Meta-Depression and Meta-Anxiety: When Mental Illness Turns on Itself

meta-depression and meta-anxiety

Meta-depression and meta-anxiety are phenomena that are rarely discussed in conversations surrounding mental illness. Yet they are common experiences for depressed and anxious people. These terms refer to the fact that one’s own depression or anxiety can itself become a contributing factor in – or aspect of – the mental health condition in question. In this way, you can become depressed about having depression and anxious about having anxiety. I wish to explore this aspect of mental illness in more depth. First, however, it will be helpful in the following discussion to examine phenomenology, as this philosophical school of thought helps to shine a light on the experiences of meta-depression and meta-anxiety.

The Phenomenological Approach to Mental Illness

When it comes to discussions about mental illness, much is often left unsaid. This is often because descriptions of mental illnesses, such as depression and anxiety, tend to focus on textbook symptomology or they involve personal accounts that don’t really get to the heart of the mental suffering. Of course, this latter point is understandable since mental illness will always entail a certain level of ineffability; plus, even if there is the potential to meaningfully describe the experience of depression or anxiety to a non-sufferer, finding the appropriate words (with sincere emotion and feeling behind them) is often quite difficult.

Despite these difficulties, there is an ever-pressing need to focus on the experience of mental illness as it appears to naked consciousness, removed from psychiatric diagnoses, theoretical assumptions, abstractions, interpretations, emotional associations, and cultural frameworks. This is the basis of phenomenology, a philosophical approach that aims to study phenomena (meaning ‘things that appear’) directly, stripped from our theorising and preconceptions. By directly examining and describing phenomena as they are experienced from the first-person point of view, phenomenologists believe we can better understand such experiences, as well as the structures of consciousness. For instance, Edmund Husserl, the founder of phenomenology, argued that the basic structure of various forms of experience – including perception, memory, imagination, emotion, desire, and volition – is what he called intentionality, which refers to consciousness being about or directed towards things, objects, events, or states of affairs (i.e. a desire is directed towards some object).

By applying this sort of phenomenological approach to mental illness, which is what the psychiatrist Karl Jaspers set out to do in the early 20th century, we can perhaps better understand the true nature of conditions like depression and anxiety. By prioritising the phenomenological approach, not just in the therapist’s office – but also in conversations about mental health, in general – we can provide sufferers with the opportunity to engage in the kind of open expression that is most conducive to relief. The more that one’s description of mental illness pertains to one’s lived, direct experience of it, the easier it may be to unburden the pain. A phenomenological stance can also help others to empathically enter the inner world of the depressed or anxious person, which itself is often vital in the healing process. Thus, phenomenology can be both highly illuminating and curative when it guides descriptions of mental illness.

With a phenomenological approach in mind, I believe there is a certain structure to conditions like depression and anxiety that is commonly overlooked – and that is the way in which depression and anxiety themselves become sources of depression and anxiety. From a Husserlian perspective, the experience of depression or anxiety may involve intentionality (or directedness) whereby the depression or anxiety is about the experience itself. Hence, based on a phenomenological analysis, we can formulate meta-depression and meta-anxiety as types of experiences with a distinct structure. Meta-depression and meta-anxiety do not seem to be fully appreciated in the psychiatric community, perhaps due to the lack of a phenomenological approach.

Just as there is metadata (data about data), metacognition (e.g. thinking about thinking, knowing about knowing, or awareness of one’s awareness), meta-jokes (jokes about jokes), and meta-emotion (emotion about emotion), there is also meta-depression and meta-anxiety. Let’s explore these phenomena in turn.

The Nature of Meta-Depression

There are many ways in which depression can turn on itself. For instance, if depression is chronic or recurring, the depression itself can be a source of hopelessness and despair, which is a key aspect of depression. A sufferer may be burdened with thoughts such as, I’ll be depressed forever, depression will always ruin my life, or I’ll never find a way to resolve my depression. In this way, the patient becomes depressed about being depressed. Similarly, one may feel that life becomes utterly pointless as a result of having depression and this, in turn, can fuel meta-depression: the mental illness itself makes one demotivated and apathetic.

Additionally, depression – which often features low self-esteem – can be a contributing factor in one’s low self-esteem. If you are suffering from depression, struggling with it for a long time, and unable to function as normal, this can feed into a negative self-image. Your depression can make you believe you’re weak, broken, defective, useless, lazy, and a failure. Here we can see how meta-depression compounds mental suffering.

The meta aspect of depression may also involve the persistent sadness that characterises the condition. When depression is particularly disruptive, constantly tortures your mind, and robs you of your ability to enjoy life, this in itself can make you feel overwhelmingly sad. This is how depression self-perpetuates. Moreover, even just feeling chronically sad can be a reason you to feel even sadder; indeed, to be crushed by sadness, all the time, can be a distressing and upsetting experience.

The Nature of Meta-Anxiety

Meta-anxiety can manifest when, as a sufferer of anxiety, you become anxious about the possibility of experiencing anxiety. This is an extremely common experience for people suffering from anxiety disorders and it, unfortunately, often results in a self-fulfilling prophecy. Because to experience anxiety about anxiety is to actualise the thing that one fears happening. The meta aspect of any mental illness is part of the reason why suffering becomes so intense, consuming, prolonged, and difficult to recover from.

Once you experience an anxiety attack, you know how deeply unpleasant and unsettling it truly is. If you are prone to suffering multiple anxiety attacks, then you may constantly feel on edge, waiting agitatedly for the next attack to arise. Of course, being nervous and worried about one’s anxiety – or in relation to anxiety-inducing situations in the future – can result in further anxiety.

Meta-anxiety may also show up in more specific forms of anxiety. Take social anxiety, for example. Prior to a social situation, as well as during it, you may worry intensely about others noticing you have social anxiety – you might turn around and feed anxious thoughts in your head related to your social anxiety, such as whether others will or can notice your nervousness, whether it’s in the form of body language (e.g. appearing tense, guarded, and fidgety), speech (e.g. speaking in a quiet and mumbled manner), or other physical signs (e.g. sweating). One is anxious, then, about one’s social anxiety in social situations.

Gaining Control Over the Meta Aspect of Mental Illness

While many symptoms of depression and anxiety may be hard to control, what we certainly have a great deal of agency over is our response to mental illness, how we subjectively decide to experience it. Meta-depression and meta-anxiety add extra layers to the suffering that don’t need to be there. To accept the experiences of depression and anxiety as they are, without giving these experiences a meta structure, can provide immense relief. Of course, this is easier said than done. Overcoming the meta aspect of mental illness takes time, patience, effort, and practice. There are also many psychotherapeutic approaches that can help patients regard their mental illness with acceptance, such as Dialectical Behaviour Therapy (DBT) and Acceptance and Commitment Therapy (ACT).

Accepting depression and anxiety can help ease the distressing experiences involved and allow them to pass more quickly. It is completely normal and understandable that people would become depressed about their depression or anxious about their anxiety. However, it’s not an inevitable or uncontrollable aspect of mental illness. By learning to consciously respond to mental suffering with acceptance, one can lift burdens that simply do not have to exist.

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