Depression and Anxiety: All Roads Lead to Rome, Don’t They?

Over the course of twenty plus years I have worked with thousands of individuals, a good number who either report as being depressed, or anxious. The really odd thing is, that other than having somewhat similar symptoms, these people were so remarkably different from each other I wonder if we (those who label and treat others) might often be guilty of a fundamental perceptual error.  Let me explain.

Suppose four people arrive at my house.  At that moment in time, if viewed from the outside, there is one common feature that cannot be denied; they are all in the same place.  Similarly, it is absolutely true that the depressed and anxious people I see in my practice have fairly similar symptoms.  But the question that perplexed me, was this, “Regardless of how they are appearing now, does it matter how they got there”?

Generally, at least in the medical field, it doesn’t seem to make any difference whatsoever.  Rather,  it seems to be commonly accepted that if the same symptoms are appearing, then the treatment should be similar.  Almost assuredly this is what happens when you go to your family G.P., and he or she prescribes you an anti-depressant or anti-anxiety pill.

But should this be the way it is done?  Doesn’t it matter who the person is who is being prescribed that medication?

I think it makes a big difference, and here is the simple explanation for this belief.

No one is like anyone else.

We are all much more remarkably different than we are similar.  We have all travelled different roads to get to where we are and so we have all learned different ways of travelling.  I may be experiencing the same symptoms as another person who feels depressed but the reasons for that, how I got there, what I experienced, how I learned to deal with issues in my life, what that life  looks like now, who my friends are, how resourceful I am, how intelligent I am, and on and on.  We are  all different.

In my practice, my primary therapeutic concern at the outset, is trying to understand who I am talking to.  I am really not so concerned about understanding the road they have traveled down, as I am in discovering how they are travelling down that road. What have they learned about their world, what have they come to believe about themselves, about others?

How does this particular person sitting across from me think, how does she protect her self from her own suffering, how much does this person trust others, how frightened or angry is he, and a whole host of other issues that take time and effort to understand.  I need to understand this to know what roads this person can now take, and which ones they can’t.  What I am trying to understand  in order to figure out where we go from here,  is where are you at?

Before any human being can trust another, they have to experience that other as being trustworthy.   In order for that to happen, they have to have the experience of actually being seen, of being understood, of being properly located by the other. In fact, there is something fundamentally freeing about the experience of being genuinely discovered by another person who has no motive other than to find out where we are.

It is precisely because we have a taken a different path to get here, that we need to find our own unique way forward. We will take that different path when we are assured that someone knows enough about us to keep an eye on where we are going; someone we have learned to trust who knows enough about us to help us make decisions and choices that may not be right for someone else, but are right for us.