Specific Depression Functionality Assessments

The Specific Functionality Assessments help us to pinpoint where the comfort zone line is so we can make sure not to go too far over it. By assessing each aspect of our condition we find where to focus our efforts. We accomplish this by creating separate graphs for the six main parts of our lives; physical, mental, emotional, spiritual, social, and career/financial.

To illustrate how the process works, Jennifer has shared her graphs along with her reasoning for scoring it the way she did. Jennifer is a forty four year old single woman. She was diagnosed for the first time after her first hospitalization in 1990, although her first suicide attempt was at the age of eight in 1967. She has since had multiple suicide attempts and hospitalizations.

Throughout Jennifer's life she experienced deep depressions and responded to them by cutting, alcohol abuse, and other attempts to treat it on her own. Since 1991, she has been working with therapists and has increased her spiritual practices, which have been a major part of her life since early on. Her spiritual interests were so strong that she spent three years in India and has done long meditations including two 10-day intensives and one 30-day intensive along with her daily practice. She feels that her spiritual life plays a big role in her insights. You can see from Jennifer's General Functionality Assessment that it is somewhat different from the "average" graph detailed in the General Functionality Assessment chapter.

Physical Depression

Jennifer's Physical Depression Chart has a Deep Depression (D) graph almost identical to the General Depression Graph. She is more aware of the physical pains and feels she understands them more. In both areas her score increased from seventy to eighty, which means she is highly aware that the physical depression is happening and why. Her functionality is the same at only ten, which indicates that during deep depressions it is a major factor in keeping her functionality low. Her comfort with the physical aspects are slightly higher (eighty vs sixty), yet her past value score is lowered from sixty to only forty. Jennifer's reason for the changes in her (D) score is that she is used to it.

The Shallow Physical Depression graph is where things get very interesting, as is true in every graph for Jennifer. She is aware of it at an extremely low intensity (ten), but also feels she has only a ten understanding of such low levels. Her functionality and comfort are highly elevated though; her functionality rises from thirty five to sixty, while her comfort rises from fifteen to sixty. Interestingly, her past value of her shallow depression plummets from seventy to only ten.

Jennifer feels that her Yoga practice along with dance and other movement practices are a major factors in why the Physical Depression Scores were so dramatically different from the General Depression Scores. She specifically recalls her day long sitting meditations as playing an important role because they taught her to handle pain for long periods. She says that the two 10-day and one 30-day experiences have had a profound affect. She also realized that weeks on end in bed doesn't change anything, but taking action even when she doesn't want to creates a major shift in physical as well as the mental, emotional, spiritual, social, and career/financial aspects of her life.

Mental Depression

Jennifer accepts that the mental depression is what really causes problems, but her graphs indicate something different. She says that thoughts are what create suffering, which is a concept from Buddhist teachings. Without the resistance to the state in thoughts it would be experienced completely differently. From a Buddhist perspective, anything the mind comes up with we shouldn't take too seriously, but when things get too intense she has problems holding on to the the practice.

The (D) graph is slightly higher in awareness (eighty vs seventy)from the General Depression Graph, while functionality, comfort, and value show modest changes too. She finds the mental aspects hard to deal with when they get intense, but her fear of losing control and relapsing into crisis helps her to focus. Her spiritual practice plays a major role because it helps her to have discipline and awareness.

It is in the (S) graph that the spiritual insights really play a role. Jennifer's scores are higher across the board. She says the mental depression doesn't bother her because years of therapy combined with her spiritual practice have given her a great understanding of what is going on.

Emotional Depression

Jennifer's Emotional Chart is one of Self-Mastery, with the exception of a slight drop to sixty in functionality during very deep emotional states. She attributes this to a lifetime of working with emotions, her meditation practice, and especially the results of her two 10 day and one 30 day sits in meditation.

Jennifer also has a Masters Degree in Counseling Psychology that she feels has a lot do do with her emotional stability and awareness. She does not practice counseling, but the knowledge gained in earning the degree is invaluable.

Spiritual Depression

Jennifer's Spiritual Depression Graph is clearly one of Self-Mastery. There is no difference for her between her deepest and shallowest states and she handles them all the same. She says it has been that way since she was a little kid. Her spiritual life has always been the central focus of her life. Everything else has always been just an attempt to fit into expectations of others.

Within that spiritual life depression is seen as a gift. She doesn't take meds because she doesn't want that aspect of her life to change. She can totally relate to the book Depression Advantage because the examples of the Saints in it feel more like her true aspirations than anything else in life. She recognizes that not taking medications is causing problems in other areas and does take them when things get out of hand, but prefers to see it all as opportunity for growth. Jennifer looks forward to a day when all of the aspects of depression are the same as the spiritual aspect.

