Against Depression

Duh, that seems obvious. Then why do we so often see it held up as a helpful part of human nature and not a debilitating illness?

In the last few days two very different takes on depression have been doing the rounds of ye olde Internets, maybe you’ve seen them? One is a new study published by Yale University which concluded that depression can have psychical effects on suffers in that it shrinks their brains. The other is a long essay, In Praise Of Depression, which posits that depression is a natural part of life, which should be endured and even celebrated. To my mind, one of these is a cheering step forward in the treatment of the illness and the other is a hideously cavalier piece of misinformation. 

There are two completely separate notions at work here: one is that our society is over-medicated, which is a truth. The other is that there are some people who need to treat their chronic, debilitating, life-threatening depression with drug therapy. These two things should not be confused and to do so is irresponsible at best and dangerous at worst. Every piece that is published which rhapsodises about the supposed "benefits" of depression provides exactly the sort of specious reasoning a depressed person looks for as an excuse to not seek treatment. If the depressed person can say to themselves, “My depression is the source of my creativity,” or, “My depression gives me insight into who I am,” then they are safe in their theory that they can’t be who they are without also being depressed.

This is, I would argue, a fallacy.

Life is not an all-you-can-eat buffet where you dine on exclusively what you prefer (pizza, beer, dessert) and eschew all the bits you don’t like (salad, salad, weird and horribly wet pasta with chickpeas in it, salad); rather life is a complex degustation menu served to you in a fine restaurant at which is it your exquisite privilege to eat, and so you are going to eat all of it, dammit. That means the salmon poached in liquorice gel, the snail porridge, the indescribably succulent pork belly, the thing that looks like it maybe has eyes in it, the fluffy chocolate mouse, the baked potato, all of it -- no matter how hard some of it is to swallow. That’s the trade-off for the gift we all get that is being alive.

Sometimes this can be an issue of semantics. Often people will use the word “depressed” when they really mean to say they are sad. The word “depression” itself has so well inserted itself into daily discourse that it doesn’t always retain is meaning. Perhaps someone means to say more accurately that they are frustrated, tired, worn-out, heart-broken, or in grief. None of these natural emotional states are analogous with depression. Depression is the almost entire absence of feeling of any kind. It’s a leaden, unmovable, inescapable sense of nothingness, like being pinned to a bed with a 40kg anvil sitting on your chest. I know this because I suffered depression for twelve years of my life before I was adequately treated for it. In that time I attempted to take my own life twice. In that time my feelings were dominated by terror, anxiety and rage, all of which I became very adept at hiding as I lived what I thought was my “authentic life”, what was my lot that I was just born with. There was no meaningful self-examination to be had here, no getting in touch with my innermost profundity, no. This was not being able to decide if I should use shampoo first, or soap in the shower and so deciding that actually, who needs showers? For weeks at a time.

When I found the doctor who was able to help me, meaningfully, it only came after a time when some friends came to my house and told me that literally, this had to stop. Another took me to a psychiatric ward for observation. It was only after measures as extreme as this that anyone could break through my other dominant personality trait -- which is common to depressed people: Herculean stubbornness. Because I’d drunk that Kool-Aid, too. I too read every story I could to back up my self-diagnosis that I was meant to be like this, that all great artists and writers and musicians had been in some way depressed. That I was never able to produce a single piece of readable, let alone publishable, work in that time did not dent this logic. I just wanted to paint myself as some kind of tragic heroine. I can’t even reason this now, in hindsight, beyond those romantic notions that greatly appeal to us in our twenties when anything other than genuine introspection seems like a very appealing solution to the problem of being an adult.

Going on medication was frightening -- I won’t lie about that. If you’ve only known one version of yourself for most of your life, then the thought of suddenly being a completely different person is terrifying. Not least for the anxious or depressed person who embraces change in much the same way you might embrace someone who recently swam in an open sewer. And again, this had to be presented to me in terms of pure logic. My doctor put it to me like this: “You are not a dumb person. So how can you make a choice about something when you only know one outcome?” Drug therapy, she said, might not work. It might take a long time to work. But if you don’t at least try and find out who you could be without your true self being constantly obscured with anxiety and terror, then how can you decide which life you want to lead?

Well hey Nostradamus, I really couldn’t argue with that. She really is an amazing doctor. She has a PhD in mindscience. 

I’m lucky that there is someone like this in the healthcare system who I was able to come across. She did not just write me a script and send me away to munch on pills for the rest of my life. The dose was tiny and rose in small increments over a long period of time. Regularly I checked in with her about how I was coping with my new reality. She put me in touch with a therapist, who was another gifted human being who was also something of a socialist and who didn’t want to take money from a university student. I consider these meetings to be genuine miracles of my life. The therapy was hard, it was about confronting all the ways in which I’d constructed by own prison because life in there was all I knew and the prospect of stepping outside it was too much to bear for so many years of my life. How I had come to be this way was less important than just knuckling down to do the work to fix it (however: genetics and life circumstances about covers it.)

When I look back now on that time, a little over five years ago, the main thing I remember is that I wept a lot. And these were not tears I cried because of the chemical changes going on in my brain, they were because I experienced real emotions for the first time since I was a child. To be in touch with the true reality of actually being alive was overwhelming, exhilarating. I’d never really known what it was to be sad, I only knew what it was to be devastated, obliterated. So I never knew that these were things that we can live through and prosper for the better for having been able to stare them down with clear eyes, even when they were awful and uncomfortable or were like being presented with some horrible-tasting dish that you can’t refuse eating. Likewise, unsurprisingly in this state I never knew what love felt like either, and discovering that was the addictively delicious pavlova that I will be eating after dinner from now on until the day that I die.

