BEFORE WE TELL SADNESS GOODBYE (WHY WE MAY NEED TO LISTEN TO SORROW BEFORE LETTING IT GO)

A few days ago, a very dear patient, who has been struggling with a significant depressive episode, said something to me during our consultation that went more or less like this:

“One thing many people don’t agree with is that I’ve started using gratitude as an alternative to my depression. Being grateful for what I still have beyond it. Grateful for some good things I can still do, or that still happen, even while I’m depressed. This sadness has been with me for three years now, and today I realize I’ve become someone who has grown used to suffering. One of the strategies I tried was precisely to allow myself to feel that pain — to experience it fully so I could face it. But I’ve been feeling it for so long that I can’t bear it anymore. So I thought I might start using another resource, you know? Instead of surrendering to sadness, I would be grateful for the good things I still have despite it.

“For example, I think: Thank you, God, that I am managing to do my daily physical activity; thank you for that online course I had wanted so much to take; thank you that I can work and feel productive. And then I go on being grateful for many other positive things in my life. I believe that, little by little, we begin to see things in a better way. At night now, I make a list of everything good that happened during the day, so I can try to see that there were good things too. Until then, I had been very hard on myself, always down, as if absolutely nothing in my life were good — and that seemed to make the sadness even worse.

“Recently I saw a man online saying that, when something bad happens to him, he thinks of three good things associated with it. For example, if he gets a flat tire, he thinks: it was only the tire, there wasn’t an accident; thankfully, I had a spare tire in good condition; good thing it happened today, when I didn’t have many appointments. That’s what I’m trying to do, besides taking my medication, of course. I’m trying to change this pattern of thinking, which had become very bad, and which I feel terribly tired of.”

Our conversation then flowed very naturally into an interesting question: what is the best way to deal with sadness? Should we live through it fully until it passes, or should we push it away by trying to see only the bright side of things?

From my point of view — which I know does not fully correspond to the experience of someone who is actually sad or depressed, though I try at the very least to approach it with empathic understanding — one thing does not necessarily exclude the other.

I see no reason why identifying the pain of sadness, recognizing it and living it inside ourselves, should prevent us from taking a different stance toward it, or even despite it. We can, and perhaps should, be grateful for the life that continues in the midst of depression, like the water of a stream that gently bends around the hard, motionless stones in its path and keeps flowing. It flows despite the obstacles.

Depression, often painfully morbid, can strike at our life and, in some cases, even put it at risk — or extinguish it altogether. But it is not the same thing as life itself. It is a devastating part of our existence, but it is not existence as such. In the same way, facts, people, losses, achievements, defeats, and even other illnesses are parts of what we live through. They do not define our identity. We are always more than what we feel, whether we realize it or not.

Sooner or later, however, we run into that old question: is the glass half full or half empty? Strictly speaking, seeing what remains inside it does not require us to ignore what is missing. It is like alternating figure and ground when looking at an image: at times we focus on the central object; at others, we shift our gaze to the surrounding field. Both still belong to the same scene.

Perhaps there is something even deeper here. Is it not by knowing what is “missing” that we come to understand what is “left”? How can we understand absence if we ignore what we wish were present? How can we explain night if we do not have the concept of day? In a very simplified way, we might even think of sadness, to some extent, as the absence of joy. Yet joy itself would be difficult to explain to someone who had never known sadness.

Perhaps the art of dealing with sadness lies precisely in finding a middle ground. To live through some of the pain, enough to recognize it, name it, and deal with it — instead of simply attempting the impossible task of completely ignoring its presence. At the same time, we must perceive the healthier areas of life, even if that perception is reduced to the ability to understand suffering as something within us, not as something that is us. To alternate figure and ground.

At this point, I need to make a few technical distinctions. Although depression often contains sadness, it is not merely sadness. Depression is a condition that may be identified as a mental disorder — brief or prolonged, acute or chronic — and it usually involves a broader set of signs and symptoms. Sadness, in turn, is an elementary affect or emotion, shared to some degree even with other species. It can be compensatory, in the sense that it may seek to bring the individual back toward a state of balance, or psychological homeostasis, after some form of loss.

