Depression

My computer contains a few half-written posts on the subject of depression. I write a paragraph or two and then abandon the work. The problem comes when I try to describe how I felt when I was in the belly of the monster. Sensations and feelings that I have been keeping a constant guard against show their dark faces. I simply become too afraid to continue. Still, something is better than nothing in this case and what follows is what I’ve managed to cobble together.

Mental injuries, for in one sense that is what depression and anxiety are, are much more subtle than physical injuries. A glance can tell you that your leg is broken. That your synapses are taking in more serotonin than they should is not so obvious. Neither are the mental distortions which take place with depression and anxiety. Is that sense of an overhanging threat or listless related to real things in the world or is it “all in your head?” Blood and broken bone is straight-forward and matter-of-fact compared to a faulty twist in your perception of reality.

When the psychologist asks if I am feeling down I am tempted to retort, “Down from what?” “What is my baseline emotional state?” The question of what it means to feel normal takes on an added difficulty.

And as skilled as we are at treating physical injury, treatment of depression is still an inexact science. Aspirin, morphine, etc. provide quick relief from pain. Treating depression would be easy if the effects of new medication and a particular dose were noticeable the next day. Instead, it may take a month to know if a particular medication will be effective. When it is effective the question of normal returns. What dose is needed to return a person to “normal?” One must not forget that sometimes it is healthy to feel sad. At what point do anti-depressants prevent someone from feeling the full-range of human emotions.

It is nearly impossible for a person who has not been depressed to understand what it feels like to have depression. Kind, well-meaning people, will tell you that they too have felt down or anxious for a time. But that is like telling a solider that you understand his experience of war because you went through basic training. Major depression is a whole different beast from regular sadness or feeling down. Perhaps they are on the same continuum, but there is a chasm in between. Being depressed is rather like being an emotional black hole which swallows up all happiness. Cheering up a person with depression is like trying to fill a black hole with a star. It simply sips down the light and asks for more. Not that depressed people like being emotional vampires or that no one should try to cheer them up. Rather one must avoid thinking that there is an easy fix.

Sometimes it is like a switch has been flipped in my brain or the throttle stuck open. A part of my brain is telling me to panic. Recognizing that this impulse is incorrect is half the battle. Still it doesn’t deal with the impulse which is surging in my mind. It is like someone whose equilibrium has been thrown off trying to walk upright. He or she knows that the sense of level is off. There is a constant expanding of energy to compensate. But how much do you compensate when you no longer know what vertical is. The very realization that your senses are lying to you is itself terrifying because it signals a separation from reality. Depression and madness are in this sense closely linked.

People often respond to suicide by a depressed person with confusion. It’s incomprehensible to them that a person could kill themselves, when his or her external circumstances aren’t that bad. I do understand why a person might prefer death to life. There can be a pain so bad, regardless of external conditions, that death seems the only possible relief. In the first book of Paradise Lost Milton’s Satan says:

The mind is its own place, and in it self

Can make a Heav’n of Hell, a Hell of Heav’n. (254-255)

In these lines Satan is attempting to ameliorate his banishment to hell. He believes he can overcome the hell around him by creating a heaven in his mind. Of course, the reverse is also possible. In book four, when Satan has left hell and is on his way to tempt Adam and Eve he laments:

Me miserable! which way shall I fly

Infinite wrath and infinite despair?

Which way I fly is Hell; myself am Hell;

And, in the lowest deep, a lower deep

Still threatening to devour me opens wide,

To which the Hell I suffer seems a Heaven. (73-78)

This became vividly real to me once. I was hiking in a beautiful place in the mountains, but in my mind was a sensation that I can only describe as a glimpse of hell. Sometimes the feeling takes on an almost physical sensation. I feel like there is a giant crack in my head, a vast gaping void. Other times my brain feels like it is being squeezed in a vise.

Relationships are equally effected by depression. On one hand, depression is invisible. People can be perfectly helpful in the case of a visible physical injury, but there is little they can do when they don’t know there is a problem. For people who do care and want to help, it can be difficult. The solution is often not simple. Furthermore, it is hard to watch someone you care about suffer. People who try to help, but in doing so reinforce the negative mental feedback loop, can cause more harm than good. I think the best that the friend of someone who is depressed can do is to be present. Listen to whatever they have to say without judging. (If they are Christian they may be thinking and feeling things about God that are usually get swept under the rug.) Reinforce the positive, not trite sayings or hallmarkesque statements, but positive truths. Push against the currents of negative thought without making the person feel guilty.

Seeing a psychologist or psychiatrist is good, probably the most important thing a person with depression and/or anxiety can do. People suggest things like exercise, eating more protein, getting more sunlight, etc. All these are positive and healthy, but they are not cures. They are a part of a complex web of factors that include brain chemistry and interpersonal relationships. Care for depression is care for a person as a whole. Awareness of this goes a long way.

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