When a depressed celebrity commits suicide, there is
always an uptick in society’s compassion for people who suffer from that
condition. It never lasts very long. Those are valuable teachable moments, but
the lesson never seems to sink in. The proof of this is that the level of
people’s patience with individual sufferers never experiences a sustained rise
in volume. Parents continue to lose patience with depressed children; people
continue to lose patience with depressed co-workers and friends; spouses lose
patience with their depressed spouses. This is due, I believe, to the mysterious
nature of depression. It cannot be measured objectively. There cannot be any
clear, observable evidence, nothing, that is, comparable to an x-ray that
displays a broken bone. Depression is invisible.
The Condition
A broken bone must be a relief for the treating doctor,
in a way. Finally, a patient with an obvious medical problem that calls for a
clearly defined course of treatment that works in the majority of cases.
Doctors don’t always get that kind of clarity, because many of their patients
present with maladies that are not immediately obvious. More often than not,
however, there are some tests that will assist the doctor. Laboratory tests, or
various mechanical imaging tests, which, taken together, can point the doctor
to a narrow range of possibilities. With depression, there is no such
assistance available. The patient presents with a wide range of more or less ambiguous
symptoms that the patient feels, but either cannot or will not express. And
that’s if the patient presents at all! Why bother? If you have a broken arm,
you go to the doctor, but if you are depressed, you most often just try to shut
up about it.
That’s the doctors. Honestly, they are of little assistance
when it comes to the treatment of depression, even in the most treatable cases.
Those would be the cases of “situational depression,” a condition that arises as
a result of a sudden, shocking event, often a terrible loss, like the death of
a parent or spouse. Note that, even in those cases, the sufferer may not
recover any quicker from the condition because of the treatment; the condition
will probably resolve just as fast if no doctor’s care is sought or given. In
more serious cases, the depression is the result of events or situations that
are lodged deep in the sufferer’s past, things that were serious enough to alter
the sufferer’s physical and emotional development. The symptomology may ebb and
flow, but the condition remains almost constant over the entire life of such a
sufferer. The doctors call this “major depression,” or “clinical depression.”
In such cases, there is not much that the doctors can do.
The Treatment
There are two main treatments that they try, or maybe
three. One, they reach for their prescription pads and offer the patient anti-depressant
drugs. These, in the experience of many sufferers, will have a beneficial
effect for between three and five or so years. After that the brain’s chemistry
will have adapted itself to the presence of the drugs and returned to the
original imbalance. The drugs are seen as a management tool, not a cure. When
the worst symptoms return, and they will, the doctor will respond by trying
different medications or combinations of medications. It is, finally, a
pointless and expensive enterprise, suitable only for bringing a patient back
from the brink of committing suicide.
The second popular treatment is “cognitive therapy.” This
is where a highly trained counselor, who is probably not a medical doctor, will
guide the sufferer in a process of holding a mirror up to their condition, in
the hope that by examining it they might come to understand themselves and make
the depression more manageable. The sufferer may, it is hoped, achieve some
measure of control over his condition. This is, in my experience, the treatment
that offers the greatest life-line to the sufferer. Note that it begins with an
admission of failure: the attempt will be to make the condition more
manageable. In that limited assistance, however, it can be very successful in
making life a little easier for the sufferer to tolerate. In the absence of
miracles, we must thank God for small favors.
There is no known cure.
The possible third treatment that I alluded to earlier is
psychotherapy, the “talking cure,” first suggested by Dr. Sigmund Freud. This
is an attempted “cure” administered by medical doctors who receive extensive post-doctoral
training in psychotherapy. The goal is to guide the sufferer through a process
of remembering and understanding the life-events that gave rise to a particular
“neurosis.” In practice, the psychiatrist sits almost silently in the room
while the sufferer talks about whatever subject presents itself. The doctor
nods his head, grunts meaningfully, and makes notes, occasionally directing the
patient to go into more detail. The idea is to cause a breakthrough, or
something of the kind. In my experience, and in my opinion, it is a colossal
waste of time, and a great expense, with no hope of success.
The Symptoms
Here is where things get difficult for the family and
friends of a depression sufferer. People who are not depressed seem incapable
of understanding what the sufferer is feeling, or why they feel like that, or
why they cannot simply recognize the problem and deal with it. They wonder how
someone can go on, year after years, and finally decade after decade, without
simply “getting over it.” The sufferer hears the same things over and over again.
“That’s all in the past!” Or, “just forget about it!” With a lot of, “why are
you so negative all the time?” It is also very likely that those with the
condition have been affected in their performance of life’s duties. The
depression has caused them to underachieve in general, or in their working life
in particular. Those around the sufferer are likely to focus on and criticize
them for self-medicating, or employing avoidance mechanisms. There is more
exacerbation than assistance in this behavior.
But the symptoms, what is it exactly that the depressed
individual is feeling on a moment to moment basis? What are the feelings that
the family member cannot understand, having never felt anything like that
themselves? Allow me to try to be useful.
I am depressed, and mightily so. “How depressed is he,
Johnny?” The only effective counsellor that I have ever had asked me in an
early session, “how long have you been feeling like this?” I was
fifty-years-old at the time. I considered my answer, and said, “since I was
about four-years-old.” She laughed out loud, thinking briefly that I was
kidding. Immediately seeing that I was not kidding, she regained her composure
and asked me if anything in particular had happened at that time. “My sister
was born.” After that, I explained, my mother became unpredictable and was more
violent with me. After that, my mother, never a warm individual, was never
loving or nurturing to me. After that, my life was a constant round of fear and
anxiety, with frequent screaming and beatings. My sister, God bless her, is a
wonderful woman and completely blameless in all of this, and, luckily, she was
not subjected to the same kind of behavior that my mother exhibited regarding
me. I, on the other hand, was doom-struck, and I have remained fearful and
anxious ever since.
Disclaimer: I am well aware that the world is full to
overflow with people who have had it much worse than me in life. Furthermore, I’ve
been very lucky in general, and my experience of life has been better than
could have been expected. I am not here to complain; I seek only to clarify
depression for the reader, partly through an examination of my own experience.
So, symptoms. Rather than go over an endless list of
feelings over the course of so many years, I will concentrate on the year between
May, 2016, and May, 2017, with a nod to the previous eight years. It was a difficult time throughout. In that
time, I had experienced expulsion and exclusion from my marriage and my home,
gradually becoming alienated from my children’s affections as well. My marriage
ended in divorce in December, 2014. In 2015, I gave away almost all of my
possessions, which had been unceremoniously thrown into a storage unit by my family. They had sold my car, without telling me, before the divorce was filed. My oldest son kept my records. Other things remained at the house, or failed to find their way to the storage unit. At $120 per month, long-term storage was an unsustainable expense for me, so I tried to find
good homes for things, donated what was appropriate to a favorite charity’s
thrift-store, allowed a few friends to take what they wanted, and just said
goodbye to the rest. I was not offered any chachkas or family pictures, and I was afraid to ask for anything.
TO BE CONTINUED
No comments:
Post a Comment