Lesson 2: Are You Depressed?
In this lesson, we will learn about the nature of depression and the diagnostic criteria for depression. Personal stories and experiences are provided to illustrate the multi-faceted nature of this illness.
Introduction
It is my fervent belief that knowledge is a necessity in the battle against mental illness, both in being vital to one's personal recovery and in fostering acceptance amongst a wider community.
Whether you choose to adopt an accepting or fighting frame of mind, the nature of depression demands our informed participation. Noted psychiatrist Charles Nemeroff MD, PhD of Emory University observed recently that "ninety percent of what we know about the brain, we've discovered in the last ten years." Several years ago, for instance, medical science did not know that the hippocampus of the brain indirectly influences emotion. Not only are we learning more about the function of the hippocampus, but we know something else unknown to medical science until just recently, that brain cells are capable of growth. Now here’s where it gets interesting: Brain cell growth occurs in the hippocampus, and the administration of an antidepressant can spur their growth. Think of Prozac as brain fertilizer, if you like. These discoveries have enormous implications in expanding our knowledge of depression and for new treatments. Add to these other neurological and genetic discoveries, and we have a whole brave new world of possibilities opening up.
But first, we need to start from the beginning. Depression is a very common term. People say they are depressed without meaning they are clinically depressed, leaving clinically depressed people to wonder if they’re depressed in the first place. So let’s start with a description of the real thing by Andrew Solomon in “The Noonday Demon: An Atlas of Depression”:
“With the depression, your vision narrows and begins to close down; it is like trying to watch TV through terrible static, where you can sort of see the picture but not really; where you cannot ever see people's faces, except almost if there is a close-up; where nothing has edges. The air seems thick and resistant, as though it were full of mushed-up bread. Becoming depressed is like going blind, the darkness at first gradual, then encompassing; it is like going deaf, hearing less and less until a terrible silence is all around you, until you cannot make any sound of your own to penetrate the quiet. It is like feeling your clothing slowly turning into wood on your body, a stiffness in the elbows and the knees progressing to a terrible weight and an isolating immobility that will atrophy you and in time destroy you."
William Styron, the Pulitzer Prize winning writer, in his memoir of depression, “A Darkness Visible”, had this to say: "... all sense of hope had vanished, along with the idea of a futurity; my brain, in thrall to its outlaw hormones, had become less an organ of thought than an instrument registering, minute by minute, varying degrees of its own suffering."
And here’s a passage from Sylvia Plath’s “Journals”:
“God, if ever I have come close to wanting to commit suicide, it is now, with the groggy sleepless blood dragging through my veins, and the air thick and gray with rain and the damn little men across the street pounding on the roof with picks and axes and chisels, and the acrid hellish stench of tar ...”
And here’s how I describe my own adolescent depression in a chapter of John Brown’s “The Gift of Depression”:
“No longer could the world and all its trials hurt me. I had entered a dark but comfortable realm beyond sense and feeling. President Kennedy would get assassinated and I wouldn't shed a tear. Winter would descend with bitter terror and I wouldn't feel the cold. The Beatles would prove to be the biggest thing since the Coming of Elvis, and I would barely notice."
