Personal Essay

Where depression begins (Or, Spikes!)

By Scott Ross

I’ve been ruminating on this subject as essay-fodder for some time. The recent “apparent” suicide, as they say in criminological circles, of Robin Williams is coincidental but not, I don’t think, incidental. The single most concise (and most heartbreakingly apt) description of chronic depression I’ve ever come across is Dick Cavett’s:

“[…] when you’re downed by this affliction, if there were a curative magic wand on the table eight feet away, it would be too much trouble to go over and pick it up.”

http://opinionator.blogs.nytimes.com/2008/06/27/smiling-through/comment-page-21/?_php=true&_type=blogs&_r=0

The roots of depression are, of course, not yet firmly fixed. That its presence indicates a chemical imbalance seems assured, but is the condition genetic, or in any case, purely genetic? At this point in my life, I feel as certain that my own chronic major depression, which has blighted most of my adult life, and indeed much of my adolescence, is a function of my father’s DNA. His father, whom he loathed, was an angry, violent man and one, I believe, who bequeathed that genetic curse to at least two of his children. Dad’s sister, my Aunt Peg, committed suicide when I was very young, and I recognize many of the behavioral symptoms of depression in myself as reflections of Dad’s own persona. My mother always resisted any such conclusions on my part (“He’s not depressed.”) but at my worst I see far too many similarities between us. (The high anxiety I also contend with comes from her side of the family, or at least from her mother’s.) It was in fact my screaming—literally screaming—at other drivers on the road that finally convinced me to seek a diagnosis. That rage was not the sole manifestation of my depressive symptoms, but it was the decisive one.

Riding in a car with my father was a test of nerve. Every other drive was an idiot, and at fault, and he could also be vindictive. More than once I clung to the armrest, terror-stricken, expecting to die at any moment while he passed a driver in a no-passing zone or even, memorably, while crossing a two-lane bridge. Interestingly, to me, while Dad despised his father for his bullying, he was incapable of seeing the ways in which his own behavior often mirrored that of my grandfather. Like the man we referred to as Grant, Dad’s temper was quick, and never far from the surface. And while he at least attempted to govern his hands, he did not always succeed. At least, not with his son. A cousin recently reminded me of just such an incident, one I’d completely forgotten but which made her extremely leery of him. Like Grant, Dad had always to be right. He could not seem to locate the proper angle at which to view himself as others saw him—a common enough failing but one which, I believe, inhibits one’s making the changes to one’s own personality necessary for self-improvement. My ex shared that blind-spot and, if confronted, made the excuse that people had to take him as he was. Everyone has to adjust to the man who will not adjust himself.

My passivity in the face of brutality, psychic or physical, is, I suspect, a result of the dictum handed down to my father by his. More than once in my pubescence and adolescence I heard the “Fight your own battles. Don’t come crying to us” speech. As a result, and because I was unable to fight, I held my torments inside. I vividly remember one pleasant autumn evening at around 14 or 15, sitting with my mother on the front stoop, and her saying, The previous two years had been a waking nightmare, that screaming hell we once called junior high school. “You used to be such a happy-go-lucky kid,” Mom observed sadly. “I don’t understand whats happened. Why you’ve changed.” I was, as always, silent. How could I tell her, even if I’d had the words then, which I surely did not, that living in hell, and being told not to whine about it, can turn the happiest child into a diffident, interior-dwelling emotional recluse?

Depression becomes manifest, we’re told, following a trauma. It may be physical or emotional. In my own case, I date the onset of my depression from the age of six or seven, when I broke my wrist in a fall from a tree. (Well, from a tree limb, to be more precise; it was a dumb stunt, and a disaster waiting to happen. Had it not been me, it would have been my sister, or one of my cousins.) In any case, I can recall sitting in a dark Canton, Ohio hospital corridor after my near-compound fracture had been X-rayed, waiting to have it placed in a cast. Was my mother with me, or had she gone off to look for a nurse, or a doctor? I no longer recall anyone near me, only the dark pall, the body-size net that cocooned me with almost as rapid a descent as the fall from that tree branch. The ensuing days are shrouded by that caul. Each time it recurred as I grew older, it was always with that same, terrible, all-encompassing swiftness. The climb back up, as anyone who’s ever been depressed, let alone depressive, can tell you, is nowhere near as swift.

