How to use metaphor to overcome depression

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3 depression-busting metaphors for depressed clients

'Depression' can be a scary diagnosis, conjuring up as it does connotations of 'disease' and 'genetic chemical imbalances' and other frightening notions. But in fact, although depression is a state of mind which significantly affects energy levels in the body, there's no real evidence that it has a biological cause beyond psychological learning or temporary response to one or more of life's setbacks.

So with no real hard evidence for a physical cause, we can see that the idea of depression as 'disease' is itself nothing more than a metaphor - but one that is often assumed to be literally true. 'Illnesses' or 'conditions' imply difficulty, outside agency, potentially long term trouble, and increased likelihood of recurrence.

It's worth bearing in mind that some depressed folk rather welcome the metaphor of 'disease', as this gives them (and allows them to give others) a socially recognized signal that their depressed state is not their fault (which, of course, it isn't, 'disease' or not), but the risk is that this label renders them more passive and less likely to take the steps that would make a difference.

There is much stronger evidence that most depression has psychological causes. Once the 'cycle of depression' is understood, we can see that it's potentially very treatable, and that metaphorical approaches can be highly effective.

Here are three powerful and hopeful metaphors that can be used when treating depressed clients that will give them a fresh perspective on their experience.

1 Flat battery

We all get tired and need to 'recharge our batteries' sometimes. Depression is basically a state of extreme exhaustion, which results in loss of hope, motivation, joy and self confidence. This exhaustion or 'flatness' occurs because depressed people spend too much time dreaming. REM, or dream sleep, isn't the restful recuperative part of sleep. That usually comes later in the sleep cycle. But the endless negative focus of depressed people during the day creates a backlog of negative arousal which REM sleep has to discharge. The brain responds by generating more REM - but at the cost of deep sleep. It's a vicious cycle.

This explanation often makes real intuitive sense to depressed people.

I might say something like:

Depression is really like a battery run flat. All that firing off of the REM response at night tires out the system, meaning that rather than getting rested from your sleep, it's been tiring you out. As you begin to worry less and relax more during the day, you'll quickly begin to dream less at night and the extra deep slow wave sleep you'll have as a result will immediately start to 're-charge your battery' so that you'll begin to awaken with renewed motivation and energy...

2 Boat on the river

I like to normalize and 'de-scarify' depression as much as possible. If someone has had a bereavement, or a divorce, or perhaps got overwhelmed at work, and then became depressed, I might suggest that carrying on as normal wouldn't be natural - or even useful! - under these circumstances. I might say that shutting down energy for a while may even be serving a valuable purpose. I might say:

Imagine a boat going along a river with many different little branches running off it. If the way ahead is suddenly blocked, you don't just carry on as if nothing has happened! The boat needs to stop for a while... in order to re-orientate. It needs to do nothing for a bit. Eventually, you may decide you can remove the blockage and continue the way you were going, or you might begin to see an alternate route you can take... but whatever happens... you need to stop for a while in order to make sense of things and decide what to do next...

This metaphor is nice because it identifies depression as a natural response to feeling stuck. It implies that this is a passing experience, that it's not their fault, and at the same time it offers a sense of hope for the future without piling on the guilt for not having done anything.

3 Flying high

Depression, because it is powered by strong emotion, tends to induce 'black or white' or 'all or nothing' thinking. If success isn't 100% but only 99%, then the whole thing has been a disaster! People are often encouraged to engage in positive thinking to help them overcome the cloud of negativity that's so typical of depression. This is excellent advice providing it is followed without falling into the very same trap, and thus ending up locked into depression for longer than necessary.

For example, a depressed person may feel that to get 'well' they need to feel absolutely great all the time and that any down days must mean the depression is back. I like to challenge this kind of utopianism indirectly with another metaphor:

You know, we all go up and down a little bit without becoming depressed and that's fine. When you're travelling in a plane, the plane is constantly going up and down a little bit... but you don't really notice it because generally and for the most part the plane is travelling forward in the right direction...

And while imparting this I might illustrate what I mean with my hand going up and down ever so slightly.

Introducing these metaphors into your work can be done quite naturally -you can drop them almost casually into conversation with your clients - but their effects can be powerfully therapeutic.

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