Depression’s Blurred Features.

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.