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
“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.
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.
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?
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.)
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:
I listened to a NPR segment this week about the connection between playing football in the NFL and brain trauma.
One retired running back said that each collision he suffered during a game “was like being in a car accident.” What a tremendous cost to pay, I thought.
For many of us, daily life is so demanding and stressful, that, like a football player, it’s like being in a series of car accidents. The word “stress” doesn’t even seem to do justice the corrosive experience of so much stress– “trauma” is more like it.
The trauma isn’t the type inflicted by bone jarring hits during a football game — it’s psychological, though no less real.
“Trauma is not just the result of major disasters. It does not happen to only some people. An undercurrent of trauma runs through ordinary life, shot through as it is with the poignancy of impermanence. I like to say that if we are not suffering from post-traumatic stress disorder, we are suffering from pre-traumatic stress disorder. There is no way to be alive without being conscious of the potential for disaster. One way or another, death (and its cousins: old age, illness, accidents, separation and loss) hangs over all of us. Nobody is immune. Our world is unstable and unpredictable, and operates, to a great degree and despite incredible scientific advancement, outside our ability to control it.”
Such trauma not only impacts our psychological/emotional and spiritual selves, but our physical brains.
In a brilliant article in The Wall Street Journal this week entitled, “Stress Starts Up The Machinery of Major Depression”, Robert Sapolsky, Ph.D., points out that there are many factors that increase our risk of major depression including genes, childhood trauma, and endocrine and immunological abnormalities.
But a frequent trigger is stress.
Sapolsky writes, “The stress angle concerns ‘adhedonia,’ psychiatric jargon for ‘the inability to feel pleasure.’ Adhedonia is at the core of the classic definition of major depression as ‘malignant sadness’”.
As a person who has a genetic history of depression in his family and childhood trauma, I was drawn into Sapolsky’s article. What was the connection between stress and the malignant sadness I’ve experienced off and on since being diagnosed with depression twelve years ago?
Who would have thought that rat brain research would help me understand the link?
Sapolsky gives us a little background about our brain structure by letting us know that our abilities to anticipate, pursue and feel pleasure revolve around a neurotransmitter called dopamine in a region of the brain called the nucleus accumbens. Then he turns to the rats for further illumination:
“Put a novel object – say, a ball – in a mouse’s cage. When the mouse encounters the ball and explores it, the arousing mystery, puzzle and challenge cause the release of a molecule in the nucleus accumbens called CRF, which boost dopamine release. If an unexpected novel object was a cat, that mouse’s brain would work vey differently. But getting the optimal amount of challenge, what we’d call ‘stimulation,’ feels good.”
We humans need just enough challenge and stress to make life interesting.
“CRF mediates this reaction: Block the molecule’s actions with a drug, and you eliminate the dopamine surge and the exploration,” writes Sapolsky. “But exposing a mouse to major, sustained stress for a few days changes everything. CRF no longer enhances dopamine release, and the mouse avoids the novel object. Moreover, the CRF is now aversive: Spritz it into the nucleus accumbens, and the mouse now avoids the place in the cage where that happened. The researchers showed that this is due to the effects of stress hormones called glucocorticoids. A switch has been flipped; stimuli that would normally evoke motivated exploration and a sense of reward now evoke the opposite. Strikingly, those few days of stress caused that anhedonic state to last in those mice for at least three months.”
Sapolsky concludes:
“But meanwhile, these findings have an important implication. Life throws lousy things at us; at times, we all get depressed, with a small letter “d.” And most people—as the clichés say—get back in the saddle; prove that when the going gets tough, the tough get going. What then to make of people who are incapacitated by major depression in the clinical sense? Unfortunately, for many, an easy explanation is that the illness is a problem of insufficient gumption: ‘Come on, pull yourself together.’ There is a vague moral taint.”
The trauma of everyday stress is an important player in major depression. When combined with genetic history and a difficult childhood, it can tip the applecart and result in what Andrew Solomon calls “The Noonday Demon”. The takeaway is that the better we get at managing the “trauma of everyday life”, the better chance we have at preventing depression.
My worry is that the society we’ve created and the hectic lives we lead make the management of stress very difficult, indeed.
From The Washington Post, a piece about cyclothymic disorder, a milder form of bipolar illness, in which they highs are not as high as a manic phase and the lows are not as low during a depressive phase. Read the Story
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, Buddhist monk
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. The nineteenth century German philosopher Arthur Schopenhauer once wrote: “The first forty years of life furnish the text, while the remaining thirty supply the commentary.” Maybe it isn’t till midlife that we really work hard to interpret the stories of our past. I believe there’s a strong urge in all of us to make a comprehensible story of one’s life at this juncture. And our parents are a large part of that tale.
