Depression tells the sufferer that there is no point, no purpose, to life. No point or purpose, that is, to the individual's own life, no real reason to do anything. All is molecules in motion, Darwinian happenstance; ours are vapid and fluttering heartbeats in a universe that doesn't give a damn. And so why eat, work, hope or care?
As a clinician it can be tempting - but is I think perfectly pointless - to try to combat the above depressive message with affirmations of the meaningfulness of living a human life. What I want to claim here though is that such affirmations miss the perspective, the from-where, of depression and so end up speaking past it. For the depressed individual has been thrown out of their life, and is - perhaps without realising it - offering a thought about the whole of it from without. They are not caught up within, and so are not bound to the purposes and meanings and teloi that arise immanently within the living of, it.
A certain kind of religious individual might want to argue that there are in fact superordinate points, purposes, to life. That life in its details gains its meaning from without. That there is some meaning beyond death, for example, which gives a purpose to the earthly life as a whole. That there is some set of higher values against which human values are to be evaluated and from which those which are viable gain their authority and meaning.
Speaking for myself I can't really make sense of such religious perspectives. But must this mean that I must agree with the depressive? Well, I want to argue here that we can make certain concessions to the depressive - that it is even healthy and helpful to do so - without in any way agreeing that one 'ought' therefore to be depressed.
Here is what I want to say: That meanings only arise immanently within life. Within one's work, family commitments, friendships, etc. That this is all just fine by me thank you very much. That meanings such as these need no outside guarantor or ground. That we can be more, or less, on-the-way with, bound-up-within the countless projects of, the details of our lives. But that the thought that 'there is no point to living one's life' arises as a kind of category mistake. That the category of the meaningless only really has an application to cases in which we might have meaningfully expected meaning to obtain. Yet how could one meaningfully expect meaning to obtain for the totality of one's life looked at from outside - given that meanings arise, perfectly happily, within the projects and relationships of a life as lived?
A constant theme of Wittgenstein's philosophy was of the helpfulness of stressing the bivalence of any genuine proposition. What could be true must also meaningfully be said to be possibly false. This however is what the depressive misses. They talk of life as a whole as meaningless in the same kind of way in which one might have previously thought that a certain proposition was meaningful but later come to see it as meaningless. But really the kind of meaninglessness that attaches to life as a whole is, we could say, of a grammatical rather than an empirical kind. It doesn't happen that life as a whole is meaningless. Rather it is that the concept of the meaningful has, I want to suggest, no meaningful application here. In this limited but misleading sense alone is it correct to say it is 'meaningless'. Instead one might more helpfully say that it is neither meaningful nor meaningless. (Compare the standard metre in Paris: if we are trying to render empirical truth we do not do well to describe it as either a metre long nor not a metre long.) In a 'new Wittgensteinian' mode we might offer that no unconfused, i.e. no genuine, meaning has yet been given to talk of 'life as a whole being meaningful'.
The depressive's talk about the meaninglessness of life-as-a-whole is taken by them to somehow impugn the meaningfulness of this or that action within it. There is no point in my brushing my teeth because there is no point in being alive. Well, let's go ahead and grant him the second, taken as a kind of grammatical truth; but why should any of us assume that the first depends on the second?
The clue to depression is to understand that it comes about as a merely partial alienation from a life as lived - a perspective within which the sufferer can still be drawn to talk of meaningfulness or meaninglessness, but a perspective which hides from itself the fact of its own non-empirical alienated-perspective-dependent character. The depressive, then, is like the metaphysician: they both 'sublime' the logic of our language.
What does this tell us about treatment? Well, it tells us that we may do best to agree with the depressive that if they want a superordinate purpose to life before they are prepared to embark on it, then they will be waiting forever (unless they have a religious conversion). We might look too at the ways in which the desire for such a super-ordinate purpose - which proffers itself as straightforwardly, self-evidently, reasonable - is in fact a rather bizarre and, as it were, metaphysically suspect desire. Perhaps we would do well to look at what that desire is designed to help the depressive avoid the pains of mourning, for example, pains which are avoided by meaning-evisceration. And we would do well too to track, voice, reflect the various meanings and values and experiences that do still (perhaps in muted form) arise within the depressive's life, to build their connection with such values and meanings and experiences. Not because it is somehow more 'true' or 'valid' to be un-depressed than depressed; not because 'life really is worth living' after all; but because in disguising from herself the ways in which she is actively cutting off from particular of her drives and cares and emotional experiences and relationships, the depressive is as it were locally (rather than globally) falsifying the phenomenology and meaning of certain of her own experiences in ways which go against the values she contingently maintains.
The hard thing is in accepting that this can be enough, and to not get sucked into playing the depressive's metaphysical game. For it is a game in which, with unwitting hubris, the manic aspect of all of us relentlessly engages when we defensively underestimate the local and fragile character of our projects and relationships.