What is a Life After Depression Meant to Look Like?

Psychiatric disorders like clinical depression rob us of our ability to experience the terrible pain and trauma of a life lived well. How deliciously ironic that a lot of people now believe those emotional experiences are themselves the manifestations of mental illness!

This is the final installment of a Wise & Well Special Report: The United States of Depression.

Recently I attended an event at the Edinburgh International Book Festival at which the author and Princeton academic Yiyun Li was being interviewed about her latest novel, The Book of Goose (2023). The discussion was wide-ranging, but what didn’t come up was that, in 2012, she had a breakdown, attempted suicide twice, was hospitalized, eventually recovered, and shortly after she returned to the land of the living to pick up the pieces of her life, her sixteen-year-old son killed himself.

I found out these aspects of her biography after the event, and I couldn’t square it. How could someone who had endured such terror and torment summon the joy with which she spoke? She was so full of grace, quick to find the humor in the moment, worldly-wise but not at all cynical. There was not even a whiff of cynicism.

The closest she came to offering advice on how to live a joyful and meaningful life was in the context of creative writing. There is a very human tendency to look inwards, she said. Lightly but emphatically, she told us: “Don’t forget to look out.”

The quiet grace of living well

Depression, it so often turns out, is a useful precursor to living a life of excellence. It’s an instruction manual, of sorts, on how to filter out the flotsam and then to hero what’s left. It’s a well-trodden path; dig into the past of people who have achieved truly amazing things, and you will almost always find trauma or hardship or terror. Abraham Lincoln experienced two major depressive breakdowns as a young man, but went on to become President of the United States. Beethoven endured terrible depressive episodes after he started losing his hearing early on in life, but he kept on going and it was in his so-called “late period” (from 1812 to his death in 1827) that he composed many of his most admired and musically innovative works, the last five piano sonatas, the late string quartets and the Ninth Symphony included.

Not everyone can be a Lincoln or a Beethoven, but those of us who endure and survive a terrible clinical depression — and here I speak from experience — know how gloriously joyous life actually can be. It is a truly great aspect of life after depression — you finally give yourself permission to break free of how unrelentingly bleak most people’s lives actually are. Because clinical depression is the body’s last defence against living the wrong life. It has nothing to do, incidentally, with mainstream “mental health” discussions (that nebulous construct which is nowadays so wide-ranging it basically means nothing). Nor does it have anything to do with worrying a lot (now called “an anxiety condition”) or being “stressed” all the time or “breaking down and burning out” (the new middle-class status symbol).

Clinical depression is the opposite of hope, not just its absence but the void in which the possibility of hope might even exist, and it is gloriously terrifying. And if you don’t seize the opportunity to make the changes you know in your heart you must, but which — for some perfectly plausible, perfectly sensible, and totally legitimate reason — you have ignored or outright denied, you will probably die. Many do. The stakes are that high.

So a post-depression life will look different, and thank goodness for it. That is the whole point. But what that life won’t look like is a perpetual sunrise of happiness and joy. Who would even want that? Life needs despair. We need despair. And what we should ask ourselves is why so much of the commentary about depression posits a false dichotomy between happiness and despair in the first place.

The rise of the worried well

These are troubled times. Meaningless jobs, family dysfunction, the collapse of manners, economic malaise. And a culture which hasn’t found a way of articulating the scale of our discontent.

Nature abhors a vacuum, and perhaps that is one of the reasons why a narrative has taken hold that we are in the grip of a mental health crisis. Modern life, it is argued, is making us all ill. Maybe it is, maybe it isn’t, but either way it is quite a limited and infantilising perspective.

Is it possible we have lost the ability to distinguish between ‘normal’ suffering and actual illness?

Dr Lucy Foulkes, an academic psychologist at Oxford University and the author of Losing Our Minds: What Mental Illness Really Is (2021), thinks so. “If every low mood is described as depression, if every psychological difficulty is framed as a mental illness,” she writes, “then we risk losing sight of the people who are truly ill.”

Foulkes encourages us to think more carefully about the language we use to describe our distress, and to make more meaningful distinctions between difficult experiences and the pathology of diagnosed mental illness.

Everyone has “mental health!”

What is a life after depression meant to look like? It’s the unassailable and joyous experience of everything in vivid technicolor: the good and the ghastly, the mad and the magnificent. It’s all of it, amplified and tainted by the knowledge we might never have lived to see it. It’s one of the gloriously perverse reasons people who once entertained ending it all, or wished they were dead, are so optimistic about the future.

