Rethinking Depression: How to Shed Mental Health Labels and Create Personal Meaning

by Eric Maisel

In this provocative and pathbreaking distillation of a career spent working with individuals seeking help with mood and motivation, Eric Maisel reveals the implications of one of the most dramatic cultural shifts of our time. In recent decades, much of the unhappiness inherent in the human condition has been monetized and labeled as the disease of depression and related “disorders.” Maisel persuasively critiques this sickness model and prescribes a potent new therapy. The existential cognitive-behavioral therapy (ECBT) he details here marries the proven methods of CBT with the powerful meaning-based orientation of existential therapy. The result is a revolutionary reimagining of life’s difficulties and a liberating model of self-care that optimizes the innate human ability to create meaning and seize opportunity — in any circumstance.

Genres: Nonfiction, Psychology, Self Help

250 pages, Kindle Edition

First published December 16, 2011

About the author

Eric Maisel, Ph.D., is the author of more than 40 books in the areas of creativity, coaching, mental health, and cultural trends. He is a psychotherapist and creativity coach, and writes for Psychology Today and Professional Artist Magazine and presents workshops internationally.

Reviews

[Jess · Rating 1 out of 5]

Depression runs in my family. This information took years to learn; there are still some deniers. And I suppose Eric Maisel might be one of those, were we acquainted. His argument that "depression" is a man-made diagnosis in support of big-med/-pharma is cute, but suspect. Yes, he can cite studies that agree with his argument, but so can his opposition.
I'm not going to take Maisel to task for his brush-off of depression - or his I'm-not-brushing-off-sadness-like-those-other-people-who-tell-you-to-just-get-over-it defense.
I'm not even going to bother wondering if Maisel thinks my dad killed himself because he was simply "unhappy" with his life or maybe because he was unable to craft some life statement, you know, because he barely got through elementary school, but whatever - because he didn't know my dad.
But I will say that for a psychologist in a for-profit book to characterize depression as a moneymaking scheme smells a bit bull-shitty. Dude is also making bank on his book that needs depression to contradict.
Good stuff: Make your life mean what you want it to. A maxim for the ages - nothing new here.
Bad stuff: I finished feeling like I had no tools, just a $10 book of ramblings.
If you're looking for guidance for managing depression, you'd be better served with - dare I say - a human therapist, who will provide the accountability and responsibility that depression often muddies. At least, that's in my version of depression.

[Jennie · Rating 1 out of 5]

Ok, I tried, I gave this book a chance. This man has clearly never been depressed in his life and gives the impression that those who feel this way fall under a blanket of symptoms.

If you feel depressed, address it immediately with you doctor or contact your local crisis line. The list that he has in this book of symptoms that a person feels that persist. I have had several doctors tell me that I am talking myself into feeling these feelings. As a depression sufferer, it is much like being a migraine sufferer, unless you have experienced the pain, it is hard to understand. It is crippling.

On page 22 he does a very immature, insulting example of someone visiting a pharmacy, telling him he is depressed, and then pushing meds. Bullshit. This is his view and I believe a dangerous one. Leave defining sadness and/or depression to their doctor. Seek out better resources, more factual resources.

[Stefan · Rating 4 out of 5]

I am not in a position to assess Maisel's contentions about depression. The way the book is presented is probably quite misleading. The impression created is that it is a self-help book for the depressed. In fact,it is a book about the significance of meaning and meaning-making in a person's life. It would be very helpful to someone who is experiencing a crisis of meaning in his or her life, or finds it difficult to find or make meaning out of life. Such a crisis might well lead to a person becoming depressed or be associated with a person's depression. Maisel seems to equate depression and meaning crisis, indicating that resolving meaning crisis and meaning-making crisis would overcome depression. However, it may be that depression is not an ontological condition but a physical condition that precisely interferes with grasping meaning and with making meaning. Still given mind-brain interaction, it could also be that an ontological intervention may somehow and to some degree affect neurochemical process. Where Maisel is spot on is with regard to meaning and meaning-making. I think his practical remarks regarding meaning and meaning-making are very apt and insightful. How do we face the world of today in all its bewildering complexity? What do we do in it? What do we do about it? How do we go about living meaningfully in this world. Maisel offers very helpful concrete suggestions in these regards! And it might be that following Maisel's advice might in fact help avoiding depression developing in the first place? Should a parent perhaps convey Maisel's advice to their adolescent progeny who are having a difficult making sense of life and themselves? (I really think a quite good idea!)I suppose there would be some clergy whose approach to depression would be to recommend following their particular religion more closely. So Maisel wants us to follow his existential faith more closely as a remedy for depression.Is Maisel's a minimal workable necessary non-theistic faith for living? Perhaps.

