Monday, June 1, 2009

Melancholia. Or, the Causes of Depression

2008-08-18 #0765 - Ruby Beach in Olympic NP, WA

This is a post I didn’t want to write, but that wanted to be written.  There will likely be more of them, too.  Why?  Because I believe this topic is under the surface of many lives, many conversations.  Especially for women.  Because life is too short to keep secrets, especially from ourselves. 

In the last twenty years, I’ve been a student of the causes and cures for depression—what the old books used to call “melancholia.” 

The first thing I learned is that I Have It.  I learned that, in the Physician’s Desk Reference (PDR), my kinds are called dysthymic disorder and major depression.  I also had postpartum depression. 

placid lake photo

The second thing I learned is that no one really knows what depression is.  No one—and I mean no one told me this—I just concluded it.  In fact, every person I’ve consulted for help with my depression has had an answer for what it is.  Mostly they don’t[ agree, though.  For instance, I’ve been told, or read, that depression is:   

a choice

an imbalance of serotonin in the brain

a failure to pray enough

a hormonal imbalance—not enough progesterone

an addiction

anger turned inward

the result of faulty cognitive behavior patterns

a reaction to medications

based in nutritional issues

a part of the grief process

the name for what’s “wrong” with you when you’ve been sad for more than 2 weeks.

a failure to carry out the mission of the U.S. Air Force

a mental malady

an emotional malady

a spiritual malady

a physiological malady

2008-08-15 #0712d1 - at Shark Reef on Lopez Island, WA

Given this list, it seems rather arrogant for the people who write the PDR—that huge compendium of things wrong with people—to presume what depression is.  The fact that my thing is called a “disorder” in itself places a judgment on huge segments of the population by labeling their internal processes as disorderly; that is, not normal. 

Secondly, the fact that so many people in the helping professions have different answers for what causes depression—and how to treat it—can itself be a mighty depressing prospect.  That these well-meaning people don’t talk to each other doesn’t help, either. 

What does all this mean?  Hell if I know.   

2008-08-18 #0760 - Ruby Beach in Olympic NP, WA

But I did learn other things, too.  I learned that plenty of smart, accomplished people have had “It.”  It’s almost common now, but back when I was twenty-eight and first diagnosed, I didn’t know that.  Abraham Lincoln is my favorite in this category.   There are so many others I’m not even going to pick some—but I will note that a disproportionate number of famous depressoids seem to have been writers, artists, and musicians.  Many of my favorites, of course, are on the list—like Hermann Hesse and Dylan Thomas. 

Gradually I made my own list about what causes depression, and even more gradually I’m learning to trust it.  On top of that list is self-judgment, and a giving up on oneself—neither of which have been helped along by the medical establishment labeling me or throwing treatments my way.  Oh, the stories I could tell.  Someday, maybe. 

 2008-08-15 #0706 - at Agate Beach on Lopez Island, WA

Here are some other ways I understand my depression.   It’s:   

a reaction to stress—either “good” or “bad”

a response to too much stimulation

a crucible for art and growth

a haven for a heart or mind or body that is simply overwhelmed.

a blessing:  thank God my body knows when it needs to go inward. 

a curse.  In a major episode, nothing could be worse. 

There are reasons for this post emerging to the surface needing to be written today, as opposed to last month, or next week.  But because I’m tired and need to get to bed, I’m going to stop here.  I’ll close with saying I was motivated to write this to reach out to others who have been diagnosed with depression and might recognize some of what I’ve written.  

 2008-08-13 #0693 - at Shark Reef on Lopez Island, WA


PurestGreen said...

Oh...crying now. Thank you thank you for this. I constantly manage what I call The Darkness, in order to function. I have never been diagnosed and have learned some of the things that affect it, make it worse or better. My mother is one who doesn't believe in depression. In her mind everyone should just get up off their butts and work harder. I learned not to express my sad emotions freely when I was younger, because essentially I was told that they were not allowed, that I had no excuse to be sad. But I couldn't help it. I still can't. Which is why I thank you, so so much.

Anonymous said...

Bless your heart (as you say sometimes). Beautiful photos. The parts I relate to most are "reaction to overstimulation" and "self-judgment." I have had success with trying to break down the thought process that I recognize as self-administered punishment on a subliminal level. But I can see how depression has many forms and many causes. Hopelessness. Isolation (but having nothing whatsoever to do with the number of people around).

Take care of yourself and keep doing what is good for your soul. People care about you and love you.

Saz said...

Well said. Well written. Informed and infected. A curse for sure. A blessing I fail to see, unless being able to understand the plight of fellow sufferers is itself a relief.

