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DEPRESSION
A gifted friend who is prone to depression called this week to say he was taking some time off to get over a recent depressive episode. He has an unusual insight into his condition; he’s able to recognise and articulate symptoms, onset, and recovery. He’ll survive. Moreover, he’ll return to creative and clever work once this latest episode is dealt with.
Some aren’t so fortunate. The Melbourne Age’s Murray Mottram struggled against depression that alienated him from friends and co-workers, and eventually killed him. Read the whole compelling, thoughtful piece.
I agree. I definitely believe in better living through chemistry, especially since it’s usually a chemical imbalance in the brain that causes non-specific depression. It’s true that drugs don’t actually “cure” the disease, but they do help alleviate the symptoms so that the sufferer can regain some perspective and escape the deadly downward spiral of negative thinking.
One of the best articles I have read on someone going through this terrible disease. The hardest part is to admit that you have a problem which you cannot solve on your own and tragically this condition makes it doubly hard to do so. I really dont see what else Anne could have done, I had no idea my father would go that far either until it was too late.
I know a lot about depression and will make a small attempt to describe it a little.
In severe depression you don’t care. You don’t care that you don’t care. If you could care, that would be something.
Perhaps you reason that you should care, but even that thought is absorbed by and into depression. Any blink of caring is only that. It’s over in an instant, seeming itself to “cause” only more depression. The caring cannot be voluntarily sustained. [In lesser cases of depression, perhaps it can be sustained to an important degree.]
You are not selfish. Selfishness makes no sense to you. You don’t care enough to be selfish. You don’t care! But the lack of caring is really only another symptom of the depression, not the defect to overcome by forcing yourself to care. Again, it can’t be done in enough of a way to effect a cure.
Quite simply, you are agonized, actually continually tortured by depression, a lack of feeling anything but “depression”. At this point, the only thing which keeps you alive is the life force itself, if you are lucky. There is something which makes you fight death, but you are always one step away from losing, which can occur at any time. You are constantly tempted to end the agony which nearly totally comprises you. This battle can be continuous.
Analyzing yourself alone or with someone else, psychotherapy, can seem to produce a benefit. But it, like caring, is transitory, lasting about 10 minutes, maybe. Others might be fooled into thinking the result is important. It is not. You are not really making “progress”.
I think what is happening here in “therapy” is that forced mental activity induces some psychochemical results, but the chemicals, or some other form of energy, quickly get degraded or dissipate.
What is possibly going on in severe depressions is an actual involution of brain activity, electrochemically, which sets up a downward spiral to eventually reach the degree constituting severe depression, as partially described above.
Obviously, any drug, especially alcohol, can contribute to the involution. Some process is getting turned off or down within your brain. But it’s hard not to seek the alcohol, or whatever, for its “numbing” effect, which then continues the down-regulating. Upregulating via methamphetamine seems to result only in a rebound down-regulating. The amphetamine probably only substitutes for what you need, disabling the latter’s production.
But, in severe depression medical drugs[ssri’s or whatever] are often lifesaving. An upward spiral can be set into effect, which can be abetted by other tactics - like self analysis and other forced mental activity.
Exercise, too, should be forced, imho. Your brain is a physical organ which initiates the exercise and can get a feedback from what it does and what the rest of your body does in exercising, and as a result of the health benefits from exercise, which include the ability to circulate your brain.
Compassion from others can be very important, no matter what form it takes.
Looking back and recoginizing “causes” is very beneficial, but mainly in regard to avoiding them in the present. Even this is not magic, and you must recognize whatever is going on within you regardless - the signs of depressive thinking: mainly disasterizing and doom-and-glooming, but also irritability, obsessiveness, inability to concentrate/confusion, negative emotions, and whatever else you have found yourself to be indicative of retrogression or involution. At some point you must make the call, meaning that you must engage the fight fully, possibly requiring more or different medication, or starting it again - because it is possible to get off medication, though no one can say who this will apply to.
