Hope Through Positivity (While We Wait for Science to Catch Up)

By Dan Perlman, LMSW

Clinical depression, or Major Depression, is characterized by “persistently depressed mood or loss of interest in activities, causing significant impairment in daily life.”  Affecting nearly 3 million Americans each year, we’re only now beginning to understand the roles stress, trauma, genetics, and neurology play. From a scientific perspective, certain areas of the inner brain are believed to help regulate mood, although scientists' current understanding of the neurological underpinnings of mood is far from certain.  A study published in The Journal of Neuroscience in 2017 found that of 24 women who had a history of depression, the hippocampus "9% to 13% smaller in depressed women compared with those who were not depressed.” 

While no one size fits all, and many medications provide meaningful benefits, it seems apparent that talk therapy remains in the forefront of treatment.  The two most commonly used for depression are cognitive-behavioral therapy (CBT) and interpersonal therapy. Just talking and thinking seems to help relieve displaced anger that has been misdirected inward at oneself.

Many clients share a feeling of "emerging from a dark hole” after a positive talk. They say that life out here is “brighter and lighter," that a pressure has been taken off their heads, or that “the pushing down and weight on my shoulders has gone away.”  Often this occurs without medication, brain scans, or any sudden financial windfall to assign as catalyst. Sometimes they’ve just come in talk to someone and gone out feeling less alone. 

Clients' stunned reactions and almost confused sentiment at the lifting clouds is breathtaking.  In essence, they experience the lifting of depression, and I imagine their prefrontal cortex is springing back to life.  When they refer to the hole of depression having "moved over there” or for some, completely disappearing, it is powerful, moving, and almost spiritual to witness.  At this point in recovery I tend to believe something outside of our awareness is happening — call it love, spirits, or karma.   Sigmund Freud once wrote that psychoanalysis is “in essence a cure by love.” When done effectively,  psychoanalytic therapy shifts and eases the blocks that stop us from loving or being able to be loved. 

Being someone who believes in something more than we can see, I occasionally look toward those who can tie our craft to even broader ideas. This brings me to a sermon by Joel Osteen (He’s the pastor who fills the 15k seat Compaq center in Houston weekly and has millions of followers worldwide). Recently I read that he said, “Choosing to be positive and having a grateful attitude is going to determine how you’re going to live your life!”  I think he’s right, and that positivity is not only infectious for our clients, but it provides the love that Freud believed can become curative. 


Dan Perlman is a therapist at Cobb Psychotherapy. If you would like support in prioritizing and taking care of your mental health, contact Cobb Psychotherapy and see how therapy can help.