08 December 2011

Being Happy Is Hard Work

"You don't know the power of the Dark Side!"

Let me put something in perspective for you. Our Lady of Peace in Louisville offers two outpatient programs for mental health issues such as depression. They meet Monday through Friday and begin at 9:00 AM. One program runs until noon; the other, 2:00 in the afternoon. That's a part-time job. Who has that kind of time?

I'm not here to attack OLOP's scheduling. Rather, my point is that there's a whole lot more to managing depression than taking your meds and thinking happy thoughts. This can be particularly frustrating for both patient and loved ones alike. There can be an expectation that dramatic results should emerge on a daily basis, and that upon completion of the program, the patient should be "all better."

It's the formality of the program, I think, that invites such lofty expectations. After all, if I took guitar lessons Monday through Friday, from 9:00 AM-2:00 PM for a month, I would expect to be able to play some chords and basic songs like "Mary Had a Little Lamb" or whatever's simple to play on a guitar. I wouldn't expect to be Chet Atkins, but I would expect to "level up" (to borrow a video game term) and have the basics for progressing with my studies. Likewise, "completing" the outpatient program "should" lead a patient to the next level in their management of their condition.

The truth is, however, that there's not much in the way of "leveling up" when it comes to depression.

There's "managed" and "not managed." There are degrees, of course, but they all come down to those two basic statuses. They can change daily. Today can be a good day; tomorrow could suck. The flip side is, as bad as today is, tomorrow could be light and enjoyable. It means we can never assume that just because we go to bed feeling well that we'll wake up that way, which can be a source of anxiety for many of us. Most people don't have to worry on a daily basis whether today will be a good day. They may dread a meeting, hate a particular project or resent a coworker, but they won't wonder every day whether they'll resent being alive. It's not a resentment that we get to choose consciously; it's a feeling that seizes us from within.

There is an erroneous belief that professional help ensures successful management of something like depression. It certainly has a positive impact and can make a world of difference, but there are no guarantees at all. Loved ones become exasperated, wondering how much longer you'll need this help before you don't need it anymore. The truth is, we'll likely always need help of some kind. Maybe we won't participate in 20 hours of outpatient group therapy weekly, but we'll need help of some kind. We can't afford to let up our guard, because depression has nothing but time. It can wait us out and strike when we're least prepared to resist it.

Those of us with depression will always have to be mindful that we can fall to the darkness within us at any time. Not to burden this post with too many varied movie references, but while texting with a friend of mine about all this recently, I was reminded of that moment in The Untouchables near the end, after Capone is hauled away from the court room where Ness throws at the gangster the words of his mentor, Malone:

We need encouragement, kindness and mercy but perhaps more than anything else, we need patience. We need it from our loved ones, but we also need it from ourselves. I still believe baseball is the greatest metaphor for life. Some people believe that when you have a chronic condition, you ought to "make the most" of each day to "make up" for the days lost to misery. It sounds reasonable, until you realize that it's impossible. There are 24 hours in a good day just as much as there are 24 hours in a bad day. We can't extend the hours in a day just because it's good. We can't retroactively have a good day; it's not like if I have a terrific Friday that somehow I can "round up" Thursday and put it in the books as a good day, too. A baseball team might lose 16-2, but the next game starts 0-0 just the same as all the others. They don't pick up where they left off at 16-2. Sure, their season record is cumulative; but we can't "win" a season in life. We can only go out there day in, day out and try to have more good days than bad.


  1. My friend I wish I had the words that you have. You need to publish this so that therapists and the like will have a true clue on what someone with depression suffers through.

  2. I'm pretty sure therapists "have a clue" what they're doing, but I do appreciate the encouragement. As for publishing what I write...that's the point of this blog! If you meant I should have a print publication, well...stay tuned. ;-)