Today I’m struggling with depression. Not the blues, but honest-to-god brain chemistry problems. In June 2003 I was diagnosed with long-term depression. We suspect that I’ve had it since I was a teenager. After about 8 months on Effexor, I woke up one day happy. It was a revelation. The fog that had surrounded me for most of my life had lifted, and it was like seeing blue sky for the first time.
Since then, my life has improved significantly. I’m happy much of the time, I’m more effective (and less annoying) at work, I don’t get as angry as I used to. But now I know what “good” feels like, so the occasional relapses are that much more unhappy. In some ways ignorance was, well, not bliss but perhaps blind.
Depression is the sort of disease where the symptom is the cause — the feeling of depression is caused by and in turn causes changes in neurotransmitters. I evidently don’t make enough serotonin, which the meds usually compensate for. But there are triggers that throw the newly regulated system out of whack. What’s very hard for me to understand is that the triggers are not physical, they’re psychological.
Being raised American in the late Twentieth Century, I’m conditioned to think of physical problems as physical and psychological problems as psychological. Doctors help with the physical stuff and psychologists help with the rest. Being ignorant and arrogant, we believed that the only connection between psychological strain and physical illness is “psychosomatic” and therefore not real.
Learning to manage my depression has shown how misguided this kind of thinking is. Which brings me back to today. Here’s what it feels like: I’m exhausted but filled with anxiety. I don’t want to talk to anybody. I don’t want to listen to messages, read my mail, play with my son. I catch myself gnawing at my fingers until they throb. My face feels heavy, and I see only fat and pimples when I look in the mirror. Life feels completely unmanageable. I look around my house and feel overwhelmed by unfolded laundry and cluttered tabletops. During these times, I can (ironically) become very productive and competent — I’m not sure whether it’s overcompensation or an attempt to bring order to a chaos that isn’t real and therefore can’t be tamed. Regardless, cleaning the house and getting a manicure never makes it all better.
What really frustrates me is that I know the cause of my relapses: Family crisis.
Not my little family out here in Califorina. Jason and Evan and I have had very few real crises. No, the trauma always comes from my siblings or parents. Here are a few highlights from recent years:
+ My sister, homeless for five years, was found. She moves in with my mother and eventually tries to light my mother’s hair on fire. She gets arrested.
+ My father has a near-fatal “cardiac event” (though eventually they decide that it wasn’t a heart attack).
+ My brother sends a suicide letter to me by email. I get it at work.
I won’t try to explain the back-story. It’s enough to know that at roughly six-month intervals my family has some sort of shocking crisis. I keep thinking there’s nothing new they can throw at me, but I’m always wrong. Each time this happens, I get upset and six weeks later (sometimes less) I realize that I’m sleeping more, biting my fingernails, avoiding my friends. I find myself listless, unfocused, depressed.
At times like these, well-meaning friends inevitably recommend meditation, exercise, “talks”. But there’s nothing to talk about, and if I had the vigor to join a gym then by definition I wouldn’t be depressed. They’re seeing things from a normal perspective. What I see is how hard everything seems. The effort seems insurmountable. I know enough to see those thoughts for what they are — echoes of the missing serotonin — but they feel true anyway.
The worst part of this is that I don’t know how to stop the pattern. Next time my family knocks the wind out of me, the symptoms will return. I don’t yet know how to duck the blow.