Others, your observers, must not slough off what they see, but must rather remain on full alert. This is difficult because it is natural to be rationalizing or dismissive, and natural to be ignorant of the whole issue to begin with. You might also throw these concerned people off by masking what you know to be the case. At this stage the problem for them is difficult. All they can do is what they think they should, which is, again, very dicey. I don’t envy them in the least. But some kind of compasion is possible, which should be presumed worth it, even if not saving. You can only do what you know to do.
Murray embodied a classic case of a well-functioning soul who fought well and masked well, doing the best he could. I would say he was even heroic, but this is usually not enough. His friends have no blame, though viewing things retrospectively they will think they do. I could have saved one or two people myself, possibly, knowing what I now know. But I couldn’t have possibly done then what I didn’t know to do then, even though I think I could do it now. Maybe I will still make a mistake! It’s a very difficult problem. People who are severely depressed often really want to die.
P.S.
Politically, what wrankles me to no end is the diversion of money and effort into causes which do not rival suicide as a problem at all. In the U.S. about 30.000 people commit suicide a year, over double the rate of all murders. Yet, for example, the Sexist Violence Against Women Act is funded Federally alone at a rate of about $3.5-5 billion, and it has no proven benefits at all, and can’t possibly have any, since all it does is blame and punish men as an explanatory model for domestic violence. It’s effect can be expected to be no more positive than that from institutionalized Racism. But there it is, a testimony to the effect of the self-absorbed bigoted morons we are faced with. [But we can demand it be sunsetted, this year!]
It would make much more sense to highlight depression as a public health issue.
I’m pretty sure this is the friend you posted about last year, Tim - yes? Sadly, it’s an absolutely classic case description of someone with severe depression. The one year anniversary of the suicide of one of my good friends was two weeks ago. I still think about him.
Medication for depression is a great breakthrough. I tell my patients, “If you could reason your way out of clinical depression, no one would ever be depressed.”
A beautifully written, and very sad, piece.
Such articles, it would be hoped, will help to diminish the stigma attached to depression and other mental illnesses.
Of course, it will never be known what caused Mr Mottram’s depression. Perhaps it was a number of things.
Posted by Major Anya on 2005 03 11 at 10:00 PM • permalinkBloody heck, this is a real mess.
Did Murray Mottram mask his symptoms to maintain his status as a man? It will be a long time before men can be easy with seeking psychiatric help, most are unwilling to visit a GP unless it is dire.
Newcastle ABC broadcaster Craig Hamilton wrote about his experiences with depression and psychosis, unfortunately reviewers judged it on its literary merits only.
Rog2 nails it.
False ‘Machismo’ hurts more men than it helps.
We just lost a very good man in our community because he would not see a doctor despite extreme discomfort that he put down to flu symptoms.
He was having a massive heart attack over a course of days and died at 44 years old, leaving a widow and two young sons, 17 and 14. He will be missed in our village.
Depression is like that drawn out heart attack. If you don’t feel ‘right’, please avail yourself of the kick ass medical establishment that we have in the Anglosphere.
Get yourself ‘sorted’ for the people that love you, even if you’re not too fond of yourself at the moment.
“Subscribe to the Age for a chance to win a luxury cruise”
What a depressing thought.
To the world at large most of us are unimportant. To our nearest and dearest we are (hopefully) very important. To ourselves, we may be so important as to be a deranged psychopath, or, at the other end of the scale, if the support of those near and dear fails, we can lose the sense of worth, the validation we all crave.
There is some validity to the guilt that people like Anne feel, but it will probably be over-magnified and unnecessarily destructive if not dissipated.
If we fail to thrive despite the best endeavours of those who love and support us - what hope is there without intervention of another force? Who will fight this act of terrorism?
Counselling is probably a bit of a lucky dip. So what if I write some crap in this diary? I can write good stuff or bad.
And when all is said and done - what is your last act of self-determination going to be?
I care about lots of things. So much so that I can be a pain. I try not to be. But being interested in the world is so good, because it gives you so much to keep up with, and to get up for every day.Here are a few posts I’ve written about my experiences. On Depression, Change, A Dream
Posted by The Apologist on 2005 03 12 at 10:14 PM • permalink
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Bitterly ironic that chemicals could probably have saved his life. Instead he used them to help end it.