By Kat Kinsman, CNN
I am 14 years old, it’s the middle of the afternoon, and I’m curled into a ball at the bottom of the stairs. I’ve intended to drag my uncooperative limbs upstairs to my dark disaster of a bedroom and sleep until everything hurts a little less, but my body and brain have simply drained down. I crumple into a bony, frizzy-haired heap on the gold shag rug, convinced that the only thing I have left to offer the world is the removal of my ugly presence from it, but at that moment, I’m too exhausted to do anything about it.
I sink into unconsciousness, mumbling over and over again, “I need help… I need help… I need help.” I’m too quiet. No one hears.
Several months, countless medical tests and many slept-through school days later, a diagnosis is dispensed, along with a bottle of thick, chalky pills. There is palpable relief from my physician and parents; nothing is physically wrong with me (thank God, not the cancer they’ve quietly feared) — likely just a bout of depression. While it helps a little to have a name for the sensation, I’m less enthralled with the diagnosis, because I know it will return. While this is the first time it’s manifested heavily enough for anyone else to see it, I’ve been slipping in and out of this dull gray sweater for as long as I can remember.
What doesn’t help at the time are the pills: clunky mid-1980s tricyclic antidepressants that seize up my bowels, cause my tongue to click from lack of moisture, and upon my return to school cause me to nearly pitch over a third-story railing from dizziness. I flush the rest and, mercifully, no one bothers me about it.
If they do, I probably don’t even notice; my brain is too occupied, thrumming with guilt, stupidity and embarrassment. Nothing is physically wrong. It’s all in your head. This ache, this low, this sickness, this sadness — they are of your making and there is no cure.
Now, 25 years later, I’ve lost too much time and too many people to feel any shame about the way my psyche is built. How from time to time, for no good reason, it drops a thick, dark jar over me to block out air and love and light, and keeps me at arm’s length from the people I love most.
The pain and ferocity of the bouts have never eased, but I’ve lived in my body long enough to know that while I’ll never “snap out of it,” at some point the glass will crack and I’ll be free to walk about in the world again. It happens every time, and I have developed a few tricks to remind myself of that as best I can when I’m buried deepest.
The thing that’s always saved me has been regular sessions with an excellent therapist and solidarity with other people battling the same gray monster (medication worked for me for a little while — I take nothing now, but it’s a lifesaver and a necessity for some). When I was diagnosed, it was not in an era of Depression Pride parades on the main street of my small Kentucky town. In 1987, less than one person in 100 was being treated for depression. That had doubled in 1997, and by 2007, the number had increased to slightly less than three.
My friend Dave was part of that tally. We met in our freshman year of college, and he was one of the loudest, funniest, most exuberant humans I’d ever met — and the most deeply depressed. Not that anyone outside our intimate circle knew; like many of us who live with the condition, he wore a brighter self in public to distract from the darkness that settled over him behind closed doors. Most people don’t see depression in others, and that’s by design. We depressives simply spirit ourselves away when we’ve dimmed so as not to stain those who live in the sun.
Dave saw it in me, though, and I in him; and for the first time in my life, I felt somewhat normal. Like I didn’t have to tap dance, sparkle and shine to distract from the fact that I was broken. I could just be me, and that wasn’t a half-bad thing in his eyes. I began to tell more people as plainly as I did other facts of my being — I was born in New Jersey, my real hair color under all this pink dye is very dark brown, and I’ve suffered from depression as long as I can remember. I’m Kat — nice to know you.
Dave never made it that far. His cracks were too deep and dark, and he poured so much vodka down into them to dilute the pain. A year after graduation, in the late summer of 1995, I was unsurprised but thoroughly gutted when I got the call — Dave had tidied his apartment, neatly laid out a note, his accounts and bills, next to checks from his balanced checkbook, and stepped into a closet with a belt.
I see Dave in little flashes all the time, still — hear his braying OHMYGAAWWWDD laugh around a corner and see his handsome gap-toothed smile in a crowd. I want to smack him full across the face for giving up and leaving us all, and I want to drag him to a computer and sit him down: Look — we’re not alone.
Dave was the first person I ever knew with Internet access. Among a million other things I wish he’d lived to see is the community of souls online, generously baring and sharing their depression struggles with strangers. There’s no substitute for quality therapy (in whatever flavor you take it) or medication (if that’s your cup of homeopathic tea), but by God, it’s hard to get there.
To see your feelings echoed and normalized in essays like comedian Rob Delaney’s much-forwarded “On Depression and Getting Help”; author Stephen Fry’s legendary letter to a fan, "It will be sunny one day”; the ongoing, public struggles of widely read bloggers and authors Dooce and The Bloggess; and guests of the no-edges-blunted WTF Podcast from comedian Marc Maron — all highly successful and public people — is to dare to let a crack of blue sky into the basement where you’ve been tucked away. I can barely imagine what it would have meant to my 14-year-old self to read Delaney’s words:
"The sole reason I’ve written this is so that someone who is depressed or knows someone who is depressed might see it. … But after having been through depression and having had the wonderful good fortune to help a couple of people who’ve been through it, I will say that as hard as it is, IT CAN BE SURVIVED. And after the stabilization process, which can be and often is f**king terrifying, a HAPPY PRODUCTIVE LIFE is possible and statistically likely. Get help. Don’t think. Get help."
