Depression is a Physical Illness

posted in: mental health | 2
A Storm Comes © 2011 Jane Waterman
A Storm Comes © 2011 Jane Waterman

A quandry for any writer, not just a blogger, arises at those times when to tell your story means to risk betraying a confidence, either that of a loved one or a villain. The former, you wish to protect with all your heart; the latter, to avoid, if only to evade a litigation! Sometimes this means walking around with your story in your head, unshared, and inevitably means silencing your own voice. I have done this from time to time in my most adult (and perhaps sanest) years, and each time I feel the lack of expression strangles me as surely as the strife that expression might bring.

A blogger, first and foremost, is an autobiographer. They tell their story as it unfolds, not with the benefit of years, as one might set out to do in later life, or even post-mortem, locked in a drawer for some unfortunate family member to discover and either publish or destroy. A blogger is also a journalist of sorts, telling a tale of life on the frontlines in the decade in which we live. It is the former role I wish to examine here, and then the latter: on my duty to explore the issues my ruminations might reveal.

As an autobiographer, our story is usually shared with at least one other intimate familiar: a family member, a friend, even a member of one’s social or recovery groups, or a member of a religious or spiritual congregation. It is our duty to tell our story truthfully, and to follow the usual literary devices of changing names and situations to protect the innocent, and as I’ve said, evade the villain.

What if, however, the story of a beloved one crosses with yours and begins to unravel the foundations of your own story? What then? Do you go to the future forever holding the story in your heart, or do you find a way to tell your overlapping tales in the most sensitive way you can?

Writing brings me to this dilemma with these responsibilities. As a teenager, my love of writing was anything but welcomed by those whom I most wished to embrace it, and as a result, even my words fell away to silence, as much as my physical self fell to invisibility. To be a writer and to be unable to write is a rather hellish situation, which on its own brings much unhappiness.

The alternative is to write, and to do so with care, love and dignity to the subject matter, and that’s what I hope to do here. I know I have crossed this line myself in recent blog posts. I’ve also come to learn that as a parent (by marriage if not by the blood I feel we share) of much-loved daughters, one cannot presume to give away their stories, but one cannot afford either to silence one’s own story when it feels critical to our purpose in life.

My daughter, A- is struggling with an intractable depression, which over the past two weeks has reached its nadir. In doing so, her depression has opened doors to my own, and dare I say, manipulated my own depression to the point where I’ve been struggling with the issues in my own past. While I’m hopeful that a new medication is beginning to restore balance to her thoughts, my own thoughts on the the subject continue to unfold.

Many people like to personify depression, indeed, personify any illness that they are confronted with. Many talk of ‘the battle’ and ‘the fight’ against depression, and give it the name of beast, black dog, monster, dragon, and so on. In doing so, we (and I have made that distinction on more than one occasion) give power to the illness called depression and ultimately, express our helplessness and hopelessness against it, at a time when we most need hope. We need some sense of hope, mastery and even power, even if that power means not listening to the lie that depression tells us.

My wife and I are, at present, co-caretakers with A- of her health and wellbeing at a time when illness reduces that sense of personal power. We do not do so lightly or gladly. Indeed, it is a great pain to see our loved one struggle as we have done. At one point, recognizing what seems to be our precarious role, A- began to seek assurances from others that they would care for her if my wife and I were no longer here. It seems painful to admit that the ‘adversary’, depression, had shifted its attention to those nearest loved ones, to punish us for our role in trying to eradicate it.

My mind began running down old familiar paths forged by depression. If a loved one looked for a way to function without us, then surely it meant that we were only a means to an end: temporarily useful, but ultimately dispensable. When one has been depressed for over twenty years, it’s frightful how quickly you can start running down those familiar neural pathways to a world where you are unimportant and invisible. You begin to review the role you have played in the world yourself, and whether you really had any value in the first place. My mind quickly began traversing those roads and sinking with them. Such is the power of a thought!

Fortunately, and it is only due to the value of a long experience with depression, and an almost as long attempt to eradicate it, I began to see what I was helping depression to do to me. I found it rather sad (I use the word sad, ironically). Depression was no great beast with its eyes fixed on my destruction. If I were to personify it, I thought rather of a bitter, twisted little man or woman seated in the corner, pointing out my deficiencies to the enlightenment and amusement of all the other people in the room, leaving me to dangle like a puppet jerked about on a string. I was going along with their little dance, and then I thought, ‘Enough’.

