Good Brain, Bad Brain
Grab your Morrissey records, today's subject is... depression.
I have avoided trying to write some sort of comprehensive "what does it all mean?" essay on this subject because, frankly, I don't know what the hell it all means, or should mean, or will mean, or might ever mean. The illness is ongoing, the coping is perpetual, and I don't have some neat capstone to drop on top of the whole mess as thought I've "conquered" it and moved on.
I am torn between the desire to be completely forthright and honest about this stuff, and to not keep talking about it. I suppose the natural compromise is this post, to which I can simply link rather than re-typing or blathering ad nauseam.
Without further ado, nuggets of content rather than the thin gruel of justification.
1. Depression
The worst aspect of my depression is what I've come to think of as "black dog time," when my enthusiasm for anything takes an Acapulco cliff-dive. It's a hard state of mind to describe-- in fact, it's a hard state of mind to even detect, and even once you have detected it it's hard to give a damn because you're, well, depressed. It's a mental cloud in which one remains perfectly capable of taking action, but primarily obsessive action, self-centered action. Not caring, conscientious, or constructive action. A depressive is supremely skilled at entertaining themselves now because now is all depression ever lets you have. It sharply retracts your chronological horizon. Now is everything, even if, to parahprase Patton Oswalt, now is consumed by sitting in bed and watching The Princess Bride 17 times in a row.
Since now has you in its fucking kung fu death grip, you don't care that three or four or twelve days have gone by. You notice, but you don't care. You can do the mental math as easily as you can when healthy, but the conclusion doesn't spark anything inside you. When the black dog has you, your only possible reaction is "meh." The future gets a "meh," too. Now won't let you give a damn about the future, so you don't exercise, you don't eat right, you don't clean, you don't fetch the mail, you don't do useful work, you don't plan. Nothing is sublime, nothing summons joy. The world loses emotional texture, and the height of your ambition is to fill all that now with something marginally diverting.
At their very worst, before proper treatment and medication, these plunges would last weeks. Weeks, cyclically consumed by this bullshit. When I'm stably medicated, these plunges are mitigated to a matter of hours, or a couple of days at worst.
2. Panic Disorder
The other significant aspect of my depression is a no-doubt highly amusing slate of anxiety and panic syndromes, which have at times reduced me to a shuddering wreck and have sharply affected my efforts to be even vaguely sociable or public since approximately 2008. They have interfered with all of my attempts to maintain an online presence, to work and communicate effectively with others, and to even get out of the damn house. It's not random happenstance that in the three years between WFC 2007 and WFC 2010, I attended precisely one convention and did no publicity or charity work. I am less forthright about my anxiety attacks than I am about my general depression because they are, I suppose you could say, more infantilizing and more painful. So now you know they exist, and that is all I wish to say about them.
3. Stoic Self-Delusion
There is an unfortunate undercurrent of tradition and feeling in our society (in many societies, in fact) that prescribes guilt, shame, and stoic self-isolation for mental illness. I know this as well as anyone because I spent years buying into this myth myself. This is not to say that there aren't times in our lives when we need to summon up the courage and the will to take a risk, but you can't simply will yourself to not have a genuine illness. Part of really, truly dealing with depression consists of realizing that it is an illness, and it needs to be monitored and mitigated just like asthma or diabetes or any of a thousand other chronic ailments. It has no moral dimension. It doesn't care how bright and beautiful your positive thoughts are.
We try so desperately to insist otherwise. It's central to our collective immortality delusion. Most of us who haven't brushed too closely against death, I suspect, have a pretty high opinion of how we could hold out against a serious flesh wound, a virulent disease, a deadly poison. Gritting our teeth heroically like a fictional character, "fighting for life." We tell ourselves that all the time… "Oh, she'll beat the cancer, she's a fighter. She's got the will to live." It's crucial to us that we cling to that straw, that notion that we can bend our will against mortality itself, and that death will blink if we truly want to live bad enough. It's insanity, pure woolly-headed magical thinking, marrow-deep optimism in the face of horrendous evidence to the contrary. It's also perfectly understandable-- we need this particular special stupidity, as a species, as families, as individuals. Hope lashes us harder and drives us farther than fear ever could.
The damnable side effect, of course, is that we sometimes insist that genuine physical and mental problems are "all in our heads" and can be wished away with a bigger smile.
4. Portrait of the Artist as a Special Snowflake
There is another truly unfortunate undercurrent / tradition which holds that "creative types" are simply destined by nature or nurture to be less emotionally stable than those around us. Our mental illnesses are ignored, idealized, and even romaticized as part of what makes us so terribly precious and special. I don't claim that I've never indulged in this fantasy myself, or that I don't understand how madness, delirium, and death make for much spicier artistic narratives than long lives and stable investment portfolios. There is, however, a line between being creative / absent-minded / quirky and being completely dysfunctional as a human being.
