Sunday, December 07, 2008

Best of: Discourse on Depression

From my continuing "Best of" selections out of 500 posts, this from 10/4/06:

I want to be honest, but in the act of writing despair seems briefly arrested. Then I would not call my state despair, exactly, which implicates the heart and will, only clinical depression. Yet clinical depression leads to despair, which can only be defined negatively: without hope, helpless, without recourse, bereft of comfort, and so on.

When my mood is normal (may it be again!) I feel like myself. In depression I become my anti-self. Whatever I do is pointless; those who love me are deceived; I have made nothing of my life, indeed, have no life, and nothing I can do will change this. I constantly berate myself for perceived failings. And this from a Lutheran who supposedly believes in grace, “God’s unmerited favor toward us.” In depression I’m sure that God made a mistake, that in my case it doesn’t apply. I don’t feel loved by God yet I believe God is love. I am not comforted by Jesus; I can’t relate to him at all, indeed, have always had tremendous trouble with the second person of the Trinity. It is an article of faith that Christ suffered all our sins and griefs on the cross, so surely his suffering included clinical depression, but that doesn’t help my depression. It just makes me feel more guilty, as if I’m failing God by not believing. I think about going to church but know in this state I will misinterpret everything as a demand and leave church feeling more guilty than ever. In depression you question your core beliefs, and my faith is certainly one thing eroded by depression. This is no suffering to make me a better person; this is the extinguishing of personality itself.

There is a sense in clinical depression that the pain of the moment is eternal pain, that one has always hated oneself, that it has never been any different. Because I have had a few days of relief here and there, I am lucky to remember that it doesn’t have to be this way. In saying that I have hope. It is intellectual hope based on past depressions; I have always, eventually, come out of them, and I have been most helped by medications and electricity. Activity is good as well; simple tasks like washing the dishes. I am not so bad that I fear my inability to wash the dishes, each dish weighing a ton as my hand shakes with the fear of not being able to do them. But I have been there. I have been at 8 kilorats and it’s not pretty.

I feel the need to justify my existence every day, but the paradox is that nothing will justify my existence. I worry about old age, my body is tired and my joints ache, I am more than unhappy, I am abandoned. I know the form of my depression goes back to infancy, but that does not change the state of depression or explain its occurrence. One must have genetic predisposition to become clinically depressed.

Have you ever felt utterly alone, like a smudge on a windshield, like a microscopic dot in infinite darkness? Have you ever suffered constant accusations in your mind telling you all was for naught? Have you been nauseated by food, taking pleasure in nothing and wishing only for death? If you’ve had such symptoms for a week straight without relief it qualifies as depression. It used to be four weeks, then two weeks, and now the APA has decided the requirement for treatment is only one week. One week can be an eternity.

Right now the one thing I look forward to is seeing a better psychiatrist, although there is no guarantee I will be able to see him come Wednesday, as he will be on call for emergencies and may not be able to stay in the office. If that happens I will no doubt think that’s exactly what I deserve, that it’s hopeless anyway, that no one can help me. But I know better. Those who follow this blog know that I experienced a few kilobunnies several weeks ago, only to fall back in the pit.

As an aside, yesterday’s poem was roundly condemned by my editor and wife, and I couldn’t agree more. In my present state I think most of the poetry I’ve ever written should be thrust into the fire. Then in depression one can have no objectivity regarding anything about the self. I had the same experience as a practicing doctor, fearing everything I said was nonsense, that it was a miracle no one perceived me as a fraud and that I did not harm anyone while practicing in a psychotic depression. At that time work did not make me feel any better or worse, so I continued to work. When a crying spell would overcome me, I’d slip in the bathroom, cry, use Visine, and wash my face with cold water. I did that for more than a year, day after day. The only relief I experienced at that time was while driving. Something about the motion was comforting, and it was the one task I felt I could still do.

At 3.5 kilorats,

Craig Erick

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