Putting Pen to Paper: Writers on Depression

That terrible mood of depression, whether it’s any good or not, is what is known as The Artist’s Reward. Ernest Hemmingway

Others imply that they know what it is like to be depressed because they have gone through a divorce, lost a job, or broken up with someone. But these experiences carry with them feelings. Depression, instead, is flat, hollow, and unendurable. It is also tiresome. People cannot abide being around you when you are depressed. They might think that they ought to, and they might even try, but you know, and they know that you are tedious beyond belief: you are irritable and paranoid and humorless and lifeless and critical and demanding, and no reassurance is ever enough. You’re frightened, and you’re frightening, and you’re “not at all like yourself but will be soon,” but you know you won’t. Kay Redfield Jamison, Night Falls Fast

That’s the thing about depression: A human being can survive almost anything, as long as she sees the end in sight. But depression is so insidious, and it compounds daily, that it’s impossible to ever see the end.  Elizabeth Wurtzel, Prozac Nation: Young and Depressed in America

In depression . . . faith in deliverance, in ultimate restoration, is absent. The pain is unrelenting, and what makes the condition intolerable is the foreknowledge that no remedy will come – – not in a day, an hour, a month, or a minute . . . It is hopelessness even more than pain that crushes the soul. William Styron, Darkness Visible: A Memoir of Madness

They flank me-Depression on my left, loneliness on my right. They don’t need to show their badges. I know these guys very well. …then they frisk me. They empty my pockets of any joy I had been carrying there. Depression even confiscates my identity; but he always does that. Elizabeth Gilbert, Eat, Pray, Love

Depression is nourished by a lifetime of ungrieved and unforgiven hurts. Penelope Sweet

Too Much Stress Can Lead to Depression

 

I listened to a National Public Radio segment about the connection between playing NFL football and brain trauma.

One retired running back said that each time he was hit when carrying the ball it was “like being in a high-impact car accident”. What a tremendous cost to pay, I thought.

For many of us, daily life is so demanding and stressful that it’s like being in a series of high-impact “stress collisions”. The word “stress” doesn’t even seem to do justice the corrosive experience of so much stress. “Trauma” is more like it.

This trauma isn’t the type inflicted by bone-jarring hits during a football game — it’s psychological, though no less real.

Psychiatrist Mark Epstein, M.D., author of the book The Everyday Trauma of Life, writes in a recent New York Times article,

“Trauma is not just the result of major disasters. It does not happen to only some people.

My Family, My Depression

“If you look deeply into the palm of your hand, you will see your parents and all generations of your ancestors. All of them are alive in the moment. Each is present in your body. You are the continuation of each of these people” – Thich Nhat Hanh

Like all parents, my Mom and Dad were flawed people – as I am. Yet, they were something more than that.

I’ve struggled to understand them much of my adult life; maybe more so now that they’re both gone. Here’s a picture of them from 1946 cleaning up the reception hall after a two-day celebration.

The nineteenth-century German philosopher Arthur Schopenhauer once wrote:

Dan’s Top Video Picks on Depression

Films can teach us a lot about depression.  Not only can they provide information.  They can also move us emotionally by drawing us into the subject with interviews, animations, and other techniques that aren’t amenable to books.  Here are my favorite videos that address the topic of depression.

Living with Depression

I came across this short video recently.  And was very moved.  It captures, with sublime music and moving images of a young woman, her struggles with clinical depression and the loneliness she endures. Powerful. Over four million people have viewed it. Running time is 3 minutes and 22 seconds

Diving Into Hell: A Powerful Memoir of Depression

From The New York Times, book reviewer and best-selling author Andrew Solomon writes, “Not so long ago, the mere fact of writing that you had suffered from depression conferred a badge of courage, but such confessions have devolved into a dull mark of solipsistic forthrightness. Famous people use such disclosures to persuade you that they are just like you, perhaps even more vulnerable; it’s a way of compensating for the discomfort attached to their glamor. Indeed, in an increasingly stratified world, people with any modicum of privilege may reveal their depression as an assertion of their common humanity. Clinical misery has taken over from death as the great equalizer. Vanity of vanities, all is depression. Into this morass daringly comes Daphne Merkin with the long-awaited chronicle of her own consuming despair, ‘This Close to Happiness: A Reckoning with Depression.'” Read the entire article here.