[Debby Hallett · Rating 5 out of 5]

This book was like a miracle to me. Since reading it, I've learned new ways to cope with depression, to the successful point where I've been off all meds for months.

I can appreciate that for some people, it hasn't been helpful to take a long, honest look at how they make meaning in their lives. But for me, it was absolutely what I needed.

The only thing that bothered me in the book was his soapbox lecture, reiterated too many times, about how we've bought into the medicate-against-feeling culture. It may be true that we look to meds to change how we feel. Some of us are OK with that and some of us aren't.

Five stars for changing my life.

[Deb · Rating 4 out of 5]

**Losing labels, finding meaning**

Depression or “depression”?

According to the author, the widespread diagnosis of depression has resulted in the medicalization, pathologization, and amplification of the natural human condition of unhappiness. He agrees with Allan Horwitz and Jermone Wakefield who asserted in _The Loss of Sadness_ that:
“Sadness is an inherent part of the human condition, not a mental disorder. Thus to confront psychiatry’s invalid definition of depressive disorder is also to consider a painful but important part of our humanity that we have tended to shunt aside in the modern medicalization of human problems.”

The author’s prescription for depression, (or “depression”) does not involve taking a pill, but instead taking an existential approach to life’s inherent sources of unhappiness:
“In order to deal with those real problems, I am suggesting, an existential program is the best answer. It is not that the problems do not exist. But only an individual human being can answer them—and only for yourself...The existential program I’ve described is my vision. It is my subjective response to what I see as the demands posted on individuals by the facts of existence. You may see life in a very different way and not share my vision. If, however, you experience the thing called “depression” and feel like exploring an existential approach to climbing out of that hole, give my program a try. The word *depression* is a corruption of language, and the more society uses it, the further it will push us all toward unhappiness. Pathologizing unhappiness creates unhappiness. Reject the very idea of depression and make meaning instead.” (pp. 210-212)

The heart-and-soul of this book is the author’s existential program to create that meaning. He explains that:
“Even if you decide to take antidepressants or engage in psychotherapy to get help with your unhappiness, you will still have to find ways of dealing with your meaning needs, the shadows of your personality, your consciousness of mortality, and the facts of existence. The existential program can help.” (p. 62)

This existential program starts with orienting your life around 3 key questions for living authentically:
1. What matters to me?
2. Are my thoughts aligned with what matters to me?
3. Are my actions aligned with what matters to me?

Next, are the 20 key elements of this plan, which incorporate existential, cognitive, and behavioral steps for finding meaning despite—and amidst—the givens of existence (pp. 57-61):

1. You look life in the eye
Removing the protective blinders that human beings put in place to avoid noticing the many painful facts of existence, including painful facts about personality shortfalls; in doing so, life as it is can finally be faced and accepted.

2. You investigate meaning
Deciding to understand “what meaning means” so that you can proceed to lead your life in ways that feel meaningful to you.

3. You decide to matter
Realizing that the universe is not built to care about you, but that *you* must care about you.

4. You accept your obligation to make meaning
Letting go of the demoralizing wish that meaning rain down on you from on high and accept that the only meaning that exists is that meaning you make.

5. You decide how to matter
Deciding how to proceed in your obligation to matter: Is there some step-by-step meaning-making process available, or is it much more a speculative, seat-of-the-pants sort of thing? Or maybe it revolves around honoring a single principle—and if so, can you name it?

6. You honor your wants, needs, and values
Taking a smart view of the human predicament and recognizing that while you want to honor the values you deem worthy, life presents you with other purposes and pleasures too, among them guilty ones.

7. You create a life-purpose vision
Creating a life-purpose vision and remembering it even when you are tired, bothered, distracted, upset, and otherwise not in the best frame of mind.

