Agency is crucial to self-esteem, meaning, and dignity. Agency exists when a person sees that her decisions, willpower, and actions have a concrete impact on the world, that they effectuate some measurable change. Research shows that jobs in which a person has no choice, latitude or discretion as to how she carries out her duties result in depression. Why? This employee has been disempowered and lost all sense of agency. She is merely a cog, a robot, less than human.
When people are stripped of their inner sense of agency, either slowly and gradually or all at once, depression is sure to follow. Complex PTSD is a clear illustration of this principle. A child subjected to emotional neglect or active parental suppression of her emotions who concludes that it is pointless to have and express emotions, loses agency, and becomes depressed. A child subjected to frequent, harsh parental criticism will conclude that her thoughts, opinions, and actions are always wrong and unwanted. She recognizes that she doesn’t matter, loses her sense of agency, and becomes depressed.
An adult who endures external events that strip her of agency will feel powerless, helpless, and hopeless, and become depressed. The examples are legion. Being cheated upon over and over against all demands and pleas for it to stop. Being repeatedly battered by a spouse or partner erases agency. Being suddenly laid off for purely economic reasons after years of giving one’s all for a company and receiving excellent performance reviews, reveals that one’s efforts never really mattered, that one was always completely disposable. Caretaking an elderly parent with dementia or a chronic physical illness who is never grateful, always critical of you for not caring enough or doing enough, wears down one’s sense of agency and leads to depression.
For these reasons the regaining of agency can substantially reduce, and sometimes even eliminate, depression. How? When someone is seriously depressed, she experiences fatigue, lethargy, and a desire to stay in bed and avoid self-care, interactions with others, and ordinary responsibilities for home and work. The longer depression keeps the person inactive, the greater the disempowerment, the shame, the overwhelm, and the belief that demands of life are too much to carry out.
When I’m dealing with a seriously depressed client who sees no way out, I urge the client to get up, get out, and walk in the fresh air, even just a block or two. These first symbolic and literal steps pave the way for increased activity and agency. Whether it’s washing the bed linens or the dishes, taking a shower, driving to the grocery store to pick up milk, making buttered toast, sorting through and opening the mail or helping your kid with homework, these simple actions shake off the rust and gradually rebuild a sorely needed sense of agency.
I have come to equate depression with a loss of agency. Each can cause or reinforce the other. You might bring up a counterexample, such as grief over the loss of a loved one. Isn’t grief a natural and expected response? How could it possibly be construed as a failure, fault or negation of agency when your spouse dies of cancer or a road accident? The loss of agency can creep in dozens of ways here. The survivor might blame herself for not detecting or speaking of the possibility of cancer earlier, for not being a strong enough supporter and medical advocate or even for not spending more time with and being more affectionate toward her deceased spouse. She might have faulted herself for asking her spouse to run the errand, not getting the brakes serviced, etc. After the death occurs the survivor might become paralyzed by sadness or numbness and shame herself into depression by withdrawing from life and not caring for her children. Grief, though natural and predictable, can feel like a loss of agency and purpose.
Grief counselors recognize this, which is why they often recommend the survivor to actively recall the best qualities of and best moments with the deceased, and to memorialize these somehow by ways as varied as making a scrapbook or creating a foundation in honor of the deceased. Grief counselors also ask their clients to think about what their lost spouse would want them to do – either endlessly sit, stare, and mope purposelessly about, date again or resume work. Grief goes with a loss of agency because survivors often feel life became pointless and fruitless when their loved one died. What is called prolonged grief disorder can signify a substantial delay in the regaining of agency. This linkage of death and loss of agency also applies in legacy trauma when wars of ethnic cleansing or genocide inflict mass killings on the targeted group. It can take generations for the descendants of their murdered ancestors to regain a sense of hope, purpose, and agency. For humans agency is like the air we breathe. It is necessary for life.