Depression, continued...

I have written reams about depression.  I still have no answer though I have been flooded with information.  Sadly, none of the information seems to benefit me.  I have lost the will to live.

I recall Melville's story of Bartleby the Scrivener.  Here was a man with a bone-tiring occupation of copying figures all day.  One day, for no reason it seems, he quit doing his job.  When his employer upbraided him for sitting and doing nothing, telling him to get to work, he blandly replied: "I prefer not to."  And from that point on, his life degenerated because he had said the great "No" to the universe.

I feel like Bartleby.  I cannot engage with life.  I have no ambition other than to survive another day.  My thoughts constantly condemn me, I think I have lost hope.  I don't think I've ever quite passed this existential Rubicon before.  Hope is the condition for survival; without it we are lost.  Hence I am lost.

Life, frankly, terrifies me.  The smallest tasks have become so anxiety-ridden I don't know how I perform them.  Washing the dishes is an overwhelming undertaking.  I do not know what to do with my free time, which is almost all my time.  I cannot write a lick of poetry, my music is moribund, my creativity vanished. 

There is no magic bullet for me--neither medications nor therapy.  Of course, I do both, but with little or no result.  My therapist sympathizes with my plight and tries to make me make an alliance with my observing ego over and above my experiential ego, to stand back and say, "That's your depression talking.  Don't go there."  Yet it seems I am helpless to resist the spiral of self-consumption, unable to distinguish the better or more objective me from the me of experience.

I'm blogging today in an attempt to give expression, to in effect organize my plight.  But again I suffer from paucity of thought.  I don't have much to say.  If people call I can hardly carry on a conversation.

Depressed people must be the most boring people on earth.

Self-consumption, self-obsession--a human is designed to look outside himself, to act upon his environment, to engage materially and socially.  I cannot.  Thank God I can still read. 

Having given up alcohol and other vices, cigarettes remain my last comfort, though they are killing me.  They taste bad and I cough and wheeze.  But they are a momentary oral satisfaction, just as food.  I can still eat.  I have become infantilized. 

I feel I ought to be institutionalized until I can somehow improve.  Yet I was institutionalized for 45 days last February and March with little result.  And twelve courses of ECT could not shake me out of depression.

Depression is an inadequate word to express the horror in which I exist.  Brain fever or melancholic seizure or simply "hell" better fits the state.  I cannot seem to will myself to will myself to live.  Suicidal thoughts plague me, indeed I am committing slow suicide through continuing to smoke.  I want an end; I would welcome death but am morally opposed to suicide, not only because it is the most selfish act one can commit but because it leaves loved ones holding the bag of guilt and sorrow.  My father committed suicide.  I envy him but refuse to succumb.  In fact my goal, my only goal at present it seems, is survival--and my chief accomplishment is not to commit suicide.

Last night my wife nearly forced me to attend a local open mic affair where I played three original songs to a great reception.  But it was not me playing; it was some robot mouthing the lyrics and strumming the chords.  Praise from others did not affect me.  I suppose criticism would have had a greater effect, since I twist everything into self-criticism in any case.

I have prayed and prayed but am entirely aware of the truth that "God helps those who help themselves."  Yet I don't know how to help myself, and when I contemplate activities, the chronic pain in my spine severely limits what I can do.  I can't volunteer to help extirpate local invasive flora, for instance, for digging would put me on my back for a day.

I did have two miraculous weeks from late September through early October when I popped out of my depression suddenly, and I thought it would last.  I was so relieved to be out of it!  Suddenly the darkness lifted and it was as if the whole experience had been unreal.  Just as suddenly the mood shift abandoned me. 

In those two weeks, among other things, I bought a wetsuit for local diving, I made arrangements to play with other musicians, I started a support group for depression, I was suddenly engaged in life.  But that life was taken from me.  I think of the story, "Flowers for Algernon," where the retarded man becomes intellectually gifted from a medication, but eventually the medication wears off and he sees himself descend from intellectual heights back to his former state and can do nothing to stop his fall. 

If you are not clinically depressed, fall down on your knees and give thanks to God.  I certainly would.  My greatest joy is not to be depressed.  I know of no worse disease, truly, and I have seen them all as a physician.  Depression is the soul-destroyer; do everything you can to maintain your optimism in the face of trying circumstances, let nothing drag you down into the pit of self-obsession, do everything you can to stay engaged with life, no matter how lowly your occupation, your disability, your situation.  Hang on to hope with your fingernails if you must; this is essential, for once you fall, you will certainly fall again, as most severe clinical depressions recur at some point in one's life after the first.  In fact clinical studies agree that after one depression a patient ought to be put on maintenance medication to prevent a recurrence--for life.

Depression damages the brain anatomically.  In autopsy studies, the central emotional regulator, the amygdala, has shrunk up to 20% in depressives.  This is a real disease, as real as tuberculosis and in my view, more deadly.  30% or more of bipolars die from it, either by accident in the manic phase or suicide in the depressive one.  Childhood leukemia has far better results in terms of treatment.

I did not want to write this today.  I wrote it for my own "health."  I do not know how it can help others, though folks have told me that my experience has somehow helped them.  May it be so.

To survive another day.  My goal.

Beyond kilorats,

CE