I have been an avid and interested reader of books, usually memoirs, describing the authors’ experiences with depression, unmanageable grief, or depressive episodes. There are a number of reasons for my interest, one being that I have an interior depression narrative of my own and the other because of my passion for delving into concepts of consciousness. Consciousness and depression must be intimately linked, of course; a person cannot feel depressed if he or she lacks a reflective sense of self or Mind. Sorrow differs, but some grief is so deep that depression enters in and squeezes the soul dry. Each narrative contains parallels to other narratives, and yet each is as unique as the author. We are “storytelling animals,” and the impetus to tell the story of depression may be to help others or to assist in re-knitting the disjunctions depression creates in consciousness.
For example: This Close to Happy, Darkness Visible, An Unquiet Mind, H is for Hawk, Hyperbole and a Half, The Year of Magical Thinking, The Solace of Open Spaces…even in the relatively brief Chapter 75 of Bruce Springsteen’s memoir Born to Run–there are dozens of such memoirs on my bookshelves, and this list does not even mention the books by poets, psychologists, and philosophers who have explored the human challenges of depression. [I have not yet read Andrew Solomon’s Noonday Demon; but it is on my list.]
Because I am a writer, these narratives, and the lyric inventions crafted by poets, teach me much about how to explain the un-nameable, to describe–in words–the kind of numb grip that a depressive crash or a monumental grief exerts on a person’s sense of self, or even of language (which fails); the way depression shrinks into nothingness a person’s feeling of shared community/communion/communication with others, even with beloved others. There’s a story there, the story of how the story itself gets subsumed by stasis.
In these cases, metaphor: the person is the story; the story loses its narrative, tapers off, stands still. No longer interesting, expressive, alive.
Unfortunately, I know that feeling. I know how it arrests creativity and savages my ability to write.
Why do we “get” depressed? What does depression do to the brain? Does the brain itself cause depression? Despite the insights medical researchers have gleaned about neurological networks, cells, synapses, the anatomy of the organ we call “the brain,” there are no answers to these questions; the former can be tracked through scans to some extent, but there is seldom a “before” MRI or PET scan with which to compare “normal” and “depressed” in a unique individual. A New York Times Health & Science article from 2005 puts things pretty succinctly:
” ‘I think that, with some notable exceptions, the community of scientists was excessively optimistic about how quickly imaging would have an impact on psychiatry,’ said Dr. Steven Hyman, a professor of neurobiology at Harvard and the former director of the National Institute of Mental Health. ‘In their enthusiasm, people forgot that the human brain is the most complex object in the history of human inquiry, and it’s not at all easy to see what’s going wrong.’
For one thing, brains are as variable as personalities.”
One of the problems is determining causation: which was first, the disease or a perceived (and possibly inaccurate) difference in brain structure or function? Is it chemical or hereditary, or is it traumatically-induced? Or are we not really seeing a difference in brain structure? Why do medications work for some people but not others? And why and how do medications work, exactly? Twelve years after Carey’s NYT article, psycho-neuro-biologist folks still do not know any definitive facts, though there is slow movement toward progress. [For a quite up-to-date and thorough but readable article about the complexities involved in depression, I recommend Harvard Health Publication’s online pamphlet “What Causes Depression?”]
From the standpoint of a person who has had a lifelong relationship with depression, I’m not sure I need a cure at this point. My depression narrative includes taking a pill that seems to help considerably; but that has not been the magic bullet that alleviated a chronic, possibly chemical, condition. What has balanced my conscious mind with my chemistry is at least as likely to be related to support, friendship, talk therapy, cognitive behavioral changes, personal motivation, love, reflection, experience, information, aging, writing, spiritual study, Zen, nature, environment, valuable work, art, and tai chi.
The Nautilus article (cited below–do consider reading it) suggests there may be an “up” side to depression:
In a study of 61 depressed subjects, 4 out of 5 reported at least one upside to their rumination, including self-insight, problem solving, and the prevention of future mistakes.
“It may be best to let depression work its miserable magic, under protective supervision.”
“Most episodes of depression end on their own—something known as spontaneous remission…” says Steven Hollon, a professor of psychology at Vanderbilt University.
The Nautilus article cites several researchers who use the evolutionary model of fitness and bargaining, concepts that Marjorie Grene might caution us away from relying too heavily upon. Drake Baer of The Science of Us, whose article was certainly titled by editors, not scientists, writes “that, in some circumstances, depression may be, in the arc of a life, yielding of insights and personal meaning. All of this is in no way meant to minimize the suffering that depression can cause — but to suggest the uses that it may serve.”
Baer’s article dwells upon the idea that there are structural and cultural concepts at work in the identification of, experience of, and healing of depression; that the “illness” or disease resides in the subjective, non-empirical, non-testable world of human consciousness (interiority). I’m on board with that suggestion. Baer closes by relating depression to katabasis, an ancient Greek word that refers to the inexorable downhill slide, the descent into the underworld, the sinking down into darkness.
Baer writes that “Katabasis leads to catharsis; not coincidentally, there’s a shared theme in the personal narratives of people who reach midlife with a sense of well-being and generativity toward others: redemption.”
My personal depression narrative, just past mid-life (by some reckoning), suggests redemption. Which is to say there’s hope.
Please, if you or someone you know and care about has challenges with depression, read the Harvard article linked in the text at very least; and check out the other links as well. This is as close as I ever get to a public service announcement, but the urgency is explicit.