Depression Screening for All?

From National Public Radio‘s program, “On Point with Tom Ashbrook,” a great conversation with experts about a new national task force’s recommendation that says everyone should be screened for depression.  Listen to the Podcast

Can Creativity Help Depression? An Interview with Carrie Barron, M.D.

Dan: Why did you write The Creativity Cure?

Carrie: I felt that the solutions out there for people with anxiety and depression were partial solutions, incomplete remedies. The way we live now causes stress for many people – the pace, the lack of rest or leisure, the relentless striving. Our technological, cerebrally focused culture has taken us out of our bodies and ourselves. Addiction to devices causes an imbalance and a malaise. When you are tied to a device 24-7 you may not be experiencing the fullness of all 5 senses, the things that make you feel energized. The primal satisfaction of making things and using the hands are slowly slipping away from us. For wellbeing, we have to make a conscious effort to maintain them. When my patients make and fix things, they feel better. Research shows that manual effort and creativity are antidotes for malaise. The Creativity Cure was written to help people find another way.

Dan: I deal with lawyers with depression and other professionals that are on their phones and computers a lot. What kinds of things would you recommend that they do with their hands for physical?

Carrie: It’s about getting out of your head. There are many cerebrally oriented people, but “ I think therefore I am” (Descartes) may not be the answer in the current culture. It is really becoming I think therefore I’m not. Too much thinking at the exclusion of physical and manual activity can make us depressed. Physicality, creativity and using your hands – – cooking or washing cars or crafting, painting walls or using watercolors — honor anatomical intent. Long ago manual action in everyday life was necessary for physical survival. Now we need these actions for psychological survival.

The need to create is primal. Paint a wooden board or do Legos with your child. Do that thing you were always drawn and do it clumsily, imperfectly. You don’t have to have any experience as an artist or a maker of things. You don’t have to have a fine result. You can just explore, begin and build. The beauty is in the inner experience. Research has shown that meaningful hand use decreases depression.

Dan: In your book, write about the unconscious mind. What do you mean by that?

Carrie: The unconscious mind, the deepest most hidden layer of our mind houses our , primal self, our instincts, our intuitions and our truth. The unconscious is a treasure trove of clues about our natural self, our unique self.  We can get in touch with the deepest layer of our mind via dreams and seemingly random thoughts. Noting where our minds naturally drift helps us learn about where we need to be and what we need to do. The unconscious is a very powerful resource.

Dan: What is our unconscious trying to tell us for people who suffer with anxiety and depression?

Carrie: Depression can have many different causes: biological, situational, genetic or hormonal. It can also be the result of trauma. Self-knowledge and insight – knowing what resides in your unconscious mind – helps with depression because as the saying goes, the truth sets us free. Talking to a pastor or a mental health professional can elucidate information that moves you forward. Understanding yourself: who you really are, what your instincts are or what you are actually upset about is key for positive change. Sometimes you think your concern is one thing and your deeper self tells you that it is another. Following unconscious clues helps you live more truthfully and happily.

Dan: You mentioned “clues” from the unconscious. Can people that are dealing with anxiety and depression unearth these clues themselves? If a person did receive such clues, how would a person know, without talking to a therapist, know what to make of these clues?

Carrie: Writing is helpful. Keep a journal. Take walks, try yoga, breathe, self-reflect, fiddle with paint, doodle, just let. Important material bubbles up when your mind slows down. Be curious and wonder, “Who am I that I love that, what does this leaning say about me, how can I this passion be part of my regular life?” Paying attention to the feeling that accompanies certain thoughts can help you. Certain involvements can make you unhappy but they are habitual so you just keep on. Acknowledging your true inner responses enables you to change. Breaking through denial is key.

