Depression: A Public Feeling
Ann Cvetkovich combines memoir and critical essay to challenge us to think beyond the medical model of depression.
Cvetkovich, Ann. Depression: A Public Feeling. Durham, NC: Duke University Press, 2012.
This is Ann Cvetkovich’s queer feminist project of theorizing depression from a cultural and social context that values feelings and emotions and frames depression as political. She sees depression as a mode of disillusionment and discontent that reflects, and is produced by, contemporary society and neoliberal capitalism. Rather than as a disease that plagues the individual, she positions depression as a political or a social feeling. Cvetkovich situates her work in the Public Feelings Project in cultural studies, a central goal of which is to “reintroduce feelings into politics” (p. 104). Her approach reflects Public Feelings’ emphasis on the inseparability of affect from politics:
Rather than seeing negative feelings of failure, mourning, despair, and shame as getting in the way of politics or needing to be converted to something more active in order to become politics, such work attends to felt experience as not only already political but as transforming our understanding of what counts as political (p. 110).
In this text, Cvetkovich is interested in alternatives to the medical model of depression which advertises pharmaceuticals as its treatment and cure. Discussions about the biochemical causes of depression might be plausible,” she writes, “but I find them trivial. I want to know what environmental, social, and familial factors trigger those biological responses—that’s where things get interesting. A drug that masks the symptoms of a response to a fucked-up world or a fucked-up life doesn’t tell me anything. I want to hear about the people like me who’ve decided not to take drugs” (p. 15). For this, Cvetkovich keeps an “archive of depression” where she draws inspiration from other academics, writers, and artists about how they manage to get through life with feelings of despair and alienation from a number of different angles that do not involve pharmaceuticals. Cvetkovich does convincingly argue that we need new forms of memoir writing about depression that counter the mainstream personal narratives of folks like Andrew Solomon, Lauren Slater, and Elizabeth Wurtzel, which all conclude that antidepressants are some sort of savior. Although the author is ambivalent about the self-help genre, she still compares her writing on depression to a self-help book aimed at “an audience of academics and queers, especially those who remain curious about the genre despite their reservations and disidentifications” (p. 209). This book envisions depression as a form of “being stuck” (Cvetkovich seems to prefer this terminology to depression) and envisions new ways of moving forward or new ways of living that go beyond medical intervention. She envisions depression as an instructive feeling, one that is productive of new kinds of knowledge.
One thing to note is that Cvetkovich’s work is theory-heavy and jargon-laden, which I think may be par for the course with cultural studies (I could be wrong about this, only guessing). Some parts of this text were difficult to decipher and persevere through. I found the introduction to be the most difficult part of the book to finish reading. In it, she touches on affect theory (which as I understand is a new school of thought in the humanities in which emotions or feelings are the privileged means of exploring cultural artifacts), critical race theory, and queer theory without going into much detail about each of these influences. The result feels like a deluge of names and ideas without very much substantive content.
The first half of the text is a memoir of Cvetkovich’s depression, which she calls “The Depression Journals.” The Depression Journals document the darkness of her life while writing her dissertation and her navigation through the academic job market. Her deepest depression comes on the heels of receiving both a book contract and a postdoctoral fellowship. She experiences a deep sense of dislocation—a disconnection from home and the familial histories it represents and an increasing unease with ordinary events of everyday life such as those of academic life, domestic life, social life, and self-care. As the depression stretches on for her, she follows up with therapists and eventually a psychiatrist who prescribes her antidepressants. She takes the drugs for a while, but eventually weans herself off after experiencing side effects. She chronicles her everyday boring and banal activities such as grocery shopping, going to the dentist, going swimming, doing yoga, and knitting and it is through these everyday rituals and habits that she eventually regains a precious sense of control over her life and body. She learns to cultivate habits and practices of physical movement, self-care, and creative expression in ways that make her life feel livable again. The Depression Journals are easy to read and are relatable. I think it’s important to point out that Cvetkovich’s type of depression is one that is not taken all that seriously in our culture. It is the sort of depression that brings your mood down low, but does not stop you from accomplishing what needs to be done in your life. Based on her description, I would not classify it as severe. This may be an unfair assessment on my part.