8. You use your existential intelligence
Reducing your experience of unhappiness by exploring your existential intelligence in the service of authenticity.

9. You focus on meaning rather than mood
Focusing on making meaning rather than on monitoring moods: Ask yourself: “Where should I invest meaning next?” instead of “How am I feeling?”

10. You snap out of trance
Resisting entering into self-protective states of haze and fog that we experience when we simply go through the motions.

11. You reckon with the facts of existence
Accepting the facts of existence are exactly what they are: They include pain and pleasure, loyalty and betrayal, life and death, and your formed personality.

12. You personalize a vocabulary of meaning
Supporting your efforts at authentic living by adopting words and phrases that allow you to communicate with yourself intelligibly.

13. You incant meaning
Marrying the power of deep breathing with short phrases that support your intentions by creating breath-and-thought bundles called “incantations” that calm and center you.

14. You maintain a morning meaning practice
Starting each day by creating an existential plan for that day by deciding where you intend to invest meaning and by identifying those parts of the day that you intend to hold as vacations from meaning.

15. You negotiate each day
Choosing your meaning opportunities, you repair meaning when it gets torn, and you accept the tedious, unrewarding, difficult bits with practiced maturity: Each day is a project requiring existential engineering skills as you bridge your way from one meaningful experience to the next.

16. You seize meaning opportunities
Engaging in meaning opportunities by seeking activities that involve love, creativity, service, self-actualization, and achievement.

17. You handle meaning crises
Handling meaning crises by deciding on the several options available to you—including getting a grip and making the best of it, initiating changes that alter and improve the situation, and investing in new meaning opportunities—to restore meaning.

18. You engage in existential self-care
Accepting the realities of life and asserting that you are the sole arbiter of the meaning in your life: Life is exactly as it is and you are obliged to keep your head up and make yourself proud.

19. You engage in cognitive self-care
Reducing sadness by talking to yourself in ways that support your intentions, so that your thoughts provide hope, defuse doubts, and settle arguments with life: What we think is how we feel, and it is up to us to get a good grip on what we think.

20. You engage in behavioral self-care
Doing real things: You do not always have to do something “out in the world” in order to make meaning or to feel less sad; sometimes the answer lies in simply adjusting your attitude or reframing the situation.

Although I do have mixed reactions to the idea that depression is just an idea (I’m a therapist), I love the author’s existential approach for dealing with life’s inherent sources of unhappiness (I’m an existentialist). Whether depression exists or not, the givens of existence certainly do. And, this book presents a wonderful prescription for navigating those givens to ultimately experience a more meaningful and authentic life.

[James · Rating 4 out of 5]

As someone who has suffered depression, I appreciated the approach and understanding of this book. While it's a bit venomous toward the industry of big medicine and pharmacology at first, the book hits its stride when it comes to grips with its existential approach and humanistic psychology. I found it really worthwhile and interesting.

[Roxann · Rating 2 out of 5]

I happened upon a book, Rethinking Depression: How to Shed Mental Health Labels and Create Personal Meaning by Eric Maisel. Eric seems to believe there is no such thing as depression, it’s just a sad mood, relabeled a disorder by the pharmaceutical companies and therapists. And, there is some reason to believe this claim. Although when someone hangs himself in the basement, I have to think that is a little more than sad mood. But, the funny thing about this book, or odd thing is on page 46 of a 212 page book, he no longer talks about depression. The rest of the book is “Your Existential Plan,” which will show you how to create your existential life and therefore no longer be depressed. So shouldn’t the book have been named “Your Existential Life: How to rethink Depression?” Just saying when ¾ of the book is about something that is what the name should be. Not a great book not very helpful, but as with anything it did stir my interest and I began looking up Existentialism.

[Benjamin Spurlock · Rating 5 out of 5]

Anyone who's struggled with depression should read this book and take heart from the existential formulations therein. Depression isn't easy, life can be hard, and there's a lot to knock us around, but by changing how we think of our emotions and our down days, we can empower ourselves and start forming a new way of doing things.

On a personal level, I found this book while in a very dark mental state, and it helped me change my thoughts around and help form a new path of meaning. I can't recommend it strongly enough.