Dan: In my work helping lawyers with burnout, anxiety and depression, many of them that seem to contact me are middle-aged. Do you find that a lot of the people, the clients you see are coming to you in midlife?

Carrie: Yes, and midlife can be the best time of life. Loss and disruption, while initially causing depression or anxiety, can lead to positive inner transformation. If we learn to seek pleasure, solace or a feeling of elevation from friendships, family, creativity, and tending to those we love, we are empowered. If you are dependent on an outside institution for your self-esteem, you are less in control of your life and more vulnerable. Define yourself; don’t let it come from the outside.

Dan: I’d like to follow up on a point you make in your book when you talk about people not being in contact with their physical bodies and a visceral since of being alive. I spoke recently with Richard O’Connor, a psychologist in New York City who wrote the book Undoing Depression. He said that depression really wasn’t really about the emotion of sadness – – but about the absence of all emotion. Is that something that you see with the depressed patients you treat?

Carrie: I think it was Andrew Solomon, author of The Noonday Demon: An Atlas of Depression, who offered that beautiful juxtaposition: the opposite of depression is vitality – – not happiness. That really captures it.

Dan: In your book you make a distinction. You indicated that The Creativity Cure is a good fit for people with mild to moderate depression anxiety, but maybe not major depression. Why?

Carrie: For those who suffer from major depression and feel that their depression is well managed, The Creativity Cure is a great option for finding more vitality. Those who at baseline have mild to moderate depression and find that meds do not help enough can discover ways to unleash creativity and happiness in the book. It takes some motivation, but once you get going, you will have more energy and a greater number of happy moments.

Dan: What percentage of your patients would you say depression plays a role in their maladies for which they’re seeing you?

Carrie: Eighty percent.

Dan: Wow – -that many. And to actually put The Creativity Cure into effect, how long do you generally work with somebody to get to the point where they can do it on their own?

Carrie: We start right away by finding out as much as we can about who that person is and what makes him or her feel alive. We think about what is working and what is not, why certain choices were made and ways to redirect the self. Through the Five Part Prescription: Insight, Movement, Mind Rest, Using Your Own Two Hands and Mind Shift people can uncover their true leanings and find more vigor, inspiration, passion. For positive change, integrate the methods into your lifestyle over several weeks. Little steps! True change is all about a little at a time and building.

Dan: In your career as therapist, have you treated lawyers with depression?

Carrie: Yes, yes.

Dan: Have you found anything about their life style that contributes to their depression?

Carrie: I think its three things for lawyers, especially those in high-pressure positions. My client Marnie comes to mind. She is a 28 year-old lawyer who has to give up her personal life at the drop of a hat when she is needed. It is tough. Number one, she is often exhausted because 17 -hour days are not uncommon. Number two, there is a lack of autonomy because this 17 -hour day can be thrust upon her at anytime and continue for weeks. Marnie, professional, committed and with good attitude, has to be available in the moment, late nights, on weekends.

But, compliance takes a toll. It makes her depressed to be in the office and not see sunlight. Not being in control of her time is hard. Even if the work is interesting, she has to give up other important involvements. Marnie feels lonely and isolated because she has little opportunity to be with old friends or to develop new ones. We are working on ways she can maintain friendships, even in text message or email shoot-outs if an in- the- flesh visit must be delayed.

Number three is that living in your head all the time, no matter how brilliant you are, is not healthy. Smart as a whip with facts and numbers, Marnie garners much more pleasure from aesthetics. She likes design but has not felt free enough to develop this interest. Colors, shapes, proportions – thinking about these things makes her happy. It is a sensual, visual way of moving through the world. A big part of the treatment is making her interest in design part of her ongoing life.

I think lawyers in general are really smart people who are great at using their minds. They have been reinforced for this all their lives, but for a richer, higher, happier state, many of these cerebral people need to get out of their heads and start using their hands. Go into a creative world. Balance mind, hands and body.

Dan: I have given many talks around the country on the topic of lawyer and one of the things I like to say is that lawyers have the most active fantasy lives of most professionals I’ve ever spoke to, where they dream of doing something else than lawyering. Can those be clues that would fit in with The Creativity Cure?

