Wednesday, August 13, 2014

A Few Thoughts About Depression

I feel compelled to put down a few thoughts on a subject about which I like to think I know a bit, having lived with depression much of my adult life. I don't pretend to be an expert, or even particularly knowledgeable beyond my own experience and observations, so please take my ramblings in the loving spirit in which they are offered, and as a jumping-off point for your own explorations.

We lost a great artist, Robin Williams, two days ago. It hit my community particularly hard because we considered him one of ours--a local, a performer, a mensch; my Facebook feed is thick with personal stories from friends and colleagues whose lives he touched with a short conversation, a wave, a kindness. By all reports, he was a truly huge-hearted, generous soul, and the world is a bit less sparkly, a bit less funny and whimsical and wonderful, for his absence.

The reason I'm getting off my lazy butt to post in here is that, in addition to the heartening outpouring of love and support for him and for his family, his death has brought out some of the worst in humanity: I just read about how some trolls have sent his daughter awful pictures and comments on her Twitter page, forcing her to leave the site for good. (One friend made the disgusted comment that "We are a species of fanged, shit-flinging apes." It's hard to dispute his contention in the face of such horrific indifference to someone's suffering, such deliberate cruelty to a total stranger.)

Many people have trotted out the old "How could he be so SELFISH to do this to his family/friends/us?" horse shit, including supposed journalists who ought to know better (Fox, I'm looking at you: for shame. And, Rush Limbaugh, for your colossally assholier-than-thou statements that it must have something to do with his politics; if I didn't already want to cock-punch you in your tiny, wizened little winkie before, I definitely do now.
...repeatedly.
...with a ball-peen hammer).

Along similar, but more well-meaning lines, several people have also said "Why couldn't he have reached out to those who loved him?"

OK. Here's the deal.
As has been said many times before (and by much better people than I):
DEPRESSION LIES.

Depression is a devious little fucker. It creates a self-narrative based on fear and self-loathing that is so pervasive, such a repetitive tape loop inside your head (I believe Anne Lamott calls it "Radio K-FKD"), it becomes difficult to hear anything else about yourself--especially anything positive. If you're depressed, compliments are suspect; criticisms are automatically assumed to be truthful, and take on overwhelming power. One of the worst things about depression and the narrative that goes along with it, is that it serves to isolate you emotionally: you feel completely alone. It's just you against that narrative, and it's relentless and knows all your weak points. It knows exactly how, and when, to kneecap you, and will take every opportunity to do just that.

Robin Williams was very likely aware just how much he was loved, and it just as likely wouldn't have made a bit of difference.

David Foster Wallace, another brilliant artist we lost to depression, put it beautifully:

“The so-called ‘psychotically depressed’ person who tries to kill herself doesn’t do so out of quote ‘hopelessness’ or any abstract conviction that life’s assets and debits do not square. And surely not because death seems suddenly appealing. The person in whom Its invisible agony reaches a certain unendurable level will kill herself the same way a trapped person will eventually jump from the window of a burning high-rise. Make no mistake about people who leap from burning windows. Their terror of falling from a great height is still just as great as it would be for you or me standing speculatively at the same window just checking out the view; i.e. the fear of falling remains a constant. The variable here is the other terror, the fire’s flames: when the flames get close enough, falling to death becomes the slightly less terrible of two terrors. It’s not desiring the fall; it’s terror of the flames. And yet nobody down on the sidewalk, looking up and yelling ‘Don’t!’ and ‘Hang on!’, can understand the jump. Not really. You’d have to have personally been trapped and felt flames to really understand a terror way beyond falling.”


Those flames are your self-narrative, licking at your feet, telling you you're weak and worthless, you're never good enough or thin enough or tall enough or smart enough or (insert yours here) enough. You could be a sixteen-year-old pimply-faced teenager, flipping burgers in your first job at Burger King, or Robin Williams. The narrative is the same. And when it's a more viable choice to jump out that window than to tolerate the flames one more day, it becomes deadly. I'm betting that every single person reading this who has depression is nodding their head right now in recognition, because they've felt the heat from those flames on their back. I know I have.


If I may make a couple of points about depression, based on both personal experience and extensive reading on the subject*:


1. We are our thoughts. We create ourselves by what we think about ourselves. Every self-thought is part of a neural patterning process that gets reinforced with each subsequent thought until we have created a narrative about ourselves.
In fact, there is a whole subset of psychology--cognitive therapy--that deals exclusively with identifying and changing those self-narratives.

2. Depression is a chemical imbalance, a neurological dis-ease. It creates a different narrative for us, one based in fear and anxiety. Fear is the grindstone that wears down our sense of worth and purpose until we continually doubt ourselves..."What's the use? Why bother?" Those negative thoughts become self-reinforcing, part of our automatic response system. And when we've ground that neural groove, we call it depression.

3. We don't actually know a whole heck of a lot about how our brain works. We're doing the best we can but psychology is only getting up to speed in terms of medical science; a lot of ideas that are accepted as reality now were taken about as seriously by the mainstream medical community as astrology and phrenology only forty to fifty years ago. And if the research is playing catch-up, cultural assumptions about mental health are even further behind. Look how many people still hold the perception that depression is merely mind over matter, instead of an actual physical disease. Would you say "Just get over it!" to a cancer sufferer? Of course not. (Not if you have a shred of humanity left, you fanged, shit-flinging ape, you.) So why is it more acceptable to say it to a depression sufferer? Simple. It's our cultural assumptions about what depression is and how it works.

4. I know I'm tap-dancing on a mine field with this one, but I'd like to address the "Why didn't he reach out to his family/friends?" question. It bugs me that there is an assumption that if we lean on our friends and family, that will be enough. I hasten to add that I didn't say we SHOULDN'T reach out to them, or that Williams' tribe haven't been supportive and helpful--but, please remember, not everyone has supportive, loving, aware friends and family: many of us have gotten more harm than help from people closest to us. Also, no matter how well-meaning, most peoples' friends and family aren't trained in dealing with mental health issues. Long-term guidance really does make a difference, and getting that guidance from someone with professional training (MFTs, clergy, psychotherapists, etc.) is much more efficacious than simply talking it out once, over cocktails, with your bestie--although there ain't nothing wrong with cocktails with your bestie as therapy. (In fact, I feel a prescription from one's doctor for regular cocktails with one's bestie is a GREAT idea.)


I have so much more to say on this subject, but I'm going to stop here for now.

Please, if you are feeling depressed, reach out. There are so many people ready to help.
More soon.
RM

*=and yes, I'd be happy to provide a reading list if you'd like.

3 comments:

abigail said...

Thank you, RM. I lost a nephew to suicide in 1984, and am about to lose another (his brother) to the same illness. In their case, it is Irish DNA, and there have been many such losses in this particular family over the decades. I have had several clinical depressions in my adult life, but have not reached the suicidal edge. One of my sons, who also suffers from depression, is an amazing psyche nurse. So we're all in this peculiar zone, and we understand the vagaries and the terrible ruthlessness of depression. I get so tired of certain ignorant voices in the general population expressing anger and disappointment when someone commits suicide. Like they did it specifically to THEM. Jesus. Mental health is just like every other organic health system; it gets sick. It's not moral failure. It's not laziness. It's not cowardice. It's a collapse of the organ, that's all. Like a heart attack, only slower. Step by step, incident by incident, attitudes about mental health failure are changing as completely as they changed re same sex marriage. Am I dreaming? God, I hope not.

Echal0tte said...

Beautifully expressed, RM!! Much love to you.

Unknown said...

You said it; we live it - every day. Right there with you and, any time you need to, CALL: especially if cocktails are involved. ;-) xxx