"Here are some obvious things about the weather:
You can’t change it by wishing it away.
If it’s dark and rainy it really is dark and rainy and you can’t alter it.
It might be dark and rainy for two weeks in a row.
It will be sunny one day.
It isn’t under one’s control as to when the sun comes out, but come out it will.
It really is the same with one’s moods, I think. The wrong approach is to believe that they are illusions. They are real. Depression, anxiety, listlessness — these are as real as the weather — AND EQUALLY NOT UNDER ONE’S CONTROL. Not one’s fault.
They will pass: they really will.”
Dave will never see those words, or these, but someone will — including the 14-year-old me who still sometimes rides shotgun as I’m driving through a storm. I show her these words, these essays, these poems, these podcasts beamed out by the other souls who glitter out in the darkness. And I take her hand and lead her up the stairs.
These are my favorite posts, podcasts and essays on living with depression. Have another? Please share it in the comments below.
Rob Delaney - On Depression and Getting Help
Marc Maron and Todd Hanson - WTF Podcast
Kay Redfield Jamison - Acknowledging Depression
The Bloggess - The fight goes on
Dooce - Surrender
Stephen Fry - It will be sunny one day
David Foster Wallace - The Depressed Person
Rebecca O’Neal - The Depressive’s Guide to Comedy
Captain Awkward - The case for therapy
Katherine Sharpe - In Praise of Depression
Mooshinindy - The Depression Ones
Miss Banshee’s Inverse Candlelight — The Slip
William Styron - Darkness Visible
Hyperbole and a Half - Adventures in Depression
If you are depressed or have had thoughts of suicide, please seek help. Here are a few resources:
I don’t diagnose people I haven’t met. More importantly, I don’t use the diagnosis of sex addiction. In thirty-one years as a sex therapist, marriage counselor, and psychotherapist, I’ve never seen sex addiction. I’ve heard about virtually every sexual variation, obsession, fantasy, trauma, and involvement with sex workers, but I’ve never seen sex addiction.
New patients tell me all the time how they can’t keep from doing self-destructive sexual things; still, I see no sex addiction. Instead, I see people regretting the sexual choices they make, often denying that these are decisions. I see people wanting to change, but not wanting to give up what makes them feel alive or young or loved or adequate; wanting the advantages of changing, but not wanting to give up what makes them feel they’re better or sexier or naughtier than other people. Most importantly, I see people wanting to stop doing what makes them feel powerful, attractive, or loved, but since they don’t want to stop feeling powerful, attractive or loved, they can’t seem to stop the repetitive sex clumsily designed to create those feelings.
The conflict over sex addiction is important to humanists for several reasons. “Sex addiction” is a special weapon now used by the religious right to combat perceived liberalism, to ignore science, and to ignite fear. It also helps legitimize anti-sex moralism and bigotry. And psychologists, judges, legislators, and the media are buying it.
Absolutely a worthwhile read.
Even if your particular depression does include sadness, it’ll only be one of many other symptoms. The others might be much more painful and salient for you than the sadness is. Some people can’t sleep, others gain weight, some think constantly about death, others can’t concentrate or remember anything. Many lose interest in sex, or food, or both. Almost everyone, it seems, experiences a crushing fatigue in which your limbs feel like stone and no amount of sleep ever helps. Then there are headaches, stomachaches, and so on.
So, depression doesn’t necessarily mean sadness to us. (And a gentle reminder to non-depressed folks: being sad doesn’t mean you’re “depressed,” either.)
Depression is not sadness; it’s an illness that often, though not always, involves sadness. No amount of happy things will make a depressed person spontaneously recover, and, usually, no amount of sad things will make a well-adjusted person with good mental health suddenly develop depression. (Grief, of course, is another matter.) And sadness, on its own, does not cause suicide.
[…]People don’t kill themselves because they’re sad. They kill themselves because they have an illness that, among other things, makes them feel sad. It also makes them feel like their life is worthless, like they’re a burden to others, like death would be easier, and all the other beliefs that lead people down the path to suicide.
There is a tendency, I think, to assume that people are depressed because they are sad. A better way to look at it is that people are sad because they are depressed. That’s why, even if we could “turn that frown upside down!” and “just look on the sunny side!” for your benefit, it would do absolutely no good. The depression would still be there, but in a different form."
The Psychology of Resilience
via The Association for Psychological Science:
As psychological scientists’ understanding of traumatic events improves, so might the psychological outcomes of people who endure trauma. That hopeful thread connected the talks in the “Disaster, Response, and Recovery” theme program at the 24th APS Annual Convention.
