Depression

I have dysthymia, a low-level, persistent depression. I’ve decided to write about it for a few reasons.

First, suicide has been in the news lately with the deaths of two celebrities. Luckily for me, I’ve never had thoughts of taking my own life. If nothing else, I’m too afraid of what I might find—or not find—on the other side of death.

Second, my own long-term depression is what’s behind the “soul desperation” that motivated me to start this “Six Months” blog site in the first place.

Third, I had a hard time getting out of bed this morning. It took me about an hour. I had a dream that was a real downer.

I don’t have major depressive disorder. Anyone who does would tell you that had they gotten out of bed at all, they wouldn’t have been able to actually exercise a little (an antidote to depression) and write this blog article.

And I don’t have situational depression, a depression caused by external events. I’ve been depressed for over 20 years now. So there’s nothing anybody can say or do to help me “snap out of it.” Nor is it anybody’s fault.

Sometimes it’s a little better. Other times, like this morning, I think, “I gotta do something about this.” I’ve gone to several doctors over the years, have been prescribed a dozen or more different medications. I get all of the side effects, but none of the intended effects. I’ve done talk therapy for about half my adult life. Nothing helps.

I’ve had worse depression as a college student. I think that’s because I had a terrible self-image. My evaluation of myself was “I suck.” Now I don’t think I suck. I think life sucks. Believe it or not, it’s progress.

I truly envy people who have a bubbly, sunny, “life is beautiful” kind of disposition. I wonder what would happen if the consciousness of such a person could somehow be transplanted into my physical brain. Would she wilt, or would she roll up her sleeves and say, “we’ve got work to do.”

For a few years in college I wrote a journal. In it, I poured all my pain, my shame, my loneliness. Here’s something I wrote my junior year, 36 years ago:

So I coast on. (Event) seems to be the only way out of a mundane, seemingly worthless existence. Why don’t I have anything or anyone to live for? I have grown tired of caring. OK, so the world doesn’t revolve around me. But don’t I matter to anybody at all? Oh crap, I’m too apathetic to think about it anymore. (Going into poetic mode) “A black darkness covers the remnants of my dreams.”

Imagine where I might have been sent if somebody found my journal and read this?

Here’s the thing. Most people think a person is either crazy or they’re not. Yet by any objective standard I was able to function well in life and be fantastically successful. I just can’t seem to derive any joy out of that. It’s the ultimate guilt trip: Anybody would envy my success, my wealth, my loving family. So why can’t I be happy?

Here’s my view: There are some mental disorders that respond well to medication, such as schizophrenia and bipolar disorder. But most psychiatric issues are on a sliding scale. You can be a little bit depressed, a little bit anxious, a little bit OCD or ADHD. I even believe they’ll eventually determine that you can be a little bit autistic. Or you can be a lot of any of these things. The only thing that truly determines whether any of these traits rises to the level of mental illness is whether they interfere with your everyday life or place you in danger.

And here’s a dirty little secret: The psychiatric profession has promoted this “you’re either crazy or you’re not” mentality.

Here’s the history: After World War II, a LOT of soldiers came back needing psychiatric help. In order to get medical insurance companies to pay for psychiatric problems, a diagnostic manual was developed around a medical model. Unlike before the war, mental illness was now treated (and paid for) like physical illness. To be fair, it was actually an improvement.

They even borrowed terminology from the medical profession: A patient is treated for a mental illness.

The problem with equating a mental illness with a physical one is that the similarities only go so far. For instance, there’s no diagnostic test to definitively determine if a person has a mental illness. Either you have cancer or you don’t, and a test can confirm that. You can’t say that about depression. Mental illness assessments are subjective and even arbitrary. That’s not to say that people don’t have psychiatric problems. It just makes it difficult to diagnose (yet another medical term).

The other difference is that people don’t resort to shame or blame about physical illness. Nobody blames a person for having cancer. Nobody blames the parents or friends of somebody who dies of heart disease. I think you know where I’m going here.

As for me, it’s a daily struggle not to give in to despair. That doesn’t mean I have ideas of killing myself. But if I did, I don’t think I’d be able to avoid these thoughts any more than I can avoid the symptoms I do experience.

I’m not crazy. I’m not ashamed. I’m just hurting with no apparent reason.

Show all of us who suffer empathy and compassion. (Hint: We all suffer.) Avoid judgment and blame. (This is where we go when we get fearful or uncomfortable.) Don’t try to fix us, just be with us. In this way, you can avoid looking down at us or stigmatizing our particular brand of suffering. None of us get to opt out of the human condition. Every one of us has our own painful stories. You do too. What are they?

We’re all in this together.