Depression study finds shame at root of issue
By Sue Wang
Oct. 2, 2007 9:59 p.m.
When World War II veterans suffering from depression were asked one simple question, their symptoms of depression immediately lifted.
“They started talking loudly and clearly instead of whispering as they had before and looked into the psychiatrist’s eyes rather than at the floor,” said Thomas Scheff, a professor emeritus at the UC Santa Barbara Department of Sociology.
The question: What were you doing during World War II?
The observations made at the English mental hospital in which the veterans were staying were later developed by Scheff into a theory of depression. The theory supports the idea that depression arises out of shame and may be alleviated by a sense of pride.
Of 83 conversations with such patients, about half were asked about their experiences during World War II. Among those who were asked the question, half of the patients had a temporary remission in which the symptoms of depression completely disappeared.
With such similar reactions to the question being common among the patients, a possible reason for the remission is the ability for a patient’s sense of pride from the war to override the feelings of shame that can cause depression, Scheff said. “Pride is often associated with a sense of acceptance as a valued member of a group,” he said.
Though the patients who exhibited the behavior were older patients, the theory can be applied to all age groups and all cultures, said Kristin Yarris, a graduate student coordinator of the Mind, Medicine and Culture group at UCLA.
“The challenge will be the extent to which we can apply (this theory) to different ages and cultures,” she said.
Shame-based depression is not uncommon among all age groups, such as young adults, for example.
For many depression patients at UCLA, depression, shame and guilt frequently occur together, said Elizabeth Gong-Guy, director of UCLA Student Psychological Services.
“A good example is a student who comes into college expecting to do just as well as they did in high school. But because the competition is at a different level, they aren’t doing as well,” she said. “As a result, they feel shame because they are unable to meet a family expectation.”
The shame, in turn, may lead to depression.
Another common instance of shame-based depression occurs in relationships with lovers or parents. “I’ve seen many students who blame themselves for the breakup and feel shame,” Scheff said.
Oftentimes, the shame will develop into a cycle that may magnify the feeling of shame. “Shame acts back on itself,” Scheff said. “When people blush, they become self-conscious and they blush even more. Similarly, when you are ashamed of being ashamed, it goes round and round and is infinitely powerful.”
In contrast to those who experience shame and place the cause of the shame on themselves, others may express shameful feelings as anger or violence.
Depression may result when shame is directed and kept inward, while violence results if the anger associated with shame is directed outward, Scheff said.
“Sometimes the person will place the fault on someone else. They avoid the pain of shame by covering it over with anger,” he said. “I refer to the two different responses to shame as “˜silenceÂ-violence.'”
With the development of this shame-based theory, many possible treatment plans can be and have been formed.
Despite biological and scientific treatment options already present, alternative methods involving psychology and social interactions are just as important because different patients have different symptoms that require different treatments, said Gong-Guy.
“Some are best treated with medication, some with psychotherapy, and some with both,” she said.
Nevertheless, most scientists suggest that a combination of treatments is most effective, she added.
Antidepressants may not be as effective as they seem because many patients have been found not to respond to the medication or may even experience negative side effects, Scheff said.
One possible alternative treatment option rests on social interactions. Scheff outlined a series of steps in his treatment plan, in which a psychiatrist or therapist first tries to go over patients’ positive memories so they can break from depression and begin to feel better. The psychiatrist would then connect with the patient and allow the patient to talk about shameful areas of his or her life so there would be no need to hide or keep it in.
Scheff will be presenting his theory of depression as well as his treatment plan in a talk on Oct. 8 from 3-5 p.m. in Haines 352 .
