Saturday, November 22, 2008

Best of: Back to Depression

From May 12, 2006:

I've sunk back into depression, unfortunately, though it was slightly predictable. My pain management doctor had given me narcotics for control, but she's in San Diego, so naturally I ran out. And I didn't plan my withdrawal properly like I did last time, so I sank immediately into depression. Today is a little better. I made a list of goals for the day. And I'm writing, which is also a good sign. If I keep this palaver up I may convince myself that I'm coming out of it.

What I really hate about depression is how I can be on the beautiful Mendocino coast where the pines parade down to the sea and take no pleasure in it. This is called "anhedonia." Then there is the incapacity to feel love towards anyone or anything; there is simply a blank wall, Sylvia Plath's "bell jar." I am convinced in my bones that my life amounts to nothing and that all would be better off without me. When I asked myself where I might be happy, I could only think of a hole in the earth. My crying jags also arrive on time; right now they are scheduled for about 3 PM. This always happens in my depressions, a clockwork biology where I can predict when I will weep like a mock turtle on a schedule about the waste I call my life. No list of accomplishments can dissuade me from the opinion that I have done nothing. The future is unimaginable; the past is an incontrovertible witness in favor of the prosecution against me.

My "life script," also, a Transactional Analysis term, feeds into this. When I did my fourth step in AA, I reduced my life and the message I received in childhood to this: "If you're not perfect, you're worthless; if you're not the best, you're nothing." I'm sure my parents did not intend me to be branded by these double-binds, but they meshed nicely with my manic-depressive disease. My new psychiatrist pointed out this psychological misperception to me in our first session, and that upset me. But he had me.

Which raises the question, "What good is self-knowledge?" If I know how I'm fucked up, can write about it, talk about it, why can't I change it? It may be too deeply embedded to dislodge. My philosophy is to accept it and try to be aware of it, as it is too late to escape the programming entirely without a severe blow to the head.

If nothing I do can proves I'm not worthless, why do I keep trying? When not depressed I think my goals might be worthy in themselves, and my worth is not entirely dependent on them, rather I have some intrinsic worth granted by the Almighty and my loved ones. Nevertheless at the core of my being, like the rubber strands wound around the mystic center of a golf ball, the mantra persists.

In Mexico I counseled an elderly lady with severe myesthenia gravis who was virtually paralyzed, had to have her diapers changed, for instance. She could still talk. How she maintained fortitude and avoided depression under such conditions amazed me. If I became totally dependent upon others, there would be nothing to prove my worth. That scares me. And life is just that thin; "car crash tomorrow." "All flesh is like grass." Everything you trust in today could be ripped away tomorrow. Think of the Christmas tsunami and Katrina.

We can't let the vulnerability of our immediate lives into the forefront of our minds too much or it will undermine our confidence in the things we actually do and strive for, letting the air out of the balloon we have constructed in an unfounded faith in the continuity of our existence and expectations.

I recently read Jack London's "Sea Wolf" for the first time, where the captain, a thoroughgoing amoral atheist, preaches the gospel of survival, of bigger fish eating littler fish, where whoever gets to indulge in the most "piggishness" was the ostensible winner. The protagonist, Humphrey Van Weyden, tries to counter these arguments with his philosophy of the sacredness of life and altruism, but discovers that his reasoning is not nearly so water tight as the captain's, especially in view of the brutal conditions on the sealing ship where he is forced to work, along with the evil character of most of the hands.

So what remedy remains me? My best philosophy is acceptance. If I accept these features in my flawed self they will not exercise the unconscious power over me that they otherwise possess. In my best moments I will be able to actually laugh at myself and the programs I swallowed whole as a small child. Alas, today is not one of those days, because the biological aspect of my depression does not yet allow me such wisdom.

This too will pass, and I will embrace this ephemeral world as substantial again. But one thing depression teaches you is how thin the spider's thread we hang from truly is.

Thine in Depression (again),



  1. C.E. - I'm curious about your thoughts on those who do not suffer from manic depression but suffer from major depressive episodes, with dysthymia in between those episodes. If I'm not majorly depressed, I'm melancholic...rarely do I feel happiness and when I do, it's for very short periods of time (maybe an hour a day). What's your philosophy on how one should come to terms with this?

    Rachel Mallino (I'm posting under Tilt Press at the moment)

  2. This shows great wisdom. It's actually quite simple. I think, personally, that the biggest problem in our culture is that people are all striving to live up to some general, arbitrary or unrealistic standard but haven't learned to love and accept themselves yet as they are. Once we are willing to look objectively at our own patterns, talents (so many people overlook their own talents because it was just doing what they needed to do to survive) and so called flaws or deviations, we can embrace them and intelligently compensate and do what we're good at and get help with what we're not.

    When I'm depressed, I don't call it depression, I call it internal work. There's something "suppressed" that needs to be dealt with. Maybe that's not much help for severe clinical depression, but I find attitude critical to my maintaining my own well being.When I cultivate good thought patterns and mental and emotional habits when I'm ok, it helps me a lot when I'm not ok.

    Thank you much for sharing the wisdom of your experience and thought and also very much for being a friend.

  3. As I've repeatedly said, dear Tilt, the first step is to see a biologically competent psychiatrist. My younger brother suffered from dysthymia and recurrent major depression into his late thirties when antidepressants vanquished the major depressions and reduced the dysthymia.

    I favor the disease model for these conditions. To survive ineffective treatment, or no treatment for that matter, takes a hell of a lot of endurance--and in those times I rely upon acceptance: don't fight depression, as with pain, let it pass through you. Above all don't blame yourself or run through laundry lists of what might have caused it; once the down cycle starts it seems self-perpetuating.

    Sure, there are psychological triggers, but the disease would manifest itself anyway, and there's no way to protect yourself against all the triggers without becoming a hermit.

    Kelton, good to see you checking out my blog. We had a wonderful walk in the redwoods yesterday, didn't we, between the calls of ravens and the mysterious saxophone player hidden in the woods? "Internal work" sounds good to a healthy psyche; to a diseased psyche it sounds like another burden--as if depression were some kind of work I had to negotiate to profit from my lows.

    From my extreme lows there comes no profit, just the ability to endure and survive without putting a gun to my head.

    Thanks for stopping by, both of you,



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