22 March 2011

On Depression

I suppose it's high time I addressed depression in this blog.  I mean, if I can devote time to reviewing Darby O'Gill and the Little People, share a checklist of Star Trek toys from Burger King and even create a label tag for John Boehner, I may as well discuss something that actually matters once in a while, right?

Depression is at least as important as those toys, right?
I can't say now when I first became depressed.  In eighth grade I once ignored a class lesson to instead compose a suicide note.  It was fittingly accusatory and morose, and a classmate--nay, a friend--interceded and reported it once I permitted him a preview of my handiwork.  I had a rather bothersome discussion with the guidance counselor and my mom, and shelved the whole thing as an anomalous writing.

My mood, however, never stabilized.  In 2000 it came to a head when I fell down the stairs while again contemplating suicide.  Again, I composed a note--this one was far more bittersweet than the angst-ridden diatribe I'd previously constructed.  I agreed this time to consult a physician and try an anti-depressant.

I don't recall all of what I sampled, but I distinctly recall that Zoloft had an adverse effect on me as a guy.  Not that it really mattered; I was single at the time and had no one to disappoint.  Still, when you're already self-conscious and consumed by an inferiority complex, impotence isn't a welcome addition to your psychological woes.  For a while, Prozac seemed to help.  At the very least, it was a lot easier for me to stave off the nagging interior voices.

Photo taken from Wikipedia commons.
Those who have never dealt with an emotional disorder assume that anti-depressants are "happy pills" for people who whine too much about the real world that everyone else deals with like a grown-up.  You can't approximate an understanding of what it's like to be depressed, no matter how many doctor's office pamphlets you've read or how many Cymbalta commercials you've seen on TV.  The best analogy I've found is one of my own, and that's to think of driving in the rain.  You can't control the rain.  It's there regardless of what you want.  Maybe it lets up, maybe it comes down harder; you can only react to it.  It's hard enough, depending on the terrain, but it's almost impossible without wipers.  Having an emotional disorder is like being deprived of those wipers.

Most people have no idea what it's like to actually resent being alive, and it's such a foreign idea to them that if you introduce it in conversation they often become defensive.  Sometimes they want to insist that you don't really feel that way.  Some of them think of your immediate circumstances and believe that you don't have sufficient cause to be depressed, as though there's some kind of criteria to be met.  Trust me, people of all walks deal with depression regardless of anything else in their lives.
Depression is an internal problem, and it doesn't give a damn about your circumstances.
When you're depressed, there is no right job to have, no right lover to share a bed with, no right car to drive, no right home to live in, no right clothes to wear.  Whatever it is that it's in your life, it's insufficient to make a difference in how you feel about yourself or your life.  People who are happy assume that you just need to make some kind of exterior change, and happiness will follow.  It doesn't work that way.  You can change jobs, seek a new lover, trade in your car, move and change your entire wardrobe and still be just as depressed as you were before you altered a thing.  Plenty of rich people have talked about depression; money didn't help, and we're talking about people with the kind of money to change everything else about their lives on a whim.

Recently, I went to the doctor and discussed my depression.  She prescribed Cymbalta, but confessed that she honestly didn't think at this point that there was anything on the market that would make a difference with me.  I've taken two pills.  Both times induced severe nausea, vomiting and left me so fatigued and out of it that I honestly had no recollection of the entire next day either time.  I won't take a third Cymbalta pill.  I don't know where that leaves me, honestly.  It's a hell of a feeling, knowing that a physician has outright said that medical science is apparently unable to help you.

If you've read this and have dealt with depression, I hope that you got something out of this.  Sometimes it's helpful to hear someone else describe our own experiences, and maybe something I've written will be of some value to you on that level.  Maybe it's just nice to know you're not alone.  Maybe you'll show this to someone, and hope that it helps them understand your situation.  Whatever you get out of it (if anything), more power to ya.  And don't be scared by my experience; there's a very good chance that one of the anti-depressants on the market can help you.  At the very least, you owe it to yourself to find out for sure.

If you haven't dealt with depression, I know exactly what I want you to get out of this.  Humility.  Know that your imagination isn't up to the task of approximating what it's like to actually be depressed.  Understand that you aren't qualified to determine who around you is entitled to be depressed.  And if someone you know indicates that he or she may be depressed, take the "that's life" speech and shove it.  No one who is depressed has ever been helped by someone who isn't depressed telling them they need to get over it. The best you can do is tell them that you will support them if they address the situation and seek help.  You'd be surprised how hard it is to seek help when you're already self-conscious about the problem.  The best you can ever do for someone who is depressed is help alleviate that singular instance of embarrassment on their part.

