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    The Dark Sadness Claims Another Victim

    By Ramona on Wed, 08/13/2014 - 9:41pm | Health, Personal

    The news that comedian Robin Williams has succumbed to deep depression is sparking thousands of conversations on the airwaves and throughout the internet.  Once the shock is over, once the tributes and the memories and the RIPs have been delivered, the talk turns, as it always does when someone commits suicide, to what it was that could possibly make someone do such a thing. He had everything going for him and it still wasn’t enough. . .  Suicide is a selfish act. . .  A cowardly act. . . Look what he’s done to his family. . .

    I come from a long line of depressives. The disease—dirty, rotten infiltrator that it is--hasn't skipped me, my children, or even my grandchildren.  In both my immediate and my extended family there have been suicides, hospitalizations, therapies and drugs—drugs that have worked miracles and drugs that have been disappointing failures.

    At times not of our choosing an unrelenting sadness washes over us and we have to struggle to keep from going under.  It may seem to others that we're weak or self-indulgent or self-destructive or stubborn or just wet blankets. From the moment it hits, it demands--and gets--all of our attention. Happiness is momentary, a fleeting teaser--a whiff and then it's gone.

    Those who have never had to deal with chronic deep depression are understandably impatient.  Because our illness is not obvious on the outside and because we can get pretty crazy with it--seeming to fight every attempt to help us get well--it's easy to give up on us.

    I haven't felt that kind of depression for several years, but I still say "us" because I know from experience the depression bug is lurking somewhere and could rear its ugly head at any time, in any place, without my permission. 

    I have been suicidal.  Depression is exhausting.  It winds us down and makes us weary.  It takes away any feeling of worth and no matter who is telling us we're loved, we're good, we deserve to be happy--we know better.  We're feeling something else.

    We are a burden not just to ourselves but to everyone around us.   Love (or the lack of love) has nothing to do with it.   When we're in a depressed state we have turned inward and our demons have locked the door.  We put on our outside face and pretend.

     The people taking turns to comfort us, to soothe us with just the right words, might as well be talking to themselves.  We indulge them, we nod our heads, we pretend for their sakes that their words are magically healing, are just what we needed, but when they've left it's as if they were never there.

    We work sometimes at convincing ourselves the people we care about would be better off without us because, if it ever comes to that, the leaving will be easier.

    The common perception is that we are our own worst enemies, when, in fact, the enemy is within us and is messing with us in ways too cruel to even fathom.  It takes all our energy to act casual while our inner demons are keeping us wedged in our darkest places. We know, even as the depression drops a curtain over our feelings and drives us down, that we must appear normal for the sake of those often at their wit's end trying to figure out what they can do to make us happy again.

    Depression doesn't work that way.  While tender loving care is a welcome and necessary aid, it's not a treatment and it's not a cure.  Depression is an illness as real and as insidious as cancer.  It's a cancer of the psyche, eroding and destroying our self-worth.  It takes with it our ability to appreciate even the smallest joys. Every depressive I've ever known carries a burden of guilt.  We should be happy.  Why can't we make ourselves happy?

    You might wonder how I got over it.   I wish I knew.  Then I might know how to avoid it the next time.  I might know how to help the people I love who still suffer.  I don't know.  I could say it was many things--true love, living in a place of beauty, thinking happy thoughts--but that would be giving in to the myth that clinical depression is based on tangibles.  It is a chemical imbalance of the brain.  There are modern pharmaceutical concoctions that do, in fact, work miracles for some, but the frequency of depression-based suicides tells us there is still much to learn, still much to do.

    We could move light years ahead if we removed the stigma from every form of mental incapacity and treated it all as the physical illness it is.  We could make life easier for the survivors of suicide victims if we stopped looking to them for answers and looked, instead, toward treating depression as a disease that kills as surely and as swiftly as any other malignant disease.  We've lost too many to it already.  We need to try something different.

    (Cross-posted at Ramona's Voices)

    Topics: 
    Health
    Personal

    Comments

    I'm very sorry to read this. My instinct is to conclude with the words "stay well" but that almost seems like a sick joke after your description of how very unwell you have often  been  tho thankfully right now.

    Peace.

