Sanctuary for the Abused
Thursday, December 27, 2007
Depression is a condition which afflicts far more people than actually receive treatment. It is a prolonged, sometimes debilitating period of sadness, characterized by a variety of symptoms. These include hypersomnolence or insomnia, weight loss or gain, lack of motivation, feelings of hopelessness or despair, and a general sense of malaise. In severe cases, suicidal feelings or ideation can occur. It is never certain whether someone will or will not act on such feelings; but it is certain that because depressive people are at a higher risk for suicide, ANY THREAT OF SUICIDE SHOULD BE TAKEN SERIOUSLY.
Nearly everyone becomes depressed at some point in their lives. Certain stresses or losses (such as a move to another home, or the death of a loved one) can send a healthy person into an emotional tailspin. Depression as a part of natural grief is a normal, healthy release of sorrow and sadness at the reality of a loss. It is, however, a sadness which is expected to pass eventually as the individual experiencing it incorporates the loss into their life.
This page is not about transitory depression. It is about chronic depression, which is a much different beast. Before I continue, (a NOTE: I am not a mental health professional. I am not qualified to be anyone's psychologist, counselor, or social worker, and I have not created this page with a mind towards being so. If you are reading this and believe you are suffering from depression, CONTACT YOUR DOCTOR to receive help. This is not a diagnostic tool, it is simply a repository of information on a subject which directly concerns me.)
With that in mind, on to the meaty stuff.
As mentioned, chronic depression is different from transitory or acute depression. It is true that the symptoms are the same; but the duration of symptoms is quite another matter. With chronic depression, you feel like that all the time, for weeks, months, or even years on end.
To illustrate what I mean, imagine the worst you've ever felt. By worst, I mean the saddest, most desperate, depressing time you've ever experienced. If you've never experienced anything like that, try to imagine (and consider yourself blessed!). Imagine that you feel like crying all the time. You eat too much, or maybe you have no appetite. You spend all day in bed, simply because you lack the motivation to get up. Your work performance fails because you are distracted by feelings of gut-wrenching sorrow, or even thoughts of suicide. You feel as if you have no friends, no family, no one loves you, and you are alone in a universe where no one cares. You don't want to do the laundry, drive the kids to ballet, make dinner, fix your car, do household chores, nothing. You don't even have the energy to turn on the TV. All you can do is get up to go to the bathroom once in awhile, and maybe (on a good day) take a bath and walk the dog. Then imagine feeling like that for years on end. One year, two years, five years, ten years, on and on.
Added to the fact that you have no energy, no motivation, and no happiness whatsoever, you may well wonder what the hell is wrong with you. Often, depression can be hard to identify, especially in people who are mildly depressed. They walk around, functioning, performing their daily routine, but with no sense of enjoyment, just a dull, lifeless sense of duty, perhaps punctured every now and then by a brief flash of laughter or contentment.
Chronic depression has many causes. It could be that someone who is normally emotionally healthy gets "stuck" in grieving over a loss, and doesn't manage to move on on their own. Depression seems to run in families, and is often associated with anxiety disorders and panic attacks; hence, there may well be a genetic factor in some people. Victims and survivors of abuse are also more prone to depression, suggesting an environmental factor. Women are also much more likely to become depressed, but the reasons why are not entirely clear. It may be that women are more likely to talk about their feelings than men are, or it may be that women's lives are generally less than ideal, leading to frustration and depression, or it may be all or none of the above, or something else entirely. I would be willing to wager that gender differences in reporting depression stem not so much from biological factors as from social ones. For instance, women are generally discouraged from expressing their anger, but are encouraged to talk about most of their other feelings; whereas men are generally discouraged from expressing any feeling other than anger. Yes, yes, I know I'm speaking in vague generalities here; but it makes sense to me that, given the above social mandates, men would be more likely to become angry while women would be more likely to become depressed, and also talk about it. Hence, a difference in reported statistics on depression by gender.
Interestingly enough, I once heard a psychologist describe depression as "anger turned inward." The dynamics of anger and depression can certainly work this way in victims of various kinds of abuse, especially if the victim is blamed for the abuser's behavior. This can also happen in a situation in which the victim's anger is not allowed in some way. Abusive families are prime breeding grounds for major depression.
