What is Depression? Read...

"The argument I put forth was fairly straightforward: the pain of severe depression is quite unimaginable to those who have not suffered it, and it kills in many instances because its anguish can no longer be borne."

~ William Styron

 

 

William Styron writes:

 

This general unawareness of what depression is really like was apparent most recently in the matter of Primo Levi, the remarkable Italian writer and survivor of Auschwitz who, at the age of sixty-seven, hurled himself down a stairwell in Turin in 1987.

Since my own involvement with the illness, I had been more than ordinarily interested in Levi’s death, and so, late in 1988, when I read an account in The New York Times about a symposium on the writer and his work held at New York University, I was fascinated but, finally, appalled. For, according to the article, many of the participants, worldly writers and scholars, seemed mystified by Levi’s suicide, mystified and disappointed. It was as if this man whom they had all so greatly admired, and who had endured so much at the hands of the Nazis—a man of exemplary resilience and courage—had by his suicide demonstrated a frailty, a crumbling of character they were loath to accept. In the face of a terrible absolute—self-destruction—their reaction was helplessness and (the reader could not avoid it) a touch of shame.

My annoyance over all this was so intense that I was prompted to write a short piece for the op-ed page of the Times. The argument I put forth was fairly straightforward: the pain of severe depression is quite unimaginable to those who have not suffered it, and it kills in many instances because its anguish can no longer be borne. The prevention of many suicides will continue to be hindered until there is a general awareness of the nature of this pain. Through the healing process of time—and through medical intervention or hospitalization in many cases—most people survive depression, which may be its only blessing; but to the tragic legion who are compelled to destroy themselves there should be no more reproof attached than to the victims of terminal cancer…. Depression is much too complex in its cause, its symptoms and its treatment for unqualified conclusions to be drawn from the experience of a single individual. Although as an illness depression manifests certain unvarying characteristics, it also allows for many idiosyncrasies; I’ve been amazed at some of the freakish phenomena—not reported by other patients—that it has wrought amid the twistings of my mind’s labyrinth.

Depression afflicts millions directly, and millions more who are relatives or friends of victims. It has been estimated that as many as one in ten Americans will suffer from the illness. As assertively democratic as a Norman Rockwell poster, it strikes indiscriminately at all ages, races, creeds and classes, though women are at considerably higher risk than men.

The occupational list (dressmakers, barge captains, sushi chefs, cabinet members) of its patients is too long and tedious to give here; it is enough to say that very few people escape being a potential victim of the disease, at least in its milder form.

Despite depression’s eclectic reach, it has been demonstrated with fair convincingness that artistic types (especially poets) are particularly vulnerable to the disorder—which, in its graver, clinical manifestation takes upward of twenty percent of its victims by way of suicide. Just a few of these fallen artists, all modern, make up a sad but scintillant roll call: Hart Crane, Vincent van Gogh, Virginia Woolf, Arshile Gorky, Cesare Pavese, Romain Gary, Vachel Lindsay, Sylvia Plath, Henry de Montherlant, Mark Rothko, John Berryman, Jack London, Ernest Hemingway, William Inge, Diane Arbus, Tadeusz Borowski, Paul Celan, Anne Sexton, Sergei Esenin, Vladimir Mayakovsky—the list goes on. (The Russian poet Mayakovsky was harshly critical of his great contemporary Esenin’s suicide a few years before, which should stand as a caveat for all who are judgmental about self-destruction.) When one thinks of these doomed and splendidly creative men and women, one is drawn to contemplate their childhoods, where, to the best of anyone’s knowledge, the seeds of the illness take strong root; could any of them have had a hint, then, of the psyche’s perishability, its exquisite fragility? And why were they destroyed, while others—similarly stricken—struggled through?

~ William Styron , Darkness Visible: A Memoir of Madness  

 

Andrew Solomon in his book, The Noonday Demon: An Atlas of Depressions writes:

“It’s so hard to regulate your life, sleep, diet, exercise, under any circumstances,” comments Norman Rosenthal of the NIMH. “Think how hard it is when you’re depressed! You need a therapist as a sort of coach, to keep you at it. Depression is an illness, not a life choice, and you have to be helped through it.”

