Welcome to From Insults To Respect. Today’s topic: How might parents wisely respond to their teenager’s experience with depression?

Imagine your thirteen-year-old teenage daughter begins to express a concern about being depressed. Many in the psychiatric profession, heavily backed up by the pharmaceutical industry, would urge you to make an appointment with a psychiatrist as fast as you can. That approach typically leads to the doctor encouraging your daughter to take pills referred to as “antidepressants.” The main argument that is made for beginning this type of treatment is, “untreated depression is associated with an increased risk of suicide.”

This fear arousing comment frequently works because parents tend to jump from this statement to the thought that treatment with so-called antidepressants either eliminates this risk or significantly reduces it. But a large body of evidence suggests just the opposite: That the use of antidepressants doesn’t reduce the risk of suicide, but actually appears to increase it. At the same time many studies have been suggesting that depression is an inherently temporal phenomenon and most episodes will remit spontaneously even in the absence of treatment. There is reason to believe that depression is often beneficial and an adaptation that evolved because it keeps individuals focused on complex social issues until they can be resolved. Medications, although they sometimes appear to work by suppressing symptoms, they do so in a manner that leaves the underlying episode unaddressed and patients at elevated risk of relapse whenever they are taken away. Moreover, these drugs are associated with a number of troubling side effects, and many find that once they start using them, stopping them can lead to some awful withdrawal reactions that are far worse than the initial experience of depression.

Long before these drugs became available, William James, arguably the most brilliant American psychologist of all time, was forced to address his 13-year-old daughter’s struggle with depression. This was back in May 1900, while James was himself suffering from heart problems.

After failing to get satisfactory care from doctors in the United States, professor James and his wife went to Europe to see if he could find a more helpful doctor. His daughter, Peg, was left with family friends, Mr. and Mrs. Clarke, and their children. Upon receiving several letters from Peg expressing the difficulties she was going through, James wrote her a long, thoughtful reply, which I present for your consideration.

The Letter

Darling Peg,

Your letter came last night and explained sufficiently the cause of your long silence. You have evidently been in a bad state of spirits again, and dissatisfied with your environment; and I judge that you have been still more dissatisfied with the inner state of trying to consume your own smoke, and grin and bear it, so as to carry out your mother’s behests made after the time when you scared us so by your inexplicable tragic outcries in those earlier letters. Well! I believe you have been trying to do the manly thing under difficult circumstances, but one learns only gradually to do the best thing; and the best thing for you would be to write at least weekly, if only a post-card, and say just how things are going. If you are in bad spirits, there is no harm whatever in communicating that fact, and defining the character of it, or describing it as exactly as you like. The bad thing is to pour out the contents of one’s bad spirits on others and leave them with it, as it were, on their hands, as if it was for them to do something about it. That was what you did in your other letter which alarmed us so, for your shrieks of anguish were so excessive, and so unexplained by anything you told us in the way of fact, that we didn’t know but what you had suddenly gone crazy. That is the worst sort of thing you can do. The middle sort of thing is what you do this time—namely, keep silent for more than a fortnight, and when you do write, still write mysteriously about your sorrows, not quite open enough.

Now, my dear little girl, you have come to an age when the inward life develops and when some people (and on the whole those who have most of a destiny) find that all is not a bed of roses. Among other things there will be waves of terrible sadness, which last sometimes for days; and dissatisfaction with one’s self, and irritation at others, and anger at circumstances and stony insensibility, etc., etc., which taken together form a melancholy. Now, painful as it is, this is sent to us for an enlightenment. It always passes off, and we learn about life from it, and we ought to learn a great many good things if we react on it rightly. 

[From margin] (For instance, you learn how good a thing your home is, and your country, and your brothers, and you may learn to be more considerate of other people, who, you now learn, may have their inner weaknesses and sufferings, too.) 

Many persons take a kind of sickly delight in hugging it; and some sentimental ones may even be proud of it, as showing a fine sorrowful kind of sensibility. Such persons make a regular habit of the luxury of woe. That is the worst possible reaction on it. It is usually a sort of disease, when we get it strong, arising from the organism having generated some poison in the blood; and we mustn’t submit to it an hour longer than we can help, but jump at every chance to attend to anything cheerful or comic or take part in anything active that will divert us from our mean, pining inward state of feeling. When it passes off, as I said, we know more than we did before. And we must try to make it last as short a time as possible. The worst of it often is that, while we are in it, we don’t want to get out of it. We hate it, and yet we prefer staying in it—that is part of the disease. If we find ourselves like that, we must make ourselves do something different, go with people, speak cheerfully, set ourselves to some hard work, make ourselves sweat, etc.; and that is the good way of reacting that makes of us a valuable character. The disease makes you think of yourself all the time; and the way out of it is to keep as busy as we can thinking of things and other people—no matter what’s the matter with our self.

I have no doubt you are doing as well as you know how, darling little Peg; but we have to learn everything, and I also have no doubt that you’ll manage it better if you ever have more of it, and soon it will fade away, simply leaving you with more experience. The great thing for you now, I should suppose, would be to enter as friendly as possible into the interest of the Clarke children. If you like them, or acted as if you like them, you need not trouble about the question of whether they like you or not. They probably will, fast enough; and if they don’t, it will be their funeral, not yours. But this is a great lecture, so I will stop. The great thing is that it is all true….

