Besting the depression beast

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“But despite the enthusiastic claims of pharmaceutical science, depression cannot be wiped out so long as we are creatures conscious of our own selves. It can at best be contained—and containing is all that current treatments for depression aim to do.”The Noonday Demon, Andrew Solomon

I admit it – I’ve written a misleading title for this post, in large part because I don’t think there is any such thing as “besting” depression in the sense that you can defeat it completely. Can you best it in that you tame it, manage it, have good days or very long spells of not having depression rule your life? Of course. And it’s in this sense that I use the term “besting”… finding, through all the trial and error that it seems to require, the right treatment for depression to deliver you (or the depressed person) the best possible outcome and way of living. And this, at best, seems to be impermanent and something about which one must be vigilant.

People who are not clinically depressed and never have been are unlikely to ever understand intrinsically true clinical depression or what it feels like. Maybe with observation and experience, we can recognize it in others (“we”, here, being laypeople without clinical depression who are the friends, loved ones and colleagues of the clinically depressed). Maybe we can get brief but “light” glimpses of the multifarious nature of depression (and other mental illnesses, which may or may not accompany depression) when we ourselves dip into our own melancholy.

Like most, I have been through circumstantial depression (when something terrible happens, and triggered by this circumstance, I react in some way akin to ‘depression’ – which can be a whole host of different things). But ultimately I retain, or at least quickly and independently regain, the ability to cope and manage without consequences or lasting physical or emotional effects. Perhaps I am, like many, predisposed to an overly thoughtful and melancholy nature… but this is not clinical depression or mental illness. I have seen the difference up close more times than I care to recount.

I think frequently and often about depression, anxiety and other illnesses, as usual in trying to understand the people around me and, more closely, the people in my life. Those who do suffer from at least depression, if not a smörgåsbord of other issues. This need to understand largely began with my father’s late-1980s breakdown and ongoing battle with crippling depression (which has manifested itself repeatedly ever since but in different guises and ways, something to which he will never admit; he discarded his Prozac after a few years and declared that he was “cured”, but he isn’t). What I continue to learn along the way informs all my interactions with people who share with me that they are depressed or otherwise mentally ill (I have many friends, family members and colleagues who have experienced these conditions at varying extremes). More recently, experiences with depressed (often undiagnosed) addicts/alcoholics have pushed me further into the investigative field, wanting not just to understand limited textbook portrayals of depression but the much more integrative and complex web of interwoven factors that make up depression as a whole.

Looking for a fresh perspective, I turned to Andrew Solomon’s The Noonday Demon. (And strangely, I was only about a fifth of the way through reading the book when Sinéad O’Connor’s recent self-published video, crying out from the depths of her own depression appeared on Facebook. A real-life reminder that depression and mental illness is everywhere, does not discriminate, and that even if stigma attached to mental illness has decreased considerably in the last 30 years, it still takes quite a lot of courage, particularly as a public figure, to put yourself out on display in such a raw, emotive, helpless state and ask for help.)

Immediately gripping in its in-depth approach, starting with the intensely personal and detailed, and weaving itself out into a mixture of the personal (both the author’s own and the experiences/anecdotes of others who have lived with depression) and journalistic/scholarly pursuit of the history of depression and its various treatments alongside the complex web of mitigating factors that change one’s relationship to depression, e.g. poverty, demographics, politics and social perception (stigma), the book has been well-worth the difficulty and time invested.

By “difficulty” here, I don’t mean that it is a challenging or excessively convoluted or academic book – in fact, it reads much more like a riveting, long-form piece in a periodical. It’s technically quite easy to read, fixate on and think about, long after you’ve put the book down. It takes some digestion; it’s almost comprehensive and encyclopedic at tackling all angles of depression. It’s for this reason that my own writing about the book is surface-level at best – a mere recommendation for those who want to understand depression, who suffer from depression and want to see hope through information.

Moreover, despite Solomon’s relatively dispassionate account of his own journey (and those of others), the book is difficult because these accounts are so human and painful to read about, to see, even through the filter of distance, what he and others have gone through, both in the throes of deepest, wildest depression and in seeking treatment. But that is where the power of this book rests – and why this work not only satisfied my desire to know and understand, as closely as I could get to being under the skin of a depressed person, but also is important as a topic of study and discussion, as a compendium of depression and how it is seen, treated, perceived on many levels. As a springboard for continued analysis and study.

Largesse

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“Unconditional acceptance of each other is one of the greatest challenges we humans face. Few of us have experienced it consistently; the addict has never experienced it—least of all from himself. “ -from In the Realm of Hungry Ghosts by Dr Gabor Maté

While knowing that generosity is not true generosity if there are expectations attached to it, it’s impossible not to attach hope. What I mean here is not so much that I expect something in return for anything I give. I just find my heart filling with an aimless and misguided hope that by offering virtually everything I have, it will somehow finally be the thing that makes everything click into place for someone else. Knowing fully that the problem is in them – it’s their fight, their fire. There is absolutely nothing I can do, or give, that can offer anything but – possibly – a slightly softer place to land when they inevitably come crashing down over and over again – I nevertheless find myself wishing otherwise.

I just finished reading two books that deal in some detail with addiction. Dr Gabor Maté’s In the Realm of Hungry Ghosts and Dr Carl Hart’s High Price were engrossing and relatively quick to read, even if they touch on some of the chemistry, neuroscience and psychology related to addiction. And it happens that my readings of these books coincide with yet another case of someone close to me relapsing – again – along with wrapping up phase one of a project I am working on in this very field.

Despite all the wisdom in the words and the science explaining addiction, it’s still very hard to grasp. Maté writes:

“the bare truth: people jeopardize their lives for the sake of making the moment livable.”

“Addictions always originate in pain, whether felt openly or hidden in the unconscious. They are emotional anesthetics.”

“Not all addictions are rooted in abuse or trauma, but I do believe they can all be traced to painful experience. A hurt is at the center of all addictive behaviors.”

“Boredom, rooted in a fundamental discomfort with the self, is one of the least tolerable mental states.”

“No human being is empty or deficient at the core, but many live as if they were and experience themselves primarily that way. Attempting to obliterate the sense of deficiency and emptiness that is a core state of any addict is like laboring to fill in a canyon with shovelfuls of dust.”

“Addiction, in this sense, is the lazy pilgrim’s path to transcendence.”

“Addiction is primarily about the self, about the unconscious, insecure self that at every moment considers only its own immediate desires—and believes that it must behave that way.”

“In Canada my book has been praised as “humanizing” the hard-core addicted people I work with. I find that a revealing overstatement—how can human beings be “humanized,” and who says that addicts aren’t human to begin with? At best I show the humanity of drug addicts. In our materialist society, with our attachment to ego gratification, few of us escape the lure of addictive behaviors. Only our blindness and self-flattery stand in the way of seeing that the severely addicted are people who have suffered more than the rest of us but who share a profound commonality with the majority of “respectable” citizens.”

Reading all of this, and all the stories and evidence in between, I try to return to this compassion I’m always harping on and sometimes struggling with. And to remember truths, such as:

“To live with an addict of any kind is frustrating, emotionally painful, and often infuriating. Family, friends, and spouse may feel they are dealing with a double personality: one sane and loveable, the other devious and uncaring. They believe the first is real and hope the second will go away. In truth, the second is the shadow side of the first and will no sooner leave than will a shadow abandon the object whose shape it traces on the ground—not unless the light comes from a different angle.”

“Unconditional acceptance of another person doesn’t mean staying with them under all circumstances, no matter what the cost to oneself.”

No, I really do not have to be the glue – or even try to be. Maybe I can only create softer landing places and shine a light from another angle.