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Depression’s Blurred Features.

12 May 2014

My friend Mark CC has an excellent post up on depression. I’m no neuroscientist, as my many neuroscientist friends will tell you. But what I believe about mental illness from being a sufferer of several, and from having those many neuroscientist friends, and having a psychologist and psychopharmacologist for a mother is this: everything is physical. Our emotions and our minds and our mental health and our consciousness. All of it is the consequence of the chemistry and physics of the brain. We certainly don’t understand how it all works yet, and we probably never will. But there’s no mystical “self”. It’s just three pounds of jelly digesting sugar and oxygen.

I have been diagnosed with major depression. I am not currently depressed. I have not had any serious symptoms of depression in several years. Shortly after my divorce, feeling I was slipping back into my old miasma of vague dread, I took a course of citalopram. It did its job and I haven’t taken any since. I’ve taken SSRIs periodically throughout my adult life, never for very long (six months, maybe, at the longest) to control what I would describe as a minor case of major depression. I’m never suicidal. I’m never unable to function. I’m just grey and lifeless and obsessed with fear and misery and loneliness.

And, of course, alcohol. My depression was absolutely co-morbid with my alcoholism. But the tweet that struck Mark so badly was, honestly, at least vaguely appropriate for me. (Though I will absolutely condemn it as a general comment – it’s risible.) I was, in a perverse way, pleased in my depression. I loved the Palahniuk-esque self-destruction of it all. The deliberate misery. The sense that I was wasting something valuable. I had this pathetic fantasy that I was a writer, and that being a writer meant being drunk and depressed and misunderstood. Well, I may have been drunk, and I may have been depressed. And yeah, maybe no one understood. But there was one thing I certainly wasn’t: a writer.

Depression has so many different manifestations. Mine was never all that severe. Along with my drinking, I lost several years of my productive life to it. But my depression was, obviously, mostly a consequence of my alcoholism. It is simply not possible to consume the quantity of alcohol that I did and not suffer depressive effects. But, I was also a depressed child long before I drank. I have been anxious and forlorn and lonely and obsessed with death and misery from my formation in the womb.

But, when I am sober, my depression responds behaviorally. It responds to exercise. To productivity. I am able, most of the time, to exert some control over it by forcing myself to do the things that I know it responds to, and then it responds to them. I know that not every depressed person’s depression allows them that privilege. My depression has responded to medication in such a way that I don’t need to continue taking medication chronically. Which is wonderful, because the medication has side effects that are unpleasant for me.

I don’t write much about my depression. Because it’s resolved for now. It can and probably will come back. Especially if I am injured and can’t exercise, or something along those lines. I write more about my alcoholism because writing about my alcoholism is part of the treatment for it that works to keep me sober. The best way for me to manage my depression is to stay sober too.

This is a long way to go to come to the point: we’re all different. Mental illness is different in different people. It has idiosyncratic expression, and different treatments work or don’t. When people like that tweeter make broad, asinine comments like he made, they’re committing a bigotry. Assembling a massive cohort of individuals, each bafflingly unique, into a grey sludge of uniformity. It’s easy to make that assemblage. It allows us to simplify. To aggrandize ourselves as having an answer. But it’s not true.

Every mind its own lattice of connections and inferences and consequences. Maybe my depression is explainable as a self-indulgent obsession with grandiose misery. It’s still physical. It’s still the consequence of the physics and chemistry of an obviously ill-formed brain. But I know how to change it. I know how to treat it. And the condemnation of fools is not part of my regimen.

6 Comments leave one →
  1. 12 May 2014 08:35

    Is that song ‘Blurred Lines’ about depression?

    There are hallmarks of depression that define it (and it even co-occurring with anxiety, that’s a thing too); reading Mark CC’s post about it resonated with me; the flatness, the not feeling, I definitely ticked those boxes when I was in the thick of my depression (the thickest part? I’m not sure how to put it right now…I’m doing a lot better, but still don’t feel like I’m really out of the woods). But then there are details of everyone’s depression that are unique; severity, specific manifestation, what works for treatment, etc. that are unique.

    I agree with you that it’s all physical at some level. I’m doing the experiment of stopping my anti-depressant now and so far, it seems to be going well. I guess I’ve changed my brain enough that it’s not needed anymore…I can only hope. At this point, I can’t really remember what made me seek treatment for my depression; perhaps the sense that it was interfering with my life/career? But it was a decision I took on my own and of course, I needed friends to help me along the way, especially during a really bad relapse period a few years ago where I just wanted to not exist; I was embarrassed to exist and I needed friends then to point out that something was really wrong.

    So yes, depression is very real. So is anxiety (though when I hear about people with social anxiety who are married…while I don’t know the story, I raise an eyebrow and say ‘you weren’t that anxious, apparently’- I say this as a still single person). Things can go wrong with the brain just like any other body part (struggling with a calf injury now that is preventing me from running…so annoying & possibly dangerous as running is one way I stave off depression).

  2. BbyHeadedDEater permalink
    12 May 2014 11:41

    “So yes, depression is very real. So is anxiety (though when I hear about people with social anxiety who are married…while I don’t know the story, I raise an eyebrow and say ‘you weren’t that anxious, apparently’- I say this as a still single person)”

    Seriously, ihstreet? So people with social anxiety can’t be married?
    There are so many reasons why that sort of judge-y assertion is off base. Including, but not limited to: the fact that many people with social anxiety still meet and interact with people; maybe they met and/or got married when the person did not have social anxiety; … Do I need to go on?
    I am a very extroverted person who also has some very real social anxiety. These aspects of me run counter to one another, fight and get in the way of one another, yes, but neither is less true because of the other.

    • 12 May 2014 11:49

      I took ihstreet’s comment to mean that he has that instinctive reaction despite knowing that mental illnesses are variable and idiosyncratic. It’s natural to have a gut reaction that might not square with the known facts. i.e., Even I will sometimes instinctively react, about an alcoholic, “That dude needs to just fucking quit drinking so much.” Even though I KNOW in my heart and bones that that’s not how it works.

      • BbyHeadedDEater permalink
        12 May 2014 11:53

        Fair enough, dr24, good point. Clearly, my reaction says plenty about me. Assume positive intent.

  3. 12 May 2014 12:22

    I believe what Ian means is that it’s hard to start a relationship when you have social anxiety (specially for a guy). I’m a very extrovert person and never was diagnosed with depression, but lately I have been having more downs than ups in my life. Dealing with your own issues and still trying to start something with another person is tough! But it’s doable and it helps you in the long term.

  4. Syd permalink
    14 May 2014 06:57

    The depression that I have seen is so debilitating that the person cannot function. It was truly frightening at the time. I take a small dose of Zoloft. Several years ago I went through a time when my wife was at the end of her drinking, and I felt hopeless about her and me. I went to a friend who is a psychiatrist and she prescribed the anti-depressant. And then last year truly was hard with so much death. So if 25 mg helps, then I am okay with it. And exercise certainly does help with so many things. It is a daily routine for me.

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