The debate as to whether or not depression will ever be truly classified as a physical illness will likely rage for some time. Ultimately, for me I find it less important to know what causes it than for people who need help to seek it. From the perspective of wellness it’s much easier to piece together your own internal clockworks than when you can’t see the forest through the trees of your depression. Other mental illness like bipolar disorder and schizophrenia are classified as physical whereas depression continues to be romanticised and otherwise put down to unknowable parts of the mind. And to reiterate, I’m not talking about regular, normal feelings which are unpleasant but which we all go through when life throws us serious curveballs. That is not depression.

I can only speak from my own experience in the hope that this will reach you if you need it: if I hadn’t finally sought treatment for my depression, if I hadn’t listened to the people in my life who loved me and whose pain in seeing me living like I was should have been enough to jolt me out of my stupor; if I’d continued to believe my own illogical arguments against getting well, well, I would not be here to write this today.

Elmo Keep is a writer. Her first book, The Two Fathers will be published by Scribe in 2014.

Image via Shutterstock

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2 comments so far..

  • Anastasia's avatar
    Date and time
    Friday 17 Aug 2012 - 11:56 AM
    How lucky you are to have found someone who is interested in treating you. Having suffered depression for over 25 years, I could go on for hours about the joys of the medical profession. Some serious education needs to be given, and sadly, you just can't teach someone to have a good "bedside manner". I've given up on treating my depression, and what will be, will be. It makes me smile to see a wonderful outcome like yours.
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  • Bathsheba E.'s avatar
    Bathsheba E.
    Date and time
    Sunday 19 Aug 2012 - 11:52 AM
    Terrific article. Thank you for your honesty & bravery in sharing your own journey through and beyond crippling depression. You've described the journey well. I'd like to add a little bit of my own commentary to your excellent writing.

    I've struggled with depression for years, like you, and have also found the combination of medication, therapy (and for me, outpatient hospitalization) to be extremely helpful in helping me build new coping and living skills. I can so relate to the tendency of those suffering from debilitating forms of depression to resist seeking outside treatment: until I experienced a complete breakdown several years ago, I was one of those people. I know there was no way I could survive and recover without that help, which continues to this day.

    One thing I'd also like to de-bunk here is a commonly-held belief that depressed people who commit suicide somehow could have "willed" themselves out of it. We have to remember that sometimes the people in our social fabric can also, tragically, become complicit in this attitude of using logic and mental strength to overcome severe depression; that somehow, seeing depression in a different light can somehow lessen its effects.

    Total bullshit! I remember being scared for my life, during my breakdown, that I was going to kill myself. It was so strange; I didn't want to kill myself, and I felt sad about it, but I knew that I wasn't going to be able to stop myself from doing it. What was even sadder was the complete bafflement of people around me, who, having seen me be a major over-achiever and highly successful professional all of my life, and their insistence on me being strong and "snapping out of it."

    This is where I bristle at published articles and social attitudes that make light of depression, when in fact, maybe they should be making light of conditions such as grief, or sadness, which are passing seasons and always end and are fuel for some of our greatest music, poetry, art and cultural signposts. Depression, on the other hand, is a gruesome beast. Anyone who's met this torturer can tell you that once in its mangled hands, life becomes, as you have aptly described it, a frozen, windowless prison cell, wherein its quite easy to lose connection with the wider outside world.

    Praise for depression? BULLSHIT! I was one of the lucky ones who survived this twisted ill-logic, coming from my own overly-developed intellect, and those around me (I ended up somehow driving myself 60 miles to the nearest mental health hospital, which luckily for me happens to be one of the best in the world) and checked myself in, which took an enormous amount of surrender: I had never given in to any concept of myself as weak before, and that in itself was and continues to be a huge obstacle to overcome in my ongoing depression management efforts. And I have to be honest and say that it's my deep love for and sense of obligation to my parenting duties of my daughter that keep me going on many days; that this is often the one reason that I can use as an effective argument against depression's sometimes overpowering ways.

    And, as a footnote to my own story let me reassure anyone who reads this that there is NOTHING nice about depression. Depression is mean. It's scary. And it can scar many people, even those who don't suffer from it themselves. Tragically, my longtime partner suffered a breakdown and ended his life two years ago. His is a textbook case of "trying to heal oneself." His efforts, which I witnessed and admired as expressions of his artistic talents and highly-developed intellect, were in fact a mask for the depths of his disease, which he hid from me and others so expertly that I was unable to even articulate to me, his closest friend, what was really going on beneath.

    It was only after his suicide that I could see his behaviors for what they were, and to this day, it breaks my heart that he had gone so far down the dark depression hole that it's likely even he didn't know what was going on. He just wanted to end his pain, which he had done such a good job of keeping all to himself. Such are the twisted ravages of the illness known as depression that even he, who supported me through my breakdown, was unable to realize that he, himself, was depressed - nor was I, in spite of my new-found skills, able to see how sick he was. Every day I ask myself: would medication have kept him alive? If, that is, he could allow himself, a proud man, to be vulnerable enough to ask for help, which he wasn't. I don't think he made a conscious choice. I think that untreated depression killed him. Just as it almost killed me.

    For reasons personal and intellectual, therefore, I have all due respect for depression. You'll never catch me playing on the ocean's shoreline when the water joyfully recedes far out, leaving starfish and other exotic creatures from the deep in its place. I know depression inside and out as the life-stealing tsunami that it is, and I will always keep an eye out for changes in the surf; for those deadly waves.
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