The author of Slaughterhouse-Five, Kurt Vonnegut, a WWII veteran like my dad, wrote:
“The most important thing I learned was that when a person dies he only appears to die. He is still very much alive in the past, so it is very silly for people to cry at his funeral. All moments, past, present, and future, always have existed, always will exist. It’s just an illusion we have here on earth that one moment follows another one, like beads on a string, and that once a moment is gone it is gone forever.”
Now that I’m 50, I still wonder what role mom and dad played in my depression. Looking at the facts, I guess it’s all too obvious: drinking and mental health issues on both sides of the fence. In my most self-absorbed moments, I blame them and feel justified in doing so. In brighter moments of lucidity, I see that they, like me, were somebody’s children once. They didn’t start out in life the way they ended up – nobody does. They were, in a real sense, victims. This fact doesn’t excuse what happened; the real pain they inflicted on their children. But it does help me to understand their plights in life. And with that understanding comes some measure of peace, a peace of heart.
Turning the pages to our Past
Jonathan Frazen, author of the best-selling book Freedom about a family that struggles with depression, writes:
“Depression, when it’s clinical, is not a metaphor. It runs in families, and it’s known to respond to medication and to counseling. However truly you believe there’s a sickness to existence that can never be cured, if you’re depressed, you will sooner or later surrender and say: I just don’t want to feel bad anymore.”
Here’s Jonathan Frazen talking about his novel on PBS:
How much of our life is determined by our familial past? How much of it is spun by choices we make apart from that past? Apart from what happened to us at the hands of parents, can we really change? I believe that shifting through our past helps us to become “unstuck.” And after all, depression is about being stuck. We can’t go forward, if we can’t go backwards and to see the truth of about past.
There are some things we can change and some we can’t. We can’t change our genetics and scientists now know that the genes we inherit play a significant role in our vulnerability to depression. There is a gene that regulates how much of a chemical called serotonin is produced. Serotonin is a neurotransmitter. The amount of serotonin that flows to your brain influences your mood, and emotional state. Those whose serotonin transporters included a gene that was shorter than would be typically expected at a certain point had a harder time bouncing back after experiencing a stress event. Chronic stress and anxiety, as I’ve written about before, have a strong correlation to a vulnerability to clinical depression.
This bit of news makes me want to know my ancestors, these ghosts of my past. These folks and I have something in common: irksome chromosomes that could flip off the happy switch in our brains from time to time.
I heard on National Public Radio that there have been 60 generations that have lived and died since the time of Jesus. Since the extent of my knowledge about my family only goes back, at best, 100 years to the time of the birth of my grandparents, that leaves me about fifty-eight generations or 1900 years of emotional and genetic history unaccounted for. I wish there was some kind of recorded history of their lives because I am a continuation of them even as my daughter is of me.
Dad’s Story
Dad was born in Buffalo in 1926, the oldest of five born to immigrants from Poland. I never met my grandparents, but from family lore I’ve learned that they were tough people who lived even tougher lives: brute physical labor for their daily staple of meat and potatoes, playing pinochle while plumes of cigarette smoke wafted up to the ceiling and crates of cheap booze on the weekends. If you looked crossways at them, they’d likely belt you in the mouth.
Alcohol played a big role my family’s drama through the generations. Sometimes they drank at home, but more often in what my grandma called “Gin mills.” Men would cash their checks in these Polish joints, throw their money on long wooden bars sip draught beer as they talked about all the scraps they’d been in that week just trying to get along in life.
My dad grew up in this world. At 17, he went off to fight in the Pacific theater against the Japanese. War must have deeply affected him, as it does all young men. Robert E. Lee, writing of his experiences in the Civil War, wrote his wife in 1864:
“What a cruel thing is war; to separate and destroy families and friends, and mar the purest joys and happiness God has granted us in this world; to fill our hearts with hatred instead of love for our neighbors and to devastate the fair face of the earth.”
Last year, I read a New York Times review of a book out about J.D. Salinger, author of The Catcher in the Rye. The article notes that Salinger, who served in the infantry during WWII in Europe, witnessed a lot of death and mayhem and struggled with depression his whole life:
“Salinger’s experiences during WWII heightened his sense of alienation. The war left him with deep psychological scars, branding ‘every aspect’ of his personality and reverberating through his writings. Salinger had suffered from depression for years, perhaps throughout his entire life, and was at times afflicted by episodes so intense that he could not relate to others.”
Ultimately, he stopped publishing, moved into a cabin in rural Connecticut and practiced Yoga and Zen meditation.
Dad clearly suffered from undiagnosed depression and PTSD, something that would, like Salinger, haunt him for the rest of his life. But war can’t explain all misery, can’t explain the storms that would rage in his head. His younger brother Roman, also a war veteran, became an alcoholic. Dad’s younger sister suffered from depression and been treated for it with medication suggesting a possible genetic propensity in our family for the illness.
Mom’s Story
Mom, like dad, was also part of WWII generation. Her older brother Joe went off to war in the Pacific for three years. As fate would have it, he met my future Dad aboard a ship in the Philippines and said, “If we ever get the hell out of this shithole, I’ve got this cute, blonde sister back in Buffalo.” They survived, my parents met, fell in love and married.