The pull yourself together brigade and the I don't want to take pills for the rest of my life, known to me as 'the curtain brigade' are in denial. Is there a rock bottom, sure.

To recover we need understanding, the realisation that this isn't to spite anyone, inspite of ourselves.

At some point, sometimes the duvet is the only answer.Until the light at the end of the tunnel shows itself.

Hang on. Dare to hope.

Imogen Lamport, AICI CIP said...

Sallymandy - hope you're not feeling too bad. I've had PND and I think also undiagnosed depression through some of my teens. I'm not there now, fortunately.

Depression is just one way the body tells you that all is not right in your life, and maybe there is something that needs changing - that's what I believe.

Jinksy said...

Intriguing post, obviously written from the heart. Will look forward to futher thoughts on this important subject.

Zuzana said...

I am very sorry that you tend to suffer from this condition and have felt alone and at times helpless.

I think we all tend to suffer, more or less from melancholy and depression. It would be odd otherwise, as happiness and joy cannot exist without sadness and pain.
I feel often down in the winter. What helps me is the fact that I am basically a very optimistic person and I tend to always try to find one good thing in any given day, no matter ho terrible that days is or how badly down I feel.

I am hoping you will have a wonderful Monday.

Suburbia said...

I like the ways you understand your depression, I think I can identify with them all. I hope you are in an OK place now. I always hope not to return there myself.

Jane said...

More of us suffer from depression than you would think.
I enjoyed your post.

Tim said...

A topic much mis-understood and in need of many more words... I'm glad that some are being written.

Nota Bene said...

Well said. Hopefully gone are the days where a pat on the head and a bottle of pills was seen as the answer. But like anything that is difficult to see it will always be misunderstood. And I suspect it's just as much an issue for men as women.

Daisy said...

Hey, I have It, too. I've kind of resigned myself to the fact that it's always going to be hiding around the corner waiting to jump out at me for the rest of my life.

I can relate to the whole self-judgment and giving up on oneself. I think at the core of my depression (and I'm not sure if it's a cause or a symptom) is a complete lack of faith in myself. Kind of makes it hard to make any progress in your life when you are constantly questioning and doubting your own judgment.

Hope that things are not too bad for you at the moment.

Stephanie N. said...

I hear you. My mom has fought "melancholia" for much of her life. I often feel powerless to help. It is good that we are open about it.

Lucy said...

Sallymandy...what a very real thing...for women, yes especially. And what I'm thinking is that now it's beginning at an even earlier age with younger girls as well. Even though we think we've come a long way as women, it seems that girls have even more to be overwhelmed about- we're honestly not moving forward. the only really positive thing that can lead to healing though, is that finally people are recognising depression as something so very real and that the mind and soul need much taking care of.Thank you so much for sharing this.

Mardel said...

I've had my own bouts with melancholia for years, and much prefer that term, as I feel depression is much to clinical a term, and treats something that I feel is a fairly common part of life as a disorder and therefore not "normal". All that thinking about depression can make me depressed.

At times I have wished I was less inclined toward the melancholy, but have accepted that it is part of who I am and have learned, for the most part, to live with my own darker thoughts. My hope is that more people learn to work their way through their darker moments, and that there is help when it is needed.

Good, thoughtful post.

The Clever Pup said...

Interesting. We have this in our family. My grandfather went for shock treatment, how barbaric is that!? My mother put us through hell when she was menopausal. For the most part it seems to have skipped me.

I hope "the black dog" skips my son too. I'm always on the lookout for it.

Keep on doing what resonates for you.

Best wishes from Toronto.


Saz said...

Sallymandy...not sure if you got to read this post I talked about when I was ROASTED by David on easter sunday.its on a theme..

La Belette Rouge said...

I MUCH prefer your definition of depression than what "they" say. As I know the black dog of depression all too well I do find that I recoil when people tell me what the cause of my depression is. The more over simplistic the explanation the more I bristle.

There is one book on depression that I return to over and over and I find more comfort in it than anything the DSM-IV has to say and that is "The Noonday Demon: An Atlas of Depression" by Andrew Solomon.

I am sending hugs, loves and hope that soon the black dog will leave you and that your white dogs will lick away your melancholia.
much love.xoxo

Suecae Sounds said...

I am there right now. Diagnosed and using medication to some success for both depression and anxiety.

I am up for psychological "research" to try to study the issues more in depth. Safe to say I have contemplated suicide when I was younger, but after a long time in the "darkness" I decided that I didn't want to stay in that state.