I am more enthusiastic about life than I have ever been, and I have that horrible bout of clinical depression to thank for it!

And what a pity that the people who get to experience all that abundance without a fight are so easily seduced into relinquishing their entitlement to it. Mental health is the new gruel for the masses. But that’s what happens, as Foulkes and others have accurately pinpointed, when we over-pathologize common emotional experiences.

The false dichotomy between happiness and despair

Mass public re-education programs about “mental health” are very helpful public policy in an era where living standards are in terrible decline. If — as a matter of macroeconomic policy — you can’t change the plight of the majority of the state’s citizens, many of whom are living objectively miserable lives, all that’s left (at least as a short-term measure) is to persuade them that they’re miserable because there’s something wrong with them, that they are, in fact, ill. It’s a fascinating and problematic intersection between a newly fashionable appetite to be ill and a wider social malaise.

This, I fear, is the ultimate source of the happiness/despair false binary. The subliminal message encoded into mental health public policy is that, if you’re unhappy, you must be mentally ill. Wrong! You might be unhappy because your life is objectively awful.

Like trust funds, stately homes and million-dollar paychecks, mental illness is the preserve of an elite minority. It’s a difficult truth people don’t want to hear, that suffering the symptoms of mental distress does not a pathological condition make. And sometimes, despair is the only rational response to a terrible life lived badly.

“[S]ometimes we may be in the realm not of psychiatric disorder,” Dr Foulkes writes, “but rather in the tangled landscape of our rich and painful lives.” Pretending otherwise only exacerbates an already very difficult problem, and it locks people into victimhood.

Don’t change your life, change your attitude. It’s window dressing. Because if we really embrace what good mental health looks like — in all its forms, in all its manifestations — every aspect of our life might change. And most people don’t have that luxury. That people even refer to it as a “luxury” is, of itself, telling.

The negative consequences of national mental health campaigns

I’m frequently surprised by how little people actually know about mental illness. Public awareness of mental illness has been transformed in recent years, but psychiatric disorders are routinely confused with the inherent stresses and drudgery of life. It’s the worst form of ignorance, because people tend to feel highly educated on the topic. As well they should, for “mental health” is everywhere, and it is super fashionable. People — especially young people — are bombarded with information telling them that there is a mental health crisis, and that they are in its grip.

It is, as a form of mis-knowledge, weirdly rose-tinted. Mental ill-health is a lot messier than mainstream commentary cares to admit, nor do I detect any meaningful shift in cultural attitudes towards those who are actually mentally ill. Visit a mental health ward and you will find shattered lives: schizophrenia and violence and psychosis. This is the sharp end of the condition. You won’t find a modern-day Balzac sitting quietly in the corner angsting over the existential misery of man. The land of meditation and mindfulness and wellness productivity mantras it is not.

The undoubtedly well-intentioned effort to improve public awareness of mental health has spectacularly backfired.

Now, people who suffer serious mental ill-health are lumped in with people who worry and ruminate and are losing at life and call it “anxiety.” In the end, this does a disservice to both groups — the people for whom mindfulness is a load of old twaddle (it is to clinical depression what rearranging the deckchairs was to the Titanic) and those who are actually fine but need to try a bit harder to do something with their life. For those people — and they are the majority — all of this mental health chitter chatter is cruelly denuding them of their autonomy.

There’s nothing wrong with “working on oneself.” Everyone should be doing that, and all but the most bone-idle and ignorant do. But there is a dark side of mindfulness, and there is increasing evidence that too much navel-gazing actually increases depression.

“If the under-examined life is not worth living,” as the glorious hell-raiser Julie Birchill put it so succinctly (she lost her son to clinical depression), “equally the over-examined life has a habit of becoming half a life.”

People can wallow in pseudo mental health non-conditions if they must, but those of us who have actually had a mental illness know that it’s much more fun focusing on strength and bravery and daring against the odds. How many people use “mental health” as a proxy for a more fundamental discontent? Are they ill or are they merely distressed?

Mindfulness. Meditation. Well-being. To be free of clinical depression is to be free of all this nonsense. Increasingly, people are starting to see it for the snake oil it is. All forms of psychological distress are the price we pay for being alive.

This article is the final installment in a Wise & Well Special Report: The United States of Depression. If you or a loved one is depressed, it’s vital to talk about it. Because depression increases the risk of suicide, consider calling the confidential National Suicide Prevention Lifeline at 1–800–273-TALK (8255) for English, 1–888–628–9454 for Spanish, or call or text 988. Global support in 44 languages is available from Befrienders Worldwide.