     

     

     


    by Flavius on Wed, 08/13/2014 - 11:33pm

    First group that needs to go to re-education camp with both depression and addictive disease is at least 75% of the medical professions, mho. And it's not just the bottom of the barrel. I know that up close and personal. There's top residents in top hospitals still, young doctors being trained right now, that have real bad judgmental and/or moralistic attitudes about sufferers being able to deal with it by force of will.

    The following point you make is such a crucial point with both depression and addictive diseases within that context

    We know, even as the depression drops a curtain over our feelings and drives us down, that we must appear normal for the sake of those often at their wit's end trying to figure out what they can do to make us happy again.

    This is the nasty catch-22. While we still have many medical professionals that "don't have a clue," the ill need the assistance of family and friends to help them find the right help. It's a tough task of trial and error and very discouraging, not something a person who is down can handle all alone, they need an advocate or two. The family and friends can't do that, won't even know they should be doing that, if the ill work hard at a process of putting the family and friends in a situation of denial.

    The ill themselves have to be re-educated to stop hiding their illness from family and friends before it's too late. You shouldn't try to appear normal. That's buying into the whole charade of value judgments, of this being a moral failing. That's just like trying to hide a diagnosis of cancer in the olden shame days of cancer. Or, to make a different analogy, that's like the olden days of football participants trying to "work through the pain" of a concussion or other serious injury and "be a man."

    Do I sound preachy? Good, I mean to, without apology. I feel very strongly about it.


    by artappraiser on Thu, 08/14/2014 - 2:28am

    I have a very dear cousin who suffers from a constellation of neurochemically mediated pain, and I know how terrifying it is to be open to his sharing of just how close he is at any given moment to simply closing the door on his struggle.  I make a point of inquiring how things are going without signaling my fear that I may learn that they, perhaps, are not going well just now.

     

    Oddly, (or perhaps not) he is highly functional, and supervises ten quants or so as head of the IT branch of a pillar of wall street whose name, for obvious reasons, I will not divulge but, trust me, you have heard of.

     

     


    by jollyroger on Thu, 08/14/2014 - 2:52am

    There is no easy way to know where those conversations should go.  Depressives rarely signal their true feelings.  Just being there, engaging in some pitter-patter shows you care.  If he wants to talk about it, you might have to grit your teeth and sit a while.  Think of it as therapy.
     


    by Ramona on Thu, 08/14/2014 - 8:44am

    I couldn't agree more, AA.  We've had many dealings with everyone from the medicos to insurance companies to rental agencies and I can tell you, it's stunning how ignorant they are about depression. 

    Our grandson's father-in-law was a psychiatrist and even though he didn't live in the same state, we ran everything by him when someone we loved was going through it.  He is gone now, sadly, but we couldn't have thrashed through that jungle of misinformation without him.

    I used to work in the Psych unit at U-M Hospital in Ann Arbor.  Out of all the doctors there, there was only one, Dr. Margolis, who I would have trusted with my own life or the lives of people I cared about.  This was back in the mid-70s and last I heard he's still there, working in their acclaimed Depression clinic.  I remember him, even way back then, pushing the idea that marijuana could be useful as a prescribed drug for easing pain, both physical and psychic. 


    by Ramona on Thu, 08/14/2014 - 8:02am

    an unrelenting sadness washes over us and we have to struggle to keep from going under

    I will try to be brief because if I am not I know that is what will happen just thinking about this subject. 

    I have a different description though: anti-endorphins. Just like endorphins produce a high; anti-endorphins produce lows. And it is not just mental lows. Mine got so bad I ended up with takosubo (stress) cardiomyopathy aka broken heart syndrome. 

    As bad as that may sound, it actually turned out to be a good thing because it made me realize that what was happening was not just mental and not just chemical. How I felt emotionally produced real physiological changes in my body. I almost wish it had happened decades ago so I could have missed taking all the experimental anti-depressant and anti-anxiety medicines that really didn't work anyway.

    Now when I feel like I am about to be overcome by anti-endorphins, I make myself concentrate on shutting them down. Not always easy and not always successful but I keep getting better at it. Side effect may be an ever shrinking attention span and an inability to read Trope's posts but I'll worry about that later. I have also managed to concoct my own anti-anxiety formula from herbs, supplements and otc medicine. I take it only when needed like aspirin or tylenol.  So far this is working out better than anything else I have ever tried and that is a lot of things. No more psychologists and no more daily bipolar meds for me if I can help it. Oh, I also concocted a cardiac polypill substitute that seems to work as well.