The second half of the book, “A Public Feelings Project,” takes the form of a critical essay in three chapters. These are interconnected reflections on her memoir form. The speculative essay that forms the second half of this book is meant to be an alternative form of tracing depression as a concept in order to resist the medicalization of it and to provide an alternative means for getting oneself unstuck.
In the first section of part two, Cvetkovich seeks alternatives to the neoliberal medical model of depression and she turns to the historical concept of acedia, an early monastic notion described as a “weariness or distress of heart” (p. 85). It is a spiritual crisis characterized by a lack of affect, but also by intense feelings of disgust, disdain, and dislike. This is an affliction that struck forth-century monks who found that they wanted to forsake the contemplative life in favor of sleeping or running away. Cvetkovich wonders if historical accounts of acedia can contribute to alternative, non-medical models of depression. This conception, she contends, can help us to understand depression as meaningful through the recognition of sadness as both “a normative part of cultural experience” and “a creative force” (p. 107). She notes that scientific accounts of depression lack a historical critique of the medicalization of depression which views depression as universal. In fact, this is a historical period that arose in the middle of the nineteenth century with the development of magic bullet medicine which was the idea that you could find a drug, target a molecular target and kill the disease. The turn to acedia and spiritual crisis provides a vantage point of depression that foregrounds matters of faith and hope as relevant to the experience of being depressed, which can manifest itself in psychic and spiritual ways in addition to biological and physical ones. Cvetkovich notes that she is not against science as a cause for depression, but she does not believe it is an either/or choice between biology and culture. Her interest in spiritual approaches to depression is a call for “more integrated relations between science and humanities in order to transform medical cultures” (p. 102).
In the second section of part two, Cvetkovich looks at race and the “emotional inheritance” of psychic trauma of a history of slavery and colonialism as well as the ordinary experiences of racism and alienation which are often omitted from a mainstream narrative of depression. Thus, Cvetkovich moves away from more popular memoirs and takes up the narratives of feminist scholars of the African diaspora as well as narratives dealing with class vulnerability and geographical displacement. Cvetkovich attempts to understand, not only how the symptoms and treatment of depression might differ for people from different racial, ethnic, or class origins, but also how North America’s history of genocide, colonialism, and dispossession engenders depression for some people in the working class, the African diaspora, and in Native American communities.
The third section of part two is dedicated to the art of crafting as an everyday sacred practice in response to depression. In a practice known as “craftivism,” she writes how feminist, queer, and disabled communities can come together and exercise their political agency in the face of racial, colonial, and neoliberal domination. She argues that the “cure” for depression resides in the art of everyday living and this is best achieved through the art of crafting. She writes:
Crafting practices inhabit the epidemic of feeling bad that is one form of insidious slow death spawned by neoliberal capitalism, especially among the middle classes, who, despite fewer material obstacles to thriving, are still bogged down by worry and—to invoke a concept that is both psychic and somatic—stress. Unlike forms of self-sovereignty that depend on a rational self, crafting is a form of body politics where agency takes a different form than application of will. It fosters ways of being in the world in which the body moves the mind rather than the other way around, or in which, echoing neurobiological views in another register, body and mind are deeply enmeshed or holistically connected. It produces forms of felt sovereignty that consist not of exercising more control over the body and senses but instead ‘recovering’ them from the mind or integrating them with it. Crafting emerges from the domestic spaces that are at the heart of women’s culture to provide a model for ways of living that acknowledge forms of structural inequality while also practicing modes of bodily and sensory life that incorporate or weave them into the fabric of daily life that literally includes texture, color, and sensory pleasure (p. 168).
