Shame and Medicine Exeter
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Shame and Depression: A Hyperawareness of The Social World

In 2001 Andrew Solomon published his book ‘The Noonday Demon: An Atlas of Depression’, in which he gives an account of what it means to experience depression. He describes how depression is “a loss of feeling, a numbness, [which] had infected all my human relations. I didn’t care about love; about my work; about family; about friends…” (Solomon 2014, p. 59). And depressive patients do complain about a feeling of not feeling, which should be allegedly contradictory painful. This quote from Solomon’s book stuck with me, but at the same time it seemed to me that something was amiss with the statement, because one feeling that is predominant in depression is shame. So, questions arose for me, such as how does one not care about any relationships—friends, family, colleagues—but at the same time, during a depression, experience strong feelings of shame? Isn’t shame constituted in a dynamic relation to the world in which we live, and not only within ourselves?

Such questions proposed themselves to me, and I started undertaking research through the use of an interview technique called phenomenological qualitative interviews. Here participants that had previously experienced depression were interviewed. The main focus of the interviews was to dwell on their first-person lived experience, and to try and bring forth a more subjective understanding of what it means to live with depression, and how it is felt.

Unlike Solomon’s descriptions, the interviews showed that people with depression seem to have a hyperawareness of their social worlds, where they care obsessively about all of their relationships. One participant described how a month before a wedding she started to consider different excuses for not showing up, and thinking about the wedding occupied most of her thoughts as she counted down the days to the wedding date. Her description was one among many, and it seems to suggest, not an utter isolation, but a rich inner social life, dominated with intense feelings of shame, seeing as she constantly thinks about how she will inevitable let everyone down, because she is ashamed of who she is, and who she has become, and she is afraid of others seeing this – because she compares herself to everyone around her, and all the things they’re able to do, and most of all the things she doesn’t do.

Self-reproach, guilt, and shame are normal feelings that everyone experiences throughout their lives, and they can often contribute to us living together harmoniously as social beings, where we are able to adhere to shared norms, and to not transgress the boundaries of others. But shame and related feelings can become increasingly unhealthy if these emotions dominate one’s self-perception, identity, and values. A person living with depression can experience that everything in their lives is failing, which can lead to a fundamental feeling of shame that heavily affects their day-to-day life. Especially when they impose unreasonably high self-expectations on themselves that they feel they must live up to.

For the depressive individual, these strong feelings of shame directly reflect back upon oneself and exist to negatively confirm their shameful existence – e.g., by getting a bad grade in school, the depressive person thinks it’s because they’re a failure of person, and not just because they might have had a bad day. And this is not only limited to expectations in one’s job, family relations, and getting good grades, but rather starts to seep out into different aspects of one’s life – making the inability to get out of bed in the morning and brush one’s teeth a fundamental flaw of the person with depression, further confirming their inability to function. It is as though every aspect of one’s life, getting a glass of water, going to the bathroom, picking up the phone, has become imbued with a shade of shame, as though telling the person that she is unable to do all of these, because she is a bad person. When thinking of shame in relation to other people, one participant in the interviews put it this way:

“That is why [social interactions] are so tough. Because putting yourself in the social situation can both be the cause of you breaking, but it can also be the cause for you learning to see the [whole] situation better. Which is the hardest – to give others a chance.” (Woman, 44)

Depending on the context, where meeting someone for a coffee can be an obligation needed to maintain a façade and friendship, it can also just be a meeting a friend, that doesn’t require anything other than being present. But the depressed person feels ashamed when with another person because their interactions can end up confirming their inabilities.

With cases of depression increasing every year, it is important to bring attention to shame and the hyperawareness of social life and relationships that depressed individuals experience, as these insights stand in direct opposition to more common narratives, like Solomon’s quoted above, about what it is like to live with depression. These new insights can help to change one’s outlook, self-perception, and help with understanding how the shame experienced in depression stems from this intense feeling of not living up to self-imposed unreachable expectations, that only applies to the individual herself.


Work Cited: Andrew Solomon (2014), The Noonday Demon: An Atlas of Depression, Vintage.

Further Reading: Meaning Making and Variation in Depression: Depressive Suicidal Thoughts as Meaningful


Oskar Otto Frohn, Master of Philosophy, M.A., from Katholieke Universiteit Leuven with specialization in Phenomenology of Psychopathology

Doi: 10.5281/zenodo.6646075


11th July 2022

 Photo credit: Unsplash. Farmhouse with a Stove. Creator Karl Pärsimägi.

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