    Sounds kooky I know but I lost all confidence in healthcare as we know it and for good reasons. I have no doubt being modestly successful at treating myself helps as much as anything of the other things I am doing. But that's okay, too.

    I am not trying to diminish anyone else's experiences in anyway. I know very well how crippling depression is. Just wanted to share in case my experience might help someone else.

    Stopping now. Unpleasant memories are building up.

     


    by EmmaZahn on Thu, 08/14/2014 - 3:16pm

    I think you have a point, Emma, and much of what you describe I'm able to do myself now.  I can sense when it is coming on and ward it off somehow, but I also know if it gets bad enough I won't be able to control it. 

    The people I'm talking about here need more help than that, and while I agree with both you and AA about the weaknesses in the medical system. What we really need to do is to work at making it better.  The horror stories about mental health patients who don't get the proper care should be a thing of the past.  We should be making advances in mental health care the same way we've made advances in physical health care.

    There are still too many people in power who want to sweep mental health issues under the rug and pretend that anyone suffering mentally could just get over it if they wanted to.  That's as close to criminal as it gets.  People are suffering, languishing and dying because of that attitude.  What we need is not just compassion but enlightenment.

    I remember when we couldn't say the word "cancer" out loud and when cancer patients were shunned as unclean Typhoid Marys.  Once the effort was made to study the disease and work at curing it the numbers of cancer deaths declined dramatically.  The same with AIDS.  I'm hoping with a little more education the same thing can happen with chronic depression.

    Thanks for writing about your own illness.  I'm so glad to hear you're doing that much better.


    by Ramona on Thu, 08/14/2014 - 3:55pm

    I think the only good doctors are ones that would work with you to help you do what you are doing even more efficiently.

    That's how I define a good doctor. They're rare, I admit it. I  am lucky not to suffer this particular malady but I have done this with others, things equally difficult, like multi-symptom auto-immune. It takes a lot of suffering along the way, going through lots of bad docs, and even getting worse from their treatments. But eventually if you don't give up you can find someone who will work with you as a team to make you feel better, even if there is no cure for what ails you. And one can even learn from the bad docs treatments if you pay attention and research what happened to you!

    By the way, this is the main reason why I was so upset about one of the main results of Obamacare being narrow networks. I don't think narrow networks is going to make for good health outcomes for many people. Actually, I fear it may lead to more iatrogenic (doctor-caused) illness. Especially with all the emphasis on testing that it has. And where people without time for their own research are going to run-of-the-mill cookie cutter primary care docs. who diagnose nearly everyone with needing to lose weight and lower their blood pressure and get some exercise, or perhaps, the bit more sophisticated alternate: "pre-diabetic."

    My most recent favorite doctor said: "We treat the patient, not the test." That's when I knew I had found "the one" after three "fails." I was only was able to do this, and help myself recover from the few pretty devastating health problems I have had in my life because: I was either covered by an open insurance plan at the time, or was uncovered and paying out of pocket, going to any doctor I wanted.

    This is the awful truth a lot of people don't realize (I know you do realize): one can't go to a doctor and sit there and say "fix me" and expect it to happen from tests. Chances are unlikely one will get "fixed" if one does that. Getting "fixed" requires a lot of research trying to figure out what may really be happening with your symptoms, learning to pay attention to them and record them and figure out patterns of when and where they happen, and then finding a doc that will work with you on the symptoms and trial and error treatment and combining test results and what you say you experienced with the treatments, listening to your reports of what they do to your body, and trying to adjust them. And also a doc who does not pooh pooh you reading up on treatments; I think people should run from those that do.


    by artappraiser on Fri, 08/15/2014 - 12:35am

    The difficulty the medical profession has with dealing with depressives is that they're working with patients who are almost always reluctant to get help.  There is no team effort with a depressive.  It takes the kind of energy they don't have when they're in their depths.  Just getting up and getting dressed in the morning is an effort, and the thought of a doctor visit and all that entails is more than they're willing to endure.  They're sure no matter who they see or what they prescribe won't work, anyway, so why bother?