Mom had an alcoholic father, also an immigrant from Poland. She recalled being asked by her mother to go find her dad on a regular basis when he didn’t return home after work. Often, during the harsh Buffalo winters, she would find him passed out in a snow bank. The only intimate moments she remembered sharing with him was when for her eighth birthday he took her to a Shirley Temple movie and bought her candy.
Mom and dad quickly had three kids. Things went well the first ten years of their marriage, but the wheels began to fall off from there on out: dad drank too much, became a gambler, womanized and had unpredictable outbursts of high octane rage. Mom collapsed back into herself and never really recovered. She began to eat a lot, added lots of pounds to her slender frame and watched T.V. all the time. Maybe the dopey sitcom narratives sliced through the quiet pain my mom carried – all the time – all of her life.
Dad died 32 years ago at the age of 56 (I was 19) from too much drinking and smoking. He died sort of unrepentant, never saying he was sorry for anything. But, in my own mind at least, I think he was sorry. I think he just couldn’t bring himself to say it because of the enormity of his sins. But I have learned to forgive him, this enemy of my childhood who I had wished as a boy that he would just die. The great poet Henry Wadsworth Longfellow once wrote:
“If we could read the secret history of our enemies we should find in each man’s life sorrow and suffering enough to disarm all hostility.”
As for my mom, well, she died almost two years ago at the age of 82 of brain cancer. I devoted a blog to her passing, but didn’t say just how difficult it was to really know mom. She was always somehow distant, like a star in the sky. She never had any friends, her family was her circle. She loved us, but often did not connect with her children; maybe because she had never been cherished as a child. She did, after all was said and done, the best she could and, in this sense, was so much easier to forgive and let go of than dad.
Walter – Second Edition
Walter, my oldest brother at age 59 and dad’s namesake, and I were walking back the other night to the parking lot after our hometown hockey team, the Buffalo Sabres, had taken a real shellacking. I asked him in the frosty, hidden darkness where men – – if they do at all – – share a sliver of their true inner lives: “Do you ever think of dad and what did he meant to you?” He replied, after a few huffing breaths: “Not really, just what a real asshole he was.”
My brother has never been in therapy, never taken antidepressants. But he had heroically forged ahead “carving out a living” as he was prone to say. Yet, I couldn’t help think about the profound effect dad’s abuse had had on him and my other three siblings. I wonder if he sometimes thinks about it at night while lying in bed with the windows cracked open on a hot summer’s night. Does he wonder why he can’t stop feeling bad about himself? Why he doesn’t feel more confidence? And the toughest part of it all, the thing that keeps me up at night when I think of my burly, big-hearted brother, is that he probably blames himself for all of these feekings as adult children of alcoholics are prone to do.
My Coming Around
As for me, a real veteran of therapy and antidepressant medications, I know all too well that my parents are still tangled up with me long after their deaths. My therapist once said that I had to work out the long buried grief of never having had the parents I needed. Over the years, I have done a lot of grieving for the childhood I didn’t have. Yet, as I was to learn, it wasn’t only my grief about my childhood troubles that I was to deal with, but for my parents as well. For the loss of their innocence, their difficult childhoods and all that they could have been.
Despite the pain in my family, there was love; fractured though it may have been. As he aged, I sensed that my dad knew that too much had gone wrong that he couldn’t fix. But in small gestures here and there, he showed affection and love. As my mom’s wake last May, I was privileged to give the eulogy. What I said was my mom’s defining quality wasn’t success, intelligence or gardening, but kindness – that this is where she planted her flowers that continue to grow in the hearts of her children and grandchildren. And what a gift that is. One that’s always in bloom.
My parents were both hopeless in their own ways. They were dealt a crummy hand in life. They were born with certain genes, into a family and time in history that they didn’t choose. The difference between them and me, the blessing that came out of my depression that didn’t for them, was that my pain forced me to finally confront my wounds and work hard to heal them – an ongoing project for us all. It forced me to examine the long unexamined within me. It gave me a choice: I could continue to live out my parents damaged views of life or embark on my own journey and discover what was real and true for me.
While it is true that none of us can avoid the pains and difficulties that come from living on this planet, what modulates the pain is love — pure and simple. Andrew Solomon, who has suffered from depression for much of his adult life, captured this in his book The Noonday Demon: An Atlas of Depression:
“Depression is a flaw in love. To be creatures who love, we must be creatures who can despair at what we lose, and depression is the mechanism of despair. When it comes, it degrades one’s self and ultimately eclipses the capacity to give or receive affection. It is the aloneness within us made manifest, and it destroys not only connection to others but also the ability to be peacefully alone with oneself. Love, though it is no prophylactic against depression, is what cushions the mind and protects it from itself.”
In the end, love really is the only thing that saves anybody.