 

Normal is a word that haunts depressives. Is depression normal? I read of normal groups and depressive groups in studies; of medication that could “normalize” depression; of “normal” and “atypical” clusters of symptoms. One of the people I met during this research said to me, “At first when these symptoms began, I thought I was going crazy. It was a big relief to find out that it was just a clinical depression and that it was basically normal.” It was, of course, basically the normal way to go crazy; depression is a mental illness, and when you are in its throes, you’re crazy as a loon, a bit balmy, a few sandwiches short of a picnic, bats in the belfry.

 

Living with depression is like trying to keep your balance while you dance with a goat— it is perfectly sane to prefer a partner with a better sense of balance.

 

In depression, the meaninglessness of every enterprise and every emotion, the meaninglessness of life itself, becomes self-evident. The only feeling left in this loveless state is insignificance.

 

Perhaps depression can best be described as emotional pain that forces itself on us against our will, and then breaks free of its externals.

Depression is not just a lot of pain; but too much pain can compost itself into depression. Grief is depression in proportion to circumstance; depression is grief out of proportion to circumstance. It is tumbleweed distress that thrives on thin air, growing despite its detachment from the nourishing earth. It can be described only in metaphor and allegory.

Saint Anthony in the desert, asked how he could differentiate between angels who came to him humble and devils who came in rich disguise, said you could tell by how you felt after they had departed. When an angel left you, you felt strengthened by his presence; when a devil left, you felt horror. Grief is a humble angel who leaves you with strong, clear thoughts and a sense of your own depth.


Depression is a demon who leaves you appalled.

 

Depression starts out insipid, fogs the days into a dull color, weakens ordinary actions until their clear shapes are obscured by the effort they require, leaves you tired and bored and self-obsessed— but you can get through all that. Not happily, perhaps, but you can get through. No one has ever been able to define the collapse point that marks major depression, but when you get there, there’s not much mistaking it.

 

The first thing that goes is happiness. You cannot gain pleasure from anything. That’s famously the cardinal symptom of major depression. But soon other emotions follow happiness into oblivion: sadness as you had known it, the sadness that seemed to have led you here; your sense of humor; your belief in and capacity for love. Your mind is leached until you seem dim-witted even to yourself. If your hair has always been thin, it seems thinner; if you have always had bad skin, it gets worse. You smell sour even to yourself. You lose the ability to trust anyone, to be touched, to grieve. Eventually, you are simply absent from yourself.

 

Illness of the mind is real illness. It can have severe effects on the body.
 

 

For me, sadness always has been and still is a more powerful feeling; and if that is not a universal experience, perhaps it is the base from which depression grows. I hated being depressed, but it was also in depression that I learned my own acreage, the full extent of my soul. When I am happy, I feel slightly distracted by happiness, as though it fails to use some part of my mind and brain that wants the exercise. Depression is something to do. My grasp tightens and becomes acute in moments of loss: I can see the beauty of glass objects fully at the moment when they slip from my hand toward the floor. “We find pleasure much less pleasurable, pain much more painful than we had anticipated,” Schopenhauer wrote. “We require at all times a certain quantity of care or sorrow or want, as a ship requires ballast, to keep on a straight course.”

 

Depression as described in DSM-IV is the leading cause of disability in the United States and abroad for persons over the age of five. Worldwide, including the developing world, depression accounts for more of the disease burden, as calculated by premature death plus healthy life-years lost to disability, than anything else but heart disease. Depression claims more years than war, cancer, and AIDS put together. Other illnesses, from alcoholism to heart disease, mask depression when it causes them; if one takes that into consideration, depression may be the biggest killer on earth.

 

 

Depression is a condition that is almost unimaginable to anyone who has not known it.

 

Not so much has changed since Antonio in The Merchant of Venice complained:

It wearies me, you say it wearies you;

 But how I caught it, found it, or came by it

What stuff’tis made of, whereof it is born I am to learn;

And such a want-wit sadness makes of me,

That I have much ado to know myself.

 

People around depressives expect them to get themselves together: our society has little room in it for moping. Spouses, parents, children, and friends are all subject to being brought down themselves, and they do not want to be close to measureless pain.

 

It appears that depression has been around as long as man has been capable of self-conscious thought.