[Heather · Rating 1 out of 5]

This book is not worth the paper it's printed on.

[Charleigh · Rating 2 out of 5]

Please don't read this book while you're depressed!

I have a lot of criticism of the first part of this book. Part One: Rethinking Depression is just three chapters, 45 pages, and not worth your time (in my opinion). I initially read the introduction and chapter 1, skipped to Part Two, and then went back and finished Part One. I think that this book is harmful to people with depression. Mr. Maisel does not believe in depression. I grant that he might have some points surrounding the pharmaceutical interest in pushing pills, and that we don't have a clear understanding of the causes of depression. This does not mean that depression does not exist, or that having a label of depression isn't useful for helping people. Mr. Maisel's arguments for the invalidity of depression are flimsy, and tend towards oversimplifying and straw-man arguments.

"If depression were an actual disease, illness, or disorder, you wouldn't be able to rid yourself of it just by removing it from your vocabulary." Sounds nice, but there is no supporting evidence that this strategy works. Wow! I don't know what depression is, and instantly I'm not suicidal! Chapter 1 starts with an oversimplified argument that unwanted emotions are being labeled as abnormal, with the example of anxiety before a public presentation. In this case, having no anxiety would be abnormal, so Mr. Maisel argues that anxiety is being pathologized. This is very dichotomous and lacks the sense of scale that is important to differentiating normal feelings from mental disorders.

Mr. Maisel takes issue with the specious definition of mental disorder. Mental disorder is a broad category, and is necessarily broad to accomodate the many types of mental disorders. Similarly, the causes and symptoms of depression are numerous because people are varied. This does not make depression any less real. I challenge you to make a non-specious definition of illness! "Illness is a disease OR a period of sickness affecting the body OR mind, caused by bacteria OR trauma OR virus etc etc" Also, knowing the cause of depression is often secondary to treating the symptoms- first we make sure the patient will survive, and then work at preventing further crises. The cause is often in the past, whether the disorder is of the mind or whether it's cancer. Knowing the cause can help, but the focus is on where to go from here.

Mr. Maisel disparages anti-depressants as not proving anything about the reality of depression as a disorder, partly because drugs simply have effects. I remember being baffled by the sentence "There is a fundamental difference between taking a drug because it is the appropriate treatment for a medical illness and taking a drug because it can have an effect." I know that Mr. Maisel doesn't believe that depression is real, but if you take as given that depression exists, then the effect of antidepressants at lifting your mood IS the appropriate treatment for that medical illness. Positive thinking alone isn't going to restore your neurotransmitters. Mr. Maisel also throws unfounded suspicion at the fact that SSRI's are prescribed to a variety of mental disorders. It's almost as though serotonin affects multiple modalities of cognition! Not to mention the co-morbidity of disorders! And several of the disorders that he includes are depression in different forms (SAD, post-partum depression). Mr. Maisel also oversimplifies and Straw-Mans psychotherapy, despite using tenants of cognitive behavioural therapy in his own prescription for a good life.

Mr. Maisel did have some good points in Part One. Chapter 2 started with an illustration of how biases and perceptions can rearrange how we ascribe meaning to information. My problem here is with his rigidity of view- if a person is viewed differently depending on whether they are introduced as a patient or a job applicant, it doesn't mean that the two viewpoints cannot co-exist. We can judge the same person for different applications. I am sure that therapists are not in the habit of demanding that their staff be perfectly free from neuroses. I am also safe to assume that when introduced to someone as a potential patient, they are eager to ascribe meaning to their behaviours that may benefit from adjustment. Mr. Maisel has good perspective in Chapter 3 when talking about historical paradigm shifts in mental disorders- neither Freudian "hysteria" nor homosexuality is seen as a disorder anymore. This way that deviance from the norm is socially constructed makes a better argument for considering depression as an invention than anything preceding it. Anyways.

The only reason that this book gets two stars in this review is that I thought that Part Two: Your Existential Plan was useful. The notion of "meaning remains slightly vague", and the chapter on cognitive self care is frankly hostile to your self. (Coldly asking how this thought serves you? Can you really turn from being enslaved by your thoughts to holding the whip over them? What about compassion and curiosity? Will you just shove your unpleasant thoughts into a box without examining from whence they came, and why?)