Do not fucking romanticize and applaud the inability to live happily in yourself or in others.
5. Reader Mail
I have received a huge number of e-mail letters and supportive notes, for which I am intensely grateful. Being reminded that these problems are commonplace, and that so many people lead happy and productive lives despite them, really has been a boon. Depression and divorce had the same effect on me at first-- I felt like an alien. I felt like one in a billion. I felt like a unique and startling failure, Lord High Mayor of Loserville, population 1 (Newt Gingrich keeps a chalet further up the slope and doesn't actually live within the town limits). Getting some actual perspective on these problems was helpful.
6. Pharmacological Caveat
With that said, there is one subject that I do not wish to ever hear about from anyone, and that is the subject of my medication. Whatever frankness I am willing to extend about the rest of my condition does not include my drug, its dosage, or the discussion of whether I should be on it at all. Please do not suggest homeopathic or non-scientific remedies, even with the very best of intentions. Please do not suggest that SSRI drugs will do terrible things to me. Undiagnosed, untreated, unmedicated depression did plenty of terrible things to me. Surely you can't have forgotten items 1 and 2 of this essay so quickly?
I appreciate the sympathy, I really do, and I understand that many people respond badly to medication. Getting it right is an idiosyncratic, individualized process. I was extremely fortunate in that the drug I was first put on, and the dosage suggested, took relatively rapid effect. I cannot live with a treatable illness that simply sucks me out of life for weeks at a time. There is no life, no career, and no future under those circumstances. It must be treated.
7. How can one tell...
... whether one is seriously ill or merely feeling blue? Good question. Let me assure you, it is easier than you can imagine to spend years assuring yourself that you're merely feeling blue, and not seriously ill. But if you suspect the latter, what should happen is:
A. You'll go through a series of questionnaires with your therapist/shrink/mental health professional, and, if they're doing their job:
B. You'll be advised to (and damn well should) schedule a check-up with a general practitioner. This will include a few blood tests for physical conditions that are known to cause malaise or emotional problems. One example, in men, would be testosterone deficiency.
When your complaints/past behavior are inventoried and other possible explanations have been ruled out, the diagnosis becomes relatively clear. Nobody can just wave a tricorder over your head and say "Aha, it's clinical depression," more's the pity.
*****
In our next exciting installment of Scott's journal: Stuff enthusiasts will find their pervasive craving for stuff has been noted!
I have avoided trying to write some sort of comprehensive "what does it all mean?" essay on this subject because, frankly, I don't know what the hell it all means, or should mean, or will mean, or might ever mean. The illness is ongoing, the coping is perpetual, and I don't have some neat capstone to drop on top of the whole mess as thought I've "conquered" it and moved on.
I am torn between the desire to be completely forthright and honest about this stuff, and to not keep talking about it. I suppose the natural compromise is this post, to which I can simply link rather than re-typing or blathering ad nauseam.
Without further ado, nuggets of content rather than the thin gruel of justification.
1. Depression
The worst aspect of my depression is what I've come to think of as "black dog time," when my enthusiasm for anything takes an Acapulco cliff-dive. It's a hard state of mind to describe-- in fact, it's a hard state of mind to even detect, and even once you have detected it it's hard to give a damn because you're, well, depressed. It's a mental cloud in which one remains perfectly capable of taking action, but primarily obsessive action, self-centered action. Not caring, conscientious, or constructive action. A depressive is supremely skilled at entertaining themselves now because now is all depression ever lets you have. It sharply retracts your chronological horizon. Now is everything, even if, to parahprase Patton Oswalt, now is consumed by sitting in bed and watching The Princess Bride 17 times in a row.
Since now has you in its fucking kung fu death grip, you don't care that three or four or twelve days have gone by. You notice, but you don't care. You can do the mental math as easily as you can when healthy, but the conclusion doesn't spark anything inside you. When the black dog has you, your only possible reaction is "meh." The future gets a "meh," too. Now won't let you give a damn about the future, so you don't exercise, you don't eat right, you don't clean, you don't fetch the mail, you don't do useful work, you don't plan. Nothing is sublime, nothing summons joy. The world loses emotional texture, and the height of your ambition is to fill all that now with something marginally diverting.
At their very worst, before proper treatment and medication, these plunges would last weeks. Weeks, cyclically consumed by this bullshit. When I'm stably medicated, these plunges are mitigated to a matter of hours, or a couple of days at worst.