I am finding out a meaning still to this day, learning to see the beauty of the world we live in. That for me is one way of choosing to not stay where I was.

Everything is on a day to day basis too, with struggles and such, but today I can also savor the experiences of happiness and other things to that nature. And that is truly a blessing!

In the end though it is part of who I am. But I have realized that I can also change and transform, so I try to work on many levels to find ways to live with my issues and to lessen their effects and basically grow.

I am a man and not a woman by the way. But I think that this might not be extremely important. Though men might not be as open about things such as these, which in itself might worsen their conditions!

Jean said...

It's such a big subject, and so difficult to talk to others about. I identified with a lot of your post, which as ever was beautifully written. thank you x

Eleonora Baldwin said...

As I commented on Saz's blog (which came up on my reader before yours for some odd reason), I have a person in my family whome I am very close to, who suffers from depression.

Posts like these are very important, Sallymandy. Very important. Thank you for this.

Ingrid Mida said...

Your willingness to share your deepest thoughts and feelings makes your writing very powerful. Many artists and writers use these feelings to fuel their work. Thank you for being so honest and open.

Duchesse said...

My sister killed herself, leaving two sons 13 and 15, after battling depression for years. So I learned it is not something one can 'snap out of'. This happened before anti-depressant drugs were available, and I have seen many people helped by these, but not all. I often wonder if with these, instead of the ECT she had so much of, she would have lived.

We miss her so everyday. The effect on her sons has been enormous and marked them. I am bereft and also angry- as she did not tell me how low she was. So I always urge anyone who is depressed to try everything, anything, and above all to take this option off the list.

I am grateful to you and to so many who responded for their resolve, their deep humanity and courage.

Kat Mortensen said...

I like that "crucible for art and growth". I'm going to go with that one.

I'm sorry you are one of the victims of this state of mind (is it okay to say that)? I do agree that women seem to be burdened with it more greatly than men. I think any depression I experience, myself is manifest in insomnia and bouts of anger, BUT menopause has much to do with it as well.


drollgirl said...

i've never been diagnosed for it -- i never bothered bringing it up to a doctor as i know they will either tell me to see a shrink or put me on medication, and i really don't want to do either of those things. but i know i have it -- constantly. it is brutal. i also think it is just part of being ME. sometimes it knocks me down completely. but usually i seem to be able to manage it. at least i think i am?

Linda Lu said...

I was helping my teacher out during my free period at school today and when I was done, I sat at the reference desk and I was online reading this. I turned to my teacher and said, "Ms. Healy did you know that some people think that depression is the failure to pray enough?" She laughed and agreed in sarcasm. Then said, "of course not, it's a chemical inbalance in the brain."

Penney said...

I'm sending the biggest hug ever! Look in the mirror.. You are awesome!! Be good to yourself...
xoxo you, Penney

Anonymous said...

How interesting I ran across your blog while checking out sewing refashions. I have gone through periods of depressions for many years. I have have fought it out on my own because I did not consider that I had a depression that drugs could help, I mean I knew why I was depressed, it was caused by circumstances in my life- not a chemical imbalance- it was either walk out or figure out how to cope with it. I usually managed to pull through and handle things and I think it did help that I knew things would be better, somehow, sometimes - and they were. Very often, I would overcome the short term visits of the "black dog' by writing a poem about it. I guess, as someone said it helps that I am basically a very happy person, but I have probably wasted lots of time huddled in a corner or suddenly, in a public place, have tears rolling down my cheeks.


ethelmaepotter! said...

Beautifully said, emotionally wrenching. Your heart and soul speak to us.
Depression becomes a part of who we are; it molds us, it targets us, it restricts us in ways others cannot understand. Maybe it gives us stronger sensitivities, or is it stronger sensitivities that mark us depressive?
May you find your own happiness, your own peace, and live each day in the knowledge that you make the world a little better for those of us who stumble across your thoughts.

Tiffany said...

You are so brave to post this. Thank you. My mother has been struggling with depression for some years now and is having a particularly difficult time at the moment - meds not helping, etc. The irony is that when I have gone through similar bouts, as I have done a number of times over the years, her response has always been 'pull yourself together and stop feeling sorry for yourself'. Reading your post reminds me to have compassion for her - she simply had no comprehension.

Midlife Roadtripper said...

Depression has not eluded me, either. If I were to define, I don't know that I could as its many faces seem to change as my life moves forward. I like "the haven for your heart and mind" the best.

To a better tomorrow. Enjoyed your site.

angela recada said...

