This week I interviewed Dr. Seth Gillihan, a clinical assistant professor of psychology at the University of Pennsylvania. He has published books on managing anxiety, depression, and OCD, and is the author of Think, Act, Be, which features the articles he’s written on depression. I chose to interview Dr. Gillihan because of his extensive work with depression and to ask what it was like to study depression on a professional level. My interview also included the question of how both living with depression affected his life as well as his career. After all many of those interested in studying psychology suffer from depression or face other mental conditions, and worry that it may stop them from pursuing their interests. I hope this interview helps such people and shows them that they can continue to follow what they love without such worries.
What led you to study CBT (cognitive behavior therapy), anxiety, and depression?
I was drawn to anxiety and depression because they seemed like conditions I could understand. I actually didn’t know at the time how much I could relate to them—I wasn’t aware of my own struggles in these areas back then. But I think anyone knows what it’s like to feelanxious or to feel down, so we can kind of extrapolate to get a sense of what a true anxiety disorder or major depression is like. That only gets you so far, of course. I don’t think you can really know what these conditions are like till you’ve experienced them yourself.
Once I knew the area I wanted to work in, I tried to figure out how I could be most helpful to people. When I was in my master’s program at GW I started hearing about something called cognitive behavioral therapy or CBT. The more I heard about it the more I was drawn to it. I liked that it was based on common sense principles that anyone could understand. I think it appealed to my science background since I was a Bio major in college and never took any psych courses. I also had a professor at GW who strongly influenced my direction, encouraging me to get advanced training in CBT in my doctoral program. So I only applied to PhD that had a strong CBT emphasis, which led me to Penn where I did the rest of my training.
What motivates you to write about depression and anxiety?
I guess two things. I write about these topics because frankly I feel like I have a good sense of what it’s like to experience them. I got involved in this field almost 20 years ago because I wanted to be helpful to people in some way. I’d always imagined that work would be one-on-one, doing therapy. The possibility of helping more people through things I write is very rewarding.
I also enjoy the process of writing. I’ve been writing since I was a kid. Back then I guess it was what you’d call early fan fiction—new adventures of the A-Team, mostly. I wrote a lot during graduate school and when I was a full-time faculty member at Penn and Haverford College. I was writing book chapters and journal articles, which is a tonof work and unfortunately very few people end up reading it. Even people in my field probably just read the abstract for the most part. To be honest when I looked at my CV it seemed like most of the publications I had didn’t serve much of a purpose, other than filling lines on my CV. I wanted to write things that people would read and find useful.
I don’t find it particularly easy to write, which is probably part of why it’s rewarding. I like trying to translate things into words that’ll resonate with someone and either give them a tool for managing what they’re dealing with or a bit of inspiration to keep going. So I try to pass along helpful ways of dealing with depression and anxiety, and encourage people to keep fighting, to treat themselves kindly, to find ways to connect to things that bring them a sense of meaning. We tend to do better in every way when we’re living a life we care about.
How long have you been studying depression and do you think you’ve found anything to help the way society views depression?
I started studying depression around 2000, so I guess it’s been about 17 years now. In the beginning I was studying what was already known about depression, especially the risk factors and the treatments that work well. In graduate school and beyond I was doing my own research to try to understand what causes depression and how we can prevent it. Now I’m back to being a consumer of research.
It’s an interesting question about finding something to help society’s view of depression. It seems like for about as long as people have been getting depressed there’s been a kind of “othering” in the way we see it. Depression is supposedly something that “mental patients” get (by the way, “mental patient” is not a term I actually use).
I think it’s helping that there’s a lot more awareness now than there used to be, but we’ve still got a long way to go obviously. I hope that by sharing my own struggles I can help in a small way to normalize the experience—to say that this is something that can happen to pretty much anyone, given the right conditions.
I also feel a responsibility to expose some of the myths about how depression should be treated. Not everyone who’s depressed needs formal treatment, and not everyone who gets treatment needs medication. The idea that depression is a “chemical imbalance caused by low serotonin” has been debunked, but that idea has lived on, making people think that medication has to be part of the treatment equation. Mild to moderate depression generally respond well to either therapy (like cognitive behavioral therapy) or medication (usually an SSRI like Prozac). More severe depression usually requires both therapy and medication.
How did depression affect your life, and if you don’t mind me asking, how long?
Thankfully the effects on my life were rather subtle, although that’s probably why it took me a while to recognize it. So I’m not really sure how long it lasted. Probably several months, and maybe as long as a year or two in a mild or “sub-threshold” form.
I think it made it harder to do some things, just finding the motivation for activities outside of my daily responsibilities. It probably led me to drink more alcohol, although at the time I don’t think I realized my mood was having that effect. It probably contributed to some problems sleeping, but it’s been a while now so I don’t remember for sure.
The most obvious effect was on the way I saw myself. I really didn’t like myself at that time. I knew my friends and family seemed to like me, but it was hard for me to imagine why. I was pretty disgusted with myself, and really for no good reason. A lot of the time I had a sense that the people who knew me had a vague feeling of dislike for me, which seems to have been entirely a product of my depressed imagination. It’s easy to see how it could have gotten a lot worse if I hadn’t seen the depression for what it was. Thankfully I had really great support from my wife and close friends, which made all the difference.
Do you have any advice for someone with depression who wants to go into the same field?
For anyone going into a field like clinical psychology, I’d want them to think about what draws them to that field. Is it primarily to be helpful to others? To “fix yourself”? Maybe some combination of the two? There’s not necessarily a wrong reason to go into this field, but it helps to know why we’re doing it.
Some really good treatments have come from psychologists’ own struggles. I’m thinking of Marsha Linehan’s DBT and Steve Hayes’s ACT. I’m guessing there are many more cases of people who used their own issues to develop effective treatments.
Regardless of what we might be dealing with, it’s really important to know it won’t get in the way of our effectiveness as a therapist. It doesn’t matter if it’s depression or anxiety or an autoimmune condition—whatever it is, you don’t want it to be a significant barrier to being helpful.
Obviously we all have things we deal with. I may not have been as effective as a therapist right after each of our kids was born and I was getting less sleep than usual. Those kinds of things are unavoidable parts of being human. But if we’re impaired to the point where we really can’t carry out our work responsibilities, or we’re so deep in a depression that we’re not able to concentrate or think clearly, then the clinical care we provide is really going to suffer. So we owe it to ourselves and to the people we serve to be as healthy as possible, and to know when we’re not able to function effectively. But I certainly wouldn’t think depression rules someone out from being a therapist. I guess I’m proof of that.
I would also say use your experience with depression—or any struggles you have—to make you a better therapist. Let it deepen your compassion for people in pain. If your heart’s going to be broken, let it break in the service of others.
I am very thankful to Dr. Gillihan for this interview and I hope that you enjoyed it. If you want to know more about his works, click here.