2. Panic Disorder
The other significant aspect of my depression is a no-doubt highly amusing slate of anxiety and panic syndromes, which have at times reduced me to a shuddering wreck and have sharply affected my efforts to be even vaguely sociable or public since approximately 2008. They have interfered with all of my attempts to maintain an online presence, to work and communicate effectively with others, and to even get out of the damn house. It's not random happenstance that in the three years between WFC 2007 and WFC 2010, I attended precisely one convention and did no publicity or charity work. I am less forthright about my anxiety attacks than I am about my general depression because they are, I suppose you could say, more infantilizing and more painful. So now you know they exist, and that is all I wish to say about them.
3. Stoic Self-Delusion
There is an unfortunate undercurrent of tradition and feeling in our society (in many societies, in fact) that prescribes guilt, shame, and stoic self-isolation for mental illness. I know this as well as anyone because I spent years buying into this myth myself. This is not to say that there aren't times in our lives when we need to summon up the courage and the will to take a risk, but you can't simply will yourself to not have a genuine illness. Part of really, truly dealing with depression consists of realizing that it is an illness, and it needs to be monitored and mitigated just like asthma or diabetes or any of a thousand other chronic ailments. It has no moral dimension. It doesn't care how bright and beautiful your positive thoughts are.
We try so desperately to insist otherwise. It's central to our collective immortality delusion. Most of us who haven't brushed too closely against death, I suspect, have a pretty high opinion of how we could hold out against a serious flesh wound, a virulent disease, a deadly poison. Gritting our teeth heroically like a fictional character, "fighting for life." We tell ourselves that all the time… "Oh, she'll beat the cancer, she's a fighter. She's got the will to live." It's crucial to us that we cling to that straw, that notion that we can bend our will against mortality itself, and that death will blink if we truly want to live bad enough. It's insanity, pure woolly-headed magical thinking, marrow-deep optimism in the face of horrendous evidence to the contrary. It's also perfectly understandable-- we need this particular special stupidity, as a species, as families, as individuals. Hope lashes us harder and drives us farther than fear ever could.
The damnable side effect, of course, is that we sometimes insist that genuine physical and mental problems are "all in our heads" and can be wished away with a bigger smile.
4. Portrait of the Artist as a Special Snowflake
There is another truly unfortunate undercurrent / tradition which holds that "creative types" are simply destined by nature or nurture to be less emotionally stable than those around us. Our mental illnesses are ignored, idealized, and even romaticized as part of what makes us so terribly precious and special. I don't claim that I've never indulged in this fantasy myself, or that I don't understand how madness, delirium, and death make for much spicier artistic narratives than long lives and stable investment portfolios. There is, however, a line between being creative / absent-minded / quirky and being completely dysfunctional as a human being.
Do not fucking romanticize and applaud the inability to live happily in yourself or in others.
5. Reader Mail
I have received a huge number of e-mail letters and supportive notes, for which I am intensely grateful. Being reminded that these problems are commonplace, and that so many people lead happy and productive lives despite them, really has been a boon. Depression and divorce had the same effect on me at first-- I felt like an alien. I felt like one in a billion. I felt like a unique and startling failure, Lord High Mayor of Loserville, population 1 (Newt Gingrich keeps a chalet further up the slope and doesn't actually live within the town limits). Getting some actual perspective on these problems was helpful.
6. Pharmacological Caveat
With that said, there is one subject that I do not wish to ever hear about from anyone, and that is the subject of my medication. Whatever frankness I am willing to extend about the rest of my condition does not include my drug, its dosage, or the discussion of whether I should be on it at all. Please do not suggest homeopathic or non-scientific remedies, even with the very best of intentions. Please do not suggest that SSRI drugs will do terrible things to me. Undiagnosed, untreated, unmedicated depression did plenty of terrible things to me. Surely you can't have forgotten items 1 and 2 of this essay so quickly?
I appreciate the sympathy, I really do, and I understand that many people respond badly to medication. Getting it right is an idiosyncratic, individualized process. I was extremely fortunate in that the drug I was first put on, and the dosage suggested, took relatively rapid effect. I cannot live with a treatable illness that simply sucks me out of life for weeks at a time. There is no life, no career, and no future under those circumstances. It must be treated.
7. How can one tell...
... whether one is seriously ill or merely feeling blue? Good question. Let me assure you, it is easier than you can imagine to spend years assuring yourself that you're merely feeling blue, and not seriously ill. But if you suspect the latter, what should happen is:
A. You'll go through a series of questionnaires with your therapist/shrink/mental health professional, and, if they're doing their job:
B. You'll be advised to (and damn well should) schedule a check-up with a general practitioner. This will include a few blood tests for physical conditions that are known to cause malaise or emotional problems. One example, in men, would be testosterone deficiency.
When your complaints/past behavior are inventoried and other possible explanations have been ruled out, the diagnosis becomes relatively clear. Nobody can just wave a tricorder over your head and say "Aha, it's clinical depression," more's the pity.
*****
In our next exciting installment of Scott's journal: Stuff enthusiasts will find their pervasive craving for stuff has been noted!
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