An excerpt from Living with Depression: Why Biology and Biography Matter along the Path to Hope and Healing (Rowman & Littlefield Publishing Group).

To be human is to experience an array of different emotions. We can feel upbeat and hopeful, cool and unconcerned or frustrated and fearful in a given day—even in a given moment. The heart of human experience beats with moments of joy and flashes of sorrow, and with textures of less potent emotions sprinkled in-between. When our moods ease back and forth along this continuum, we experience a healthy sense of well-being. Most people have good days and bad days, and persevere without becoming sidelined. However, there are individuals whose moods crescendo to an overexcited state, plummet toward a hopeless abyss, or cycle between these extremes. People who have these chronic fluctuations in mood don’t have a healthy sense of well-being. Their emotional experiences negatively impact how they feel, their connections to school and work, friends and family, as well as their general physical health. These mood fluctuations stem from illness—specifically a mental illness—and are categorized as mood disorder.

But not all mental illness is experienced in a universal way. In the case of  depression, there are symptoms and diagnostic markers that are shared, but your depression will have its own distinctive feel—as will my depression. The factors that make depression such a unique experience are your biology (your genetic makeup and biological predispositions) and your biography (your life experience); what I call the “Two-B Factor.”

It’s essential to get a thorough diagnosis for depression from a healthcare professional –  and then to follow the prescribed treatment plan. But it’s also vital to know how your biology and biography come into play. Taking the time to understand your genetic lineage and the details of your personal life story helps you appreciate the uniqueness of your depression. Research tells us that most individuals abandon their treatment because they begin to compare their illness against those of others. When you start to measure the trajectory of your depression in that way, you set yourself up for treatment failure.

“My cousin  didn’t have to wait weeks for medication to work, why is it taking so long for me to feel better?”

“I’ve heard that other people don’t have to work this hard to shake negative thoughts.”

“Why do I have to stay on medication indefinitely when others don’t?”

If you’re in psychotherapy or taking medication longer than most people, remind yourself that “one size fits all” doesn’t apply for depression. The reason(s) why it may take longer for you to respond to medication is likely due to  biological, metabolic or genetic issues. The reason(s) you may have to work longer at combating depressive thoughts will be influenced by the way you problem solve or approach life stressors – and that comes from the way you’ve moved through life experiences. Accepting the facets of your biology and biography allow you to tailor your depression recovery in an exclusive, distinctive way – one that isn’t measured against another’s.

“My cousin didn’t have to wait weeks for medication to work, but I’m someone who has to give it some more time.” 

“I need to keep working on changing my negative thoughts to positive ones. It’s hard for me to shake my old ways of thinking.”

“My neurobiology is such that I need to remain on medication indefinitely.”

Not learning about your biology and biography holds you hostage and keeps you helpless in the pursuit of recovery because you don’t know who you are  and what you need.  Awareness, on the other hand, empowers you with facts, details and specifics. And these experiences not only bring substance and uniqueness to your life, they also become data to be used in the management of your depression.

Deborah Serani is a psychologist and author of Living with Depression: Why Biology and Biography Matter along the Path to Hope and Healing. 

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