I reviwed a lady with F33.4 Recurrent depressive disorder, currently in remission.
She is unhappy. She in not clinically depressed. Real life is unpleasant so she feels saddened. A normal human emotion to a normal situation. I've no pill for this scenario, either.
It's difficult. Some clever philosopher who's name escapes me reckoned there are only 3 outcomes to choose for any problem :
- you address it, solving it
- you accept it, then live with it
- you don't accept it, then walk away from the situation
In a simplistic, reductionist way it's true, how else would you manage any situation?
With this in mind, I counsel her in all 3 areas. I make suggestions and look at solutions; she's not keen to make pragmatic change. She's not keen to look at accepting her situation; she wants to feel happy. She won't leave her abusive husband, her home of 20-odd years or her nearby difficult/thieving grandchildren to walk away from the stresses to live with her daughter, on the coast.
She wants to be in the same situation, with the same stresses, making no changes, but feel happy. She's well, she's not depressed, she's active. We agree there are no outward signs I'd see differently if she were happy (i.e. she's going to bingo, she's going shopping, she's knitting for family, she bakes for the local church), her mood's not changing her bahviour or limiting her one iota. It's just, the joy of life's not quite there any more and she's like it back, through a pill, please.
I can treat depression, most of the time. But gifting bliss is beyond me. I am not a stand up comic, a clown, or a Butlins red coat. Making people happy is not my job. So why do I sometimes feel it should be?