[Gabriel Clarke · Rating 3 out of 5]

Oh GOD this book was annoying. Repetitive, smug, directive, lacking in empirical rigour, biased and dismissive of mental illness. In some way, a long, polysyllabic version of Crocodile Dundee's classic put down of those who seek out the counselling and analyst's profession's support - "Haven't they got any mates?"

On the other hand, I can't deny that he has a point in his central proposition that much of the natural existential state of the human condition has been cynically medicalised and I've taken a fair bit of his prescriptions in response to this to heart. But it's a bit like begrudgingly having to agree with Russell Brand on politics - I hate the framing of the message so much, I'm almost driven to take the opposing view out of pure orneriness.

[Roxana · Rating 4 out of 5]

Ok, so my review will probably be quite unpopular, but please bear with me.
It's true that this is the 3rd book on depression I've read, after a lot of articles and soul searching, and talks with people suffering from depression and anxiety (such as myself). It probably helps that I started reading this more thoroughly after I finished Johann Hari's Lost Connections, which for me was a blessing in SO many ways.

But back to this book. What did piss me off was the author's tone of voice. There were times when I felt yelled at and berated for even having used the word depression. But, there is a but.

I also felt that he's misunderstood a lot. Because he's not actually saying that depression doesn't exist. Just that we keep mislabeling it as a mental disorder, when it's so much more than that. What I got from what he's saying is that depression is not a wiring problem in our brains, but that it goes beyond that.

And, as you probably know, there are biological, psychological and social causes for depression. So I tend to think he's just focusing on the social and psychological ones.

As I was reading, though, I must admit that I felt my brain resisting the information, and shout at him that he know nothing. Until I realized that what Maisel is saying is to get out of our comfort zones. Because it's the easy way out to just say "I'm depressed, I need to take my pills to feel better", rather than searching for the cause and solving the problems that fester.

Still, proceed with caution and read the book when you're feeling more Zen. :)

[Trisha Roberson · Rating 2 out of 5]

The author rejects the medical veracity of "depression" (calling the industry "Big Doctor" a la Big Brother) and instead recommends the pursuit of philosophical existentialism. There are some good takeaways, like focusing on making meaning rather than monitoring mood. However, a big FUCK YOU to the author for shaming STD's.

[N. · Rating 2 out of 5]

1.5 stars

[Yan Bussieres · Rating 2 out of 5]

It looks like it was written pretty fast. After reading "Lost Connections" by Johann Hari, I feel like this book is a scam.

[Glad1981 · Rating 2 out of 5]

Bought it after reading a really good, really intelligent article by the same author. I was really enthusiastic beginning that book, and my disappointment was all the bigger. There are some quite good parts, but at the core the author is convinced that the diagnostic of depression is the result of a conspiracy between big pharma and the research. Now I am convinced that there is all kind of unsound relations between M.D.s and the pharmaceutical industry. But imagining that a whole sickness was plotted out of thin air is downright crazy.

[Gary]

Excellent Book!

If anyone suffering from "Unhappiness" doesn't relate to anything mentioned in this book, then there's little hope! If I can read a book, and feel like the book is describing me in many way, then to me, I'm seeing the truth. And that's exactly what this book did for me. It opened the window on the facts of being human and experiencing Unhappiness, or more commonly referred to as Depression! But more importantly, the author also gives the reader practical insights, along with suggestions and actions to take that make sense. I will add that this book is not a pill. It does take Action, or Work if you want to experience positive change. With that said, if you're suffering from depression, I would highly recommend at least giving this book a read. I'd also recommend his "The Van Gogh Blues" book.

[Schonink · Rating 3 out of 5]

Some of the works published should probably get better peer-reviewed these days. Eric's Rethinking Depression is one of these examples. The book itself contains too much repetition and sometimes eluded, intentionally or not, from explaining some of the crucial as well as controversial concepts more in depth.

[Safoura · Rating 3 out of 5]

Really liked the book although still think in some cases medication is really helpfull

[David · Rating 1 out of 5]

Finished maybe 20 pages or so. Horrible.