Social Depression

The Social Depression is identified by Jennifer as the toughest part. She is an isolator by nature, which is a contributing factor of her spiritual interest. It is her attempt to fit into a materialist society that she identifies as her biggest issue.

Jennifer sees early childhood family trauma as the source of most of the problems. Her father was an alcoholic with abusive behaviors, so she lived in fear of interactions with him. But it was her mother's reaction to an "A-" in school that caused her first suicide attempt as well as her lifelong struggle with depression that would have played out differently.

Jennifer is brilliantly intelligent. She got an "A" in every class and easily earned advanced degrees. her first non-A was at eight years old while she was in the third grade. Along with the "A-" in "conduct" was a note that "she is very shy and needs to participate more in class." Her mother completely flipped out. After the incident Jennifer became a social extravert "poser" and a "robot." Whenever depression becomes too deep it brings all of this back to mind and is the source of problems handling it in this aspect of her life.

In (S) depressions the "poser" aspect is still strong. Jennifer sees that in the past she was trying to fit in, but no longer cares. She can do it as necessary to work and function in society, but when depression gets too deep that ability completely shuts down. She feels she needs an environment with intelligence, creativity, likable people, and a high level of independence to function at her best.

It doesn't show up on her graph as much, but you can see in her reasoning pertaining to her scores that social depression is a major contributor to her problems that should be addressed in her program of improvement. Her inability to recognize it until it gets to fifty percent is a great place to start focusing her attention.

Career/Financial Depression

Career Financial is the worst of all areas. Jennifer's graph takes a deeply disordered turn during both deep and shallow Career/Financial Depression. Combined with (and clearly overlapping) Social Depression, the two hijack the entire depression. While she could otherwise be in self-mastery during deep and shallow depressions, her functionality and comfort are destroyed.

During deep states, Jennifer doesn't care at all about career success, position, title, or even money. She loses jobs and ends up broke because she either melts down completely or can't stand being in the job any longer. She ends up always moving away because she gets bored right away.

Even in shallow depressions there is no career that has any real meaning or real value. It is just a way to make money. When asked what would she would do if she won the lottery, her reply was that she would write books and volunteer in a way that served people in a similar fashion as Saints might do.

Jennifer might want to consider meeting with a career coach to help her discover where her interests might best line up with different career paths than what she has previously pursued. A career coach could help her identify her strengths and weaknesses and help her to align them with her interests. Together they could explore whether or not that would mean additional training and put together a plan to help Jennifer attain a meaningful line of work.

Analysis       

If you compare Jennifer's General Functionality Depression Graph (left) with the generic Managed Stage one (right), it is readily apparent that she is far from the hypothetical "normal" Managed Stage person. Her awareness and comfort during deep depressions is much higher, yet her functionality and comfort during shallow depressions is dramatically reduced. She makes an interesting example for that reason alone, but the wild disparity in her Specific Functionality Assessments is what makes her graphs the perfect example for learning the concepts.

Focusing on deep depression, you can see that Jennifer loses functionality from the physical aspects, but her's is mostly a disorder of Social and Career/Financial Depression. They are the only parts of depression that show the classic loss of understanding, functionality, and comfort illustrated in the generic graph on the right.

Jennifer's deep mental depression clearly also takes it's toll. Her comfort and even present value are higher than the norm, but her comment that "the mental depression is what really causes problems" belies her ratings. This is a perfect illustration of why the dialog about the reasons for the scores is so important. The graphs may help to see the general patterns, but the explanations are where the real insight is.

What is amazing is Jennifer's insight that lead to Emotional and Spiritual Self-Mastery. It is a prime example of the power of the concept because it clearly shows where the focus needs to be. It makes sense to focus on physical aspects such as exercise, diet, etc., but the real work is in addressing the social and career/financial issues. Based on the reasoning that produced the graphs, it seems that she would be immensely helped by a MFT or LCSW therapist because of their focus on such issues.

Another interesting option that may be explored is the life of a spiritual monastic. Jennifer's lifelong central focus on spiritual life may explain the divergence in her charts: she is trying to fit into careers and social structures that do not work for her temperament. A spiritual counselor or a short term trial in a monastery might help Jennifer to gain important insights.

This illustration is not meant as a diagnosis, but to show how the graphs, and especially the explanations that accompany them, can help determine what options to explore. Jennifer is already using the tools mentioned here (therapists, counselors, yoga, etc.) and has found the process useful in identifying tools to help her grow to the next level.

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