“Most people are exposed to what we consider traumatic events at least several times in their life,” said the lead speaker, George Bonanno of Columbia University, who then set the tone for the program with a question. “Is disaster psychologically harmful to everyone?”
Bonanno has demonstrated through statistical modeling that humans are actually quite resilient in the face of disastrous events. While disasters can cause major psychological trauma that can’t be fixed with a quick and easy solution, over time most people demonstrate an impressive ability to rebound from a frightening incident.
Data over the years have revealed four patterns of response to traumatic events, Bonanno said. The most severe is chronic dysfunction, often manifesting as posttraumatic stress disorder (PTSD), which typically affects 5 to 30 percent of those involved in a disaster. Up to 25 percent of people display a recovery response, with another 15 percent showing a delayed stress response.
The most common response is actually resilience, Bonanno said. Roughly 35 to 65 percent of people who experience a disaster return to their normal routine shortly after the event, and stay there. A recent study of war veterans, for instance, not only demonstrated that roughly 7 percent of soldiers who were deployed one time developed PTSD but that 83 percent showed exemplary mental health in the face of potentially traumatic combat situations.
Recent research has shown that resilience has also been the most common documented response to events such as a nightmare mudslide in Mexico or the September 11 attacks. The prevalence of resilience suggests it stems from many sources.
“We tend to think there’s one or two things that can make people resilient,” said Bonanno. “That’s probably not the case.”
Silvia Koller of Rio Grande do Sul Federal University in Brazil, studies the concept of resilience as it applies to her native country. While Brazil has the eighth largest economy in the world, the country continues to struggle with extreme income inequality, a history of military rule, problematic education and health systems, and heavy violence in certain regions. At the same time, said Koller, Brazilians have a strong will for change, as well as powerful family systems and community programs.
Koller recently conducted a large study of trauma among impoverished youths in a number of Brazilian cities. Using self-report questionnaires from more than 5,200 14- to 24-year-olds, Koller and colleagues documented risk-exposure (such as domestic problems, economic struggles, and community violence) and markers of maladjustment (such as drug use, delinquency, sexual risk-taking). They also measured potentially protective factors like school attachment, self-efficacy, and family support.
The researchers found a strong link between risk-exposure and maladjustment, but they also found that protective conditions mitigated the negative effects of this relationship. Promoting these positive social elements might increase resilience even among a very disadvantaged population, Koller said.
“Our results indicate that risk factors were positively associated with maladjustment, but psychosocial protective factors diminish that association,” she said. “It gives some hope that we can work on protective factors to better the life of those youth.”
Psychological scientists have also learned much about traumatic responses through imaging technology — especially about PTSD, reported Lisa Shin of Tufts University. Shin and her colleagues use functional brain scanners to measure brain activity at rest and then take measurements again again when participants are reminded of traumatic events.
The researchers in Shin’s lab, as well as others in the field, have observed greater activation of the amygdala (which detects threats) and the dorsal anterior cingulate cortex (a fear-mediation center) in people who suffer from PTSD. They’ve also found lower activation of the medial prefrontal cortex/rostral anterior cingulate cortex, an area involved in fear-extinction, in these same populations.
“Extinction is the process of learning that the thing that used to predict threat no longer predicts threat,” Shin said. “You need to have an intact medial prefrontal cortex in order for extinction learning — and especially extinction memory — to occur normally.”
The good news, said Shin, is that psychological scientists are starting to find evidence that certain treatments can rehabilitate brain abnormalities associated with PTSD. For instance, some research has shown that cognitive behavioral therapy can increase activity in the rostral anterior cingulate cortex — perhaps a sign that the ability to learn when threats have abated is growing stronger among patients.
The program’s final speaker, Dirk Helbing of the Swiss Federal Institute of Technology, in Zurich, spoke beside a large tower of cardboard boxes, which he cautioned anyone in the audience who “likes to talk to lawyers” not to sit near. Helbing, who is a sociologist rather than a psychological scientist, uses a physics-based approach to understand the complicated behavioral interactions that govern the world.
“Society obviously is a complex system and it requires a combination of many different sciences to understand,” he said.
Helbing is affiliated with the FuturICT project — an effort to understand the role that information communication technologies (ICT) play in cultural networks. The ultimate goal of FuturICT is to manage human resilience in the face of social problems, and to develop new instruments for evaluating behavioral interactions that occur around the world.
One of these instruments is called the “planetary nervous system,” an online dataset that can reveal a picture of global social and economic networks in real time. The system could potentially detect instabilities in social capital and provide a tool for policy makers to confront these weaknesses before disasters occur. Helbing believes the disappearance of trust, for instance, played a role in the recent financial collapse.
“In order to make society more resilient, we need to overcome barriers to conventional thinking,” concluded Helbing, who then stepped off the podium and burst through the tower of boxes — and emerged unscathed.