If we dare to think in terms of something like a “psychic physiology,” sadness has a function. It may even represent a kind of healthy resource. It signals that something in our vital space has been lost, shaken, or threatened. It is, therefore, an invitation to strategic withdrawal, reorganization, and the creation of new meaning.

The psychological pain that characterizes sadness plays a role. In fact, I often see in clinical practice that, when we investigate more deeply, the symptoms associated with psychic phenomena tend to have a certain “logic” to them — but that is a subject for another conversation.

Sadness is not a disease in itself, something to be excised as one might remove a tumor. It is something to be understood, tolerated for a time, and processed within us before we can truly let it go. Perhaps it is an attempt by our psyche to help us adapt to a new situation, while also signaling that change to those around us.

Sadness is not exactly the same thing as melancholy either, although the two words are often used interchangeably in everyday language. Sadness, as we have seen, can be understood as an emotion, a response to loss, frustration, or disappointment. Melancholy is a more elaborate term, linked to the subjective experience of emptiness, lack, withdrawal of investment from the world, and the loss of one’s sense of personal value. It is more symbolic. It cannot be reduced simply to “feeling sad.”

From a strictly medical-biological perspective — always debatable, always incomplete, and always insufficient to encompass the full complexity of human experience — sadness and grief have an evolutionary role. In the face of loss, defeat, or something that leaves the defeated individual vulnerable, sadness may induce withdrawal, favoring energy conservation, mobilizing care from the group, and even signaling fragility to an aggressor, leading the aggressor to stop fighting because the fight is no longer perceived as necessary.

Rather than being merely an “error” of nature, sadness may have been, to some extent, a resource for survival. At the end of this post, I list a few examples from the vast literature on the subject, although the matter remains open to debate. And, of course, among human beings, all of this becomes infinitely more intricate, because culture, language, memory, symbols, and biography cover this basic affect with layer upon layer of meaning.

Still, perhaps something of our nature continues to cry out through sadness: a request for help, for shelter, for support; an invitation to rise again. And this signal is addressed not only to others, but also to ourselves.

For this reason, sadness may deserve to be listened to. Not idealized. Not immediately fought, as if it were always an enemy to be quickly exterminated. But understood. Because it may reveal something real: a deprivation that has always existed but was perceived only late in life; an unresolved loss; a life lived out of alignment with who we are; a love that was missing; a project that collapsed; a wounded identity; a hope that has grown weak.

Under different circumstances, sadness is something to be understood, tolerated for some time, internally processed, and only then left behind — like an attempt by the psyche to adapt us to a new situation.

But listening to sadness does not mean handing over the government of one’s life to it. And perhaps this is where gratitude, far from representing naïveté or alienation, may assume a deeply therapeutic role.

Not blind gratitude. Not forced gratitude. Not artificial gratitude used to deny pain. But lucid, strategic gratitude, oriented by meaning. A gratitude that does not erase suffering, but refuses to grant it a monopoly over existence.

When someone, even while depressed, is able to say, “There is still something good here,” that gesture represents the rescue of something healthy and preserved within the self. Often, it marks the beginning of an internal reorganization. Not the denial of shadow, but the refusal to be reduced to it.

In this sense, gratitude can be understood as a form of resistance. A way of preserving the ability to see that life exceeds suffering, even when suffering seems to occupy the entire horizon.

Perhaps that is why the topographical image contained in the word depression has always seemed so suggestive to me. A depression in the ground is a lowering of the terrain, a point from which the horizon disappears. Whoever is down there cannot see far. And yet, the fact that one cannot see the horizon does not mean that it has ceased to exist.

Sometimes, gratitude is precisely the exercise of imagining, sustaining, and remembering what we cannot see at that moment. It keeps alive within us the idea that there is something beyond the dark hollow in which we find ourselves.