    There is no clear-cut diagnosis based on physical symptoms.  The patient can't describe where the pain is.  Depression is still a mystery, even to the doctors who have studied it, and no two patients present the same way.  If doctors appear to be floundering it's because they are.  That's why meds play such a big part.  We know there are certain anti-depressants and psychotropic drugs that work for some patients, and all they can do is try them to see if they'll work with this one.

    If there are miracle recoveries they're most often strictly by accident.  Trial and error.  That's not to say there aren't mental health professionals who should be in some other kind of work, but after years of dealing with them I've come to understand the difficulties. 

    More research about depression needs to be done, and it needs to be done on a massive scale.  We need to talk about it and bring it out into the open.  We need to stop losing good people to depression.  We've made great headway in diseases like cancer, hypertension and diabetes.  Those diseases were death sentences at one time and now they're not.  Concerted efforts and non-stop studies made all the difference.  We could do that for depression if we took it seriously enough.


    by Ramona on Fri, 08/15/2014 - 8:16am

    Thanks for writing this, Ramona. Great post.

    It's amazing how many people refuse to accept that depression is a medical condition, and insist that you can think your way out of it somehow. The comment that you "shouldn't be depressed" because you have all these things that should make you happy is totally clueless: depression is an illness that keeps anything from making you happy.

    I think the stubborn refusal to get it is driven by fear. Understanding what depression really is means accepting that our minds are not really our own, because our thoughts and emotions are biochemistry that can be influenced by other pieces of biochemistry. That we aren't masters of our own minds is scary, but pretending that we are doesn't fix anything.


    by Doctor Cleveland on Thu, 08/14/2014 - 4:59pm

    Yes, Doc, if we're ever to get to the bottom of depression, we need to keep harping that it is a medical condition.  Under new ACA guidelines mental health care is expanded for some but not for all.  it's a start but it's not enough.  We need to get the politics out of health care entirely and then maybe we can actually work at saving people's lives.


    by Ramona on Fri, 08/15/2014 - 8:26am

    Too many still think of depression as simply being depressed. Oh, everyone feels down sometimes, he's just having a bad day, she'll get over it. Tomorrow is Just around the corner - cheer up! Clinical depression is no more the same as "being depressed" than having Alzheimer's is just a matter of "forgetting things".

    As a society, and as an extension our medical community, we are in our infancy when it comes to understanding the brain. We all have to work together - including our government - to continue to explore that amazing organ, and to heal it when it's damaged.


    by barefooted on Thu, 08/14/2014 - 5:46pm

    Clinical depression is no more the same as "being depressed" than having Alzheimer's is just a matter of "forgetting things".

    Brilliant.  Would you mind if I borrowed it?


    by Ramona on Fri, 08/15/2014 - 7:37am

    Of course I don't mind, but it's kind of you to ask.


    by barefooted on Fri, 08/15/2014 - 1:18pm

    Thank you.  I will give credit to Barefooted. 


    by Ramona on Sat, 08/16/2014 - 8:15am

    Ramona,

    I have been so wrapped up (probably avoiding my own demons) in trying to put all of the pieces of the world into one nice little rational cereal box.  Not doing so well (avoiding or being rational).

    This is just such a beautiful essay, painful yes, but it hits home for so many of us and our families.  It is something I will be certain to share, I promise you.  Thank you Ramona. 

    Strength.

    Bruce 

     


    by Bruce Levine on Fri, 08/15/2014 - 7:56am

    Thank you, Bruce.  Depression hits us all in one way or another.  I doubt there is a family out there who hasn't been affected by it.  If we could just work at eliminating the shame.  We still have far to go.


    by Ramona on Fri, 08/15/2014 - 8:41am

     I have to agree that it is a selfish act. Many may feel that it is excusable because of  the crushing weight of depression, but "selfish" is still an accurate description.

      I'm on medication for depression and anxiety, and I've known two people who committed suicide, so I'm not speaking as someone who knows nothing about it. I was considering suicide at one point, and I was being selfish.


    by Anonymous (not verified) on Sat, 08/16/2014 - 8:23pm