I thought I was the only one to use the term "melancholy" to refer to how I often feel. While I haven't been diagnosed, I have this, too, as does most of my father's family. I've had it much of my life. It's something that always hangs over my head, waiting. I've tried to believe that happiness is a choice, and often it is, but melancholy settles on you whether you want it to or not. And it stays until it wants to leave.

How generous of you to write about this so openly. You are even more special to me now that I know we have this in common, too.

It's not easy to admit feeling this way, in our culture where we always feel the pressure to smile, showing all our teeth and screaming and shouting, proving we're all having "fun" all the time.

Cynthia L. H. said...

Dear sallymandy,
Bold. Brilliant. Articulate. You put into words, thoughts that are difficult to express.
Thank you,

Unknown said...

I think at one time or another, everyone has suffered with some sort of degree of depression. I also see your point about "a crucible for art and growth". It seems when I have been........ blue, under the weather, depressed, looking inward........... that the most has come out of me. This is a great article and kudos for you to write it and open up to so many.

Working Mum said...

Insightful, eloquent and brave. I think if you scratch the surface, most women will have suffered at some degree at some time in their lives.

ChrisA said...

As someone married to a Friend of the Black Dog (his self-description) I thought I understood depression but until this year never really did. Losing my job, having yet another lost opportunity to have a child of our own, etc.
One day I woke up and realized I felt the Black Dog visiting me too. Luckily, my husband is wise enough to tell me "yes, I saw it needed to see it too".
Your description is right on.
Thank you for your honesty.

Seeker said...

My dear, thank you so much for this post. I must tell you that I feel so related to it.
I've had two major depressions and I fight it all days of my life. I think that's why I want to colour my world.
I've tryed some expressions of art,to express me when I'm not balanced, but because of many life circunstances(?) I ended just dressing me as a piece of art.
If that makes any sense.....

Thank you dear.

Lots of love

xxx said...

Beautifully written..
best wishes

Jennifer Campaniolo said...

Hi SallyMandy,

I'm so glad you were brave enough to post this. Let me just join the voices of people who have been diagnosed with depression. For me, it's Seasonal Affective Disorder (SAD), as well as the depression that comes on as a result of my overly-anxious brain! I've read that rates of depression in the United States are higher than in many developed countries. Many of the people I know (myself included) are on some sort of medication for it. There doesn't seem to be one cure-all. Some things I've found that helped are:

Exercise (even if it's just a daily walk)
Sleeping 8 hours
Writing about it
Cooking (it gets your mind off the bad stuff)
Hugging someone you love
Letting yourself feel depressed for a while without feeling guilty about it
Distracting yourself
Writing a gratitude list
Talking with a friend
Petting an animal
Doing something kind for someone else in need

Of course, when you're depressed, it can be very hard to motivate yourself to do anything! But since I was diagnosed, I have been working on finding new ways to enjoy and appreciate my life, and also accept that there will be times I'll be deeply sad.

Be well,


Velveteen Rabbit said...

Thank you for posting your sweetly honest words...
So many of them struck a chord....I think you have another follower if you don't mind Sallymandy

sallymandy said...

Hello everyone: Wow, I thought I had responded to your comments here, and find my responses aren't here. Maybe I only thought I did that..?! Well, suffice it to say that your warm responses and opening up have made it so very worthwhile for me to face my trepidation and put this out there. It's been a week of a lot of internal mental and emotional shifts as a result of writing this, and it's because we as people from all over the world connected over a fundamental human issue. Thank you so much. Love, SM

Anonymous said...

I think you have a very interesting perspective on "melancholia". You are very brave to share this with the world and I admire you for doing so.

As a long time sufferer of the bite marks of the black dogs, it is important to listen to what others feel is the cause/effect/affect of their depression.

"A crucible for art and growth" is one thing I have never experienced in depression. Any growth I have had has been after the depression has lifted. I have most often felt that manic depressives (bipolar) do creative work when they are "up" and are incapable of any work when "down". Of course, a rapidly cycling bipolar may make this distinction difficult to assess.

I have never found my major depressions to be reactive to stress or life changes; they come in good times and in bad. I do get situational depression, such as when my mother died; but it is a relatively simpler type of depression or "melancholia" to work through.

Best wishes.

Exmoorjane said...

Saz sent me.....and with good reason. I've been wrestling with my black dog for many years (but more often just lie back and let it bite the hell out of me). Your analysis has a lot of resonance for me.... my Jungian therapist of many years ago said that depression was a crucible for creative endeavour and a vital part of moving on - she cited the myth of Inanna, that we have to hang on the meathook in the underworld before we can surface and be truly Queen of our Self.
Shall return here for more of your wisdom. Thank you for writing this.