***

Here, I recognize, I am looking at the full side of the glass. And that perspective is not always easy to access, especially in depression. Very often, it is the disorder itself that prevents it. There are clinical pictures that require psychotherapy, medication, neuromodulation, concrete life changes, a support network, time, follow-up care, and sometimes a great deal of effort just to get through one day at a time.

But if we can understand that we are not sadness, and that something in us is greater than sadness — just as a stream contains banks, water, fish, and stones without being only bank, water, fish, or stone — then the healthy part within us has been activated. And that is the part that will begin the work of reconstruction that needs to be done.

There is an old Brazilian soul-pop song from the late twentieth century whose refrain says, in free translation, “Bye-bye, sadness, you don’t need to come back.” Perhaps our attitude can indeed be something like that: goodbye, sadness. You don’t need to return.

But I understand that I can only say this if I have first recognized sadness. When I perceive that it has begun to impregnate the image I have of myself and to confuse my capacity to deliberate, I become able, little by little, to take back command of my life and prevent sadness from leading me to a dark, empty, lonely place, stripped of perspective.

Like every act of resistance, this movement requires courage. The courage to look at one’s own condition without disguise. To recognize limits. To admit pain. To name what is missing. To accept fragility.

When we honestly ask what exists within us, we also open ourselves to answers that may hurt even more. Even so, it is this courage that makes it possible to search for exits from the place into which we have fallen.

The courage to ask for help. The courage to expose one’s intimacy to a psychotherapist. The courage to place a new medication inside one’s own body. The courage to change habits, revise directions, establish necessary cuts, sustain necessary losses, and try paths that may not work immediately — paths that, at some point, may need to be reviewed, adjusted, or replaced, but that may eventually bring us back, as fully as possible, to ourselves.

And perhaps even propel us toward new paths, toward new perspectives opening up on a horizon that has now become visible again.

A possible debate remains for another time: the meaning of what we have lost. Is what makes us unhappy the loss or absence of the lost good itself? Or is it something deeper and more obscure within us, something that the lost object merely represents? I will let you know here when I write about that subject.

Returning, then, to gratitude for what continues to exist in life — without requiring us to deny pain — gratitude reveals itself as a decisive gesture. It allows us to see that there is something beyond melancholy. When charged with meaning and integrated into a strategy for living, it becomes much more than gratitude: resilience, learning in the face of pain, and the capacity to transcend it.

It is our inherent, inevitable, and instinctive tendency toward self-preservation, happiness, and life in all its splendor.

May we tolerate sadness only long enough to listen to it — and, in the end, to say goodbye.

***

References used for this reflection on sadness, depression, and evolutionary hypotheses about emotions

1. Gilbert, P. (2016). Depression: The evolution of powerlessness. Routledge.
2. Price, J., Sloman, L., Gardner, R. Jr., Gilbert, P., & Rohde, P. (1994). The social competition hypothesis of depression. British Journal of Psychiatry, 164(3), 309–315. DOI: 10.1192/bjp.164.3.309
3. Hagen, E. H. (2011). Evolutionary theories of depression: A critical review. Canadian Journal of Psychiatry, 56(12), 716–726. DOI: 10.1177/070674371105601203
4. Andrews, P. W., & Thomson, J. A. Jr. (2009). The bright side of being blue: Depression as an adaptation for analyzing complex problems. Psychological Review, 116(3), 620–654. PMID: 19618990
5. Nesse, R. M. (2004). Natural selection and the elusiveness of happiness. Philosophical Transactions of the Royal Society B: Biological Sciences, 359(1449), 1333–1347. DOI: 10.1098/rstb.2004.151
6. Nesse, R. M., & Ellsworth, P. C. (2009). Evolution, emotions, and emotional disorders. American Psychologist, 64(2), 129–139. DOI: 10.1037/a0013503
7. Welling, H. (2003). An evolutionary function of the depressive reaction: The cognitive map hypothesis. New Ideas in Psychology, 21(2), 147–156. DOI: 10.1016/S0732-118X(03)00017-5

 

 

 

 

 

 

 

 

Image source: AI-generated illustration created with ChatGPT / DALL·E from a prompt by the author.