Chronic Shame and Depression: A Vicious Cycle
Learning to distinguish shame from guilt helped me better manage my mental health.by Krysta Scripter
I feel guilty about damn near everything.
I don't clean my house enough. I don't love my husband enough. I don't work as hard as I should. I don't reach out to friends enough. I don't take care of my family enough.
No matter what, it feels like I'm never enough.
I still struggle with this, even when I know I'm exhausted and need a break. It's hard to wrap my brain around the idea of taking care of myself when I'm constantly listing things I still need to do. Not living up to my own expectations makes me depressed.
I was dealing with a series of bad days, feeling burned out on work and unable to accomplish basic tasks, when I finally blurted out to my husband that I felt worthless as a writer and also felt guilty for not doing more.
"That's not guilt," he said. "You're talking about how you feel, not what you did. That's shame."
This conversation surprised me. While I had used the two terms synonymously when referring to my emotions, I almost felt worse about the idea of feeling ashamed rather than feeling guilty. But why was that?
Was my shame the root of my depression, or the other way around? Could I deal with one without dealing with the other? Why did I feel so ashamed about my shame?
Guilt versus shame
Shame and guilt are often used interchangeably, but professionals have recently started distinguishing between the two.
In his book The Science of Shame, Dr. Gerald Fishkin explains that shame is one of the least understood aspects of human emotion.
"Historically, shame and guilt have not had clear distinctions," he writes, noting that guilt is a reaction based on our behaviors.
"Shame, on the other hand, is an organic biological response that is expressed as a visceral and not an intellectual reaction."
The key thing to note about shame, and the negative self-talk it produces, is that it is completely irrational.
"Our thoughts follow our experience of shame rather than the other way around. Shame is unlike guilt in this way," Fishkin writes. "Since shame is built into our systems and our self-image, we experience it first and think about it later."
Shame doesn't follow any logical reaction — it's rooted in emotion. A shame attack, when feelings of worthlessness and self-loathing spiral out of control, is almost impossible to stop once it's started.
In her book Escaping Emotional Abuse: Healing from the Shame You Don't Deserve, psychotherapist and author Beverly Engel writes that "debilitating or toxic shame is a type of shame that is so all-consuming that it negatively affects every aspect of people's lives."
She continues: "(Toxic shame affects) their perception of themselves, their relationships with others, their ability to be intimate with a romantic partner, their ability to risk and achieve success in their career, and their overall physical and emotional health."
The vicious cycle of shame and depression
What makes shame even more difficult to manage is that it's both a trigger and a symptom of depression.
"The relationship is bidirectional, though, so when shame is worse, depression worsens. When depression is worse, it can increase the levels of shame," said Eric Patterson, licensed therapist and contributing writer for Choosing Therapy.
When the root of depression is actually shame, or shame exacerbates feelings of depression, treating one without the other leaves patients with an incomplete healing process.
Hilary Jacobs Hendel, a New York-based psychotherapist and author, shares the story of a severely depressed man who suffered from shame so acutely that his depression could not be treated by traditional methods.
"He interprets his distress, which is caused by his emotional aloneness, as a personal flaw," Hendel writes.
"He blames himself for what he is feeling and concludes that there must be something wrong with him. This all happens unconsciously."
The man's depression could only be treated once his shame was addressed in a therapeutic setting that allowed him to recognize his emotions and deal with them accordingly.
Countering shame with compassion
According to Fishkin, we have two primary affective responses: shame and compassion.
"Compassion is a connectedness that transcends language and emotion," he writes. "I cannot control it — it's not intellectual. It is a deep connection of association with the other."
Fishkin believes compassion-focused therapy is far more likely to help patients move towards healing.
"Self-compassion means forgiving ourselves for the sins we did not commit," he writes.
"It means learning how to stop carrying shame, the shame perpetuated by those who violated us in the first place — those who directly or indirectly told us that we were not good enough through their words or actions."
Therapist and author Deedee Cummings also recommends professional therapy for those looking to process shame.
"Most people need to spend several therapy sessions talking through the source of the shame, receiving the validation that they are not horrible people and that we all make mistakes, and then replacing the negative self-talk with positive self-talk," she said.
"Most important piece of advice: Don't let your shame be so loud that it talks you out of talking to a professional about it."
Dealing with chronic shame can be debilitating and exacerbate other mental health issues, and it's not always appropriately addressed.
Even recognizing it can be difficult, evidenced by my years of feeling "guilty" about not being enough when I was really feeling shame about who I was. I still struggle with feeling shame in nearly everything I do.
Understanding how shame works, however, has helped me understand where my emotions are coming from. It's always been difficult to be kind to myself, but it's heartening to learn that self-compassion is the treatment for shame.
The next time I'm starting to spiral into shame, maybe I can remember what I learned here, and treat myself with a bit more kindness.
The help of a trained therapist in this situation cannot be overstated, and I still have a lot of work to do. But recognizing shame for what it is, and understanding compassion's role in healing, has moved me one step closer.