Van Praag (1998) suggested that certain types of depression can arise from dysregulation of the anxiety and aggression systems, and, undoubtedly, anger and anxiety are often part of depressed states. In recent years, I have been interested in the idea that, when people are in aversive situations (for example, losing control over situations, or, subject to shaming or non-supportive environments), not only are these stressful but also there is an automatic triggering of basic evolved defensive behaviours (Gilbert 2000a). There is a range of such behaviours, including fight, flight, submission, and help-seeking (Gilbert, 2000a, 2001c). Dixon (1998; personal communication, 1993) pointed out that if one arouses but then blocks the execution of a defensive response (such as flight and escape) in animals (such as rodents), one often sees passivity and immobility. Gilbert (1992) noted that LH studies in animals often involve arousing but blocking the innate defence of active escape behaviour. Moreover, many of the serious life difficulties associated with chronic stress (Morriss & Morriss, 2000) and depression, as found by Brown and Harris (1978; Brown et al., 1987), could be seen as entrapments; that is, people are highly motivated to get away from their current situation (aroused flight motivation) but feel unable to. Brown et al. (1995) explored this possibility and found that loss events associated with a sense of humiliation (feeling subordinated) and feeling trapped (unable to get away from the situation) were more predictive of depression than major loss events alone. Viewing a psychotic illness as a serious life event, Birchwood et al. (1993) found that those who felt unable to control the illness, and where flight motivated to their illness (wanted to get away from it), were more vulnerable to depression than those who engaged with and managed their illness. Gilbert and Allan (1998) developed an entrapment questionnaire and found that feelings of wanting to get away (high flight motivation) but being trapped were highly associated with depression, defeat, and hopelessness. Using focus groups of depressed people, Gilbert and Gilbert (2003) found that feeling trapped by both life events and the depression itself was a common experience of depression. Indeed, I am struck by how often the theme of entrapment comes up in depression—including its archetypal imagery—being stuck in a dark hole and unable to escape or get out. Rowe (1983) has long argued that depression is experienced as 'aprison', powerfully capturing the notion of entrapment. Of course, torture, as discussed above, is clearly one of entrapment. It has also been commonly observed that when some depressed people make plans to kill themselves (escape), their affect can improve, sometimes quite substantially. Here, at least, escape seems the primary affect regulator because after death there is not much hope of achieving anything (see Baumeister, 1990, for a discussion of these issues).
It can be useful for clinicians to explore and work with these themes (Gilbert, 2000b; Swallow, 2000), not least because people can feel trapped and resentful for a host of reasons, and entrapment can be associated with suicide (Williams, 1997). Moreover, Leahy (2000) has suggested that people can remain stuck or trapped in unhelpful situations or relationships because they feel they have invested too much in them to let go ('sunk costs'). This is not to suggest that, say, fight or flight would be adaptive if acted on. While sometimes aiding flight (as in leaving an abusive spouse) can be therapeutic, at other times turning off flight motivation may involve helping people to 'take on' their problems (engage rather than avoid or take flight), change their thinking, and cope in different ways. Moreover, learning how to be assertive might limit brooding resentment and rage. There might be many ways to lower fight/flight activation, but lowering it could do much to take pressure off the stress systems (Gilbert, 2000b).
In fact, if one considers the idea that depression is associated with an array of aroused defensive behaviours, such as fight, flight, help-seeking, and submission, one finds evidence that all these tend to be blocked, ineffective, or poorly regulated in depressed people. As reviewed elsewhere (Gilbert, 2001a), depressed people can be anxious and avoidant; can have raised irritation and anger levels; can be fearful of their anger, although they can have anger attacks (Brody et al., 1999); and may be ashamed and avoidant help seekers (Cramer, 1999), or their help seeking may turn people away (Segrin & Abramson, 1994). Suffice it to say that it looks as if the limbic system is in a high state of stress arousal, firing off defensive impulses to fight or escape, but because these are blocked or ineffective (or, if acted on, make things worse), the system stays in a state of chronic stress with all the disruptive feedback such states produce.
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This guide Don't Panic has tips and additional information on what you should do when you are experiencing an anxiety or panic attack. With so much going on in the world today with taking care of your family, working full time, dealing with office politics and other things, you could experience a serious meltdown. All of these things could at one point cause you to stress out and snap.