At this point in the letter, James changes the subject, explaining how his treatment for his heart problem is going, what he has been doing to deal with things back home even though he is thousands of miles away, and expressing frustration about the cold, sunless weather.  He then concludes:

Your mother is sleeping, and will doubtless add a word to this when she wakes. Keep a merry heart—“time and hour run through the roughest day”—and believe me ever your most loving  

W.J.

How did Peg end up after receiving this letter? She wrote to her mother that, “Papa’s letter was a beautiful one; it cheered me immensely.” She also said she was determined to act upon Papa’s advice; and “with God’s help I think I shall be a better girl.”

She went on to attend Bryn Mawr College, acted in a couple of plays, married, and had two children. She was viewed as the best of citizens in San Francisco, working with the civil rights group, supporting the Community Chest operations and heading up the Ladies’ Protection and Relief, and devoted her time as war began in 1939 to British War Relief. Throughout her life, she did have two more bouts with depression, but she handled them well. The last one, at her husband’s urging, she went with him hiking in the foothills near Santa Clara, and after a while, the exhilarating experience of being in the wonderful and exhilarating landscape, along with the lively exercise, led to the depression passing. The family legend pronounced this a California cure for a New England psychological illness.

My Interpretation

Dr Jeffrey Rubin

The letter begins as a response to a letter Peg had written to her parents after a long silence. Apparently, she had been led to be silent because of her mother’s urging that when she is in a bad state of spirits she should try to “consume her own smoke,” and grin and bear it.

For those who are not familiar with the phrase, it means to accept aggravations in silence and to react with an extra effort of hard work so that those about you may not be annoyed with the smoke, dust, and soot of your complaints. Plainly, James was not satisfied with this approach. Thus he explains to Peg that the best thing for her to do is to communicate with her parents at least weekly about how she is doing, including sharing with them if she is in bad spirits and describing it exactly as she would like.

James’ next words may sound contradictory. He tells Peg the worst thing for her to do is to pour out the contents of her bad spirits on others. And then he writes that because she refers to her sorrow in her most recent letter in too mysterious a manner, he wishes that she be more open about it.

I’m not really sure what distinction James was trying to make here. My best guess is he was trying to encourage her to avoid TAKING OUT her sad/upset feelings on others, but still speak openly about what she is feeling, at least to her parents.

James, in the end, chose to encourage Peg to express what she is going through as she wishes. I like this, particularly if what she expresses is to be received with empathy and love. Note that James signs off his letter with the words, “…believe me ever your most loving W.J.” I think this strikes exactly the right tone.

Elsewhere in the letter, James begins to frame Peg’s experience as helpful for producing “an enlightenment,” if “we react on it rightly.” The wrong way, according to James, is to get into the habit of accepting the woe without doing anything constructive about it. The right way is “to jump at every chance to attend to anything cheerful or comic or take part in anything active that will divert us from our mean, pining inward state of feeling.”

It is interesting that James suggests that when we act wrongly, it is “usually a sort of disease, when we get it strong, arising from the organism having generated some poison in the blood.” Two years later, in his classic book The Varieties of Religious Experience, he refers to this type of biological theory as “simple-minded” and “superficial medical talk.” To explain his position, he wrote that many so-called “healthy-minded” individuals believe that those who worry are “morbid minded” and “diseased,” but it may very well be true that “the world’s meaning most comes home to us when we lay them most to heart.” Like James, I view framing these challenging experiences as a type of disease as flawed. It is much more helpful to view them as useful tools that, if handled well, can potentially provide us with some enlightenment.

I also agree with James that there is a right way and a wrong way to deal constructively with our feelings of woe, but perhaps we differ on some specifics of what is to be viewed as wrong. James claimed in the letter that we must try to make our sad feelings last as briefly as possible and not an hour longer than we can help.

I believe that, rather than fighting against melancholy, we should allow ourselves some time to be with it, just as we would if an old friend came to visit. We can spend this time observing, in a nonjudgmental manner, the emotions drifting through us in a manner similar to a scientist observing a flock of birds flying off in the distant sky. When it comes to grief, we need not set some artificial time limit by which we “should be” through with the process.

Nevertheless, just as when a friend visits, after a while we come to recognize that it is best to move on to other valuable activities, just as James recommends. But later, we can go back to letting ourselves take some time to be with our sad feelings once again, going back and forth like this until the roughest parts of these experiences have passed. For me, taking time to be with my feelings like this, and also taking time to respond as James suggests, works very well. Similarly, if we can teach our children to accept and handle these ebbs and flows, it is likely to benefit us both.

I’m not suggesting that James would disagree with me on this issue. He wrote his letter to Peg when he wasn’t feeling well, and in a day or two, with more time to reflect, he no doubt would have added far more nuance to this topic, some of which might well be in line with my own views.

Although the letter should not be viewed as a full account of James’ position on what to say to a child under similar circumstances, I offer it because it provides some relevant ideas for 21^st-century parents to consider when deciding how best to respond to their children’s struggles.

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Some people will enjoy reading this blog by beginning with the first post and then moving forward to the next more recent one; then to the next one; and so on. This permits readers to catch up on some ideas that were presented earlier and to move through all of the ideas in a systematic fashion to develop their emotional intelligence. To begin at the very first post you can click HERE.

Depressionmelancholyteenage depressionWilliam James