27 comments:

  1. Well, I hope that Flickchart does offer a small reprieve to help alleviate and distract you from your depression. My father is clinically manic depressive, so I know a lot about the illness. Your involvement with my labor-of-love site has been tremendous, and it's very much appreciated.

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  2. Nathan, you bring up a point I should have addressed, and that's the value of distraction when dealing with depression. Sometimes I've found that the best I can manage is to distract myself enough that I stop being conscious of the inner turmoil. There's no formula; sometimes just browsing Twitter can buy me a few minutes and other times I can sit through a two hour movie and never become engaged by what I'm seeing. Those moments, though, when all the stars align and I do manage to lose myself are important and yes, Flickchart has been very helpful to me in the last year as a means of distraction. (Not sure what kind of endorsement that is, mind you!)

    Best of luck to your dad. I had a classmate in college who was manic depressive and he seemed even more tormented than me. I think I prefer the stability of my nearly constant state.

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  3. Travis, I always love to read your offerings. My brother survives with bi-polar disorder every day, and it is heartbreaking, even on the periphery. Your description of your particular depression helps me to understand a wee bit of what so many people experience every day.

    Your perseverance is admirable. Thank you.

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  4. Brenda, I don't think there's anything particularly admirable about my perseverance. There have been a lot of times when I've been dragged along by life more than I've made any effort to keep up with it. I'm suspect your brother has had a similar go of things. I wish him well.

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  5. My friend Travis, who I admire, respect and adore. And I selfishly hope that makes even a tiny difference.

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  6. That's all very kind of you, Shawnee. Oh, and if anyone reading this wants to see the true potential of a blog's power to affect you, leave this little rag of mine and spend some time reading Shawnee's. Sometimes I read her posts and I don't add anything here for days because I'm embarrassed about how frivolous my content usually is.

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  7. Thank you for this; the point you make about the difficulty of seeking help when you are aware of it rings so true!

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  8. Don't think I had depression, but growing up I often contemplated death, suicide, hopelessness, sadness. Most of it changed post marriage for me and vanished completely after our son arrived. But having thought thoughts that cd not be explained logically, being unable to articulate most of what I was feeling, I know exactly what you mean. God bless and I'm saying a prayer for you Travis.

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  9. Anonymous, I hope that whatever obstacles may have been in your mind that you overcame them and searched for the help you feel you needed. Those who haven't dealt with depression have a hard time understanding why it can be so hard to become pro-active about combating it.

    Ratrage, I'm obviously not qualified to ascertain whether you did or did not experience depression but it certainly sounds as though you've dealt with, at the very least, some incarnation of it. It's encouraging to hear that those inner voices have quietened for you.

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  10. I get this. I've also been on prozac and zoloft. The first turned me into a zombie. The second gave me oversensitivity to color, light, noise and taste and in turn actually worsened my depression. It all came to a head, when after a class one night I looked at the busy road beside the building I had had my class in and thought how inviting and warm the lights of the cars speeding by looked. I started walking towards it, and about ten feet from the road I realized what I was doing, and stopped myself. I threw the rest of the zoloft away and haven't taken an antidepressant since. I'm not saying that antidepressants all fail, for some people they do work, but they don't work for everyone. For me, I don't think anything will ever take away the depression, but when I think of the alternative, living like a zombie, or worse, being even more of a wreck, I'd take the depression any day of the week.

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  11. I dealt with depression for years and it wasn't until I started taking fish oil that it started to lift. It's worth a try.

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  12. I'm certainly happy you've found something helpful, but I would feel irresponsible not to note that while fish oil is certainly worth a try, you should probably check with your physician first to make sure it won't interact adversely with anything else you may be taking. You'd be surprised how different things react to one another in your system!

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  13. Yeah, that's pretty scary. Definitely glad to hear you stopped short of traffic! I'm glad anti-depressants exist, that's for sure, but I really do wish that stories like yours were heard more often. Maybe that would help dispel people of the myth that they're one-size-fits all "happy pills" that magically make it all go away. And I might add, it's heartbreaking that you've found a situation where being depressed is actually preferable. I understand your apprehension to trying something else, but I do hope something comes along that makes a more positive difference for you. Thanks for sharing.

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  14. Have you looked into Vagus Nerve Stimulation? http://www.mayoclinic.com/health/vagus-nerve-stimulation/MY00183

    I also suffer from Bi-Polar Disorder, as well as several other problems. I hope that you find relief to your symptoms.

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  15. Travis, your last paragraph sums up my feelings about people who are so wrapped up in themselves that they don't see the person next to them who are suffering. This is a great post. I have suffered from depression for 30 years. I wish you the best in search for normalcy.

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  16. First I've heard of it, but I'll ask my doctor when I see her next. Thanks for sharing, and I wish you well.

