful and tragic cognitive maladaptation. If we want to solve depression, we have to start deeper. We have to get in touch with the real moment-to-moment, what happens underneath the words we lean into so heavily.
Another depressive might not find the same 'yearning for elsewhere' that I did. Those words might just be a personal Zen koan, something that resonates with me and me alone. But I confidently believe that every depressive's suffering is in some way a happening, a profound phenomena. Recognizing that with as much nuance and understanding as possible is the minimal prerequisite for countering it—you have to know what's happening if you want to figure out how to make it no longer happen.
Recognizing this with increasing conviction has given me some dim long-term hope for the first time in a long time. That, too, is a happening.
footnotes
{1} I didn't care too much if this was an accurate use of “tanha”, but borrowed the word because the feeling manifested as a painful attachment to the future.
{2} I differentiate the “yearning for elsewhere” from “tanha” broadly, because where tanha attaches itself to many things (perhaps all things), this feeling is defined by its relation to the category of outside the present moment. I could have called it “elsewhere-tanha”, keeping in line with “future-tanha”, but freeing myself from my concerns about butchering Pali makes this all a little easier to discuss.
{3} I've begun to read Gendlin's classic book “Focusing”. What I experienced seems like a textbook case of what he describes as a “felt shift”. I haven't finished the book, so I can't unequivocally recommend it yet, but if this sort of thing interests you it's likely worth checking out.