Dr. Harvey Max Chochinov is a distinguished professor of psychiatry at the University of Manitoba. His latest book is Dignity in Care: The Human Side of Medicine.
In February, just a few months after being elected to the United States Senate, Pennsylvania politician John Fetterman entered into a treatment program for depression. In an interview with CBS News show Sunday Morning last month, he recounted suffering a stroke in May, 2022, then fighting through a grueling Senate race that severely impacted his mental health. “You may have won,” he recalled thinking, “but depression can absolutely convince you that you actually lost.”
That’s because depression is a liar.
Depression tells you you’re not good enough. It whispers in your ear that you are flawed, that you are letting everyone down and that your life really doesn’t matter. When things are particularly bad, depression seems to be shouting these lies from the rooftops.
Depression sets a passing grade on your life that is insurmountable, and so, inevitably, depression tells you that you are failing. It leaves you feeling like the person you once were, or the person you think you need to be, is broken. This idea of “brokenness” or “fractured personhood” explains how depression tries to convince you to destroy yourself – why ending your life seems to be a way out. We try to eliminate the things we hate. Depression makes you believe your life is permanently shattered, and suicide offers a way of destroying the person you can no longer tolerate.
Depression isn’t concerned about logic, nor does it set rational expectations. I recall a physician who took his own life after his sibling died of the very disease in which he specialized. Depression, no doubt, convinced him he should have been able to save his sibling, and he, in turn, destroyed the person he somehow felt was responsible for not delivering a cure. The trauma of losing his sibling found him facing the limitations of what was possible, to which depression responded, “You should have been able to do more.”
The nature of trauma – whether physical, emotional or spiritual – has the capacity to shatter your sense of being in control. Irrespective of the type of trauma you encounter, including being a witness to trauma, the result is a heightened risk of suicide.
But why is this the case?
Those experiencing physical or sexual assault discover that they can be overpowered, leaving them feeling fragile and weak. Those experiencing intimate partner violence or child abuse discover that familial connections don’t necessarily protect them from violence, leaving them feeling defenceless. Those who are imprisoned learn that they cannot will themselves free, leaving them feeling trapped. The bereft discover that love can’t protect those they cherish from the ravages of illness or calamity, leaving them feeling helpless. And those bearing witness to trauma learn that their abhorrence and horror carry no sway whatsoever, leaving them feeling like impotent bystanders.
Feeling fragile, weak, defenceless, trapped, helpless or impotent in the wake of trauma is at complete odds with the person they once were or the person they want to be. And so, in directing their rage inward, they destroy the person they deem broken, fractured and unworthy of living.
Depression will try to convince you that you are beyond help, and that no words or advice or insight will loosen its pathological grip. Escaping this psychological monster won’t happen by trying to fulfill its insurmountable expectations; that will only cause additional torment, having you chase a finish line that is forever moving further down the track. This will make you feel inadequate, flawed – like you are failing; hence, playing right into depression’s hand.
Like many who encounter depression, I suspect Mr. Fetterman will emerge from this experience feeling humbled – acutely aware of his own flaws and limitations.
But here is the truth. Listen carefully, even though depression will try to tell you otherwise. Those perceived flaws and limitations have nothing to do with failing, but rather are simply part of being human. All humans are vulnerable and mortal. All human beings stumble and struggle and eventually yield to forces beyond their control.
For everyone, and without exception, personhood can fracture and life, at times, leaves us feeling broken. Leonard Cohen wrote, “There is a crack in everything, that’s how the light gets in.” That light is our glorious, fragile, collective humanity.
Depression, being an incessant liar, wants to hide that truth, intent to keep you languishing in the dark.
May the light get in once again.