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  17. In fairness to others, depression is an "invisible" disease, and it's even harder to recognize if you haven't had enough exposure to it to realize that it's not just an exaggerated state of sadness. I try to remember that there are still a lot of people who have no idea what depression is really like. It's as though we're part of a secret society and only we can truly recognize one another. Only, this secret society sucks and none of us should be in it!

    And I, too, wish you well in your search. Thank you for the kind words.

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  18. I took Prozac until it "zombified" me, but it was the first drug that did control my depression. Now I take welbutrin (not an SRI) and have for about 10 years, it has made a tremendous difference for me and my family.

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  19. I'm glad you eventually found something that works. You raise a very important point about the impact that being depressed has on one's family. I kind of avoided addressing that myself largely because I'm not up to confronting it, really. I share all these personal insights online, but my own family never seem to follow my Facebook posts back to this blog and frankly, I just don't have it in me to bring these things up in person. I know I'm hard to be around at times, particularly when I have to be forced to leave the house and be around other people. I know I've been a burden on my wife, though she's much too polite to admit it.

    Regardless of my own situation, it's certainly encouraging to hear that something has made a difference for you and yours, and that you endured long enough to find that something. Kudos.

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  20. Tattered Edges9/05/2011 8:13 AM

    It's surprising and disheartening really how ineffective first line treatment of common illnesses really are. Depression effects 1 in 5, some would argue as many as 1 in 3 and yet we really don't have much of an idea how to treat it.

    A friend of mine recently had a vegas nerve stimulator implanted and I've been reading up on it. On the one hand it seems a fairly drastic measure but on the other hand if it works then almost certainly well worth it.

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  21. I too suffer with depression, have done for 15 yrs and everything you've said here rings true. I admire you for putting it out there with such truthfulness and heart. I had a course of anti-depressants coupled with CBT (cognitive behavioural therapy). It dragged me out of the utter despair phase where you feel trapped inside yourself, your body going through the motions and you're just the passenger looking for a way out. I still struggle with depression still now and have been told I will for forever - on and off.

    The secret seems to be learning to recognise the signs of when it's coming and motivating yourself enough to do something about it - change your surroundings and routine, seek distractions, reach out to someone and say you feel the rain coming on and you could do with some company; the worst thing a depressive person can do is spend too much time in their own company... or so I've learnt in my case anyway. Reaching out is so hard - but it always helps. Depression takes away the sense that you have choices,n it makes you feel worthless and helpless and a lost cause. The reality is you are none of these things. You have choices and you can learn to cope.

    You learn coping mechanisms through CBT and you know, they do work, most of the time. I'd recommend it. It wasn't a cure for me but it can be a fix. You take what you can get. Exercise is helping me too at the moment - at it's absolute base, depression is a chemical imbalance (hence everyone wanting a simple cure all pill to fix it and send you out smiling).

    My depression is a constant battle, I'm always having to remind myself to see the good side to every bad side. There is help out there - you have to fight to find it and it takes time to get results but it's there.

    In my darkest moments I have one comment that always helps me - "They are just thoughts, they have no power." It's only when I give the dark thoughts power, or meaning, or my time that they start to over take me. But they are just thoughts, brain farts if you like!

    So a hug to any one else suffering with it - you are never alone. x

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  22. This is one of the best explanations of depression I've ever read. I've dealt with it for at least 30 years now. After several tries, I've gotten some help from zoloft, but I can only take half the lowest prescribed dose or I start to lose my memory. Since I'm a doctor, that is an unacceptable situation.

    I used to look around at my life, which is everything I could ever want it to be, really, and wonder what else I could possibly do to make things better. The way I've finally come to understand it is, my brain lies to me about what I should be feeling. It tells me something is very wrong when in fact things are just fine. It's a good friend, but it's a liar.

    CBT did help me a little; conventional therapy did not. I get through the bad times by staying alive for something. It was my mother until she died, then getting through med school, and now it's my kids. I exercise like hell; if serotonin Imbalances can lie and tell me things are bad, then endorphins can lie and tell me they're great.

    You know what's funny about depression, though? I find it hard to believe that everyone doesn't feel this way, that not everyone hates waking up every morning. Some people are happy. What the heck?

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  23. Hi, Travis,

    Thank you. We're neighbors - I have a cabin here in Depression Valley too and I've shared your post with a bunch of people I know who want to help, but have NO clue what it's really like to really, truly not want to be alive. Not even, necessarily, because you want to die as because you just feel like you've run out of any other option for stopping the pain. My personal pet peeve are the people who tell you, "Oh, you don't really mean that" when you say (in my case) "Maybe it would have been better if I hadn't survived the surgery), or who respond to "I want to die" with "Oh! Don't even SAY such thing" because it makes them uncomfortable. No support, no offer to help, because the whole idea makes their teeth itch, but then they're the ones standing around the funeral of a suicide, grumbling about how "selfish" the corpse was... Thank you for writing about depression and living with it in a way that someone who's never even vacationed in this valley might understand.