Far too many people, even well-meaning people, mistake “sadness” for depression. Everyone has known sadness. Almost everyone has experienced depression, even if only for a day. And “sad” is to chronic depression as “happy” is to acute mania. I liken my depression to walking under water, every moment of every day. I smile at times, I even laugh, on occasion. But what a friend describes as feeling like a weight that will not leave her, remains. I rise, although never easily, and never with the sensation of sleep having refreshed me. I go to work. I function. But if I gave in to impulse, I would not rise. I could not function. Those who refuse to “believe there’s such a thing as depression” (and there is a shocking number of such people, most of them, in my experience, highly educated and otherwise intelligent) should take up residence in my skin for an hour. If they did not instantly change their thinking (and I ennoble such purblind obtuseness with the positive noun) I should be amazed. A co-worker, whose anxieties and attendant neuroses make mine look like the proverbial walk in the woods, says that he wishes he could touch such doubters on the shoulder and transfer how he feels to them for 24 hours. Because, outwardly, we do not appear to be suffering, our illness is not generally perceived, even when we give every indication of it. We’re “difficult.” We’re “self-involved.” We’re “unpleasant.” “Unproductive.” More than one friend has told me I have “an edge,” never quite understanding that it might be because all of my interior edges have been ground to the nub.

For far too many of us, the combinations of therapy and medication simply do not work. When I was first diagnosed, in the mid 1990s, I was placed on Prozac, the “miracle” of the moment. within six weeks, I had regained that “happy-go-lucky kid.” I felt as I hadn’t since the age of 12. But one-third of Prozac users will cease to respond to the drug over time, and I, unhappily, was in that statistic. Within six months, the pall was back, and blacker than before. Because I knew then that it was possible for me to feel better. In this way, that experience is almost worse than the disease itself: I’ve been through a veritable pharmacopeia since then, and nothing I’ve taken since has had the slightest positive effect. Ketamine, if and when it is ever placed on the market, might be the answer. It has the virtue of taking effect, not in weeks, but in hours or even minutes. If all else fails, there is always electroconvulsive therapy, but that is extreme, and requires so lengthy a procedure I’m not sure my medical insurance even covers it, or even if I could take the necessary time away from the office to effect it.

Severe depressive episodes are known as “spikes.” I was trying to remember when my depression mutated from occasional spikes to a chronic condition. I’m not sure, but I suspect it was in my late 20s; before that, I endured the spikes but had the wherewithall to work both full-time and part-time jobs simultaneously, and (at an age very close to 25) to enroll myself in college, arrange for Pell Grants, and drive myself from North Carolina to Vermont. Further, after that particular disaster, to arrange for a transfer to a different school, come back home, work for a year and a half, take on the editorship of an Arts Council newsletter to pay for my matriculation, and somehow, get myself to Amherst, Massachusetts. The slowly accumulating exhaustion, the sense of someone constantly twisting a rubber band around my temples, the increasing incidents of emotional spikes… all of that came some time during my otherwise rather happy years at Hampshire College. So it was after my return, at 29, that the condition gradually became so debilitating it forced me to seek diagnosis, and therapy.

The spikes, however, remain.

Worse, they come with increasing frequency. And each subsequent plunge into the abyss takes longer to climb out of, requires a greater pull on my diminished—and diminishing—reserves. The recent death of my mother after a long struggle with Alzheimer’s, notwithstanding its being in a way a relief, for her and for her family, especially my sister, who cared for her the last three years of her life, still served to spike my depression in unexpected ways, and with astonishing swiftness; I could feel it wrapping me in its insidious embrace on the drive back from seeing Mom the last time, and only in the last few days has it retreated sufficiently to take me from deep slough of despond to what I am accustomed to: My usual, plodding, exhausting, “norm” of chronic depression.

Some know-nothings and professional reactionaries have, typically, taken the occasion of Williams’ suicide to bloviate upon the matter of courage versus cowardice. And while I hold suicide as a perfectly reasonable response to insupportable pain, and reserve the right myself to exit at a time of my choosing should my depression prove endless and intractable, I would also say this: No one who survives, day after weary day of this condition can remotely be called a coward. As Seneca noted, “Sometimes even to live is an act of courage.” So is reserving judgment, or at least, governing one’s tongue when one is an smug ignoramus.

can-stock-photo_csp11801220

Text copyright 2014 by Scott Ross

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