Her prescription for getting out of stuckness is that of a life of contemplation and action as opposed to apathy and passivity. For her, this is achieved through daily activities that are meditative, like writing that focuses on paying attention to what is immediately present and valuing the ordinary and the detail (she mentions both Natalie Goldberg and Anne Lamott here), yoga, swimming, or crafting. She calls this spiritual practice, the utopia of ordinary habit, which transforms rituals into forms of embodiment or through creative enterprise. This, she acknowledges, may be hard to accept for those who are skeptical of spiritual or quasi-religious language. Indeed, her detailed excursion into the emotional and potentialities of crafting seemed to fall short of proposing a radical alternative model of cultural engagement with depression.
Also, surprisingly similar to Cvetkovich’s utopia of everyday habit and focus on spiritual practice is the teaching of dialectical behavioral therapy (DBT) developed by Dr. Marsha Linehan. DBT is a way for those in overwhelming psychic pain to learn life skills and ways of coping, such as mindfulness as well as self-care and compassion for self and others. The practice of mindfulness is nearly the same as what Cvetkovich refers to as a “slow living” (p. 167). For slow living, she turns to the art of crafting. What interests Cvetkovich in crafting is the process itself, the repetition it requires which is a special mode of attention similar to that required for meditation. She claims she writes “about crafting in the context of depression because, as a form of daily activity (whether individual or collective) that can sooth the mind and even raise the spirit, it presents an alternative to treating depression with drugs. It also reframes what we mean by treatment since crafting and other activities like it may not be cures or antidotes but ways in which depression and related affects are lived with rather than banished” (p. 189). This is similar to the idea behind DBT and many Buddhist views that suggest learning to become comfortable with and accepting of negative feelings and emotions instead of trying to drive them away is the key to becoming at peace. I am surprised that Cvetkovich does not make the link between what she is suggesting and the overwhelming influence of DBT on psychotherapy.
One thing that bothered me when reading this text was the “quality” of Cvetkovich’s depression. And I am bothered that it bothered me because I think perhaps this is too judgmental of a criticism to have. But as someone who has suffered from chronic severe depression, I cannot begin to describe the debilitating effects it brings to all areas of life. So when Cvetkovich writes that she is convinced that there are real and possible solutions for the depression that ails us, that “[t]here is nothing wrong with our biology or our intelligence; sometimes we are just stuck.” (p. 68), I am convinced that the depression that she describes is perhaps not the severest form of depression that is referred to in the DSM or in other memoirs of depression. Hers seems to be a low-lying depression that corresponds with feelings of hopelessness and apathy, but one that does not get in the way of her meeting her obligations in life and interacting socially. She also notes that her depression was alleviated with visits with friends, swimming, yoga, and crafting. She promotes the transformative power of daily habit as a way to combat depression. But for many, depression is not like this. For me, depression is a dark, inescapable place. It’s like being locked in a room with no light, windows, or door. It is so dark that you cannot even see your hands in front of your face let alone a way out. It is waking up each morning wishing you had died in your sleep. In depression such as this, maybe antidepressants or some kind of medical intervention is the only ethical answer. I tend to believe it is.
Another issue I had with this text is that Cvetkovich argues that mainstream depression memoirs by middle-class women are both fetishized and narcissistic which comes as a surprise considering Cvetkovich self-describes her work as confessional feminism. She also touches on the idea of gender resistance briefly, but does not say enough about depression as a means of resistance for daughters against their gender roles. These are gender roles that assume them to be passive, good, nice, and not exhibiting anger or violence. She also does not address how girls have traditionally been labeled as mentally ill when they did not conform to their gender roles.
Unlike other contributions to the field, her memoir is not primarily an account of the effects of pharmacological treatment. Her text successfully formulates a new way of writing about depression and should prompt some introspection from those within academia about the value of combining critical analysis with personal accounts of emotional experience. Certainly there should be more to understanding depression than the medical model.