The experience of untreated serious depression is one of an endless, static, emotional darkness. It is a barren desert where nothing but despair springs eternal. It goes on and on and on, with no end in sight, no hope, and no promise for a happy future. Depression is a gray fog which settles evenly into a person's self, obscuring the good in life. The depressed person moves slowly through life, never feeling quite happy with anything, and never understanding why. Often, they lack energy and motivation, and can't figure out what's wrong with themselves. They fail school, lose jobs, fail in their relationships, and are unable to put their finger on the reasons why, often blaming other problems, or blaming themselves. "I must just be lazy," they might think. And if they look back, their entire life often looks just like their present: dim, lethargic, dark, and depressing. Maybe they've even considered suicide, just to stop the insanity of a pain and sorrow that they can't even identify.
However, it is possible to treat depression. Psychotherapy is one option. Medication, to restore chemical imbalances in the brain, is another option. Sometimes, medication is the only option for someone who is so suicidal that they need care NOW. Depending on the reasons for the depressive episode (and, I suppose, the duration), treatment may be relatively rapid, or may take years. Some people do better with therapy, others with medication; and there are differing medical and psychological schools of thought on both subjects. Often, the most effective treatment is a combination of medication and counseling. A competent, sympathetic counselor who understands the dynamics of depression can literally be a lifesaver for someone who badly needs to crawl out of the pit, but cannot do so on their own.
As mentioned, some people actually have a chemical imbalance in their brain which causes their depression. For such people, medication can be astounding in how much it helps. A few days or weeks on the right medication can deliver a noticeable amount of motivation and energy, and can allow a depressed person to feel happiness, contentment, even joy and enthusiasm again. (NOTE: ONLY YOU AND YOUR DOCTOR (OR PSYCHIATRIST) can determine whether or not a drug is right for you. Not every drug works with every person, and some people don't do well on medication at all.)
Are depressed people sick or diseased somehow?
There seems to be an attitude held by [way too many] people that depressed people are sick, unstable, and can't be trusted to behave rationally. I have heard of people losing their jobs or getting demoted because they admitted that they battled depression; and while I really hope this is simply an urban legend, I also realize that humans are inherently suspicious and tend towards reactionism. Hence, the aforementioned attitude -- and the need to correct it.
Depression is a problem. That is certainly true. But I don't consider it a sickness or disease. I prefer to think of it as a condition which a person must deal with, like arthritis or diabetes. And, just as some diabetics must take insulin, so must some depressed folks take medication.
Depression is an equal opportunity illness (but then, what illness isn't?). It hits rich and poor, black and white, male and female, teachers, doctors, artists, homeless, politicians, skilled laborers, computer nerds, teen-agers, police officers, farmers, truck drivers, anyone. And it's true enough that some people can't deal with it, or don't recognize it and go about their lives never getting any treatment. Some people end up as a suicide statistic. But nobody's depression ever "infected" anyone else.
It's like any other condition. It needs to be treated, so that people suffering from it can live well, do what they do well, and truly reach their potential. I think that if a person is making all the effort they can to get their depression treated, then they deserve support instead of rejection, because they're aware of the problem and are doing something about it. Even if they're not getting treatment, no depressed person deserves ostracism.
A Word About Suicide
I have heard suicide referred to as an act of utter selfishness. However, I doubt that the person who said such a thing has much capacity for compassion and empathy. If suicide is a selfish act, I doubt that it is driven by the self-exalting idea of arrogance, nor the idea that the suicidal person considers herself alone in terms of superiority, and fills her head with thoughts of how wonderful she is. Rather, I suspect any self-centeredness revolves around the terrible solitude of complete and utter self-loathing.
Regardless of why people take their own lives, it is generally considered an unnatural act to want to do so. As mentioned, TAKE THREATS OF SUICIDE SERIOUSLY. Get on the horn and get the person help IMMEDIATELY. If they really do want to off themselves, nothing will stop them -- but trying to help is better than ignoring the person. There is enough death and destruction in the world already; we don't need more. If people ignore the problem of suicide, it isn't the problem which will go away, it's the people. So DON'T ignore it.