Although I have been depressed for so many years, and as such, can claim to be somewhat of an expert on it, even I have failed miserably to understand what it is. Depression is a mental illness. While I have said the words, and embraced them to understand my condition, I haven’t really understood what is meant by mental illness.

The brain, which is the seat of control in our body, is also the seat of mental illness. The brain at its most fundamental, is a physical and chemical system, relying on chemical neurotransmitters and electrical impulses to direct every element of our function, including whether to move a leg, or whether to cry. The brain is part of our body, but when it comes to the illness of that brain, we suddenly no longer treat it as a physical illness. It becomes a mental illness, with the attendant urgings from the well-meaning to the horribly ill-informed, that ultimately we are in control of it and can do the logistical equivalent of ‘snapping out’ of it.

Most sane people agree that physically based illnesses like cancer, Parkinsons’ or even eczema are not caused by some moral failure or spiritual weakness. Whatever diagnoses of convenience we make, the brain is still part of a physical system. There is a gathering theory that mental illness is not caused by chemical imbalance (for example, https://www.theguardian.com/education/2002/jan/10/medicalscience.healthandwellbeing), and these well-meaning, but ill-informed people believe they are doing us a favour with it. I agree wholeheartedly that the tendency for psychiatrists and even general practitioners to prescribe ill-fitting and even destructive prescription drugs without solid physical evidence is a problem, but we are also doing a great disservice by denying there is any illness at all.

For many years I was plagued by the thoughts that accompany a major depressive disorder. I managed to go to work most of the time, but most mornings I stood on the platform as the train rushed in and fantasized about throwing myself under it. Under my sleeves, I’d carry dozens of scratches that were made with a blade as if to excise the pain and to go on functioning as the normal person does. There was something wrong with my brain, and still is at times (although many of my suicidal and self-harm thoughts have become a soup of chemical habituation, if nothing else). To say that my brain was normal would be nothing short of criminal.

Normal people, however much I loathe the term, don’t fantasize about their own death on a daily basis. There is an illness, and an illness must be treated. As much as I love cognitive-based therapy, and have found it to be the most effective at treating an intractable depression like mine, I believe it is like physiotherapy for the brain. If the brain is a largely physical-chemical system, then thoughts are also physical-chemical in origin (treating the soul as yet another system) and can be trained physically and chemically, much as my arm was when I broke it. To say that we should not treat brain illnesses because they are not chemical imbalances is disingenuous, and is to my mind, the equivalent of throwing the baby out with the bathwater.

I have found myself on a moderate course recently with an alternative to Prozac, which has on and off managed to help my thinking resume a more normal course over the past twenty  years. The drug is a combination of St-John’s wort, Valerian, passion flower, supported by 5-HTP. I find that on this blend, the calmness returns to the frenetic thoughts that are my brain under the stress of the illness, depression, and I begin to find the strength and particularly the focus to continue to work on my health, including my CBT ‘physiotherapy’.

Most reasonable people would not ask a person with diabetes to forego insulin, or a person with cancer to forego chemotherapy. Why then would they oppose the treatment of another physical system: the brain? Why then, do we let emotion overrule logic (rather ironic, when in ‘normal’ people, the brain is the seat of logic) when it comes to treating depression?

When we treat depression, we are not treating the boogeyman. We are not treating a mental illness so much as we’re treating a physical illness. Let’s not forget that fundamental fact.

Blessings,
Jane

2 Responses

  1. Annette McKinnon (@a
    | Reply

    So you really have "invisible illness" squared.

    I saw this story this morning and saved it to send to you. What a shock – a depressed famous person!! https://www.irishtimes.com/newspaper/features/2013
    Did you ever grow passion flowers? My son did once and they were amazing and exotic

    • Jane Waterman
      | Reply

      Hi Annette!

      So it would seem… it feels like it's all around me, and it befuddles me that our collective governments do so little about this epidemic.

      Thanks so much for the Springsteen article. I've always admired his work and his lyrics, and it seems (not surprisingly) that his history definitely informed his work.

      I've never tried to grow passion flowers, but I've seen them often at local sanctuaries here and they are beautiful. They look fairly delicate, so I don't know if I'd have any luck. I would love to have a little greenhouse one day, but that will have to wait for the right combination of money and skills to enter my life. :)

      Blessings,

      Jane

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