Carrie: Fantasizing is a sign of mental health. It’s a good thing. Learning about your inclinations through daydreams might lead you to change your life in a big way or make it better in small ways. Tiny steps allow for big changes because they foster consistency and this builds a new self in a solid way. If you’re interested in learning how to make beautiful cupcakes you can do that for an hour on the weekend. Play guitar, write poems, tend tomatoes in a vegetable garden and do it for a few minutes a day. Start small and make it part of you. Keep dreaming and keep doing. Contentment is about maintaining an identity that integrates your creative

Why It’s Important to Join a Depression Support Group

“What can I do to help my depression?”

Well, there are many things you go do, really:  therapy, medication, etcetera, etcetera.

But one idea you might not have given much thought to: join a depression support group.  There are many benefits.   I have belonged to one for the past seven years. Here are some of my thoughts about why it’s good for you and how to find one.

Why It’s Good For You

One of the worst aspects of depression is the loneliness that sufferers endure.  There are several reasons why this is so: they don’t feel up to being with other people, others simply don’t understand, or they feel a sense of shame and hide.  While it may be a good idea to take “timeout” from others to enjoy some peace or not share with others that we have strong reason to believe won’t understand, these strategies are often maladaptive and only serve to maintain and/or fuel one’s depression.  Here is a bit of hard-won wisdom I’ve learned:  when I feel the worst is when I most need to be with other people and share.

depression-loneliness-and-gambling-addiction-300x300

Being with others is even more critical when you’re in pain.  You need to communicate your distress and know that your “tribe” will listen and care.  When this doesn’t happen, you feel alone, distressed and even abandoned.  You wander in the wilderness of pain by yourself and endure it as best you can.  But don’t you deserve better than that?

Having a place to admit and share your story

Andrew Solomon, author of the best-selling book The Noonday Demon: An Atlas of Depression, writes:

Depression is a disease of loneliness. Many untreated depressives lack friends because it saps the vitality that friendship requires and immures its victims in an impenetrable sheath, making it hard for them to speak or hear words of comfort. Worldly success does little to assuage that agony, as Robin Williams’ suicide makes clear. Love, both expressed and received, is helpful, not because it  ameliorates the symptoms of depression (it does not), but because it gives people evidence that life may be worth living if they can only get better. It gives them a place to admit to their illness, and admitting it is the first step toward resolving it.

Besides the psychological salve that support can bring to the wounds of your loneliness, there are important physiological reasons for being part of a support group.

Positive experiences can also be used to soothe, balance, and even replace negative ones.  When two things are held in the mind at the same time, they start to connect with each other.  That’s one reason why talking about hard feelings with someone who’s supportive can be so healing: painful feelings and memories get infused with the comfort, encouragement, and closeness you experience with the other person. (Buddha’s Brain: The Practical Neuroscience of Happiness, Love & Wisdom, Rick Hanson, Ph.D. with Richard Mendius, M.D.)

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I’ve talked to hundreds of folks about depression over the years and often found that a good chunk are resistant to joining a support group.  They feel tired and unmotivated to do so or feel hopeless that anything, even this, will help their depression. They have to meet this resistance and push forward because as depression expert Richard O’Connor, Ph.D. once told me, “Depression isn’t your fault.  But it is your responsibility to get better.”  And a support group, together with treatment, is one of the best ways for you to take responsibility for getting and staying better.

Small steps are best.  Before going to a group, get in touch with the contact person for the group and speak with them by phone, or, better yet, meet them for coffee to see if the group would be a good fit for you.

How to Find a Support Group

It isn’t as hard to find a support group as you may think.  Here’s my list:

The Depression & Bipolar Support Alliance

The National Alliance for the Mental Ill

Anxiety and Depression Association of America

Mental Health America

If you are a lawyer, check in with your local and/or state ABA’s Lawyers Assistance Program.

If there isn’t a support group in your community, my next blog will address how to create one.

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