Another article on Clinical Depression from long ago, posted for the benefit of those who need it now.
We see many stories from survivors of cancer, heart failure, addiction and more. Here is my survivor story. But first some factual background.
What Is Clinical Depression?
Clinical Depression is a progressively deepening melancholy accompanied by an increasing tendency to withdraw from social activity and eventually even personal relationships. In advanced stages the victim is so disinterested in everything that they neglect personal hygiene and meals and begin to shut out everyone and everything as they focus entirely on their own self-loathing. Suicidal tendencies are common in this stage.
Contrary to popular opinion, clinical depression is not a purely psychological disorder. Like schizophrenia and bi-polar disorder, clinical depression has an organic basis. Depression has been tied to low levels of a neurotransmitter called serotonin. This agent bridges the gaps between ganglia in the brain and allows the proper “firing” of nerve impulses that make thought possible. Serotonin is a short -lived compound because the body breaks it down; if this breakdown process exceeds the body’s production of serotonin, a shortage results.
It is not clearly understood whether depression causes low serotonin levels or whether low serotonin levels cause depression, but the two are definitely linked.
Treatments for Clinical Depression
If caught early, clinical depression can be treated with education and redirection. A counselor or therapist can provide pamphlets and books that describe what depression is, how it works and how common this disorder is. Just knowing these things, along with counseling, can allow the victim to redirect their thinking, focusing on positive aspects of their life to negate the depressive attitude. Just knowing you are not the only one helps.
Most commonly, this initial treatment is augmented by the use of prescription antidepressants that prevent the body from breaking down serotonin too quickly. Many of these pharmaceuticals have potentially severe side effects. Natural remedies such as St. John’s Wort, available over the counter and at low cost, are often effective but pose reduced threat to the user.
In severe cases, inpatient therapy combined with drug therapy may be required.
Depression: A View From the Inside
Like water circling a whirlpool, it begins as a slow, lazy, nearly imperceptible swirl that draws you off your life’s course. Once caught in the thing’s pull, if corrective action is not taken early, the spiral begins to tighten and speed up until eventually you are sucked inescapably down the funnel.
My recovery began in the suicide watch section of the psych ward of St. Elizabeth’s Hospital. I had called my counselor and told her about having been in the grocery store buying canned soup when I suddenly started shaking. I could not hold onto anything, dropping the cans I held then I crumpled to the floor and began to sob. Try as I might, I could not stop crying. It was mortifying to become such a spectacle in the middle of the crowded store. I managed to get to my feet and stumble out. I got home — somehow — and called my counselor.
The spell had passed by then but I was still scared. She told me to get to the hospital and they would give me something to help; she would call ahead to let them know is was on my way.
The hospital did not dispense something to help, they incarcerated me; against my will. And I was angry about it! The next two days are a blur, I remember only trying desperately to convince everyone that I was not “nuts”.
Recovery began with my first group therapy session. The orderlies rounded up seven or eight of us and herded us into a room, sat us at tables and passed out paper and pencils. The therapist said some soothing words about how we are not alone, many, many people have gone through what we are now, and explaining the mechanics of what was happening to us. I’d heard it all before, I barely listened. Then she told us to write on the paper 5 things about ourselves that are good.
I picked up my pencil and thought, “Five things that are good about me, OK, number 1…” I stared at the paper, thinking. Nothing. A complete blank! Try as I might, I could not think of a single aspect or attribute of myself that qualified as ‘good’. Lots of bad things, but nothing good.
The others were scribbling away on their papers. What was wrong with me? They could do it, why not me? The therapist worked the room, going from one patient to the next, commenting softly on their answers. I stared at my paper, not daring to look up. After a while she started dismissing the others and they slipped out one at a time. I sat and stared at the paper, tears of frustration welling in my eyes. Self-hatred rising in my heart.
The therapist took the seat opposite me and looked at me for a moment. I could feel her looking, gently, not critically, but I dared not meet her eyes.
“You can’t think of anything good?” She asked so gently is was almost a whisper. I shook my head and the floodgates broke. I sobbed like a child, uncontrollably. She let me go until I was able to rein it in just a bit. Then she asked, “Will you let me help you?”
She asked a series of questions; where I worked, what I liked to do, who my friends were, who my family members were, and used my responses to ask more questions that forced me to rediscover things that I was good at, who liked me and why, what things in my life make me happy. She told me nothing, only asked questions. As we went, it became easier to find positives.
A story is told of Robert Louis Stevenson, author of Treasure Island. Robert was a sickly child and one night his nurse came to tuck him in and found him with his nose pressed against the frosty pane of his bedroom window. He was transfixed by an old lamplighter slowly working his way through the black night, lighting each street lamp along his route. Robert exclaimed, “See; look there; there’s a man poking holes in the darkness.”
My fog of depression had solidified into an ebony sarcophagus, sealing out all positive thoughts, all hope. ‘Poking holes in the darkness’ is what that therapist did for me that day. By allowing a few rays of hope to poke in through a few chinks in that armor coating, I was able to grab onto that hope and begin shoving at those chinks, enlarging the holes, allowing more positivism inside to encourage me more.
Another week of inpatient care resulted in my being deemed sane enough to be trusted on my own recognizance. My battle was not over; it would be a long journey, more set-backs were ahead, but this was the start of my trek back to sanity. Once set on the right pathway it has been a matter of choosing right thinking over wrong thinking — and some medication. And exercise. Physical activity produces an endorphin that lifts one’s mood.
What To Do, When
The biggest mistake we can make when we suspect a friend or relative is experiencing clinical depression is to leave them alone and hope they ‘snap out of it’. Most times, if asked, they will tell you that they are fine; just tired. And they probably believe that because that is the way it appears. Clinical depression is surreptitious; it steals in without your recognition. It works slowly, secretly, so you don’t see it … until it’s too late.
Depression and suicide as a result of current economic conditions are on the rise. Even without that added motivation, in the last 45 years suicide rates have increased by 60% worldwide. Suicide is among the three leading causes of death among those aged 15-44 years in some countries, and the second leading cause of death in the 10-24 years age group. These figures do not include suicide attempts which are up to 20 times more frequent than completed suicide.
Don’t wait for your loved ones, especially teens, to get snared by the whirlpool. If you even suspect a problem, get the literature, study it, talk to them about it and encourage them to seek counseling while it is early and easily treatable. The longer you wait, the harder it will be on everyone.