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  24. I accept that not every pharmaceutical is going to work the same way for each patient; if they did, there'd really be no need for different medications. Speaking for myself as a patient, what I find upsetting is that I've been so resistant to nearly all of them. Since publishing this piece, I began taking Remeron--it, too, proved useless to me--and Lamotrigine--which seems to help enough that I'm calling it a "win." My disinterest in life and self-loathing are at least on a leash at present, though I still hear them barking.

    When I take a wider view of the experiences of others who have to fight depression, though, I become increasingly alarmed at how discouraging it is when that first line of treatment fails. I know how crushed I've been each time I had to report to a doctor that I'm still messed up in the head. I've gone through this with Crohn's, too, where each time something has failed me, I begin to feel even more marginalized. "I'm so screwed up, nothing can even help me!" I keep thinking. There comes a point where I don't even want to try anything new because it all just seems pointless. I just take it for granted for myself, but when I think about others out there feeling that, it breaks my heart.

    Thank you for sharing. I hope your friend has success with the nerve stimulator!

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  25. I'm certainly glad to hear you've found something that seems to help. I certainly agree about distractions and mental/emotional anchors; blogging forces me to concentrate on a specific subject for at least a little while...though I have to write fairly quickly before I begin thinking how stupid I am for writing something that nobody wants to read and that kind of thing.

    I'm skeptical about the value of making changes to one's life. Certainly there are triggers that we should learn to recognize and avoid, and I do agree that sometimes a trigger is something environmental or otherwise within our power to change. But I've had enough change of venue and activity over the years that I'm certain I will face depression regardless of where I am or what I do.

    I remember going to the University of Louisville to pick up my bachelor's degree. My wife parked outside and waited for me to just walk to the bursar's office and get it. It took me no more than ten minutes to walk to get it, ask for it and get back to the car. I felt a pang of excitement when it was handed to me, that I finally had accomplished something. By the time I got back to the car, it was just a worthless sheet of paper that didn't mean a damn thing. My wife, who had been so supportive and encouraging as I trudged through my junior and senior years, never got to see that brief flicker of satisfaction I had over getting my degree. That was five years ago. It's not displayed. It's not even framed. In fact, it's still in its envelope, hidden from view because I can't make myself want to look at it.

    I was depressed at two different schools while earning my degrees (I went to a community college for my associate's to save some money), as well as every grade school along the way. I was depressed in each job I've held and I've been depressed wherever I lived. I've been depressed regardless of which social circle I was part of at any given time. I can't imagine changing any part of my life that would make a difference.

    Still, if you find that changing something--anything--that helps, then more power to you! I thank you for sharing, and I wish you well with your continued fight.

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  26. This, even more than the availability of helpful treatment options, is the biggest part of fighting depression that I've encountered. I have kept this to myself over the years from quite a lot of people because I knew they didn't believe depression was real. Had I expressed my feelings, rather than allowing it to change their minds, they would have rejected me as being a theatrical buzz-kill. And on more than one occasion, I actually took the chance and shared...and was told I was a theatrical buzz-kill.

    Those people who don't understand depression have no idea how much harm they do to us by insisting that depression is some kind of made-up Ponzi scheme to sell "happy pills" to people who need to just grow up and get over things. Every time I hear that nonsense about "That's life," I want to strangle the person saying it. For them, the bad times are fleeting; they're to be expected, but so too are they to be overcome. They have no idea what it's like when your default daily life is living in a bad time, where you don't expect a good time to come along and, sadly, you don't expect it to last if it ever does.

    The worst part about this misunderstanding is that there comes a point where the depressed person feels so marginalized that suicide becomes something you think about: "I'll show them how serious this is!" There's no greater sacrifice than one's own life, and people don't take their lives out of selfishness. They do it because they feel it's the best thing they can do, for themselves to end the pain and sometimes to open the eyes of the people around them. When a person feels that they've run out of ways to reach those around them, they begin to think, "It's too late for me, but maybe when I'm dead they'll understand and look out for others."

    I thank you for sharing and I wish you well. I hope my post helps you reach those around you.

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  27. Dr. Anonymous, your last point is one of the most commonly shared reactions to depression that I've encountered. So many of us were surprised when we first learned that our default state of mind was so dramatically different from most of the people we know. It's that difference in paradigms that is at the heart of the misunderstanding about what depression really is, and it's my sincere hope that we can cross that divide in such a way that leads non-depressed people to better appreciate what it's like to resent waking up each time you do.

    Thank you for sharing, and for the kind words. I wish you well.

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