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The Existential Crisis, Depression, Anxiety and Mortality

Allan Schwartz, LCSW, Ph.D.

fall leavesThis is a comment that one of our readers recently posted in reaction to an article titled, "Loneliness, A Deadly Disease"

Both the article and the full comment can be viewed at this URL:
http://www.mentalhelp.net/poc/view_index.php?idx=119&d=1&w=5&e=15057

"The facts are these:
We live in a society that places utterly no value on human interaction. The overwhelming attitude of most people is rampant consumption and fostering an unquenchable thirst for more. The one avenue that most of us have in the pursuit of this is work. Lots and lots and lots of work. For good or for bad or for worse, that is the sole avenue of self-worth for many people; dare I even say most people?
And so that is to where I restrict my social outlet. I have long since given up on relationships because they have become the definition of filling other people's needs with no expectation of any kind that mine will be filled in turn..."

The person who posted this comment makes some valid observations about the pursuit of consumption and work. However, his premise that the root of the problem is that this society does not value human interaction is one with which I disagree.

From my perspective as a therapist and as a reader of fiction and philosophy, the root of the problem is human and universal. If you will permit me to become biblical for a moment, Adam and Eve's real punishment for biting the apple of knowledge in the Garden of Eden, was not only becoming aware of sexuality, but of the fact that life is finite and limited. Unlike all other living creatures, we are aware of death.

What is an existential crisis? It is the realization that each of us will one day die. It is understanding that life is not endless and that our days on this planet are numbered. 

From the beginning of time, people have asked themselves the existential question, "If I am doomed to die, what is the point of my life?" It is a terrifying question and different people have attempted to answer it in different ways.

Those who are deeply religious deny there is an existential crisis because faith brings with it the achievement of an after-life. For these people, life is not limited but continues for all eternity. This is common to all the major world religions: Judaism, Catholicism, Christianity and Islam.

According to the author Ernest Becker, in his book The Denial of Death, most people put the notion of death out of their awareness and go about living their lives without thinking about their mortality. However, there are times when the fact of death breaks through to their conscious minds. When that happens they become temporarily terrified until the crisis passes and they achieve a new balance. What causes mortality to break through to consciouness? The death of friends, relatives and loved ones confronts even the greatest deniers of the fact that life is finite.

Depression and Anxiety

There are those who seem to have greater difficulty denying the fact of death. Among these are individuals who struggle with panic and anxiety disorders and various types of depression. Today, we are able to look at many of the causes of these disorders and find such factors as chemical imbalances in the brain, traumatizing childhoods and adulthoods, and such problems as neglect, abuse and addictions.

As a result of better understanding the causes of emotional disorders, we have greatly improved treatments with medications and more precise types of psychotherapies.

Yet, we tend to overlook the importance and even reality of each person's existential crisis. It is this crisis that I believe lies at the roots of depression and anxiety, in addition to those factors already mentioned. If this true, then what can we do about it in addition to medication and psychotherapy?

We each need to find meaning in our lives. Meaning is found through interpersonal relationships. This is also pointed out by the brilliant psychiatrist and psychotherapist, Irvin Yalom, MD. I highly recommend his many wonderful books, both fiction and non fiction.

As Yalom points out, it is the realization and knowledge that we influence others in ways that are positive that can provide a sense of meaning in our lives. That is why loneliness is so deadly. However, many people fail to realize that they have enormous influence on the lives of others. Whether they are friends or family, they are important to us and we are important to them. There are also the relationships with those at work and those we casually meet while walking in the street, riding the bus or train, and shopping in the supermarket and clothing store.

The pursuit of material items can be temporarily exciting but ends in a return to feelings of emptiness. The real "unquenchable thirst," the commentator mentioned, comes from meaninglessness.

In addition to acknowledging our importantance to others, it is also important to know that each of us is unique and individual. To put it another way, "No one else is quite like me. No one else had the specific events of childhood that happened to me and in the specific ways they happened." This is why you, me and each one of us is unique and special.

As John Donne said it centuries ago:

"No man is an island, entire of itself...any man's death diminishes me, because I am involved in mankind; and therefore never send to know for whom the bell tolls; it tolls for thee."

Donne was meaning three things:

1. That none of us are isolated because we are all interconnected,

2. We are all aware of death,

3. One man's death diminishes all mankind.

If you feel depressed and anxious, it is important that you enter psychotherapy. The therapy could be Cognitive Behavioral, Psychoanaytic, Jungian, Dialectical or some other. However, the treatment should include a search for ways to define life and its personal meanings through interaction with others and the removal of blocks to successful and intimate interacting. By "intimate" I do not mean sex as much as closeness, warmth and honesty. Let's not leave out your uniqueness and specialness as a human being.

Your comments, questions and observations are strongly encouraged and welcome.

Allan N. Schwartz, PhD