Saturday, July 26, 2008

Can We Talk About Depression?

One of the most noteworthy articles I have read in the last month was Smiling Through, a New York Times blog by former talk-show host Dick Cavett recounting his battles with depression. But as touching as the article was, many of the comments, some 500 of them sent in by readers were even more so. More than anything else, the common theme was that depression is still widely misunderstood by those who have never experienced it. Cavett gives his credentials as “Having been there myself.” Me too.

Depression is a lot more common than most people believe.
It has been estimated that about 4.3% of the world's population is affected. Indeed, there are a number of famous people past and present who have suffered from either depression or bipolar disorder. Bipolar disorder also known as manic depression can be an equally debilitating condition where abnormally low (depressed) moods alternate with abnormally high (manic) moods. You would think that such a common and serious problem would be discussed more openly if for no other reason but to encourage those who suffer to seek treatment. But sadly for many, depression (along with other mental illnesses) remains a dirty little secret most of us can’t talk about.

The first public talk about depression that I can remember goes back to 1972 when Democratic presidential candidate George McGovern selected
Senator Thomas Eagleton as his running mate. Shortly after, newspapers exposed Eagleton’s dirty little secret that between 1960 and 1966, Eagleton checked himself into a hospital three times for physical and nervous exhaustion, receiving electric shock treatments twice. The thoughts of a depressed Eagleton receiving electric shock treatments must have conjured up images of a science fiction monster which was apparently too much for the media and many others to take. So McGovern reluctantly had to replace his nominee. However, it should be pointed out that although Eagleton’s depression made him apparently unfit to be a vice president, he served successfully in the US Senate from 1968 until 1987. And one of Abraham Lincoln’s biographers Joshua Wolf Shenk, wrote these words in
Abraham Lincoln fought clinical depression all his life, and if he were alive today, his condition would be treated as a "character issue"—that is, as a political liability. His condition was indeed a character issue: it gave him the tools to save the nation.
But it is most important to point out that many effective ways to treat depression like anti-depressant drugs were unavailable to Lincoln. Today, enduring depression without treating it is needless suffering!

So what is depression? Is it the same as sadness? While a depressed person can obviously feel sad, interchanging the two words is what causes the confusion.

Sadness is something we feel as a normal reaction to some of life’s events. And for losses that are especially painful, we grieve. But while sadness and grieving can last for a period of time, a normal person will eventually recover and be able to function as before.

But some of us are unable to mentally recover from events like this even after a longer period of time. And some people feel sad for long periods of time with no apparent event that triggered it. These are the people suffering from a medical condition called depression.

For those who experience it, depression is so much more than just sadness. It often robs us of the will to do anything about it. As Dick Cavett relates:
Apparently one thing I said on “Larry King” back then hit home hard. It was that when you’re downed by this affliction, if there were a curative magic wand on the table eight feet away, it would be too much trouble to go over and pick it up.
And at its worst, it can even rob us of the will to live.
The most extreme problem that depression presents is suicide. It’s the reason you don’t dare delay treatment. Don’t mess with it. Run for help — whether it’s talk therapy, drug therapy or the miraculous results of ECT (electroconvulsive therapy, erroneously labeled “shock therapy”). The shock involved is closer to insulin shock than electric shock. It’s a toss-up whether more people have been scared off it by “One Flew Over the Cuckoo’s Nest” than have been scared off medication by Tom Cruise’s idiotic braying on the subject on “The Today Show.”

Suicide rarely happens when you are all the way down in the uttermost depths. Again, it’s too much trouble. Perhaps the saddest irony of depression is that suicide happens when the patient gets a little better and can again function sufficiently. “She seemed to be improving,” is the sad cry of the mourners.
For those well-meaning people who suggest to those who may be suffering from depression to just “Snap out of it.” or “Cheer up.” I hope the preceding paragraphs have given you a better understanding of what these people may be actually feeling.

But help is available! For a professional but very readable overview of depression, you can check out this link from the American Psychiatric Association on Depression which includes the following:
For many people, depression cannot always be controlled for any length of time simply by exercise, changing diet, or taking a vacation. It is, however, among the most treatable of mental disorders: between 80% and 90% of people with depression eventually respond well to treatment, and almost all patients gain some relief from their symptoms.
I suffered from depression and got professional help. My anti-depressant medication helps me to now live a more normal life (but I have had some relapses). And while some brand-name medications can cost hundreds of dollars a month, some drugs that may well be just as effective are available as generics for a little as $4 a month at Wal-Mart in addition to Sam’s Club, Target, and some supermarket chains. This is worth noting because unfortunately, many health insurers still place more stringent limits on mental health benefits — something that needlessly prolongs the stigma around receiving mental health care.

As a practical matter for most of us with mild to moderate depression, a visit to the family physician is a good place to start so that any other medical conditions can be ruled out. The family physician can then refer the patient to a psychologist or psychiatrist if needed. Talk therapy is often effective either in place of medication (especially for mild depression) or in addition to it.

For those who may be suffering from more severe depression especially with
suicidal thoughts, these options are available to you:
  • Dial: 911
  • Dial: 1-800-273-TALK (the National Suicide Prevention Lifeline)
  • Check yourself into the emergency room.
  • Tell someone who can help you find help immediately.
And please consult this link if someone you know is suicidal.

In closing, I would like to offer these concluding words from the above Depression article to not only you the reader, but any friends or loved ones who may be suffering from depression.

Depression is never normal and always produces needless suffering. With proper diagnosis and treatment, the vast majority of people with depression will overcome it. If you are experiencing symptoms of depression, see your family physician or psychiatrist, describe your concerns and request a thorough evaluation. 

1 comment:

Anonymous said...

What you have written is accurate and heartfelt. I think you should send it to health care organizations to add to their online resources for their patients and patients' families. It will inform both people who are ashamed of their mental illness and also their loved ones. Beautifully written, Tony. You should be proud!!